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1.
Mem. Inst. Oswaldo Cruz ; 114: e180450, 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-976243

RESUMO

BACKGROUND Amazon, the largest tropical forest of the world, has suffered from dengue outbreaks since 1998. Cerebrospinal fluid (CSF) of patients, from Amazonas state, suspected of central nervous system (CNS) viral infection was studied using molecular and immunological methods. OBJECTIVE To evaluate the importance of CSF investigation in patients with acute dengue virus (DENV) infection of CNS. METHODS CSF samples of 700 patients were analysed by reverse transcription polymerase chain reaction (RT-PCR) to detect the presence of dengue virus (DENV) RNA and by enzyme-linked immunosorbent assay (ELISA) to detect presence of DENV specific IgM. FINDINGS DENV infection was detected in 4.3% of the CSF samples; 85.7% (24/28) by DENV IgM and 14.3% (4/28) by viral RNA. DENV detected by viral RNA were to be found serotypes DENV-2 (three patients) and DENV-1 (one patient). The neurological diagnosis in patients CNS infection of DENV included encephalitis (10), meningoencephalitis (10), meningitis (6), acute myelitis (1), and encephalomyelitis (1). The majority (89.3%) had intrathecal inflammation: pleocytosis, hyperproteinorrachia and DENV IgM antibodies. Hypoglycorrhachia and/or high levels of lactate in CSF were found in 36% of the patients. Co-infection (CMV, HIV, EBV, and/or Mycobacterium tuberculosis) was observed in eight (28.6%) cases. CONCLUSIONS We found intense inflammatory CSF that is unusual in CNS disorders caused by dengue infection. It may be due co-infections or the immunogenetic background of the local Amerindian Brazilian population. CSF examination is an important diagnostic support tool for neurological dengue diagnosis.


Assuntos
Humanos , Líquido Cefalorraquidiano/metabolismo , Infecções por Flavivirus/prevenção & controle , Meningite/terapia , Imunoglobulina M/análise , Vírus da Dengue , Encefalite
2.
Rev. patol. trop ; 48(2): 109-120, 2019.
Artigo em Inglês | LILACS | ID: biblio-1025836

RESUMO

Although microscopic alterations have been detected in tongues and salivary glands of chagasic patients and the identification of biomarkers in saliva has proved advantageous, there are no studies evaluating tongue function and total salivary IgA, IgG and IgM levels in chronic chagasic patients. The aim of this study was to evaluate tongue function, salivary flow rate, and total salivary IgA, IgG and IgM levels comparing chronic and non-infected individuals. 37 patients were selected: chronic cardiac chagasic patients (n=6), chronic chagasic patients with the associated form of the disease (cardiopathy and megaesophagus) (n=11), and non-chagasic individuals (n=20). The tongue function underwent a phonoaudiological evaluation. The salivary flow rate was measured by sialometry. The total salivary IgA, IgG and IgM levels were evaluated by sandwich ELISA assay. Chagasic patients with the associated form of the disease presented higher salivary flow rate and lower salivary protein levels. No significant differences were noted in the lingual function or in the total salivary immunoglobulin levels among the groups. Although patients with chagasic megaesophagus presented higher levels of salivary flow and lower salivary protein, the fact that there were no significant differences in lingual function and total salivary immunoglobulin levels among the groups led to the conclusion that chronic chagas disease does not modify the lingual function or the total IgA, IgG and IgM salivary levels. The present study was the first to evaluate the function of the tongue and salivary total immunoglobulin levels in Chagas disease.


Assuntos
Doenças das Glândulas Salivares , Glândulas Salivares , Imunoglobulina A , Imunoglobulina G , Imunoglobulina M , Doença de Chagas
3.
Arch. argent. pediatr ; 116(3): 179-185, jun. 2018. tab, graf
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-950007

RESUMO

Introducción. El Mycoplasma pneumoniae puede estar implicado en la exacerbación refractaria del asma, Objetivo. Establecer la prevalencia de la infección por Mycoplasma pneumoniae en pacientes con exacerbación aguda del asma. Material y método. Se realizó un estudio prospectivo, transversal, observacional, caso-control, en pacientes mayores de 2 años y menores de 12. Se determinaron anticuerpos inmunoglobulina M (IgM) para M. pneumoniae por serología por técnica de ensayo por inmunoabsorción ligado a enzima (enzyme-linked immunosorbent assay; ELISA en sus siglas en inglés), utilizando el kit NovaLisa® NovaTec. Se consideró prueba positiva a valores > 11 NTU (NovaTec unidades). El análisis estadístico fue análisis de la varianza (analysis of variance; ANOVA, por sus siglas en inglés) y chi cuadrado con un nivel de significancia de p < 0,05. Resultados. Se estudiaron 180 niños, 130 correspondieron al grupo de niños asmáticos y 50, al grupo control. La IgM específica fue positiva en 60 pacientes, que correspondió al 46,15% de niños asmáticos (p < 0,001). La gravedad de la exacerbación estuvo relacionada directamente con los niveles de IgM (p < 0,001). La tasa de hospitalización fue de 75%, asociada de forma significativa con los niveles de IgM específica (p < 0,001). Conclusión. Nuestros datos sugieren que en los niños con asma aguda, tienen alta prevalencia (46%) de infección por Mycoplasma pneumoniae y estrecha relación entre la exacerbación aguda grave del asma y la infección por Mycoplasma pneumoniae. Estos resultados podrían tener implicaciones terapéuticas orientadas hacia la utilización de antibióticos específicos contra este microorganismo atípico.


Introduction. Mycoplasma pneumoniae may be involved in refractory asthma exacerbation. Objective. To determine the prevalence of Mycoplasma pneumoniae infection in patients with acute asthma exacerbation. Material and method. A prospective, crosssectional, observational, case-control study was carried out in patients older than 2 years old and younger than 12. Immunoglobulin M (IgM) antibodies were serologically determined for M. pneumoniae, using the NovaLisa® NovaTec kit for enzyme-linked immunosorbent assay (ELISA). Test results ≥ 11 NTU (NovaTec units) were regarded as positive. The statistical analysis was performed by means of the analysis of variance (ANOVA) and the χ² test, with a significance level of p < 0.05. Results. One hundred and eighty children were studied, of which 130 had asthma and 50 comprised the control group. Specific IgM was positive for 60 patients, that is 46.15% of the asthmatic children (p < 0.001). The severity of the exacerbation was directly related to IgM levels (p < 0.001). Hospitalization rate was 75%, and it was significantly associated to specific IgM levels (p < 0.001). Conclusion. Our data suggest that children with acute asthma show a high prevalence (46%) of Mycoplasma pneumoniae infection and that there is a close relation between severe acute asthma exacerbation and the presence of Mycoplasma pneumoniae infection. These findings might result in therapeutic implications centered in the use of specific antibiotics to fight this atypical organism.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Pneumonia por Mycoplasma/epidemiologia , Asma/fisiopatologia , Mycoplasma pneumoniae/isolamento & purificação , Pneumonia por Mycoplasma/complicações , Asma/microbiologia , Índice de Gravidade de Doença , Imunoglobulina M/imunologia , Ensaio de Imunoadsorção Enzimática/métodos , Estudos de Casos e Controles , Doença Aguda , Prevalência , Estudos Transversais , Estudos Prospectivos , Hospitalização/estatística & dados numéricos
5.
Arq. bras. med. vet. zootec. (Online) ; 70(1): 205-212, Jan.-Feb. 2018. tab, graf
Artigo em Português | LILACS, VETINDEX | ID: biblio-888098

RESUMO

O presente trabalho avaliou o papel do baço no armazenamento e na reativação das linhagens de células B, representadas por células IgM positivas imunomarcadas no tecido esplênico, bem como a funcionalidade dessas células, sobre a cinética dos linfócitos e na produção sistêmica de anticorpos em tilápias-do-nilo (Oreochromis niloticus). Foram separados dois grupos: grupo memória, constituído por peixes previamente imunizados com hemácia de carneiro a 2,5%, para a geração da memória imune, e o grupo naive, que recebeu o mesmo volume de solução salina a 0,65%. Após 32 dias, os dois grupos foram submetidos a uma nova dose do antígeno na mesma concentração, volume e via de inoculação. A reativação dos clones de memória foi evidenciada pelo aumento do número de células IgM positivas no baço do grupo memória no dia zero/pré-imune. Além disso, o mesmo grupo apresentou aumento dos títulos de anticorpos séricos no 14º dia e no número absoluto de linfócitos no 21º dia em relação ao grupo naive. Esses resultados sugerem que o baço não seja apenas um local de armazenamento, mas também de reativação de células B de memória em tilápia-do-nilo.(AU)


This work aimed to evaluate the role of the spleen in storage and reactivation of the memory B cells, represented by IgM positive cells and the systemic production of sheep antibodies anti-red cell in Nile tilapia (Oreochromis niloticus). Two groups were established: the memory group, containing fish previously immunized with a 2,5% sheep anti-red cell, to generate the immune memory; and the naive group, containing fish that received a 0,65% saline solution. After 32 days, both groups were subjected to a new dose of the same antigen at the same concentration, volume, and inoculation via. The memory clones reactivation was correlated to the increase of the IgM positive cells in the spleen in the memory group at 0 day. The memory group showed an increase in the absolute number of lymphocytes at 21 days and an increase in the antibodies at 14 days after inoculation when compared to the naive group. The results suggest that the spleen may be a storage and reactivation place of memory B cells in Nile tilapia.(AU)


Assuntos
Animais , Formação de Anticorpos , Ciclídeos/sangue , Ciclídeos/imunologia , Imunoglobulina M/análise , Imunoglobulinas/administração & dosagem
6.
Mem. Inst. Oswaldo Cruz ; 113(8): e170433, 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-955113

RESUMO

BACKGROUND The diagnosis of dengue is complex. Until recently, only specialised laboratories were able to confirm dengue infection. However, this has changed with the newly available immunochromatographic rapid tests. Early diagnosis is of great interest, and point-of-care rapid tests have been increasingly used in Brazil. Most of those tests have not undergone validation in the Brazilian population. In this context, we decided to evaluate a rapid test introduced in the Federal District (FD). OBJECTIVES To estimate the accuracy and reliability of the SD Bioeasy Dengue Duo rapid test and its components to detect dengue infections in a consecutive sample of symptomatic residents in the FD, Brazil. METHODS In total, 1353 venous blood samples were collected between 2013 and 2014. Two hundred and six positive samples (cases) and 246 negative samples (non cases) were required for sensitivity and specificity estimation, respectively; for agreement evaluation, we used 401 samples. The reference standard used was a composite of MAC-ELISA, virus isolation and real-time polymerase chain reaction (RT-qPCR). The evaluation was conducted prospectively under field conditions in the public health units of the FD. FINDINGS The results for the overall accuracy of the rapid test (NS1/IgM combined) showed 76% sensitivity and 98% specificity. The sensitivity for the NS1 component (67%) was better than that for the IgM component (35%). The positive likelihood ratio was 46, and the negative likelihood ratio was 0.24. The reliability of the test (NS1/IgM combined) demonstrated crude agreement of 98% (Kappa index 0.94). MAIN CONCLUSIONS The present phase III, large-scale validation study demonstrates that the rapid test SD Bioeasy Dengue Duo has moderate sensitivity (NS1/IgM combined) and high specificity. Therefore, the test is useful in confirming the diagnosis of dengue, but not enough to rule out the diagnosis. Our results also suggest that Dengue virus (DENV) viral load estimated through the RT-qPCR and antibody level measured through the MAC-ELISA could have had a direct influence on the accuracy of the rapid test.


Assuntos
Humanos , Imunoglobulina M/análise , Dengue/diagnóstico , Diagnóstico Precoce , Brasil/epidemiologia , Chile/epidemiologia , Reação em Cadeia da Polimerase em Tempo Real , Anticorpos Antivirais/sangue
7.
An. bras. dermatol ; 92(4): 534-536, July-Aug. 2017. graf
Artigo em Inglês | LILACS | ID: biblio-887014

RESUMO

Abstract: We report a 12-year-old girl who presented with recurrent angioedema on the face, trunk, and extremities, and concomitant marked weight gain for 5 years. During the episode, her white blood cell count increased to 47.7×109/L with 89.9% eosinophils, followed by elevated serum level of IL-5, IgE, IgM, and LDH. Histopathology showed perivascular eosinophilic infiltration and diffuse eosinophilic infiltration throughout the dermis. Possible causes of hypereosinophilia and eosinophilic infiltration of vital organs were ruled out. We also tested the FIP1L1/PDGFRa and ETV6/PDGFRb fusion gene to exclude the possibility of myeloid and lymphatic vessel neoplasms. The patient was treated with methylprednisolone and discharged with an oral prednisolone taper, which resulted in complete remission of the edema and normalization of peripheral blood eosinophil count, serum IL-5 level, IgE, IgM, and LDH.


Assuntos
Humanos , Feminino , Criança , Eosinofilia/complicações , Angioedema/complicações , Angioedema/patologia , Recidiva , Imunoglobulina E/sangue , Imunoglobulina M/sangue , Ganho de Peso , Interleucinas/sangue , Eosinofilia/patologia
8.
Acta bioquím. clín. latinoam ; 51(1): 75-81, mar. 2017. tab
Artigo em Espanhol | LILACS | ID: biblio-886101

RESUMO

La aterosclerosis es la patología vascular de mayor prevalencia, lo cual motiva numerosas investigaciones sobre su fisiopatogenia. Las lipoproteínas pueden ser modificadas por mecanismos de oxidación y acetilación entre otros, a nivel de sus componentes lipídicos como proteicos, tornándose aterogénicas. Las Apolipoproteínas B100 modificadas (ApoB100m), desempeñan un rol activo en el desarrollo de las lesiones ateroscleróticas conjuntamente con otros factores de riesgo. Éstas tienen la capacidad de producir respuesta inmune llevando a la producción de anticuerpos y la subsecuente formación de complejos inmunes. La importancia de los anticuerpos contra las ApoB100m en la aterogénesis todavía no está clara, existiendo datos contradictorios respecto a si su rol es protectivo o aterogénico. Se establecieron dos objetivos: Determinar los niveles de complejos inmunes circulantes IgM-ApoB100m por enzimoinmunoanálisis, en sujetos normales (sin riesgo aterogénico) y pacientes con alto riesgo y establecer su correlación con los factores de riesgo aterogénico ya establecidos, mediante un estudio observacional transversal. Se obtuvieron valores medios más elevados de IgM-ApoB100m en el grupo de sujetos normales. Los complejos inmunes IgM-ApoB100m correlacionan negativamente con los factores de riesgo aterogénicos clásicos (sexo masculino, avanzada edad, dislipemia, LDL-C aumentado y HDL-C disminuido).


Atherosclerosis is the most prevalent vascular disease, which motivates extensive research on its pathogenesis. Lipoproteins can be modified by acetylation and oxidation mechanisms, at the level of lipid components as protein, becoming atherogenic. Modified Apolipoprotein B100 (ApoB100m), play an active role in the development of atherosclerotic lesions in conjunction with other risk factors. These have the ability to produce immune response leading to antibody production and subsequent formation of immune complexes. The importance of antibodies against ApoB100m in atherogenesis is still unclear since, contradictory data exist on whether their role is protective or atherogenic. Two objectives were established: to determine the levels of circulating immune complexes IgM-ApoB100m by enzyme immunoassay, in normal subjects (without atherogenic risk) and high-risk patients and to establish its correlation with atherogenic risk factors established by a cross-sectional study. Higher mean values of IgM-ApoB100m were obtained in the group of normal subjects. Immune complexes IgM-ApoB100 negatively correlated with classic atherogenic risk factors (male, older, dyslipidemia, increased LDL-C and decreased HDL-C).


A aterosclerose é a doença vascular mais prevalente, o que motiva numerosas pesquisas sobre sua patogênese. As lipoproteínas podem ser modificadas por meio de mecanismos de oxidação e de acetilação entre outros, em nível de seus componentes lipídicos como proteicos, tornando-se aterogênicas. As apolipoproteínas B100 modificadas (ApoB100m), desempenham um papel ativo no desenvolvimento de lesões ateroscleróticas em conjunto com outros fatores de risco. Elas têm a capacidade de produzir resposta imune que conduz à produção de anticorpos e subsequente formação de complexos imunes. A importância de anticorpos contra a ApoB100m na aterogênese ainda não é clara, existindo dados contraditórios sobre se seu papel é de proteção ou aterogênico. Foram estabelecidos dois objetivos. Determinar os níveis de complexos imunes circulantes IgM-ApoB100m por enzimoimunoanálise em indivíduos normais (sem risco aterogênico) e pacientes de alto risco e, estabelecer sua correlação com os fatores de risco aterogênico já estabelecidos por um estudo Observacional Transversal. Foram obtidos valores médios mais elevados de IgM-ApoB100m no grupo de indivíduos normais. Os complexos imunes IgM-ApoB100 correlacionam negativamente com os fatores de risco aterogênicos clássicos (sexo masculino, idosos, dislipidemia, LDL-C aumentado e HDL-C diminuído).


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Aterosclerose , Imunoglobulina M/análise , Doenças Cardiovasculares , HIV , Imunoglobulinas/análise
9.
Pesqui. vet. bras ; 37(2): 195-203, fev. 2017. tab, graf
Artigo em Português | LILACS, VETINDEX | ID: biblio-834022

RESUMO

O conhecimento do metabolismo dos animais é de suma importância para se obter sucesso em qualquer atividade que envolva rebanhos. Objetivou-se determinar o perfil bioquímico sérico de vacas Jersey clinicamente saudáveis no pré e pós-parto, mantidas em sistema de criação semi-intensivo na região de Uberlândia, Minas Gerais, Brasil. Realizou-se o exame clínico e coleta de sangue de 40 vacas da raça Jersey multíparas e lactantes em 15 momentos, entre -150 dias pré-parto até 60 dias pós-parto (DPP). No laboratório, foram analisadas as concentrações séricas de proteínas totais, albumina, globulinas, ureia, creatinina, ácidos graxos não esterificados (NEFA), ß-hidroxibutirato (BHBA), triglicerídeos, colesterol, lipoproteínas de alta densidade (HDL), lipoproteínas de muita baixa densidade (VLDL), lipoproteínas de baixa densi­dade (LDL), aspartato aminotransferase (AST), gama-glutamil transferase (GGT), creatina quinase (CK), cálcio, fósforo e magnésio. Dos 40 animais, apenas 21 vacas atenderam aos critérios de inclusão e seus dados foram utilizados. Procedeu-se o teste de Tukey para os dados paramétricos e para os dados não paramétricos realizou-se o teste de Kruskal Wallis na comparação entre os momentos avaliados. Não houve interferência do balanço energético negativo e da hipocalcemia subclínica na ocorrência de doenças uterinas e no desempenho reprodutivo. Concluiu-se que vacas da raça Jersey apresentam perfil bioquímico caracterizado por hiperglobulinemia durante o periparto, além de níveis elevados de triglicérides, entretanto, sem comprometimento da função hepática e desempenho reprodutivo.(AU)


The understanding of animal metabolism is important for the success of livestock activity. The aim of this study was to determine the serum biochemical profile of clinically healthy Jersey cows in pre and postpartum, housed in semi-intensive production system in Uberlândia, Minas Gerais, Brazil. Clinical examination and blood collection from 40 multiparous lactating dairy cows, between -150 days prepartum up to 60 days postpartum (DPP) were performed. At the laboratory, serum parameters of total proteins, albumin, globulins, urea, creatinine, non-esterified fatty acids (NEFA), ß-hydroxybutyrate (BHBA), triglycerides, cholesterol, high density lipoprotein (HDL), very low density lipoproteins (VLDL), low density lipoproteins (LDL), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), creatine kinase (CK), calcium, phosphorus and magnesium were analyzed. To the total of cows (n=40) enrolled, only 21 cows were complied with the inclusion criterias. It was proceeded the Tukey test for parametric data, and to the nonparametric data it was held the Kruskal Wallis test for the comparison between days evaluated. There was no interference of negative energy balance and subclinical hypocalcemia in the occurrence of uterine diseases and reproductive performance. In conclusion, Jersey cows have biochemical profile characterized by hyperglobulinemia during peripartum, and high levels of triglycerides, but without impaired liver function and reproductive performance.(AU)


Assuntos
Animais , Feminino , Bovinos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Metabolismo/fisiologia , Parâmetros , Período Periparto/metabolismo , Triglicerídeos/sangue , Testes Hematológicos/veterinária
10.
Rev. Inst. Med. Trop. Säo Paulo ; 59: e2, 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-842764

RESUMO

ABSTRACT Introduction: The World Health Organization (WHO) recommends one single dose of the Yellow Fever (YF) vaccine based on studies of antibody persistency in healthy adults. We assessed the prevalence and titers of YF virus neutralizing antibodies in previously vaccinated persons aged ≥ 60 years, in comparison to younger adults. We also evaluated the correlation between antibody titers and the time since vaccination among participants who received one vaccine dose, and the seropositivity among participants vaccinated prior to or within the past 10 years. Methods: previously vaccinated healthy persons aged ≥ 18 years were included. YF virus neutralizing antibody titers were determined by means of the 50% Plaque Reduction Neutralization Test. Results: 46 persons aged ≥ 60 years and 48 persons aged 18 to 59 years were enrolled. There was no significant difference in the prevalence of YF virus neutralizing antibodies between the two groups (p = 0.263). However, titers were significantly lower in the elderly (p = 0.022). There was no correlation between YF virus neutralizing antibody titers and the time since vaccination. There was no significant difference in seropositivity among participants vaccinated prior to or within the past 10 years. Conclusions: the clinical relevance of the observed difference in YF virus neutralizing antibody titers between the two groups is not clear.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , Vacina contra Febre Amarela/imunologia , Vírus da Febre Amarela/imunologia , Febre Amarela/prevenção & controle , Fatores Etários , Brasil , Imunoglobulina M/sangue , Febre Amarela/imunologia
11.
Mem. Inst. Oswaldo Cruz ; 111(11): 692-696, Nov. 2016. tab
Artigo em Inglês | LILACS | ID: biblio-829249

RESUMO

Hepatitis E virus (HEV) infection has a worldwide distribution and represents an important cause of acute hepatitis. This study aims to investigate the occurrence of HEV infection and factors associated with this infection in patients with acute non-A, non-B, non-C hepatitis in Central Brazil. From April 2012 to October 2014, a cross-sectional study was conducted among 379 patients with acute non-A, non-B, non-C hepatitis in the City of Goiania, Central Brazil. Serum samples of all patients were tested for serological markers of HEV infection (anti-HEV IgM and IgG) by ELISA. Positive samples were confirmed using immunoblot test. Anti-HEV IgM and IgG positive samples were tested for HEV RNA. Of the 379 serum samples, one (0.3%) and 20 (5.3%) were positive for anti-HEV IgM and IgG, respectively. HEV RNA was not found in any sample positive for IgM and/or IgG anti-HEV. After multivariate analysis, low education level was independently associated with HEV seropositivity (p = 0.005), as well as living in rural area, with a borderline p-value (p = 0.056). In conclusion, HEV may be responsible for sporadic self-limited cases of acute hepatitis in Central Brazil.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Vírus da Hepatite E/imunologia , Hepatite E/epidemiologia , Doença Aguda , Brasil/epidemiologia , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Anticorpos Anti-Hepatite/sangue , Hepatite E/imunologia , Immunoblotting , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Prevalência , Estudos Soroepidemiológicos
12.
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 14(2): 68-74, ago. 2016. tab
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-869087

RESUMO

El dengue constituye una de las enfermedades transmitidas por mosquitos más importante a nivel mundial. La enfermedad puede cursar con un cuadro asintomático, presentarse con un amplio rango de manifestaciones clínicas inespecíficas o cierto porcentaje puede derivar en casos graves. Este estudio observacional descriptivo de corte transverso tuvo como objetivo determinar las características clínicas, parámetros hematológicos y presencia de IgM en 92 pacientes que acudieron al IICS-UNA con sospecha clínica de dengue en el periodo 2009 al 2013. Se utilizó el MAC-ELISA desarrollado en el IICS-UNA, se registraron los datos clínicos-epidemiológicos a través de una encuesta y se determinaron los parámetros hematológicos. Se obtuvieron resultados positivos para IgM en 51/92 (55%) pacientes y resultados negativos en 41/92 (45%). Las características clínicas más frecuentes fueron: fiebre, cefalea, mialgias y artralgias. Entre los pacientes con IgM positiva, 14/51 (27%) manifestaron dolores abdominales, 19/51 (37%) reportaron letargo o postración y 20/51 (39%) declararon tener náuseas y/o vómitos, 4/51 (8%) presentaron leucopenia, 10/51 (20%) valores de hematocrito disminuido y 6/51 (12%) plaquetopenia. Sólo 13/92 (14%) pacientes declararon haber cursado con la enfermedad anteriormente. Del total de pacientes, 4/92 (4%) manifestaron haber presentado algún tipo de hemorragia. Los resultados obtenidos en el estudio refuerzan la importancia de integrar todos los parámetros posibles: detección de IgM, perfil hematológico y la clínica del paciente con sospecha de dengue para brindar un mejor diagnóstico. Así también, es necesario resaltar en cuanto a los signos de alarma para una intervención rápida a fin de evitar complicaciones.


Dengue is one of the most important mosquito-borne diseases worldwide. The disease may present as asymptomatic, with a wide range of non-specific clinical manifestations or acertain percentage can result in severe cases. This observational, descriptive, crosssectional study aimed to determine the clinical features, hematological parameters and the presence of IgM in 92 patients who attended to IICS-UNA with clinical suspicion of denguefrom 2009 to 2013. The MAC-ELISA developed at IICS-UNA was used, clinical and epidemiological data were recorded through a survey and hematological parameters were determined. Positive results for IgM in 51/92 (55%) patients were obtained and negative results in 41/92 (45%). The most frequent clinical features were fever, headache, muscleand joint pains. Among patients with positive IgM, 14/51 (27%) reported abdominal pain,19/51 (37%) reported lethargy or prostration and 20/51 (39%) reported having nausea and/or vomiting, 4/51(8%) had leucopenia, 10/51 (20%) decreased hematocrit values and6/51 (12%) presented thrombocytopenia. Only 13/92 (14%) patients reported a previous DENV infection. Of the total, 4/92 (4%) presented some type of bleeding. The results of thestudy reinforce the importance of integrating all possible parameters: IgM detection, hematological and clinical profile of patients with suspected dengue to provide better diagnosis. It is also necessary to emphasize warning signs for a quick intervention to avoid complications.


Assuntos
Humanos , Adulto , Feminino , Dengue/diagnóstico , Imunoglobulina M/análise , Saúde Pública , Sinais e Sintomas
13.
Rev. cuba. pediatr ; 88(1): 67-73, ene.-mar. 2016. tab
Artigo em Espanhol | LILACS, CUMED | ID: lil-775059

RESUMO

INTRODUCCIÓN: la miositis aguda benigna infantil es un proceso poco frecuente, transitorio y autolimitado, que afecta predominantemente a la edad escolar tras una infección viral. OBJETIVO: divulgar esta forma de presentación de una virosis y contribuir a su diagnóstico. MÉTODOS: se estudiaron 13 pacientes, ingresados en el Hospital Pediátrico Docente del Cerro, por síndrome febril durante el año 2013 con inmunoglobulina M positiva antidengue, que presentaron impotencia funcional y concentraciones de creatininfosfokinasa superiores a 190 µl. Se evaluaron elementos demográficos, clínicos y niveles enzimáticos, y se aplicó el estadígrafo promedio. RESULTADOS: los signos y síntomas más comunes en todos los pacientes resultaron ser la fuerza muscular disminuida, el dolor intenso a la presión de los músculos gastrocnemios y la flexión dorsal de ambos pies. El dolor retro-ocular y el rash se presentaron indistintamente en ambos sexos. El promedio de edad fue de 11 años. Las cifras de la frecuencia cardiaca, respiratoria y tensión arterial fueron normales. La duración de los síntomas clínicos tuvo una media aritmética de 4 días. El conteo de leucocitos alcanzó promedio de 6 000 x 109/L, plaquetas 170 000 x 109/L, el hematocrito 37 vol/% y creatininfosfokinasa 217 µl. CONCLUSIONES: se concluye que el dolor muscular intenso con impotencia funcional en la extremidades inferiores, acompañado de cifras de cratinfosfokinasa elevadas en pacientes con inmunoglobulina M positiva antidengue, confirma el diagnóstico de miositis viral en el curso de esta arbovirosis. Se comenta que en Cuba no se ha efectuado algún reporte sobre esa entidad, por lo cual es oportuno realizar la presente comunicación que contribuya a su divulgación.


INTRODUCTION: benign acute childhood myositis is a infrequent, transient and self-limited process that mainly affects children at school age after viral infections. OBJECTIVE: to disseminate information on this form of presentation of a type of virosis and to contribute to its correct diagnosis. METHODS: thirteen patients admitted to the teaching pediatric hospital of Cerro with febrile syndrome during 2013 were studied. They showed positive anti-dengue M immunoglobuline, functional impotence and creatinin-phosphokinase over 190 µl. Several demographic and clinical elements as well as enzyme levels were assessed and the average statistic was applied. RESULTS: most frequent signs and symptoms in all the patients were reduced muscle strength, intense pain to gastrocnemy muscle pressure and dorsal flexion of both feet. The retroocular pain and rash occurred regardless of sex. The average age was 11 years. The heart and respiratory rate and blood pressure figures were all normal. The duration of clinical systems had an arithmetic mean of 4 days. Leukocyte count reached averages of 6 000 x 109/l; platelets showed 170 000 x 109/L; hematocrit reached 37 vol/% and creatinine-phosphokinase was 217 µl. CONCLUSIONS: intense muscular pain with functional impotence at the lower limbs accompanied by high creatinin-phosphokinase figures in patients with positive antidengue M immunoglobulin confirms the diagnosis of viral myositis in the course of this arbovirosis. It is commented that there has been no report on this disease in Cuba so far, so it is timely to provide the present communication in order to contribute to dissemination of information about this entity.


Assuntos
Humanos , Pré-Escolar , Criança , Imunoglobulina M , Doenças Musculares/complicações , Doenças Musculares/diagnóstico , Epidemiologia Descritiva , Dengue/diagnóstico
14.
Cad. saúde pública ; 32(1): e00095815, 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-772666

RESUMO

Abstract Dengue cases have increased in younger age groups in Brazil. Maternal anti-dengue antibodies can have a protective effect in the first months of life, but their decline can increase the risk of severe dengue. A prospective birth cohort was established in 2011-2012 in the city of Recife, Pernambuco State, Brazil, to determine the incidence of serotype-specific dengue infection and the kinetics of transferred maternal anti-dengue antibodies in the first years of life. This article describes the design, methods and preliminary results of this cohort study. 354 children underwent clinical and laboratory monitoring for two years, with 15% losses to follow-up. The overall rate of new infections was approximately 10% in the first year of follow-up. Information on the force of serotype-specific dengue infection and the evaluation of transferred maternal antibodies can contribute to understanding dengue etiopathogenesis.


Resumo Casos de dengue têm aumentado em grupos etários mais jovens no Brasil. Anticorpos antidengue maternos podem exercer efeito protetor nos primeiros meses de vida, mas seu declínio pode aumentar o risco de dengue grave. Uma coorte de nascimento prospectiva foi estabelecida na cidade do Recife, Pernambuco, Brasil, entre 2011-2012, para determinar a incidência de infecção sorotipo-específica do dengue e cinética dos anticorpos antidengue materno-transferidos nos primeiros anos de vida. Este artigo descreve o desenho, os métodos e resultados preliminares deste estudo de coorte. Trezentas e cinquenta e quatro crianças foram acompanhadas clínico e laboratorialmente por dois anos, com 15% de perdas de seguimento. A taxa global de novas infecções foi de aproximadamente 10% na coorte de crianças no primeiro ano de seguimento. Informações sobre a força de infecção sorotipo-específica do dengue nos primeiros anos de vida, bem como a avaliação da cinética de anticorpos materno-transferidos poderão contribuir para a compreensão da etiopatogenia da doença.


Resumen Los casos de dengue han aumentado en los grupos de edad más jóvenes en Brasil. Los anticuerpos antidengue maternos pueden ejercer un efecto protector en los primeros meses de vida, pero su decremento puede aumentar el riesgo de dengue grave. Una cohorte de nacimientos prospectiva se estableció en la ciudad de Recife, Pernambuco, Brasil, entre 2011-2012, para determinar la incidencia de infección serotipo-específica de dengue y la cinética de los anticuerpos antidengue materno-transferidos durante los primeros años de vida. Este artículo describe el diseño, los métodos y resultados preliminares de este estudio de cohorte. 354 niños fueron acompañados clínicamente y en laboratorio durante dos años, con un 15% de pérdidas en el seguimiento. La tasa global de nuevas infecciones fue de aproximadamente un 10% en la cohorte de niños durante el primer año de seguimiento. La información sobre la fuerza de infección serotipo-específica del dengue en los primeros años de vida, así como la evaluación de la cinética de los anticuerpos materno-transferidos, podrá contribuir a la comprensión de la etiopatogenia de la enfermedad.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Anticorpos Antivirais/sangue , Vírus da Dengue/imunologia , Dengue/epidemiologia , Doenças Endêmicas , Brasil/epidemiologia , Dengue/imunologia , Ensaio de Imunoadsorção Enzimática , Métodos Epidemiológicos , Imunidade Materno-Adquirida , Imunoglobulina G/sangue , Imunoglobulina M/sangue
15.
Rev. bras. hematol. hemoter ; 38(3): 193-198, 2016. tabela, gráfico
Artigo em Inglês | LILACS | ID: biblio-834154

RESUMO

Background: The term dangerous universal blood donor refers to potential agglutination of the erythrocytes of non-O recipients due to plasma of an O blood group donor, which contains high titers of anti-A and/or anti-B hemagglutinins. Thus, prior titration of anti-A and anti-B hemagglutinins is recommended to prevent transfusion reactions. Objective: The aim ofthis study was to estimate the frequency of dangerous universal donors in the blood bank of Belo Horizonte (Fundac¸ão Central de Imuno-Hematologia ­ Fundac¸ão Hemominas ­ Minas Gerais) by determining the titers of anti-A and anti-B hemagglutinins in O blood group donors. Method: A total of 400 O blood group donors were randomly selected, from March 2014 to January 2015. The titers of anti-A and anti-B hemagglutinins (IgM and IgG classes) were obtained using the tube titration technique. Dangerous donors were those whose titers of anti-A or anti-B IgM were ≥128 and/or the titers of anti-A or anti-B IgG were ≥256. Donors were characterized according to gender, age and ethnicity. The hemagglutinins were characterized by specificity (anti-A and anti-B) and antibody class (IgG and IgM). Results: Almost one-third (30.5%) of the O blood group donors were universal dangerous. The frequency among women was higher than that of men (p-value = 0.019; odds ratio: 1.66; 95% confidence interval: 1.08­2.56) and among young donors (18­29 years old) it was higher than for donors between 49 and 59 years old (p-value = 0.015; odds ratio: 3.05; 95% confi- dence interval: 1.22­7.69). There was no significant association between dangerous universal donors and ethnicity, agglutinin specificity or antibody class. Conclusion: Especially platelet concentrates obtained by apheresis (that contain a substantial volume of plasma), coming from dangerous universal donors should be transfused in isogroup recipients whenever possible in order to prevent the occurrence of transfusion reactions


Assuntos
Humanos , Doadores de Sangue , Transfusão de Sangue , Hemaglutininas , Serviço de Hemoterapia , Imunoglobulina G , Imunoglobulina M , Reação Transfusional
16.
Rev. chil. infectol ; 32(6): 658-663, tab
Artigo em Espanhol | LILACS | ID: lil-773272

RESUMO

Introduction: Toxoplasmosis is a worldwide disease; it can cause decreased vision or even blindness. The route of transmission in humans may vary according to the habits of the region; probably the ingestion of raw or undercooked meat is the main source of infection. Objective: To determine the seroprevalence of toxoplasmosis in an eye clinic, the frequency of ocular toxoplasmosis (OT) and risk habits for acquiring the infection. Materials and Methods: Adult patients consulting in the Retina Department of the Teaching Hospital of the National University of Asuncion, Paraguay between August and September, 2014 were included. Prior informed consent, socio-demographic and epidemiological data related to T. gondii infection were obtained. In addition a blood sample for the determination of anti T. gondii IgG antibodies by the ELISA method was taken and ophthalmologic evaluation for the diagnosis of OT was made. Results: A total of 80 patients with mean ± SD age of 53 ± 20 years were studied, with slight predominance of women (55%). The seroprevalence of toxoplasmosis was 84% (67/80) and OT was detected in 8.9% of the 67 seropositive persons. The habit of not washing vegetables with sodium hypochlorite and eat meat from wild animals was related to higher risk of infection in this population. Conclusion: It is important to conduct research at the population level to establish the epidemiology of toxoplasmosis in our country. Information on prophylactic measures to prevent infection by T. gondii should be given to the population.


Introducción: La toxoplasmosis es una enfermedad de distribución mundial, que puede ocasionar disminución de la visión hasta ceguera. La vía de transmisión en el hombre puede variar de acuerdo a los hábitos de cada región, siendo probablemente la ingestión de carne cruda o mal cocida la principal vía de contagio. Objetivo: Determinar la seroprevalencia de toxoplasmosis en una clínica oftalmológica, la frecuencia de toxoplasmosis ocular (TO) y los hábitos de riesgo para adquirir la enfermedad. Pacientes y Métodos: Fueron incluidos 80 pacientes adultos que consultaron en el Departamento de Retina de la Cátedra de Oftalmología del Hospital de Clínicas entre agosto y septiembre de 2014. Previo consentimiento informado, se obtuvieron los datos socio-demográficos y epidemiológicos relacionados a la infección por Toxoplasma gondii. Además se tomó una muestra de sangre para la determinación de anticuerpos del tipo IgG anti T. gondii por el método de ELISA y se realizó la evaluación oftalmológica para el diagnóstico de TO. Resultados: La edad promedio ± DE fue de 53 ± 20 años, con leve predominio de mujeres (55%). La seroprevalencia de toxoplasmosis fue de 84% (67/80) y la TO se detectó en 8,9% de los 67 seropositivos. Se observó que el hábito de no lavar las verduras con hipoclorito de sodio y comer carne silvestre presentó mayor riesgo de contraer la infección en esta población. Conclusión: Es importante realizar trabajos de investigación a nivel poblacional para establecer la epidemiología de la toxoplasmosis en nuestro país. Se debe dar a conocer a la población las medidas de profilaxis para evitar la infección por T. gondii.


Assuntos
Adulto , Animais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Toxoplasma/imunologia , Toxoplasmose Ocular/diagnóstico , Anticorpos Antiprotozoários/sangue , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Paraguai/epidemiologia , Fatores de Risco , Estudos Soroepidemiológicos , Toxoplasmose Ocular/epidemiologia
17.
Rev. méd. hered ; 26(4): 230-237, oct.-dic.2015. tab, graf
Artigo em Espanhol | LILACS | ID: lil-781704

RESUMO

La toxoplasmosis es una infección ocasionada por Toxoplasma gondii, peligrosa durante la gestación. La presencia de anticuerpos IgG específicos implica contacto previo individuo-parásito, mientras que la detección de IgM anti-T. gondii, es considerada marcador de infección aguda, fase en la que se incrementa además el título IgG. Objetivo: Determinar la frecuencia y título de anticuerpos contra Toxoplasma gondii en gestantes. Material y métodos: Estudio transversal, se determinó el título de IgG y la presencia de IgM específicas contra el parásito, mediante técnicas de aglutinación y Enzimoinmunoanálisis, respectivamente, en muestras de suero de mujeres en el primer, segundo o tercer trimestre de embarazo que asistieron a su control prenatal en el Centro de Imagenología y Laboratorio Clínico, durante el segundo semestre del año 2014. Resultados: Se evaluaron 167 pacientes, de las cuales 115 (68,9%) fueron negativas y 52 (31,1%) positivas para IgG anti T. gondii; dentro del último grupo se rastreó IgM específica en 35 pacientes, hallándose solo una positiva (3%). La titulación para IgG anti-T. gondii mostró resultados desde 1:1 a 1:8 diluciones en las 34 pacientes negativas para IgM específica y de 1:16 diluciones, en el caso positivo. Conclusión: Los resultados obtenidos en el presente estudio permiten concluir que una tercera parte de la población gestante presenta anticuerpos asociados a memoria inmunológica contra T.gondii a títulos bajos, y sólo una minoría (inferior al 5%) evidencia concomitantemente huella serológica de infección reciente...


Toxoplasmosis is caused by Toxoplasma gondii and it is especially dangerous during pregnancy. The presence of IgG antibodies against T. gondii indicates past infection, while the presence of IgM indicates acute infection. Objective: To determine the frequency and titers of antibodies against T. gondii in pregnant women in Cucuta, Colombia. Methods: A cross sectional study was carried out in which titers of IgG and IgM to T. gondii were measured using agglutination and immunoassay methods in serum samples of first, second and third trimester pregnant women who attended pre-natal control in the Center for Imagenology and Clinical Laboratory during the second semester of 2014. Results: 167 women were evaluated; 115 (68.9%) were negative for IgG and 52 (31.1%) were positive; specific IgM was search for in 35 of these IgG positive women, only one was positive (3%). IgG titers varied from 1:1 to 1:8 in the 34 IgM seronegative women, but was 1:16 in seropositive women. Conclusions: One third of the population studied was previously infected showing low titers of IgG, the minority showed evidence of acute infection...


Assuntos
Humanos , Imunoglobulina G , Imunoglobulina M , Gestantes , Toxoplasmose , Toxoplasmose/diagnóstico , Colômbia , Estudos Transversais , Epidemiologia Descritiva
18.
Mem. Inst. Oswaldo Cruz ; 110(7): 914-920, Nov. 2015. tab, graf
Artigo em Inglês | LILACS | ID: lil-764594

RESUMO

Leprosy inflammatory episodes [type 1 (T1R) and type 2 (T2R) reactions] represent the major cause of irreversible nerve damage. Leprosy serology is known to be influenced by the patient’s bacterial index (BI) with higher positivity in multibacillary patients (MB) and specific multidrug therapy (MDT) reduces antibody production. This study evaluated by ELISA antibody responses to leprosy Infectious Disease Research Institute diagnostic-1 (LID-1) fusion protein and phenolic glycolipid I (PGL-I) in 100 paired serum samples of 50 MB patients collected in the presence/absence of reactions and in nonreactional patients before/after MDT. Patients who presented T2R had a median BI of 3+, while MB patients with T1R and nonreactional patients had median BI of 2.5+ (p > 0.05). Anti-LID-1 and anti-PGL-I antibodies declined in patients diagnosed during T1R (p < 0.05). Anti-LID-1 levels waned in MB with T2R at diagnosis and nonreactional MB patients (p < 0.05). Higher anti-LID-1 levels were seen in patients with T2R at diagnosis (vs. patients with T1R at diagnosis, p = 0.008; vs. nonreactional patients, p = 0.020) and in patients with T2R during MDT (vs. nonreactional MB, p = 0.020). In MB patients, high and persistent anti-LID-1 antibody levels might be a useful tool for clinicians to predict which patients are more susceptible to develop leprosy T2R.


Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Anticorpos Antibacterianos/sangue , Antígenos de Bactérias/imunologia , Glicolipídeos/imunologia , Imunoglobulina M/sangue , Hanseníase Multibacilar/diagnóstico , Anticorpos Antibacterianos/imunologia , Suscetibilidade a Doenças , Ensaio de Imunoadsorção Enzimática , Imunoglobulina M/imunologia , Mycobacterium leprae/imunologia
19.
Rev. Soc. Bras. Med. Trop ; 48(5): 524-531, Sept.-Oct. 2015. tab, graf
Artigo em Inglês | LILACS | ID: lil-763325

RESUMO

ABSTRACTINTRODUCTION:Since women are frequently the minority among blood donors worldwide, studies evaluating this population usually reflect male features. We assessed the features of female blood donors with positive serology for HBV and compared them with those of men.METHODS The study comprised consecutive blood donors referred to a specialized liver disease center to be evaluated due to HBsAg- and/or anti-HBc-positive tests.RESULTS: The study encompassed 1,273 individuals, 219 (17.2%) of whom were referred due to positive HBsAg test and 1,054 (82.8%) due to reactive anti-HBc test. Subjects' mean age was 36.8±10.9 years, and 28.7% were women. Female blood donors referred for positive HBsAg screening tests demonstrated higher prevalence of healthcare workers (9.3% vs 2.5%) and lower prevalence of sexual risk behaviors (15.1% vs 41.1%) and alcohol abuse (1.9% vs 19.8%) compared to men. Women had lower ALT (0.6 vs 0.8×ULN), AST (0.6 vs 0.8×ULN), direct bilirubin (0.2 vs 0.3mg/dL), and alkaline phosphatase (0.5 vs 0.6×ULN) levels and higher platelet count (223,380±50,293 vs 195,020±53,060/mm3). Women also had a higher prevalence of false-positive results (29.6% vs 17.0%). No differences were observed with respect to liver biopsies. Female blood donors referenced for reactive anti-HBc screening tests presented similar clinical, epidemiological, and biochemical characteristics to those reported for positive HBsAg screening tests and similarly had a higher prevalence of false-reactive results.CONCLUSIONS: Compared to men, female blood donors with positive HBsAg and/or anti-HBc screening tests demonstrated higher prevalence of professional risk and false-positive results and reduced alteration of liver chemistry.


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doadores de Sangue/estatística & dados numéricos , Hepatite B/epidemiologia , Brasil/epidemiologia , Métodos Epidemiológicos , Reações Falso-Positivas , Anticorpos Anti-Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/imunologia , Hepatite B/diagnóstico , Imunoglobulina M/sangue , Fatores Sexuais
20.
Mem. Inst. Oswaldo Cruz ; 110(6): 732-738, Sept. 2015. tab, graf
Artigo em Inglês | LILACS | ID: lil-763098

RESUMO

The aim of this study was to evaluate an enzyme-linked immunoassay with recombinant rhoptry protein 2 (ELISA-rROP2) for its ability to detectToxoplasma gondii ROP2-specific IgG in samples from pregnant women. The study included 236 samples that were divided into groups according to serological screening profiles for toxoplasmosis: unexposed (n = 65), probable acute infection (n = 48), possible acute infection (n = 58) and exposed to the parasite (n = 65). When an indirect immunofluorescence assay forT. gondii-specific IgG was considered as a reference test, the ELISA-rROP2 had a sensitivity of 61.8%, specificity of 62.8%, predictive positive value of 76.6% and predictive negative value of 45.4% (p = 0.0002). The ELISA-rROP2 reacted with 62.5% of the samples from pregnant women with probable acute infection and 40% of the samples from pregnant women with previous exposure (p = 0.0180). Seropositivity was observed in 50/57 (87.7%) pregnant women with possible infection. The results underscored that T. gondii rROP2 is recognised by specific IgG antibodies in both the acute and chronic phases of toxoplasmosis acquired during pregnancy. However, the sensitivity of the ELISA-rROP2 was higher in the pregnant women with probable and possible acute infections and IgM reactivity.


Assuntos
Feminino , Humanos , Gravidez , Antígenos de Protozoários/imunologia , Ensaio de Imunoadsorção Enzimática/métodos , Imunoglobulina G/sangue , Proteínas de Membrana/imunologia , Complicações Parasitárias na Gravidez/diagnóstico , Proteínas de Protozoários/imunologia , Toxoplasmose/diagnóstico , Antígenos de Protozoários/sangue , Intervalos de Confiança , Ensaio de Imunoadsorção Enzimática/normas , Técnica Indireta de Fluorescência para Anticorpo , Imunoglobulina G/isolamento & purificação , Imunoglobulina M/sangue , Imunoglobulina M/isolamento & purificação , Invenções/normas , Proteínas de Membrana/genética , Valor Preditivo dos Testes , Complicações Parasitárias na Gravidez/sangue , Complicações Parasitárias na Gravidez/imunologia , Proteínas de Protozoários/genética , Proteínas Recombinantes , Padrões de Referência , Sensibilidade e Especificidade , Toxoplasma/imunologia , Toxoplasmose/sangue , Toxoplasmose/imunologia
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