Activation profile of CXCL8-stimulated neutrophils and aging

Neutrophils are pivotal effector cells of innate immunity representing the first line of defense against aggression. They are the first cells to arrive at the site of the aggression, where they can directly eliminate the invading microorganisms. Their activation and recruitment into peripheral tissues is indispensable for host defense. With aging, there are alterations of the receptor by driven functions of human neutrophils as a decrease in the functional changes in signaling elicited by specific receptors, as CXCR1. We investigated the activation of neutrophils from elderly after the cells were cultivated with CXCL8. Although, CXCL8 induced elastase (ELA) secretion, data showed neither myeloperoxidase (MPO) activity nor production of IL-6, IL-10, GM-CSF by neutrophils from elderly compared with young individuals. On the other hand, in the presence of only LPS or LPS associated with CXCL8 neutrophils from elderly individuals, there were significant levels of IL-6, IL-10, GM-CSF but not MPO. These results indicate that neutrophils from elderly do not respond to CXCL8 stimulus, but they are activated by LPS to produce cytokines. However, MPO activity from elderly individuals was not different in the presence or absence of LPS and CXCL8

Antimicrobial activity of calcium hydroxide and chlorhexidine on intratubular Candida albicans

This study investigated the efficacy of calcium hydroxide and chlorhexidine gel for the elimination of intratubular Candida albicans (C. albicans). Human single-rooted teeth contaminated with C. albicans were treated with calcium hydroxide, 2% chlorhexidine gel, calcium hydroxide plus 2% chlorhexidine gel, or saline (0.9% sodium chloride) as a positive control. The samples obtained at depths of 0–100 and 100–200 µm from the root canal system were analyzed for C. albicans load by counting the number of colony forming units and for the percentage of viable C. albicans using fluorescence microscopy. First, the antimicrobial activity of calcium hydroxide and the 2% chlorhexidine gel was evaluated by counting the number of colony forming units. After 14 days of intracanal medication, there was a significant decrease in the number of C. albicans colony forming units at a depth of 0–100 µm with chlorhexidine treatment either with or without calcium hydroxide compared with the calcium hydroxide only treatment. However, there were no differences in the number of colony forming units at the 100–200 µm depth for any of the medications investigated. C. albicans viability was also evaluated by vital staining techniques and fluorescence microscopy analysis. Antifungal activity against C. albicans significantly increased at both depths in the chlorhexidine groups with and without calcium hydroxide compared with the groups treated with calcium hydroxide only. Treatments with only chlorhexidine or chlorhexidine in combination with calcium hydroxide were effective for elimination of C. albicans

Antimicrobial activity of triantibiotic paste, 2% chlorhexidine gel, and calcium hydroxide on an intraoral-infected dentin biofilm model

Introduction: The purpose of this study was to evaluate the antimicrobial activity of calcium hydroxide, 2% chlorhexidine gel, and triantibiotic paste (ie, metronidazole, minocycline, and ciprofloxacin) by using an intraorally infected dentin biofilm model. Methods: Forty bovine dentin specimens were infected intraorally using a removable orthodontic device in order to induce the biofilm colonization of the dentin. Then, the samples were treated with the medications for 7 days. Saline solution was used as the control. Two evaluations were performed: immediately after the elimination of the medication and after incubation in brain-heart infusion medium for 24 hours. The Live/Dead technique (Invitrogen, Eugene, OR) and a confocal microscope were used to obtain the percentage of live cells. Nonparametric statistical tests were performed to show differences in the percentage of live cells among the groups (P < .05). Results: Calcium hydroxide and 2% chlorhexidine gel did not show statistical differences in the immediate evaluation. However, after application of the brain-heart infusion medium for 24 hours, 2% gel chlorhexidine showed a statistically lesser percentage of live cells in comparison with calcium hydroxide. The triantibiotic paste significantly showed a lower percentage of live cells in comparison with the 2% chlorhexidine gel and calcium hydroxide groups in the immediate and secondary (after 24 hours) evaluations. Conclusions: The triantibiotic paste was most effective at killing the bacteria in the biofilms on the intraorally infected dentin model in comparison with 2% chlorhexidine gel and calcium hydroxide

Reações adversas a medicamentos levando crianças a atendimento na emergência hospitalar

Determinou-se incidência de reações adversas a medicamentos (RAM) que levaram crianças a atendimento de emergência em um hospital universitário de São Paulo, SP. Foram analisadas, retrospectivamente, 23.286 fichas de atendimento (FA) em emergência pediátrica, a partir de código CID que indicasse possível RAM. Observaram-se 83 (0,36%) RAMs. A maioria ocorreu na faixa etária entre 1 a 5 anos com leve predominância no sexo masculino (51,8%). Os medicamentos mais implicados foram antibacterianos para uso sistêmico (53,0%), vacinas (9,6%) e analgésicos (7,2%). A maior parte das RAMs foram manifestações dérmicas (54,2%) ou gastrointestinais (22,9%). Duas RAMs foram consideradas graves (2,4%) e levaram a internação; enquanto 61,4% foram leves e 36,1% foram moderadas. A incidência foi inferior à literatura, provavelmente por ser estudo retrospectivo, utilizando-se o CID para seleção das FA. Observou-se que, no Brasil, as RAMs levam crianças a atendimento de emergência, com características semelhantes às de outros países. Intervenções são necessárias para melhorar o diagnóstico e a utilização de antimicrobianos, uma vez que foram os medicamentos mais implicados nas RAMs observadas. A pesquisa no setor de emergência hospitalar é importante para se conhecer as RAMs que ocorrem fora do contexto hospitalar, podendo contribuir para identificar aquelas de maior gravidade. A metodologia utilizada, apesar das limitações, requer poucos recursos humanos e materiais, sendo uma boa alternativa para um diagnóstico inicial, que deve ser sucedido por estudos mais elaborados e de maior sensibilidade para detectar essas reações e propor medidas dirigidas à sua prevenção.

Níveis de células somáticas sobre a proteólise do queijo Mussarela

Objetivou-se, com a realização deste trabalho, avaliar o efeito do nível de células somáticas sobre a microbiota e a proteólise do queijo Mussarela, durante o período de armazenamento. Foram selecionadas vacas com contagem de células somáticas ≤200mil células/mL; de > 200 a ≤400mil células/mL; de >400mil células/mL a ≤750mil células/mL e >750mil células/mL e que não tinham recebido tratamento com antimicrobianos nos dias que antecederam a coleta da matéria-prima. Os queijos produzidos foram avaliados após 1; 15 e 30 dias de armazenamento para a contagem de coliformes a 35ºC, coliformes a 45ºC, psicrotróficos e bactérias ácido lácticas. Paralelamente, foram determinados os índices de extensão e profundidade da proteólise. O experimento completo foi repetido quatro vezes e o delineamento experimental foi em blocos aleatórios. Na análise estatística, utilizou-se a análise de variância seguida do teste de Tukey, considerando p<0,05 como probabilidade mínima aceitável para diferença entre as médias. O leite com elevada contagem de células somáticas apresentou concentração menor de proteína e maior de nitrogênio não proteico. Observou-se diminuição das bactérias ácido lácticas no queijo elaborado com leite composto de células somáticas >750mil células/mL. Não obstante, ocorreu um aumento significativo na extensão e profundidade da proteólise durante o período de armazenamento, resultados observados nos queijos fabricados com o leite com células somáticas >400mil células/mL. Portanto, para se produzir um queijo Mussarela de boa qualidade torna-se necessário o controle da matéria prima, e esta deve apresentar células somáticas inferiores a 400mil células/mL.

Impact of the rapid antigen detection test in diagnosis and treatment of acute pharyngotonsillitis in a Pediatric emergency room

OBJECTIVE: To evaluate the impact of the routine use of rapid antigen detection test in the diagnosis and treatment of acute pharyngotonsillitis in children. METHODS: This is a prospective and observational study, with a protocol compliance design established at the Emergency Unit of the University Hospital of Universidade de São Paulo for the care of children and adolescents diagnosed with acute pharyngitis. RESULTS: 650 children and adolescents were enrolled. Based on clinical findings, antibiotics would be prescribed for 389 patients (59.8%); using the rapid antigen detection test, they were prescribed for 286 patients (44.0%). Among the 261 children who would not have received antibiotics based on the clinical evaluation, 111 (42.5%) had positive rapid antigen detection test. The diagnosis based only on clinical evaluation showed 61.1% sensitivity, 47.7% specificity, 44.9% positive predictive value, and 57.5% negative predictive value. CONCLUSIONS: The clinical diagnosis of streptococcal pharyngotonsillitis had low sensitivity and specificity. The routine use of rapid antigen detection test led to the reduction of antibiotic use and the identification of a risk group for complications of streptococcal infection, since 42.5% positive rapid antigen detection test patients would not have received antibiotics based only on clinical diagnosis.