Testemunha da tuberculose : antígeno liparabinomannan

O estudo pretendeu abordar a imunidade humoral na Tuberculose. Foi um estudo de teste diagnóstico que avaliou um antígeno específico, constituinte da parede celular da micobactéria, denominado LIPOARABINOMANNAN (LAM), proveniente de Cambridge, MA, USA da Companhia Dyna-Gen. O objetivo principal do estudo foi a detecção de anticorpos IgG anti-LAM em casos de tuberculose pulmonar, extrapulmonar e formas combinadas da doença. A casuística total compreendeu 173 pacientes portadores de tuberculose, sendo a mesma confirmada por métodos bacteriológicos e/ou anatomopatológicos de biópsias de diversos órgãos em 114 casos (65,8%). Em 46 casos (26,5%) a doença se confirmou por rigorosos critérios clínicos, radiológicos e de seguimento após tratamento adequado. Cento e quinze pacientes eram do sexo masculino (66,5%) e 58 do sexo feminino (33,5%). Cento e trinta e um eram brancos (75,7%), 24 negros (13,9%) e 18 mistos (10,4%). O total de formas pulmonares foi de 88 casos (51%), sendo 81 (46,8%) formas bacilíferas e 7 casos (4,0%) não-bacilíferas. Dos casos com baciloscopia direta negativa, 3 apresentaram culturas positivas, 2 culturas negativas e em 2 casos a mesma não foi realizada. Formas extrapulmonares compreenderam 71 casos (41%) com predomínio de forma miliar, ganglionar, pleural e do SNC. A combinação de ambas as formas ocorreu em 14 casos (8,1%). Radiologicamente, houve predomínio de lesões escavadas (30,1%), consolidação (13,9%), padrão miliar (11%) e exame radiológico normal (11%), além de outros achados. Da série, 118 pacientes eram HIV negativos (68,2%) e 55 eram HIV positivos (31,8%). As principais comorbidades associadas foram Diabetes Melittus (DM), Alcoolismo, Cardiopatia e Neoplasia, entre outras. Exames culturais foram realizados em 145 pacientes, sendo que em 72 casos a cultura foi positiva (41,6%) e foi negativa em 10 casos (5,8%). Dos 72 exames culturais positivos, o teste do MycoDot foi positivo em 47 casos (65,2%) e negativo em 25 (34,7%). Em 10 exames culturais negativos, o mesmo foi positivo em 6 casos (60%) e negativo em 4 casos (40%). Em 63 exames culturais não realizados, o teste do MycoDot foi positivo em 46 casos e negativos em 17. Os resultados do teste MycoDot na série total foram: positivos em 120 pacientes (69,4%) e negativos em 53 pacientes (30,6%). As formas pulmonares bacilíferas, não bacilíferas, extrapulmonares e combinadas apresentaram sensibilidade de 74,1%, 85,7%, 63,4% e 64,3% respectivamente. O grupo controle foi de 77 indivíduos assim distribuídos: 41 sadios, 16 portadores de lesões residuais de tuberculose, 6 sadios com BCG prévia, 6 sadios sem BCG prévia e 8 com outras comorbidades. O resultado do teste MycoDot foi negativo em 73 casos (94,8%) e positivo em 4 casos (5,2%). A sensibilidade da casuística total foi de 69,4%, a especificidade foi de 94,8%, o valor preditivo positivo (VPP) foi de 96,8% e o valor preditivo negativo (VPN) foi de 57,9%. Dos pacientes HIV positivos a sensibilidade foi de 61,8% e a especificidade foi de 100%. Nos pacientes HIV negativos a sensibilidade foi de 72,9% e a especificidade foi de 94,7%. Concluiu-se que o Teste MycoDot é de fácil realização, baixo custo, podendo ser útil como uma ferramenta adicional para o diagnóstico da tuberculose.

Resposta imune à saliva de flebotomíneos (diptera: psychodidae) em indivíduos residentes em áreas urbana e periurbana no nordeste do brasil

Visceral leishmaniasis (VL) has a wide geographical distribution in tropical and subtropical areas of the planet, which is a protozoan parasite of the genus Leishmania. This pathogen is transmitted to the host through the sandflies bite, with its saliva, the immune response that leads to both. In the state of Rio Grande do Norte, 85% of the sand flies captured is Lutzomyia longipalpis, but the second most abundant, Lutzomyia evandroi, it deserves emphasis because its wide distribution and eclectic behavior. The exposure of people living in endemic areas for the insect vector VL greatly increases the chances of infection. This study aimed to evaluate aspects of the epidemiological profile of VL in endemic areas of human and nonendemic in the metropolitan area of Natal, as well as verify the abundance and seasonal fluctuations of sandflies species in two counties endemic for VL. Were collected in the municipalities of Nísia Floresta, Parnamirim, São Gonçalo do Amarante and Macaíba, of which groups of females were separated for further dissection of the salivary glands and identification of species. The blood samples used were from individuals of two Natal s districts where it has never been reported cases of VL and neighborhoods of Parnamirim applicants who present cases of VL. In the municipality of Nísia Floresta, the most abundant species was L. evandroi with 38.39%, followed by L. longipalpis with 36.22%, L. walkeri 19.67% L. lenti 3.81%, L. wellcomei 1.39% and L. whitmani 0.52%. Already in Parnamirim the proportions were L. walkeri with 73.15%, L. evandroi with 10.55%, L. wellcomei 7.63%, L. longipalpis 6.37%, L. whitmani 1.46%, L. sordellii 0.52%, L. intermedia 0.21 and L. shanonni 0.1%. In both municipalities was observed higher abundance of species distributed in the initial months of the year, as February and March. The study showed that no difference in exposure to the vector of VL among individuals from endemic and non endemic area for this disease. But there are differences in exposure between individuals of L. longipalpis and L. evandroi, confirming the great powers of the first vector. It was also characterized as predominant phenotype in the population of endemic areas who had negative serologic responses to antigens of Leishmania and result in negative Montenegro skin test (DTH), indicating that much of the population hasn t been bitten by infected insects

Marcadores nutricionais e inflamatórios e sua associação com a morbimortalidade em hemodiálise

Background: Malnutrition, inflammation and comorbidities are frequent in patients with chronic renal failure in hemodialysis (HD), contributing for morbidity and mortality. Aims: To evaluate the correlation between anthropometric, laboratory parameters, bioelectrical impedance (BIA) and inflammatory markers with the morbidity and mortality of patients in HD, as well as the impact of its alterations throughout 12 months. Methods: 143 patients of a dialysis facility in Northeast Brazil were evaluated throughout 18 months. Patients with more than 3 months on dialysis, older than 18 years, without amputation of hands and feet, were included in the study. We performed a clinical (subjective global assessment - SGA), anthropometric (BMI, percent of ideal weight, MAC, MAMC, MAMA, percent of fat mass and TSF), laboratory (albumin, creatinine, lymphocyte count as nutritional markers and CRP, IL-6 and TNF- as inflammatory markers) evaluation and BIA (reactance, phase angle and percent of body cell mass) at the beginning of study and after 3, 6 and 12 months of follow-up. The association between study variables and deaths and hospitalizations in 6 and 12 months was investigated. The variable with significance < 10% in the univariate analysis had been enclosed in a multivariate logistic regression analysis. We also investigated the risk of mortality and hospitalization associated with differences in measurements of the variables at baseline and six months later. Results: Patients were aged 52.2 ± 16.6 years on the average, 58% were male, and mean dialysis vintage was 5.27 ± 5.12 years. The prevalence of malnutrition varied from 7.7-63.6%, according to the nutritional marker. The variables associated with morbidity and mortality in 6 and 12 months had been creatinine ≤ 9.45 mg/dl, phase angle ≤ 4.57 degrees, BMI ≤ 23 kg/m2, age ≤ 64.9 years, reactance ≤ 51.7 ohms; Charlson´s index ≥ 4 and socioeconomic status ≤ 7. During six months of follow up, decrease in albumin was associated with significantly higher mortality risk. Conclusions: This study detected that the best predictors of morbidity and mortality between nutritional and inflammatory markers are phase angle, reactance, creatinine and BMI and that changes in albumin values over six 107 months provide additional prognostic information. The authors believe that parameters of BIA may detect early changes in nutritional status and emphasize that longitudinal studies with larger number of patients are necessary to confirm these data and to recommend BIA as a routine nutritional evaluation in HD patients

Extração, caracterização e avaliação bioativa do extrato de Rumex acetosa

Studies show the great influence of free radicals and other oxidants as responsible for aging and degenerative diseases. On the other hand, the natural phenolic compounds has shown great as antioxidants to inhibit lipid peroxidation and lipoxygenase in vitro. Among these, is highlighted trans-resveratrol ( 3,5,4 `- trihydroxystilbene ) phenolic compound , characterized as a polyphenol stilbene class. The vegetables popularly known as "Azedinha" (Rumex Acetosa) has trans-resveratrol in its composition and from this, the present work aimed to study on the supercritical extraction and conventional extraction (Soxhlet and sequential) in roots of Rumex Acetosa, evaluating the efficiency of extractive processes, antioxidant activity, total phenolic content and quantification of trans-resveratrol contained in the extracts. Extractions using supercritical CO2 as solvent, addition of co-solvent (ethanol) and were conducted by the dynamic method in a fixed bed extractor. The trial met a 23 factorial design with three replications at the central point, with the variable reply process yield and concentration of trans-resveratrol and pressure as independent variables, temperature and concentration of co-solvent (% v/v). Yields ( mass of dry extract / mass of raw material used ) obtained from the supercritical extraction ranged from 0,8 to 7,63 % , and the best result was obtained at 250 bar and 90 °C using the co-solvent 15% ethanol (% v/v). The value was calculated for YCER a flow rate of 1,0 ± 0,17 g/min resulting in 0,0469 CO2 ( g solute / g solvent ). The results of the mass yield varied between conventional extractions 0,78 % ( hexane) and 9,97 % (ethanol). The statistical model generated from the data of the concentration of trans-resveratrol performed as meaningful and predictive for a 95% confidence. GC analysis on HPLC (High Performance Liquid Chromatography), transresveratrol was quantified in all extracts and concentration values ranged between 0,0033 and 0,42 ( mg / g extract) for supercritical extracts and between 0,449 and 17,046 (mg / g extract) to conventional extractions and therefore, the Soxhlet extraction with ethanol for more selective trans-resveratrol than the supercritical fluid. Evaluation of antioxidant (radical method to sequester 2,2- diphenyl-1- picryl - hydrazyl - DPPH) the supercritical extracts resulted in EC50 values (concentration effective to neutralize 50% of free radicals) of between 7,89 and 18,43 mg/mL , while resulting in a Soxhlet extraction with EC50 values in the range of 6,05 and 7,39 mg/mL. As for quantification of the phenolic compounds (Method Spectrophotometer Folin-Ciocalteau) the supercritical extracts resulted in values between 85,3 and 194,79 mg GAE / g extract, whereas values derived from the Soxhlet extract resulted in values between 178,5 and 237,8 mg GAE / g extract. The high antioxidant activity can not be attributed solely to the presence of phenolic compounds, but the presence of other antioxidants in the existing Rumex acetosa

A useful panel for the diagnosis of Hirschsprung disease in rectal biopsies: calretinin immunostaining and acetylcholinesterase histochesmistry

The pathological evaluation of rectal biopsies for the diagnosis of Hirschsprung disease has been a challenging issue. We analyzed prospectively the usefulness of calretinin immunostaining and acetylcholinesterase (AChE) histochesmistry in rectal biopsies for the diagnosis of Hirschsprung disease. Frozen tissue samples from 43 patients were used for AChE histochemistry and paraffin-embedded sections for calretinin immunohistochemistry and conventional histology (hematoxylin and eosin [H&E]). Activity for AChE, was demonstrated in 13 of 43 cases, and the absence of immunoreactivity for calretinin was observed in 14 of 43 cases. Conventional histology (H&E) did not reveal ganglion cells in 24 of 43 cases. The results on calretinin were in good agreement with AChE according to the κ index (0.946; P < .001) and presented significantly higher specificity (96.7 × 63.3; P < .002) and accuracy (97.6 × 74.4; P < .003) when compared with conventional histology (H&E). The final diagnosis of Hirschsprung disease was confirmed in 13 of 43 patients who were submitted to surgical treatment. The results of the present study indicate that calretinin can be a good tool in ruling out the diagnosis of Hirschsprung disease, by showing positive staining in ganglion cells and intrinsic nerve fibers, whereas AChE is useful in confirming the diagnosis of Hirschsprung disease, by revealing activity of this enzyme in hypertrophied nerve fibers. The association between calretinin and AChE can be a useful panel for the histopathologic evaluation of rectal biopsies for the diagnosis of Hirschsprung disease. © 2013 Elsevier Inc. All rights reserved.

Dental fluorescence: Potential forensic use

In cases of identification of bones, skeletal segments or isolated bones, searching for biotypologic diagnostic data to estimate an individual's age enables comparing these data with those of missing individuals. Enamel, dentin and pulp undergo remarkable changes during an individual's life. The enamel becomes more mineralized, smoother and thinner, and deteriorates because of physiological and pathological factors. Dental pulp decreases in volume due to the deposition of secondary dentin; thus, the dentin becomes thicker with time. In natural teeth, the fluorescence phenomenon occurs in dentin and enamel and changes in those tissues may alter the expression of the natural tooth color. The aim of this study was to assess the correlation between age and teeth fluorescence for individuals from different age groups. The sample consisted of 66 randomly selected Brazilians of both genders aged 7-63 years old. They were divided into 6 groups: Group 1 - aged 7-12 years, Group 2 - aged 13-20 years, Group 3 - aged 21-30 years, Group 4 - aged 31-40 years, Group 5 - aged 41-50 years and Group 6 - aged between 51 and 63 years. Upper right or left central incisors were used for the study. Restored and aesthetic rehabilitated teeth were excluded from the sample. The measurement of tooth fluorescence was carried out via computer analysis of digital images using the software ScanWhite DMC/Darwin Systems - Brazil. It was observed that dental fluorescence decreases when comparing the age groups 21-30, 31-40, 41-50 and 51-63 years. The results also showed that there is a statistically significant difference between the groups 41-50 years and 21-30 years (p=. 0.005) and also among the group 51-63 years and all other groups (p< 0.005). It can be concluded that dental fluorescence is correlated with age and has a similar and stable behavior from 7 to 20 years of age. It reaches its maximum expected value at the age of 26.5 years and thereafter decreases. © 2013 Elsevier B.V.

Variabilidade genética de vírus sincicial respiratório humano isolados de crianças hospitalizadas e de crianças de creche

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

Avaliação dos achados mamográficos classificados na categoria 4 do sistema BI_RADS® e sua correlação histopatológia

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Bactérias do grupo do Bacillus cereus em leite e estudo enterotoxigênico das cepas isoladas

Pós-graduação em Medicina Veterinária - FCAV

Revisão taxonômica do gênero Hassar Eigenmann & Eigenmann, 1888, com a descrição osteológica de Hassar orestis (Steindachner, 1875) (Siluriformes, Doradidae)

O gênero Hassar (Doradidae) é um grupo natural de Siluriformes Neotropical. No presente trabalho foi realizada revisão taxonômica do referido gênero com a descrição osteológica de Hassar orestis, espécie-tipo do gênero. Este estudo foi fundamentado no levantamento e análise de caracteres morfológicos, morfométricos, merísticos e de padrão de coloração para o reconhecimento das espécies válidas e conseqüentes diagnoses e redescrições. Foram analisados 727 exemplares, provenientes de instituições nacionais e estrangeiras, envolvendo indivíduos preservados em álcool, preparados para esqueleto seco, diafanizados, radiografados e fotografados. Os exemplares foram analisados diretamente ou com auxílio de microscópio-estereoscópico e câmara clara. Medidas foram feitas, preferencialmente, do lado esquerdo do indivíduo. A descrição osteológica de Hassar orestis foi fundamentada na análise de 23 exemplares de instituições nacionais e estrangeiras e foi dividida em grupos funcionais osteológicos que são: elementos do neurocrânio, arco mandibular, arco hióide, arcos branquiais, esqueleto axial, placas nucais e nadadeira dorsal, sistema látero-sensorial e esqueleto apendicular. Os dados foram digitalizados e armazenados em formato de planilhas. Os resultados mostraram que Hassar é formado por duas espécies válidas: H. orestis e H. affinis. Hassar orestis é a espécie-tipo, tendo como sinônimo H. ucayalensis. Hassar affinis tem como sinônimos H. wilderi, H. iheringi e H. woodi. Hassar orestis e H. affinis se diferenciam pela posição do 1° espinho medial (no escudo infranucal ou entre o 1° e 8° escudo lateral vs. entre o 9° e 16° escudo lateral), número de escudos laterais providos de espinho medial (24 a 33 vs. 18 a 23) e pelos divertículos marginais filiformes da bexiga natatória (distintamente maiores vs. reduzidos ou ausentes). Os adultos (> 14 cm) de H. orestis e H. affinis diferiram pela altura do pedúnculo caudal (4,11-5,71% SL vs. 5,73 -7,63% SL) e pelo tamanho da pálpebra adiposa (conspícua e alongada na borda anterior dos olhos vs. tênue na borda anterior dos olhos). Não houve diferenças morfológicas, morfométricas e merísticas entre jovens e adultos da mesma espécie. As espécies apresentaram o mesmo padrão de coloração. Exemplares de H. orestis (N=551) possuem mancha enegrecida subterminal nos primeiros raios da nadadeira dorsal, diferentemente de H. affinis (N=176) cuja mancha pode ser subterminal ou terminal. A presença de prolongamento cartilaginoso no primeiro raio da nadadeira dorsal, em alguns machos de H. orestis, corroborou o dimorfismo sexual para espécie. Exemplares de H. orestis, provenientes dos rios Amazonas, Solimões e Negro, diferem da população do rio Branco e das Bacias dos rios Essequibo e Orinoco pela presença ou não de espinhos nos escudos timpânicos e no escudo infranucal. Não há diferença quanto à bexiga natatória dessas populações. A distribuição de H. affinis foi ampliada para os rios Solimões, Tapajós, baixo e alto Xingu, Tocantins, Araguaia, Parnaíba e Sistema Pindaré-Mearim. Hassar affinis e H. orestis apresentam ampla distribuição, parcialmente disjunta, com uma área de simpatria. A descrição osteológica da espécie-tipo proporcionou um melhor conhecimento anatômico do grupo, que serve de dado básico para trabalhos como anatomia, ontogenia, ecomorfologia e futuros eventuais trabalhos de sistemática e taxonomia.

Risk factors for anaplasmosis in dairy cows during the peripartum

Anaplasma marginale is endemic in tropical and subtropical areas around the world. Some studies have suggested that cows during peripartum may present a transient immunosuppression state and development of clinical signs of anaplasmosis. The aim of this study was to investigate the relationship between some risk factors and the seroprevalence of A. marginale in dairy cows during peripartum in Rio de Janeiro, Brazil. The risk factors analyzed in association with the prevalence of antibodies against A. marginale in dairy cows were calving season, reproductive experience, breed standard, tick infestations, stocking density, and milk yield. The antibodies against A. marginale were tested in indirect enzyme-linked immunosorbent assays. A primary screening using a 2 x k contingency table of the exposed variables with the outcomes was performed. All variables for which p < 0.20 were included in a fixed effects log regression. The risk factors investigated to anaplasmosis were calving (OR 2.61, IC 1.08-7.63), breed standard (OR 3.83, IC 0.08-0.28), reproductive experience (OR 33.7, IC 2.14-5.16), milk yield (OR 3.9, IC 2.24-7.03), Rhipicephalus microplus infestations (OR 10.3, IC 0.05-0.17), and stocking density (OR 22.3, IC 0.05-0.17). Low titers of antibodies against A. marginale during peripartum had been characterized as a period previous to development of clinical anaplasmosis. Thus, studies on anaplasmosis should consider each farm as an epidemiological unit, where environmental and immunological factors may influence the endemic status of the pathogen.

Multi-scale structural and chemical analysis of sugarcane bagasse in the process of sequential acid-base pretreatment and ethanol production by Scheffersomyces shehatae and Saccharomyces cerevisiae

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

Analysis of Climatic Factors Impact on RSV Infection Distribution in Children Attending Childcare at Northwest Region of São Paulo, Brazil

Respiratory syncytial virus (RSV) was detected in samples collected from children from 0 to 6 years of age with acute respiratory infection, attending public childcare on Northwest region of São Paulo, Brazil. RSV distribution was associated to seasonal climatic variables as temperature, rainfall and relative air humidity. We utilized samples of nasopharyngeal aspirate collected during the period of July 2003 to September 2005. RT-PCR was the chosen method for viral identification. Results showed that from the 817 samples (collected from 179 children), 7.7% (63/817) were RSV positive. In 2003, RSV was detected from July until October. In 2004, RSV infections occurred in March, May, June, July, October, November, and December. In 2005, RSV was detected in March, April, May, August, and September. RSV circulation patterns in childcare children showed seasonal distribution associated to decreases in temperature and relative air humidity. RSV was detected in childcare children as an important viral agent causing respiratory infections, with varying patterns of circulation into the cohort during the study period. Moreover, RSV distribution showed to be associated with the dry season on Northwest region of São Paulo, Brazil.

Reliability of pelvic floor muscle strength assessment in healthy continent women

Background: The aim of this study was to compare pelvic floor muscle (PFM) strength using transvaginal digital palpation in healthy continent women in different age groups, and to compare the inter- and intra-rater reliability of examiners performing anterior and posterior vaginal assessments.Methods: We prospectively studied 150 healthy multiparous women. They were distributed into four different groups, according to age range: G1 (n = 37), 30-40 years-old; G2 (n = 39), 41-50 years-old; G3 (n = 39), 51-60 years-old; and G4 (n = 35), older than 60 years-old. PFM strength was evaluated using transvaginal digital palpation in the anterior and posterior areas, by 3 different examiners, and graded using a 5-point Amaro's scale.Results: There was no statistical difference among the different age ranges, for each grade of PFM strength. There was good intra-rater concordance between anterior and posterior PFM assessment, being 64.7%, 63.3%, and 66.7% for examiners A, B, and C, respectively. The intra-rater concordance level was good for each examiner. However, the inter-rater reliability for two examiners varied from moderate to good.Conclusions: Age has no effect on PFM strength profiles, in multiparous continent women. There is good concordance between anterior and posterior vaginal PFM strength assessments, but only moderate to good inter-rater reliability of the measurements between two examiners.