Validação de intervalos de referência de exames bioquímicos do laboratório de análises clínicas de um hospital universitário / Validation of reference intervals for biochemical tests at the clinical analysis laboratory of a university hospital

Introdução: Os intervalos de referência (IRs) disponibilizados em laudos de exames laboratoriais orientam a interpretação dos resultados, respaldando a avaliação clínica realizada por profissionais de saúde. Objetivo: Validar IRs de parâmetros bioquímicos, com base nas características da população local, bem como em informações disponíveis nas bulas dos reagentes e na literatura científica. Material e Métodos: Foi realizado um estudo observacional, descritivo e transversal para padronização de IRs de trinta e quatro parâmetros bioquímicos, executados pelo laboratório de análises clínicas de um hospital universitário. Participaram do estudo quarenta indivíduos adultos, pareados pelo sexo, que responderam um questionário sobre o estado geral de saúde. Uma amostra de sangue foi coletada de cada participante e analisada conforme os padrões do laboratório. Resultados: Os dados obtidos com os voluntários saudáveis permitiram a validação dos IRs de albumina, alanina aminotransferase, amilase, aspartato aminotransferase, bilirrubina direta, bilirrubina indireta, bilirrubina total, cálcio iônico, capacidade total e latente de fixação de ferro, creatinoquinase fração MB, cloro, ferro, fosfatase alcalina, fósforo, gama glutamiltransferase, glicose, lipoproteína de alta densidade, lactato, lactato desidrogenase, lipase, magnésio, potássio, proteínas totais, saturação da transferrina, sódio, triglicerídeos e ureia, de ambos os sexos. Ácido úrico foi validado apenas para o sexo masculino e creatinoquinase total (CK) foi validado apenas para o sexo feminino. Conclusão: Os IRs contidos nas bulas destes reagentes representam a população atendida pelo laboratório e podem continuar sendo utilizados. Em contrapartida, os IRs dos analitos colesterol total, lipoproteína de baixa densidade, cálcio, ácido úrico feminino e CK masculino não foram validados e necessitam de novos estudos para a validação dos intervalos de referência utilizados

Introduction: The reference intervals (RIs) provided in laboratory test reports orientate the interpretation of results, supporting the clinical evaluation performed by health professionals. Objective: Validate RIs of biochemical parameters, based on the characteristics of the local population, as well as on information available in the package inserts of the reagents and in the scientific literature. Material and Methods: An observational, descriptive, and cross-sectional study was carried out for the standardization of RIs of thirty-four biochemical parameters, performed by the Clinical Analysis laboratory of a university hospital. Forty adult individuals, matched by sex, participated in the study, who answered a questionnaire about their general health status. A blood sample was taken from each participant and analyzed according to laboratory standards. Results: Data obtained from healthy volunteers allowed the validation of the RIs of albumin, alanine aminotransferase, amylase, aspartate aminotransferase, direct bilirubin, indirect bilirubin, total bilirubin, ionic calcium, total and latent iron-binding capacity, creatine kinase MB fraction, chlorine, iron, alkaline phosphatase, phosphorus, gamma glutamyltransferase, glucose, high density lipoprotein, lactate, lactate dehydrogenase, lipase, magnesium, potassium, total proteins, transferrin saturation, sodium, triglycerides and urea, of both sexes. Uric acid has been validated for males only and total creatine kinase (CK) has been validated for females only. Conclusion: The RIs contained in the package inserts of these reagents represent the population assisted by laboratory and can continue to be used. The RIs of total cholesterol, low-density lipoprotein, calcium, female uric acid and male CK analytes were not validated and require further studies to validate the reference intervals used

Adenovirus and rotavirus recovery from a treated effluent through an optimized skimmed-milk flocculation method.

Sewage treatment may be insufficient for the complete removal of enteric viruses, such as human adenoviruses (HAdV) and group A rotavirus (RVA). The differences in the efficiency of the treatment methodologies used may interfere with the detection of these viruses. The objective of this study was to optimize a skimmed-milk flocculation technique for the recovery of HAdV and RVA in the samples of treated effluent. The treated effluent collected at the wastewater treatment plant (WWTP) was processed via four protocols including modifications in the initial centrifugation step and the final concentration of skimmed-milk. The viral load and recovery rate were determined by quantitative PCR TaqMan® System. The highest recovery rates of HAdV, RVA, and bacteriophage PP7 (internal control process) were obtained when the concentration of skimmed-milk was doubled and no centrifugation step was used for the sample clarification. The optimized protocol was assessed in a field study conducted with 24 treated effluent samples collected bi-monthly during 2015. HAdV and RVA were detected in 50.0% (12/24) and 33.3% (08/24) of the samples tested, respectively, throughout the year, without seasonal variation (p > 0.05). This study corroborates the use of the organic flocculation method for virus recovery in environmental samples with the adaptation of the protocols to different aquatic matrices.

Perfil epidemiológico da tuberculose em Juiz de Fora, município prioritário no estado de Minas Gerais / Epidemiological profile of tuberculosis in Juiz de Fora, priority municipality in Minas Gerais state

Introdução: A tuberculose (TB) é considerada um dos maiores problemas mundiais de saúde. Visando a eliminação dessa doença, a organização mundial de saúde (oms) elaborou um plano, chamado "The end TB strategy", cujas metas propostas foram adotadas pelo ministério da saúde. Juiz de Fora é a segunda cidade do estado de minas Gerais com os maiores números de casos dessa doença sendo considerada município prioritário para controle da TB. Objetivo: Realizar uma análise do perfil epidemiológico da TB na cidade de Juiz de Fora nos anos de 2008 a 2017, comparando os dados registrados a nível nacional, estadual e municipal, bem como avaliar o cenário municipal frente às metas propostas pelo plano de enfrentamento da TB. Material e métodos: Foi realizado um estudo transversal, descritivo, de série temporal utilizando dados secundários disponibilizados pelo Departamento de Informática do sistema Único de saúde (DATAsus). Resultados: O coeficiente de incidência e mortalidade da TB assim como a taxa de abandono de tratamento verificados em Juiz de Fora, de 2008-2017, superaram as médias nacionais e estaduais, além de extrapolarem as metas previstas no plano de enfrentamento da TB. Cabe ressaltar, no entanto, que a proporção de teste rápido de HIV e o número de cultura de escarro realizados entre os casos de retratamento de TB superaram as médias nacional e estadual. Conclusão: O perfil epidemiológico da TB em Juiz de Fora revelou uma situação em alguns aspectos piores em relação ao cenário nacional e estadual, mas também evidenciou que medidas já estão sendo realizadas pelo município para o enfrentamento da doença.

Introduction: Tuberculosis (TB) is considered one of the biggest global health problems. In order to eliminate this disease, the World Health organization (WHo) elaborated a plan, called The end TB strategy, whose goals were implemented by the Brazilian National ministry of Health. Juiz de Fora is the second city in minas Gerais with higher numbers of disease cases that is being considered a priority municipality for the TB control. Objectives: Analyze the epidemiological profile of TB in Juiz de Fora from 2008 to 2017, comparing data recorded at national, state and municipal level, as well as to access the municipal scenario against the targets proposed by the WHo plan. Material and methods: A cross-sectional, descriptive, time series study was performed using secondary data provided by the Brazilian Unified Health System's Department of Informatics (DATASUS). Results: The TB incidence and mortality coefficient as well as treatment drop-out rate observed in Juiz de Fora, from 2008-2017, exceeded national and state averages, in addition to extrapolating the targets set in the WHo plan. It should be noted, however, that the proportion of rapid HIV test and the number of sputum culture performed among retreatment TB cases exceeded national and state averages. Conclusion: In some aspects, the TB epidemiological profile in Juiz de Fora revealed a situation worse than national and state scenario, but also showed that arrangements are already being carried out by the municipality to confront the disease.

The role of human adenoviruses type 41 in acute diarrheal disease in Minas Gerais after rotavirus vaccination

Abstract Human adenovirus species F (HAdV-F) type 40 and 41 are commonly associated with acute diarrheal disease (ADD) across the world. Despite being the largest state in southeastern Brazil and having the second largest number of inhabitants, there is no information in the State of Minas Gerais regarding the role of HAdV-F in the etiology of ADD. This study was performed to determine the prevalence, to verify the epidemiological aspects of infection, and to characterize the strains of human adenoviruses (HAdV) detected. A total of 377 diarrheal fecal samples were obtained between January 2007 and August 2011 from inpatient and outpatient children of age ranging from 0 to 12 years. All samples were previously tested for rotavirus, norovirus, and astrovirus, and 314 of 377 were negative. The viral DNA was extracted, amplified using the polymerase chain reaction and the HAdV-positive samples were sequenced and phylogenetically analyzed. Statistical analyses were performed using the Chi-square test (p < 0.05), considering two conditions: the total of samples tested (377) and the total of negative samples for the remaining viruses tested (314). The overall prevalence of HAdV was 12.47% (47/377); and in 76.60% (36/47) of the positive samples, this virus was the only infectious agent detected. The phylogenetic analysis of partial sequences of 32 positive samples revealed that they all clustered with the HAdV-F type 41. The statistical analysis showed that there was no correlation between the onset of the HAdV infection and the origin of the samples (inpatients or outpatients) in the two conditions tested: the total of samples tested (p = 0.598) and the total of negative samples for the remaining viruses tested (p = 0.614). There was a significant association in the occurrence of infection in children aged 0–12 months for the condition 1 (p = 0.030) as well as condition 2 (p = 0.019). The occurrence of infections due to HAdV did not coincide with a pattern of seasonal distribution. These data indicate the significant involvement of HAdV-F type 41 in the etiology of ADD in Minas Gerais, which demonstrates the importance of other viral agents in the development of the disease after the introduction of rotavirus vaccine immunization.

The role of human adenoviruses type 41 in acute diarrheal disease in Minas Gerais after rotavirus vaccination.

Human adenovirus species F (HAdV-F) type 40 and 41 are commonly associated with acute diarrheal disease (ADD) across the world. Despite being the largest state in southeastern Brazil and having the second largest number of inhabitants, there is no information in the State of Minas Gerais regarding the role of HAdV-F in the etiology of ADD. This study was performed to determine the prevalence, to verify the epidemiological aspects of infection, and to characterize the strains of human adenoviruses (HAdV) detected. A total of 377 diarrheal fecal samples were obtained between January 2007 and August 2011 from inpatient and outpatient children of age ranging from 0 to 12 years. All samples were previously tested for rotavirus, norovirus, and astrovirus, and 314 of 377 were negative. The viral DNA was extracted, amplified using the polymerase chain reaction and the HAdV-positive samples were sequenced and phylogenetically analyzed. Statistical analyses were performed using the Chi-square test (p<0.05), considering two conditions: the total of samples tested (377) and the total of negative samples for the remaining viruses tested (314). The overall prevalence of HAdV was 12.47% (47/377); and in 76.60% (36/47) of the positive samples, this virus was the only infectious agent detected. The phylogenetic analysis of partial sequences of 32 positive samples revealed that they all clustered with the HAdV-F type 41. The statistical analysis showed that there was no correlation between the onset of the HAdV infection and the origin of the samples (inpatients or outpatients) in the two conditions tested: the total of samples tested (p=0.598) and the total of negative samples for the remaining viruses tested (p=0.614). There was a significant association in the occurrence of infection in children aged 0-12 months for the condition 1 (p=0.030) as well as condition 2 (p=0.019). The occurrence of infections due to HAdV did not coincide with a pattern of seasonal distribution. These data indicate the significant involvement of HAdV-F type 41 in the etiology of ADD in Minas Gerais, which demonstrates the importance of other viral agents in the development of the disease after the introduction of rotavirus vaccine immunization.

Relationship between viral detection and turbidity in a watershed contaminated with group A rotavirus.

Enteric viruses are present in aquatic environments due to contamination by raw sewage, even in the absence of fecal coliforms, which are considered to be significant indicators when it comes to microbial water quality assessment. This study investigated the presence of group A rotavirus (RVA) in surface water from a river basin in Minas Gerais, Brazil, assessing the influence of the urbanization, the rainfall, and the microbiological and physico-chemical parameters regarding water quality. Forty-eight surface water samples collected in urbanized and non-urbanized areas, both in dry and rainy periods, were obtained throughout the study. The viral particles were concentrated by adsorption-elution in a negatively charged membrane. Fecal coliforms, as well as physico-chemical water parameters were determined at each point in all collections. The RVA was detected in 62.5 % (30/48) of the water samples through a real-time PCR assay. All the sequenced RVA strains belonged to genotype I1. The RVA was detected in 50.0 % (11/22) of the water samples regarded as being acceptable by current microbiological standards. The presence of the RVA and the viral load were influenced by the collection area (p < 0.05). It was also observed a significant association between the RVA and detecting the turbidity of water (p < 0.05). The collected data showed a high level of contamination in this watershed by the discharge of raw sewage, highlighting the need for urgent measures to improve water quality, ensuring the safe use of this matrix.