Epidemiologia e etiologia das dermatofitoses em Goiânia, GO, Brasil

Os dermatófitos são um grupo de fungos taxonomicamente relacionados que têm a capacidade de invadir os tecidos queratinizados (pele, pêlo e unha) dos homens e animais produzindo infecções denominadas dermatofitoses. Com o intuito de avaliar a epidemiologia e etiologia das infecções causadas por estes fungos em Goiânia, GO, foram examinadas no Laboratório de Micologia do Instituto de Patologia Tropical e Saúde Pública da Universidade Federal de Goiás, de janeiro a dezembro de 1999, 1.955 amostras de indivíduos com suspeita clínica de dermatofitoses. Foram isolados 445 (22,8%) cepas de dermatófitos e identificados principalmente Trichophyton rubrum (49,4%), Trichophyton mentagrophytes (30,8%) e Microsporum canis (12,6%). Quanto à localização das lesões, os membros inferiores, unhas dos pés e couro cabeludo foram as regiões mais acometidas. Neste estudo foram avaliados dados correlacionados a sexo, faixa etária, local das lesões e agente etiológico.

The usefulness of Umelosa hepatitis C vírus qualitative kit as supplemental test for confirmation of hepatitis C virus infection

Forty voluntary blood donors from two different blood banks in Havana, Cuba, who were repeatedly reactive on the routine screening of antibodies to hepatitis C virus, by Umelisa HCV test, were analyzed for the presence of HCV RNA using a nested PCR assay of the HCV 5' untranslated region, Umelosa HCV qualitative. Sera from 45 patients of a specialized gastroenterology consultation, positive to Umelisa HCV, were also assayed with the Umelosa HCV qualitative, to establish their condition related to the presence of HCV RNA previously to the indication of a treatment or after three, six or twelve months of antiviral therapy. Serum HCV-RNA was detected in 21/40 (52.5%) donors who had repeatedly positive ELISA results, confirming the HCV infection for them. In specialized consultation HCV-RNA was detected by PCR analysis in 30/45 (66%) analyzed sera.

Evaluation of a commercial test based on ligase chain reaction for direct detection of Mycobacterium tuberculosis in respiratory specimens

A ligase chain reaction DNA amplification method for direct detection of Mycobacterium tuberculosis (Abbott LCx MTB) in respiratory specimens was evaluated. Results from LCx MTB Assay were compared with those from acid fast bacilli smear, culture, and final clinical diagnosis for each patient. A total of 297 respiratory specimens (sputum and bronchial lavage) from 193 patients were tested. The sensitivity, specificity, positive predictive value and negative predictive value of LCx vs culture were 92.7%, 93%, 67.8% and 98.7%, respectively. When compared to the clinical final diagnosis, the sensitivity, specificity, PPV and NPV for LCx were 88.9%, 96.8%, 86.5% and 97.4%, respectively. The sensitivity of LCx MTB assay was 75% for smear-negative, culture positive samples. The results indicate that LCx MTB assay is a rapid, simple and valuable technique as a complementary tool for the diagnosis of tuberculosis.

Evaluation of an immunochromatography test for malaria diagnosis under different storage conditions

This study aimed to evaluate the second-generation OptiMal test for malaria diagnosis under various storage conditions. It detected all the positive samples, except for two Plasmodium malariae samples. Further research evaluating diverse environmental conditions are important for ICT test applicability in Brazilian malaria areas.

Suscetibilidade antimicrobiana de uropatógenos em pacientes ambulatoriais na cidade de Goiânia, GO

Em função do aumento de microrganismos multirresistentes causadores de cistite, este estudo teve como objetivo identificar os patógenos causadores de infecção do trato urinário em mulheres, além de traçar o perfil de suscetibilidade antimicrobiana. Foram analisadas 442 amostras de urina, no período compreendido entre junho de 2002 e agosto de 2003. A identificação dos germes isolados foi realizada por provas bioquímicas e enzimáticas e o antibiograma pelo método de difusão em disco. Ocorreram quadros laboratoriais de infecção do trato urinário em 17,6% dos casos. Foi observada a Escherichia coli como o microrganismo prevalente causador de infecção do trato urinário (67,9%). As bactérias Gram-negativas foram resistentes à amoxicilina em 74,6% dos casos analisados, sendo sensíveis em maior índice a ceftazidima e gentamicina. As bactérias Gram-positivas foram resistentes em maior índice à ampicilina (72,7%), sendo sensíveis a trimetoprim/sulfametoxazol, vancomicina e linezolida. Concluiu-se que o estudo da resistência bacteriana é necessário para indicar novas opções terapêuticas.

Diagnóstico laboratorial de enteroparasitoses oportunistas, com ênfase nas microsporidioses humanas, em Goiânia-GO

Os microsporídios são protozoários, emergentes e oportunistas, responsáveis por patologias de alta morbi-mortalidade, principalmente em indivíduos com distúrbios imunes. Este estudo visa determinar o perfil clínico-laboratorial destes agentes. No total, foram avaliados 723 pacientes divididos em dois grupos: I) Indivíduos imunodeprimidos/imunossuprimidos; II) Indivíduos aparentemente imunocompetentes. Estes, após livre e esclarecido consentimento, foram entrevistados e cederam amostras fecais, sendo todas submetidas a técnicas de HPJ, Rugai, Faust e colorações específicas para coccídios e microsporídios. A freqüência de microsporídios foi 1,3% (5/393) no grupo I, enquanto no outro grupo foi quatro vezes menor. A ocorrência de outras enteroparasitoses oportunistas também foi maior no grupo I. Conclui-se, por um lado, que estes agentes estão em nosso meio, e por outro, necessitamos aprimorar o diagnóstico clínico e laboratorial, para definir a distribuição geográfica destes agentes no Estado de Goiás e no Brasil.

Identificação de espécies de Malassezia em pacientes com pitiríase versicolor em Goiânia-GO

O objetivo deste estudo foi verificar a freqüência de pitiríase versicolor e identificar leveduras do gênero Malassezia, de pacientes encaminhados ao laboratório de Micologia da Universidade Federal de Goiás em Goiânia. Foram diagnosticados 95 casos de pitíriase versicolor e identificados quatro espécies de Malassezia: Malassezia furfur, Malassezia sympodialis, Malassezia globosa e Malassezia obtusa.

Detection of Mycobacterium leprae infection in wild nine-banded armadillos (Dasypus novemcinctus) using the rapid ML Flow test

Mycobaterium leprae infection was investigated in armadillos from the State of Espírito Santo, Brazil. The ML Flow test was performed on 37 nine-banded armadillos and positive results were found in 11 (29.7%). The ML Flow test may be used to identify possible sources of Mycobaterium leprae among wild armadillos.

Preliminary observations on fluids incubated with Wuchereria bancrofti using the immunochromatographic test

To assess the performance of the immunochromatographic test for filariasis, adult Wuchereria bancrofti worms were incubated under different conditions. The tests were strongly positive with incubation fluids from both living and mechanically damaged females. Negative results were observed with incubation fluids from all male worms and from intact dead females.

Prevalence and predictors of positive tuberculin skin test results in a research laboratory

Latent tuberculosis was studied in a research laboratory. A prevalence of positive tuberculin skin test results (> 15mm) of 20% was found and the main predictors were place of birth in a foreign country with high prevalence of tuberculosis and a history of contact with patients with untreated active tuberculosis.

Fisioterapia e ganhos em Saúde numa Unidade de Cuidados Continuados

RESUMO: Atualmente, toda a envolvência do envelhecimento, desencadeada por um aumento crescente do número de pessoas idosas, incapazes de satisfazer as exigências do autocuidado e de viver autonomamente na comunidade, torna relevante o papel da fisioterapia no suporte ao idoso. O objetivo geral deste trabalho é caracterizar a evolução do nível de independência nas atividades da vida diária (AVD’s), dos indivíduos que realizam fisioterapia numa unidade de cuidados continuados integrados (UCCI). Trata-se de uma abordagem quantitativa, observacional, longitudinal e descritiva. A população do estudo incide nos indivíduos admitidos na UCCI do Hospital do Mar (HM). Da presente população é retirada uma amostra por conveniência, num período de quatro meses, de acordo com critérios de inclusão e exclusão. Os instrumentos utilizados para a recolha de informação foram: um inquérito por questionário para o levantamento das características sócio-demográficas, de saúde e hábitos de vida; o Método de Avaliação Biopsicossocial (MAB - Classificação) para a avaliação do nível de independência nas AVD’s; e o Timed Up and Go (TUG) para a avaliação da mobilidade funcional. Os principais resultados mostraram, segundo o MAB - Classificação, diferenças significativas, entre os dois momentos de avaliação (antes da fisioterapia e no momento da alta da fisioterapia), resultando num maior nível de independência funcional nas AVD’s no momento da alta da fisioterapia. Em relação ao TUG, a média da duração do teste diminuiu no momento da alta da fisioterapia, em relação ao momento antes da fisioterapia, traduzindo-se num aumento da mobilidade funcional. Concluindo, conseguiu-se evidenciar que os indivíduos submetidos a tratamentos de fisioterapia numa UCCI, obtêm um nível de independência funcional mais elevada no momento da alta da fisioterapia, do que antes de serem objetos desta intervenção; o mesmo sucedendo, em relação à mobilidade funcional.---------------ABSTRACT: Currently, the issue aging, triggered by an increasing number of elderly people, unable to meet the demands of self-care and live independently in the community, makes relevant the role of physiotherapy in support to the elderly. The aim of this work is to characterize the evolution of the level of independence in activities of daily living (ADLs), of individuals who perform physiotherapy in long term care hospital. This is a quantitative, observational, longitudinal and descriptive approach.The population of the study focuses on individuals admitted in long-term care in Hospital do Mar. Of this population is withdrawn a convenience sample within a period of four months, according to the inclusion and exclusion criteria. The instruments used for collecting data were a questionnaire to survey the socio-demographic, health and lifestyle characteristics; Método de Avaliação Biopsicossocial (MAB - Classificação) to assess the level of independence in activities of daily living (ADLs); and the Timed Up and Go (TUG) to assess functional mobility. The main results showed, according to the MAB - Classificação, significant differences between the two time points (before physiotherapy and at discharge from physiotherapy), resulting in a higher level of functional independence in ADLs at discharge from physiotherapy. Regarding the TUG, the average duration of the test decreased at discharge from physiotherapy, relative to the time before physiotherapy, translating into an increase of functional mobility. In conclusion, we were able to show that individuals undergoing physiotherapy treatments in long-term care hospital, obtaining a higher level of functional independence at discharge from physiotherapy than before objects of this intervention; the same applies with respect to functional mobility.

Evaluation of the use of real-time PCR for human T cell lymphotropic virus 1 and 2 as a confirmatory test in screening for blood donors

INTRODUCTION: HTLV-1/2 screening among blood donors commonly utilizes an enzyme-linked immunosorbent assay (EIA), followed by a confirmatory method such as Western blot (WB) if the EIA is positive. However, this algorithm yields a high rate of inconclusive results, and is expensive. METHODS: Two qualitative real-time PCR assays were developed to detect HTLV-1 and 2, and a total of 318 samples were tested (152 blood donors, 108 asymptomatic carriers, 26 HAM/TSP patients and 30 seronegative individuals). RESULTS: The sensitivity and specificity of PCR in comparison with WB results were 99.4% and 98.5%, respectively. PCR tests were more efficient for identifying the virus type, detecting HTLV-2 infection and defining inconclusive cases. CONCLUSIONS: Because real-time PCR is sensitive and practical and costs much less than WB, this technique can be used as a confirmatory test for HTLV in blood banks, as a replacement for WB.

A built-in self-test technique for high speed analog-to-digital converters

Fundação para a Ciência e a Tecnologia (FCT) - PhD grant (SFRH/BD/62568/2009)

Standardization of an ELISA test using a recombinant nucleoprotein from the Junin virus as the antigen and serological screening for arenavirus among the population of Nova Xavantina, State of Mato Grosso

INTRODUCTION: Arenavirus hemorrhagic fever is a severe emerging disease. METHODS: Considering that the levels of antibodies against arenavirus in the Brazilian population are completely unknown, we have standardized an ELISA test for detecting IgG antibodies using a recombinant nucleoprotein from the Junin virus as the antigen. This protein was obtained by inserting the gene of the Junin virus nucleoprotein into the genome of Autographa californica nucleopolyhedrovirus, using the Bac-to-Bac baculovirus expression system. This recombinant baculovirus was used to infect S. frugiperda cells (SF9). RESULTS: The infection resulted in synthesis of high concentrations of recombinant protein. This protein was detected on 12.5% polyacrylamide gel and by means of Western blot. Using the standardized ELISA test, 343 samples from the population of Nova Xavantina were analyzed. We observed that 1.4% of the serum samples (five samples) presented antibody titers against arenavirus. CONCLUSIONS: These results show the population studied may present exposure to arenavirus infection.

Evaluation of the six-minute walk test in patients with chronic heart failure associated with Chagas' disease and systemic arterial hypertension

INTRODUCTION: To evaluate physical capacity as determined by the six-minute walk test (6MWT) in patients with chronic heart failure due to Chagas' disease associated with systemic arterial hypertension (Chagas-SAH). METHODS: A total of 98 patients routinely followed at the Cardiomyopathy Outpatient Service were recruited. Of these, 60 (61%) were diagnosed with Chagas disease and 38 (39%) with Chagas-SAH. RESULTS: The distance walked during 6 min was 357.9 ±98 m for Chagas-SAH patients and 395.8 ± 121m for Chagas cardiomyopathy patients (p >0.05). In patients with Chagas-SAH, a negative correlation occurred between the 6MWT and the total score of the Minnesota Living with Heart Failure Questionnaire (r= -0.51; p=0.001). No other correlations were determined between 6MWT values and continuous variables in patients with Chagas-SAH. CONCLUSIONS: The results of the 6MWT in Chagas-SAH patients are similar to those verified in Chagas cardiomyopathy patients with chronic heart failure. Coexistence of SAH does not seem to affect the functional capacity of Chagas cardiomyopathy patients with chronic heart failure.