Índice de risco de malignidade para tumores do ovário incorporando idade, ultra-sonografia e o CA-125

OBJETIVOS: calcular a sensibilidade, a especificidade e a acurácia das variáveis: idade da paciente, aspecto ultra-sonográfico e dosagem do marcador CA-125 para o diagnóstico diferencial entre tumores malignos e benignos do ovário. Estabelecer, ainda, índice de risco de malignidade (IRM) com a incorporação dessas três variáveis e calcular a sua sensibilidade, especificidade e acurácia para aquele diagnóstico diferencial. MÉTODOS: foram incluídas prospectivamente 100 pacientes portadoras de tumor do ovário com indicação cirúrgica. As variáveis idade, resultado da ultra-sonografia e níveis do CA-125 foram avaliadas isoladamente e depois em conjunto, sob a forma de índice (IRM). O estudo compreendeu a avaliação da sensibilidade, da especificidade e da acurácia diagnóstica e a aplicação das medidas: razão de probabilidade, razão de chances e dos testes: t de Student, chi² e regressão logística com análise uni e multivariada. RESULTADOS: para a variável idade, a sensibilidade, a especificidade e a acurácia diagnóstica foram respectivamente 58,8, 68,2 e 65,0%. Para a ultra-sonografia, 88,2, 77,3 e 81,0%. Para a dosagem do CA-125 esses valores foram 64,7, 74,2 e 71,0%. Quando as três variáveis foram agrupadas sob a forma do IRM observou-se sensibilidade de 76,5%, especificidade de 87,9% e acurácia diagnóstica de 84,0%. CONCLUSÕES: o IRM constituído pela associação das variáveis idade da paciente, resultado da ultra-sonografia e dosagem do CA-125 é indicador valioso para se distinguir entre tumores malignos e benignos de ovário, principalmente no que diz respeito à sua especificidade.

Correlação entre os níveis de Ca-125 séricos e os achados cirúrgicos em mulheres com sintomas sugestivos de endometriose

OBJETIVO: Correlacionar os níveis séricos pré-operatórios do antígeno do câncer 125 (Ca-125) e os achados laparoscópicos em mulheres com sintomas dolorosos sugestivos de endometriose. MÉTODOS:Um estudo retrospectivo foi realizado incluindo todas as mulheres com sintomas de dor pélvica suspeitos para endometriose operadas por laparoscopia no período de janeiro de 2010 a março de 2013. As pacientes foram divididas em 2 grupos de acordo com a dosagem de Ca-125 (<35 U/mL e >35 U/mL). Subsequentemente, as pacientes com endometrioma ovariano foram excluídas e uma análise adicional foi conduzida novamente de acordo com os níveis do Ca-125. Os seguintes parâmetros foram comparados entre os grupos: presença de endometrioma, presença e número de lesões de endometriose profunda infiltrativa (EPI) e escore da American Society for Reproductive Medicine. A análise estatística foi realizada com o programa Statistica versão 8.0, usando o teste exato de Fisher, o teste t de Student e o teste Mann-Whitney, quando necessário. Os valores p<0,05 foram considerados estatisticamente significativos. RESULTADOS: Durante o período de estudo, um total de 350 mulheres foram submetidas a tratamento laparoscópico de endometriose. Cento e trinta pacientes (37,1%) apresentaram Ca-125 >35 U mL e 220 (62,9%) apresentaram Ca-125 <35 U/mL. A presença de endometrioma ovariano (47,7 versus 15,9%), lesões de EPI (99,6 versus 78,6%) e lesões de EPI intestinal (60 versus 30,9%) foi mais frequente, e o escore da AFSr foi maior (34 versus 6) no primeiro grupo. Na segunda análise, excluindo as pacientes com endometrioma ovariano (>35 U/mL=68 pacientes e <35 U/mL=185 pacientes), resultados semelhantes foram obtidos. A presença de lesões de EPI (91,2 versus 76,2%), lesões de EPI intestinal (63,2 versus 25,4%), lesões de EPI de bexiga (20,6 versus 4,8%) e lesões de EPI ureteral (7,3 versus 1,6%) foi mais frequente, e o escore da AFSr foi maior (10 versus 6) no grupo Ca-125>35 U/mL. CONCLUSÕES: Em mulheres com sintomas dolorosos pélvicos suspeitos para endometriose com dosagem pré-operatória de Ca-125 >35 U/mL, a investigação de EPI é mandatória, especialmente quando não se identifica endometrioma ovariano em exames de imagem.

Influência dos Íons Mg, Ca, Fe, Cu e Zn sobre a tensão superficial estática de soluções contendo surfatante

O objetivo do estudo foi avaliar a influência da presença de cinco íons em uma calda de pulverização contendo o surfatante Aterbane. A tensão superficial foi analisada por meio da medição da massa de um conjunto de 25 gotas, com quatro repetições constituindo um tratamento. O trabalho foi dividido em duas etapas. Na primeira, os tratamentos foram combinados em esquema fatorial 9x5x2, sendo nove concentrações do surfatante Aterbane (0,01; 0,025; 0,05; 0,1; 0,2; 0,5; 1; 2; e 3%), cinco íons (Mg++, Ca++, Fe+++, Cu+++ e Zn+++) e duas concentrações desses elementos (10 e 100 ppm). Na segunda etapa, os tratamentos foram combinados em esquema fatorial 5x5x1, utilizandose os mesmos cinco elementos (Mg++, Ca++, Fe+++, Cu+++ e Zn+++), em cinco concentrações (1, 5, 20, 50 e 200 ppm), com apenas uma concentração do surfatante Aterbane (0,025%). Outros nove tratamentos permitiram avaliar as tensões superficiais das concentrações do surfatante (0,01; 0,025; 0,05; 0,1; 0,2; 0,5; 1; 2; e 3%) sem a adição dos íons. Os resultados mostraram que houve interferência dos íons sobre as soluções, já que, com exceção do Fe+++ (na concentração de 10 e 100 ppm) e do Cu+++ (na concentração de 100 ppm), todos os íons reduziram a tensão mínima alcançada e aumentaram a eficiência do surfatante, implicando benefícios à ação do surfatante e sobre as características de possíveis soluções de aplicação. Todos os íons avaliados promoveram reduções nas tensões superficiais de soluções do surfatante na concentração de 0,025%.

Induction of neutralizing antibodies in mice immunized with scorpion toxins detoxified by liposomal entrapment

The possibility of producing neutralizing antibodies against the lethal effects of scorpion toxins was evaluated in the mouse model by immunization with an immunogen devoid of toxicity. A toxic fraction (5 mg) from the venom of the scorpion Tityus serrulatus was entrapped in sphingomyelin-cholesterol liposomes. The liposomes were treated for 1 h at 37oC with a 1% (w/w) trypsin solution in 0.2 M sodium carbonate buffer, pH 8.3. This treatment led to a strong reduction in venom toxicity. Immunization was performed as follows: mice were injected sc with 20 µg of the liposome-entrapped toxic fraction on days 1 and 21 and a final injection (20 µg) was administered ip on day 36. After injection of the immunogen, all mice developed an IgG response which was shown to be specific for the toxic antigen. The antibodies were measured 10 days after the end of the immunization protocol. In an in vitro neutralization assay we observed that pre-incubation of a lethal dose of the toxic fraction with immune serum strongly reduced its toxicity. In vivo protection assays showed that mice with anti-toxin antibodies could resist the challenge with the toxic fraction, which killed, 30 min after injection, all non-immune control mice

Experimental chronic entrapment of the sciatic nerve in adult hamsters: an ultrastructural and morphometric study

Entrapment neuropathy is a group of clinical disorders involving compression of a peripheral nerve and interference with nerve function mostly through traction injury. We have investigated the chronic compression of peripheral nerves as an experimental procedure for detecting changes in ultrastructural nerve morphology. Adult hamsters (Mesocricetus auratus, N = 30) were anesthetized with a 25% pentobarbital solution and received a cuff around the right sciatic nerve. Left sciatic nerves were not operated (control group). Animals survived for varying times (up to 15 weeks), after which they were sacrificed and both sciatic nerves were immediately fixed with a paraformaldehyde solution. Experimental nerves were divided into segments based upon their distance from the site of compression (proximal, entrapment and distal). Semithin and ultrathin sections were obtained and examined by light and electron microscopy. Ultrastructural changes were qualitatively described and data from semithin sections were morphometrically analyzed both in control and in compressed nerves. We observed endoneurial edema along with both perineurial and endoneurial thickening and also the existence of whorled cell-sparse structures (Renaut bodies) in the subperineurial space of compressed sciatic nerves. Morphometric analyses of myelinated axons at the compression sites displayed a remarkable increase in the number of small axons (up to 60%) in comparison with the control axonal number. The distal segment of compressed nerves presented a distinct decrease in axon number (up to 40%) comparatively to the control group. The present experimental model of nerve entrapment in adult hamsters was shown to promote consistent histopathologic alterations analogous to those found in chronic compressive neuropathies.

The first report in Brazil of severe infection caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA)

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emergent pathogen in Brazil. However, there are no data on the prevalence of CA-MRSA. We report here the first well-characterized case of severe life-threatening CA-MRSA infection in a child living in Rio de Janeiro city. The patient had many complications including hematogenous osteomyelitis and involvement of multiple sites requiring drainage of soft-tissue abscess, and pleural and pericardial empyema. The MRSA isolates recovered were genotyped using PFGE, SCCmec typing and multilocus sequence typing. Disk diffusion tests were performed following Clinical and Laboratory Standards Institute recommendations. In addition, the presence of Panton-Valentine leukocidin (PVL) was assessed by PCR amplification, using specific primers for lukF-pv (encoding for the F subunit of the PVL). The bacterial isolates were related to the ST30-SCCmecIV lineage (Oceania Southwest Pacific clone), a PVL producer CA-MRSA previously detected in Porto Alegre, RS, Brazil. Also, the isolates analyzed were susceptible to all non-β-lactam antibiotics tested. The present report demonstrates that disseminated CA-MRSA disease is also occurring in Rio de Janeiro. Thus, the empirical treatment of moderate or severe infections suspected of being associated with CA-MRSA needs to be reviewed in order to allow prompt initiation of an effective therapy that also covers these microorganisms.

Influência da adição de íons Ca++ e Mg++ na dureza de géis de concentrado proteíco de soro de leite bovino

Inúmeros estudos vêm sendo realizados com o objetivo de compreender o comportamento das proteínas do Concentrado Protéico de Soro (CPS). A capacidade destas proteínas em formar géis estáveis a temperaturas entre 70ºC e 90ºC, é uma propriedade funcional importante para a confecção de vários produtos alimentícios, tais como: produtos de padaria, cárneos, texturizados e lácteos. A concentração protéica, pH, composição iônica e temperatura podem ser controladas para obter um gel com as características desejadas. Neste trabalho foi investigado o efeito dos íons metálicos bivalentes Ca++ e Mg++, na propriedade de dureza de géis de CPS induzidos termicamente. Dispersões protéicas a 6; 7 e 8% de proteína do CPS a pH 6,3 com 0; 7,5; 15; 30 e 75mm de CaCl2 ou MgCl2 foram aquecidas a 75ºC por 45 min, resfriadas a 4ºC por 12 horas, e os géis avaliados em um texturômetro TA-XT2. Os géis formados com maiores concentrações do sal adicionado obtiveram maiores valores de dureza na faixa estudada. Nas concentrações de 15 a 75mM os valores de dureza dos géis com a adição de CaCl2 foram significativamente maiores (p<0,05) do que com adição de MgCl2. Na concentração de 8% de proteínas do CPS ambos os tratamentos atingem o maior valor de dureza (p<0,05) a 30mM do sal adicionado. O cálcio iônico mostrou ter um importante papel na formação do gel de proteínas do soro.

Application of Response Surface Methodology to study the effect of different calcium sources in fish muscle-alginate restructured products

Sodium alginate needs the presence of calcium ions to gelify. For this reason, the contribution of the calcium source in a fish muscle mince added by sodium alginate, makes gelification possible, resulting a restructured fish product. The three different calcium sources considered were: Calcium Chloride (CC); Calcium Caseinate (CCa); and Calcium lactate (CLa). Several physical properties were analyzed, including mechanical properties, colour and cooking loss. Response Surface Methodology (RSM) was used to determine the contribution of different calcium sources to a restructured fish muscle. The calcium source that modifies the system the most is CC. A combination of CC and sodium alginate weakened mechanical properties as reflected in the negative linear contribution of sodium alginate. Moreover, CC by itself increased lightness and cooking loss. The mechanical properties of restructured fish muscle elaborated were enhanced by using CCa and sodium alginate, as reflected in the negative linear contribution of sodium alginate. Also, CCa increased cooking loss. The role of CLa combined with sodium alginate was not so pronounced in the system discussed here.

Production of isomaltulose obtained by Erwinia sp. cells submitted to different treatments and immobilized in calcium alginate

In recent decades, there has been an increase in the studies of isomaltulose obtainment, due to its physicochemical properties and physiological health benefits. These properties, which include low cariogenicity, low glycemic index and greater stability, allow the use of this sweetener as a substitute for sucrose in foods; besides the fact that it can be converted to isomalt, a dietary non-cariogenic sugar alcohol used in pharmaceuticals as well as in the food industry. Isomaltulose (6-O-α-D-glucopyronosyl-1-6-D-fructofuranose) is a disaccharide reducer obtained by the enzymatic conversion of sucrose - the α-glucosyltransferase enzyme. Different treatments were performed for the preparation of whole cells; lysed cells; and crude enzyme extract of Erwinia sp. D12 strain immobilized in calcium alginate. The packed bed column of granules, containing Erwinia sp. cells sonicated and immobilized in calcium alginate (CSI), reached a maximum conversion of 53-59% sucrose into isomaltulose and it presented activity for 480 hours. The converted syrup was purified and the isomaltulose crystallization was performed through the lowering of temperature. The isomaltulose crystals presented purity of 96.5%.

Conservation of Williams pear using edible coating with alginate and carrageenan

The aim of this study was to evaluate the physical and chemical parameters of Williams pear, stored at 25 ºC for 15 days, with and without edible coating. Edible coatings prepared with alginate 2% and carrageenan 0.5% were tested. The analyses carried out on the samples were: weight loss, pH, soluble solids, firmness, and color. The edible coatings were characterized in terms of mechanical properties, permeability, thickness, and opacity. The results show that the application of edible coatings with carrageenan and alginate in pears influenced physical and chemical characteristics such as weight loss, pH, total soluble solids, color, and firmness of the fruit. However, the alginate coating showed the best results on pear conservation since it had lower water vapor permeability and greater tensile strength, and therefore it can be used as a protective film on these fruits.

Raw-appearing Restructured fish models made with Sodium alginate or Microbial transglutaminase and effect of chilled storage

Restructuring by adding Sodium Alginate or Microbial Transglutaminase (MTGase) using cold gelation technology make it possible to obtain many different raw products from minced and/or chopped fish muscle that are suitable for being used as the basis of new restructured products with different physicochemical properties and even different compositions. Special consideration must be given to their shelf-life and the changes that may take place during chilling, both in visual appearance and physicochemical properties. After chilled storage, the restructured models made with different muscular particle size and composition at low temperature (5 °C), it was observed that microbial growth limited the shelf-life to 7-14 days. Mechanical properties increased (p < 0.05) during that time, and higher values were observed in samples elaborated by joining small muscle particle size than in those elaborated by homogenization. There was no clear increase in the cooking yield and purge loss, and no significant colour change (p > 0.05) was detected during storage.

Evaluation of some residual bioactivities of microencapsulated Phaseolus lunatus protein fraction with carboxymethylated flamboyant (Delonix regia) gum/sodium alginate

Recent studies have shown the beneficial effect of peptides, an unexploited source could be Phaseolus lunatus being an important raw material for those functional products in order to improve their utilization. In addition to improve the beneficial effect of bioactive peptides the microencapsulation could be a way to protect the peptides against the environment to which they are exposed. P. lunatus protein fraction (<10 kDa of weight) was encapsulated using a blend of carboxymethylated flamboyant gum (CFG) and sodium alginate (SA) at different concentrations of CaCl2 and hardening times. After in vitro digestion of microcapsules the residual activity, in the intestinal system, both inhibition of agiotensin-converting enzyme (I-ACE) and antioxidant activity obtained were in a range of 0.019-0.136 mg/mL and 570.64-813.54 mM of TEAC respectively. The microencapsulation employed CFG/SA blends could be used controlled delivery of peptide fractions with potential use as a nutraceutical or therapeutic agents.