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Authors
Abstract(s)
Este relatório de estágio foi elaborado como parte integrante da Unidade Curricular
Estágio, e está estruturado em três capítulos que descrevem a minha experiência
profissionalizante nas áreas de Investigação, Farmácia Hospitalar e Farmácia
Comunitária.
O capítulo 1 refere-se ao meu trabalho de investigação centrado na Trichomonas
vaginalis, um parasita protozoário urogenital responsável pela tricomonose,
comumente conhecida pelo nome anterior tricomoníase, uma infeção sexualmente
transmissível, prevalente em todo o mundo. Devido à natureza inespecífica dos
sintomas da tricomonose, o diagnóstico clínico é insuficiente. Os aspetos clínicos mais
característicos como o aspeto em framboesa ou em morango do epitélio vaginal e do
colo uterino e o corrimento vaginal espumoso são raros, pelo que exames laboratoriais
são essenciais para um diagnóstico preciso. É importante compreender as
características dos testes de diagnóstico disponíveis para garantir que este seja
adequado e assim promover um tratamento eficaz.
O presente estudo, conduzido no CICS-UBI, divide-se em duas partes. A primeira foca a
otimização de uma técnica da PCR com base num protocolo padrão e num conjunto de
primers desenvolvidos pelo grupo de trabalho do CICS-UBI, enquanto a segunda parte
aplica essa metodologia para investigar a prevalência do parasita a 209 amostras de
DNA extraído de exsudatos vaginais em uma população feminina de risco elevado de
aquisição da parasitose.
As amostras positivas pela técnica da PCR são comparadas com os resultados
disponibilizados pela técnica de microscopia em preparação a fresco.
A prevalência da T. vaginalis encontrada nesta população, por microscopia em
preparação a fresco foi de 0,96%, enquanto pela técnica da PCR observada foi de
7,66%.
Os resultados em relação ao diagnóstico pela T. vaginalis, demonstraram uma baixa
concordância entre o ensaio PCR e a microscopia em preparação a fresco (Kappa de
Cohen = 0,2088). Através deste estudo, foi possível avaliar a infeção por T. vaginalis em mulheres de um
grupo de risco e confirmar que a prevalência neste grupo específico é de facto maior
que a população em geral. Para além disso, foi avaliada um bom desempenho dos
primers para a deteção da infeção por T. vaginalis e a técnica da PCR utilizada através
do protocolo padrão otimizado apresentou bons valores de sensibilidade e
especificidade para o diagnóstico desta infeção.
O Capítulo 2 descreve as competências e conhecimentos alcançados no estágio
curricular em Farmácia Hospitalar nos Serviços Farmacêuticos do CHUCB, que
decorreu no período de 3 de outubro a 25 de novembro de 2022, sob orientação da Drª
Olímpia Fonseca.
Por último, o capítulo 3 relata as atividades e conhecimentos adquiridos durante o meu
estágio curricular em Farmácia Comunitária na Farmácia São Cosme na Covilhã, entre
28 de novembro de 2022 a 17 de fevereiro de 2023, sob orientação do Dr. Carlos
Tavares.
This internship report was prepared as part of the Internship Curriculum Unit and is structured in three chapters that describe my professional experience in the areas of Research, Hospital Pharmacy and Community Pharmacy. Chapter 1 refers to my research work focusing on Trichomonas vaginalis, a urogenital protozoan parasite responsible for trichomonosis, commonly known by its former name trichomoniasis, a sexually transmitted infection prevalent throughout the world. Due to the non-specific nature of the symptoms of trichomoniasis, clinical diagnosis is insufficient. The most characteristic clinical features such as the raspberry or strawberry appearance of the vaginal epithelium and cervix and frothy vaginal discharge are rare, so laboratory tests are essential for an accurate diagnosis. It is important to understand the characteristics of the diagnostic tests available to ensure that they are appropriate and thus promote effective treatment. This study, conducted at CICS-UBI, is divided into two parts. The first focuses on the optimization of a PCR technique based on a standard protocol and a set of primers developed by the CICS-UBI working group, while the second part applies this methodology to investigate the prevalence of the parasite in 209 DNA samples extracted from vaginal exudates in a female population at high risk of acquiring the parasitosis. The samples that tested positive using the PCR technique were compared with the results provided by the fresh microscopy technique. The prevalence of T. vaginalis in this population by fresh preparation microscopy is 0.96%, while by PCR it is 7.66%. The results for T. vaginalis diagnosis showed low agreement between the PCR assay and fresh preparation microscopy (Cohen's Kappa = 0.2088). Through this study, it was possible to evaluate T. vaginalis infection in women from a risk group and realize that the prevalence in this specific group continues to be higher than in the general population. In addition, the performance of the primers for the detection of T. vaginalis infection was assessed and the PCR technique used through the optimized standard protocol showed good sensitivity and specificity values for the diagnosis of this infection. Chapter 2 describes the skills and knowledge achieved during the curricular internship in Hospital Pharmacy at the CHUCB Pharmaceutical Services, which took place from October 3 to November 25, 2022, under the guidance of Drª Olímpia Fonseca. Finally, Chapter 3 reports on the activities and knowledge acquired during my curricular internship in Community Pharmacy at the São Cosme Pharmacy in Covilhã, between November 28, 2022, and February 17, 2023, under the guidance of Dr. Carlos Tavares.
This internship report was prepared as part of the Internship Curriculum Unit and is structured in three chapters that describe my professional experience in the areas of Research, Hospital Pharmacy and Community Pharmacy. Chapter 1 refers to my research work focusing on Trichomonas vaginalis, a urogenital protozoan parasite responsible for trichomonosis, commonly known by its former name trichomoniasis, a sexually transmitted infection prevalent throughout the world. Due to the non-specific nature of the symptoms of trichomoniasis, clinical diagnosis is insufficient. The most characteristic clinical features such as the raspberry or strawberry appearance of the vaginal epithelium and cervix and frothy vaginal discharge are rare, so laboratory tests are essential for an accurate diagnosis. It is important to understand the characteristics of the diagnostic tests available to ensure that they are appropriate and thus promote effective treatment. This study, conducted at CICS-UBI, is divided into two parts. The first focuses on the optimization of a PCR technique based on a standard protocol and a set of primers developed by the CICS-UBI working group, while the second part applies this methodology to investigate the prevalence of the parasite in 209 DNA samples extracted from vaginal exudates in a female population at high risk of acquiring the parasitosis. The samples that tested positive using the PCR technique were compared with the results provided by the fresh microscopy technique. The prevalence of T. vaginalis in this population by fresh preparation microscopy is 0.96%, while by PCR it is 7.66%. The results for T. vaginalis diagnosis showed low agreement between the PCR assay and fresh preparation microscopy (Cohen's Kappa = 0.2088). Through this study, it was possible to evaluate T. vaginalis infection in women from a risk group and realize that the prevalence in this specific group continues to be higher than in the general population. In addition, the performance of the primers for the detection of T. vaginalis infection was assessed and the PCR technique used through the optimized standard protocol showed good sensitivity and specificity values for the diagnosis of this infection. Chapter 2 describes the skills and knowledge achieved during the curricular internship in Hospital Pharmacy at the CHUCB Pharmaceutical Services, which took place from October 3 to November 25, 2022, under the guidance of Drª Olímpia Fonseca. Finally, Chapter 3 reports on the activities and knowledge acquired during my curricular internship in Community Pharmacy at the São Cosme Pharmacy in Covilhã, between November 28, 2022, and February 17, 2023, under the guidance of Dr. Carlos Tavares.
Description
Keywords
Farmácia Comunitária Farmácia Hospitalar Microscopia em Preparação a Fresco Pcr Trichomonas Vaginalis