17 resultados para abnormal laboratory result

em Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho"


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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Solvents represent an important group of environmental pollutants to which people are exposed daily in the workplace. The physico chemical properties of solvents may result in disturbances to cellular structures, including damage to DNA. However, the effects of mixtures of solvents are not well known. Mutations caused by environmental agents are related to cancer development and other degenerative diseases. The work in a research laboratory that uses several types of solvents is equally predisposed to these hazards. In this study, we evaluated the mutagenicity of urine from 29 subjects exposed occupationally to solvents in a chemistry research laboratory and 29 subjects without occupational exposure (controls). Urine samples were collected in polyethylene containers at the end of the work shift. For the concentration and extraction of urine samples the XAD-2 resin was used with acetone as an eluting agent. Several strains of Salmonella typhimurium (TA100, TA98, TA97a, TA1535, YG1024) should be used to assess mutagenic susceptibilities among workers exposed to organic solvents. Different doses of extract (1.5; 3.0; 6.0 and 12.0 m/ equivalents of urine per plate) were tested on S. typhimurium strains TA100 and YG 1024, with and without metabolic activation. The mutagenic activity, measured in Salmonella typhimurium YGI1024 with S9 mix, was significantly greater in urine from workers than from controls (p <= 0.05). These results indicate the relevance of using biomarkers to assess the risk of occupational exposure to organic solvents.

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Objective: To describe the prevalence of hysteroscopic findings and histologic diagnoses inpatients with abnormal uterine bleeding (AUB).Design: Retrospective series of consecutive patients.Setting: Tertiary care University hospital and private office.Patient(s): Four thousand fifty-four hysteroscopies with biopsy in patients with AUB evaluated between June 1993 and December 2004.Intervention(S): Hysteroscopies were performed using 2.9-mm or 4-mm telescopes with CO2 or saline as the distension media. Biopsies were (lone with a 5-mm grasper or with a Novak's curette.Main Outcome Measure(s): Prevalence of hysteroscopic findings and histologic analysis of biopsies.Result(S): Endometrial polyp was the most frequent hysteroscopic finding, accounting for 1,374 (33.9%) cases. Normal uterine cavity and cervical canal were found in 814 (20.1%) patients. Submucous fibroids were diagnosed in 302 (7.5%) women. Normal endometrium was the most frequent histologic diagnosis, accounting for 1,888 (46.6%) cases. Endometrial polyp was found in 1, 115 (27.5%) patients. Endometrial hyperplasia was diagnosed in 613 (15.1%) and endometrial cancer in 105 (2.6%) women.Conclusion(s): Endometrial polyps are the most frequent hysteroscopic findings in patients with AUB, whereas normal endometrium is the most frequent histologic diagnosis.

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Objetivos: construir a curva de regressão do b-hCG pós-mola hidatiforme completa (MHC) com remissão espontânea e comparar com a curva de regressão pós-MHC com tumor trofoblástico gestacional (TTG). Análise comparativa da curva de regressão do b-hCG das portadoras de MHC, acompanhadas no Serviço, com a curva de regressão observada por outros autores1-3. Métodos: foi realizada avaliação clínica e laboratorial (dosagem sérica de b-hCG), na admissão e no segmento pós-molar, de todas as pacientes com MHC, atendidas entre 1990 e 1998 no Hospital das Clínicas de Botucatu - Unesp. O resultado da determinação seriada do b-hCG foi analisado em curvas log de regressão. A evolução da curva de regressão do b-hCG foi analisada e comparada em MHC com remissão espontânea e MHC com TTG numa curva log de regressão, com intervalo de confiança de 95%. A curva log de regressão do grupo de remissão espontânea foi comparada com curvas consideradas padrão1,2. Foram construídas curvas log individuais de todas as pacientes e classificadas de acordo com os quatro tipos de curva (I, II, III e IV), propostos para o seguimento pós-molar³. Resultados: 61 pacientes com MHC tiveram seguimento pós-molar completo, 50 (82%) apresentaram remissão espontânea e 11 (18%) desenvolveram TTG. No grupo de pacientes com MHC e remissão espontânea, o tempo para alcançar a normalização dos níveis do b-hCG, após o esvaziamento molar, foi até 20 semanas. As pacientes que desenvolveram TTG apresentaram desvio precoce da curva de regressão normal do b-hCG, 4 a 6 semanas após o esvaziamento molar. Nestas pacientes, a quimioterapia foi introduzida em média na 9ª semana pós-esvaziamento molar. Conclusões: a curva de regressão do b-hCG pós-MHC com remissão espontânea apresentou declínio log exponencial, semelhante ao observado por outros autores1,2, e diferente das MHC com TTG. Foram identificados três tipos de curvas de regressão do b-hCG, semelhantes aos de Goldstein³, I, II e IV, e outros dois tipos diferentes de regressão do b-hCG: V (regressão normal) e VI (regressão anormal).

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Predation of zoeas by megalopae of Ucides cordatus is frequently observed in the laboratory during larval rearing, a phenomenon that could considerably reduce the output of larviculture. Experiments were carried out in the present study to assess how the survivorship of larvae at the end of the larviculture is influenced by cannibalism by megalopae on the larvae of earlier stages, as well as on other megalopae. In addition, tests were performed to assess whether the adoption of different feeding protocols can decrease cannibalism rates. Experiments were carried out in plastic vials containing ocean water (salinity 25 g L-1) under controlled environmental conditions (26 degrees C and 16:8 h LD photoperiod). An ensemble analysis of all the developmental stages indicated that zoeal mortality rates were significantly higher in the presence of megalopae, a result that is consistent with cannibalism by megalopae. However, separate analysis for each developmental stage indicated that only zoea IV, V and VI show reduced survivorship. No cannibalism was detected among megalopae. Food supplementation using Artemia sp. at a density of 6 nauplii mL(-1) proved to be successful in reducing cannibalism rates, whereas supplementation at a lower density (0.3 nauplii mL(-1)) failed to show such an effect. The implications of these results for the larviculture of U. cordatus are discussed.

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Two species of plants commonly known as barbatim (a) over tildeo occur in Brazil, Stryphnodendron adstringens (Fabaceae) (true barbatim (a) over tildeo) and Dimorphandra mollis (Caesalpiniaceae) (false barbatim (a) over tildeo). These two species have a similar flowering period and are considered by beekeepers to cause bee mortality during this period. Flowers were collected from both species, dehydrated, ground and incorporated into an experimental diet for bees of two different species, Apis mellifera and Scaptotrigona postica. Both plant species were toxic to A. mellifera, reducing their median survival. D. mollis was toxic to S. postica, and Stryphnodendron adstringens reduced median survival of this bee species even when used at a concentration of 2.5%. In a choice experiment carried out with A. mellifera and the two plant species, the honey bees could choose not to feed on the diets containing the flowers, and feed on sugar and honey instead, but they did not. This shows us that the flowers of S. adstringens were not repellent to the bees. The plants were more toxic to A. mellifera than to Scaptotrigona postica, a result that can be explained by the fact that A. mellifera was introduced into Brazil whereas S. postica is a native stingless bee.

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CONTEXTO E OBJETIVO: Crianças e adolescentes que vivem em situação de vulnerabilidade social apresentam uma série de problemas de saúde. Apesar disso, ainda é controversa a afirmação sobre a existência de alterações cognitivas e/ou sensoriais. O objetivo deste estudo foi investigar aspectos relacionados ao processamento auditivo, através da aplicação de testes de potencial evocado auditivo de tronco encefálico (PEATE) e avaliação comportamental do processamento auditivo em crianças em situação de rua, comparando a um grupo controle. TIPO DE ESTUDO E LOCAL: Estudo transversal no Laboratório de Processamento Auditivo, Faculdade de Medicina da Universidade de São Paulo. MÉTODOS: Os testes de processamento auditivo foram aplicados em um grupo de 27 indivíduos, subdivididos em grupos de 11 crianças (7 a 10 anos) e 16 adolescentes (11 a 16 anos) de ambos os sexos, em situação de vulnerabilidade social, e comparado a um grupo controle, formado por 21 crianças, subdivididas em grupos de 10 crianças e 11 adolescentes, pareados por idade, sem queixas. Também se aplicou os PEATE para investigação da integridade da via auditiva. RESULTADOS: Para ambas as faixas etárias, foram encontradas diferenças significantes entre grupos estudo e controle para a maioria dos testes aplicados, sendo que o grupo estudo apresentou desempenho estatisticamente pior do que o controle para todos os testes, exceto para o teste pediatric speech intelligibility. Apenas uma criança apresentou resultado alterado para os PEATE. CONCLUSÕES: Os resultados demonstraram pior desempenho do grupo estudo (crianças e adolescentes) para os testes comportamentais de processamento auditivo, apesar de estes apresentarem integridade da via auditiva em nível de tronco encefálico, demonstrada pela normalidade nos resultados do PEATE.

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STUDY OBJECTIVE: To validate hysteroscopic view with histology in cases of endometrial hyperplasia and cancer in patients with abnormal uterine bleeding (AUB)DESIGN: Retrospective study.(Canadian Task Force classification II-3).SETTING: University teaching hospitals in Rio de Janeiro and São Paulo, and private office in Rio de Janeiro.PATIENTS: Four thousand and fifty-four patients with AUB in whom hysteroscopic views were complete and the histologic result was conclusive.INTERVENTION: Four thousand and fifty-four office hysteroscopies with complete views and conclusive histologic results. The material for histologic examination was obtained through biopsy of the lesion in an outpatient unit or through the resection of the entire lesion in patients who underwent surgery. Histology was considered the gold standard and compared with the hysteroscopic view.MEASUREMENTS AND MAIN RESULTS: In the histology of the 4054 examinations, 613 (15.2%) were endometrial hyperplasia, and 105 (2.6%) were endometrial cancer. The most frequent hysteroscopic finding was endometrial polyps (31.2%). In endometrial hyperplasia, the sensitivity of the hysteroscopic view was 56.3% (95% CI 52.21-60.2%), specificity was 89.1% (95% CI 88.0%-90.1%), positive predictive value (PPV) was 48.0% (95% CI 44.3%-51.7%), negative predictive value (NPV) was 92.0% (95% Cl 90.1%-92.9%), and accuracy was 72.7% (95% CI 70.7%-74.7%). Accuracy was defined as the proportion of correct results among the hysteroscopic examinations. In endometrial cancer, the sensitivity of the hysteroscopic view was 80.0% (95% Cl 71.1%-87.2%), specificity was 99.5% (95% CI 99.2%-99.7%), PPV was 81.5% (95% Cl 72.7%-88.5%), NPV was 99.5% (95% CI 99.2%-99.7%), and accuracy was 89.8% (95% CI, 85.9%-93.6%). In the 814 patients (20.0%) in whom the hysteroscopic view was normal, there were no false negatives for endometrial cancer; however, there were 37 (4.5%) false negatives for endometrial hyperplasia. In the histologic cases of endometrial cancer, 101 (96.2%) hysteroscopic views were compatible with cancer or hyperplasia (80.0% and 16.2%, respectively). Ninety-seven out of 103 hysteroscopic views with cancer findings (94.2%) had histologic diagnosis of cancer or hyperplasia (81.5% and 12.6%, respectively).CONCLUSION: It seems that even in face of good validity of hysteroscopic view for endometrial hyperplasia and cancer, histologic study is mandatory in the presence of any lesion as the hysteroscopic view cannot completely replace the histologic study in patients with AUB. (C) 2006 AAGL. All rights reserved.

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Hemoglobin variants originate mainly by simple amino acid substitutions, the result of nucleotide sequence changes. Recently, the number of known abnormal hemoglobins has increased due to improvement in analysis methodologies; however, many laboratories are not prepared to correctly identify mutants. Hb S is a very well-characterized hemoglobin variant that varies in prevalence in different regions of Brazil. However, there is a type of Hb that presents electrophoretic migration in alkaline pH similar to Hb S, named S-like Hb, which can be incorrectly diagnosed; therefore, its frequency is underestimated. We obtained reference ranges for Hb S by HPLC, and we examined the electrophoretic and chromatographic profiles of S-like Hb. Hb Hasharon, Hb D-Los Angeles, Hb Korle-Bu, Hb Lepore, Hb D-Iran, Hb G-like, Hb Queens, Hb Montgomery, and Hb Q-India were found. Cases of association between two beta chain mutants were also found. Electrophoresis in alkaline and acid pH was utilized to initially screen these Hb variants, and globin chain electrophoresis at both high and low pH was performed to identify the globin chain mutant. Chromatographic analysis permitted the identification of the hemoglobin variant and also facilitated the quantification of these variants. Therefore, an association of classical laboratory diagnostic methodologies is fundamental for the correct identification of suspect Hb variants. The S and S-like hemoglobin profiles determined in this study will help in the diagnosis of these variants in health care services.

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Canine brains infected with rabies virus were submitted to decomposition by being left at room temperature of 25 to 29 degrees C for up to 168 h. At 24 h intervals, brain fragments were analyzed by immunofluorescence (IF) and by the mouse intracerebral inoculation (MI) test to confirm the diagnosis of rabies and to measure the putrefaction effect on the accuracy of the diagnosis. Forty eight h after the beginning of the experiment, the MI test showed signs of impairment with four negative results, while after 72 h, 100% of the results were negative to the MI test and only one result was negative to the IF test, indicating that the threshold period for accurate diagnosis is 24 to 48 h before putrefaction. The authors recommend the shipment of suspected cases of rabies to the laboratory for confirmation, but the use of putrid materials for diagnosis is meaningless because of false-negative results.

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With the exception of the cleft lip, developmental defects (DD) of the lip are rare. The upper lip originates from the ectomesenchyme and is formed by the merging of the nasal medial and lateral processes with the maxillary process. Disturbances during this formation period can cause DD with functional and/or esthetic repercussions. We present a case of DD of the upper lip in a patient with a history of progressive growth of the left lateral portion of the upper lip that occurred from the time of birth until the age of 22 years. Clinical examination revealed hypertrophy of the area from the left philtral columns to the left commissure of the lip, extending the portion of the surface mucosa creating a flaccid and asymptomatic tissue mass. All other buccal structures appeared to be within normal limits and without any evidence of defects or deformities. In the surgical planning we decided to carry out corrective surgery in two phases. The first phase accomplished a conservative excision of the total abnormal labial tissue mass with a CO2 laser radiation (5 W in continuous mode, bunch diameter φ = 0.6 mm with a power density of 768 W/cm2 and fluency of 0.231 J/cm2) being careful to preserve the vermilion portion of the lip. Postsurgical clinical evaluations were done every three days until the skin sutures were removed and then every seven days until two months post surgery. While the entire mass of excessive tissue could not be completely removed, the removal of the excessive mucosal tissue produced a very good outcome relative to lip function, with a good esthetic result without scarring, and good tissue mobility. The results showed that the CO2 laser is an extremely useful instrument that can provide excellent control of the surgical field and allow for healing that produces excellent functional and esthetic results. © 2005 Taylor & Francis.

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Accessing vaginal pH is fundamental during gynaecological visit for the detection of abnormal vaginal flora (AVF), but use of pH strips may be time-consuming and difficult to interpret. The aim of this study was to evaluate the VS-SENSE test (Common Sense Ltd, Caesarea, Israel) as a tool for the diagnosis of AVF and its correlation with abnormal pH and bacterial vaginosis (BV). The study population consisted of 45 women with vaginal pH ≥ 4.5 and 45 women with normal pH. Vaginal samples were evaluated by VS-SENSE test, microscopy and microbiologic cultures. Comparing with pH strips results, VS-SENSE test specificity was 97.8% and sensitivity of 91%. All severe cases of BV and aerobic vaginitis (AV) were detected by the test. Only one case with normal pH had an unclear result. Concluding, VS-SENSE test is easy to perform, and it correlates with increased pH, AVF, and the severe cases of BV and AV. Copyright © 2010 Gilbert G. G. Donders et al.

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Pós-graduação em Genética - IBILCE