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1.
Mem Inst Oswaldo Cruz ; 107(6): 813-5, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22990973

RESUMEN

Coccidioidomycosis is a systemic mycosis with a variable clinical presentation. Misdiagnosis of coccidioidomycosis as bacterial pneumopathy leads to inappropriate prescription of antibiotics and delayed diagnosis. This report describes an outbreak among armadillo hunters in northeastern Brazil in which an initial diagnosis of bacterial pneumonia was later confirmed as coccidioidomycosis caused by Coccidioides posadasii. Thus, this mycosis should be considered as an alternative diagnosis in patients reporting symptoms of pneumonia, even if these symptoms are only presented for a short period, who are from areas considered endemic for this disease.


Asunto(s)
Armadillos/microbiología , Coccidioidomicosis/diagnóstico , Enfermedades Pulmonares Fúngicas/diagnóstico , Neumonía Bacteriana/diagnóstico , Neumonía/diagnóstico , Adolescente , Animales , Brasil/epidemiología , Coccidioides/aislamiento & purificación , Coccidioidomicosis/epidemiología , Brotes de Enfermedades , Humanos , Enfermedades Pulmonares Fúngicas/epidemiología , Masculino , Persona de Mediana Edad , Neumonía/epidemiología , Neumonía Bacteriana/tratamiento farmacológico , Microbiología del Suelo
2.
Nat Prod Res ; 36(18): 4740-4745, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34812686

RESUMEN

This study aims to evaluate the wound healing potential of lectin isolated from the seeds of Centrolobium microchaete (Mart. ex Benth) (CML) on cutaneous wounds in mice. CML did not show cytotoxicity on murine dermal fibroblasts (L929 cell line). The wounds treated with CML (200 µg/mL) showed a decrease in area within 12 days post-operative (P.O.) when compared to control. On 3rd and 7th day P.O., the CML-treated group exhibited fibroblast proliferation and neovascularization. On 12th day P.O., complete restructuring of the epithelial layer and connective tissue was observed in the CML-treated group, whereas control groups exhibited incomplete reepithelialization. CML treatment enhanced the wound closure via the wound contraction process, resulting in the restructuring of the skin layers on 12th day P.O. In conclusion, CML induced a fast and efficient wound healing, suggesting that it can be used as a promising therapeutic tool to heal acute wounds.


Asunto(s)
Fabaceae , Lectinas , Animales , Lectinas/farmacología , Ratones , Semillas , Piel , Cicatrización de Heridas
3.
Acta Trop ; 224: 106154, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34599890

RESUMEN

Chagas Disease (CD) is a neglected illness whose immunopathological mechanisms have not yet been plainly elucidated. The asymptomatic (indeterminate) form of CD is a long-term condition and approximately 20% to 35% of the individuals with this form evolve into one of the three chronic symptomatic clinical forms of CD, namely: cardiac, digestive or cardio-digestive (mixed). A variant of blood monocytes characterized by low expression of the HLA-DR antigen (CD14+/HLA-DRlow/‒) constitutes a subtype of myeloid-derived suppressor cells (MDSCs) whose main function is to regulate exacerbated inflammatory processes. The development of the symptomatic forms of CD can be related to the interaction between the host's immune system and the CD14+/HLA-DRlow/‒ immunosuppressive monocytes. Here, we evaluated, by flow cytometry, the absolute number and the HLA-DR antigenic density of this population of MDSCs in 57 patients with the diagnosis of CD: 34 with the symptomatic clinical forms (26 cardiac and 8 mixed) and 23 with the asymptomatic (indeterminate) form. The asymptomatic form exhibited a greater number of CD14+/HLA-DRlow/‒ monocytes and, accordingly, a low HLA-DR antigenic density, when compared to the symptomatic forms. It is possible to speculate that the predominance of CD14+/HLA-DRlow/- monocytes in the patients with the asymptomatic (indeterminate) form might have been a factor that could delay or even prevent the evolution of the asymptomatic form to the symptomatic forms of Chagas Disease.


Asunto(s)
Enfermedad de Chagas , Monocitos , Citometría de Flujo , Antígenos HLA-DR , Humanos , Receptores de Lipopolisacáridos
5.
Rev Inst Med Trop Sao Paulo ; 57(2): 145-52, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25923894

RESUMEN

By controlling the transmission of Chagas disease, the challenge of providing assistance to millions of infected patients that reach old age arises. In this study, the socioeconomic, demographic and comorbidity records of all elderly chagasic patients followed at the Pharmaceutical Care Service of the Chagas Disease Research Laboratory were assessed. The information related to the clinical form of the disease was obtained from medical records provided by the Walter Cantídio University Hospital. The profile of the studied population was: women (50.5%); mean age of 67 years; retired (54.6%); married (51.6 %); high illiteracy rate (40.2%); and family income equal to the minimum wage (51.5%). The predominant clinical forms of Chagas disease were cardiac (65.3%) and indeterminate (14.7%). The main electrocardiographic changes were the right bundle branch block (41.0%), associated or not with the anterosuperior left bundle branch block (27.4%). The average number of comorbidities per patient was 2.23 ± 1.54, with systemic arterial hypertension being the main one found (67.0%). It was found that the elderly comprise a vulnerable group of patients that associate aging with cardiac and/or digestive disorders resulting from the evolution of Chagas disease and other comorbidities, which requires special attention from health services to ensure more appropriate medical and social care.


Asunto(s)
Enfermedad de Chagas/epidemiología , Servicios Farmacéuticos , Anciano , Brasil/epidemiología , Enfermedad Crónica , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos
6.
Rev Soc Bras Med Trop ; 47(6): 770-4, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25626657

RESUMEN

INTRODUCTION: Schistosomiasis is endemic in 76 countries and territories. Several studies have found an inverse correlation between parasitic disease and the development of allergies. The purpose of the present study was to determine whether infection with Schistosoma mansoni in subjects with a low parasite load is protective against allergy. The final sample consisted of 39 S. mansoni-positive and 52 S. mansoni-negative residents of a small community in northeastern Brazil. METHODS: All subjects were submitted to the Kato-Katz test, anti-S. mansoni IgG measurement, the prick test for aeroallergens, eosinophil counts and serum IgE measurement. RESULTS: Subjects who reacted to one or more antigens in the prick test were considered allergic. Only 7 S. mansoni-positive subjects (17.9%) reacted to one or more antigens, whereas 20 S. mansoni-negative subjects (38.5%) tested positive for allergy. CONCLUSIONS: Our findings suggest that, in areas of low endemicity, infection with S. mansoni significantly reduces the risk of the development of allergy in subjects with a low parasite load.


Asunto(s)
Alérgenos/inmunología , Anticuerpos Antihelmínticos/sangre , Antígenos Helmínticos/inmunología , Hipersensibilidad Inmediata/inmunología , Schistosoma mansoni/inmunología , Esquistosomiasis mansoni/inmunología , Animales , Brasil/epidemiología , Estudios de Casos y Controles , Heces/parasitología , Humanos , Inmunoglobulina E , Recuento de Huevos de Parásitos , Esquistosomiasis mansoni/epidemiología , Pruebas Cutáneas
8.
Rev Soc Bras Med Trop ; 45(4): 510-3, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22930048

RESUMEN

INTRODUCTION: The laboratory diagnosis of schistosomiasis is based mainly on the detection of parasite eggs in stool samples through the Kato-Katz (KK) technique, reading one slide by test. However, a widely known limitation of parasitological methods is reduced sensitivity, particularly in low endemic areas. METHODS: To increase sensitivity, we conducted further slide readings from the same stool sample using the parasitological method associated with a serological test. We used the KK method (three slides) and the IgG anti-Schistosoma mansoni-enzyme-linked immunosorbent assay (ELISA) technique to diagnose schistosomiasis in low endemic areas in the Brazilian State of Ceará. Fecal samples and sera from 250 individuals were analyzed. RESULTS: Sixteen percent and 47.2% of samples were positive in parasitological tests and serological tests, respectively. Parasitological methods showed that 32 (80%) individuals tested positive on the first slide, 6 (15%) on the second slide, and 2 (5%) on the third. The performance of the ELISA test in the diagnosis, using the KK method as diagnostic reference, showed a negative predictive value of 100%, with specificity and positive predictive values of 62.8% and 33.9%, respectively. CONCLUSIONS: In this study, the increase from one to three slides analyzed per sample using the KK technique was shown to be a useful procedure for increasing the diagnostic sensitivity of this technique.


Asunto(s)
Anticuerpos Antihelmínticos/sangre , Heces/parasitología , Inmunoglobulina G/sangre , Schistosoma mansoni/aislamiento & purificación , Esquistosomiasis mansoni/diagnóstico , Adulto , Animales , Brasil/epidemiología , Estudios Transversales , Ensayo de Inmunoadsorción Enzimática/métodos , Femenino , Humanos , Masculino , Recuento de Huevos de Parásitos/métodos , Schistosoma mansoni/inmunología , Esquistosomiasis mansoni/epidemiología , Sensibilidad y Especificidad
9.
Acta Trop ; 120 Suppl 1: S138-41, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20522322

RESUMEN

Considering the decrease of disease burden caused by intestinal schistosomiasis in many endemic settings, more sensitive diagnostic methods are needed to plan and monitor control measures. We conducted a cross-sectional survey in a rural community in northeast Brazil (317 inhabitants). A combined approach including repeated faecal examinations and ELISA testing was applied. In a first round, single stool samples were collected from 305 (96.2%) participants. Three Kato-Katz (KK) smears were prepared from each sample, and IgG ELISA was performed from serum samples. In the 85 cases of negative KK smears, but positive ELISA results, three additional faecal samples were collected in a second round, and another five KK smears prepared. In the first round of KK analysis, 11/287 (3.8%; 95% confidence interval; 1.92-6.75) were positive. After examining up to eight smears per individual (second round), prevalence of schistosomiasis increased to 8.7% (95% confidence interval: 5.9-12.5). In total, 96/287 (33.4%, 95% confidence interval: 28.0-39.2) samples were positive by ELISA testing. There were no false negative ELISA results. Specificity, positive and negative predictive values of ELISA as compared to up to eight KK smears from three stool samples (reference diagnosis) were 72.9%, 26.0% and 100%, respectively. A single KK smear detected only 12% of the 25 infections; this increased to 44% (three smears, one stool sample), 84% (five smears, three stool samples) and 96% (six smears, four stool samples). We conclude that in low-endemic areas in Brazil the use of KK continues being an important tool. The additional benefit of preparing more than six KK smears from repeated stool samples is negligible. ELISA may be useful for screening populations, with subsequent confirmation of diagnosis by KK or other more sensitive, but highly specific methods.


Asunto(s)
Anticuerpos Antihelmínticos/sangre , Enfermedades Endémicas , Heces/parasitología , Schistosoma mansoni/inmunología , Schistosoma mansoni/aislamiento & purificación , Esquistosomiasis mansoni/diagnóstico , Adolescente , Adulto , Animales , Brasil/epidemiología , Niño , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Esquistosomiasis mansoni/epidemiología , Esquistosomiasis mansoni/parasitología , Sensibilidad y Especificidad , Adulto Joven
10.
J Bras Pneumol ; 37(3): 308-16, 2011.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-21755185

RESUMEN

OBJECTIVE: To determine the clinical and epidemiological profile of patients who are candidates for TNF-α inhibitor use and are classified as having latent tuberculosis (LTB), as well as to evaluate the outcomes of prophylactic treatment with isoniazid. METHODS: A prospective descriptive analysis followed by an analytical, observational, cross-sectional study of the outcomes of prophylactic treatment in a group of 45 candidates for TNF-α inhibitor use. We evaluated the patients through anamnesis, clinical examination, chest X-ray, and tuberculin skin test (TST) using the Mantoux method. RESULTS: The mean age was 45 years, and 56.0% of the patients were female. Chronic rheumatic diseases, chronic dermatological diseases, and Crohn's disease were present in 46.7%, 40.0%, and 13.3% of the patients, respectively. The mean TST induration was 14.6 mm (range: 5-30 mm). The majority (n = 30) of the 45 patients (66.7%) had an induration > 10 mm. In the 16 patients with BCG vaccination scars, the mean induration was 15.7 mm, and 14 of those patients had an induration > 10 mm. Chest X-ray results were considered normal, with minimal alterations, in 64.4% and 35.6% of the patients, respectively. The treatment with isoniazid was abandoned by 1 patient (2.2%) and completed by 41 (91.2%), whereas it was interrupted because of drug-induced hepatitis in 2 (4.4%), and 1 patient (2.2%) was transferred to another hospital. Of those who completed the treatment, 5 experienced mild side effects. CONCLUSIONS: Determining the profile of candidates for TNF-α inhibitor use is important for the management of LTB treatment and for the establishment of clinical protocols for the use and monitoring of the use of these medications.


Asunto(s)
Antituberculosos/uso terapéutico , Inmunosupresores/uso terapéutico , Inflamación/microbiología , Isoniazida/uso terapéutico , Tuberculosis Latente/diagnóstico , Tuberculosis Latente/tratamiento farmacológico , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Adolescente , Adulto , Niño , Enfermedad Crónica , Métodos Epidemiológicos , Femenino , Humanos , Inflamación/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Prueba de Tuberculina , Tuberculosis Pulmonar/prevención & control , Adulto Joven
11.
Rev. Inst. Med. Trop. Säo Paulo ; 57(2): 145-152, Mar-Apr/2015. tab, graf
Artículo en Inglés | LILACS | ID: lil-744729

RESUMEN

By controlling the transmission of Chagas disease, the challenge of providing assistance to millions of infected patients that reach old age arises. In this study, the socioeconomic, demographic and comorbidity records of all elderly chagasic patients followed at the Pharmaceutical Care Service of the Chagas Disease Research Laboratory were assessed. The information related to the clinical form of the disease was obtained from medical records provided by the Walter Cantídio University Hospital. The profile of the studied population was: women (50.5%); mean age of 67 years; retired (54.6%); married (51.6 %); high illiteracy rate (40.2%); and family income equal to the minimum wage (51.5%). The predominant clinical forms of Chagas disease were cardiac (65.3%) and indeterminate (14.7%). The main electrocardiographic changes were the right bundle branch block (41.0%), associated or not with the anterosuperior left bundle branch block (27.4%). The average number of comorbidities per patient was 2.23 ± 1.54, with systemic arterial hypertension being the main one found (67.0%). It was found that the elderly comprise a vulnerable group of patients that associate aging with cardiac and/or digestive disorders resulting from the evolution of Chagas disease and other comorbidities, which requires special attention from health services to ensure more appropriate medical and social care.


Controlando-se a transmissão da doença de Chagas, surge o desafio de prestar assistência a milhões de pacientes infectados que chegam à velhice. Neste estudo, foram avaliados os registros socioeconômicos, demográficos e de comorbidades de todos os pacientes chagásicos idosos acompanhados no Serviço de Atenção Farmacêutica do Laboratório de Pesquisa em Doença de Chagas. As informações relacionadas à forma clínica da doença foram obtidas a partir de registros médicos disponibilizados pelo Hospital Universitário Walter Cantídio. O perfil da população estudada foi de: mulheres (50,5%); idade média de 67 anos; aposentados (54,6%); casados (51,6%); alta taxa de analfabetismo (40,2%); e renda familiar de um salário mínimo (51,5%). As formas clínicas predominantes da doença de Chagas foram a cardíaca (65,3%) e a indeterminada (14,7%). As principais alterações eletrocardiográficas foram o bloqueio de ramo direito (41,0%), associado ou não ao bloqueio ântero superior esquerdo (27,4%). O número médio de comorbidades por paciente foi de 2,23 ± 1,54, sendo a hipertensão arterial sistêmica a principal encontrada (67,0%). Verificou-se que os idosos constituem grupo vulnerável de pacientes que associam o envelhecimento com as alterações cardíacas e/ou digestivas resultantes da evolução da doença de Chagas e outras comorbidades, o que exige atenção especial dos serviços de saúde para um atendimento médico e social mais adequado.


Asunto(s)
Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Chagas/epidemiología , Servicios Farmacéuticos , Brasil/epidemiología , Enfermedad Crónica , Estudios Transversales , Factores Socioeconómicos
12.
Rev. Soc. Bras. Med. Trop ; 47(6): 770-774, Nov-Dec/2014. graf
Artículo en Inglés | LILACS | ID: lil-732977

RESUMEN

Introduction Schistosomiasis is endemic in 76 countries and territories. Several studies have found an inverse correlation between parasitic disease and the development of allergies. The purpose of the present study was to determine whether infection with Schistosoma mansoni in subjects with a low parasite load is protective against allergy. The final sample consisted of 39 S. mansoni-positive and 52 S. mansoni-negative residents of a small community in northeastern Brazil. Methods All subjects were submitted to the Kato-Katz test, anti-S. mansoni IgG measurement, the prick test for aeroallergens, eosinophil counts and serum IgE measurement. Results Subjects who reacted to one or more antigens in the prick test were considered allergic. Only 7 S. mansoni-positive subjects (17.9%) reacted to one or more antigens, whereas 20 S. mansoni-negative subjects (38.5%) tested positive for allergy. Conclusions Our findings suggest that, in areas of low endemicity, infection with S. mansoni significantly reduces the risk of the development of allergy in subjects with a low parasite load. .


Asunto(s)
Animales , Humanos , Alérgenos/inmunología , Anticuerpos Antihelmínticos/sangre , Antígenos Helmínticos/inmunología , Hipersensibilidad Inmediata/inmunología , Schistosoma mansoni/inmunología , Esquistosomiasis mansoni/inmunología , Brasil/epidemiología , Estudios de Casos y Controles , Heces/parasitología , Inmunoglobulina E , Recuento de Huevos de Parásitos , Pruebas Cutáneas , Esquistosomiasis mansoni/epidemiología
13.
Emerg Infect Dis ; 13(2): 287-9, 2007 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17479893

RESUMEN

Two waterborne outbreaks of toxoplasmosis have been described recently in southern Brazil. We present data from a community-based study of pregnant women in northeastern Brazil. Consumption of homemade ice was the only variable associated with seropositivity (adjusted odds ratio, 3.1, 95% confidence interval, 1.53-6.24). Our results suggest that water is a source of infection with Toxoplasma gondii.


Asunto(s)
Toxoplasmosis/epidemiología , Agua/parasitología , Adolescente , Adulto , Animales , Anticuerpos Antiprotozoarios , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Oportunidad Relativa , Embarazo , Complicaciones Parasitarias del Embarazo/epidemiología , Complicaciones Parasitarias del Embarazo/parasitología , Factores de Riesgo , Toxoplasma/aislamiento & purificación
14.
Rev. Soc. Bras. Med. Trop ; 45(4): 510-513, July-Aug. 2012. graf
Artículo en Inglés | LILACS | ID: lil-646906

RESUMEN

INTRODUCTION: The laboratory diagnosis of schistosomiasis is based mainly on the detection of parasite eggs in stool samples through the Kato-Katz (KK) technique, reading one slide by test. However, a widely known limitation of parasitological methods is reduced sensitivity, particularly in low endemic areas. METHODS: To increase sensitivity, we conducted further slide readings from the same stool sample using the parasitological method associated with a serological test. We used the KK method (three slides) and the IgG anti-Schistosoma mansoni-enzyme-linked immunosorbent assay (ELISA) technique to diagnose schistosomiasis in low endemic areas in the Brazilian State of Ceará. Fecal samples and sera from 250 individuals were analyzed. RESULTS: Sixteen percent and 47.2% of samples were positive in parasitological tests and serological tests, respectively. Parasitological methods showed that 32 (80%) individuals tested positive on the first slide, 6 (15%) on the second slide, and 2 (5%) on the third. The performance of the ELISA test in the diagnosis, using the KK method as diagnostic reference, showed a negative predictive value of 100%, with specificity and positive predictive values of 62.8% and 33.9%, respectively. CONCLUSIONS: In this study, the increase from one to three slides analyzed per sample using the KK technique was shown to be a useful procedure for increasing the diagnostic sensitivity of this technique.


INTRODUÇÃO: O diagnóstico laboratorial da esquistossomose é baseada principalmente na detecção de ovos do parasito nas fezes, realizada pela técnica de Kato-Katz (KK), com a leitura de uma lâmina por teste. No entanto, uma limitação conhecida dos métodos coproscópicos é a reduzida sensibilidade, especialmente nas áreas de baixa endemicidade. MÉTODOS: A fim de reduzir essa limitação, realizamos mais leituras da mesma amostra de fezes pelo método coproscópico e associamos a um teste sorológico.Utilizamos o método de KK (três lâminas) e a técnica de IgG-ELISA, buscando aumentar a sensibilidade do diagnóstico da esquistossomose em área de baixa endemicidade, no Estado Brasileiro do Ceará. Amostras de fezes e soro de 250 indivíduos foram analisadas. RESULTADOS: Destas, 40 e 118 foram positivas nos testes coproscópico e sorológico, respectivamente. Na coproscopia, 32 (80%) indivíduos tiveram testes positivos na primeira lâmina, 6 (15%) na segunda e 2 (5%) apenas na terceira lâmina. O desempenho do teste de ELISA no diagnóstico utilizando-se o método KK como referência de diagnóstico, demonstrou valor preditivo negativo de 100% mas a especificidade e o valor preditivo positivo foram de 62,8% e 33,9%, respectivamente. CONCLUSÕES: Neste estudo, o aumento de uma para três lâminas analisadas por amostra pelo KK, mostrou ser um procedimento útil para o aumento da sensibilidade diagnóstica desta técnica.


Asunto(s)
Adulto , Animales , Femenino , Humanos , Masculino , Anticuerpos Antihelmínticos/sangre , Heces/parasitología , Inmunoglobulina G/sangre , Schistosoma mansoni/aislamiento & purificación , Esquistosomiasis mansoni/diagnóstico , Brasil/epidemiología , Estudios Transversales , Ensayo de Inmunoadsorción Enzimática/métodos , Recuento de Huevos de Parásitos/métodos , Sensibilidad y Especificidad , Schistosoma mansoni/inmunología , Esquistosomiasis mansoni/epidemiología
15.
Mem. Inst. Oswaldo Cruz ; 107(6): 813-815, set. 2012. ilus
Artículo en Inglés | LILACS | ID: lil-649499

RESUMEN

Coccidioidomycosis is a systemic mycosis with a variable clinical presentation. Misdiagnosis of coccidioidomycosis as bacterial pneumopathy leads to inappropriate prescription of antibiotics and delayed diagnosis. This report describes an outbreak among armadillo hunters in northeastern Brazil in which an initial diagnosis of bacterial pneumonia was later confirmed as coccidioidomycosis caused by Coccidioides posadasii. Thus, this mycosis should be considered as an alternative diagnosis in patients reporting symptoms of pneumonia, even if these symptoms are only presented for a short period, who are from areas considered endemic for this disease.


Asunto(s)
Adolescente , Animales , Humanos , Masculino , Persona de Mediana Edad , Armadillos/microbiología , Coccidioidomicosis/diagnóstico , Enfermedades Pulmonares Fúngicas/diagnóstico , Neumonía Bacteriana/diagnóstico , Neumonía/diagnóstico , Brasil/epidemiología , Coccidioides/aislamiento & purificación , Coccidioidomicosis/epidemiología , Brotes de Enfermedades , Enfermedades Pulmonares Fúngicas/epidemiología , Neumonía Bacteriana/tratamiento farmacológico , Neumonía/epidemiología , Microbiología del Suelo
16.
J. bras. pneumol ; 37(3): 308-316, maio-jun. 2011. tab
Artículo en Portugués | LILACS | ID: lil-592659

RESUMEN

OBJETIVO: Traçar o perfil clínico-epidemiológico de pacientes candidatos ao uso de fármacos anti-TNF-α diagnosticados como portadores de tuberculose latente (TBL) e avaliar os desfechos do tratamento profilático com isoniazida. MÉTODOS: Análise descritiva prospectiva seguida de um estudo analítico observacional transversal dos desfechos do tratamento profilático em um grupo de 45 candidatos ao uso de fármacos anti-TNF-α. A avaliação dos pacientes constou de anamnese, exame clínico, radiografia de tórax e teste tuberculínico (TT) por Mantoux. RESULTADOS: A idade média dos pacientes foi 45 anos, e 56,0 por cento dos pacientes eram mulheres. Doenças reumatológicas crônicas, doenças dermatológicas crônicas e doença de Crohn estavam presentes em 46,7 por cento, 40,0 por cento e 13,3 por cento dos pacientes, respectivamente. A média de enduração do TT foi 14,6 mm (variação: 5-30 mm). A maioria dos pacientes (n = 30; 66,7 por cento) apresentou enduração > 10 mm. Dos 16 pacientes com cicatriz vacinal BCG, a média de enduração foi de 15,7 mm, sendo que 14 tiveram enduração > 10 mm. Os resultados de radiografia de tórax foram considerados normais e com alterações mínimas em 64,4 por cento e em 35,6 por cento, respectivamente. Apenas 1 paciente (2,2 por cento) abandonou o tratamento com isoniazida, 41 (91,2 por cento) completaram o tratamento, 2 (4,4 por cento) tiveram de interromper o tratamento por hepatite medicamentosa, e 1 (2,2 por cento) foi transferido para outro hospital. Dos que completaram o tratamento, 5 apresentaram efeitos colaterais leves. CONCLUSÕES: A determinação do perfil dos candidatos ao uso de inibidores do TNF-α é importante para o manejo do tratamento da TBL, bem como para estabelecer protocolos clínicos de uso e acompanhamento do uso desses fármacos.


OBJECTIVE: To determine the clinical and epidemiological profile of patients who are candidates for TNF-α inhibitor use and are classified as having latent tuberculosis (LTB), as well as to evaluate the outcomes of prophylactic treatment with isoniazid. METHODS: A prospective descriptive analysis followed by an analytical, observational, cross-sectional study of the outcomes of prophylactic treatment in a group of 45 candidates for TNF-α inhibitor use. We evaluated the patients through anamnesis, clinical examination, chest X-ray, and tuberculin skin test (TST) using the Mantoux method. RESULTS: The mean age was 45 years, and 56.0 percent of the patients were female. Chronic rheumatic diseases, chronic dermatological diseases, and Crohn's disease were present in 46.7 percent, 40.0 percent, and 13.3 percent of the patients, respectively. The mean TST induration was 14.6 mm (range: 5-30 mm). The majority (n = 30) of the 45 patients (66.7 percent) had an induration > 10 mm. In the 16 patients with BCG vaccination scars, the mean induration was 15.7 mm, and 14 of those patients had an induration > 10 mm. Chest X-ray results were considered normal, with minimal alterations, in 64.4 percent and 35.6 percent of the patients, respectively. The treatment with isoniazid was abandoned by 1 patient (2.2 percent) and completed by 41 (91.2 percent), whereas it was interrupted because of drug-induced hepatitis in 2 (4.4 percent), and 1 patient (2.2 percent) was transferred to another hospital. Of those who completed the treatment, 5 experienced mild side effects. CONCLUSIONS: Determining the profile of candidates for TNF-α inhibitor use is important for the management of LTB treatment and for the establishment of clinical protocols for the use and monitoring of the use of these medications.


Asunto(s)
Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Antituberculosos/uso terapéutico , Inmunosupresores/uso terapéutico , Inflamación/microbiología , Isoniazida/uso terapéutico , Tuberculosis Latente/diagnóstico , Tuberculosis Latente/tratamiento farmacológico , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Enfermedad Crónica , Métodos Epidemiológicos , Inflamación/tratamiento farmacológico , Prueba de Tuberculina , Tuberculosis Pulmonar/prevención & control
17.
Rev. bras. anal. clin ; 38(3): 201-206, jul.-set . 2006. tab
Artículo en Portugués | LILACS | ID: lil-461313

RESUMEN

Giardíase é uma protozoose intestinal causada por Giardia lamblia. A eosinofilia (>500/mm3) nas parasitoses é geralmente encontrada nas infecções por nematódeos e raramente é referida na literatura em relação à infecção por G. lamblia. Este estudo foi desenhado a fim de determinar a relação entre IL-5 e presença de eosinofilia em crianças e adolescentes com giardíase. Foram selecionadas 38 crianças e adolescentes na faixa etária de 0-18 anos portando exclusivamente G. lamblia e 32 crianças e adolescentes com giardíase. Foram selecionadas 38 crianças e adolescentes. Foram excluídas nesta fase do projeto pacientes portadoras de outros parasitas. No momento da entrega do material fecal era coletado sangue para a realização do hemograma, dosagem da IgE e IL-5. A casuística foi dividida em 3 grupos. Grupo 1: portadores de giardíase e eosinofilia (N:20), Grupo 2: portadores de giardíase sem eosinofilia (N:18) e Grupo 3: pacientes com ausência de parasitose (N:32). Resultados: Nos casos de giardíase, 52.6 apresentaram eosinofilia. Grupo 1: 100.


Asunto(s)
Masculino , Femenino , Humanos , Eosinofilia , Giardia , Giardiasis/inmunología , Inmunoglobulina E , Interleucina-5 , Prevalencia
18.
Rev. bras. anal. clin ; 37(3): 169-174, 2005. tab
Artículo en Portugués | LILACS | ID: lil-477221

RESUMEN

O objetivo do trabalho foi avaliar o uso de teste combinado na identificação de infecção recente de HIV-1/2 em doadores de sangue do Centro de Hematologia e hemoterapia do Ceará. Um novo ensaio (VIDAS HIV DUO/BioMérieux), que detectava antígenop24 e IgG anti-HIV-1/2 foi introduzido à rotina e realizado em 998 doadores. Doadores com resultados positivos ou inconclusivos foram convocados para nova coleta e testes de ELISA e Western Blot (HIV Blot 2.2/Murex) foram novamente realizados. Sensibilidade,especificidade, razão de verossimilhança e o coeficiente Kappa foram calculados. Dentre os 998 doadores, 937 foram negativos nos três ensaios de ELISA e 61 (6,1 por cento) apresentaram resultados positivos ou inconclusivos em pelo menos um teste. Entre os 61 doadores, 11 confirmaram-se positivos e 50 negativos no Western Blot. Nenhum caso de soroconversão foi verificado. A sensibilidade do teste combinado foi de 100 por cento. As especificidades encontradas para os ensaios foram 99,0 por cento (Vironostika HIV Uni-form II plus O),99,3 por cento (VIDAS HIV DUO) e 99,7 por cento (ICE HIV-1.0.2).O coeficiente Kappa entre os testes de rotina foi de 60,4 por cento. As concordâncias entre o teste combinado e os testes ICE HIV-1.0.2 e Vironostika HIV Uni-form II plus O foram Kappa=68,30 por cento e Kappa=54,10 por cento, p<0,0001, respectivamente. Os resultados mostraram que o desempenho do teste combinado é comparável aos métodos existentes no mercado. Entretanto, novos estudos são necessários para que se confirme sua utilidade na detecção de infecção recente de HIV em serviços de bancos de sangue


Asunto(s)
Humanos , Donantes de Sangre , Anticuerpos Anti-VIH , Seropositividad para VIH , VIH-1 , VIH-2 , Western Blotting
19.
An. bras. dermatol ; 64(1): 25-7, jan.-fev. 1989. tab
Artículo en Portugués | LILACS | ID: lil-67475

RESUMEN

Foram estudadas 665 culturas positivas para dermatófitos no período de janeiro de 1980 a agosto de 1987, que mostraram ser cinco as espécies impliccadas. Trychophyton tonsurans (43,8%), Trychophyton rubrum (39,2%). Trychophyton mentagrophytes (13,8%). Microsporum canis (2,4%). Epidermophton floccosum (0,8%)


Asunto(s)
Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Humanos , Masculino , Femenino , Historia del Siglo XX , Dermatomicosis/etiología , Brasil
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