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Pereira BAS, Cavalcante RDS, Pereira-Chioccola VL, Melhem MDSC, de Carvalho LR, Mendes RP. Standardization of Semi-Quantitative Dot Blotting Assay-Application in the Diagnosis, Follow-Up, and Relapse of Paracoccidioidomycosis. Microorganisms 2024; 12:351. [PMID: 38399756 PMCID: PMC10892552 DOI: 10.3390/microorganisms12020351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
INTRODUCTION This study standardized a semi-quantitative dot blotting assay (DB) and a quantitative real-time polymerase chain reaction (qPCR) to detect specific antibodies for Paracoccidioides brasiliensis and its DNA in PCM patients. METHODOLOGY We evaluated 42 confirmed PCM patients upon admission using a serological double agar gel immunodiffusion test (DID), DB, and molecular tests (qPCR in total blood). The control groups included 42 healthy individuals and 37 patients with other infectious diseases. The serological progress during treatment was evaluated in eight patients, and there was a relapse diagnosis in ten patients using the Pb B.339 strain antigen. The cut-off points for the serological tests were determined by a receiver operator characteristic curve. RESULTS The DB and DID tests showed similar accuracy, but the DB identified lower antibody concentrations. Cross-reactions were absent in the DB assay. In the relapse diagnoses, DB exhibited much higher sensitivity (90%) than DID (30%). CONCLUSIONS A DB assay is easier and faster than a DID test to be performed; DB and DID tests show the same accuracy, while blood qPCR is not recommended in the diagnosis at the time of admission; cross-reactions were not observed with other systemic diseases; DB and DID tests are useful for treatment monitoring PCM patients; and a DB assay is the choice for diagnosing relapse. These findings support the introduction of semi-quantitative DB assays in clinical laboratories.
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Affiliation(s)
- Beatriz Aparecida Soares Pereira
- UNESP Botucatu, School of Medicine—Discipline of Infectology, São Paulo State University, Botucatu 18618-689, São Paulo State, Brazil; (R.d.S.C.); (M.d.S.C.M.); (R.P.M.)
| | - Ricardo de Souza Cavalcante
- UNESP Botucatu, School of Medicine—Discipline of Infectology, São Paulo State University, Botucatu 18618-689, São Paulo State, Brazil; (R.d.S.C.); (M.d.S.C.M.); (R.P.M.)
| | | | - Marcia de Souza Carvalho Melhem
- UNESP Botucatu, School of Medicine—Discipline of Infectology, São Paulo State University, Botucatu 18618-689, São Paulo State, Brazil; (R.d.S.C.); (M.d.S.C.M.); (R.P.M.)
- FUMS Campo Grande, School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil
| | - Lídia Raquel de Carvalho
- Institute of Biosciences—Department of Biodiversity and Biostatistics, UNESP Botucatu, São Paulo State University, Botucatu 18618-689, São Paulo State, Brazil;
| | - Rinaldo Poncio Mendes
- UNESP Botucatu, School of Medicine—Discipline of Infectology, São Paulo State University, Botucatu 18618-689, São Paulo State, Brazil; (R.d.S.C.); (M.d.S.C.M.); (R.P.M.)
- FUMS Campo Grande, School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil
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Tomazini KA, Pereira BAS, Sylvestre TF, Cavalcante RDS, de Carvalho LR, Mendes RP. Reproducibility of double agar gel immunodiffusion test using stored serum and plasma from paracoccidioidomycosis patients. J Venom Anim Toxins Incl Trop Dis 2023; 29:e20220045. [PMID: 36660367 PMCID: PMC9842191 DOI: 10.1590/1678-9199-jvatitd-2022-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/15/2022] [Indexed: 01/18/2023] Open
Abstract
Background Serological evaluation performed by double agar gel immunodiffusion test (DID) is used for diagnosis, evaluation of severity, management of paracoccidioidomycosis patients, and development of new clinical studies. For these reasons, the Botucatu Medical School of UNESP maintains a serum bank at the Experimental Research Unit with patient clinical data. This study aimed to evaluate the influence of the freeze-thaw cycle and different blood matrices on the titration of circulating antibodies. Methods The study included 207 patients with confirmed (etiology-demonstrated) or probable (serology-demonstrated) paracoccidioidomycosis, and DID was performed with culture filtrate from Paracoccidioides brasiliensis B339 as antigen. First experiment: the antibody levels were determined in serum samples from 160 patients with the chronic form and 20 with the acute/subacute form, stored at -80oC for more than six months. Second experiment: titers of 81 samples of serum and plasma with ethylenediaminetetraacetic acid (EDTA) or heparin, from 27 patients, were compared according to matrix and effect of storage at -20oC for up to six months. Differences of titers higher than one dilution were considered discordant. Results First experiment: test and retest presented concordant results in serum stored for up to three years, and discordant titers in low incidence in storage for four to six years but high incidence when stored for more than six years, including conversion from reagent test to non-reagent retest. Second experiment: serum, plasma-EDTA and plasma-heparin samples showed concordant titers, presenting direct correlation, with no interference of storage for up to six months. Conclusions Storage at -80oC for up to six years has no or little influence on the serum titers determined by DID, permitting its safe use in studies depending on this parameter. The concordant titrations in different blood matrices demonstrated that the plasma can be used for immunodiffusion test in paracoccidioidomycosis, with stability for at least six months after storage at -20oC.
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Affiliation(s)
- Karina Andressa Tomazini
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil.,Correspondence:
| | - Beatriz Aparecida Soares Pereira
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil
| | | | - Ricardo de Souza Cavalcante
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Lídia Raquel de Carvalho
- Department of Biodiversity and Biostatistics, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Rinaldo Poncio Mendes
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil
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Levorato-Vinche AD, Melhem MDSC, Bonfietti LX, de-la-Cruz-Chacón I, Boaro CSF, Fabro AT, Ferreira G, da Silva JDF, Dos Santos DC, Pereira BAS, Marçon C, Maza L, de Carvalho LR, Mendes RP. Antifungal activity of liriodenine on clinical strains of Cryptococcus neoformans and Cryptococcus gattii species complexes. J Venom Anim Toxins Incl Trop Dis 2022; 28:e20220006. [PMID: 36118844 PMCID: PMC9469771 DOI: 10.1590/1678-9199-jvatitd-2022-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/27/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Cryptoccocal meningitis continues to present high incidence among AIDS patients. The treatment of choice is the synergistic combination of flucytosine (5-FC) with amphotericin B deoxycholate (AmBd) or its lipid formulations. However, 5-FC is unavailable in many countries and AmB demands hospitalization. The combination of AmB with the fungistatic fluconazole (FLC) or the use of high FLC daily doses alone became the choice. Nonetheless, sterilization of cerebrospinal fluid is delayed with FLC monotherapy, mainly with high fungal burden. These findings suggest the search for new antifungal compounds, such as liriodenine. Methods: Liriodenine antifungal activity was evaluated by three procedures: determining the minimum inhibitory concentration (MIC) on 30 strains of the Cryptococcus neoformans (C. neoformans) complex and 30 of the Cryptococcus gattii (C. gattii) complex, using EUCAST methodology and amphotericin B deoxycholate as control; performing the time-kill methodology in two strains of the C. neoformans complex and one of the C. gattii complex; and injury to cryptococcal cells, evaluated by transmission electron microscopy (TEM). Liriodenine absorption and safety at 0.75 and 1.50 mg.kg-1 doses were evaluated in BALB/c mice. Results: Liriodenine MICs ranged from 3.9 to 62.5 μg.mL-1 for both species complexes, with no differences between them. Time-kill methodology confirmed its concentration-dependent fungicidal effect, killing all the strains below the limit of detection (33 CFU.mL-1) at the highest liriodenine concentration (32-fold MIC), with predominant activity during the first 48 hours. Liriodenine induced severe Cryptococcus alterations - cytoplasm with intense rarefaction and/or degradation, injury of organelles, and presence of vacuoles. Liriodenine was better absorbed at lower doses, with no histopathological alterations on the digestive tract. Conclusion: The fungicidal activity confirmed by time-kill methodology, the intense Cryptococcus injury observed by TEM, the absorption after gavage administration, and the safety at the tested doses indicate that the liriodenine molecule is a promising drug lead for development of anticryptococcal agents.
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Affiliation(s)
- Adriele Dandara Levorato-Vinche
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Marcia de Souza Carvalho Melhem
- Mycology Unit, Adolfo Lutz Institute, Public Health Reference Laboratory, Secretariat of Health of the State of São Paulo, São Paulo, SP, Brazil.,Medical School, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Lucas Xavier Bonfietti
- Mycology Unit, Adolfo Lutz Institute, Public Health Reference Laboratory, Secretariat of Health of the State of São Paulo, São Paulo, SP, Brazil
| | - Iván de-la-Cruz-Chacón
- Instituto de Ciencias Biológicas, Universidad de Ciencias y Artes de Chiapas, Tuxtla Gutierrez, Chiapas, Mexico
| | - Carmen Sílvia Fernandes Boaro
- Department of Biostatistics, Plant Biology, Parasitology and Zoology, Botucatu Biosciences Institute, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Alexandre Todorovic Fabro
- Department of Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Gisela Ferreira
- Department of Biostatistics, Plant Biology, Parasitology and Zoology, Botucatu Biosciences Institute, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Julhiany de Fátima da Silva
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Daniela Carvalho Dos Santos
- Department of Structural and Functional Biology, Botucatu Biosciences Institute, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Beatriz Aparecida Soares Pereira
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Camila Marçon
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Lariza Maza
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Lídia Raquel de Carvalho
- Department of Biostatistics, Plant Biology, Parasitology and Zoology, Botucatu Biosciences Institute, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Rinaldo Poncio Mendes
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil
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Negrão DR, Mischan MM, de Pinho SZ, de Carvalho LR, Gomes RL, de Souza Passos JR. How temperature variation affects white-rot fungi mycelial growth dynamics: a nonlinear mixed models approach. Fungal Biol 2021; 125:860-868. [PMID: 34649672 DOI: 10.1016/j.funbio.2021.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 11/27/2022]
Abstract
This study aimed to model mycelial growth in a factorial experiment with two species of white rot fungi growing at five temperatures. The nonlinear models evaluated were logistic, Gompertz, Weibull and von Bertalanffy. The adjustments were performed first by evaluating the fixed and mixed-effects models with random effects, added to the fixed parameters. Then, the best adjusted model was improved by an adequated covariance structure, and dummy variables were added to the parameters asymptote (α) and abscissa of the inflection point (β) in the model in order to verify the effect of the experiment factors, species and temperatures on the regression parameters. The criteria used to compare models were residual variance and Akaike information criterion. Gompertz and von Bertalanffy mixed-effects models were better adjusted. The parameters differed between species. Moreover, the linear and quadratic effects of temperature evaluated in each species were significant. The models were reparametrized in order to consider two parameters of interest: velocity (μ) at the inflection point and lag time (λ). The maximum growth velocity was obtained at 25.4 °C by S. ostrea, while T. villosa was achieved at 30.5 °C; both fungi suffered less lag time by increasing the temperature.
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Affiliation(s)
- Djanira Rodrigues Negrão
- Plant Protection Department, College of Agricultural Sciences (FCA), Lageado Experimental Farm, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Martha Maria Mischan
- Bioestatistic, Plant Biology, Parasitology and Zoology Department, Bioscience Institute (IBB), Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil
| | - Sheila Zambello de Pinho
- Bioestatistic, Plant Biology, Parasitology and Zoology Department, Bioscience Institute (IBB), Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil
| | - Lídia Raquel de Carvalho
- Bioestatistic, Plant Biology, Parasitology and Zoology Department, Bioscience Institute (IBB), Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil
| | - Rafaela Lanças Gomes
- Bioestatistic, Plant Biology, Parasitology and Zoology Department, Bioscience Institute (IBB), Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil
| | - José Raimundo de Souza Passos
- Bioestatistic, Plant Biology, Parasitology and Zoology Department, Bioscience Institute (IBB), Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil.
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Carvalho GC, de Oliveira RAP, Araujo VHS, Sábio RM, de Carvalho LR, Bauab TM, Corrêa I, Chorilli M. Prevalence of vulvovaginal candidiasis in Brazil: a systematic review. Med Mycol 2021; 59:946-957. [PMID: 34137857 DOI: 10.1093/mmy/myab034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/26/2021] [Accepted: 06/15/2021] [Indexed: 12/18/2022] Open
Abstract
Vulvovaginal candidiasis (CVV) is a condition whose signs and symptoms are related to inflammation caused by Candida spp infection. It is the second leading cause of vaginitis in the world, representing a public health problem. The present systematic review comes with the proposal of analyze and identify the available evidence on CVV prevalence in Brazil, pointing out its variability by regions. For this, a systematic literature review was carried out with meta-analysis of cross-sectional and cohort studies, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guide recommendations, and was registered in the International Prospective Register of Systematic Reviews (PROSPERO 2020 CRD42020181695). The databases used for survey were LILACS, Scielo, Scopus, PUBMED, Web of Science and CINAHL. Fifteen studies were selected to estimate CVV prevalence in the Brazilian territory. South and Southeast regions have higher prevalences than the North and Northeast regions, no data were found for the Midwest region. The estimated prevalence for Brazil is 18%, however, it is suggested that this number is higher due to underreporting and the presence of asymptomatic cases. Therefore, new epidemiological studies are recommended throughout Brazil, to elucidate the profile of this disease in the country, in addition to assisting in the elaboration of an appropriate prevention plan by state. LAY ABSTRACT Data found in the literature regarding the epidemiological profile of VVC in Brazil are obsolete and incomplete, so the present systematic review has the proposal to analyze and identify the evidence on VVC prevalence in Brazil. The estimated prevalence is 18%, however, this number can be higher.
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Affiliation(s)
- Gabriela Corrêa Carvalho
- Department of Drugs and Pharmaceutics, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
| | | | - Victor Hugo Sousa Araujo
- Department of Drugs and Pharmaceutics, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
| | - Rafael Miguel Sábio
- Department of Drugs and Pharmaceutics, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
| | - Lídia Raquel de Carvalho
- Biostatistics department, Institute of Biosciences, São Paulo State University (UNESP), 18618687 Botucatu, Brazil
| | - Taís Maria Bauab
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
| | - Ione Corrêa
- Nursing department, Medical School, São Paulo State University (UNESP), 18618687 Botucatu, Brazil
| | - Marlus Chorilli
- Department of Drugs and Pharmaceutics, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
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Lucio Filho CEP, Bertanha M, Prata MP, Carvalho LRD, Jaldin RG, Sobreira ML, Janzen J, Yoshida WB. Efficacy and safety of glucose, glucose and polidocanol combination, liquid polidocanol and polidocanol foam in the treatment of reticular veins: A randomized study in rabbits. Phlebology 2021; 36:303-312. [PMID: 33030404 DOI: 10.1177/0268355520964293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare the efficacy and safety of sclerosing agents injected in dorsal veins of rabbit ears. METHODS Sixty ears of 30 rabbits were randomly allocated in: 1% liquid polidocanol, 1% polidocanol foam, 0.2% polidocanol-glucose 70% solution, glucose 75% or 0.9% saline. Outcomes included efficacy (luminal occlusion), complications (phlebitis, neovascularization, ulceration at the puncture site, necrosis and local inflammation) and histology (sclerosis, recanalization vein and surrounding tissues inflammation, blood extravasation, recanalization, lymphangiogenesis, destruction of cartilage and neoangiogenesis). RESULTS Sclerosis was superior in Foam Group (76.9%), but also with 30.7% necrosis (p = 0.003), 46.15% ulceration (p = 0.003), and 69.2% local inflammation (p < 0.0001). Neovascularization were similar. Histology showed 38.5% phlebitis (p = 0.004) and necrosis (p = 0.03) in the foam group. CONCLUSIONS Sclerosis with foam and liquid polidocanol were superior to the other groups, but specially polidocanol foam at the expense of greater frequency of adverse events.
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Affiliation(s)
| | - Matheus Bertanha
- Department of Surgery and Orthopedics, School of Medicine of Botucatu, Paulista State University, UNESP, São Paulo, Brazil
| | - Marcela Polachini Prata
- Department of Surgery and Orthopedics, School of Medicine of Botucatu, Paulista State University, UNESP, São Paulo, Brazil
| | - Lídia Raquel de Carvalho
- Department of Biostatistics-Biosciences Institute, Paulista State University, UNESP, São Paulo, Brazil
| | - Rodrigo Gibin Jaldin
- Department of Surgery and Orthopedics, School of Medicine of Botucatu, Paulista State University, UNESP, São Paulo, Brazil
| | - Marcone Lima Sobreira
- Department of Surgery and Orthopedics, School of Medicine of Botucatu, Paulista State University, UNESP, São Paulo, Brazil
| | - Jan Janzen
- Department of Biostatistics-Biosciences Institute, Paulista State University, UNESP, São Paulo, Brazil
- Histopathologie und VascPath, Bern, Switzerland
| | - Winston Bonetti Yoshida
- Department of Surgery and Orthopedics, School of Medicine of Botucatu, Paulista State University, UNESP, São Paulo, Brazil
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Mattos K, Cocio TA, Chaves EGA, Borges CL, Venturini J, de Carvalho LR, Mendes RP, Paniago AMM, Weber SS. An update on the occurrence of Paracoccidioides species in the Midwest region, Brazil: Molecular epidemiology, clinical aspects and serological profile of patients from Mato Grosso do Sul State. PLoS Negl Trop Dis 2021; 15:e0009317. [PMID: 33826630 PMCID: PMC8055028 DOI: 10.1371/journal.pntd.0009317] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 04/19/2021] [Accepted: 03/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Paracoccidioidomycosis (PCM) is a systemic and endemic fungal infection in Latin American, mainly in Brazil. The majority of PCM cases occur in large areas in Brazil, comprising the South, Southeast and Midwest regions, with the latter demonstrating a higher incidence of the species Paracoccidioides lutzii. METHODOLOGY AND MAIN FINDINGS This study presents clinical, molecular and serological data of thirteen new PCM cases during 2016 to 2019 from the state of Mato Grosso do Sul, located in the Midwest region, Brazil. From these thirteen cases, sixteen clinical isolates were obtained and their genomic DNAs were subjected to genotyping by tub1 -PCR-RFLP. Results showed Paracoccidioides brasiliensis sensu stricto (S1) (11/16; 68.8%), Paracoccidioides restrepiensis (PS3) (4/16; 25.0%) and P. lutzii (1/16; 6.2%) as Paracoccidiodes species. Therefore, in order to understand whether the type of phylogenetic species that are circulating in the state influence the reactivity profile of serological tests, we performed double agar gel immunodiffusion (DID), using exoantigens from genotyped strains found in this series of PCM cases. Overall, our DID tests have been false negative in about 30% of confirmed PCM cases. All patients were male, most with current or previous rural activity, with ages ranging from 17 to 59 years, with 11 patients (84.6%) over 40 years of age. No clinical or epidemiological differences were found between Paracoccidioides species. However, it is important to note that the only case of P. lutzii died as an outcome. CONCLUSIONS This study suggests P. brasiliensis sensu stricto (S1) as the predominant species, showing its wide geographic distribution in Brazil. Furthermore, our findings revealed, for the first time, the occurrence of P. restrepiensis (PS3) in the state of Mato Grosso do Sul, Brazil. Despite our setbacks, it would be interesting to provide the complete sequencing of these clinical isolates to complement the molecular information presented.
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Affiliation(s)
- Karine Mattos
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Tiago Alexandre Cocio
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto (FMRP/USP), Universidade de São Paulo, São Paulo, Ribeirão Preto, Brazil
| | - Edilânia Gomes Araújo Chaves
- Laboratório de Biologia Molecular, Instituto de Ciências Biológicas, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Clayton Luiz Borges
- Laboratório de Biologia Molecular, Instituto de Ciências Biológicas, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - James Venturini
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Lídia Raquel de Carvalho
- Universidade Estadual Paulista (UNESP), Departamento de Bioestatística do Instituto de Biociência de Botucatu, Botucatu, São Paulo, Brazil
| | - Rinaldo Poncio Mendes
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Universidade Estadual Paulista ‘Júlio Mesquita Filho’ (UNESP), Faculdade de Medicina de Botucatu, São Paulo, Brazil
| | - Anamaria Mello Miranda Paniago
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Simone Schneider Weber
- Laboratório de Biociência (LaBio), Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Instituto de Ciências Exatas e Tecnologia (ICET), Universidade Federal do Amazonas, Itacoatiara, Amazonas, Brazil
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Souza KM, De Vivo I, Chen CY, Nogueira FR, Aun AG, Arruda NM, Lara JR, Silva MAP, Figueiredo DBS, Corrêa CR, de Carvalho LR, Braz JRC, Braz LG, Braz MG. Oxidative stress, DNA damage, inflammation and gene expression in occupationally exposed university hospital anesthesia providers. Environ Mol Mutagen 2021; 62:155-164. [PMID: 33341964 DOI: 10.1002/em.22420] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
Considering the importance and lack of data of toxicogenomic approaches on occupational exposure to anesthetics, we evaluated possible associations between waste anesthetic gases (WAGs) exposure and biological effects including oxidative stress, DNA damage, inflammation, and transcriptional modulation. The exposed group was constituted by anesthesia providers who were mainly exposed to the anesthetics sevoflurane and isoflurane (10 ppm) and to a lesser degree to nitrous oxide (150 ppm), and the control group was constituted by physicians who had no exposure to WAGs. The oxidative stress markers included oxidized DNA bases (comet assay), malondialdehyde (high-performance liquid chromatography [HPLC]), nitric oxide metabolites (ozone-chemiluminescence), and antioxidative markers, including individual antioxidants (HPLC) and antioxidant defense marker (ferric reducing antioxidant power by spectrophotometry). The inflammatory markers included high-sensitivity C-reactive protein (chemiluminescent immunoassay) and the proinflammatory interleukins IL-6, IL-8 and IL-17A (flow cytometry). Telomere length and gene expression related to DNA repair (hOGG1 and XRCC1), antioxidant defense (NRF2) and inflammation (IL6, IL8 and IL17A) were evaluated by real-time quantitative polymerase chain reaction. No significant differences (p > .0025) between the groups were observed for any parameter evaluated. Thus, under the conditions of the study, the findings suggest that occupational exposure to WAGs is not associated with oxidative stress or inflammation when evaluated in serum/plasma, with DNA damage evaluated in lymphocytes and leucocytes or with molecular modulation assessed in peripheral blood cells in university anesthesia providers. However, it is prudent to reduce WAGs exposure and to increase biomonitoring of all occupationally exposed professionals.
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Affiliation(s)
| | - Immaculata De Vivo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Chung-Yen Chen
- Antioxidants Research Laboratory, Jean Mayer Human Nutrition Research Center on Aging (HNRCA), Tufts University, Boston, Massachusetts, USA
| | | | - Aline Garcia Aun
- Medical School, São Paulo State University (UNESP), Botucatu, Brazil
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Pissurno NSCA, Esteves LDM, Benedito JM, Giglio VP, de Carvalho LR, Mendes RP, Paniago AMM. Impact of laryngeal sequelae on voice- and swallowing-related outcomes in paracoccidioidomycosis. J Venom Anim Toxins Incl Trop Dis 2020; 26:e20200008. [PMID: 32863829 PMCID: PMC7433646 DOI: 10.1590/1678-9199-jvatitd-2020-0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background The present study was carried out aiming to evaluate the impact of laryngeal sequelae on the quality of life of treated paracoccidioidomycosis (PCM) patients. Methods This cross-sectional study was conducted at the Otorhinolaryngology Outpatient Clinic of the University Hospital, Federal University of Mato Grosso do Sul, Brazil. Thirty-two PCM patients considered clinically and immunologically cured were included: 16 with laryngeal involvement during the active phase of the disease (laryngeal PCM group) and 16 without laryngeal involvement (control group). They were submitted to structured interview, otorhinolaryngology examination, videolaryngoscopy, videoendoscopic swallowing study, completed two questionnaires for voice self-assessment - Voice-related Quality of Life (V-RQOL) and Voice Handicap Index (VHI) - and were asked to score their voices on a scale from zero to 10 (self-assessment of vocal quality). Results Dysphonia was present in 50% of the cases. Patients with laryngeal PCM presented worse voice-related quality of life scores on the V-RQOL and poorer vocal quality self-assessment than the control group. No significant differences in the VHI were found between the groups. None of the participants developed dysphagic sequelae, although some minor changes were observed on videoendoscopic examination. Conclusion There were no dysphagia complaints and only a few mild changes were found on the fiberoptic endoscopic evaluation of swallowing, suggesting that this evaluation should be performed only in specific cases. Patients with laryngeal involvement presented worse V-RQOL and self-assessment voice quality. This study contributes to the current knowledge of the functional assessment of the larynx affected by PCM and the impact of dysphonia on quality of life.
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Affiliation(s)
| | - Lucas da Motta Esteves
- Medical School, Federal University of Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil
| | | | - Vanessa Ponsano Giglio
- Maria Aparecida Pedrossian University Hospital, Federal University of Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil
| | | | - Rinaldo Poncio Mendes
- Medical School, Federal University of Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.,Botucatu Medical School, São Paulo State University (UNESP), Botucatu, SP, Brazil
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10
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Piña SP, Corrêa CDC, Carvalho LRD, Weber SAT. Comprehensiveness, readability, and reliability of Brazilian websites available for lay people's guidance on adenotonsillectomy. Braz J Otorhinolaryngol 2019; 87:66-73. [PMID: 31439530 PMCID: PMC9422416 DOI: 10.1016/j.bjorl.2019.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 05/29/2019] [Accepted: 06/30/2019] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Adenotonsillectomy is an invasive surgical procedure, which may encourage the search for information by the lay population through online search engines. The quality of this information, however, requires an evaluation due to the wide diversity of the available content. OBJECTIVE To evaluate the quality, in terms of ethical principles, readability and comprehensiveness, of the most accessed websites concerning guidance to parents/guardians related to their children's recommended adenotonsillectomy. METHODS The websites mentioned on the first 10 pages obtained after the search using "removal", "tonsils" and "adenoids" as keywords, after applying the inclusion and exclusion criteria, were selected. All were assessed using the Flesch Readability Index and Health on the Net Code tools, in addition to an evaluation of the content by two independent evaluators. The data were described, and the inter-rater agreement was calculated by the Kappa coefficient. RESULTS 34 websites were found, of the 100 assessed ones, which met the inclusion and exclusion criteria using the Google and Yahoo! Tools. Sixteen (47%) pages were considered reasonably difficult/difficult to read according to the Flesch Readability Index. Most of them met less than half of the analyzed ethical requirements according to the Health on the Net Code, and the overall comprehensiveness average was considered insufficient. CONCLUSION A deficit of overall quality (comprehensiveness, readability, and ethical principles) was demonstrated for the websites available to parents or guardians about the adenotonsillectomy procedure in children.
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Affiliation(s)
- Sofia Prata Piña
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Botucatu, São Paulo, Brazil
| | - Camila de Castro Corrêa
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Botucatu, São Paulo, Brazil
| | - Lídia Raquel de Carvalho
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Bioestatística, Botucatu, São Paulo, Brazil
| | - Silke Anna Theresa Weber
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Botucatu, São Paulo, Brazil.
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11
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Pinto RDM, Sampaio VDS, de Melo GC, Alecrim MDGC, Mattos K, Perdomo RT, Cordeiro SDC, Parente AFA, de Carvalho LR, Mendes RP, Lacerda MVG, Monteiro WM, Weber SS. Overview of artemisinin effectiveness during outset years of its implementation in the western Brazilian Amazon. Mem Inst Oswaldo Cruz 2019; 114:e190075. [PMID: 31038549 PMCID: PMC6489370 DOI: 10.1590/0074-02760190075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 03/27/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND METHODS FINDINGS MAIN CONCLUSIONS
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Affiliation(s)
| | - Vanderson de Souza Sampaio
- Fundação de Vigilância em Saúde, Brasil; Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Brasil; Universidade do Estado do Amazonas, Brazil
| | - Gisely Cardoso de Melo
- Universidade do Estado do Amazonas, Brazil; Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Brasil; Universidade do Estado do Amazonas, Brazil
| | | | | | | | | | | | | | | | - Marcus Vinícius Guimarães Lacerda
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Brasil; Universidade do Estado do Amazonas, Brazil; Fundação Oswaldo Cruz-Fiocruz, Brazil
| | - Wuelton Marcelo Monteiro
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Brasil; Universidade do Estado do Amazonas, Brazil
| | - Simone Schneider Weber
- Universidade Federal de Mato Grosso do Sul, Brazil; Universidade Federal do Amazonas, Brazil
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Carmona BM, Almeida CCA, Vieira WDB, Fascio MDNC, Carvalho LRD, Vane LA, Barbosa FT, do Nascimento Junior P, Módolo NSP. [Ultrasound dynamics of gastric content volumes after the ingestion of coconut water or a meat sandwich. A randomized controlled crossover study in healthy volunteers]. Rev Bras Anestesiol 2018; 68:584-590. [PMID: 30195629 DOI: 10.1016/j.bjan.2018.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 06/08/2018] [Accepted: 06/15/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Adequate preoperative fasting is critical in preventing pulmonary aspiration of gastric content. We proposed to study the sonographic gastric content dynamics after the ingestion of liquid or solid food in healthy volunteers and confront it with current guidelines for preoperative fasting times. METHODS We performed a prospective, crossover, evaluator-blinded study involving 17 healthy volunteers of both sexes. Each participant fasted for 10h and was subjected to a baseline gastric ultrasound, intake of 400mL of coconut water or a 145g, 355kcal meat sandwich, and sonographic gastric evaluations after 10min and every hour until the stomach was completely empty. RESULTS At baseline, all subjects had an empty stomach. At 10min, gastric content [mean + standard deviation (SD)] was 240.4 + 69.3 and 248.2 + 119.2mL for liquid and solid foods, respectively (p>0.05). Mean + SD gastric emptying times were 2.5 + 0.7 and 4.5 + 0.9h for liquid and solid foods, respectively (p<0.001). For the drink, the stomach was completely empty in 59% and 100% of the subjects after two and four hours, and for the sandwich, 65% and 100% of the subjects after four and seven hours, respectively. CONCLUSIONS Sonographic gastric dynamics for coconut water and a meat sandwich resulted in complete gastric emptying times higher and lower, respectively, than those suggested by current guidelines for preoperative fasting.
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Affiliation(s)
| | | | - Waldônio de Brito Vieira
- Fundação Santa Casa de Misericórdia do Pará, Departamento de Radiologia e Imagem de Diagnóstico, Belém, PA, Brasil
| | | | | | - Luiz Antonio Vane
- Universidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatu, SP, Brasil
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13
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Sylvestre TF, Cavalcante RDS, da Silva JDF, Paniago AMM, Weber SS, Pauletti BA, de Carvalho LR, dos Santos LD, Mendes RP. Serological proteomic biomarkers to identify Paracoccidioides species and risk of relapse. PLoS One 2018; 13:e0202804. [PMID: 30157221 PMCID: PMC6114792 DOI: 10.1371/journal.pone.0202804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 08/09/2018] [Indexed: 12/20/2022] Open
Abstract
The sensitivity of the double agar gel immunodiffusion test is about 90% in patients with untreated paracoccidioidomycosis (PCM), but it is much lower in cases of relapse. In addition, serum from patients with PCM caused by Paracoccidioides lutzii, frequent in the Midwest region of Brazil, do not react with the classical antigen obtained from Pb B-339. These findings showed the need for alternative diagnostic methods, such as biological markers through proteomics. The aim of this study was to identify biomarkers for the safe identification of PCM relapse and specific proteins that could distinguish infections caused by Paracoccidioides brasiliensis from those produced by Paracoccidioides lutzii. Proteomic analysis was performed in serum from 9 patients with PCM caused by P. brasiliensis, with and without relapse, from 4 patients with PCM produced by P. lutzii, and from 3 healthy controls. The comparative evaluation of the 29 identified plasma proteins suggested that the presence of the immunoglobulin (Ig) alpha-2 chain C region and the absence of Ig heavy chain V-III TIL indicate infection by P. lutzii. In addition, the absence of complement factor B protein might be a predictor of relapse. The evaluation of these proteins in a higher number of patients should be carried out in order to validate these findings.
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Affiliation(s)
| | | | | | | | - Simone Schneider Weber
- Universidade Federal de Mato Grosso do Sul (UFMS), Faculdade de Medicina, Campo Grande, Brazil
- Instituto de Ciências Exatas e Tecnologia (ICET), Universidade Federal do Amazonas (UFAM), Itacoatiara, Brazil
| | | | - Lídia Raquel de Carvalho
- Universidade Estadual Paulista (UNESP), Instituto de Biociência de Botucatu, Botucatu, São Paulo, Brazil
| | | | - Rinaldo Poncio Mendes
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Botucatu, São Paulo, Brazil
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Levorato AD, Moris DV, Cavalcante RDS, Sylvestre TF, de Azevedo PZ, de Carvalho LR, Mendes RP. Evaluation of the hepatobiliary system in patients with paracoccidioidomycosis treated with cotrimoxazole or itraconazole. Med Mycol 2017; 56:531-540. [DOI: 10.1093/mmy/myx080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 08/24/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Adriele Dandara Levorato
- Tropical Diseases Department, São Paulo State University (UNESP), Faculdade de Medicina de Botucatu, Campus Botucatu, Brazil
| | | | - Ricardo de Souza Cavalcante
- Tropical Diseases Department, São Paulo State University (UNESP), Faculdade de Medicina de Botucatu, Campus Botucatu, Brazil
| | - Tatiane Fernanda Sylvestre
- Tropical Diseases Department, São Paulo State University (UNESP), Faculdade de Medicina de Botucatu, Campus Botucatu, Brazil
| | - Priscila Zacarias de Azevedo
- Tropical Diseases Department, São Paulo State University (UNESP), Faculdade de Medicina de Botucatu, Campus Botucatu, Brazil
| | | | - Rinaldo Poncio Mendes
- Tropical Diseases Department, São Paulo State University (UNESP), Faculdade de Medicina de Botucatu, Campus Botucatu, Brazil
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15
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Curval LG, França ADO, Fernandes HJ, Mendes RP, de Carvalho LR, Higa MG, Ferreira EDC, Dorval MEC. Prevalence of intestinal parasites among inmates in Midwest Brazil. PLoS One 2017; 12:e0182248. [PMID: 28934218 PMCID: PMC5608187 DOI: 10.1371/journal.pone.0182248] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 07/14/2017] [Indexed: 11/21/2022] Open
Abstract
Background Intestinal parasitic infections constitute a public health issue in developing countries, with prevalence rates as high as 90%, a figure set to escalate as the socioeconomic status of affected populations deteriorates. Investigating the occurrence of these infections among inmates is critical, since this group is more vulnerable to the spread of a number of infectious illnesses. Methods This cross-sectional, analytical, quantitative study was conducted in July 2015 at prison facilities located in Midwest Brazil to estimate the prevalence of parasitic infection among inmates. For detection of parasites, 510 stool samples were examined by ether centrifugation and spontaneous sedimentation. Results Eight parasitic species were detected, with an overall prevalence of 20.2% (103/510). Giardia lamblia and Entamoeba histolytica/dispar were the most frequent pathogenic parasites. Endolimax nana was the predominant non-pathogenic species. Nearly half of the subjects (53/103; 51.4%) were positive for mixed infection. Logistic regression revealed that inmates held in closed conditions were more likely to contract parasitic infections than those held in a semi-open regime (OR = 1.97; 95% CI = 1.19–3.25; p = 0.0085). A higher prevalence of parasitic infections was observed among individuals who had received no prophylactic antiparasitic treatment in previous years (OR = 10.2; 95% CI = 5.86–17.66; p < 0.001). The other factors investigated had no direct association with the presence of intestinal parasites. Conclusion Infections caused by directly transmissible parasites were detected. Without adequate treatment and prophylactic guidance, inmates tend to remain indefinitely infected with intestinal parasites, whether while serving time in prison or after release.
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Affiliation(s)
- Larissa Gabrielle Curval
- Graduate Program in Infectious and Parasitic Diseases, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
- * E-mail:
| | - Adriana de Oliveira França
- Graduate Program in Infectious and Parasitic Diseases, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Henrique Jorge Fernandes
- Department of Animal Sciences, Universidade Estadual de Mato Grosso do Sul, Aquidauana, MS, Brazil
| | - Rinaldo Pôncio Mendes
- Visiting Professor, School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Lídia Raquel de Carvalho
- Department of Biostatistics, Biosciences Institute of Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Minoru German Higa
- Graduate Program in Infectious and Parasitic Diseases, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
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16
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Lemos SVD, Vianna IG, Castiglia YMM, Golim MDA, Souza AVGD, Carvalho LRD, Deffune E, Nascimento PD, Módolo NSP, Vianna PTG. Cyclosporine A attenuates apoptosis and necrosis after ischemia-reperfusion-induced renal injury in transiently hyperglycemic rats. Acta Cir Bras 2017; 32:203-210. [PMID: 28403344 DOI: 10.1590/s0102-865020170030000004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 02/21/2017] [Indexed: 11/22/2022] Open
Abstract
Purpose: To investigate the effects of cyclosporine A on renal ischemia-reperfusion injury during transient hyperglycemia in rats. Methods: In a model of ischemia-reperfusion-induced renal injury and transiently induced hyperglycemia by intraperitoneal injection of glucose, 2.5 g.kg-1, Wistar rats were anesthetized with either isoflurane or propofol and received intravenous cyclosporine A, 5 mg.kg-1, five minutes before reperfusion. Comparison groups were isoflurane and propofol sham groups and isoflurane and propofol ischemia-reperfusion-induced renal injury. Renal tubular cell viability was quantitatively assessed by flow cytometry after cell culture and classified as early apoptosis, necrotic cells, and intact cells. Results: Early apoptosis was significantly higher in isoflurane and propofol anesthetized animals subjected to renal ischemia-reperfusion injury when compared to both cyclosporine A treated and sham groups. Necrosis percentage was significantly higher in propofol-anesthetized animals subjected to renal ischemia-reperfusion injury. The percentage of intact cells was lower in both, isoflurane and propofol anesthetized animals subjected to renal ischemia-reperfusion injury. Conclusion: In a model of ischemia-reperfusion-induced renal injury, cyclosporine A, 5 m.kg-1, administered five minutes before renal reperfusion in rats with acute-induced hyperglycemia under either isoflurano or propofol anesthesia, attenuated early apoptosis and preserved viability in renal tubular cells, regardless of the anesthetic used.
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Affiliation(s)
- Sylvio Valença de Lemos
- Fellow PhD degree, Postgraduate Program in Anesthesiology, Department of Anesthesiology, Botucatu Medical School, Universidade Estadual de São Paulo (UNESP), Botucatu-SP, Brazil. Conception and design of the study, acquisition of data, manuscript writing, critical revision
| | - Isabela Galvão Vianna
- Fellow, Experimental Surgery, Department of Anesthesiology, Botucatu Medical School, UNESP, Botucatu-SP, Brazil. Manuscript writing
| | - Yara Marcondes Machado Castiglia
- PhD, Full Professor, Department of Anesthesiology, Botucatu Medical School, UNESP, Botucatu-SP, Brazil. Critical revision, final approval of the version to be published
| | - Marjorie de Assis Golim
- PhD, Biologist, Department of Internal Medicine, Botucatu Medical School, UNESP, Botucatu-SP, Brazil. Technical procedures, histopathological examinations
| | - Aparecida Vitória Gonçalves de Souza
- Fellow PhD degree, Postgraduate Program in Anesthesiology, Department of Anesthesiology, Botucatu Medical School, UNESP, Botucatu-SP, Brazil. Acquisition of data
| | - Lídia Raquel de Carvalho
- PhD, Assistant Professor, Department of Biostatistics, Bioscience Institute of Botucatu, UNESP, Botucatu-SP, Brazil. Statistical analysis
| | - Elenice Deffune
- PhD, Assistant Professor, Department of Internal Medicine, Botucatu Medical School, UNESP, Botucatu-SP, Brazil. Technical procedures, histopathological examinations
| | - Paulo do Nascimento
- PhD, Associate Professor, Department of Anesthesiology, Botucatu Medical School, UNESP, Botucatu-SP, Brazil. Manuscript preparation and writing, critical revision
| | - Norma Sueli Pinheiro Módolo
- PhD, Full Professor, Department of Anesthesiology, Botucatu Medical School, UNESP, Botucatu-SP, Brazil. Manuscript preparation and writing, critical revision
| | - Pedro Thadeu Galvão Vianna
- PhD, Full Professor, Department of Anesthesiology, Botucatu Medical School, UNESP, Botucatu-SP, Brazil. Conception and design of the study, analysis and interpretation of data, critical revision, final approval of the version to be published
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Ramalho GL, Vane MF, Lima LC, Vane LF, Amorim RB, Domingues MA, Moraes JMSD, Carvalho LRD, Tanaka PP, Vane LA. Noradrenaline and dobutamine effects on the volume expansion with normal saline in rabbits subjected to hemorrhage. Acta Cir Bras 2016; 31:621-628. [PMID: 27737348 DOI: 10.1590/s0102-865020160090000008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 08/21/2016] [Indexed: 11/21/2022] Open
Abstract
PURPOSE: To evaluate the effects of dobutamine (DB), noradrenaline (NA), and their combination (NADB), on volume retention in rabbits submitted to hemorrhage. METHODS: Thirty six rabbits were randomly divided into 6 groups: SHAM, Control, Saline, DB, NA, DB+NA. All the animals, except for SHAM, were subjected to hemorrhage of 25% of the calculated blood volume. Control animals were replaced with their own blood. The other groups received NSS 3 times the volume withdrawn. The intravascular retention, hematocrit, diuresis, central venous pressure, mean arterial pressure, NGAL, dry-to-wet lung weight ratio (DTWR) and the lung and kidney histology were analyzed. RESULTS: Replacement with NSS and NA, DB or NA+DB did not produce differences in the intravascular retention. After hemorrhage, the animals presented a significant decrease in the MAP and CVP, which were maintained until volume replacement. Regarding NGAL, dry-to-wet-lung-weight ratio, lung and kidney histology, there were no statistical differences between the groups. CONCLUSION: The use of noradrenaline, dobutamine or their combination did not increase the intravascular retention of volume after normal saline infusion.
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Affiliation(s)
- Gualter Lisboa Ramalho
- Fellow PhD degree, Postgraduate Program in Anesthesiology, Botucatu Medical School, Universidade Estadual Paulista (UNESP), Botucatu-SP, Brazil. Conception, design, intellectual and scientific content of the study
| | - Matheus Fachini Vane
- MD, Division of Anesthesiology, Medical School, University de São Paulo (USP), Brazil. Conception of the study, manuscript writing
| | | | - Lucas Fachini Vane
- Master, Guaratingueta School of Engineering, UNESP, Brazil. Acquisition of data
| | - Rosa Beatriz Amorim
- PhD, Department of Anesthesiology, Botucatu Medical School, UNESP, Brazil. Technical procedures
| | | | - José Mariano Soares de Moraes
- PhD, Division of Anesthesiology, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Brazil. Manuscript writing, critical revision
| | | | - Pedro Paulo Tanaka
- PhD, Department of Anesthesiology, Stanford University, Medical School, California, USA. Critical revision
| | - Luiz Antonio Vane
- Full Professor, Department of Anesthesiology, Botucatu Medical School, UNESP, Brazil. Manuscript writing, critical revision, supervised all phases of the study
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Shimabukuro FH, Costa VMD, Silva RCD, Langoni H, da Silva AV, de Carvalho LR, Domingues PF. Prozone effects in microscopic agglutination tests for leptospirosis in the sera of mice infected with the pathogenic Leptospira interrogans serovar Canicola. Mem Inst Oswaldo Cruz 2014; 108:668-70. [PMID: 23903987 PMCID: PMC3970589 DOI: 10.1590/0074-0276108052013022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 05/13/2013] [Indexed: 11/22/2022] Open
Abstract
Mice experimentally infected with a pathogenic strain of Leptospira interrogans serovar Canicola produced false negative results (prozone effect) in a microscopic agglutination test (MAT). This prozone effect occurred in several serum samples collected at different post-infection times, but it was more prominent in samples collected from seven-42 days post-infection and for 1:50 and 1:100 sample dilutions. This phenomenon was correlated with increased antibody titres in the early post-infection phase. While prozone effects are often observed in serological agglutination assays for the diagnosis of animal brucellosis and human syphilis, they are not widely reported in leptospirosis MATs.
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Fonseca CRBD, Strufaldi MWL, de Carvalho LR, Puccini RF. Adequacy of antenatal care and its relationship with low birth weight in Botucatu, São Paulo, Brazil: a case-control study. BMC Pregnancy Childbirth 2014; 14:255. [PMID: 25085236 PMCID: PMC4131026 DOI: 10.1186/1471-2393-14-255] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 07/22/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Birth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. The purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil. METHODS A case-control study was conducted in Botucatu, São Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the official medical records of pregnant women). The study population consisted of two groups, each with 860 newborns. The case group comprised newborns weighing less than 2,500 grams, while the control group comprised live newborns weighing greater than or equal to 2,500 grams. Adequacy of ANC was evaluated according to three measurements: 1. Adequacy of the number of ANC visits adjusted to gestational age; 2. Modified Kessner Index; and 3. Adequacy of ANC laboratory studies and exams summary measure according to parameters defined by the Ministry of Health in the Program for Prenatal and Birth Care Humanization. RESULTS Analyses revealed that LBW was associated with the number of ANC visits adjusted to gestational age (OR = 1.78, 95% CI 1.32-2.34) and the ANC laboratory studies and exams summary measure (OR = 4.13, 95% CI 1.36-12.51). According to the modified Kessner Index, 64.4% of antenatal visits in the LBW group were adequate, with no differences between groups. CONCLUSIONS Our data corroborate the association between inadequate number of ANC visits, laboratory studies and exams, and increased risk of LBW newborns. No association was found between the modified Kessner Index as a measure of adequacy of ANC and LBW. This finding reveals the low indices of coverage for basic actions already well regulated in the Health System in Brazil. Despite the association found in the study, we cannot conclude that LBW would be prevented only by an adequate ANC, as LBW is associated with factors of complex and multifactorial etiology. The results could be used to plan monitoring measures and evaluate programs of health care assistance during pregnancy, at delivery and to newborns, focusing on reduced LBW rates.
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Affiliation(s)
| | | | - Lídia Raquel de Carvalho
- />Department of Biostatistics, Institute of Biosciences, Paulista State University, UNESP, Botucatu, São Paulo Brazil
| | - Rosana Fiorini Puccini
- />Department of Pediatrics, Federal University of São Paulo, UNIFESP, São Paulo, São Paulo Brazil
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Sylvestre TF, Silva LRF, Cavalcante RDS, Moris DV, Venturini J, Vicentini AP, de Carvalho LR, Mendes RP. Prevalence and serological diagnosis of relapse in paracoccidioidomycosis patients. PLoS Negl Trop Dis 2014; 8:e2834. [PMID: 24787147 PMCID: PMC4006716 DOI: 10.1371/journal.pntd.0002834] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 03/16/2014] [Indexed: 11/30/2022] Open
Abstract
A review of 400 clinical records of paracoccidioidomycosis (PCM) patients, 93 with the acute/subacute (AF) and 307 with the chronic form (CF), attended from 1977 to 2011, selected as to the schedule of release for study by the Office of Medical Records at the University Hospital of the Faculdade de Medicina de Botucatu-São Paulo State University--UNESP, was performed to detect cases in relapse. The control of cure was performed by clinical and serological evaluation using the double agar gel immunodiffusion test (DID). In the diagnosis of relapse, DID, enzyme-linked immunosorbent assay (ELISA) and immunoblotting assay (IBgp70 and IBgp43) were evaluated. Out of 400 patients, 21 (5.2%) went through relapse, 18 of them were male and 3 were female, 6∶1 male/female ratio. Out of the 21 patients in relapse, 15 (4.8%) showed the CF, and 6 (6.4%) the AF (p>0.05). The sensitivity of DID and ELISA before treatment was the same (76.1%). DID presented higher sensitivity in pre-treatment (80%) than at relapse (45%; p = 0.017), while ELISA showed the same sensitivity (80% vs 65%; p = 0.125). The serological methods for identifying PCM patients in relapse showed low rates of sensitivity, from 12.5% in IBgp70 to 65.0% in IBgp43 identification and 68.8% in ELISA. The sensitivity of ELISA in diagnosing PCM relapse showed a strong tendency to be higher than DID (p = 0.06) and is equal to IBgp43 (p = 0.11). In sum, prevalence of relapse was not high in PCM patients whose treatment duration was based on immunological parameters. However, the used methods for serological diagnosis present low sensitivity. While more accurate serological methods are not available, we pay special attention to the mycological and histopathological diagnosis of PCM relapse. Hence, direct mycological, cytopathological, and histopathological examinations and isolation in culture for P. brasiliensis must be appropriately and routinely performed when the hypothesis of relapse is considered.
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Affiliation(s)
- Tatiane Fernanda Sylvestre
- Tropical Diseases Department - Faculdade de Medicina de Botucatu – Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brazil
| | | | - Ricardo de Souza Cavalcante
- Tropical Diseases Department - Faculdade de Medicina de Botucatu – Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brazil
| | | | - James Venturini
- Laboratory of Experimental Immunology, Department of Biological Science, Faculty of Science, São Paulo State University – UNESP, São Paulo, Brazil
| | | | | | - Rinaldo Poncio Mendes
- Tropical Diseases Department - Faculdade de Medicina de Botucatu – Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brazil
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Carraretto AR, Vianna Filho PTG, Castiglia YMM, Golim MDA, Souza AVGD, Carvalho LRD, Deffune E, Vianna PTG. Does propofol and isoflurane protect the kidney against ischemia/reperfusion injury during transient hyperglycemia? Acta Cir Bras 2013; 28:161-6. [DOI: 10.1590/s0102-86502013000300001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 01/21/2013] [Indexed: 01/04/2023] Open
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de Oliveira Semenzati G, de Souza Salgado B, Rocha NS, Michelin Matheus SM, de Carvalho LR, Garcia Martins RH. Histological and immunohistochemical study of the expression of p53 and ki-67 proteins in the mucosa of the tongue, pharynx and larynx of rats exposed to cigarette smoke. Inhal Toxicol 2013; 24:723-31. [PMID: 22954396 DOI: 10.3109/08958378.2012.715317] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Head and neck cancers are linked to smoking. The most affected sites are the oral cavity, pharynx and larynx. Experimental studies show epithelial lesions caused by cigarette smoke. OBJECTIVES To investigate in rats the effects of acute cigarette smoke exposure on the mucosa of the tongue, pharynx and larynx. MATERIAL AND METHOD Wistar rats were allocated into two groups of 20 animals: CG (control) receiving food and water ad libitum and TG (Tobacco) exposed to the smoke of 40 cigarettes/day for 60 days. Biopsy of their tongues, pharynxes and larynxes were subjected to histopathological, histomorphometric and immunohistochemical studies of protein p53 and ki-67. RESULT The histological analysis of tongue from the Tobacco group revealed epithelial hyperplasia (90%), basal cell hyperplasia (95%) and mild to moderate dysplasia (85%). In pharynx showed basal cell hyperplasia (85%), dysplasia (25%) and vascular congestion (95%). In larynx showed basal cell hyperplasia (70%), epithelial hyperplasia (55%), congestion (100%) and inflammatory infiltrate (25%). Morphometric analysis revealed that keratin layer thickness was greater in the tobacco group. P53 immunoexpression was negative in both groups. Ki-67 immunoexpression was positive in basal cell nuclei but in parabasal cell nuclei it was positive only in the Tobacco group. CONCLUSIONS The exposure of animals to cigarette smoke for 60 days resulted in benign lesions. The duration of exposure was not enough to cause the development cancer, as confirmed by the negative expression of p53 protein in all slides examined. Analysis of ki-67 expression showed intense epithelial proliferation in response to damage.
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Affiliation(s)
- Graziela de Oliveira Semenzati
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Student of Botucatu Medical School, São Paulo State University- UNESP, Botucatu, Brazil
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Medeiros TP, Vianna PTG, da Silva LM, de Carvalho LR, Wady GE, Braz LG, Castiglia YMM. Renal function after laparoscopic cholecystectomy and analgesia with tramadol and dipyrone or ketorolac. Health (London) 2013. [DOI: 10.4236/health.2013.511a1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Pontes AG, Rehme MFB, Micussi MTABC, Maranhão TMDO, Pimenta WDP, Carvalho LRD, Pontes A. A importância do teste de tolerância à glicose oral no diagnóstico da intolerância à glicose e diabetes mellitus do tipo 2 em mulheres com síndrome dos ovários policísticos. Rev Bras Ginecol Obstet 2012; 34:128-32. [DOI: 10.1590/s0100-72032012000300007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 01/20/2012] [Indexed: 11/21/2022] Open
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da Fonseca CRB, Strufaldi MWL, de Carvalho LR, Puccini RF. Risk factors for low birth weight in Botucatu city, SP state, Brazil: a study conducted in the public health system from 2004 to 2008. BMC Res Notes 2012; 5:60. [PMID: 22270068 PMCID: PMC3285524 DOI: 10.1186/1756-0500-5-60] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 11/28/2011] [Accepted: 01/23/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Low birth weight (LBW), defined as birth weight less than 2500 g, has a complex etiology and may be a result of premature interruption of pregnancy or intrauterine growth restriction. The objective of this study was to provide information on determinants of LBW and contribute to the understanding of the problem in Brazil. METHODS A case-control study was conducted in Botucatu city, SP state, Brazil. The study population consisted of 2 groups with 860 newborns in each group as follows: low weight newborns (LWNB) and a control group (weight ≥ 2500 g). Secondary data from 2004 to 2008 were collected using the Live Birth Certificate (LBC) and records from medical charts of pregnant women in Basic Health Units (BHU) and in the Public University Hospital (UH). Variables were as follows: maternal socio-demographic characteristics, pregnancy and birth conditions including quality of prenatal care according to 3 criteria. They were based on parameters established by the Ministry of Health (MH), one of them, the modified Kessner Index. The multivariable analysis by logistic regression was used to evaluate the association between variables and LBW. RESULTS According to the analysis, the factors associated with LBW were as follows: prematurity (OR = 56.98, 95% CI 29.52-109.95), twin pregnancy (OR = 20.00, 95% CI 6.25-100.00), maternal smoking (OR = 2.12, 95% CI 1.33-3.45), maternal malnourishment (OR = 2.30, 95% CI 1.08-5.00), maternal obesity (OR = 2.30, 95% IC 1.18-4.48), weight gain during pregnancy less than 5 kg (OR = 2.63, 95% CI 1.35-5.00) and weight gain during pregnancy more than 15 kg (OR = 2.26, 95% CI 1.16-4.41). Adequacy of prenatal care visits adjusted to gestational age was less frequent in the LBW group than in the control group (68.7% vs. 80.5%, x2 p < 0.001). According to the modified Kessner Index, 64.4% of prenatal visits in the LWNB group were adequate. CONCLUSION LWNB are a quite heterogeneous group of infants concerning their determinants and prevention actions against LBW and the follow-up of these infants have also been very complex. Therefore, improvement in the quality of care provided should be given priority through concrete actions for prevention of LBW.
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Affiliation(s)
- Cátia Regina Branco da Fonseca
- Department of Pediatrics, Julio de Mesquita Filho São Paulo State University, Botucatu Medical School, Botucatu, SP, Brasil
| | | | - Lídia Raquel de Carvalho
- Department of Biostatistics, Julio de Mesquita Filho São Paulo State University, Institute of Biosciences, Botucatu, SP, Brasil
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Abstract
Frutosaminas são proteínas séricas glicadas formadas continuamente resultantes da ligação entre a glicose e proteínas circulantes, e correspondem à avaliação glicêmica de aproximadamente uma a duas semanas em gatos. A concentração de frutosamina tem sido utilizada para a diferenciação entre a hiperglicemia persistente e transitória induzida pelo estresse, sendo considerado o teste padrão ouro para o controle da glicemia em gatos diabéticos. O objetivo deste trabalho consistiu em avaliar a influência dos estados de estresse agudo e crônico em gatos sobre os níveis séricos de frutosamina. Foram selecionados 62 felinos provenientes do atendimento no Hospital Veterinário da FMVZ - UNESP Botucatu, distribuídos em três grupos: felinos com histórico de qualquer doença ou condições de estresse, excluindo-se o diabetes mellitus (DM), por um período máximo de 48 horas (Grupo A, n = 21) ou por um período superior a 120 horas (Grupo B, n = 27). O terceiro grupo (Grupo C = controle) foi formado por 14 felinos saudáveis. Os grupos foram avaliados quanto às dosagens séricas de frutosamina, glicose, proteína e albumina. Foi constatado um aumento significativo nos valores de frutosamina tanto nos animais submetidos ao estresse agudo quanto crônico, porém os níveis mantiveram-se dentro do intervalo de referência. Da mesma forma, os animais, em média, também se encontravam em normoglicemia, apesar da correlação positiva entre as concentrações de glicose e frutosamina. Conclui-se que a concentração de frutosamina sofre influência dos estados de estresse agudo e crônico em gatos, mantendo-se, porém, dentro dos limites de referência, sendo, portanto, útil no diagnóstico do DM.
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Braz MG, Mazoti MÁ, Giacobino J, Braz LG, Golim MDA, Ferrasi AC, de Carvalho LR, Braz JRC, Salvadori DMF. Genotoxicity, cytotoxicity and gene expression in patients undergoing elective surgery under isoflurane anaesthesia. Mutagenesis 2011; 26:415-20. [PMID: 21257718 DOI: 10.1093/mutage/geq109] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
There are numerous studies reporting on the effects of inhalation anaesthesia in cells of exposed individuals but not much is known about the ability of isoflurane (ISF) to induce oxidative DNA damage. However, surgery is often associated with a temporary perioperative immunological alteration, and some volatile anaesthetics seem to contribute to a transient lymphocytopenia after surgery. We conducted a study to evaluate a possible genotoxic effect, including oxidative DNA damage, and apoptosis in peripheral lymphocytes of 20 patients American Society of Anaesthesiologists physical status I undergoing minor elective surgery lasting at least 120 min, under anaesthesia with ISF. We also investigated the expression of several genes in blood cells. Blood samples were collected at three time points: before anaesthesia (T(1)), 2 h after the beginning of anaesthesia (T(2)) and on the first post-operative day (T(3)). General DNA damage and oxidised bases (Fpg and endo III-sites) in blood lymphocytes were evaluated using the comet assay. Lymphocytes were phenotyped and apoptosis was evaluated by flow cytometry. In addition, expressions of hOGG1 and XRCC1, genes involved in DNA repair, and BCL2, a gene related to apoptosis, were assessed by quantitative real-time polymerase chain reaction. Results showed no statistically significant difference in the level of DNA damage and oxidised bases among the three sampling times. Anaesthesia with ISF did not increase the percentage of cells in early or late apoptosis in cytotoxic or helper T lymphocytes. Lower hOGG1 and BCL2 expressions were detected at T(3) in comparison to the other two previous time points, and there was significantly lower expression of XRCC1 at T(3) in relation to T(2). In conclusion, the exposure to ISF did not result in genotoxicity and cytotoxicity in lymphocytes and in toxicogenomic effect in leukocytes, although DNA repair and apoptosis-related genes were down-regulated on the first post-operative day.
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Affiliation(s)
- Mariana Gobbo Braz
- Department of Pathology, UNESP - Univ Estadual Paulista, 18618-970, Botucatu-São Paulo, Brasil.
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Cataneo DC, Kobayasi S, Carvalho LRD, Paccanaro RC, Cataneo AJM. Accuracy of six minute walk test, stair test and spirometry using maximal oxygen uptake as gold standard. Acta Cir Bras 2010; 25:194-200. [PMID: 20305888 DOI: 10.1590/s0102-86502010000200013] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Accepted: 12/07/2009] [Indexed: 11/22/2022] Open
Abstract
PURPOSE: To assess the accuracy of the variables stair climbing time (SCt), stair climbing power (SCP), six-minute walk test distance (6MWT), and forced expiratory volume in 1 second (FEV1) using maximal oxygen uptake on exercise (VO2max) as the gold standard. METHODS: Tests were performed in 51 patients. FEV1 was measured by spirometry and 6MWT was performed in a flat 120-m corridor. Stair climbing test was performed on a 6-flight stairway to obtain SCt and SCP. VO2max was measured by ergospirometry, using the Balke protocol. Pearson's linear correlation and p values were calculated between VO2max and the other variables tested. For accuracy calculations, variable cutoff points were obtained through receiver operating characteristic (ROC) curves, dividing individuals into normal or unhealthy. Kappa statistic was used to calculate concordance. RESULTS: Accuracy was: SCt - 86%, 6MWT - 80%, SCP - 71%, FEV1(L) - 67%, FEV1(%) - 63%. SCt and 6MWT showed 93.5% sensitivity when combined in parallel, and 96.4% specificity in series. CONCLUSION: SCt presented the best accuracy. SCt and 6MWT combined showed nearly 100% sensitivity or specificity. Thus, these simple exercise tests should be more routinely used, especially when an ergospirometer is not available to measure VO2max.
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Rocha APC, Kraychete DC, Lemonica L, de Carvalho LR, de Barros GAM, Garcia JBDS, Sakata RK. Pain: current aspects on peripheral and central sensitization. Rev Bras Anestesiol 2009; 57:94-105. [PMID: 19468623 DOI: 10.1590/s0034-70942007000100011] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2006] [Accepted: 09/07/2006] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Current research has focused on the biochemical and structural plasticity of the nervous system secondary to tissue injury. The mechanisms involved in the transition from acute to chronic pain are complex and involve the interaction of receptor systems and the flow of intracellular ions, second messenger systems, and new synaptic connections. The aim of this article was to discuss the new mechanisms concerning peripheral and central sensitization. CONTENTS Tissue injury increases the response of nociceptors, known as sensitization or facilitation. These phenomena begin after the local release of inflammatory mediators and the activation of the cells of the immune system or specific receptors in the peripheral and central nervous system. CONCLUSIONS Tissue and neuronal lesions result in sensitization of the nociceptors and facilitation of the central and peripheral nervous conduction.
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Macoris MDLDG, Andrighetti MTM, Otrera VCG, Carvalho LRD, Caldas Júnior AL, Brogdon WG. Association of insecticide use and alteration on Aedes aegypti susceptibility status. Mem Inst Oswaldo Cruz 2008; 102:895-900. [PMID: 18209926 DOI: 10.1590/s0074-02762007000800001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Accepted: 11/09/2007] [Indexed: 11/21/2022] Open
Abstract
Dengue and dengue hemorrhagic fever, vector-borne diseases transmitted by the mosquito Aedes aegypti, are presently important public health problems in Brazil. As the strategy for disease control is based on vector control through the use of insecticides, the development of resistance is a threat to programs efficacy. The objective of this study was to compare the Aedes aegypti susceptibility in nine vector populations from the state of São Paulo and seven from Northeast region of Brazil, since there was a difference on group of insecticide used between the areas. Bioassays with larvae and adult were performed according to the World Health Organization methods. The results showed higher resistance levels to organophosphates group in populations from the Northeast region where this group was used for both larvae and adult control than in São Paulo where organophosphates were used for larvae and pyretroids for adult control. Resistance to pyretroids in adults was widespread in São Paulo after ten years of use of cypermethrin while in vector populations from the Northeast region it was punctual. The difference in resistance profile between the areas is in accordance to the group of insecticide used.
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Affiliation(s)
- Maria de Lourdes da Graça Macoris
- Superintendência de Controle de Endemias, Núcleo de Pesquisa SR 11/Marília, Av. Santo Antonio 1627, 17506-040 Marília, São Paulo, Brasil.
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Molina AC, Godoy ID, Carvalho LRD, Caldas Júnior AL. Situação vacinal infantil e características individuais e familiares do interior de São Paulo. Acta Sci Health Sci 2008. [DOI: 10.4025/actascihealthsci.v29i2.1077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Sakai RL, Abrão GMG, Ayres JFV, Vianna PTG, de Carvalho LR, Castiglia YMM. Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery. SAO PAULO MED J 2007; 125:315-21. [PMID: 18317600 PMCID: PMC11020569 DOI: 10.1590/s1516-31802007000600003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2006] [Revised: 10/17/2007] [Accepted: 10/19/2007] [Indexed: 12/11/2022] Open
Abstract
CONTEXT AND OBJECTIVE The significant relationship between upper abdominal surgery and early (perioperative) pulmonary events was investigated among patients with preoperative pulmonary conditions undergoing general anesthesia. DESIGN AND SETTING Retrospective study for which data were obtained prospectively from 1999 to 2004, at a tertiary university hospital. METHODS We retrospectively studied 3107 patients over 11 years old presenting American Society of Anesthesiologists (ASA) status I, II or III who underwent upper abdominal surgery under general anesthesia and were discharged to the recovery room. The preoperative conditions analyzed using logistic regression were: age, sex, ASA physical status, congestive heart failure, asthma, chronic obstructive pulmonary disease (COPD), respiratory failure and smoking. The outcomes or dependent variables included intraoperative and postoperative events: bronchospasm, hypoxemia, hypercapnia, prolonged intubation and airway secretion. RESULTS Among these patients (1500 males, 1607 females, mean age 48 years, 1088 ASA I, 1402 ASA II and 617 ASA III), there were 80 congestive heart failures, 82 asthmatics, 122 with COPD, 21 respiratory failures and 428 smokers. Logistic regression analysis showed that female sex (p < 0.001), age over 70 years (p < 0.01), smoking (p < 0.001) and COPD (p < 0.02) significantly influenced pulmonary event development, particularly hypoxemia and bronchospasm, at both times but not in the same patients. Asthma and congestive heart failure cases did not present pulmonary events in the recovery room. CONCLUSION In upper abdominal surgery under general anesthesia, female sex, age over 70, smoking and COPD were independent risk factors for intra and postoperative pulmonary events.
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Affiliation(s)
- Rafael Luis Sakai
- Department of Anesthesiology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp), Botucatu, São Paulo, Brazil
| | - Graciela Maria Gera Abrão
- Department of Anesthesiology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp), Botucatu, São Paulo, Brazil
| | - José Franscisco Vasques Ayres
- Department of Anesthesiology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp), Botucatu, São Paulo, Brazil
| | - Pedro Thadeu Galvão Vianna
- Department of Anesthesiology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp), Botucatu, São Paulo, Brazil
| | - Lídia Raquel de Carvalho
- Department of Anesthesiology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp), Botucatu, São Paulo, Brazil
| | - Yara Marcondes Machado Castiglia
- Department of Anesthesiology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp), Botucatu, São Paulo, Brazil
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de Carvalho TB, de Carvalho LR, Mascarini LM. Occurrence of enteroparasites in day care centers in Botucatu (São Paulo State, Brazil) with emphasis on Cryptosporidium sp., Giardia duodenalis and Enterobius vermicularis. Rev Inst Med Trop Sao Paulo 2007; 48:269-73. [PMID: 17086314 DOI: 10.1590/s0036-46652006000500006] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2005] [Accepted: 05/11/2006] [Indexed: 11/22/2022] Open
Abstract
The occurrence of the enteroparasites was verified in 279 children (0 to 6 years) of four municipal day cares of Botucatu/SP. Three samples of each child's feces were collected and processed by the methods of Hoffman-Pons-Janner, Faust and Ritchie and subsequent coloration of the fecal smear by the methods of Auramina-O and Ziehl-Neelsen modified for diagnosis of Cryptosporidium sp. and Graham method for diagnosis of Enterobius vermicularis. Of the analyzed children we verified a prevalence of intestinal parasitism in 53.40%, and the most frequent parasite was Giardia duodenalis (26.88%). Significant association was verified among enteroparasitosis, family income, maternal education and age; the lowest enteroparasite frequency occurred in children of families with larger income and higher education. It was observed that G. duodenalis is more prevalent in children from 0 to 4 years and E. vermicularis is more frequent in children between three and four years old. The high enteroparasite prevalence in day cares suggests complex structure in its epidemiology, where factors beyond sanitation should be considered.
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Affiliation(s)
- Thaís Batista de Carvalho
- Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, SP, Brazil
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Pereira JC, Schelp AO, Montagnoli AN, Gatto AR, Spadotto AA, de Carvalho LR. Residual signal auto-correlation to evaluate speech in Parkinson’s disease patients. Arq Neuro-Psiquiatr 2006; 64:912-5. [PMID: 17220994 DOI: 10.1590/s0004-282x2006000600004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2006] [Accepted: 08/04/2006] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: To evaluate the maximum residual signal auto-correlation also known as pitch amplitude (PA) values in patients with Parkinson’s disease (PD) patients. METHOD: The signals of 21 Parkinson’s patients were compared with 15 healthy individuals, divided according age and gender. RESULTS: Statistical difference was seen between groups for PA, 0.39 for controls and 0.25 for PD. Normal value threshold was set as 0.3; (p<0.001). In the Parkinson’s group 80.77%, and in the control group only 12.28%, had a PA<0.3 demonstrating an association between these variables. The dispersion diagram for age and PA for PD individuals showed p=0.01 and r=0.54. There was no significant difference in relation to gender and PA between groups. CONCLUSION: The significant differences in pitch’s amplitude between PD patients and healthy individuals demonstrate the methods specificity. The results showed the need of prospective controlled studies to improve the use and indications of residual signal auto-correlation to evaluate speech in PD patients.
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De Luca LA, Gonçalves MDFVS, de Carvalho LR. Mastalgia cíclica pré-menstrual: placebo versus outras drogas. Rev Assoc Med Bras (1992) 2006; 52:265-9. [PMID: 16967147 DOI: 10.1590/s0104-42302006000400029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2005] [Accepted: 02/11/2005] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To compare therapeutic effects of placebo with intake of low doses of acetyl-salysilic acid (aspirin) and a compound of retinol, pyridoxine chlorhydrate and tocopherol acetate. METHODS The study is a prospective, controlled, triple blinded, randomized trial. From 259 patients, 81 were selected in order to follow rigid criteria of inclusion. They were divided into three groups of 27 patients, taking aspirin, vitamins or placebo respectively. The number of patients in each group was considered satisfactory for statistical analysis. Pain was scored as Grade 1 (without pain), Grade II (moderate pain) and Grade III (severe pain). The Tukey test was applied for comparison of results (statistical significance 5%). RESULTS Clinical parameters, age, weight, BMI, parity and lactation period were similar for each group. There was a decrease of pain intensity in all groups, that was even more pronounced for the placebo group. DISCUSSION Emphasis was given to symptomatic treatment of cyclic premenstrual mastalgia with symptoms considered to be the expression of a physiological process that can be treated with simple drugs or placebo. Usual therapeutic approaches with several drugs are criticized, including results and contraindications. CONCLUSION This study based upon acceptable trial methodology (randomized, triple blinded, placebo controlled, prospective) did not show significant differences in the treatment of cyclic mastalgia.
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Affiliation(s)
- Laurival A De Luca
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Botucatu, UNESP
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Gobbo Braz L, Braz JRC, Módolo NSP, do Nascimento P, Brushi BAM, Raquel de Carvalho L. Perioperative cardiac arrest and its mortality in children. A 9-year survey in a Brazilian tertiary teaching hospital. Paediatr Anaesth 2006; 16:860-6. [PMID: 16884469 DOI: 10.1111/j.1460-9592.2006.01876.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The incidence of perioperative cardiac arrest and mortality in children is higher than in adults. This survey evaluated the incidence, causes, and outcome of perioperative cardiac arrests in a pediatric surgical population in a tertiary teaching hospital between 1996 and 2004. METHODS The incidence of cardiac arrest during anesthesia was identified from an anesthesia database. During the study period, 15,253 anesthetics were performed in children. Data collected included patient demographics, surgical procedures (elective, urgent, or emergency), ASA physical status classification, anesthesia provider information, type of surgery, surgical areas, and outcome. All cardiac arrests were reviewed and grouped by the cause of arrest and death into one of four groups: totally anesthesia-related, partially anesthesia-related, totally surgery-related, or totally child disease or condition-related. RESULTS There were 35 cardiac arrests (22.9 : 10,000) and 15 deaths (9.8 : 10,000). Major risk factors for cardiac arrest were neonates and children under 1 year of age (P < 0.05) with ASA III or poorer physical status (P < 0.05), in emergency surgery (P < 0.05), and general anesthesia (P < 0.05). Child disease/condition was the major cause of cardiac arrest or death (P < 0.05). There were seven cardiac arrests because of anesthesia (4.58 : 10,000)--four totally (2.62 : 10,000) and three partially related to anesthesia (1.96 : 10,000). There were no anesthesia attributable deaths reported. The main causes of anesthesia attributable cardiac arrest were respiratory events (71.5%) and medication-related events (28.5%). CONCLUSIONS Perioperative cardiac arrests were relatively higher in neonates and infants than in older children with severe underlying disease and during emergency surgery. The fact that all anesthesia attributable cardiac arrests were related to airway management and medication administration is important in prevention strategies.
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Affiliation(s)
- Leandro Gobbo Braz
- Department of Anaesthesiology, School of Medicine, UNESP, District of Rubião Júnior, Botucatu, São Paulo State, Brazil.
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Nascimento P, de Paiva Filho O, de Carvalho LR, Braz JRC. Early hemodynamic and renal effects of hemorrhagic shock resuscitation with lactated Ringer's solution, hydroxyethyl starch, and hypertonic saline with or without 6% dextran-70. J Surg Res 2006; 136:98-105. [PMID: 16815449 DOI: 10.1016/j.jss.2006.04.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2006] [Revised: 04/17/2006] [Accepted: 04/21/2006] [Indexed: 11/16/2022]
Abstract
BACKGROUND Considering the renal effects of fluid resuscitation in hemorrhaged patients, the choice of fluid has been a source of controversy. In a model of hemorrhagic shock, we studied the early hemodynamic and renal effects of fluid resuscitation with lactated Ringer's (LR), 6% hydroxyethyl starch (HES), and 7.5% hypertonic saline (HS) with or without 6% dextran-70 (HSD). MATERIALS AND METHODS Forty-eight dogs were anesthetized and submitted to splenectomy. An estimated 40% blood volume was removed to maintain mean arterial pressure (MAP) at 40 mm Hg for 30 min. The dogs were divided into four groups: LR, in a 3:1 ratio to removed blood volume; HS, 6 mL kg(-1); HSD, 6 mL kg(-1); and HES in a 1:1 ratio to removed blood volume. Hemodynamics and renal function were studied during shock and 5, 60, and 120 min after fluid replacement. RESULTS Shock treatment increased MAP similarly in all groups. At 5 min, cardiac filling pressures and cardiac performance indexes were higher for LR and HES but, after 120 min, there were no differences among groups. Renal blood flow and glomerular filtration rate (GFR) were higher in LR at 60 min but GFR returned to baseline values in all groups at 120 min. Diuresis was higher for LR at 5 min and for LR and HES at 60 min. There were no differences among groups in renal variables 120 min after treatment. CONCLUSIONS Despite the immediate differences in hemodynamic responses, the low-volume resuscitation fluids, HS and HSD, are equally effective to LR and HES in restoring renal performance 120 min after hemorrhagic shock treatment.
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Affiliation(s)
- Paulo Nascimento
- Department of Anesthesiology, UNESP - University of São Paulo State, Medical School of Botucatu, Botucatu/SP, Brazil.
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Barbosa AMP, Carvalho LRD, Martins AMVDC, Calderon IDMP, Rudge MVC. Efeito da via de parto sobre a força muscular do assoalho pélvico. Rev Bras Ginecol Obstet 2005. [DOI: 10.1590/s0100-72032005001100008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Villela NR, Nascimento Júnior PD, Carvalho LRD, Teixeira A. Efeitos da dexmedetomidina sobre o sistema renal e sobre a concentração plasmática do hormônio antidiurético: estudo experimental em cães. Rev Bras Anestesiol 2005; 55:429-40. [DOI: 10.1590/s0034-70942005000400007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2004] [Accepted: 03/08/2005] [Indexed: 11/22/2022] Open
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Ruiz Júnior RL, de Carvalho LR, Cataneo AJM. Compensatory lung growth: protein, DNA and RNA lung contents in undernourished trilobectomized rats. Acta Cir Bras 2005; 20:219-24. [PMID: 16033180 DOI: 10.1590/s0102-86502005000300005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To demonstrate compensatory lung growth (CLG) by lung contents of proteins, DNA, and RNA in undernourished young adult rats, submitted to pulmonary trilobectomy. METHODS We used 137 male Wistar rats, randomly distributed into 9 groups; they were submitted to three treatments (control, thoracotomy, and trilobectomy), and sacrificed at three different times (7, 30, and 90 days). In trilobectomy we removed the right median, accessory, and caudal lobes. We studied lung proteins, DNA, and RNA contents. RESULTS In the cranial lobe and left lung, protein content was higher in trilobectomized rats however there was insufficient CLG to make up for the loss. The increase of DNA in the cranial lobe and left lung of trilobectomized rats was sufficient to compensate for this loss, resulting in a similar content to controls. RNA content in trilobectomized rats, was higher in the cranial lobe and left lung, more efficient in the cranial lobe, but less than in the other groups. CONCLUSIONS CLG occurred in trilobectomized rats, probably with cell hyperplasia and little hypertrophy, due to the large DNA compensation and small RNA compensation. This was markedly different to well-nourished animals, who had pronounced hypertrophy.
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Affiliation(s)
- Raul Lopes Ruiz Júnior
- Department of Orthopedics and Surgery, State University of São Paulo (UNESP), Botucatu, SP, Brazil.
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Abstract
OBJECTIVES Assessment of opinions and practices of pediatricians concerning sleep-disordered breathing (SDB) in children. METHODS Randomly 516 pediatricians were selected in the state of São Paulo, Brazil. A survey mailed to them included questions regarding: their professional profile, knowledge about SDB in childhood, opinions and practices for diagnosis and treatment of these diseases. RESULTS 112 anonymous completed surveys were returned (21.7%). The teaching of SDB during medical school and pediatric residency raining was considered unsatisfactory respectively by 65.2% and 34.8% of the pediatricians. Forty-nine respondents (43.8%) rated their knowledge about SDB in children as regular, 39 (34.8%) as good and 17 (15.2%) as unsatisfactory. The most important sleep-related questions were: mouth breathing, breathing pauses, sleep amount, excessive daytime sleepiness and nocturnal wheezing. Clinical aspects regarded as the most significant for suspecting obstructive sleep apnea syndrome (OSAS) were: breathing pauses, adenoid hypertrophy, mouth breathing, craniofacial anomaly and snoring. The most frequent practices for evaluation of OSAS in children were: cavum radiography with referral to an otorhinolaryngologist (25%) and nocturnal pulse oximetry (14.2%). Only 11.6% of pediatricians recommended overnight polysomnography and 4.5%, nap polysomnography. The most effective practices for SDB were considered to be: adenoidectomy and adenotonsillectomy, parents counseling, weight loss and sleep hygiene. CONCLUSIONS There is a gap between research on SDB in childhood and pediatric practice.
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Affiliation(s)
- Aracy Pereira Silveira Balbani
- Faculdade de Medicina, Departamento de Bioestatística, Instituto de Biociências, Universidade Estadual Paulista Júlio de Mesquita Filho.
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Oliveira ABD, De Luca LA, Carvalho GT, Arias VEA, Carvalho LRD, Assunção MDC. [Immunoexpression of c-erbB-2 in intraductal proliferative lesions of the female breast]. Rev Assoc Med Bras (1992) 2004; 50:324-9. [PMID: 15499488 DOI: 10.1590/s0104-42302004000300043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Genetic modifications are related to genesis and development of cancer. Neoplasias in various organs express the c-erbB-2 oncogene. In intraductal proliferations of the breast it has been assessed as a risk factor for subsequent development of carcinoma. The c-erbB-2 immunoexpression in intraductal epithelial proliferations and the relationship with histopathological characteristics of ductal carcinoma in situ (DCIS) were evaluated. METHODS File material from 88 women, which were tissue samples formalin-fixed, paraffin-embedded blocks, was used. Of these 51 presented with DCIS and 37 with ductal hyperplasia without atypia. Ages of the women ranged from 35 to 76 years. All cases were reviewed and nuclear grade, presence of necrosis, preponderance of histological subtype and its extension were verified. Specimens were obtained for the c-erB-2 immunohistochemical study of 84 of the women in question. RESULTS No expression of the oncogene was verified in the hyperplasias without atypias and in tissues adjacent to all tissue samples. Expression of c-erbB-2 was verified in 9 (19.1%) of the DCIS (p = 0.0001). Immunoexpression was not related to the extension of the lesions. The c-erbB-2 immunoexpression in DCIS was correlated to the histological subtype (p = 0.019), necrosis (p = 0.0066), nuclear grade (p = 0.0084) and Van Nuys Classification (p = 0.039). CONCLUSIONS Expression of c-erbB-2 was significant in proliferative lesions with risk (DCIS) and was correlated to histopathological characteristics: high nuclear grade, presence of necrosis and comedy subtype. There was no expression in the hyperplasias without atypias and adjacent tissues.
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Dourado VZ, Antunes LCDO, Carvalho LRD, Godoy I. Influência de características gerais na qualidade de vida de pacientes com doença pulmonar obstrutiva crônica. J Bras Pneumol 2004. [DOI: 10.1590/s1806-37132004000300005] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: Não há consenso a respeito dos fatores que influenciam a qualidade de vida nos portadores de doença pulmonar obstrutiva crônica (DPOC). Entretanto, a sua determinação pode nortear abordagens que visem à melhora da qualidade de vida desses pacientes. OBJETIVO: Avaliar fatores que podem interferir na qualidade de vida de pacientes com DPOC selecionados para reabilitação pulmonar. MÉTODO: Foram avaliados vinte e um pacientes com doença pulmonar obstrutiva crônica moderada a grave. Pressão inspiratória máxima (PImax), teste de caminhada de seis minutos (TC6), composição corpórea, função pulmonar, gases sangüíneos, dinamometria de membros superiores, força muscular de quadríceps e questionário de qualidade de vida do Hospital Saint George (SGRQ) foram estudados. RESULTADOS: Foram observadas correlações negativas estatisticamente significativas entre as seguintes variáveis: escore do domínio "Impacto" com o volume expiratório forçado no primeiro segundo (VEF1) (r = -0,68; p = 0,004), relação entre VEF1 e capacidade vital forçada (VEF1/CVF) (r = -0,61; p = 0,014), pico de fluxo expiratório (PFE) (r = -0,53; p = 0,015), TC6 (r = -0,63; p = 0,001) e índice de massa corpórea (IMC) (r = -0,64; p = 0,002); escore do domínio "Atividades" com PImax (r = -0,57; p = 0,007), saturação de O2 (SpO2) (r = -0,52; p = 0,018) e TC6 (r = -0,58; p = 0,007); escore do domínio "Sintomas" com IMC (r = -0,60; p = 0,005); e escore "Total" com VEF1 (r = -0,64; p = 0,01), PFE (r = -0,47; p = 0,033) e IMC (r = -0,57; p = 0,009). A regressão múltipla linear indicou como principais variáveis independentes o IMC, com influência significativa nos domínios sintomas (p = 0,002), impacto (p = 0,009) e no escore total (p = 0,024), e o TC6, com influência significativa nos domínios atividades (p = 0,048) e impacto (p = 0,010). CONCLUSÕES: O IMC e o TC6 tiveram influência nos índices de qualidade de vida. Portanto, estas variáveis devem ser consideradas nas estratégias para melhorar a qualidade de vida de pacientes com doença pulmonar obstrutiva crônica.
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Schelp AO, Cola PC, Gatto AR, Silva RGD, Carvalho LRD. Incidência de disfagia orofaríngea após acidente vascular encefálico em hospital público de referência. Arq Neuro-Psiquiatr 2004; 62:503-6. [PMID: 15273852 DOI: 10.1590/s0004-282x2004000300023] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A doença vascular encefálica (AVE) é a principal causa de morte no Brasil. As seqüelas em indivíduos pós-acidente vascular encefálico incluem distúrbios motores, distúrbios de fala ou de linguagem e distúrbios de deglutição. A disfagia orofaríngea ocorre em cerca de 50% dos pacientes com AVE. Este estudo teve por objetivo determinar a incidência da disfagia após AVE. Foram avaliados todos os pacientes que deram entrada em hospital universitário de referência no período de um ano, tão logo apresentassem condições para avaliação clínica, fonoaudiológica e neurológica (102 pacientes), com análise objetiva da deglutição (61 pacientes). Foi observada incidência de disfagia em 76,5% dos pacientes avaliados clinicamente, este percentual elevando-se a 91% com avaliação videofluoroscópica. A alta incidência de disfagia observada neste estudo que avaliou pacientes com amplo espectro de gravidade, em diferentes fases de recuperação, ressalta a importância de equipe multidisciplinar, incluindo fonoaudiólogos capacitados, para avaliar os distúrbios da deglutição nos diversos momentos de recuperação dos AVEs.
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Ruiz Júnior RL, Carvalho LRD, Cataneo AJM. Crescimento pulmonar compensatório (CPC): massa corpórea, conteúdo protéico e massa pulmonares em ratos subnutridos trilobectomizados. Acta Cir Bras 2004. [DOI: 10.1590/s0102-86502004000200012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO:Avaliar o comportamento bioquímico do CPC após trilobectomia no rato adulto jovem subnutrido. MÉTODOS: Foram utilizados 137 ratos "Wistar", machos, subnutridos pela oferta de 33% da ingestão diária normal na fase de adaptação e durante o experimento, distribuídos por sorteio, em 9 grupos experimentais, submetidos a três tratamentos (Controle, Toracotomia, Trilobectomia) e sacrificados em três momentos (7, 30 e 90 dias). Na Trilobectomia foram extirpados os lobos médio, acessório e caudal direitos, que representavam 55% do tecido pulmonar. Estudou-se os seguintes atributos e variáveis: massa corpórea e pulmonar, relação entre massa pulmonar e corpórea e conteúdos protéicos pulmonares. RESULTADOS: No lobo cranial e no pulmão esquerdo, tanto a massa quanto os conteúdos protéicos, nos trilobectomizados, foram maiores em todos os momentos do estudo quando comparados aos demais, sendo este aumento suficiente para compensar a perda dos três lobos. Os conteúdos protéicos do lobo cranial e do pulmão esquerdo, nos trilobectomizados, tiveram o mesmo comportamento da massa pulmonar, mas este aumento não foi suficiente para compensar a perda dos três lobos. CONCLUSÕES: Nos ratos adultos subnutridos trilobectomizados ocorre CPC. A recuperação da massa pulmonar é total, mas o conteúdo protéico pulmonar apesar de aumentar, não chega aos valores dos ratos não trilobectomizados.
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Villela NR, Nascimento Júnior PD, Carvalho LRD. [Cardiovascular effects of two dexmedetomidine doses: experimental study in dogs.]. Rev Bras Anestesiol 2003; 53:784-96. [PMID: 19471697 DOI: 10.1590/s0034-70942003000600009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2003] [Accepted: 03/21/2003] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES There has been a growing interest in the anesthetic use of dexmedetomidine, a new alpha2-adrenergic agonist, due to decreased anesthetics consumption and better cardiovascular stability that it promoter. This study aimed at investigating cardiovascular effects of two different dexmedetomidine doses in anesthetized dogs. METHODS The study involved 36 adult dogs anesthetized with propofol, fentanyl and isoflurane distributed in three groups which received: G1, 20 ml saline injection in 10 minutes, followed by 20 ml of the same solution infused in one hour; G2, 20 ml dexmedetomidine-containing saline (1 microg.kg-1) in 10 minutes, followed by 20 ml of the same solution infused one hour; and G3, of dexmedetomidine-containing saline (2 microg.kg-1) in 10 minutes, followed by 20 ml of the same solution infused in one hour. Cardiovascular attributes were evaluated in four moments: M1, control, M2, after initial 20 ml injection of the studied solution, coincident with the beginning of the same solution injection in one hour; M3, 60 minutes after M2 and M4, 60 minutes after M3. RESULTS G2 heart hate (HR) was decreased at M2, returning to baseline values at M3, while in G3 it was decreased at M2 but was kept so throughout the experiment. There has been progressive HR increase in G1. There were no significant changes in mean blood pressure in all group. Systemic vascular resistance (SVR) was maintained stable in G2 and G3, but was decreased in G1 at M3. Cardiac index (CI) was not significantly changed in G2 and G3, but has progressively increased in G1. CONCLUSIONS In dogs under these experimental conditions, dexmedetomidine has induced a dose-dependent HR decrease, has inhibited isoflurane-induced SVR decrease and has prevented hyperdynamic responses throughout the experiment.
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Nahás EAP, Pontes A, Traiman P, Nahás Neto J, De Luca LA, Borges VTM, Carvalho LRD. Efeitos da Histerectomia Total Abdominal sobre o Fluxo Sangüíneo Ovariano. Rev Bras Ginecol Obstet 2002. [DOI: 10.1590/s0100-72032002000500007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Abstract
Os objetivos deste estudo foram realizar um levantamento dos hábitos de saúde relacionados aos fatores de risco em indivíduos hipertensos hospitalizados e identificar o conhecimento dessa clientela quanto à importância do controle desses fatores para a hipertensão arterial. Foram entrevistados 32 hipertensos que se encontravam hospitalizados em uma unidade de internação clínica de um hospital escola. Apesar de a clientela referir que controlava alguns dos fatores de risco para a hipertensão arterial e de saber da importância desse controle, a elevação da pressão arterial manteve-se mesmo durante a hospitalização, e a maioria, tinha comprometimento de órgãos-alvo. Há a necessidade de buscarmos medidas educativas que conduzam às mudanças no estilo de vida dessas pessoas para que haja o controle dos fatores de risco e da evolução da doença.
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Vianna PTG, Vilela EP, Cordon FCO, Carvalho LRD. [Simplified method to maintain propofol blood concentration in an approximately constant level associated to nitrous oxide in pediatric patients]. Rev Bras Anestesiol 2002; 52:272-85. [PMID: 19479090 DOI: 10.1590/s0034-70942002000300002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2001] [Accepted: 10/06/2001] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Maintaining target-controlled propofol blood concentrations in approximately constant levels is a technique that can be used in a simple way in the operating room. The aim of this study was to compare in clinical and laboratorial terms propofol infusion in children, using Shorts and Marshs pharmacokinetic parameters. METHODS Forty-one patients of both genders, aged 4 to 12 years, physical status ASAI or ASAII were distributed in two groups: Group S (n = 20) and Group M (n = 21). Shorts pharmacokinetic parameters were applied to group S, while Marshs pharmacokinetic parameters were applied to group M. Intravenous anesthesia was induced with 30 microg.kg-1 bolus alfentanil, 3 mg.kg-1 propofol and 0.08 mg.kg-1 pancuronium. Patients were intubated and anesthesia was maintained with N2O/O2 (60%) in controlled mechanical ventilation. Propofol infusion in group S was 254 microg.kg-1 (30 min) followed by 216 microg.kg-1.min-1 for additional 30 minutes. Propofol infusion in group M was 208 microg.kg-1 (30 min.) followed by 170 microg.kg-1.min-1 for additional 30 minutes. Using specific pharmacokinetic parameters for each group, the goal was a target-concentration of 4 microg.kg-1 propofol. Three blood samples were collected (at 20, 40 and 60 minutes) to measure propofol by the High Performance Liquid Chromatography method. RESULTS Groups S and M were similar in age, height, weight and gender (p > 0.05). There were no statistically significant differences between groups in SBP, DBP, HR, FiN2O, hemoglobin SpO2 and end tidal P ET CO2. The number of repeated alfentanil boluses showed no statistically significant difference between both groups. Bispectral index (BIS) showed also no statistically significant differences between M0 (awaken) and remaining moments in both groups. Error Performance Median (EPM) and Error Performance Absolute Median (EPAM) values were statistically different between groups in moment 60. Median propofol blood concentrations (microg.kg-1) were significantly different between groups M and S in moment 60 and between moments 40 and 60 in group S. CONCLUSIONS Anesthesia with propofol using Marshs pharmacokinetic parameters (group M) showed a lower error rate for obtaining 4 microg.kg-1 propofol target-concentration. In addition, less propofol was needed to obtain similar clinical results. For these reasons, it should be the method of choice for children ASA I aged 4 to 12 years.
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Simonetti JP, Batista L, de Carvalho LR. [Health habits and risk factors in hypertensive patients]. Rev Lat Am Enfermagem 2002; 10:415-22. [PMID: 12817396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
The purposes of this study were to assess the health habits related to risk factors in hospitalized hypertensive patients and to identify these patients' knowledge on the importance of controlling these factors. Thirty two hypertensive patients hospitalized at a University Hospital were interviewed. Although these patients mentioned that they controlled the risk factors for hypertension and that they knew about the importance of this control, a high blood pressure was observed even during hospitalization and the majority of them presented damage in target organs. There is a need to search for educative measures that will enable a change in the life style of these patients, encouraging them to control the risk factors and the evolution of the disease.
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