Detection of Mycobacterium leprae in saliva and the evaluation of oral sensitivity in patients with leprosy.

The aim of this study was to investigate sensitivity disorders in the oral cavity related to the presence of Mycobacterium leprae in the saliva of treatment-naïve patients with leprosy in the state of Amazonas, Brazil. A cross-sectional study was conducted involving 45 subjects with leprosy. The subjects were interviewed to evaluate the sensitivity of the oral cavity. For the detection of M. leprae, saliva and slit-skin smear samples were collected. The samples were analysed using a bacteriological index (BI) protocol and the real-time quantitative polymerase chain reaction (qPCR). The results indicated that 15 of the 45 (33.3%) subjects with leprosy showed decreased oral sensitivity, which confirmed the importance of the oral cavity sensitivity evaluation. There was not a direct relationship between the presence of M. leprae in saliva and changes in oral sensitivity. Positive saliva qPCR results from six (31.6%) of 19 paucibacillary (PB) patients suggested the possibility of a new site for sample collection. Positive results using these diagnostic techniques (BI, slit-skin smear and saliva qPCR) increased to 55.5%, thus opening the possibility of combining these different techniques to increase the rate of positive diagnoses, especially in PB patients.

Detection of Mycobacterium leprae in saliva and the evaluation of oral sensitivity in patients with leprosy

The aim of this study was to investigate sensitivity disorders in the oral cavity related to the presence of Mycobacterium leprae in the saliva of treatment-naïve patients with leprosy in the state of Amazonas, Brazil. A cross-sectional study was conducted involving 45 subjects with leprosy. The subjects were interviewed to evaluate the sensitivity of the oral cavity. For the detection of M. leprae, saliva and slit-skin smear samples were collected. The samples were analysed using a bacteriological index (BI) protocol and the real-time quantitative polymerase chain reaction (qPCR). The results indicated that 15 of the 45 (33.3%) subjects with leprosy showed decreased oral sensitivity, which confirmed the importance of the oral cavity sensitivity evaluation. There was not a direct relationship between the presence of M. leprae in saliva and changes in oral sensitivity. Positive saliva qPCR results from six (31.6%) of 19 paucibacillary (PB) patients suggested the possibility of a new site for sample collection. Positive results using these diagnostic techniques (BI, slit-skin smear and saliva qPCR) increased to 55.5%, thus opening the possibility of combining these different techniques to increase the rate of positive diagnoses, especially in PB patients.

Platelet aggregation and quality control of platelet concentrates produced in the Amazon Blood Bank.

BACKGROUND: The study of platelet aggregation is essential to assess in vitro platelet function by different platelet activation pathways. OBJECTIVE: To assess aggregation and biochemical parameters of random platelet concentrates produced at the Fundação HEMOAM using the quality control tests defined by law. METHODS: Whole blood samples from 80 donors and the respective platelet concentrate units were tested. Platelet concentrates were tested (platelet count, aggregation and pH) on days 1, 3 and 5 of storage. Additionally a leukocyte count was done only on day 1 and microbiological tests on day 5 of storage. Collagen and adenosine diphosphate were used as inducing agonists for platelet aggregation testing. RESULTS: Donor whole blood had normal aggregation (aggregation with adenosine diphosphate = 67% and with collagen = 78%). The median aggregation in platelet concentrates with adenosine diphosphate was low throughout storage (18% on day 1, 7% on day 3 and 6% on day 5) and the median aggregation with collagen was normal only on day 1 and low thereafter (54.4% on day 1, 20.5% on day 3 and 9% on day 5). CONCLUSION: Although the results were within the norms required by law, platelet concentrates had low aggregation rates. We suggest the inclusion of a functional assessment test for the quality control of platelet concentrates for a more effective response to platelet replacement therapy.

Platelet aggregation and quality control of platelet concentrates produced in the Amazon Blood Bank

BACKGROUND: The study of platelet aggregation is essential to assess in vitro platelet function by different platelet activation pathways. OBJECTIVE: To assess aggregation and biochemical parameters of random platelet concentrates produced at the Fundação HEMOAM using the quality control tests defined by law. METHODS: Whole blood samples from 80 donors and the respective platelet concentrate units were tested. Platelet concentrates were tested (platelet count, aggregation and pH) on days 1, 3 and 5 of storage. Additionally a leukocyte count was done only on day 1 and microbiological tests on day 5 of storage. Collagen and adenosine diphosphate were used as inducing agonists for platelet aggregation testing. RESULTS: Donor whole blood had normal aggregation (aggregation with adenosine diphosphate = 67 percent and with collagen = 78 percent). The median aggregation in platelet concentrates with adenosine diphosphate was low throughout storage (18 percent on day 1, 7 percent on day 3 and 6 percent on day 5) and the median aggregation with collagen was normal only on day 1 and low thereafter (54.4 percent on day 1, 20.5 percent on day 3 and 9 percent on day 5). CONCLUSION: Although the results were within the norms required by law, platelet concentrates had low aggregation rates. We suggest the inclusion of a functional assessment test for the quality control of platelet concentrates for a more effective response to platelet replacement therapy.

Parasitoses intestinais e fatores socioambientais de uma população da área Periurbana de Manaus - AM / Intestinal parasitosis and socio-environmental factor sof a population from peri-urban area of Manaus - AM

Descrever a prevalência de parasitoses intestinais em pacientes que procuraram uma Unidade Básica de Saúde e conhecer as condições e características socioambientais de uma população de área periurbana de Manaus - AM, Brasil. Métodos: Estudo realizado pela demanda espontânea de pacientes em Unidade Básica de Saúde, Zona Norte de Manaus, Amazonas, entre abril a julho de 2007, realizando-se exames parasitológicos, em 400 amostras de fezes pelo método de Hoffmann-Pons-Janer, e entrevistas. Resultados: Do total, 271/400 (67,8%) continham parasitos, sendo 181/268 (45,25%) amostras do sexo feminino; 147/224 (36,7%) com idade entre 19 e 85 anos; 119/170 (29,75%) com ensino fundamental incompleto; 207/299 (51,75%) com renda familiar entre um e três salários mínimos; 220/316 (55%) naturais do Amazonas; 192/284 (48%) desenvolviam atividades do lar; 199/298 (49,7%) consumiam água do poço artesiano público; 106/152 (26.5%) tratavam a água e 165/248 (66%) não tratavam a água consumida. Os helmintos mais frequentes: Ascaris lumbricoides 48 (12%), Enterobius vermicularis 44 (11%), Ancilostomídeos 38 (9,5%). Protozoários: Entamoeba histolytica 83 (20,8%), Entamoeba coli e a Endolimax nana 79 (19,8%) e 79 (19,8%) respectivamente, Giardia lamblia 41 (10,3%) e Iodamoeba butschlii 17 (4,3%). Observou-se monoparasitismo por E. histolytica em 83 (20,8%), biparasitismo 104/271 (26%) E. histolytica e A. lumbricóides, E. histolytica e E. vermicularis, E. histolytica e G. lamblia. Conclusões: Registrou-se alta prevalência de parasitos em população jovem de baixa renda familiar, baixo nível cultural, predominantemente mulheres do lar. Entre os fatores socioambientais associados a esses índices estão a deficiência nos serviços de água e de esgoto sanitário.

To describe the prevalence of intestinal parasitosis in patients who sought a Basic Health Unit and get to know the conditions and socio-environmental characteristics of a population of peri-urban area of Manaus - AM, Brazil. Methods: A study conducted by spontaneous demand of patients in a Basic Health Unit, Northern Zone of Manaus, Amazonas, between April and July 2007, conducting parasitological examination in 400 stool samples by Hoffmann-Pons-Janer?s method, and interviews. Results: From the total, 271/400 (67,8%) contained parasites; 181/268 (45,25%) samples were of females; 147/224 (36,7%) aged between 19 and 85 years; 119/170 (29,75%) with incomplete elementary school; 207/299 (51.75%) with a family income between one and three minimum wages; 220/316 (55%) were natural from Amazonas; 192/284 (48%) worked at home; 199/298 (49,7%) consumed water from artesian public well; 106/152 (26.5%) treated the water; 165/248 (66%) did not treat the consumed water. The most frequent helminthes found: Ascaris lumbricoides 48 (12%), Enterobius vermicularis 44 (11%), Ancilostomídeos 38 (9,5%). Protozoa: Entamoeba histolytica 83 (20,8%), Entamoeba coli and Endolimax nana, 79 (19,8%) e 79 (19,8%) respectively, Giardia lamblia 41 (10,3%) and Iodamoeba butschlii 17 (4,3%). It was observed monoparasitism for E. histolytica 83 (20,8%), biparasitism 104/271 (26%) E. histolytica and A. lumbricóides, E. histolytica and E. vermicularis, E. histolytica and G. lamblia. Conclusions: We recorded a high prevalence of parasites in young people with low income, low cultural level, predominantly women of the household. Among the environmental factors associated with these indexes are a deficiency in water services and sanitary sewer.

Hanseníase em Coari: aspectos epidemiológicos da doença na região do médio Solimões no estado do Amazonas / Hansen´s disease in Coari: epidemiological aspects of the disease in middle Solimões river, state of Amazonas

O objetivo deste estudo é descrever os aspectos demográficos, as caracteristícas clínicas e epidemiológicas da hanseníase, de forma a traçar o perfil epidemiológico da hanseníase no Município de Coari, Estado do Amazonas. Trata-se de um estudo descritivo baseado na análise de uma amostra de 226 pacientes diagnosticados no período entre 1997 a 2006. Na análise dos dados foram utilizados os testes do qui-quadrado de Pearson, t de Student e ANOVA. No período do estudo observou-se um declínio de 63,1% no coeficienete de prevalência da hanseníaes, 47,6% no de detecção geral, além de uma redução de 91,9% na detecção em menores de 15 anos. Foi constatada associação estatística ao nivel de 5% do sexo em relação à classificação operacional (p <0,001) e da idade em relação ao grau de inacapacidade demonstra que no município de Coari há um grande número de casos com diagnóstico tardio e ainda uma possível prevalência oculta da doença.

Hanseníase em Coari: aspectos epidemiológicos da doença na região do médio Solimões no estado do Amazonas / Hansen's disease in Coari: epidemiological aspects of the disease in middle Solimões river, state of Amazonas

O objetivo deste estudo é descrever os aspectos demográficos, as características clínicas e epidemiológicas da hanseníase, de forma a tratar o perfil epidemiológico da hanseníase no Município de Coari, Estado do Amazonas. Trata-se de um estudo descritivo baseado na análise de uma amostra de 226 pacientes diagnosticados no período entre 1997 entre 2006. Na análise dos dados foram utilizados os testes do qui quadrado de Pearson, t de Student e ANOVA. No período do estudo observou-se um declínio de 63,1 por cento no coeficiente de prevalência da hanseníase, 47,6 por cento no de detecção geral, além de uma redução de 91,9 por cento na detecção em menores de 15 anos. Foi constatada associação estatística ao nível de 5 por cento do sexo em relação à classificação operacional (p menor que 0,001) e da idade em relação ao grau de incapacidade (p igual a 0,002). O alto número de pacientes com graus I e II de incapacidade demonstra que no município de Coari há um grande número de casos com diagnóstico tardio e ainda uma possível prevalência oculta da doença.

Anticorpos anti-eritrocitários em pacientes com Coombs direto positivo infectados com malária por P. vivax e P. falciparum / Anti-erithrocytes antibodies in patients with positive direct Coombs infected with P. vivax and P. falciparum malaria

Para se determinar a prevalência de anticorpos anti-eritrocitários de grupo sanguíneo foram analizadas 247 amostras de sangue de pacientes com malária vivax e falciparum com teste de Coombs direto positivo atendidos na Fundação de Medicina Tropical Manaus-Amazonas no período entre setembro/99 a março/2000.Realizaram-se os testes laboratoriais de Coombs direto, dosagens de hemoglobina, bilirrubina e eletroforese de proteínas.Das amostras testadas, 13,3 apresentaram Coombs direto positivo, sendo o anticorpo da classe IgG (33,3) o mais freqüente. Dos pacientes com malária vivax e Coombs direto positivo, 17 apresentaram anemia possivelmente devido a hemólise por auto-imunidade com o envolvimento da gamaglobulina IgG.Não foram detectados anticorposcontra antígenos de grupos sanguíneos nem aloanticorpos séricos.Torna-se necessário a realização de outras pesquisas para avaliação da existência de associação entre a positividade do Coombs direto e anemia ou se a mesma interfere ou não com o curso da doença.