Blood discard rate in a blood center in Curitiba - Brazil. Ten years of study.

INTRODUCTION: Development of technologies to reduce transfusion risks of infectious diseases is a major characteristic of hemotherapy. Thus, each donation undergoes clinical and serological screening tests to ensure the donated blood do not offer risks to the receiver. OBJECTIVE: Evaluate the prevalence of positive serology in blood donations rejected by Hemobanco (Curitiba - PR) in the period ranging from January 2003 to December 2012. METHODOLOGY: During the period studied, we observed the total number of donations and its division according to gender. We also analyzed the number of rejected donations due to seropositivity, considering the diseases investigated routinely in blood banks in Brazil, and the frequency of discards according to age groups. RESULTS: Within the period studied, 399,280 donations were performed. 62.0% donors were male. Comparing 2003 to 2012, we noticed a significant decrease of discards, from 10.2% to 5.0%, respectively. There was a reduction of seropositivity for HIV, HBsAg and anti-HBc and an increase for Chagas Disease, hepatitis C, syphilis and HTLV. The age group with the highest prevalence for discards changed: it used to be the 40-59 years old group in 2003, and became the 20-39 years old group in 2012. CONCLUSION: There was an increase in the number of donations in Hemobanco and a decrease in total discards due to seropositive donations. Most donors were male. The most prevalent cause of discards only amongst seropositive donation discards is seropositivity for anti-HBc. There was a significant increase of donors aged between 20 and 39 years old.

The serum angiotensin converting enzyme and lysozyme levels in patients with ocular involvement of autoimmune and infectious diseases.

BACKGROUND: Increased serum levels of angiotensin converting enzyme and lysozyme are considered as inflammatory markers for diagnosis of sarcoidosis which is an autoimmune inflammatory disease. The purpose of this study is to evaluate the significance of differences in serum angiotensin converting enzyme and lysozyme levels of patients with ocular involvement of other autoimmune inflammatory and infectious diseases. METHODS: This is a prospective study involving patients with ankylosing spondylitis, behcet's disease, presumed sarcoidosis, presumed latent tuberculosis, presumed latent syphilis, and control group. The serum levels of angiotensin converting enzyme and lysozyme were analyzed by enzyme-linked immunosorbent assay. Bonnferoni analysis was used to assess pairwise comparisons between the groups. RESULTS: There was a significant increase in serum angiotensin converting enzyme level in patients with presumed sarcoidosis compared to ankylosing spondylitis (p = 0.0001), behcet's disease (p = 0.0001), presumed latent tuberculosis (p = 0.0001), presumed latent syphilis (p = 0.0001), and control group (p = 0.0001). The increase in serum lysozyme level was significant for patients with presumed sarcoidosis with respect to ankylosing spondylitis (p = 0.0001), behcet's disease, (p = 0.0001) presumed latent tuberculosis (p = 0.001), presumed latent syphilis (p = 0.033), and control group (p = 0.0001). CONCLUSION: Elevated serum angiotensin converting enzyme levels are significant for patients with presumed sarcoidosis compared to ocular involvement of other autoimmune diseases such as behcet's disease and ankylosing spondylitis, and ocular involvement of infectious diseases such as presumed latent tuberculosis and presumed latent syphilis. However, elevated serum lysozyme level might be also detected in ocular involvement of infectious diseases such as presumed latent tuberculosis and presumed latent syphilis. TRIAL REGISTRATION NUMBER: NCT02627209. Date of registration: 12/09/2015.

Liver involvement in HIV-infected patients diagnosed with syphilis.

PURPOSE: Liver involvement in syphilis has been studied in cohorts of human immunodeficiency virus (HIV)-negative individuals despite the scarcity of data on such HIV-infected patients. Th aim of this study was to assess hepatic involvement of HIV-infected patients diagnosed with syphilis. METHODS: Patients with syphilis and liver involvement, including all stages of syphilis, were systematically identified in our HIV cohort between 2004 and 2008. RESULTS: Of the 1,599 HIV-infected patients identified during the study period, 100 were diagnosed with acute syphilis, all of whom were male. Of these 100 patients, 84% were men who have sex with men. Laboratory parameters of liver involvement were present in 19 of the 100 HIV-infected patients with syphilis; these resolved after successful antibiotic treatment. Among these 19 patients, six were diagnosed to be in the latent stage, with elevated liver enzymes and parameters of inflammation representing the only distinctive feature. CONCLUSIONS: Based on our results, syphilis should be included in the differential diagnosis of increased liver enzymes in HIV-infected patients.

The hyaluronidase associated with Treponema pallidum facilitates treponemal dissemination.

Treponema pallidum contains hyaluronidase (Hase) associated with its surface. Experiments were performed to determine the functional role of this enzyme in syphilitic infection. The effects of incubating organisms with rabbit anti-bovine Hase or normal or immune sera were compared. Preincubation of treponemes with anti-Hase resulted in inhibition of treponemal degradation of hyaluronic acid, indicating that these antisera did in fact retard enzyme activity. Anti-Hase did not immobilize or neutralize T. pallidum. In addition, rabbits were immunized with bovine Hase and then challenged intradermally with organisms; subsequent lesion development was not affected. Anti-Hase did not block treponemal attachment to cultured testicular fibroblasts but did inhibit attachment to isolated capillaries. Rabbit amnions were used as an in vitro model for dissemination of T. pallidum. Anti-Hase retarded the penetration of organisms through the amnions. This inhibitory effect was dependent on the presence of amniotic hyaluronic acid. When this glycosaminoglycan was selectively removed, the anti-Hase lost its ability to inhibit treponemal penetration. When exogenous hyaluronic acid was added back to treated amnions, the inhibitory effect of anti-Hase was restored. Evans blue experiments were used to characterize treponeme-induced vascular leakage following intradermal inoculation of T. pallidum. Prior treatment of organisms with anti-Hase reduced dermal leakage of the dye, indicating the involvement of the treponemal Hase in causing vessel leakage. Finally, rabbit testicular infections were used as an in vivo model for dissemination; one testis was infected, and after 10 to 13 days, treponemes in the opposite testis were quantitated. The anti-Hase restricted dissemination of organisms. These findings point to the functional role of the treponemal Hase in facilitating disseminated syphilis.

The human respiratory nasal mucosa in nasal syphilis. A histochemical study.

The enzymatic changes in tertiary nasal syphilis were studied in 5 patients. The cholinesterase was increased in the subepithelium, around the glands and blood vessels, denoting parasympathetic hyperactivity. Acid phosphatase was increased in the epithelium, stromal histiocytes, around the glands and ducts, indicating increased phagocytotic activity. Alkaline phosphatase was increased in the capillary endothelium and periglandular stroma, denoting marked vascular changes. Succinic dehydrogenase, alkaline phosphatase, alpha esterase and PAS-alcian blue were diminished in the epithelium and glands, denoting diminished secretory activity, hence a diminished natural defence mechanism of the nasal mucosa. When serological tests are inconclusive, these findings become an important adjuvant to a final diagnosis.

Mucopolysaccharidase of Treponema pallidum.

Treponema pallidum (Nichols strain) exhibited mucopolysaccharidase activity. Acidic mucopolysaccharides were broken down more rapidly by viable treponemes than by heat-inactivated treponemes or membrane filtrates of treponemal suspensions. Ouchterlony immunodiffusion demonstrated the occurrence of antibodies to the hyaluronidase-like enzyme within syphilitic sera. After intratesticular inoculation of 2 x 10(7) to 6 x 10(7) treponemes, these anti-mucopolysaccharidase antibodies were detected between 9 and 35 days postinoculation. In addition, acidic mucopolysaccharides were present in the serum of infected animals 9 and 16 days postinoculation. Immune serum that contained antibodies to the mucopolysaccharidase restricted treponemal breakdown of acidic mucopolysaccharides. It has been previously demonstrated that immune rabbit serum contains a factor that blocks attachment of T. pallidum (Nichols strain) to cultured mammalian cells. This factor was effectively absorbed by prior incubation with bovine hyaluronidase. It is postulated that T. pallidum attaches to acidic mucopolysaccharides on the surface of cultured cells through the mucopolysaccharidase enzyme at the surface of the organisms. These findings are discussed in terms of the histopathogenesis of T. pallidum with applications to the healing immune response.

[Lysozyme content in the serum and organs of rabbits with a syphilitic infection]. / Soderzhanie lizotsima v syvorotke i organakh krolikov pri sifiliticheskoi infektsii

The levels of lysozyme in the serum and organs of Shienshilla male rabbits infected with Nico-s treponema were determined. The studies showed that the lues infection affected the factors of non-specific immunity, which was evident from the changes in the lysozyme titer. Administration of benzylpenicillin resulted in a marked decrease in the lysozyme titer in all cases. The experiments are indicative of advisability of studying the use of crystalline lysozyme in combination with antibiotics for increasing the efficacy of therapy of syphilitic infection.