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Inomata Silva BL, da Cunha Rodrigues FE, Tsukimata MY, Botelho BJS, Santos LCC, Dos Santos Pereira Neto G, Lima ACR, André NP, Galdino SM, Monteiro DC, Yoshikawa GT, Mendonça LT, do Amaral JLA, de Britto Pereira Cruz R, Onuma DO, Vallinoto ACR, de Carvalho Klemz BN, Vallinoto IMVC. Fibromyalgia in patients infected with HTLV-1 and HTLV-2. Front Med (Lausanne) 2024; 11:1419801. [PMID: 39247631 PMCID: PMC11377305 DOI: 10.3389/fmed.2024.1419801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 08/15/2024] [Indexed: 09/10/2024] Open
Abstract
Background Reports on the association between HTLV-2 infection and the development of diseases in the human host are rare, which has led the scientific community to believe that HTLV-2 is not an important etiological agent of lymphoproliferative or neurodegenerative disorders, which is the case for HTLV-1. In the present study, we demonstrated cases of fibromyalgia in HTLV-1 carriers and, in an unprecedented finding, in two patients with confirmed HTLV-2 infection. Methods A total of 957 individuals visited the Virology Laboratory at the Federal University of Pará for screening and confirmation tests for HTLV-1/2 infection. Individuals with confirmed HTLV-1 and HTLV-2 infection were clinically evaluated for signs and symptoms associated with infection. Results Sixty-nine individuals (7.2%) were identified as positive for HTLV infection, with 56 confirmed cases of HTLV-1 infection (5.9%), 12 cases of HTLV-2 infection (1.2%) and one case classified as undetermined (0.1%). Sixteen (23.2%) of these patients presented with rheumatological signs and complained of diffuse pain throughout the body; 12 of whom were infected by HTLV-1 (75%) and 4 were infected by HTLV-2 (25%). After anamnesis and careful evaluation, four patients were diagnosed with fibromyalgia, two of whom were infected by HTLV-1 (16.7%; 2/12) and two by HTLV-2 (50%; 2/4). The clinical follow-up and laboratory analysis results are reported in detail in this paper. Conclusion Considering the clinical cases presented herein as the first reports of patients with HTLV-2 infection with clinical symptoms of fibromyalgia, the importance of further studies on the pathogenicity of HTLV-2, similar to what have already been performed for HTLV-1, is highlighted. Our results also confirm previous evidence of an association between HTLV-1 infection and fibromyalgia.
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Affiliation(s)
- Bianca Lumi Inomata Silva
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | - Francisco Erivan da Cunha Rodrigues
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | - Márcio Yutaka Tsukimata
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | | | - Luciana Cristina Coelho Santos
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitário, Universidade Federal do Pará, Belém, Brazil
| | - Gabriel Dos Santos Pereira Neto
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitário, Universidade Federal do Pará, Belém, Brazil
| | - Aline Cecy Rocha Lima
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitário, Universidade Federal do Pará, Belém, Brazil
| | - Natália Pinheiro André
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | - Sarah Marques Galdino
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | - Danniele Chagas Monteiro
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | | | | | - Juliana Lasmar Ayres do Amaral
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | | | - Débora Oliveira Onuma
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
- Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitário, Universidade Federal do Pará, Belém, Brazil
| | | | - Izaura Maria Vieira Cayres Vallinoto
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
- Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitário, Universidade Federal do Pará, Belém, Brazil
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Aben-Athar CYUP, Sampaio EC, Pinto DS, Vallinoto ACR, Cayres Vallinoto IMV. Providing a Nursing Care Plan as a Requirement for Secondary Prevention for People Living With HTLV-1. Front Med (Lausanne) 2022; 9:854970. [PMID: 35547232 PMCID: PMC9082148 DOI: 10.3389/fmed.2022.854970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/31/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction The absence of nursing care plans aimed at people living with HTLV-1 (PLHTLV) led us to develop and test a proposed nursing care plan based on the evaluation of 55 PLHTLV to outline interventions according to the clinical stage. Methods After interviews with symptomatic patients, nursing diagnoses were made using the NANDA International Nursing Diagnoses (The International Nursing Knowledge Association). Subsequently, interventions were selected through the Classification of Nursing Interventions (NIC), and expected results were selected through the Classification of Nursing Outcomes (NOC). Results The actual diagnoses included (ii) chronic pain, (iii) impaired urinary elimination, and (iv) sexual dysfunction; the health promotion diagnosis was (i) risk-prone health behavior; and the risk diagnoses were (i) risk of feeling powerless and (ii) risk of falls in adults. Nursing care must prevent the lack of adherence to monitoring, establish goals and promote family involvement. A safe home environment requires intervention for fall prevention. Full support in understanding pharmacological and non-pharmacological therapies for chronic pain is needed. Interventions allow patients with impaired urinary function to be reintroduced to society. For sexual dysfunction, it is necessary to discuss safe sex and behavioral changes. Regarding risk behaviors, it is necessary to guide the patient/family, adapt language to the education level of these individuals, and help them better accept the condition, among other guidelines. Conclusion The development of a nursing care plan for PLHTLV is essential for preventing the rapid progression of disease and the improvement of the quality of life of PLHTLV and should be included in the multidisciplinary approach to the secondary level of prevention of HTLV-1.
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Affiliation(s)
- Cintia Yolette Urbano Pauxis Aben-Athar
- Faculdade de Enfermagem, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Edilson Coelho Sampaio
- Faculdade de Enfermagem, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Denise Silva Pinto
- Laboratório de Estudos em Reabilitação Funcional, Núcleo de Medicina Tropical da Universidade Federal do Pará, Belém, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Izaura Maria Vieira Cayres Vallinoto
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
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Sampaio EC, Aben-Athar CYUP, Pinto DDS, Vallinoto ACR, Cayres Vallinoto IMV. Occupational Therapy for People Living With Human T-Lymphotropic Virus 1: Importance and Effectiveness of an Intervention Plan at the Level of Prevention and Rehabilitation. Front Med (Lausanne) 2022; 9:859889. [PMID: 35425772 PMCID: PMC9001934 DOI: 10.3389/fmed.2022.859889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/07/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy (HAM) restricts activities of daily living (ADLs), affecting health and quality of life. Occupational therapy is used to promote independence during ADL in people living with HTLV (PLHTLV). Objective To quantify the clinical aspects, levels of functionality, performance in ADLs and occupational roles of PLHTLV and propose an occupational therapeutic intervention. Method A cross-sectional, descriptive, observational study was designed with 40 PLHTLV monitored at two referral laboratories of the Federal University of Pará. The Evandro Chagas Research Institute Neurological Disability Scale (EIPEC-2), the Barthel Index and the Occupational Roles Identification List were applied. The G test and Fisher’s exact test (to identify associations between qualitative variables), the Mann–Whitney test (to identify associations between quantitative variables) and Pearson correlation analysis (to identify associations between the total Barthel Index and EIPEC-2 scores) were performed with Microsoft Excel and BioEstat 5.0, and the significance level was set at p ≤ 0.05. Results Motor aspects, the presence of spasticity, sensory aspects, and pain in the lumbar region and lower limbs were significantly (p = 0.0002) higher among symptomatic individuals, who also had more difficulties urinating, traveling up and down stairs and transferring from a chair to a bed. Being a worker, performing housework and socializing (with friends or family members) were the most affected activities among HAM patients. Conclusion The impact of HAM on PLHTLV should include an intervention plan with occupational therapists in rehabilitation programs to create an important third-level prevention initiative, which may help achieve short-, medium-, and long-term goals. Asymptomatic PLHTLV should also be able to prevent future ADL impairment.
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Affiliation(s)
- Edilson Coelho Sampaio
- Institute of Health Sciences, Federal University of Pará, Belém, Brazil.,Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Cintia Yolette Urbano Pauxis Aben-Athar
- Institute of Health Sciences, Federal University of Pará, Belém, Brazil.,Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Denise da Silva Pinto
- Institute of Health Sciences, Federal University of Pará, Belém, Brazil.,Laboratory of Studies in Functional Rehabilitation of the Tropical Medicine Center, Federal University of Pará, Belém, Brazil
| | | | - Izaura Maria Vieira Cayres Vallinoto
- Institute of Health Sciences, Federal University of Pará, Belém, Brazil.,Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
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