Topography and morphometry of the infraorbital and mandibular foramen of the common sloth (Bradypus variegatus) for use in the application of perineural anaesthesia.

A local anaesthetic block performed in cranial and mandibular foramina contributes towards analgesia and the reduction of systemic anaesthesia in procedures in the oral cavity. However, anatomical differences between in wild animals may require adaptations to the anaesthetic and surgical manoeuvres of the head used in domestic animals. With that in mind, we aimed to describe the topography and morphometry of the infraorbital and mandibular foramina in Bradypus variegatus, to support perineural anaesthetic approaches in the cranio-mandibular region of this species. We demonstrated that in B. variegatus there is no significant variability in the morphometric data, allowing access to the studied foramina to occur in a similar way in adult individuals. Finally, we understand that the techniques for the infraorbital and mandibular foramen needed to be adapted due to the anatomical singularities of the species, which culminated in new reference points for more assertive needle positioning.

Aortic branches and rete mirabile of the limbs of two-toed sloth (Choloepus didactylus).

Choloepus didactylus has reduced metabolism and difficulty in thermoregulation owing to its low body mass, and there are few studies related to the vascularization of abdominal and thoracic organs in this species. Therefore, we macroscopically described the arteries that comprise the aortic arch, thoracic aorta, and abdominal aorta. Six specimens were used, and their arterial systems filled with red latex before fixation in 10% formaldehyde, and fragments of the rete mirabile were processed for histological analysis using light and scanning electron microscopy. In these species, the aortic arch had two branches: the brachiocephalic trunk and left subclavian artery. The initial portion of the abdominal aorta presented four different ramifications, besides to the peculiarities of the adrenal, renal, and iliac arteries. Microscopy of the rete mirabile revealed a muscular artery surrounded by smaller muscular arteries, veins, nerves, and lymphatic tissue joined by connective tissue. Thus, the data obtained have clinical and surgical importance, with applicability in procedures involving vascularization of the thoracic and abdominal organs. We suggest that the rete mirabile is an efficient thermoregulatory structure because it allows the accumulation of blood and the countercurrent heat exchange, as there is no blood mixing.

Urogenital development and sexual differentiation in males of the species Dasyprocta fuliginosa.

Thirteen black agouti (Dasyprocta fuliginosa) male fetuses, acquired in two areas of the Amazon Forest, were used for the purpose of morphologically describing the fetal male urogenital organs with a focus on addressing histological and macroscopic aspects. The organs of interest were dissected and photographed in situ and ex situ. Fragments were collected and subjected to routine histological processing for inclusion in paraffin, which was cut and stained by haematoxylin and eosin and Gomori's Trichrome methods and subsequently analysed in a light microscope. The results showed that the urinary tract is like that of domestic animals and is composed of smooth unilobed kidneys covered by a dense capsule of connective tissue and divided into two well-defined regions, cortical and medullary. Ureters, urethra and urinary bladder also showed macroscopic and microscopic characteristics similar to those of domestic animals. The penis of these animals has fibroelastic characteristics, with numerous keratinized structures at its apex. In the middle third of the penis, a "U" shaped penile flexure was seen; the glans penis is covered by a keratinized epidermis containing horny spicules. The presence of a penile bone in an endochondral ossification process was observed, being more developed in gestational ages greater than 76 days. The annex glands were not observed, probably because they were fetuses; only the ampulla of the ductus deferens was identified.

Comparative morphology of the paw pad of the main arboreal Xenarthras from Amazon.

Paw pads are specializations of the integument and important shock absorbers of the locomotor system, as well as pressure, pain, temperature, storage and excretion sensors. Aiming to describe the paw pad morphology of the main arboreal xenarthras species in the Amazon, 16 animals were studied, Bradypus variegatus (6), Choloepus didactylus (5), Tamandua tetradactyla (3) and Cyclopes didactylus (2) that after death were donated to the Animal Morphological Research Laboratory (LaPMA / Ufra). The corpses were thawed and fixed with 10% aqueous formalin solution. The paw pads were measured, photographed and removed by skin incision dorsally to them. Fragments were used for routine histological processing, using two staining techniques: Hematoxylin-Eosin (HE) and Gomori's Trichrome, in sections of 6 to 8 µm. Choloepus didactylus, Tamandua tetradactyla and Cyclopes didactylus have digital paw pads, one in each digit, and one palm, as well as a plantar, whose shapes and colours are distinct from each other. Bradypus variegatus, however, has only one palmar and one plantar pad. Histologically, they have keratinized stratified squamous epithelium, supported by a large amount of collagen fibres and fibroblast cords in the dermis and hypodermis. Groups of eccrine sweat glands were observed in the reticular dermis of C. didactylus, B. variegatus, T. tetradactyla and only in the hypodermis of Cyclopes didactylus.

Enantioselectivity of Pentedrone and Methylone on Metabolic Profiling in 2D and 3D Human Hepatocyte-like Cells.

Pentedrone and methylone can express stereoselectivity in toxicokinetic and toxicodynamic processes. Similarly, their chiral discrimination in metabolism, which was not yet evaluated, can result in different metabolic profiles and subsequent hepatotoxic effects. Therefore, the aim of this work was to assess, for the first time, both the hepatic cytotoxic and metabolic profile of pentedrone and methylone enantiomers using physiologically relevant in vitro models. The hepatotoxicity of these compounds was observed in a concentration-dependent manner in human stem-cell-derived hepatocyte-like cells (HLCs) cultured under 3D (3D-HLCs) and 2D (2D-HLCs) conditions. Enantioselectivity, on the other hand, was only shown for pentedrone (1 mM) in 3D-HLCs, being R-(-)-pentedrone the most cytotoxic. Furthermore, the metabolic profile was initially evaluated in human liver microsomes (HLM) and further demonstrated in 3D-HLCs and 2D-HLCs applying a gas chromatography coupled to a mass spectrometer (GC-MS) technique. Methylone and pentedrone showed distinct and preferential metabolic routes for their enantiomers, resulting in the production of differentiated metabolites; R-(+)-methylone and R-(-)-pentedrone are the most metabolized enantiomers. In conclusion, the results demonstrated enantioselectivity for pentedrone and methylone in the metabolic processes, with enantioselectivity in cytotoxicity for pentedrone.

Morphology of the male reproductive tract of Eira barbara.

Eira barbara, popularly known as irara, is a medium-sized carnivore member of the Mustelidae family. Despite its important role in the ecosystems in which its lives, data on the internal morphology of E. barbara remains scarce. Therefore, this study aimed to provide knowledge regarding the anatomy of the male reproductive system of this species to improve understanding of its reproduction to inform its conservation. We studied seven specimens who had died after being run over. The specimens were dissected for the evaluation of the reproductive system, which comprised a globular scrotum; a small pendulum covered with light-coloured hair; a pair of testicles of firm consistency and ellipsoid shape and suspended in the scrotum by the spermatic cord; a paired duct system; an ampoule of the deferens duct and prostate constituting the set of attached glands; a urethra divided into pelvic and penile portions; a penis with a baculum having a novel "C" shaped apex; and a prepuce. Microscopically, the testicular parenchyma consisted of seminiferous tubules separated by intertubular spaces formed by loose connective tissue, fibrocytes, Leydig cells, and blood and lymph vessels. The epididymis was surrounded by a capsule of dense connective tissue and extended to form septa. The baculum was microscopically classified as a compact bone containing several bony lamellae with osteocytes and osteoblasts. The macro and microscopic findings were generally similar to those of domestic carnivores, with some notable differences.

Primary results of STRONG: An open-label, multicenter, phase 3b study of fixed-dose durvalumab monotherapy in previously treated patients with urinary tract carcinoma.

BACKGROUND: Prior durvalumab (anti-PD-L1 agent) studies in platinum-refractory metastatic urothelial carcinoma evaluated a dose of 10 mg/kg administered every two weeks. The nonrandomised phase 3b STRONG study (NCT03084471) evaluated the safety and efficacy of fixed-dose durvalumab at a more convenient dosing schedule in a previously treated patient population, more similar to a real-world clinical setting. PATIENTS AND METHODS: 867 patients with urothelial or nonurothelial urinary tract carcinoma (UTC) who progressed on or after platinum or nonplatinum chemotherapy were treated with durvalumab 1500 mg every four weeks; 87% had an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0-1, and 13% had an ECOG PS of 2. The primary end-point was the incidence of adverse events of special interest (AESIs), including immune-mediated AEs (imAEs). Secondary and exploratory end-points included overall survival (OS), objective response rate (ORR) and disease control rate (at six and 12 months) (DCR). RESULTS: AESIs of any grade were reported in 51% of patients (8% grade ≥ 3). The incidence of imAEs was 11% (2% grade ≥ 3). The median OS was 7.0 months (95% confidence interval [CI]: 6.4-8.2) and ORR was 18% (95% CI: 14.8-20.6), with complete responses in 5% of patients and a DCR at six months of 19% (95% CI: 16.1-22.1). CONCLUSION: Fixed-dose durvalumab monotherapy every four weeks has an acceptable safety profile and yields durable clinical activity in previously chemotherapy-treated patients with UTC. Safety and efficacy are consistent with previous durvalumab studies and other anti-PD-1/PD-L1 agents in this setting. CLINICALTRIALS. GOV IDENTIFIER: NCT03084471https://clinicaltrials.gov/ct2/show/NCT03084471.

Ocular microscopy of Bradypus variegatus.

Bradypus variegatus, popularly known as common sloth or brown-throated sloth, is a species with wide geographical distribution in Brazil. Expand on the literature about the species, we aimed to describe the morphology of its eye and its main annexes. For this study, six frozen specimens donated to the Animal Morphological Research Laboratory of the Federal Rural University of Amazonia were used. The specimens were fixed in a 10% aqueous solution of formaldehyde. The structures that constitute the ocular apparatus were identified and described after dissection and histological analysis using light microscopy. The bulbar conjunctiva presented a stratified cuboidal epithelium, with a considerable number of serous glands. The stroma layer and the posterior limiting lamina were found well defined in the species. The corneoscleral meshwork possessed a large opening for drainage of aqueous humour, followed by a wide retinal region, in which a layer of photoreceptors was visualized. Cones and rods could not be discriminated from each other. Microscopy of the medial angle of the eye revealed the cartilage and glands of the third eyelid, and a well-developed lacrimal gland structure. Bradypus variegatus distinguishing features and similarities in comparison with other domestic and wild mammal and bird species already described were investigated, which expounded the limited knowledge that is presently available on the morphology of wild fauna. The data extend the limited knowledge that are presently available on the ocular histology of B. variegatus.

Comprehensive Metabolomics and Lipidomics Profiling of Prostate Cancer Tissue Reveals Metabolic Dysregulations Associated with Disease Development.

Prostate cancer (PCa) is a global health problem that affects millions of men every year. In the past decade, metabolomics and related subareas, such as lipidomics, have demonstrated an enormous potential to identify novel mechanisms underlying PCa development and progression, providing a good basis for the development of new and more effective therapies and diagnostics. In this study, a multiplatform metabolomics and lipidomics approach, combining untargeted mass spectrometry (MS) and nuclear magnetic resonance (NMR)-based techniques, was applied to PCa tissues to investigate dysregulations associated with PCa development, in a cohort of 40 patients submitted to radical prostatectomy for PCa. Results revealed significant alterations in the levels of 26 metabolites and 21 phospholipid species in PCa tissue compared with adjacent nonmalignant tissue, suggesting dysregulation in 13 metabolic pathways associated with PCa development. The most affected metabolic pathways were amino acid metabolism, nicotinate and nicotinamide metabolism, purine metabolism, and glycerophospholipid metabolism. A clear interconnection between metabolites and phospholipid species participating in these pathways was observed through correlation analysis. Overall, these dysregulations may reflect the reprogramming of metabolic responses to produce high levels of cellular building blocks required for rapid PCa cell proliferation.

Inherited Thyroid Tumors With Oncocytic Change.

Familial non-medullary thyroid carcinoma (FNMTC) corresponds to 5-10% of all follicular cell-derived carcinoma (FCDTC). Oncocytic thyroid tumors have an increased incidence in the familial context in comparison with sporadic FCDTC, encompassing benign and malignant tumors in the same family presenting with some extent of cell oxyphilia. This has triggered the interest of our and other groups to clarify the oncocytic change, looking for genetic markers that could explain the emergence of this phenotype in thyroid benign and malignant lesions, focusing on familial aggregation. Despite some advances regarding the identification of the gene associated with retinoic and interferon-induced mortality 19 (GRIM-19), as one of the key candidate genes affected in the "Tumor with Cell Oxyphilia" (TCO) locus, most of the mutations follow a pattern of "private mutations", almost exclusive to one family. Moreover, no causative genetic alterations were identified so far in most families. The incomplete penetrance of the disease, the diverse benign and malignant phenotypes in the affected familial members and the variable syndromic associations create an additional layer of complexity for studying the genetic alterations in oncocytic tumors. In the present review, we summarized the available evidence supporting genomic-based mechanisms for the oncocytic change, particularly in the context of FNMTC. We have also addressed the challenges and gaps in the aforementioned mechanisms, as well as molecular clues that can explain, at least partially, the phenotype of oncocytic tumors and the respective clinico-pathological behavior. Finally, we pointed to areas of further investigation in the field of oncocytic (F)NMTC with translational potential in terms of therapy.

Epigenomics in Hurthle Cell Neoplasms: Filling in the Gaps Towards Clinical Application.

It has been widely described that cancer genomes have frequent alterations to the epigenome, including epigenetic silencing of various tumor suppressor genes with functions in almost all cancer-relevant signalling pathways, such as apoptosis, cell proliferation, cell migration and DNA repair. Epigenetic alterations comprise DNA methylation, histone modification, and microRNAs dysregulated expression and they play a significant role in the differentiation and proliferation properties of TC. In this review, our group assessed the published evidence on the tumorigenic role of epigenomics in Hurthle cell neoplasms (HCN), highlighting the yet limited, heteregeneous and non-validated data preventing its current use in clinical practice, despite the well developed assessment techniques available. The identified evidence gaps call for a joint endeavour by the medical community towards a deeper and more systematic study of HCN, aiming at defining epigenetic markers in early diagnose, allowing for accurate stratification of maligancy and disease risk and for effective systemic treatment.

Advances and Perspectives in Prostate Cancer Biomarker Discovery in the Last 5 Years through Tissue and Urine Metabolomics.

Prostate cancer (PCa) is the second most diagnosed cancer in men worldwide. For its screening, serum prostate specific antigen (PSA) test has been largely performed over the past decade, despite its lack of accuracy and inability to distinguish indolent from aggressive disease. Metabolomics has been widely applied in cancer biomarker discovery due to the well-known metabolic reprogramming characteristic of cancer cells. Most of the metabolomic studies have reported alterations in urine of PCa patients due its noninvasive collection, but the analysis of prostate tissue metabolome is an ideal approach to disclose specific modifications in PCa development. This review aims to summarize and discuss the most recent findings from tissue and urine metabolomic studies applied to PCa biomarker discovery. Eighteen metabolites were found consistently altered in PCa tissue among different studies, including alanine, arginine, uracil, glutamate, fumarate, and citrate. Urine metabolomic studies also showed consistency in the dysregulation of 15 metabolites and, interestingly, alterations in the levels of valine, taurine, leucine and citrate were found in common between urine and tissue studies. These findings unveil that the impact of PCa development in human metabolome may offer a promising strategy to find novel biomarkers for PCa diagnosis.

Urinary Volatilomics Unveils a Candidate Biomarker Panel for Noninvasive Detection of Clear Cell Renal Cell Carcinoma.

Clear cell renal cell carcinoma (ccRCC) is the most common type of kidney cancer usually associated with asymptomatic development and risk of systemic progression. Hence, reliable molecular biomarkers of ccRCC are needed to provide early and minimally invasive detection. In this study, urinary volatilome profiling of patients diagnosed with ccRCC (n = 75), and cancer-free controls (n = 75), was performed to investigate the presence of a volatile signature characteristic of ccRCC. Volatile organic compounds (VOCs) in general, and more specifically volatile carbonyl compounds (VCCs), present in urine were extracted by headspace solid-phase microextraction coupled with gas chromatography-mass spectrometry (HS-SPME-GC-MS). Supervised multivariate models showed a good discriminatory power of ccRCC patients from controls in urine. Overall, 22 volatile metabolites were found significantly altered between the two groups, including aldehydes, ketones, aromatic hydrocarbons, and terpenoids. A candidate six-biomarker panel, comprising octanal, 3-methylbutanal, benzaldehyde, 2-furaldehyde, 4-heptanone, and p-cresol, depicted the best performance for ccRCC detection with 83% sensitivity, 79% specificity, and 81% accuracy. Moreover, the ccRCC urinary volatilome signature suggested dysregulation of energy metabolism and overexpression of enzymes associated with carcinogenesis. These findings provide the molecular basis for the fine-tuning of gas-sensing materials for application in the development of a bioelectronic sensor.

Translational Potential of Epigenetic-Based Markers on Fine-Needle Aspiration Thyroid Specimens.

The awareness of epigenetic alterations leading to neoplasia attracted the attention of researchers toward its potential use in the management of cancer, from diagnosis to prognosis and prediction of response to therapies. Our group has focused its attention on the epigenomics of thyroid neoplasms. Although most of the epigenetic studies have been applied on histological samples, the fact is that cytology, through fine-needle aspiration, is a primary diagnostic method for many pathologies, of which thyroid nodules are one of the most paradigmatic examples. This has led to an increasing literature report of epigenetic studies using these biological samples over the past decade. In this review, our group aimed to document recent research of epigenetic alterations and its associated assessment techniques, based on cytology material. Our review covers the main epigenetic categories-DNA methylation, histone modification, and RNA-silencing-whose evidence in thyroid cytology samples may represent solid soil for future prospectively designed studies aiming at validating patterns of epigenetic alterations and their potential use in the clinical management of thyroid neoplasms.

Discovery of Volatile Biomarkers for Bladder Cancer Detection and Staging through Urine Metabolomics.

Timely diagnosis is crucial to improve the long-term survival of bladder cancer (BC) patients. The discovery of new BC biomarkers based in urine analysis is very attractive because this biofluid is in direct contact with the inner bladder layer, in which most of the neoplasms develop, and is non-invasively collected. Hence, this work aimed to unveil alterations in the urinary volatile profile of patients diagnosed with BC compared with cancer-free individuals, as well as differences among patients diagnosed at different tumor stages, to identify candidate biomarkers for non-invasive BC diagnosis and staging. Urine analysis was performed by headspace solid-phase microextraction coupled with gas chromatography-mass spectrometry (HS-SPME-GC-MS). The results unveiled that BC patients have a distinct urinary volatile profile characterized by higher levels of several alkanes and aromatic compounds, and lower levels of aldehydes, ketones and monoterpenes. Seventeen significantly altered volatiles were used to evaluate the performance for overall BC detection, disclosing 70% sensitivity, 89% specificity and 80% accuracy. Moreover, distinct urinary volatile profiles were found among patients diagnosed at different tumor stages (Ta/Tis, T1 and ≥T2). This work identified distinct urinary volatile signatures of BC patients with potential for non-invasive detection and staging of bladder cancer.

S616-p-DRP1 associates with locally invasive behavior of follicular cell-derived thyroid carcinoma.

PURPOSE: Dynamin-related protein 1 (DRP1), a mitochondrial fission protein, and its active form phosphorylated at Serine 616 (S616-p-DRP1) have been increasingly associated with tumorigenesis and invasion in various tumor models, including oncocytic thyroid cancer (TC). In this study, the expression of DRP1 and S616-p-DRP1 and its relationship with patients' clinicopathological characteristics, tumor genetic profiles, and clinical outcomes were assessed in a large series of follicular cell-derived TC (FCDTC). METHODS: Retrospective biomarker study characterizing the clinicopathological and immunochemistry DRP1 and S616-p-DRP1 expression of a series of 259 patients with FCDTC followed in two University Hospitals. RESULTS: DRP1 expression was positive in 65.3% (169/259) of the cases, while the expression of the S616-p-DRP1 was positive in only 17.3% (17/98). DRP1-positive expression was significantly associated with differentiated tumors (67.7 vs. 48.0%; P = 0.049), non-encapsulated tumors (73.8 vs. 57.4%; P = 0.011) and thyroid capsule invasion (73.4 vs. 57.5%; P = 0.013). S616-p-DRP1-positive expression was significantly associated with tumor infiltrative margins (88.9 vs. 11.1%; P = 0.033), thyroid capsule invasion (29.8 vs. 3.1%; P = 0.043), lymph node metastases (23.3 vs. 8.1%; P = 0.012), and higher mean cumulative radioiodine dosage (317.4 ± 265.0 mCi vs. 202.5 ± 217.7 mCi; P = 0.038). S616-p-DRP1 expression was negatively associated with oncocytic phenotype (0.0 vs. 26.2%; P = 0.028). CONCLUSIONS: S616-p-DRP1 is a better candidate than DRP1 to identify tumors with locally invasive behavior. Prospective studies should be pursued to assess S616-p-DRP1 role as a molecular marker of malignancy in TC and in patients' risk assessment.

Pterygodermatites (Multipectines) affinis (Jägerskiöl, 1904) (Nematoda: Rictulariidae), a parasite of Cerdocyon thous (Linnaeus, 1766) (Carnivora: Canidae) from the Brazilian Amazon.

Among the Nematodes of Cerdocyon thous, the genus Pterygodermatites is characteristic for presenting cuticular projections along the body, being mentioned in different hosts in South America, although there are no records of its occurrence in the Amazon Biome. To enable further exploration in terms of their morphology and morphometry, the nematodes collected from cadavers of C. thous were fixed and observed using bright field microscopy and scanning electron microscopy, revealing characteristics compatible with P. (Multipectines) affinis, thus contributing more information about the geographic distribution of the parasite, as well as knowledge of the helminthological fauna of wild mammals in the Brazilian Amazon.

A Panel of Urinary Volatile Biomarkers for Differential Diagnosis of Prostate Cancer from Other Urological Cancers.

Our group recently developed a urinary 6-biomarker panel for the diagnosis of prostate cancer (PCa) which has a higher level of accuracy compared to the serum prostate specific antigen (PSA) test. Herein, urine from an independent cohort of PCa patients and cancer-free controls was analyzed to further validate the discriminative power of that panel. Additionally, urine from patients diagnosed with bladder cancer (BC) and renal cancer (RC) were included to evaluate the site-specificity of the panel. Results confirmed the ability of the 6-biomarker panel to discriminate PCa patients from controls, but not from other urological cancers. To overcome this limitation, an untargeted approach was performed to unveil discriminant metabolites among the three cancer types. A 10-biomarker panel comprising the original panel plus four new metabolites was established to discriminate PCa from controls, BC, and RC, with 76% sensitivity, 90% specificity, and 92% accuracy. This improved panel also disclosed better accuracy than serum PSA test and provides the basis for a new non-invasive early detection tool for PCa.

New findings on urinary prostate cancer metabolome through combined GC-MS and 1H NMR analytical platforms.

INTRODUCTION: The inherent sensitivity of metabolomics allows the detection of subtle alterations in biological pathways, making it a powerful tool to study biomarkers and the mechanisms that underlie cancer. OBJECTIVES: The purpose of this work was to characterize the urinary metabolic profile of prostate cancer (PCa) patients and cancer-free controls to obtain a holistic coverage of PCa metabolome. METHODS: Two groups of samples, a training set (n = 41 PCa and n = 42 controls) and an external validation set (n = 18 PCa and n = 18 controls) were analyzed using a dual analytical platform, namely gas chromatography-mass spectrometry (GC-MS) and proton nuclear magnetic resonance spectroscopy (1H NMR). RESULTS: The multivariate analysis models revealed a good discrimination between cases and controls with an AUC higher than 0.8, a sensitivity ranging from 67 to 89%, a specificity ranging from 74 to 89% and an accuracy from 73 to 86%, considering the training and external validation sets. A total of 28 metabolites (15 from GC-MS and 13 from 1H NMR) accounted for the separation. These discriminant metabolites are involved in 14 biochemical pathways, indicating that PCa is highly linked to dysregulation of metabolic pathways associated with amino acids and energetic metabolism. CONCLUSION: These findings confirmed the complementary information provided by GC-MS and 1H NMR, enabling a more comprehensive picture of the altered metabolites, underlying pathways and deepening the understanding of PCa development and progression.

Discriminatory accuracy of serological tests for detecting Trypanosoma cruzi using the ROC curve and the standard methodology / Precisión discriminatoria de pruebas serológicas para Trypanosoma cruzi aplicando metodología estándar y de curva COR

Abstract Introduction: Serological tests are used to confirm Trypanosoma cruzi infection and their discriminatory accuracy depends on the established decision threshold. Both, the standard methodology and the receiver operating characteristic (ROC) curve methodology allow obtaining such threshold. Objective: To compare the discriminatory accuracy of the standard methodology and the ROC curve methodology regarding serological tests for confirming T. cruzi infection. Materials and methods: A set of anti-T. cruzi antibodies values from subjects previously classified as healthy or as having Chagas disease were used, and computer simulations were performed under homoscedasticity and heteroscedasticity conditions. Sensitivity, specificity, 100% sensitivity, 100% specificity, and perfect-decision were calculated. Results: The discriminatory accuracy obtained with the standard methodology favored specificity (98.22% to 99.56%) over sensitivity (67.25% to 87.14%), while in the ROC curve methodology a balance between sensitivity (94.56% and 96.44%) and specificity (90.35% and 92.11%) was observed. Also, in the ROC curve methodology a greater perfect-decision ratio was observed, which, under homoscedasticity conditions, was >90%. Decisions thresholds were affected by het-eroscedasticity conditions. Conclusion: The ROC curve methodology showed better discriminatory accuracy, therefore its use for calculating decision thresholds in serological tests for detecting Chagas disease is recommended.

Resumen Introducción. Las pruebas serológicas se utilizan para detectar infección por Trypanosoma cruzi y su precisión discriminatoria depende del umbral de decisión establecido. La metodología estándar y la de curva característica operativa del receptor (COR) permiten obtener tal umbral. Objetivo. Comparar la precisión discriminatoria de la metodología estándar y la metodología de curva COR en lo que respecta a pruebas serológicas para detectar infección por T. cruzi. Materiales y métodos. Se utilizó un conjunto de valores de anticuerpos contra T. cruzi de individuos clasificados como chagásicos o sanos y se realizaron simulaciones computarizadas en condiciones homocedásticas y heterocedásticas. Se calculó sensibilidad, especificidad, sensibilidad = 100%, especificidad = 100% y decisión-perfecta. Resultados. La precisión discriminatoria de la metodología estándar favoreció la especificidad (98.22% a 99.56%) sobre la sensibilidad (67.25% a 87.14%), mientras que la de la curva COR mostró un equilibrio entre sensibilidad (94.56% y 96.44%) y especificidad (90.35% y 92.11%). Esta última metodología también evidenció una mayor proporción de decisión-perfecta, la cual llegó a ser >90% en condiciones de homocedasticidad. Los umbrales de decisión fueron afectados por las condiciones de heterocedasticidad. Conclusión. La metodología de la curva COR mostró una mejor precisión discriminatoria, por lo que se recomienda su uso para el cálculo de umbrales de decisión en pruebas serológicas para la enfermedad de Chagas.