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1.
Lett Appl Microbiol ; 67(3): 285-291, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29908032

RESUMO

Vulvovaginal candidiasis (VVC) is an inflammatory disease of the vulva and vagina caused by different yeasts of the genus Candida which is responsible for infection in pregnant patients who attended Maternidade Escola Januário Cicco, Rio Grande do Norte, Brazil. From 41 samples, 19 yeasts were identified phenotypically as Candida albicans and one as Candida glabrata which is reported as the non-albicans species most frequently isolated from vulvovaginitis. The susceptibility to selected antifungal agents (flucytosine, fluconazole, voriconazole, amphotericin B, caspofungin and micafungin) was determined, and the association between patient-related signs and symptoms aided the construction of an epidemiological profile. Antifungal susceptibility testing performed by automated method showed that all strains were sensitive to the drugs tested, including the C. glabrata specimen despite its known resistance or dose-dependent susceptibility to azole derivatives. Regarding patient signs and symptoms, no statistically significant association between these and the establishment of VVC was found. It can be concluded that the laboratorial diagnosis of VVC is necessary prior to the administration of treatment, since only 48·78% of the patients had VVC but for all of them antifungal therapy were prescribed. SIGNIFICANCE AND IMPACT OF THE STUDY: Vulvovaginal candidiasis (VVC) is a problem that affects a significant number of pregnant women worldwide. This type of fungal infection generates great discomfort due to the symptomatology and difficulties of diagnosis and treatment. In view of the scarcity of data in the State of Rio Grande do Norte, Brazil, regarding studies carried out on fungal populations of the genus Candida associated with VVC in pregnant women, this study considered relevant, the phenotypic and genotypic identification of the species, to estimate the prevalence, to determine their susceptibility to the antifungal and to correlate with signs and symptoms.


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candidíase Vulvovaginal/microbiologia , Complicações na Gravidez/microbiologia , Adolescente , Adulto , Anfotericina B/farmacologia , Brasil/epidemiologia , Candida/genética , Candida/isolamento & purificação , Candida glabrata/isolamento & purificação , Candidíase Vulvovaginal/epidemiologia , Equinocandinas/farmacologia , Feminino , Fluconazol/farmacologia , Humanos , Lipopeptídeos/farmacologia , Micafungina , Testes de Sensibilidade Microbiana , Gravidez , Complicações na Gravidez/epidemiologia , Prevalência , Instituições Acadêmicas/estatística & dados numéricos , Adulto Jovem
3.
Haemophilia ; 23(5): 682-688, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28440005

RESUMO

INTRODUCTION: Although the regular replacement of clotting factor concentrates (prophylaxis) has been well established as the standard of care for severe haemophilia, the high cost of factor concentrates has limited access to prophylaxis in countries with under-developed or developing economies. AIMS: We studied the health gap that could be addressed by providing unlimited access to clotting factor concentrates with implementation of long-term prophylaxis initiated from an early age in life. METHODS: We performed a cross-sectional study of a random, representative sample of boys with moderate and severe haemophilia at three haemophilia treatment centres in Sao Paulo, Brazil, and one centre in Toronto, Canada. RESULTS: Canadian subjects were more often treated with prophylaxis, and began treatment at an earlier age. Fewer Canadian subjects had bleeds within the preceding 6 months (19 vs. 34, P = 0.003). Canadian subjects had lower (better) Pettersson radiographic scores (1.5 vs. 6.0, P = 0.0016), lower (better) Hemophilia Joint Health Scores (5.5 vs. 10.5, P = 0.0038), higher (better) Activity Scale for Kids scores (96.6 vs. 92.0, P = 0.033), more time spent in vigorous activity, and higher (better) social participation scores. CONCLUSIONS: Our findings suggest that increasing access to clotting factor concentrates for young boys with severe haemophilia is a global imperative.


Assuntos
Efeitos Psicossociais da Doença , Países em Desenvolvimento , Recursos em Saúde , Hemofilia A/epidemiologia , Adolescente , Brasil/epidemiologia , Canadá/epidemiologia , Criança , Estudos Transversais , Indicadores Básicos de Saúde , Hemofilia A/diagnóstico , Hemofilia A/terapia , Humanos , Masculino , Qualidade de Vida , Índice de Gravidade de Doença
4.
Osteoporos Int ; 27(4): 1547-1557, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26572757

RESUMO

UNLABELLED: We studied bone mineral density (BMD) of children exposed to long-term warfarin. BMD Z-scores ≤ -2.0 were estimated to occur in less than one fifth of the patients after 10 years of warfarin exposure, and BMI and growth hormone deficiency predicted BMD changes over time. These predictors can help identify high-risk patients. INTRODUCTION: Children with chronic diseases are at increased risk of developing thrombosis, which may require long-term warfarin therapy. Warfarin could further jeopardize the bone health of a population already at risk for bone fragility. Our objective was to investigate the occurrence and timing of low bone mineral density (BMD) and the predictors that influence BMD trajectory in children receiving warfarin for >1 year. METHODS: We analyzed the results of an institutional protocol that includes dual-energy X-ray absorptiometry, with or without spinal X-rays and laboratory biomarkers, as required. RESULTS: Low BMD (age, sex, race, and height-for-age-Z-score adjusted BMD Z-score ≤ -2.0) was detected in 13 % (9/70) of the patients at some point during their follow-up; these patients were more likely to have complex underlying medical conditions and low body mass index (BMI) percentile. BMD Z-scores remained within normal range in 87 % of children. Survival analysis showed that the estimated 10-year abnormal BMD-free rate for the entire group was 81 % (95 % confidence interval [CI] 69 to 93 %). Trajectory analysis revealed that BMI percentiles at baseline and growth hormone deficiency (GHD) were associated with lower BMD Z-scores at the first assessment, whereas baseline BMI percentile was the only predictor of BMD Z-score over time. CONCLUSIONS: Our findings identified BMI and GHD as risk factors influencing BMD in children exposed to long-term warfarin, creating an opportunity for early detection and intervention in these patients.


Assuntos
Anticoagulantes/efeitos adversos , Osteoporose/induzido quimicamente , Varfarina/efeitos adversos , Absorciometria de Fóton/métodos , Anticoagulantes/administração & dosagem , Índice de Massa Corporal , Densidade Óssea/efeitos dos fármacos , Criança , Pré-Escolar , Progressão da Doença , Esquema de Medicação , Feminino , Hormônio do Crescimento Humano/deficiência , Humanos , Lactente , Estudos Longitudinais , Masculino , Osteoporose/fisiopatologia , Fraturas por Osteoporose/induzido quimicamente , Fraturas por Osteoporose/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , Varfarina/administração & dosagem
5.
Haemophilia ; 22(1): 126-33, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26634793

RESUMO

INTRODUCTION: Children at risk for bleeding injuries are restricted from body contact during physical activity but current recommendations are based on expert opinion. AIM: Evaluate high-speed digital video recording as an objective measure of body contact risk during physical activity. METHODS: Observational study of physical activities among healthy children, grouped according to participation in teams (vs. individual) and on their perceived risk of injury (high/low). High speed digital video recordings documented the collision target (floor/ground/ice, people, wall, equipment), estimated speed, and impact rates for team and individual activities, with and without expected body contact. RESULTS: Among 348 participating children (3-16 years, 51% female), 32% to 78% experienced at least one contact. Impact type varied significantly (chi-square, p < 0.001) by activity category. Unstructured and Team high risk activity impacts were primarily with the floor/ground, whereas Individual low risk activities were characterized by equipment impacts. Impact speeds were typically 1.0 to 2.1 m s(-1) . Higher impact speeds occurred during instructional classes (2.1 m s(-1) ), unstructured free swim (1.9 m s(-1) ) and ball hockey (1.7 m s(-1) ). Impact rates were higher during Team high risk and Team low risk sports (3.0 and 1.8 impacts per minute, respectively) compared to Individual (high or low risk) or Unstructured activities (0.2-0.3 impacts per minute). CONCLUSIONS: High speed video recordings of childhood physical activity are a feasible method for characterizing the frequency, type, direction and speed of impacts. Quantifying the impacts that occur during childhood physical activity could inform the guidelines for physical activity participation among children with identified bleeding risks.


Assuntos
Exercício Físico , Intenção , Gravação em Vídeo , Adolescente , Traumatismos em Atletas/etiologia , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Humanos , Masculino , Risco
6.
Int J Immunogenet ; 43(6): 376-382, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27528546

RESUMO

Inflammatory bowel disease consists of multifactorial diseases whose common manifestation is inflammation of the gastrointestinal tract and their pathogenesis remains unknown. This study aimed to analyse the gene polymorphisms in Brazilian patients with inflammatory bowel disease. A total of 101 patients diagnosed with inflammatory bowel disease were analysed for the tumour necrosis factor-alpha (-308 G/A; rs1800629) and interleukin-10 (-1082 G/A; rs1800896) gene polymorphisms. Genotyping was performed through polymerase chain reaction-sequence-specific primer, then fractionated on 2% agarose gel and visualized after staining by ethidium bromide. The anatomic-clinical form of Crohn's disease (CD) predominant was the inflammatory (32.75%), followed by fistulizing (29.31%) and 27.58% stricturing. As control group, a total of 136 healthy subjects, from the same geographical region, were enrolled. The statistical analyses were performed using R program. The frequency of the A allele at tumour necrosis factor-alpha was high in ulcerative colitis (UC) patients (51%) than in controls (22%; P > 0.01). No statistical difference was found with the genotypic and allelic frequencies of CD patients compared to controls (P = 0.54). The polymorphism -1082G/A of interleukin-10 was not statistical different between the diseases compared to controls. Tumour necrosis factor-alpha (TNF-α) (-308G/A) is associated with UC onset, suggesting that the presence of -308A allele could confer a relative risk of 3.62 more to develop UC in general population. Further studies, increasing the number of individuals, should be performed to ratify the role of TNF-α in the inflammatory bowel disease pathogenesis.


Assuntos
Colite Ulcerativa/genética , Doença de Crohn/genética , Estudos de Associação Genética , Doenças Inflamatórias Intestinais/genética , Fator de Necrose Tumoral alfa/genética , Adulto , Alelos , Colite Ulcerativa/patologia , Doença de Crohn/patologia , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Doenças Inflamatórias Intestinais/patologia , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Regiões Promotoras Genéticas
7.
Genet Mol Res ; 15(4)2016 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-27813554

RESUMO

Systemic lupus erythematosus (SLE) is a complex autoimmune disorder presenting heterogeneous clinical manifestations. A number of genes involved in SLE susceptibility are related to the type I interferon (IFN) pathway. IFN mediates innate immune responses and its increased levels contribute to the breakdown of peripheral tolerance. Interferon-induced helicase C domain 1 (IFIH1) activates and modulates IFN responses through its caspase recruitment domain. In this study, we analyzed four IFIH1 single nucleotide polymorphisms (SNPs): rs6432714, rs10930046, rs1990760, and rs3747517, in 337 patients with SLE and 373 healthy individuals from southeast and northeast Brazil. Our results did not find an association between IFIH1 SNPs and SLE (P value >0.025 after Bonferroni's adjustment). However, meta-analysis of peer-reviewed articles from 2008 to 2015 and data from this study indicated an association between rs1990760 and SLE onset (P < 0.05). This is the first association analysis on IFIH1 polymorphisms and SLE susceptibility in Brazilian populations.


Assuntos
Estudos de Associação Genética , Interferon Tipo I/genética , Helicase IFIH1 Induzida por Interferon/genética , Lúpus Eritematoso Sistêmico/genética , Brasil , Predisposição Genética para Doença , Humanos , Imunidade Inata/genética , Lúpus Eritematoso Sistêmico/patologia , Polimorfismo de Nucleotídeo Único , Transdução de Sinais
8.
Genet Mol Res ; 15(3)2016 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-27706606

RESUMO

Criminal traces commonly found at crime scenes may present mixtures from two or more individuals. The scene of the crime is important for the collection of various types of traces in order to find the perpetrator of the crime. Thus, we propose that hematophagous mosquitoes found at crime scenes can be used to perform genetic testing of human blood and aid in suspect investigation. The aim of the study was to obtain a single Aedes aegypti mosquito profile from a human DNA mixture containing genetic materials of four individuals. We also determined the effect of blood acquisition time by setting time intervals of 24, 48, and 72 h after the blood meal. STR loci and amelogenin were analyzed, and the results showed that human DNA profiles could be obtained from hematophagous mosquitos at 24 h following the blood meal. It is possible that hematophagous mosquitoes can be used as biological remains at the scene of the crime, and can be used to detect human DNA profiles of up to four individuals.


Assuntos
Aedes/química , Impressões Digitais de DNA/métodos , DNA/isolamento & purificação , Genética Forense/métodos , Aedes/fisiologia , Animais , Mordeduras e Picadas/sangue , Células Sanguíneas/química , Crime , DNA/genética , Feminino , Testes Genéticos/métodos , Voluntários Saudáveis , Humanos , Masculino , Repetições de Microssatélites
9.
Genet Mol Res ; 14(4): 17730-8, 2015 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-26782418

RESUMO

Type 1 diabetes mellitus (T1D) is an organ-specific autoimmune disease characterized by T-cell mediated self-destruction of insulin-producing ß cells in the pancreas. T1D patients are prone to develop other glandular autoimmune disorders, such as autoimmune thyroid disease that occurs simultaneously with autoimmune polyglandular syndrome type III (APSIII). Signal transducer and activator of transcription 4 (STAT4) is a well-known regulator of proinflammatory cytokines, and interferon-induced with helicase C domain 1 (IFIH1) is activated in the interferon type I response. Both genes have been examined separately in autoimmune diseases and, in this study, we assessed their joint role in T1D and APSIII. We conducted a case-control study, enrolling 173 T1D patients and 191 healthy controls from northeastern Brazil, to assess the distribution of the rs7574865 and rs3024839 SNPs in STAT4 and the rs3747517 and rs1990760 SNPs in IFIH1 in T1D and APSIII patients. Additionally, we conducted a meta-analysis with the rs7574865 SNP in STAT4 (1392 T1D patients and 1629 controls) and the rs1990760 SNP in IFIH1 (25092 T1D patients and 28544 controls) to examine their association with T1D. Distribution of STAT4 and IFIH1 allelic frequencies did not show statistically significant differences between T1D patients and controls in our study population; however, the meta-analysis indicated that SNPs in STAT4 and IFIH1 are associated with T1D worldwide. Our findings indicate that although STAT4 and IFIH1 SNPs are not associated with T1D in a Brazilian population, they might play a role in susceptibility to T1D on a larger worldwide scale.


Assuntos
RNA Helicases DEAD-box/genética , Diabetes Mellitus Tipo 1/genética , Poliendocrinopatias Autoimunes/genética , Fator de Transcrição STAT4/genética , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/patologia , Feminino , Estudos de Associação Genética , Predisposição Genética para Doença , Humanos , Lactente , Recém-Nascido , Células Secretoras de Insulina/metabolismo , Células Secretoras de Insulina/patologia , Helicase IFIH1 Induzida por Interferon , Masculino , Pessoa de Meia-Idade , Poliendocrinopatias Autoimunes/complicações , Poliendocrinopatias Autoimunes/patologia , Polimorfismo de Nucleotídeo Único , Transdução de Sinais/genética
10.
Genet Mol Res ; 14(4): 18936-44, 2015 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-26782543

RESUMO

Type 1 diabetes mellitus (T1D) is a complex disorder characterized by an autoimmune response against human pancreatic beta-cells. Patients with T1D can also develop a response toward one or more other factors, such as in autoimmune thyroiditis (AITD) and celiac disease (CD). In the presence of T1D + AITD, the patient is diagnosed with autoimmune polyglandular syndrome type III (APSIII); patients with APSIII may also present with CD. These diseases have a strong genetic component and share many susceptibility genes, suggesting potentially overlapping pathogenic pathways. Polymorphisms in the TNF-α(rs1800629), CTLA-4 (rs231775), and PTPN22 (rs2476601) genes have been previous associated with T1D; however, there is no consensus regarding their role in T1D and scarce literature focusing on AIDT and/or CD. Thus, we analyzed these genetic variants in 205 Northeast Brazilian patients with T1D and with/without AITD and/or CD, and in 308 healthy controls. The PTPN22 gene variants were associated with T1D susceptibility and APSIII [odds ratio (OR) = 2.57 and 2.77, respectively]. CTLA4 rs231775 and TNF-αrs1800629 were not associated with T1D onset in the Brazilian population. However, when comparing APSIII individuals in the T1D only group, we observed an association of the TNF-αSNP in the allelic (P = 0.0442; OR = 0.44) and dominant models (P = 0.0387; OR = 0.40). This study reinforces the importance of CTLA-4 and other variants in unraveling the pathogenic mechanisms of T1D in different populations and in understanding their relationships with the development of other T1D-related autoimmune diseases.


Assuntos
Antígeno CTLA-4/genética , Diabetes Mellitus Tipo 1/genética , Proteína Tirosina Fosfatase não Receptora Tipo 22/genética , Fator de Necrose Tumoral alfa/genética , Adolescente , Adulto , Idade de Início , Brasil , Criança , Estudos de Associação Genética , Predisposição Genética para Doença , Humanos , Polimorfismo de Nucleotídeo Único , Análise de Sequência de DNA , Adulto Jovem
11.
Genet Mol Res ; 14(1): 29-33, 2015 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-25729932

RESUMO

The aim of this study was to perform an association study between seven Fyn-binding protein gene (FYB)-tag single nucleotide polymorphisms (SNPs) and type I diabetes mellitus (T1DM), as well as with disease age of onset. We also assessed the role of FYB SNPs in the insurgence of autoimmune polyglandular syndrome type III (APSIII), characterized by the simultaneous presence of autoimmune thyroid disease and celiac disease, in patients with T1DM from a Northeastern Brazilian population. One hundred and seventy-seven patients with T1DM and 190 healthy individuals were genotyped for seven tag SNPs, covering most of the FYB locus, using real-time polymerase chain reaction amplification. There was no significant difference in the distribution of allele and genotype frequencies among patients and healthy individuals. Moreover, none of the tag SNPs were associated either to T1DM age of onset or to the insurgence of APSIII. However, since the FYB protein is a key component in T cell response, its gene variants might play a role in protein function, which might be testable in a population with different genetic backgrounds or by using functional assays.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/genética , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/genética , Predisposição Genética para Doença , Poliendocrinopatias Autoimunes/complicações , Poliendocrinopatias Autoimunes/genética , Polimorfismo de Nucleotídeo Único/genética , Adolescente , Brasil , Estudos de Casos e Controles , Feminino , Frequência do Gene , Humanos , Masculino
12.
Genet Mol Res ; 14(1): 2876-84, 2015 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-25867437

RESUMO

Genetic association studies determine how genes influence traits. However, non-detected population substructure may bias the analysis, resulting in spurious results. One method to detect substructure is to genotype ancestry informative markers (AIMs) besides the candidate variants, quantifying how much ancestral populations contribute to the samples' genetic background. The present study aimed to use a minimum quantity of markers, while retaining full potential to estimate ancestries. We tested the feasibility of a subset of the 12 most informative markers from a previously established study to estimate influence from three ancestral populations: European, African and Amerindian. The results showed that in a sample with a diverse ethnicity (N = 822) derived from 1000 Genomes database, the 12 AIMs had the same capacity to estimate ancestries when compared to the original set of 128 AIMs, since estimates from the two panels were closely correlated. Thus, these 12 SNPs were used to estimate ancestry in a new sample (N = 192) from an admixed population in Recife, Northeast Brazil. The ancestry estimates from Recife subjects were in accordance with previous studies, showing that Northeastern Brazilian populations show great influence from European ancestry (59.7%), followed by African (23.0%) and Amerindian (17.3%) ancestries. Ethnicity self-classification according to skin-color was confirmed to be a poor indicator of population substructure in Brazilians, since ancestry estimates overlapped between classifications. Thus, our streamlined panel of 12 markers may substitute panels with more markers, while retaining the capacity to control for population substructure and admixture, thereby reducing sample processing time.


Assuntos
Indígena Americano ou Nativo do Alasca/genética , População Negra/genética , Polimorfismo de Nucleotídeo Único , População Branca/genética , Indígena Americano ou Nativo do Alasca/etnologia , Indígena Americano ou Nativo do Alasca/estatística & dados numéricos , População Negra/etnologia , População Negra/estatística & dados numéricos , Brasil , Feminino , Frequência do Gene , Genética Populacional/métodos , Genética Populacional/estatística & dados numéricos , Genótipo , Humanos , Masculino , População Branca/etnologia , População Branca/estatística & dados numéricos
13.
S Afr J Surg ; 53(3 and 4): 45-47, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28240483

RESUMO

BACKGROUND: The parotid tissue can give rise to a large variety of benign and malignant neoplasms. The objective of this study was to describe the management and outcome of parotid gland tumours over a 15-year period. METHOD: The records of consecutive patients treated by parotid gland excision from January 1995 to December 2008 were reviewed retrospectively. Data recorded were age, gender, history, physical findings, surgical procedure, fine-needle aspiration biopsy (FNAB), final pathological diagnosis and complications. RESULTS: The vast majority of patients (306) had benign neoplasms, and 14 patients had malignant neoplasms. Overall, pleomorphic adenoma contributed to 76% of the lesions, and Warthin's tumour to 17%. The sensitivity and specificity of FNAB was 79% and 100%, respectively. There were 15 cases of marginal mandibular transitory paresis and 12 cases of seroma. Marginal mandibular definitive paralysis was observed in three cases with malignant tumour. CONCLUSION: Standardised parotidectomy is a safe operation, with a low complication rate.

14.
Klin Monbl Augenheilkd ; 231(4): 348-50, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24771165

RESUMO

PURPOSE: Canaloplasty is a safe and effective alternative in glaucoma surgery, avoiding the risk for hypotony and bleb-related complications. Two cases of hemorrhagic Descemet membrane detachment (DMD) after canaloplasty are reported in patients who did not have previous surgery. RESULTS: Two patients with primary open-angle glaucoma underwent canaloplasty because of medically uncontrolled intraocular pressure (IOP). Canaloplasty was performed using a flexible microcatheter, viscoelastic material and a tensioning suture. The day after surgery, hemorrhagic DMD was observed in the inferior quadrants in both patients on slit-lamp biomicroscopy. THERAPY: For the size and location (occlusion of the visual axis), aspiration of blood and descemetopexy with air tamponade were performed promptly. In both cases, a small translucent scar remained. CONCLUSIONS: Circumferential cannulation and viscodilation of the Schlemm canal increases the risk for DMD, which may be aggravated by blood reflux resulting from the tensioning suture and low postoperative IOP. Surgeons should be aware of this specific and potentially sight-threatening complication in classic canaloplasty. Immediate intervention is recommended for good visual prognosis.


Assuntos
Lâmina Limitante Posterior/lesões , Lâmina Limitante Posterior/cirurgia , Hemorragia Ocular/etiologia , Hemorragia Ocular/cirurgia , Cirurgia Filtrante/efeitos adversos , Glaucoma/complicações , Glaucoma/cirurgia , Idoso , Hemorragia Ocular/diagnóstico , Glaucoma/diagnóstico , Humanos , Masculino , Resultado do Tratamento
15.
Haemophilia ; 19(6): 861-5, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23786255

RESUMO

Health-related quality of life (HRQoL) is an important outcome from the perspective of boys with haemophilia and their parents. Few studies have captured the HRQoL of boys with haemophilia in developing countries. This article reports on the cross-cultural adaptation of the Canadian Haemophilia Outcomes - Kids Life Assessment Tool (CHO-KLAT) for use in São Paulo, Brazil. The CHO-KLAT(2.0) was translated into Portuguese, and then translated back into English. The original English and back-translation versions were compared by a group of three clinicians, whose first language was Portuguese. The resulting Portuguese version was assessed through a series of cognitive debriefing interviews with children and their parents. This process identified concepts that were not clear and revised items to ensure appropriate understanding through an iterative process. The initial back-translation was not discrepant from the original English version. We made changes to 66% of the CHO-KLAT(2.0) items based on clinical expert review and 26% of the items based on cognitive debriefings. In addition, two new items were added to the final Portuguese version to reflect the local cultural context. The final result had good face validity. This process was found to be extremely valuable in ensuring the items were accurately interpreted by the boys/parents in São Paulo Brazil. The results suggest that professional translators, clinical experts and cognitive debriefing are all required to achieve a culturally appropriate instrument. The Portuguese CHO-KLAT(2.0) is well understood by Sao Paulo boys/parents. The next step will be to test its validity and reliability locally.


Assuntos
Hemofilia A/psicologia , Hemofilia B/psicologia , Qualidade de Vida , Adolescente , Brasil , Criança , Humanos , Entrevistas como Assunto , Masculino , Apoio Social , Inquéritos e Questionários , Tradução
16.
Haemophilia ; 19(6): 866-9, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23786300

RESUMO

Psychosocial outcomes are important in the perspective of boys with haemophilia. However, health-related quality of life (HRQoL) is based on self-report, and assumes adequate literacy. Yet, literacy is rarely assessed prior to data collection. This study sought to identify criteria that might indicate the level of literacy of children being recruited for clinical trials and to develop a simple method to prescreen those whose literacy was uncertain. We developed a brief screening tool in the form of two stories, at a grade 3 reading level, followed by comprehension questions. We applied the screening test to a sample of haemophilic boys between the ages of 7 and 13 years to assess their literacy. The data were analysed to determine the best criteria to use in identifying the ability to independently self-report for HRQoL studies. Twenty-four Brazilian boys (7.9-12.8) completed the testing. The results showed that 17 (70.8%) were literate (were able to both read and comprehend), and could complete a questionnaire without assistance. All boys over 11.0 years of age were sufficiently literate. Grade level was not found to be a helpful criterion. We recommend that all children under the age of 11.0 years be prescreened before providing self-reported HRQoL data. Those with limited literacy should be provided assistance to ensure comprehension of the questions. This is important to ensure high-quality data on HRQoL for future clinical trials.


Assuntos
Hemofilia A/psicologia , Hemofilia B/psicologia , Qualidade de Vida , Adolescente , Brasil , Criança , Escolaridade , Nível de Saúde , Humanos , Masculino , Inquéritos e Questionários
17.
Genet Mol Res ; 12(2): 1603-20, 2013 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-23765967

RESUMO

Our objective was to establish a minimum number of morphological descriptors for the characterization of banana germplasm and evaluate the efficiency of removal of redundant characters, based on univariate and multivariate statistical analyses. Phenotypic characterization was made of 77 accessions from Bahia, Brazil, using 92 descriptors. The selection of the descriptors was carried out by principal components analysis (quantitative) and by entropy (multi-category). Efficiency of elimination was analyzed by a comparative study between the clusters formed, taking into consideration all 92 descriptors and smaller groups. The selected descriptors were analyzed with the Ward-MLM procedure and a combined matrix formed by the Gower algorithm. We were able to reduce the number of descriptors used for characterizing the banana germplasm (42%). The correlation between the matrices considering the 92 descriptors and the selected ones was 0.82, showing that the reduction in the number of descriptors did not influence estimation of genetic variability between the banana accessions. We conclude that removing these descriptors caused no loss of information, considering the groups formed from pre-established criteria, including subgroup/subspecies.


Assuntos
Ecótipo , Musa/genética , Agricultura , Algoritmos , Entropia , Variação Genética , Análise Multivariada , Musa/anatomia & histologia , Fenótipo , Análise de Componente Principal , Sementes/crescimento & desenvolvimento
18.
Lupus ; 21(4): 445-8, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21997967

RESUMO

Protein-losing enteropathy is a rare manifestation of systemic lupus erythematosus. We report the case of an 18-year-old woman that presented initially with diarrhoea and anasarca. During evaluation, there was low serum albumin of 1.6 g/dl (3.5-5.2 g/dl) and a positive antinuclear antibody test (1:2560). Anti-Sm antibodies (ELISA) were positive in addition to low serum C3 of 35 mg/dl. A scintigraphy using 99mTc-labelled albumin was positive for abdominal protein loss. A diagnosis of systemic lupus erythematosus related protein-losing enteropathy was made. She was started on prednisolone 40 mg/day without amelioration; a month later, azathioprine (100 mg/day) was added, leading to normalization of serum albumin and resolution of symptoms within 4 months. After 1.5 years, the patient developed a 2.9 g 24-h proteinuria while still in remission of the protein-losing enteropathy, receiving 5 mg prednisone and 100 mg azathioprine daily.


Assuntos
Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Enteropatias Perdedoras de Proteínas/diagnóstico , Enteropatias Perdedoras de Proteínas/etiologia , Adolescente , Anticorpos Antinucleares/sangue , Azatioprina/uso terapêutico , Biomarcadores/sangue , Complemento C3/análise , Diarreia/etiologia , Quimioterapia Combinada , Edema/etiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Hipoalbuminemia/etiologia , Imunossupressores/uso terapêutico , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Nefrite Lúpica/etiologia , Prednisolona/uso terapêutico , Prednisona/uso terapêutico , Enteropatias Perdedoras de Proteínas/sangue , Enteropatias Perdedoras de Proteínas/tratamento farmacológico , Proteinúria/etiologia , Albumina Sérica/análise , Fatores de Tempo , Resultado do Tratamento
19.
Lupus ; 21(6): 625-31, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22323338

RESUMO

Systemic lupus erythematosus (SLE) is an autoimmune disease that results in inflammation and tissue damage. The etiology of SLE remains unknown, but recent studies have shown that the innate immune system may have a role in SLE pathogenesis through the secretion of small cationic peptides named defensins. The aim of the study was to determine the possible involvement in SLE of three functional single nucleotide polymorphisms (SNPs) (c.-52G>A, c.-44C>G and c.-20G>A) in the 5'UTR region of DEFB1 gene, by analyzing them in a population of 139 SLE patients and 288 healthy controls. The c.-52G>A SNP showed significant differences in allele and genotype frequency distribution between SLE patients and controls (p = 0.01 and p = 0.02 respectively) indicating protection against SLE (A allele, OR = 0.68, AA genotype OR = 0.51). Significant differences were also observed for c.-44C>G SNP, the C/G genotype being associated with susceptibility to SLE (OR = 1.60, p = 0.04). Moreover, statistically significant differences between patients and controls were found for two DEFB1 haplotypes (GCA and GGG, p = 0.01 and p = 0.02 respectively). When considering DEFB1 SNPs and SLE clinical and laboratory manifestations, significant association was found with neuropsychiatric disorders, immunological alterations and anti-DNA antibodies. In conclusion, our results evidence a possible role for the c.-52G>A and c.-44C>G DEFB1 polymorphisms in SLE pathogenesis, that can be considered as possible risk factors for development of disease and disease-related clinical manifestations. Additional studies are needed, to corroborate these results as well as functional studies to understand the biological role of these SNPs in the pathogenesis of SLE.


Assuntos
Lúpus Eritematoso Sistêmico/etnologia , Lúpus Eritematoso Sistêmico/genética , Polimorfismo de Nucleotídeo Único/genética , beta-Defensinas/genética , Adolescente , Adulto , Idoso , Brasil , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença/etnologia , Predisposição Genética para Doença/genética , Genótipo , Haplótipos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
20.
Int J Immunogenet ; 39(1): 32-8, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22035380

RESUMO

Mannose-binding lectin (MBL) is a protein able to bind to carbohydrate patterns on pathogen membranes; upon MBL binding, its' associated serine protease MBL-associated serine protease type 2 (MASP2) is autoactivated, promoting the activation of complement via the lectin pathway. For both MBL2 and MASP2 genes, the frequencies of polymorphisms are extremely variable between different ethnicities, and this aspect has to be carefully considered when performing genetic studies. While polymorphisms in the MBL-encoding gene (MBL2) have been associated, depending upon ethnicity, with several diseases in different populations, little is known about the distribution of MASP2 gene polymorphisms in human populations. The aim of our study was thus to determine the frequencies of MBL2 (exon 1 and promoter) and MASP2 (p.D371Y) polymorphisms in a Brazilian population from Rio de Janeiro. A total of 294 blood donor samples were genotyped for 27 polymorphisms in the MBL2 gene by direct sequencing of a region spanning from the promoter polymorphism H/L rs11003125 to the rs1800451 polymorphism (at codon 57 in the first exon of the gene). Genotyping for MASP2 p.D371Y was carried out using fluorogenic probes. To our knowledge, this is the first study reporting the prevalence of the MASP2 p.D371Y polymorphism in a Brazilian population. The C allele frequency 39% is something intermediate between the reported 14% in Europeans and 90% in Sub-Saharan Africans. MBL2 polymorphisms frequencies were quite comparable to those previously reported for admixed Brazilians. Both MBL2 and MASP2 polymorphisms frequencies reported in our study for the admixed Brazilian population are somehow intermediate between those reported in Europeans and Africans, reflecting the ethnic composition of the southern Brazilian population, estimated to derive from an admixture of Caucasian (31%), African (34%) and Native American (33%) populations. In conclusion, our population genetic study describes the frequencies of MBL2 and MASP2 functional SNPs in a population from Rio de Janeiro, with the aim of adding new information concerning the distribution of these SNPs in a previously unanalysed Brazilian population, thus providing a new genetic tool for the evaluation of the association of MBL2 and MASP2 functional SNPs with diseases in Brazil, with particular emphasis on the state of Rio de Janeiro.


Assuntos
Genética Populacional , Lectina de Ligação a Manose/genética , Serina Proteases Associadas a Proteína de Ligação a Manose/genética , Polimorfismo de Nucleotídeo Único , Adolescente , Adulto , Brasil/etnologia , Etnicidade , Éxons , Feminino , Corantes Fluorescentes/metabolismo , Frequência do Gene , Genoma Humano , Projeto HapMap , Humanos , Masculino , Lectina de Ligação a Manose/metabolismo , Serina Proteases Associadas a Proteína de Ligação a Manose/metabolismo , Pessoa de Meia-Idade , Regiões Promotoras Genéticas , Análise de Sequência de DNA/métodos , Adulto Jovem
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