Avaliação de dois testes sorológicos comerciais para diagnóstico das infecções pelo FIV e pelo FeLV / Evaluation of two point-of-care tests to diagnosis of FIV and FeLV infections

FIV e FeLV são retrovírus associados principalmente com neoplasias. Dois testes rápidos são disponibilizados no Brasil para o diagnóstico dessas infecções: um kit de imunocromatografia de fluxo bidirecional (SNAP® Combo IDEXX) e um kit de imunocromatografia de fluxo lateral unidirecional (ALERE/BIONOTE Anigen Rapid). O objetivo deste estudo foi comparar o teste SNAP® com o teste ALERE. Amostras de sangue de 178 gatos foram testadas utilizando-se ambos os kits. A reação em cadeia de polimerase em tempo real (qPCR) foi empregada como método confirmatório para todos os resultados. O teste SNAP® apresentou sensibilidade e especificidade de 100% para FIV; a sensibilidade e a especificidade do teste ALERE foram de 96,15% e 98,68%, respectivamente. A sensibilidade e a especificidade para o FeLV foram de 93,02% e 96,30% para o teste SNAP® e de 90,70% e 97,78% para o teste ALERE. Ainda em relação ao FeLV, três amostras com resultado positivo na qPCR obtiveram resultado falso-negativo em ambos os testes. Não houve diferença estatisticamente significante entre os métodos. Considerando a qPCR como padrão-ouro, o teste SNAP® apresentou maior sensibilidade e especificidade para o FIV, e o teste ALERE apresentou maior especificidade para o FeLV. Os resultados mostraram uma boa correlação entre os testes.(AU)

FIV and FeLV are Retrovirus associated mainly with feline neoplasms. Two point-of-care tests are commercially available in Brazil for diagnosis of these infections: a bidirectional flow immunochromatography kit (IDEXX SNAP ® Combo) and a lateral unidirectional flow immunochromatography kit (ALERE/BIONOTE Anigen Rapid). The aim of this study was to compare SNAP ® and ALERE tests. Blood samples obtained from 178 cats were evaluated using both tests. Quantitative real-time polymerase chain reaction (qPCR) was used as confirmatory test for all samples. The sensitivity and specificity of SNAP ® test was 100% for FIV, and for ALERE test was 96.15% and 98.68%, respectively. The sensitivity and specificity for FeLV was 93.02% and 96.30% for SNAP ® test and 90.70% and 97.78% for ALERE test. Three samples with a qPCR positive result for FeLV obtained a false negative result in both SNAP ® and ALERE tests. There was no statistically significant difference between the two methods. Considering qPCR as gold standard method, the SNAP® test showed higher sensitivity and specificity for FIV, and the ALERE test presented higher specificity for FeLV. The results showed good agreement among the tests.(AU)

Examining the accumulated oxygen deficit method in front crawl swimming.

The present study investigated the Accumulated Oxygen Deficit (AOD) method in front crawl swimming with the aims to assess the robustness of the oxygen uptake/swimming velocity regression line and to quantify the precision of the AOD. Twenty-nine male swimmers performed two swimming tests in different days, with a 24 h recovery between tests: a graded test and an all-out test. The all-out test was performed either in 100 m (n=11), 200 m (n=13) or 400 m (n=5). Through all testing expired gases were collected breath by breath and analysed with a K4b2 Gas Analyser (Cosmed, Rome, Italy) connected to an AquaTrainer Valve (Cosmed, Rome, Italy). The error of oxygen uptake/swimming velocity regression lines was approximately 4-5 ml x kg (-1) x min (-1)) and the regressions allowed an extrapolation of the energy cost to higher intensities with a standard error of prediction of approximately 3-4 ml x kg (-1) x min (-1). However, the data variability was considerable (95% confidence intervals of the linear extrapolation larger than 13 ml x kg (-1) x min (-1)). The AOD imprecision varied among the three distance events from approximately 3-13 ml x kg (-1). These absolute errors are small, considering the time that subjects took to cover the three distances, but relative to the AOD values that were estimated they can be considered high, especially in the 400 m bout.

Possible mechanisms of late-life-onset allergic diseases and asthma in the senior citizen.

The clinical spectrum of allergic diseases and asthma changes over the life span of the individual and is influenced by a wide variety of anatomic, physiologic, and immunologic factors. Nowhere do these changes play a more important role than in the elderly patient with allergic disease or asthma where the culmination of these events contribute to disease expression, which at times can result in irreversible endstage disease. It is estimated that between 2010 and 2030 the elderly population will increase by 75% and will represent a significant proportion of consumers of total health care resources. This presentation will examine possible mechanism(s) that contribute to the development of late-onset allergic diseases and asthma in the elderly as a possible basis for identification of antecedents of endstage disease and interventive strategies for the prevention of the irreversible consequences in this population.

Persistent cough: differential diagnosis.

Cough may be defined as a physiologic response to foreign or noxious substances that enter or irritate the respiratory tract. It is the fifth most common symptom complex for which patients seek medical care and which results in more than 30 million office visits per year. When cough is present for more than three weeks it is referred to as chronic or persistent cough. This presentation will examine the differential diagnosis of persistent cough together with a description of the autonomic innervation of the human airways, mechanism(s) of cough, and approach to the patient.

Study of the effects of vacuuming on the concentration of dust mite antigen and endotoxin.

BACKGROUND: Dust mite antigens are major sources of allergens in house dust and together with endotoxin, a proinflammatory component of gram negative bacteria also found in house dust, are important causes of tissue injury involved in the pathogenesis and severity of allergic diseases, eg, asthma. OBJECTIVE: To determine the effectiveness of vacuuming in reducing the quantity of dust mite antigens, Dermatophagoides pteronyssinus (Der p and Der p2) and endotoxin using a quantitative ELISA assay and to correlate results with those obtained using a qualitative rapid dipstick method for Der p2. METHODS: Four specimens of house dust were collected using a Kirby Model G5 vacuum cleaner with a Micron Magic Filtration system from an approximately 54" x 18" standardized area of rug from each of 20 homes at 4 time intervals over a 6-week period, ie, a baseline specimen #1 at 0 week; specimen #2 at 1 week; specimen #3 at 5 weeks (1 month after specimen #2); specimen #4 at 6 weeks (1 week after specimen #3). Three intervals were compared, ie, period 1-2 (1 week), period 2-3 (1 month), and period 3 to 4 (1 week). The concentrations of Der p1 and Der p2 were determined in dust samples using a standard ELISA assay and the concentration of endotoxin was detected using a limulus amebocyte lysate assay. Concentrations of Der p2, determined by the standard ELISA assay, were compared to those in the same samples determined by a rapid dipstick method. RESULTS: A wide range of values for total weight of unprocessed dust (0.3 to 59 g, X = 8.7) and finely sieved dust (0.1 to 19 g, X = 3) from all specimens were found. In finely sieved dust specimens the mean concentrations of Der p1, Der p2 and endotoxin were 775, 1310, and 3836 ng/g of dust, respectively. Following weekly vacuuming there was an increase in concentration of Der p1, Der p2, and endotoxin in 20%, 35%, and 63% of the houses, respectively, compared to in monthly vacuuming in which increases were seen in 65%, 50%, and 63% of the houses, respectively. In contrast, there was a decrease in concentration of Der p1, Der p2 and endotoxin with weekly vacuuming in 43%, 60%, and 37% of the houses respectively versus in monthly vacuuming in 15%, 35%, and 37% of the houses respectively. A correlation coefficient of 0.7 was found for the concentration of Der p2 in 37/40 samples tested detected using the ELISA method compared with rapid dipstick assay. CONCLUSION: The results of this study support the effectiveness of vacuuming on the reduction of dust mite antigens (Der p1 and Der p2) ie, Der p2 > Der p1. This reduction was more pronounced with weekly compared with monthly vacuuming. No reduction in the concentration of endotoxin was found. A good correlation was found between results obtained by ELISA and rapid dipstick assay for Der p2.

Therapeutic perspectives in food allergy.

The therapeutic perspectives in food allergy are thus based upon known principles and mechanisms of tissue injury mediated by immunologic reactions. A thorough knowledge of these, together with new approaches to the identification, elimination, and modification of these reactions, is essential in the management of the patient with food allergy.