RESUMO
OBJECTIVE: To assess the sensitivity and specificity of a new polymerase chain reaction (PCR) assay with uninterrupted reverse transcription and complementary DNA amplification (RT-PCR) for the diagnosis of enteroviral (EV) meningitis in children. DESIGN: A prospective, cohort study. SETTINGS: Two medical centers: 1 university hospital and 1 children's hospital in San Diego County, California, during a 5-week period. PATIENTS: All pediatric patients younger than 16 years who underwent a lumbar puncture for evaluation of possible meningitis. MAIN OUTCOME MEASURES: The results of cerebrospinal fluid (CSF) RT-PCR were compared with viral cultures and clinical histories. RESULTS: During the 5-week period, 90 patients were entered into the study. Nonpolio EVs were cultured from 10% (9/90) of the patients from the following sites: CSF, 6.7% (6/90) of the patients; stool, 19% (4/21) of the patients; and throat swabs, 5.6% (1/18) of the patients. The EV genome was detected in the CSF by using RT-PCR in 7 of 9 EV culture-positive patients. The sensitivity and specificity of the CSF RT-PCR assay to detect EV meningitis were 77.8% and 100%, respectively. This compared with a sensitivity of 66.7% for detection of EV in CSF by viral culture alone. CONCLUSION: The new RT-PCR assay is a rapid and reliable method for the detection of EV infection in childhood.
Assuntos
Infecções por Enterovirus/líquido cefalorraquidiano , Enterovirus/genética , Genoma Viral , Meningite Viral/líquido cefalorraquidiano , Reação em Cadeia da Polimerase/métodos , Cultura de Vírus/métodos , Criança , Pré-Escolar , Infecções por Enterovirus/virologia , Humanos , Lactente , Recém-Nascido , Meningite Viral/virologia , Estudos Prospectivos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Transcrição GênicaRESUMO
A case of primary adenocarcinoma of the small intestine presented as an abdominopelvic mass. The only site of secondary involvement was the left ovary. Postoperatively six courses of 5-fluorouracil, cisplatin and adriamycin were administered. At the 31-month follow-up there was no evidence of recurrent disease.
Assuntos
Adenocarcinoma/patologia , Neoplasias Intestinais/patologia , Neoplasias Ovarianas/secundário , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/cirurgia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cisplatino/administração & dosagem , Doxorrubicina/administração & dosagem , Feminino , Fluoruracila/administração & dosagem , Humanos , Neoplasias Intestinais/tratamento farmacológico , Neoplasias Intestinais/cirurgia , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/patologiaRESUMO
The objective of this study was to evaluate the effect of α-ketoglutarate on redox state parameters and arterial elasticity in elderly mice. Mice in the control group were fed with standard diet, while the experimental animals received the diet supplemented either with calcium (Ca-AKG) or sodium salt of α-ketoglutarate (Na-AKG). The experimental animals were divided into 4 groups with 10 individuals in each: control I (12 months old), control II (2 months old), experimental group I fed with Ca-AKG (12 months old) and experimental group II fed with Na-AKG (12 months old). Mice treated with Ca-AKG as well as the control II animals demonstrated significantly higher level of total antioxidant status (TAS), comparing to the control I animals and those treated with Ca-AKG. Thiobarbituric acid reactive substances (TBARS) level in blood plasma was found significantly lower in young and Ca-AKG treated mice. TBARS liver concentration was significantly different in each examined group. The study also demonstrates the decrease in TBARS level in Ca-AKG treated animals. Treatment with Na-AKG significantly increased glutathione peroxidase activity and decreased the activity of superoxide dismutase. The presented results suggest that Ca-AKG protects the organism against the free radicals related elderly processes. The study presents also the effect of Ca-AKG treatment on arterial elastic characteristics in elderly mice. The beneficial effect of Ca-AKG on ageing organisms was confirmed via redox state stabilization and blood vessel elasticity improvement.
Assuntos
Envelhecimento/efeitos dos fármacos , Artérias/efeitos dos fármacos , Ácidos Cetoglutáricos/farmacologia , Animais , Antioxidantes/metabolismo , Artérias/metabolismo , Artérias/fisiologia , Cálcio da Dieta/farmacologia , Dieta , Suplementos Nutricionais , Elasticidade/efeitos dos fármacos , Radicais Livres/metabolismo , Glutationa Peroxidase/metabolismo , Homeostase/efeitos dos fármacos , Fígado/metabolismo , Camundongos , Oxirredução , Superóxido Dismutase/metabolismo , Substâncias Reativas com Ácido Tiobarbitúrico/metabolismoRESUMO
The notion of 'family empowerment' is of crucial importance in any kind of psychosocial intervention directed to families with children living with HIV/AIDS. The goal is to restore self-efficacy and self-esteem, encourage positive coping and help family members make their own choices. Two settings for psychosocial intervention are described: an outpatient clinic within a larger medical institution and a therapeutic camp for families with children. Different psychotherapeutic and counselling strategies and approaches are briefly presented. Preliminary results based on work with families with children infected and/or affected by HIV/AIDS are described. The conclusion is that interventions that involve different settings seem to be most effective, especially for the most vulnerable families. The important issue is also collaboration between different service providers and NGOs.
Assuntos
Saúde da Família , Terapia Familiar/métodos , Infecções por HIV/terapia , Adaptação Psicológica , Adolescente , Assistência Ambulatorial/métodos , Criança , Filho de Pais com Deficiência , Pré-Escolar , Infecções por HIV/psicologia , Infecções por HIV/transmissão , Humanos , Lactente , Transmissão Vertical de Doenças Infecciosas , Relações Interinstitucionais , Ambulatório Hospitalar , AutoimagemRESUMO
Impregnated Swiss mice were irradiated 2 h daily on days 1-18 of gestation in nonthermal (1 or 10 mW/cm2) or thermogenic (40 mW/cm2) 2,450-MHz microwave (MW) fields. On the 19th day of pregnancy all dams were killed to check the number of resorptions. Living fetuses were isolated, weighed and checked for the presence of macroscopically visible malformations of skeleton and cleft palate (CP) and/or lip (CLP). Some of the pregnant mice in each group were injected intraperitoneally on the 9th day of gestation with 10 mg/kg of cytosine arabinoside (ara-C), a well-known teratogen resulting under the above conditions in the appearance of about 15% (42 of 354) of resorbed implantation points and the development of CP or CLP in about 30% (96 of 312) of fetuses. Exposure to nonthermal MW fields during pregnancy did not lead to resorptions or detectable malformations; however, the body mass of 19-day fetuses was significantly lower than in sham-irradiated controls. MW hyperthermia (40 mW/cm2) applied during pregnancy led to an increased number of resorptions - about 25% (37 of 157) compared to 2% (6 of 306) in controls. Significant enhancement of the teratogenic potency of ara-C was observed after combined exposure to both ara-C and MWs during pregnancy. In dams treated with ara-C alone about 20% (62 of 358) resorptions and about 30% (91 of 296) fetuses with CL or CLP were found; additional exposure in MW fields (10 mW/cm2), not resulting per se in resorptions or detectable malformations, increased the numbers to 45% (213 of 448) of resorptions and to 70% (167 of 235) fetuses with CL or CLP.+
Assuntos
Anormalidades Induzidas por Medicamentos/etiologia , Anormalidades Induzidas por Radiação/etiologia , Citarabina/toxicidade , Micro-Ondas/efeitos adversos , Animais , Peso Corporal/efeitos dos fármacos , Peso Corporal/efeitos da radiação , Feminino , Morte Fetal/etiologia , Gravidez , RatosRESUMO
Diverticulum of the female urethra has an incidence of 1.4% to 4.7%. It is generally agreed that the majority of these are acquired lesions. There is, however, evidence that some are of congenital origin. Documented cases of diverticula with colon-type tissue are rare. A case of urethral diverticulum with colonic epithelium and features of Paneth cell metaplasia is presented. Causes, symptoms, diagnostic methods, and treatment are discussed.
Assuntos
Colo/patologia , Divertículo/congênito , Doenças Uretrais/congênito , Adulto , Divertículo/patologia , Epitélio/patologia , Feminino , Humanos , Metaplasia , Doenças Uretrais/patologiaRESUMO
BACKGROUND: Enteroviruses (EV) cause a broad spectrum of human diseases, of which aseptic meningitis is among the most common and most clinically vexing. While the clinical symptoms of meningitis caused by bacteria, fungi and viruses are similar, the diagnosis, therapy and outcome of disease caused by these agents vary greatly. In order to appropriately manage meningitis patients, rapid and reliable diagnosis of EV meningitis impacts significantly on patient management. OBJECTIVE: To develop a direct and uninterrupted RNA amplification of enteroviruses using rTth DNA polymerase. STUDY DESIGN: Purified coxsackievirus B6 RNA of various concentrations was amplified by rTth DNA polymerase-mediated amplification to determine analytic sensitivity. The specificity of the EV amplification was examined with a panel of nucleic acids from 36 EV serotypes, 15 non-EV pathogens and 10 coded clinical specimens of cerebrospinal fluid (CSF). RESULTS: All EV serotypes tested were detected successfully by this method at a sensitivity of 1 TCID(50) with the exception of echoviruses 1, 5, 22 and 23. Echovirus 5 was detected at 10 TCID(50), and echovirus 1 was detected at 100 TCID(50). Echoviruses 22 and 23 were not detectable at 100 TCID(50). Cross-reactivity of EV RT-PCR assay with 15 known non-EV meningitis pathogens has not been observed. Results of 10 CSF tested with this system correlated well with tissue culture. CONCLUSIONS: We have developed an EV amplification assay which has several important advantages over previously reported methods. This assay employs rTth DNA polymerase which possesses both reverse transcriptase and DNA polymerase activities, simplifying RNA reverse transcription and DNA amplification to an uninterrupted reaction. Additionally, potential carryover contamination and enhanced amplification specificity is provided by substituting dUTP for dTTP and adding uracil N-glycosylase (UNG) in the amplification reaction. Finally, the detection of amplified product is via a colorimetric, microwell format permitting the use of readily available instrumentation.
RESUMO
Abortion hysterectomy has been discredited as the method of performing simultaneous pregnancy termination and elective sterilization for women with undesired pregnancies who simultaneously wish to end their child-bearing potential. The procedure continues to be advocated, however, for cases in which there is an underlying gynecologic pathologic condition. The morbidity of this procedure has not been directly compared with that for indicated hysterectomy in nonpregnant women. Between January 1976 and January 1987, 50 patients underwent abortion hysterectomy at The University of Chicago. The morbidity and mortality rates of these patients were compared with those of 50 premenopausal nonpregnant women undergoing abdominal hysterectomy for gynecologic pathologic status. There was no statistically significant different between the groups in the duration of surgery, estimated blood loss, or infectious morbidity. No operative site infections or other adverse sequelae were noted at the time of final postoperative examination. These data support the relative safety of abdominal abortion hysterectomy for women with undesired pregnancy in whom hysterectomy is indicated for an underlying gynecologic pathologic condition.