Validação interlaboratorial do teste de polarização fluorescente para o diagnóstico sorológico da brucelose bovina

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Accuracy of zoomed digital image in the detection of periodontal bone defect: in vitro study

Objectives: (1) To evaluate the intraobserver agreement related to image interpretation and (2) to compare the accuracy of 100%, 200% and 400% zoomed digital images in the detection of simulated periodontal bone defects.Methods: Periodontal bone defects were created in 60 pig hemi-mandibles with slow-speed burs 0.5 mm, 1.0 mm, 1.5 mm, 2.0 mm and 3.0 mm in diameter. 180 standardized digital radiographs were made using Schick sensor and evaluated at 100%, 200% and 400% zooming. The intraobserver agreement was estimated by Kappa statistic (kappa). For the evaluation of diagnostic accuracy receiver operating characteristic (ROC) analysis was performed followed by chi-square test to compare the areas under ROC curves according to each level of zooming.Results: For 100%, 200% and 400% zooming the intraobserver agreement was moderate (kappa = 0.48, kappa = 0.54 and kappa = 0.43, respectively) and there were similar performances in the discrimination capacity, with ROC areas of 0.8611 (95% CI: 0.7660-0.9562), 0.8600 (95% CI: 0.7659-0.9540), and 0.8368 (95% CI: 0.7346-0.9390), respectively, with no statistical significant differences (chi(2)-test; P = 0.8440).Conclusions: A moderate intraobserver agreement was observed in the classification of periodontal bone defects and the 100%, 200% and 400% zoomed digital images presented similar performances in the detection of periodontal bone defects.

Papel da ultrassonografia axilar e da punção aspirativa por agulha fina na seleção de pacientes para a biópsia do linfonodo sentinela

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Punção aspirativa de linfonodo axilar guiada pela ultrassonografia é eficaz como método de predição de acometimento linfonodal em pacientes com câncer de mama?

OBJETIVO: Avaliar a viabilidade e acurácia diagnóstica da ultrassonografia pré-operatória combinada com biopsia por agulha fina (US-PAAF) e do exame clínico da axila em pacientes com câncer de mama.MÉTODOS: Neste estudo prospectivo 171 axilas de pacientes com câncer de mama foram avaliadas pelo exame clínico e ultrassonografia (US) com e sem biopsia por agulha fina (PAAF). Os linfonodos com espessura cortical maior que 2,3 mm na ultrassonografia foram considerados suspeitos e submetidos a US-PAAF.RESULTADOS: A análise de regressão logística não mostrou correlação estatisticamente significativa entre exame clínico e axilas positivas no exame patológico. Em relação à avaliação axilar com US, o risco de achados anatomopatológicos positivos aumentou 12,6 vezes, valor Kappa de Cohen foi de 0,12 para exame clínico, 0,48 para US e 0,80 para US-PAAF. A acurácia foi de 61,4% para o exame clínico, 73,1% para os US e 90,1% para US-PAAF. Análise Receiver Operating Chracteristics (ROC) mostrou que uma espessura de 2,75 mm cortical correspondeu à mais elevada sensibilidade e especificidade na predição metástase axilar (82,7 e 82,2%, respectivamente).CONCLUSÕES: A US combinada com aspiração por agulha fina é mais precisa que o exame clínico na avaliação do status axilar no pré-operatório em mulheres com câncer de mama. Aquelas que são US-PAAF positivo podem ser direcionadas para esvaziamento linfonodal axilar imediatamente, e somente aqueles que são US-PAAF negativos devem ser considerados para biópsia de linfonodo sentinela.

Variabilidade no andar com ultrapassagem de obstáculo de idosos com doença de Parkinson

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Trace elements as tumor biomarkers and prognostic factors in breast cancer: a study through energy dispersive x-ray fluorescence

Background The application and better understanding of traditional and new breast tumor biomarkers and prognostic factors are increasing due to the fact that they are able to identify individuals at high risk of breast cancer, who may benefit from preventive interventions. Also, biomarkers can make possible for physicians to design an individualized treatment for each patient. Previous studies showed that trace elements (TEs) determined by X-Ray Fluorescence (XRF) techniques are found in significantly higher concentrations in neoplastic breast tissues (malignant and benign) when compared with normal tissues. The aim of this work was to evaluate the potential of TEs, determined by the use of the Energy Dispersive X-Ray Fluorescence (EDXRF) technique, as biomarkers and prognostic factors in breast cancer. Methods By using EDXRF, we determined Ca, Fe, Cu, and Zn trace elements concentrations in 106 samples of normal and breast cancer tissues. Cut-off values for each TE were determined through Receiver Operating Characteristic (ROC) analysis from the TEs distributions. These values were used to set the positive or negative expression. This expression was subsequently correlated with clinical prognostic factors through Fisher’s exact test and chi-square test. Kaplan Meier survival curves were also evaluated to assess the effect of the expression of TEs in the overall patient survival. Results Concentrations of TEs are higher in neoplastic tissues (malignant and benign) when compared with normal tissues. Results from ROC analysis showed that TEs can be considered a tumor biomarker because, after establishing a cut-off value, it was possible to classify different tissues as normal or neoplastic, as well as different types of cancer. The expression of TEs was found statistically correlated with age and menstrual status. The survival curves estimated by the Kaplan-Meier method showed that patients with positive expression for Cu presented a poor overall survival (p < 0.001). Conclusions This study suggests that TEs expression has a great potential of application as a tumor biomarker, once it was revealed to be an effective tool to distinguish different types of breast tissues and to identify the difference between malignant and benign tumors. The expressions of all TEs were found statistically correlated with well-known prognostic factors for breast cancer. The element copper also showed statistical correlation with overall survival.

Analysis of rocuronium in human plasma by liquid chromatography-tandem mass spectrometry with application in clinical pharmacokinetics

Rocuronium (ROC) is a neuromuscular blocking agent used in surgical procedures which is eliminated primarily by biliary excretion. A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for analysis of ROC in human plasma. Separation of ROC and IS (verapamil) was performed using an endcapped C-18 column and a mixture of water:acetonitrile:trifluoracetic acid (50:50:0.1, v/v) as mobile phase. Aliquots of 100 mu L of human plasma were extracted at pH 3, using dichloromethane. The lower limit of quantification of 5 ng/mL shows the high sensitivity of this method. Intra- and inter-assay precision (as relative standard deviation) was all <= 14.2% and accuracy (as relative standard error) did not exceed 10.1%. The validated method was successfully applied to quantify ROC concentrations in patients under surgical procedures up to 6 h after the administration of the 0.4-0.9 mg/kg ROC. The pharmacokinetic parameter estimations of ROC showed AUC/dose of 563 mu g min/mL, total clearance of 2.5 mL/min/kg, volume of distribution at steady state of 190 mL/kg and mean residence time of 83 min. (C) 2013 Elsevier B.V. All rights reserved.

Comparison of different methods of erythrocyte dysmorphism analysis to determine the origin of hematuria

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)