Molecular imprinted nanoelectrodes for ultra sensitive detection of ovarian cancer marker

The relentless discovery of cancer biomarkers demands improved methods for their detection. In this work, we developed protein imprinted polymer on three-dimensional gold nanoelectrode ensemble (GNEE) to detect epithelial ovarian cancer antigen-125 (CA 125), a protein biomarker associated with ovarian cancer. CA 125 is the standard tumor marker used to follow women during or after treatment for epithelial ovarian cancer. The template protein CA 125 was initially incorporated into the thin-film coating and, upon extraction of protein from the accessible surfaces on the thin film, imprints for CA 125 were formed. The fabrication and analysis of the CA 125 imprinted GNEE was done by using cyclic voltammetry (CV), differential pulse voltammetry (DPV) and electrochemical impedance spectroscopy (EIS) techniques. The surfaces of the very thin, protein imprinted sites on GNEE are utilized for immunospecific capture of CA 125 molecules, and the mass of bound on the electrode surface can be detected as a reduction in the faradic current from the redox marker. Under optimal conditions, the developed sensor showed good increments at the studied concentration range of 0.5–400 U mL−1. The lowest detection limit was found to be 0.5 U mL−1. Spiked human blood serum and unknown real serum samples were analyzed. The presence of non-specific proteins in the serum did not significantly affect the sensitivity of our assay. Molecular imprinting using synthetic polymers and nanomaterials provides an alternative approach to the trace detection of biomarker proteins.

Voltammetric immunosensor for the diagnosis of celiac disease based on the quantification of anti-gliadin antibodies

Antibodies against gliadin are used to detect celiac disease (CD) in patients. An electrochemical immunosensor for the voltammetric detection of human anti-gliadin antibodies (AGA) IgA and AGA IgG in real serum samples is proposed. The transducer surface consists of screen-printed carbon electrodes modified with a carbon nanotube/gold nanoparticle hybrid system, which provides a very useful surface for the amplification of the immunological interactions. The immunosensing strategy is based on the immobilization of gliadin, the antigen for the autoantibodies of interest, onto the nanostructured surface. The antigen–antibody interaction is recorded using alkaline phosphatase labeled anti-human antibodies and a mixture of 3-indoxyl phosphate with silver ions (3-IP/Ag+) was used as the substrate. The analytical signal is based on the anodic redissolution of the enzymatically generated silver by cyclic voltammetry. The electrochemical behavior of this immunosensor was carefully evaluated assessing aspects as sensitivity, non-specific binding and matrix effects, and repeatability and reproducibility. The results were supported with a commercial ELISA test.

Efeitos de dois programas de exercício na endurance de tronco, controlo lombo-pélvico, perceção de dor lombar e fadiga, funcionalidade e qualidade de vida: Pilates Clínico vs Exercícios segundo McGill

Introdução: A lombalgia crónica assume uma elevada prevalência e graves repercussões a nível socioeconómico, sendo inúmeras as abordagens terapêuticas para o seu tratamento e prevenção. Existindo forte evidência da eficácia dos exercícios terapêuticos no seu tratamento, importa saber quais os mais efetivos. Objectivos: Comparar a efetividade de dois programas de exercício terapêutico na endurance do tronco, no controlo lombo-pélvico, na perceção de dor lombar e fadiga, na funcionalidade e na qualidade de vida em mulheres com lombalgia crónica não especifica, cuidadoras de idosos. Métodos: 24 mulheres foram divididas aleatoriamente em três grupos de 8. Durante 6 semanas, um grupo serviu de controlo (GC) e os outros dois grupos realizaram um programa de exercícios: Pilates Clínico (GP) ou exercícios segundo McGill (GM), com os outcomes medidos em ternos de endurance de tronco pelos testes de McGill, controlo lombo-pélvico pelos testes Active Straight Leg Raise e teste de controlo lombo-pélvico segundo McGill, dor lombar pela Numerical Rating Scale, fadiga pela escala de Borg, funcionalidade através do Questionário de Incapacidade de Roland Morris e qualidade de vida através do Questionário de Estado de Saúde (SF36-V2). Resultados: Relativamente à endurance, verificaram-se diferenças entre grupos no rácio flexores/extensores (p=0,005), e no rácio lateroflexores à esquerda/extensores (p=0,027), sendo que o GP apresentou um rácio estatisticamente inferior ao GC em ambos. Não existiram diferenças estatisticamente significativas entre os 3 grupos no controlo lombo-pélvico, perceção de dor, fadiga e funcionalidade, apesar das melhorias observadas intra-grupos. Relativamente à qualidade de vida, a dimensão saúde em geral aumentou significativamente no GP (p=0,020) e a função social no GM (p=0,045). Conclusão: A implementação dos programas de exercício Pilates Clínico e Exercícios segundo McGill numa amostra de cuidadoras de idosos com lombalgia crónica não especifica, parece ter um efeito positivo quando comparados com os do grupo de controlo sobre a endurance do tronco, controlo lombo-pélvico, perceção de dor lombar e fadiga, funcionalidade e qualidade de vida.

Efeitos imediatos de um Sustained Natural Apophyseal Glide na atividade muscular dos eretores espinhais, na dor e na amplitude de flexão, em indivíduos com dor lombar crónica não específica

Introdução: O Sustained Natural Apophyseal Glide tem sido sugerido como uma técnica com potenciais benefícios na redução da dor e no aumento da amplitude de flexão lombar em indivíduos com dor lombar. Contudo, não existe evidência sobre esta técnica na atividade muscular dos eretores espinhais. Objetivo: Avaliar os efeitos imediatos de um Sustained Natural Apophyseal Glide na atividade muscular dos eretores espinhais, na intensidade da dor e na amplitude real de flexão lombar, em indivíduos com dor lombar crónica não específica. Métodos: Estudo experimental com uma amostra de 20 estudantes universitários, com dor lombar crónica não específica e com dor à flexão da coluna lombar, que foram aleatoriamente distribuídos em dois grupos: experimental - Sustained Natural Apophyseal Glide e placebo – intervenção placebo. Foram avaliadas a atividade muscular dos eretores espinhais recorrendo à eletromiografia de superfície (bioPLUX research®), a intensidade da dor através da Escala Visual Analógica e a amplitude real de flexão lombar pelo método de duplo inclinómetro (Universal Inclinometer®), antes e após a intervenção, pela análise do movimento de flexão-extensão do tronco. O nível de significância foi de 0,05. Resultados: Foram encontradas diferenças significativas, em ambos os grupos, para a fase de relaxamento (Grupo experimental: p=0,013 e Grupo placebo: p=0,047), assim como para a fase de extensão, no grupo experimental (p=0,037), verificando-se uma diminuição da atividade muscular da baseline para a avaliação final. A Análise da Covariância revelou que, relativamente à intensidade da dor, verificaram-se diferenças significativas entre os dois grupos (p=0,002), sendo que o grupo experimental diminuiu mais 2cm na Escala Visual Analógica do que o grupo placebo. Pela análise da amplitude real de flexão lombar, embora o aumento não fosse significativamente diferente entre os grupos (p=0,086), o grupo experimental teve mais 1,7º de aumento do que o grupo placebo. Conclusão: Os resultados sugerem que, a curto prazo, o Sustained Natural Apophyseal Glide parece produzir um efeito significativo na diminuição da atividade muscular dos eretores espinhais, durante o movimento dinâmico de extensão do tronco, assim como no alívio da dor. Embora não se tenham observado alterações significativas no aumento da amplitude articular, os resultados no grupo experimental foram superiores à diferença mínima detetável, sugerindo um efeito positivo da técnica aplicada.

Solution enthalpies of 1,4-dioxane: Study of solvent effects through quantitative structure-property relationships

Solution enthalpies of 1,4-dioxane have been obtained in 15 protic and aprotic solvents at 298.15 K. Breaking the overall process through the use of Solomonov's methodology the cavity term was calculated and interaction enthalpies (Delta H-int) were determined. Main factors involved in the interaction enthalpy have been identified and quantified using a QSPR approach based on the TAKA model equation. The relevant descriptors were found to be pi* and beta, which showed, respectively, exothermic and endothermic contributions. The magnitude of pi* coefficient points toward non-specific solute-solvent interactions playing a major role in the solution process. The positive value of the beta coefficient reflects the endothermic character of the solvents' hydrogen bond acceptor (HBA) basicity contribution, indicating that solvent molecules engaged in hydrogen bonding preferentially interact with each other rather than with 1,4-dioxane. (C) 2013 Elsevier B.V. All rights reserved.

Immunohistochemistry in formalin-gel fixed tissues

There are several hazards in histopathology laboratories and its staff must ensure that their professional activity is set to the highest standards while complying with the best safety procedures. Formalin is one of the chemical hazards to which such professionals are routinely exposed. To decrease this contact, it is suggested that 10% neutral buffered liquid formalin (FL) is replaced by 10% formalin-gel (FG), given the later reduces the likelihood of spills and splashes, and decreased fume levels are released during its handling, proving itself less harmful. However, it is mandatory to assess the effectiveness of FG as a fixative and ensure that the subsequent complementary techniques, such as immunohistochemistry (IHC), are not compromised. Two groups of 30 samples from human placenta have been fixed with FG and FL fixatives during different periods of time (12, 24, and 48 hours) and, thereafter, processed, embedded, and sectioned. IHC for six different antibodies was performed and the results were scored (0–100) using an algorithm that took into account immunostaining intensity, percentage of staining structures, non-specific immunostaining, contrast, and morphological preservation. Parametric and non-parametric statistical tests were used (alpha = 0•05). All results were similar for both fixatives, with global score means of 95•36±6•65 for FL and 96•06±5•80 for FG, and without any statistical difference (P>0•05). The duration of the fixation had no statistical relevance also (P>0•05). So it is proved here FG could be an effective alternative to FL.

Formal caregivers of older adults: reflection about their practice

OBJECTIVE To understand the job function of caregivers of older adults and contribute to the debate on the consolidation of this professional practice. METHODOLOGICAL PROCEDURES This is a descriptive, qualitative, and exploratory study. Four focal group sessions were performed in 2011 with 11 elderly companions, formal caregivers of older adults in the Programa Acompanhante de Idosos (Program for Caregivers of Older Adults), Sao Paulo, SP, Southeastern Brazil. These sessions, guided by a semi-structured script, were audio-recorded and fully transcribed. Data were analyzed using the Content Analysis technique, Thematic Modality. RESULTS In view of considering the caregivers of older adults as a new category of workers, it was difficult to define their duties. The elderly companions themselves as well as the care receivers, their families, and the professionals that comprised the team were unclear about their duties. The professional practice of these formal caregivers has been built on the basis of constant discussions and negotiations among them and other team members in Programa Acompanhante de Idosos during daily work. This was achieved via a recognition process of their job functions and by setting apart other workers’ exclusive responsibilities. CONCLUSIONS The delimitation of specific job functions for elderly companions is currently one of the greatest challenges faced by these workers to develop and consolidate their professional role as well as improve Programa Acompanhante de Idosos.

Influência de diferentes estratégias de estabilização lombopélvica e de programas de exercícios de controlo motor no Active Straight Leg Raise

Introdução: O Active Straight Leg Raise (ASLR) tem sido sugerido como um indicador clínico da estabilidade lombopélvica. Estratégias passivas e ativas podem contribuir para aumentar esta estabilidade, assim como programas de exercício baseados nas mesmas estratégias ativas. Objetivos: Comparar os efeitos imediatos da compressão pélvica manual (CP), do drawing-in (DI) e do bracing abdominal (BA) durante o ASLR em indivíduos com e sem dor lombopélvica crónica e inespecífica, e avaliar o efeito prolongado das manobras de estabilização ativas através dos programas de exercícios de controlo motor, Pilates e McGill. Métodos: Estudo transversal, com uma amostra de 111 voluntários, 52 sem dor lombopélvica (NLPPG) e 59 com dor lombopélvica (LPPG), e estudo experimental, formado pelo LPPG dividido em 19 no grupo controlo (GC), 20 no grupo pilates (GP) e 20 no grupo mcgill (GMg). Foi avaliado o ASLR padrão, o ASLR com CP, o ASLR com DI e ASLR com BA. Os participantes foram avaliados antes e após as 8 semanas de implementação dos programas exercícios de McGill e Richardson, apenas aos respetivos grupos. Resultados: O LPPG apresentou significativamente maior score no ASLR comparativamente ao NLPPG (z=-9,361; p<0,001). Apesar do BA ter apresentado scores inferiores às restantes estratégias (p<0,001), todas elas foram capazes de diminuir o score do ASLR (p<0,001). Após a aplicação dos programas de exercícios, verificou-se que o GP (p<0,001) e o GMg (p<0,001) apresentaram scores significativamente menores no ASLR, relativamente ao GC. No GP e no GMg verificou-se uma diminuição do score do ASLR (Z=-4,028; p<0,001; Z=-4,179; p<0,001, respetivamente). Além disso, GMg apresentou uma tendência para apresentar menores scores do ASLR comparativamente ao GP. Conclusão: Qualquer uma destas manobras de estabilização quando adicionada ao ASLR pode aumentar a estabilidade lombopélvica, especialmente o BA. Os exercícios de Pilates e de McGill permitiram melhorar os scores do ASLR.

Intestinal spirochetosis: first cases reported in Brazil and the use of immunohistochemistry as an aid in histopathological diagnosis

Colonization of the colon and rectum by intestinal spirochetes is detected for the first time in Brazil in 4 of 282 (1.41%) patients who had undergone sigmoidoscopy and/or colonoscopy with a histopathological diagnosis of chronic non specific-colitis. This frequency is probably understimated, since surgically obtained specimens were not considered in the present study. Histopathological diagnosis was performed using routine stains like hematoxylin-eosin which showed the typical, of 3-µm thick hematoxyphilic fringe on the brush border of the surface epithelium, and by silver stains like the Warthin-Starry stain. Immunohistochemical procedures using two, polyclonal, primary antibodies, one against Treponema pallidum and the other against Leptospira interrogans serovar copenhageni serogroup Icterohaemorrhagiae cross-reacted with spirochetal antigen/s producing a marked contrast of the fringe over the colonic epithelium, preserving the spiral-shaped morphology of the parasite. In one case with marked diarrhea, immunohistochemistry detected spirochetal antigen/s within a cell in an intestinal crypt, thus demonstrating that the infection can be more widely disseminated than suspected using routine stains. Immunohistochemical procedures, thus, greatly facilitate the histological diagnosis of intestinal spirochetosis and may contribute to a better understanding of the pathogenesis of the disease. Transmission and scanning electron microscopy performed in one case showed that the spirochete closely resembled the species designated as Brachyspira aalborgi.

Immunological status of ENL (Erythema Nodosum Leprosum) patients: its relationship to bacterial load and levels of circulanting IL-2R

Recent data suggest that the clinical course of reactional states in leprosy is closely related to the cytokine profile released locally or systemically by the patients. In the present study, patients with erythema nodosum leprosum (ENL) were grouped according to the intensity of their clinical symptoms. Clinical and immunological aspects of ENL and the impact of these parameters on bacterial load were assessed in conjunction with patients' in vitro immune response to mycobacterial antigens. In 10 out of the 17 patients tested, BI (bacterial index) was reduced by at least 1 log from leprosy diagnosis to the onset of their first reactional episode (ENL), as compared to an expected 0.3 log reduction in the unreactional group for the same MDT (multidrug therapy) period. However, no difference in the rate of BI reduction was noted at the end of MDT among ENL and unreactional lepromatous patients. Accordingly, although TNF-alpha (tumor necrosis factor) levels were enhanced in the sera of 70.6% of the ENL patients tested, no relationship was noted between circulating TNF-alpha levels and the decrease in BI detected at the onset of the reactional episode. Evaluation of bacterial viability of M. leprae isolated from the reactional lesions showed no growth in the mouse footpads. Only 20% of the patients demonstrated specific immune response to M. leprae during ENL. Moreover, high levels of soluble IL-2R (interleukin-2 receptor) were present in 78% of the patients. Circulating anti-neural (anti-ceramide and anti-galactocerebroside antibodies) and anti-mycobacterial antibodies were detected in ENL patients' sera as well, which were not related to the clinical course of disease. Our data suggest that bacterial killing is enhanced during reactions. Emergence of specific immune response to M. leprae and the effective role of TNF-alpha in mediating fragmentation of bacteria still need to be clarified.

Cerebrospinal fluid profiles in acquired immunodeficiency syndrome with and without neurocryptococcosis

Cryptococcosis is one of the most common fungal infections of the central nervous system (CNS) in AIDS patients and meningoencephalitis or meningitis is a frequently observed manifestation. However, systematic studies of cerebrospinal fluid (CSF) composition from AIDS patients with CNS cryptococcosis have been few. CSF samples from 114 HIV seropositive patients whose clinical complaint suggested CNS involvement, were analyzed; 32 samples from patients diagnosed as having neurocryptococcosis (Group 1) and 82 samples from patients with no identified neurological disfunction (Group 2). Based on cytological and biochemical results, two distinct profiles were observed: Normal (Group 1 = 31%, Group 2 = 39%); Abnormal (Group 1 = 69%, Group 2 = 61%). Lymphocytes were the most frequent cells in both groups. Our CSF cytological and biochemical findings showed that in AIDS patients liquoric abnormalities are quite frequent, non-specific and difficult to interpret. In these circumstances a systematic search to identify the etiologic agent using microbiological and/or immunological assays must be routinely performed

ELEVATED ALANINE AMINOTRANSFERASE (ALT) IN BLOOD DONORS: AN ASSESSMENT OF THE MAIN ASSOCIATED CONDITIONS AND ITS RELATIONSHIP TO THE DEVELOPMENT OF HEPATITIS C

The determination of aminotranferases levels is very useful in the diagnosis of hepatopathies. In recent years, an elevated serum ALT level in blood donors has been associated with an increased risk of post-transfusion hepatitis (PTH). The purpose of the study was to research the factors associated with elevated ALT levels in a cohort of voluntary blood donors and to evaluate the relationship between increased ALT levels and the development of hepatitis C (HCV) infection. 166 volunteer blood donors with elevated ALT at the time of their first donation were studied. All of the donors were questioned about previous hepatopathies, exposure to hepatitis, exposure to chemicals, use of medication or drugs, sexual behaviour, contact with blood or secretions and their intake of alcohol. Every three months, the serum levels of AST, ALT, alkaline phosphatase, gamma glutamyl transpeptidase, cholesterol, triglyceride and glycemia are assessed over a two year follow-up. The serum thyroid hormone levels as well as the presence of auto-antibodies were also measured. Abdominal ultrasound was performed in all patients with persistently elevated ALT or AST levels. A needle biopsy of liver was performed in 9 donors without definite diagnostic after medical investigation. The presence of anti-HCV antibodies in 116 donors were assayed again the first clinical evaluation. At the end of follow-up period (2 years later) 71 donors were tested again for the presence of anti-HCV antibodies. None of donors resulted positive for hepatitis B or hepatitis C markers during the follow-up. Of the 116 donors, 101 (87%) had persistently elevated ALT serum levels during the follow-up. Obesity and alcoholism were the principal conditions related to elevated ALT serum levels in 91/101 (90.1%) donors. Hypertriglyceridemia, hypercholesterolemia, hypothyroidism and diabetes mellitus also were associated with increased ALT levels. Only 1/101 (0.9%) had mild chronic active non A-G viral hepatitis and 3/101 (2.9%) had liver biopsy with non-specific reactive hepatitis. The determination of ALT levels was not useful to detect donors infected with HCV at donation in Brazil, including the initial seronegative anti-HCV phase.

TOXOCARIASIS: SEROLOGICAL DIAGNOSIS BY INDIRECT ANTIBODY COMPETITION ELISA

Toxocariasis is caused by infection of man by Toxocara canis and Toxocara cati larvae, the common roundworm of dogs and cats. Because larvae are difficult to detect in tissues, diagnosis is mostly based on serology. Non specific reactions are observed mainly due to cross-reactivity with Ascaris sp antigens. This investigation aimed at developing and evaluating an indirect antibody competition ELISA (IACE) employing a specific rabbit IgG anti-Toxocara canis excretory-secretory antigens as the competition antibody, in order to improve indirect ELISA specificity performed for toxocariasis diagnosis. For that, the rabbit IgG was previously absorbed by Ascaris suum adult antigens. Sensitivity and specificity of IACE were first evaluated in 28 serum samples of mice experimentally infected with T. canis embryonated eggs. Adopting cut-off value established in this population before infection, sensitivity and specificity were 100% after 20 days post-inoculation. For human population IACE was evaluated using sera from 440 patients with clinical signs of toxocariasis and the cut-off value was established with 60 serum samples from apparently healthy individuals. Using as reference test the indirect ELISA performed by Adolfo Lutz Institute, sensitivity was 60.2%, specificity was 98% and concordance was 77.3%. Repeatability of IACE was evaluated by the inter-reactions variation coefficient (2.4%).

HANTAVIRUS PULMONARY SYNDROME (HPS) IN GUARIBA, SP, BRAZIL: REPORT OF 2 CASES

Human infections caused by a hantavirus were reported in different regions of the State of São Paulo (SP), Brazil during the first six months of 1998. Two cases of fatal pulmonary syndrome occurred in May of 1998 in the City of Guariba, located in the Northeastern Region of SP. Both patients worked in a corn storage barn infested by rodents. These patients, after 2 or 3 days of non-specific febrile illness, developed a severe interstitial pneumonia spreading widely in both lungs, causing respiratory failure and death. At autopsy both patients showed lung interstitial edema with immunoblast-like mononuclear cell infiltrates, consistent with a viral etiology. Hantavirus infection was diagnosed by ELISA in both cases and by RT-PCR in one of the patients. Aspects of the clinical presentation, physiopathology and differential diagnosis of Hantavirus Pulmonary Syndrome are discussed.

Gold nanoparticle to antibody conjugates for diagnosis applications: molecular interactions and immunoassay development

Thesis for the Master degree in Structural and Functional Biochemistry