Infecções endodônticas primária x secundária: perfil microbiano, níveis de endotoxinas e ácido lipoteicóico, sinais e sintomas / Primary x secondary endodontic infections: microbial profile, endotoxins and lipoteichoic acid levels, signs and symptoms

Esta pesquisa clínica teve como objetivo comparar a carga e composição microbiana bem como as concentrações de LPS e LTA encontradas na infecção endodôntica primária (IEP) e na infecção endodôntica secundária (IES). Além disso, a correlação desses achados com características clínicas e tomográficas também foram investigadas. Sessenta dentes de pacientes com IEP (31) e IES (29) foram submetidos à avaliação clínica e tomográfica, seguido do tratamento endodôntico ou retratamento. Amostras foram coletadas de cada canal radicular utilizando cones de papel. Logo após a abertura coronária (IEP) ou após a desobturação dos canais (IES) o conteúdo coletado foi submetido à técnica de cultura microbiológica para determinar a carga microbiana de bactérias anaeróbias e ao método Checkerboard DNA-DNA hybridization para investigação de espécies bacterianas presentes. O teste de Lisado de Amebócito de Limulus e o Ensaio de Imunoabsorção Enzimática foram utilizados para quantificar os níveis de LPS e LTA. Os dados obtidos foram correlacionados com os achados clínicos e tomográficos. Maiores quantidades de bactérias cultiváveis e de LPS foram encontradas na IEP (p < 0,05). Não houve diferença nos níveis de LTA entre IEP e IES (p > 0,05). A mediana de espécies por canal radicular encontrada na IEP foi de 9 espécies e na IES foi de 22 (p < 0,05). As espécies bacterianas mais prevalentes detectadas na IEP foram P. gingivalis (14/31) e S. intermedius (14/31). Na IES, as espécies mais prevalentes foram P. gingivalis (21/29) e C. rectus (20/29). LPS foi correlacionado positivamente com um maior volume da lesão periapical (p < 0,05). Níveis de LTA não foram relacionados a sinais e sintomas ou ao volume da lesão periapical (p > 0,05). Concluiu-se que dentes com IEP tiveram maiores quantidades de carga microbiana e de LPS do que os dentes com IES. Uma maior quantidade de LPS foi correlacionada positivamente com um maior volume de destruição óssea periapical. Uma ampla interação de espécies bacterianas específicas resultou em diferentes características clínicas(AU)

This clinical research aimed to compare the microbial load and composition as well as the LPS and LTA concentrations found in Primary Endodontic Infection (PEI) and Secondary Endodontic Infection (SEI). In addition, the correlation of these findings with clinical and tomographic features was also investigated. Sixty patients' teeth with PEI (31) and SEI (29) were submitted to clinical and tomographic assessment, followed by endodontic treatment or retreatment. Samples were taken from each root canal using paper points. After the coronary opening (PEI) or after the removal of root filling material (SEI), the collected samples were submitted to the microbiological culture technique to determine the microbial load of anaerobic bacteria and to the Checkerboard DNA-DNA hybridization method for investigation of present bacterial species. The Limulus amebocyte lysate assay and enzyme-linked immunosorbent assay were used to quantify LPS and LTA levels. The data obtained were correlated with clinical and tomographic findings. A higher number of cultivable bacteria and LPS was found in PEI (p < 0.05). There was no difference in LTA levels between PEI and SEI (p> 0.05).The median number of species per root canal found in PEI was 9 and 22 in SEI (p < 0.05). The most prevalent bacterial species detected in PEI were P. gingivalis (14/31) and S. intermedius (14/31). In SEI, the most prevalent species were P. gingivalis (21/29) and C. rectus (20/29). LPS was positively correlated with a larger periapical lesion volume (P < 0.05). LTA levels were not related to signs and symptoms or periapical lesion volume (p> 0.05). It was concluded teeth with PEI had higher contents of microbial load and LPS than teeth with SEI. However, a more diverse microbiota was found in SEI than that of PEI. Higher content of LPS was positively correlated with larger periapical bone destruction. A widely interaction of specific microbial species resulted in different clinical features(AU)

Medical Devices; Immunology and Microbiology Devices; Classification of the Zinc Transporter 8 Autoantibody Immunological Test System. Final order.

The Food and Drug Administration (FDA or we) is classifying the zinc transporter 8 autoantibody immunological test system into class II (special controls). The special controls that apply to the device type are identified in this order and will be part of the codified language for the zinc transporter 8 autoantibody immunological test system's classification. We are taking this action because we have determined that classifying the device into class II (special controls) will provide a reasonable assurance of safety and effectiveness of the device. We believe this action will also enhance patients' access to beneficial innovative devices, in part by reducing regulatory burdens.

Medical devices; immunology and microbiology devices; classification of John Cunningham Virus serological reagents. Final order.

The Food and Drug Administration (FDA) is classifying John Cunningham Virus (JCV) serological reagents into class II (special controls). The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.

Monoclonal antibody testing for fecal calprotectin is superior to polyclonal testing of fecal calprotectin and lactoferrin to identify organic intestinal disease in patients with abdominal discomfort.

BACKGROUND AND AIMS: Fecal calprotectin and lactoferrin are sensitive markers of mucosal inflammation. We compared three different assays in their ability to identify patients with organic intestinal disease. METHODS: In a post-hoc analysis of a prospective study, we examined 405 unselected patients with abdominal complaints referred for endoscopy to the University Hospital Basel, Switzerland. Calprotectin (EK-CAL, Bühlmann Laboratories, Switzerland; PhiCal, Calpro AS, Norway) and lactoferrin (IBD-Scan, Techlab, USA) were measured using enzyme-linked immunosorbent assays. The presence of a clinically significant endoscopic finding was the primary endpoint of the study. Final diagnoses were adjudicated blinded to calprotectin values. RESULTS: The prevalence of organic intestinal disease was 35.3%. Receiver operating characteristics analysis calculated an area under the curve (AUC) for EK-CAL of 0.918, which was significantly better than for PhiCal (AUC 0.842, P<0.001) and IBD-Scan (AUC 0.830, P=0.003) to identify patients with organic intestinal disease. Overall test accuracy was 88.1% for EK-CAL, 83.7% for PhiCal, and 81.3% for IBD-Scan. Optimal cut-off value calculated for PhiCal and IBD-Scan were lower than recommended by the manufacturer. CONCLUSIONS: Monoclonal testing of calprotectin is superior to both polyclonal calprotectin testing and fecal lactoferrin in identifying symptomatic patients with organic intestinal disease.

Actividad de la telomerasa e infección por VPH en raspados cervicales de mujeres que desarrollaron lesiones escamosas intraepiteliales de alto grado: un estudio de seguimiento / Telomerase activity and HPV infection in cervical smears of women with high grade squamous intraephitelial lesions: a follow-up study

Objetivo: Describir la AT y la infección por VPH en el seguimiento de mujeres que pertenecen a la cohorte de Bogotá. Métodos: Se analizaron 79 muestras del seguimiento de 25 mujeres que desarrollaron LEI-AG y 149 muestras del seguimiento de 34 mujeres con citología normal. La detección del VPH se realizó usando PCR-EIA GP5+/GP6+ y RLB. La AT se midió mediante TRAP-ELISA. Resultados: El análisis mostró que de los 25 casos, 8 fueron casos prevalentes (ingresaron al estudio con la LEI-AG) y los 17 casos restantes fueron incidentes (la lesión se detectó durante el seguimiento). De estas 17 mujeres, 12 (70,5%) presentaron AT y VPH al momento del diagnóstico o en una visita previa, con VPH de alto riesgo (VPH-AR), principalmente de la especie α-9. Tres mujeres (17,7%) mostraron infecciones transitorias por VPH y 2 (11,8%) no tuvieron VPH o AT al diagnóstico. El seguimiento de la mujeres con citología normal mostró que solo ocho mujeres tuvieron VPH y AT al mismo tiempo (23,5%), 21/34 mujeres (61,8%) tuvieron eventos transitorios de VPH durante el seguimiento y 5 (14,7%) no tuvieron VPH durante todo el seguimiento. Conclusiones: Detectar AT e infección por VPH-AR al mismo tiempo parecen predecir el riesgo de LEI-AG.

Objective: To describe telomerase activity (TA) and HPV infection in follow up of women in the Bogotá cohort. Methods: Analysis was carried out on 79 follow up samples from 25 women who developed LEI-AG, and 149 follow up samples from 34 women with normal cytology. HPV detection was made with PCR-EIA GP5+/GP6+ and RLB. TA was measured with TRAP-ELISA. Results: Analysis revealed that out of the 25 cases, 8 were prevalent (enrolled in the study with LEI-AG), and the remaining 17 incidental (lesion was detected during follow up). Among these 17 women, 12 (70.5%) had, at diagnosis or during a previous checkup, TA and high-risk HPV (HPV-AR), primarily type α-9. Three women (17.7%) had transitory HPV infections, and 2 (11.8%) had neither HPV nor TA at diagnosis. Follow up on women with normal cytology revealed that only eight women (23.5%) had HPV and TA at the same time, 21/34 women (61.8%) had transitory HPV event during follow up, and 5 (14.7%) had no HPV during entirety of follow up. Conclusions: Detection of TA and simultaneous HPV-AR infection apparently predicts LEI-AR risk.

Tamizaje serológico y con PCR para determinar la prevalencia de Chlamydia trachomatis en pacientes con vaginosis y vaginitis inespecífica que asisten a hospitales de la Secretaría de Salud de Bogotá / Serologic and PCR screening to determine the prevalence of Chlamydia trachomatis in patients with vaginitis and inespecific vaginitis in two public hospitals in Bogotá

Chlamydia trachomatis (CT) es uno de los agentes etiológicos más importantes en las infecciones de transmisión sexual. En la mujer CT causa patologías tales como cervicitis, uretritis y enfermedad pélvica inflamatoria, entre otras. Los objetivos de este trabajo fueron determinar la prevalencia de la infección y la concordancia de las pruebas diagnósticas para CT en pacientes sintomáticas de vaginitis o leucorrea inespecífica, que asistieron al hospital Pablo VI de Bosa y al Hospital del Sur de Bogotá, durante los meses de junio y julio de 2004. Se obtuvieron 180 muestras simultáneas de suero y de orina para la determinación de IgG, IgM e IgA anticlamidia y para PCR, respectivamente. La detección de los anticuerpos para CT en suero se realizó mediante el método ELISA (VIRCEL) y la detección del DNA en orina se hizo con la prueba AMPLICOR CT PCR (ROCHE). La prevalencia de la infección fue del 31 porciento (56 casos). La mediana de edad en mujeres con evidencia de infección reciente o activa fue de 23 años; 37 pacientes (66)porciento positivas para algún marcador tenían infección activa. En 24 participantes (42.8)porciento con infección activa, de acuerdo con los resultados serológicos, no se detectó el DNA en orina; en 14 pacientes (25 porciento de las pacientes positivas en las pruebas serológicas) se encontró el PCR positivo en las muestras de orina. Una prevalencia del 31 porciento en mujeres sintomáticas indica que la infección por Chlamydia es un problema para la salud pública. Implantar un programa de tamizaje para la búsqueda activa de casos, así como la búsqueda activa de contactos sexuales, reducirá el peso socioeconómico de la infección. La prueba ideal para diagnóstico tanto de cervicitis como de uretritis en el mismo procedimiento deberá utilizar muestra de orina y de cepillado cervical.

Rapid competitive enzyme-linked immunosorbent assay for detection of antibodies to peste des petits ruminants virus.

Peste des petits ruminants (PPR) is a contagious viral disease of small ruminants that is of economic importance in Africa, the Middle East, and Asia. We developed a rapid competitive enzyme-linked immunosorbent assay (rapid c-ELISA) for the diagnosis and surveillance of PPR. This assay detects PPR virus (PPRV) antibodies in serum samples by quantifying the amount of monoclonal antibody (MAb) P-3H12 after 30 min of incubation of a serum-MAb conjugate mixture on plates coated with a PPRV recombinant nucleocapsid protein (rPPRV-N). We tested 249 PPRV-positive serum samples and 733 PPRV-negative serum samples from field ruminants. The threshold of percent inhibition (PI) was determined to be <50 on the basis of the mean PI plus 3 standard deviations for sera from PPRV-negative ruminants. The relative specificity and sensitivity of the rapid c-ELISA were 98.5% (722 of 733 serum samples) and 93.4% (234 of 249 serum samples), respectively. The rapid c-ELISA sensitively detected PPRV antibodies in hyperimmune sera (virus neutralization test [VNT] titer, >512), even at dilutions > or = 512 in normal goat serum, and as early as 6 to 13 days postinfection from 12 goats, each of which was infected with one of the four PPRV lineages. Hyperimmune sera from animals experimentally vaccinated with rinderpest virus gave positive results by the rapid c-ELISA when the rinderpest virus VNT titers were >512, although the rapid c-ELISA titers were very low (2 to 16). However, the rapid c-ELISA was negative when the rinderpest virus VNT titer was < or = 128. The rapid c-ELISA developed in the present work provides a short turnaround time and could be a useful tool for the diagnosis of PPR and screening for PPRV in the field.

Detección de antígenos dominantes para el diagnóstico de cisticercosis por inmunoelectrotransferencia (Eitb) / Detection of dominants antigens to diagnosis of cisticercosis for immunoelectrotransference (Eitb)

Se emplearon quistes liofilizados de Cisticerco cellullosae para preparar un extracto antigénico, el cual se utilizó en la identificación de antígenos de Taenia soliumreconocidos por inmunoglobulinas G de pacientes con cisticercosis, por medio de la prueba de inmunoelectrotransferencia (EITB). Se estudiaron 193 muestras (105 líquidos cefalorraquídeos - LCR y 88 sueros) de individuos con diagnóstico de cisticercosis por hallazgos clínicos, epidemiológicos y serológicos mediante el inmunoensayo enzimático (ELISA). El análisis de las proteínas antigénicas por electroforesis, permitió identificar polipéptidos de 29, 45, 66, 96 y 116 kDa principalmente, así como también algunos menores de 29 kDa. Los de mayor frecuencia de aparición en muestras de suero y LCR fueron los de 29, 45 y 66 kDa. Por lo tanto, estos antígenos inmunodominantes, podrían emplearse con predilección en estudios epidemiológicos y clínicos de cisticercosis por western blot

Medical devices; immunology and microbiology devices; classification of the West Nile Virus IgM capture Elisa assay. Final rule.

The Food and Drug Administration (FDA) is classifying the West Nile Virus IgM Capture Elisa assay into class II (special controls). The agency is taking this action in response to a petition submitted under the Federal Food, Drug, and Cosmetic Act (the act) as amended by the Medical Device Amendments of 1976 (the amendments), the Safe Medical Devices Act of 1990, and the Food and Drug Administration Modernization Act of 1997 (FDAMA). The agency is classifying this device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device. Elsewhere in this issue of the Federal Register, FDA is announcing the availability of a guidance document that will serve as the special control for the device.

Immunology and Microbiology Devices; Classification of Anti-Saccharomyces cerevisiae (S. cerevisiae) Antibody (ASCA) Test Systems. Food and Drug Administration, HHS. Final rule.

The Food and Drug Administration (FDA) is classifying the Anti-Saccharomyces cerevisiae (S. cerevisiae) antibody (ASCA) test system into class II (special controls). The special control that will apply to this device is a guidance document entitled "Guidance for Industry and FDA Reviewers: Class II Special Control Guidance Document for Anti-Saccharomyces cerevisiae (S. cerevisiae) Antibody (ASCA) Premarket Notifications." Elsewhere in this issue of the Federal Register. FDA is announcing the availability of this guidance document. The agency is taking this action in response to a petition submitted under the Federal Food, Drug, and Cosmetic Act (the act) as amended by the Medical Device Amendments of 1976, the Safe Medical Devices Act of 1990, and the Food and Drug Administration Modernization Act of 1997. The agency is classifying these devices into class II (special controls) in order to provide a reasonable assurance of the safety and effectiveness of the devices.

La microbiología en la transfusión sanguínea / Microbiology in blood transfusion

La familia de los Retrovirus se encuentra en el hombre y en los animales y son una causa considerable de mortalidad. Aunque se sabe que existen hace casi 100 años, su rol como agentes patógenos humano se recononoció hace aproximadamente 15 años. Su Genoma está compuesto por ARN. Los cuadro Retrovirus humanos: HIV-1, HIV-2, HTLV-1 y HTLV-II comparten cararterísticas comunes aunque se trata de entidades diferentes. Los ensayos que se utilizan para cada uno de estos virus son similares tanto en los principios como en las técnicas. En este primer apartado (I) del ensayo "Los Retrovirus" de detallará: etipatología, configuración antigénetica, respuesta inmune específica del huésped, clasificación de los métodos de diagnósticos sérico de HIV-1 y HIV-2 luego se completará el dictum mediante una lista parcial de los equipos comerciales de diagnóstico en el Anexo 1 (AU)

La microbiología en la transfusión sanguínea / Microbiology in blood transfusion

La familia de los Retrovirus se encuentra en el hombre y en los animales y son una causa considerable de mortalidad. Aunque se sabe que existen hace casi 100 años, su rol como agentes patógenos humano se recononoció hace aproximadamente 15 años. Su Genoma está compuesto por ARN. Los cuadro Retrovirus humanos: HIV-1, HIV-2, HTLV-1 y HTLV-II comparten cararterísticas comunes aunque se trata de entidades diferentes. Los ensayos que se utilizan para cada uno de estos virus son similares tanto en los principios como en las técnicas. En este primer apartado (I) del ensayo "Los Retrovirus" de detallará: etipatología, configuración antigénetica, respuesta inmune específica del huésped, clasificación de los métodos de diagnósticos sérico de HIV-1 y HIV-2 luego se completará el dictum mediante una lista parcial de los equipos comerciales de diagnóstico en el Anexo 1

Anticuerpos anti-VHC en insuficientes renales crónicos / Anti-HCV antibodies in patients with chronic renal failure

El virus de la hepatitis C es la principal causa de hepatitis post-transfusional en el mundo, pero poco se conoce acerca de la transmisión en los pacientes con insuficiencia renal crónica y en las unidades de hemodialisis. El presente trabajo estimó la prevalencia de los anticuerpos anti-VHC en los pacientes con insuficiencia renal crónica del Departamento de Nefrología del Hospital Universitario de los Andes, en Mérida Venezuela. Se admitieron 22 pacientes al estudio, todos con insuficiencia renal crónica. Los datos médicos referentes a factores de riesgo (trasnfuciones, drogadicción y promiscuidad sexual) fueron obtenidos de las historias clínicas y las encuestas aplicadas a los pacientes. Un ELISA anti-VHC de segunda generación fue usado como prueba serológica. De los 22 pacientes estudiados, 5 fueron anti-VHC positivos y 17 fueron negativos. Los 5 pacientes seropositivos eran hemodializados, lo cual arrojó una prevalencia del 22,7 por ciento en el grupo de estudio. Todos los pacientes insuficientes renales crónicos no hemodializados fueron anti-VHC (p= 0.0047). No hubo asociación significativa entre transfuciones y positividad al anti-VHC (p= 0.36). La hemodiálisis podría ser un factor de riesgo en la trasmisión del virus de la hepatitis C

Doadores de sangue anti-VHC reagentes: o que significa e qual a conduta a ser adotada / Anti-HCV positive blood donors: what's the meaning and what's the conduct to take

A introducao dos testes por tecnica imunoenzimatica (ELISA) para a deteccao do anti-VHC em doadores de sangue representou um consideravel avanco na profilaxia das hepatites pos-transfusionais. No entanto, com razoavel frequencia, doadores anti-VHC reagentes e com transaminases normais nao sao portadores do VHC, enquanto que aqueles com transaminases elevadas o sao. Os ELISAs atualmente ja estao em sua terceira geracao, existindo variacoes em sua sensibilidade e especificidade. Recomenda-se que doadores anti-VHC reagentes (ELISA) sejam avaliados com testes mais especificos, como, por exemplo, o RIBA. A frequencia com que um doador anti-VHC reagente (ELISA) tem sua infeccao confirmada pelo RIBA e muito variavel. O metodo mais sensivel para identificar viremia e a reacao em cadeia da polimerase. Ha evidencias de que a grande maioria dos doadores anti-VHC reagentes (ELISA e RIBA) sao portadores de hepatopatia, de grau variavel

The use of enzyme-linked immunosorbent assays to study the plasma disposition of sheep polyclonal and rat monoclonal digoxin-specific Fab fragments in the rabbit.

The plasma disposition of sheep polyclonal digoxin-specific Fab (fragment antigen-binding) fragments has been studied in rabbits after their intravenous injection (1 mg kg-1) using enzyme-linked immunosorbent assays exploiting both the species-specificity (ELISA1) and the digoxin-specificity (ELISA2) of digoxin-specific Fab fragments. The log concentration versus time profiles were best described by a biexponential plasma disposition when either assay was used. Although the plasma concentrations determined by ELISA1 and ELISA2 at each sampling time were not significantly different, there was a tendency for certain ELISA2 values to be higher. This resulted in the ELISA2-derived data giving a significantly longer distribution half-life (t1/2 alpha), but similar values for elimination half-life (t1/2 beta), apparent volume of distribution at steady state (Vdss), and clearance. Using ELISA2, which was generally the more sensitive assay, to compare the plasma disposition of the sheep polyclonal digoxin-specific Fab fragments with rat monoclonal digoxin-specific Fab fragments, it was shown that the rat product had a shorter t1/2 alpha (11 vs 22 min), a t1/2 beta which was not significantly different (253 vs 168 min), but a faster clearance (1.2 vs 0.7 mL kg-1 min-1), associated with a much larger Vdss (321 vs 108 mL kg-1). The extracellular fluid volume, using thiocyanate as a marker, was about 216 mL kg-1 for the nine rabbits used. This suggests that the rat preparation penetrates more extensively into the extracellular space and may indicate that some degree of extracellular binding or cell penetration is occurring.