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1.
Clin Nutr ESPEN ; 33: 283-289, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31451268

RESUMO

BACKGROUND AND AIMS: Low-grade chronic inflammation is a condition underlying many serious diseases but there is no good single biomarker which can estimate and monitor the severity of the inflammation. C-reactive protein (CRP) is the best validated and most extensively used marker. The aims of the study were to investigate the extent to which CRP levels associate with levels of micronutrients. METHODS: We retrieved the levels of S-hsCRP and nutritional variables fB-ß-carotenes, fS-Q10 (Ubiquinon), fS-Fe, E-Cu, fS-A vitamin, B-Se, B-Zn, and fB-B12 vitamin from the database of clinical laboratory Mila Oy from the years 1988-2018, a total of nearly 18 800 samples from outpatient clinics, Helsinki and Oulu, Finland. Sample sizes for nutritional variables measured concurrently with S-hsCRP varied between 4356 and 8621. S-hsCRP levels were categorized into five ordered categories. The levels of each micronutrient in those categories were compared using analysis of variance (ANOVA). Males and females were analyzed separately. RESULTS: It was observed that an increase of S-hsCRP associated with the decrease of fS-Fe (p < 0.001 for both genders); fS-A vitamin (p < 0.001 for both genders), and fS-ß-carotenes (p < 0.001 for both genders); these are considered negative acute phase reactants. For both genders there was no significant association between the levels of fS-B12 vitamin (p = 0.14 for males; p = 0.03 for females), fS-Q10 (p < 0.001 for males; p = 0.06 for females) and fB-Se (p < 0.001 for males; p = 0.01 for females) and the categorized S-hsCRP. In contrast, fB-Zn (p < 0.001 for both genders) behaved like a positive acute phase reactant whereas copper measured from washed blood cells (E-Cu) did not display any significant associations with S-hsCRP (p = 0.001 for males; p = 0.05 for females). CONCLUSIONS: A linear association was observed for some micronutrients - the higher the degree of low-grade inflammation (S-hsCRP), the more disturbed were the levels of some micronutrients. For clinicians, this finding means that inflammation needs to be acknowledged when assessing micronutrient deficiency. Substitution therapy should be implemented only after the inflammation has been rectified.

5.
Front Immunol ; 8: 382, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28421079

RESUMO

The presence of toxic indoor molds with accompanying bacterial growth is clearly detrimental to human health. The pathophysiological and toxicological effects of toxins and structural components of molds and bacteria have been clarified in experiments conducted in tissue culture and animals, and there is convincing epidemiologic evidence; nonetheless their implications for human health are either ignored or denied, at least in Finland. In this communication, we describe two cohorts suffering severe sequelae to mold-related illness. One cohort is a nine-member family with pets that moved into a new house, which soon proved to be infested with pathogenic molds. The other cohort consists of 30 teachers and 50 students from a mold-infested school building. The first cohort experienced a plethora of mucosal irritation, neurological, skin, allergic, and other symptoms, with all family members ultimately developing a multiple chemical syndrome. In the second cohort, we detected a greatly elevated prevalence of autoimmune conditions and malignancies. We claim that mold-related illness exists in multiple facets; if not simply a transient mucosal irritation or even an increased risk of asthma onset or its exacerbation. We propose a scheme to explain the natural course of the mold-related illness. We recommend that future studies should combine data from, e.g., cancer, autoimmune, and endocrine disorder registers and neurological and mental health or neuropsychological registers with mold-exposed individuals being monitored for prolonged follow-up times.

6.
Front Immunol ; 7: 239, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27379100

RESUMO

New biomarkers are needed for discriminating active tuberculosis (TB) from latent TB infection (LTBI), especially in vulnerable groups representing the major diagnostic challenge. This pilot study was carried out to explore the diagnostic potential of selected genes, IFN-γ, IL-17, IL-4, and FoxP3, associated with TB immunity and immunopathology. IFN-γ, IL-17, IL-4, and FoxP3 mRNA expression levels were measured by quantitative reverse transcription PCR (RT-qPCR) from antigen-stimulated peripheral blood mononuclear cells of patients with active TB (n = 25); patients with miscellaneous inflammatory disorders and concomitant LTBI (n = 20), rheumatoid arthritis (RA) being the most predominant in the group (n = 11); and in healthy Bacillus Calmette-Guérin (BCG) vaccinees (n = 8). While the levels of FoxP3 mRNA did not differ between the tested groups, the cumulative expression levels of purified protein derivative-stimulated IFN-γ, IL-17, and IL-4 mRNAs were found to distinguish active TB from the whole group of LTBI with 48% sensitivity and 85% specificity. When restricting the LTBI group to RA cases only, the sensitivity was 56% and specificity 100%. When interpreting the result as positive in at least one of the mRNAs IFN-γ, IL-17, or IL-4, sensitivity of 64% and specificities of 75% (heterogeneous group of LTBI) or 100% (LTBI with RA) were achieved. Moderate discrimination of active TB from LTBI with miscellaneous inflammatory underlying conditions by using combined quantitative expression of IFN-γ, IL-17, and IL-4 mRNA seems not to be of high diagnostic potential.

7.
J Sep Sci ; 39(14): 2853-61, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27196985

RESUMO

Tuberculosis is a devastating contagious disease caused by Mycobacterium tuberculosis. This is the first report describing the development of novel capillary electrophoresis methods to detect lipoarabinomannans shed into the blood circulation by replicating bacteria. The novelty of the methods is the detection without derivatization. The lipoarabinomannan is detected owing to the ionization of the diverse functional groups of the structure, such as the multibranched mannan domain or the phosphatidyl group. Four alkaline solutions were used; normal polarity in three of them and reversed polarity in one. Urinary lipoarabinomannans by saccharide domains were identified with direct absorbance detection. The accuracy and the analytical sensitivity were then validated with cello-, manno- and xylooligosaccharides. Lipoarabinomannan detection was feasible within 20 min (RSD 2.1%). This method worked at the dynamic range of 0.1-10 µg/mL. With reversed polarity, indirect absorbance detection, and pH 9.0 electrolyte were used, the analytes migrated already within 5 min (RSD 0.01%). Inorganic nonabsorbing ions were used for this method optimization. This improvement resulted in the detection limit of 1 pg/mL in water and in the linear dynamic range of 1 pg/mL to 10 ng/mL. In conclusion, the described method has great potential as a point-of-care assay for clinical use.


Assuntos
Lipopolissacarídeos/urina , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose/urina , Biomarcadores/urina , Eletrólitos/química , Eletroforese Capilar , Humanos
8.
Int J Food Microbiol ; 226: 53-60, 2016 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-27041390

RESUMO

Campylobacter jejuni is the leading cause of bacterial gastroenteritis and chicken is considered a major reservoir and source of human campylobacteriosis. In this study, we investigated temporally related Finnish human (n=95), chicken (n=83) and swimming water (n=20) C. jejuni isolates collected during the seasonal peak in 2012 using multilocus sequence typing (MLST) and whole-genome MLST (wgMLST). Our objective was to trace domestic human C. jejuni infections to C. jejuni isolates from chicken slaughter batches and swimming water. At MLST level, 79% of the sequence types (STs) of the human isolates overlapped with chicken STs suggesting chicken as an important reservoir. Four STs, the ST-45, ST-230, ST-267 and ST-677, covered 75% of the human and 64% of the chicken isolates. In addition, 50% of the swimming water isolates comprised ST-45, ST-230 and ST-677. Further wgMLST analysis of the isolates within STs, accounting their temporal relationship, revealed that 22 of the human isolates (24%) were traceable back to C. jejuni positive chicken slaughter batches. None of the human isolates were traced back to swimming water, which was rather sporadically sampled. The highly discriminatory wgMLST, together with the patient background information and temporal relationship data with possible sources, offers a new, accurate approach to trace back the origin of domestic campylobacteriosis. Our results suggest that potentially a substantial proportion of campylobacteriosis cases during the seasonal peak most probably are due to other sources than chicken meat consumption. These findings warrant further wgMLST-based studies to reassess the role of other reservoirs in the Campylobacter epidemiology both in Finland and elsewhere.


Assuntos
Campylobacter jejuni/genética , Galinhas/microbiologia , Tipagem de Sequências Multilocus , Natação , Microbiologia da Água , Animais , Infecções por Campylobacter/epidemiologia , Infecções por Campylobacter/microbiologia , Finlândia/epidemiologia , Humanos
10.
Pediatr Infect Dis J ; 35(3): 349-51, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26584055

RESUMO

Childhood cervical lymphadenitis caused by nontuberculous mycobacteria is a diagnostic challenge for the clinician. We present a new promising diagnostic method for childhood nontuberculous mycobacterial lymphadenitis. The modified T-SPOT.TB test with purified protein derivative as an additional antigen is noninvasive with estimated sensitivity and specificity of 1.00 and 0.81, respectively.


Assuntos
ELISPOT/métodos , Linfadenite/diagnóstico , Linfadenite/imunologia , Infecções por Micobactéria não Tuberculosa/diagnóstico , Infecções por Micobactéria não Tuberculosa/imunologia , Micobactérias não Tuberculosas/imunologia , Biópsia , Estudos de Casos e Controles , Pré-Escolar , Feminino , Finlândia , Humanos , Lactente , Linfonodos/microbiologia , Linfonodos/patologia , Linfadenite/microbiologia , Masculino , Infecções por Micobactéria não Tuberculosa/microbiologia
12.
J Clin Microbiol ; 52(12): 4147-54, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25232158

RESUMO

A total of 95 human Campylobacter jejuni isolates acquired from domestic infections and collected from three districts in Finland during the seasonal peak (June to September) in 2012 were analyzed by PCR-based multilocus sequence typing (MLST) and by whole-genome sequencing (WGS). Four predominant sequence types (STs) were detected among the isolates: ST-45 (21%) and ST-230 (14%, ST-45 clonal complex [CC]), ST-267 (21%, ST-283 CC), and ST-677 (19%, ST-677 CC). In districts 1 and 3, most of the infections occurred from early July to the middle of August, with a peak at weeks 29 to 31, but in district 2, the infections were dispersed more evenly throughout 3 months (June to August). WGS data were used for further whole-genome MLST (wgMLST) analyses of the isolates representing the four common STs. Shared loci of the isolates within each ST were analyzed as distance matrices of allelic profiles by the neighbor-net algorithm. The highest allelic variations (>400 different alleles) were detected between different clusters of ST-45 isolates (1,121 shared loci), while ST-230 (1,264 shared loci), ST-677 (1,169 shared loci), and ST-267 isolates (1,217 shared loci) were less diverse with the clusters differing by <40 alleles. Closely related isolates showing no allelic variation (subclusters) were detected among all four major STs. In some cases, they originated from different districts, suggesting that isolates can be epidemiologically connected and may have the same infection source despite being originally identified as sporadic infections.


Assuntos
Infecções por Campylobacter/epidemiologia , Infecções por Campylobacter/microbiologia , Campylobacter jejuni/classificação , Campylobacter jejuni/genética , Tipagem Molecular , Tipagem de Sequências Multilocus , Idoso , Idoso de 80 Anos ou mais , Campylobacter jejuni/isolamento & purificação , Criança , Pré-Escolar , Análise por Conglomerados , DNA Bacteriano/química , DNA Bacteriano/genética , Feminino , Finlândia/epidemiologia , Variação Genética , Genoma Bacteriano , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Homologia de Sequência
14.
Duodecim ; 130(8): 793-9, 2014.
Artigo em Finlandês | MEDLINE | ID: mdl-24822329

RESUMO

Factors affecting transmission of contagious diseases There are differences in the transmission rate of infectious diseases. The mathematic estimates of the transmission rate of various contagious diseases are impossible to predict. The Basic reproduction number, the so-called Ro-value tends to extrapolate the number of persons who can get infected from one person. To prevent some contagious diseases, a high rate of herd immunity is required. This immunity is achieved by mass vaccination. Infections are transmitted by aerosol, drop, fecalo-oral, blood or contact routes. Nosocomial infections are transmitted usually by contact or fecalo-oral routes whereas the majority of healthcare related infections are transmitted by contact with infected blood or through aerosol transmission.


Assuntos
Controle de Doenças Transmissíveis/métodos , Doenças Transmissíveis/transmissão , Doenças Transmissíveis/imunologia , Infecção Hospitalar/imunologia , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/transmissão , Humanos , Imunidade Coletiva , Modelos Estatísticos , Fatores de Risco , Vacinação
15.
Front Immunol ; 4: 418, 2013 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-24363655

RESUMO

On a population-based level, the incidence of reactive arthritis (ReA) is 0.6-27/100,000. The definition of ReA varies and its pathogenesis is not yet clear. Attempts in basic immunology to suggest hypotheses for proliferation of forbidden B cell clones, molecular mimicry, and involvement of cross-reactive antibodies are helpful but not sufficient. Importantly, for the clinical diagnosis of the preceding infection, serology is widely used. Unfortunately, the accuracy of associations between serologic findings and clinical conclusions is plagued by poor standardization of methods. So far, few attempts have been done to examine the pitfalls of different approaches. Here, we review several serologic techniques, their performance and limitations. We will focus on serology for Yersinia, Campylobacter, Salmonella, Shigella, and Chlamydia trachomatis because these bacteria have a longer history of being associated with ReA. We also address controversies regarding the role of serology for some other bacteria linked to autoimmune disorders.

16.
BMC Infect Dis ; 13: 573, 2013 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-24308801

RESUMO

BACKGROUND: Data exploring the potential use of effector molecules produced by cytotoxic T lymphocytes (CTLs) in the immunodiagnostics of tuberculosis (TB) are scarce. The present study focused a) to gain an insight into the discriminatory power of CTLs in patients with acute pulmonary or extra-pulmonary TB, or latent tuberculosis infection (LTBI); and b) to evaluate the influence of various anti-TB therapeutic schemes on the immunological profiles of residual CTLs. METHODS: Immunological signatures of antigen-specific CTLs were explored in patients with active pulmonary and extra-pulmonary TB, LTBI and in those treated for TB decades ago by using ELISPOT, intracellular flow cytometry and extracellular CD107a detection. RESULTS: No difference was seen between active TB, LTBI or any of those treated for TB in the ELISPOT analysis of antigen-specific Granzyme B (GrB), Perforin (Prf) and interferon-gamma (IFN-γ) producing lymphocytes, the FACS analysis of the intracellular expression of IFN-γ, or the surface expression of CD107a degranulation factor of both CD8+ and CD4+ antigen-specific T cell subsets. The effector memory (TEM) phenotype proved predominant in the surface marker profiling both in active TB and LTBI. The proportion of the CD107a degranulation factor proved higher in the central memory (TCM) than in the other cell subsets in all the study groups. Interestingly, functionally and phenotypically similar CTLs profiles were observed in active TB, LTBI and in all the three groups treated for TB. CONCLUSION: The phenotypic and functional profiling of CTLs has a limited potential in the immunodiagnostics of active TB. Antigen-specific CTLs persist in patients treated for TB decades ago regardless of the efficacy of implemented and completed anti-TB therapy.


Assuntos
Linfócitos T Citotóxicos/imunologia , Tuberculose/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Citotoxicidade Imunológica , ELISPOT , Feminino , Citometria de Fluxo , Humanos , Interferon gama/genética , Interferon gama/imunologia , Proteína 1 de Membrana Associada ao Lisossomo/genética , Proteína 1 de Membrana Associada ao Lisossomo/imunologia , Masculino , Pessoa de Meia-Idade , Subpopulações de Linfócitos T/imunologia , Tuberculose/genética
18.
J Med Virol ; 85(9): 1598-601, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23852685

RESUMO

The aim of the study was to evaluate the performance of the new mariPOC(®) method against the direct fluorescent antibody assay (DFA) as the primary reference method for rapid virus detection from nasopharyngeal aspirates and swab samples. The study was an open prospective evaluation during the seasonal winter epidemics in the Mikkeli Central Hospital, Finland. Altogether, 283 samples were analyzed; 124 (43.8%) were from young children (<5 years old). Discrepant samples were resolved by PCR. With nasopharyngeal aspirate samples, the sensitivity and clinical specificity of the mariPOC(®) assay for influenza A virus and respiratory syncytial virus, were 85.7% (CI 69.7-95.2) and 90% (CI 52.0-80.5), and 100% and 99.5%, respectively. The mariPOC(®) performed less well with swab samples having sensitivities at 77.3% (CI 54.6-92.2) and 67.4% (CI 52-80.5), respectively. The specificities were as for nasopharyngeal aspirates. Importantly, similar performance was observed regardless of the cohort age group. In conclusion, the mariPOC(®) test system has a high potential and utility in duty units because it is fast, simple, and multianalyte. The importance of personnel training for proper sample collection should be emphasized.


Assuntos
Técnicas de Laboratório Clínico/métodos , Vírus da Influenza A/isolamento & purificação , Influenza Humana/diagnóstico , Sistemas Automatizados de Assistência Junto ao Leito , Infecções por Vírus Respiratório Sincicial/diagnóstico , Vírus Sinciciais Respiratórios/isolamento & purificação , Virologia/métodos , Pré-Escolar , Finlândia , Humanos , Influenza Humana/virologia , Nasofaringe/virologia , Estudos Prospectivos , Infecções por Vírus Respiratório Sincicial/virologia , Sensibilidade e Especificidade
19.
Clin Vaccine Immunol ; 20(9): 1479-82, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23825194

RESUMO

Diagnosis of active tuberculosis by detection of urinary lipoarabinomannan (uLAM) from Mycobacterium tuberculosis is an attractive approach. Concentrating urine 100-fold allowed quantitation of uLAM at levels equal to picograms/ml of nonconcentrated urine. The approach of concentrating urine 100-fold improved the clinical sensitivity of the Clearview TB enzyme-linked immunosorbent assay (ELISA) from 7% to 57% yet impaired its specificity from 97% to 89%. (This study has been registered at University Hospital of Turku under registration no. 47/180/2009, Helsinki University Central Hospital under 149/2010, University Hospital of Kuopio under 105/2010, and China Medical University Hospital, Taichung, under DMR-99-IRB-075-2.).


Assuntos
Antígenos de Bactérias/urina , Técnicas de Laboratório Clínico/métodos , Lipopolissacarídeos/urina , Mycobacterium tuberculosis/imunologia , Tuberculose/diagnóstico , Adulto , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Humanos , Masculino , Sensibilidade e Especificidade
20.
Emerg Infect Dis ; 19(7): 1041-8, 2013 07.
Artigo em Inglês | MEDLINE | ID: mdl-23777752

RESUMO

Streptococcus equi subspecies zooepidemicus (S. zooepidemicus) is a zoonotic pathogen for persons in contact with horses. In horses, S. zooepidemicus is an opportunistic pathogen, but human infections associated with S. zooepidemicus are often severe. Within 6 months in 2011, 3 unrelated cases of severe, disseminated S. zooepidemicus infection occurred in men working with horses in eastern Finland. To clarify the pathogen's epidemiology, we describe the clinical features of the infection in 3 patients and compare the S. zooepidemicus isolates from the human cases with S. zooepidemicus isolates from horses. The isolates were analyzed by using pulsed-field gel electrophoresis, multilocus sequence typing, and sequencing of the szP gene. Molecular typing methods showed that human and equine isolates were identical or closely related. These results emphasize that S. zooepidemicus transmitted from horses can lead to severe infections in humans. As leisure and professional equine sports continue to grow, this infection should be recognized as an emerging zoonosis.


Assuntos
Doenças dos Cavalos/diagnóstico , Infecções Estreptocócicas/veterinária , Streptococcus equi/genética , Criação de Animais Domésticos , Animais , Genes Bacterianos , Doenças dos Cavalos/microbiologia , Doenças dos Cavalos/transmissão , Cavalos , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular , Tipagem de Sequências Multilocus , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/transmissão , Streptococcus equi/isolamento & purificação , Zoonoses
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