RESUMEN
Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent the progression of multiple sclerosis (MS). This is a prospective multicentric Brazilian MS trial comparing two conditioning regimens: BEAM/horse ATG and CY/rabbit ATG. Most (80.4%) of the 41 subjects in the study had the secondary progressive MS subtype and the mean age was 42 years. The baseline EDSS score in 58.5% of the subjects was 6.5 and 78% had a score of 6.0 or higher, respectively. The complication rate during the intra-transplantation period was 56% for all patients: 71.4% of the patients in the BEAM/hATG group and 40% in the CY/rATG group (P=0.04). Three subjects (7.5%) died of cardiac toxicity, sepsis and alveolar hemorrhage, all of them in the BEAM/ATG group. EFS was 58.54% for all patients: 47% in the BEAM/hATG group and 70% in the CY/rATG group (P=0.288). In conclusion, the CY/rATG regimen seems to be associated with similar outcome results, but presented less toxicity when compared with the BEAM/hATG regimen. Long-term follow-up would be required to fully assess the differences in therapeutic effectiveness between the two regimens.
Asunto(s)
Trasplante de Células Madre Hematopoyéticas/métodos , Esclerosis Múltiple/terapia , Acondicionamiento Pretrasplante/métodos , Adulto , Animales , Suero Antilinfocítico/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Carmustina/administración & dosificación , Citarabina/administración & dosificación , Etopósido/administración & dosificación , Femenino , Rechazo de Injerto/prevención & control , Movilización de Célula Madre Hematopoyética , Caballos , Humanos , Masculino , Melfalán/administración & dosificación , Persona de Mediana Edad , Calidad de Vida , ConejosRESUMEN
Ainda sao raros os casos de infeccao por hepatite C (HCV)na regiao central do Brasil. Neste estudo, 2.350 doadores voluntarios de sangue foram avaliados, resultando em prevalencias para o anti-HCV de 2,2 (por cento), pelo ELISA de segunda geracao, e de 1,4 por cento, apos o ensaio confirmatorio "line immunoassay". Anticorpos contra os antigenos "core", NS4 e NS5 do HCV foi observada em 76,6 (por cento) dos doadores anti-HCV positivos. A positividade da reacao em cadeia da polimerase (PCR) mostrou-se relacionada a reatividade aos diferentes antigenos do HCV no "line immunoassay". A maioria dos doadores positivos tiveram historia previa de exposicao parenteral. A combinacao de ALT>50 UI/1 e positividade ao anti-HBc parece nao ser eficaz como marcadores indiretos para a infeccao pelo HCV, entretanto a dosagem do ALT e a deteccao de anti-HCV sao indicadas na triagem de doadores de sangue brasileiros.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Hepacivirus/inmunología , Hepatitis C/epidemiología , Hepatitis Crónica/diagnóstico , Donantes de Sangre , Brasil , Reacción en Cadena de la Polimerasa , Factores de RiesgoAsunto(s)
Humanos , Masculino , Femenino , Donantes de Sangre , Seroprevalencia de VIH , Bancos de Sangre , Brasil , Ensayo de Inmunoadsorción EnzimáticaRESUMEN
Screening tests of 62,814 blood donations carried out between October 85 and October 87 in all five blood banks of Goiânia, Central Brazil, were analysed. The private institutions (3 blood banks) collected 80% of all donations and the remaining were collected by public blood banks. Seroprevalence of HIV, HBsAg, Chagas' disease and syphilis were compared with data obtained in the surveillance system and from previous surveys in an attempt to validate this source of health information. A seroprevalence of 0.07% for AIDS (one ELISA test) was calculated, which may suggest the presence of 1900 infected individuals, in the population of the State of Goiás as a whole. This figure seems reasonably close to the official data obtained by compulsory notification. For Chagas' disease, hepatitis B and syphilis seroprevalence of 3.3%, 1.3% and 4.1% were obtained, respectively. The potential usefulness and the limitations of screening in blood banks as a source of reliable morbidity indicator is discussed.