Comparação de resultados de exames sorológicos para sífilis realizados em um hospital público da região oeste do Paraná / Comparison of results from syphilis serological tests performed in a public hospital from the western region of Paraná

Objetivo: O objetivo desta pesquisa foi estimar a prevalência da positividade de testes sorológicos para sífilis nos pacientes atendidos pelo Hospital Universitário do Oeste do Paraná (HUOP) e descrever parte de suas características socioepidemiológicas. Métodos: Estudo transversal que utilizou como fonte de dados informações do prontuário eletrônico Tasy®, referentes aos resultados de exames de VDRL e FTA-Abs realizados no HUOP, entre janeiro de 2015 e dezembro de 2019. Resultados: Durante este período foram liberados laudos de 26.968 testes de VDRL, realizados no Laboratório do HUOP e o nú- mero de resultados reagentes foi de 1.014. Em relação ao FTA-Abs, foram liberados 383 resultados e destes 116 foram reagentes. O estudo evidenciou um aumento de resultados reagentes do teste não treponêmico VDRL de 2017 a 2019. Conclusão: Neste estudo foi observado um aumento progressivo no diagnóstico de sífilis, e isto reflete a situação da doença em todo o Brasil que, mesmo com protocolos de diagnóstico e tratamento, persiste numa posição de grande destaque na saúde pública. Os dados apresentados demonstram a importância do serviço do HUOP para o diagnóstico desta doença para grande parte do oeste paranaense.

Objective: The objective of this research was to estimate the positivity prevalence of syphilis serological tests, in the patients attended in the State Universitary Hospital from Western of Paraná (HUOP), and to describe part of their socioepidemiological characteristics. Methods: Transversal study, which made use of the informations contained in the electronic medical reports software Tasy®, regarding the results of exams of VDRL and FTA-Abs, performed in the HUOP between january of 2015 and december of 2019. Results: During the studied period, reports on 26,968 VDRL tests were performed in the HUOP laboratory and the number of reagent results is 1,104. Towards the FTA-Abs test, 383 tests were performed and 116 of these were positive. The study showed an increasing number of reagent results for VDRL between 2017 and 2019. Conclusion: In this study, a progressive increase in the diagnosis of syphilis was observed, this reflects the situation of the disease all around the brazillian country, in which, even with well defined diagnostic and treating protocols, the infection persists in a prominent position for the public health. The presented data shows the importance of the HUOP's service to the population, in regards to the syphilis diagnose.

Relationships among Antibodies against Extractable Nuclear Antigens, Antinuclear Antibodies, and Autoimmune Diseases in a Brazilian Public Hospital.

One characteristic of autoimmune diseases (ADs) is the production of autoantibodies for extractable nuclear autoantigens, which may aid in the discrimination of the different types of autoimmune diseases and is related to different antinuclear antibody (ANA) patterns. The present study verified the profile of patient samples tested for extractable nuclear antigens (ENA) antibodies in a public hospital and correlated the ENA results with ANA patterns and patient diagnoses. The study reviewed data in the medical records of patients who underwent anti-ENA tests at a public hospital in the West of the State of Paraná from February 2011 to January 2017. Patients were classified according to age, ethnicity, gender, anti-ENA test results, ANA results, and the presence or absence of AD. Thirty-six (20.9%) samples of the 172 anti-ENA tests were positive, seven (4.1%) samples were undetermined, and 129 (75%) exhibited negative results. The ANA reagent was found in 84.3% of the anti-ENA-positive samples. The anti-SSA/Ro autoantibody exhibited the highest frequency in the group, 41.7% (15/36). The most common pattern was nuclear fine speckled, which was found in 24.3% of the samples. The association results indicated a significant relationship between ANA titer and diagnosis in the anti-ENA- and ANA-positive patients. The anti-ENA-negative patients were diagnosed with an AD in 35% (45/129) of the cases, and 75% (27/36) of the anti-ENA-positive patients were diagnosed with an AD. Systemic lupus erythematosus and scleroderma were the most common pathologies in the antigen-positive patients. The anti-ENA test is a good marker to aid in the complex clinical diagnosis of patients with autoimmune diseases.

Indução do padrão citoplasmático em forma de "bastões e anéis" através do tratamento da hepatite C: relato de caso / Induction of cytoplasmic pattern in the form of "rods and rings" through the treatment of hepatitis C: a case report

Paciente do sexo feminino, queixando-se de astenia e dor em hipogastro, foi admitida no pronto-socorro do Hospital Universitário do Oeste do Paraná (HUOP). Durante a anamnese relatou tratamento de infecção crônica pelo vírus da hepatite C (VHC) com inteferon peguilado e ribavirina. Dentre os exames laboratoriais solicitados, a pesquisa de autoanticorpos contra antígenos celulares (PAAC-HEp-2), conhecido tradicionalmente como fator antinúcleo (FAN), apresentou fluorescência em forma de bastões e/ou anéis no citoplasma das células. Esse padrão é caracterizado por bastões de 3-10 µm e anéis com 2-5 µm de diâmetro espalhados através do citoplasma da célula. Portanto, esse novo padrão tem sido designado como "bastões e anéis" (traduzido do inglês: Rods and Rings, RR). O alvo antigênico dessa reação foi identificado como inosina-5'-monofosfato desidrogenase tipo 2 (IMPDH2) que é uma enzima chave na síntese de nucleotídeos púricos. A enzima IMPDH2 agregada ou modificada em forma de RR nos pacientes tratados com ribavirina pode tornar-se antigênica e induzir uma resposta autoimune. É possível que o interferon alfa estimule a ocorrência de reatividade anti-RR aparentemente induzida pela ribavirina. Até o momento não se sabe por que o padrão RR em células HEp-2 ocorrem apenas em uma fração de pacientes portadores do VHC. Os dados apresentados em trabalhos anteriores possibilitam afirmar que esses anticorpos associados ao padrão RR estão fortemente relacionados com o tratamento da hepatite C. Além disso, pode-se afirmar que a ocorrência de reatividade anti-RR é promovida pela terapia combinada com interferon alfa e ribavirina.

Female patient, complaining of weakness and pain in hypogastric, was admitted to the emergency department of the University Hospital of the West of Paraná (HUOP). During the interview reported treatment of chronic infection with hepatitis C virus (HCV) with peginterferon and ribavirin. Among the laboratory tests ordered, the search for self-antibodies against cellular antigens, traditionally known as antinuclear factor, showed fluorescence shaped like rods and/or rings in the cytoplasm of cells. This study attempts to clarify the relationship between this pattern not yet completely understood and the clinical picture of the patient. This pattern is characterized by 3–10 µm rods or rings with 2–5 µm in diameter scattered throughout the cytoplasm of the cell. Therefore, this new standard has been designated as "rods and rings" (RR). The antigenic target of this reaction was identified as inosine-5'-monophosphate dehydrogenase type 2 (IMPDH2) which is a key enzyme in the synthesis of purine nucleotides. The IMPDH2 enzyme aggregated or modified shaped RR in those patients treated with ribavirin may become antigenic and induce an autoimmune response. It is possible that interferon alpha stimulates the occurrence of anti-RR reactivity apparently induced by ribavirin. So far it is not known why the standard RR in HEp2 cells occurs only in a fraction of patients with HCV. Previous studies presented in this paper allow affirming that these antibodies associated with the standard RR are strongly related to hepatitis C. Moreover, it can be stated that the occurrence of anti-RR reactivity is promoted by combination therapy with interferon and ribavirin.

Induction of cytoplasmic pattern in the form of "rods and rings" through the treatment of hepatitis C: a case report.

Female patient, complaining of weakness and pain in hypogastric, was admitted to the emergency department of the University Hospital of the West of Paraná (HUOP). During the interview reported treatment of chronic infection with hepatitis C virus (HCV) with peginterferon and ribavirin. Among the laboratory tests ordered, the search for self-antibodies against cellular antigens, traditionally known as antinuclear factor, showed fluorescence shaped like rods and/or rings in the cytoplasm of cells. This study attempts to clarify the relationship between this pattern not yet completely understood and the clinical picture of the patient. This pattern is characterized by 3-10 µm rods or rings with 2-5 µm in diameter scattered throughout the cytoplasm of the cell. Therefore, this new standard has been designated as "rods and rings" (RR). The antigenic target of this reaction was identified as inosine-5'-monophosphate dehydrogenase type 2 (IMPDH2) which is a key enzyme in the synthesis of purine nucleotides. The IMPDH2 enzyme aggregated or modified shaped RR in those patients treated with ribavirin may become antigenic and induce an autoimmune response. It is possible that interferon alpha stimulates the occurrence of anti-RR reactivity apparently induced by ribavirin. So far it is not known why the standard RR in HEp2 cells occurs only in a fraction of patients with HCV. Previous studies presented in this paper allow affirming that these antibodies associated with the standard RR are strongly related to hepatitis C. Moreover, it can be stated that the occurrence of anti-RR reactivity is promoted by combination therapy with interferon and ribavirin.

Effectiveness of periodontal treatment on the improvement of inflammatory markers in children.

AIM: It is known that atherosclerosis begins in childhood, a behaviour towards oral health care and metabolic control, since an early age, is essential for patients with cardiovascular disease. The aim of this research was to evaluate the effectiveness of periodontal treatment full-mouth scaling and root planning (FMSRP), applied to children without systemic diseases, correlating with periodontal clinical and blood parameters (lipid profile and inflammatory markers). MATERIALS AND METHODS: The 29 patients were divided into two groups, group 1 (14) - scaling and rot planning (SRP), group 2 (15) - FMSRP and the follow-up was conducted among 180 days. RESULTS: The results showed a significant improvement in clinical periodontal parameters (p<0.05) in both groups. In the analyzed blood parameters there was a greater evidence, with a significant improvement (p<0.05), in total cholesterol (TC), triglycerides (TGs), fibrinogen (FGN), and interleukin-6 (IL-6) CONCLUSIONS: Thus, we suggest that both periodontal treatments were effective in children without any systemic diseases.

Lipid profiles and inflammatory markers after periodontal treatment in children with congenital heart disease and at risk for atherosclerosis.

Due to the biological associations between periodontal and cardiovascular diseases, as well as the fact that atherosclerosis begins in childhood, behavior based on oral health care and metabolic control from an early age is essential for patients with cardiovascular disease. The aim of this research was to examine the effect of full-mouth scaling and root planing on the reduction of periodontal disease in children with congenital heart disease. In this study, treatments were related to clinical periodontal parameters and also to blood ones, such as lipid profile and inflammatory markers. The patients were divided into two groups: group 1 (n=17), scaling and root planing; and group 2 (n=16), full-mouth scaling and root planing. The results showed a significant improvement in clinical periodontal parameters (P<0.05) in both groups. Considering lipid parameters, total cholesterol, triglycerides, and very-low-density lipoprotein parameters showed significant improvement (P<0.05). There was also an improvement in C-reactive protein (ultrasensitive) in the group treated with scaling and root planing (P<0.05). Fibrinogen and interleukin-6 parameters improved (P<0.05) in both groups. We suggest that both periodontal treatments were effective in children with congenital heart disease, though neither demonstrated superiority.

Effects of Low-Level Laser Therapy, 660 nm, in Experimental Septic Arthritis.

The effectiveness of low-level laser therapy (LLLT) in the presence of an infectious process has not been well elucidated. The aim of the study was to evaluate the effects of LLLT in an experimental model of septic arthritis. Methods. Twenty-one Wistar rats were divided as follows: control group, no bacteria; placebo group, bacteria were inoculated; Treated group, bacteria were injected and treatment with LLLTwas performed. To assess nociception, a von Frey digital analgesimeter was applied. Synovial fluid was streaked to analyze bacterial growth. The standard strain of S. aureus was inoculated in the right knee. LLLT was performed with 660 nm, 2 J/cm(2), over 10 days. After treatment, the knees were fixed and processed for morphological analysis by light microscopy. Results. It was found that nociception increases in the right knee. There was a lack of results for the seeding of the synovial fluid. The morphological analysis showed slight recovery areas in the articular cartilage and synovia; however, there was the maintenance of the inflammatory infiltrate. Conclusion. The parameters used were not effective in the nociception reduction, even with the slight tissue recovery due to the maintenance of inflammatory infiltrate, but produced no change in the natural history of resolution of the infectious process.