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Reference intervals for serum immunoglobulins G, M and E levels in Brazilian children aged 1 to 10 years: a population-based study G years populationbased population based
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Assis, Sandra Breder

; Slhessarenko, Natasha

; Fontes, Cor Jesus Fernandes

Jornal de Pediatria

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jun 2024, Volume 100 N. 3 Pages 256 - 262

Abstract: En | Text: En | PDF: En

Abstract Objective: To determine the reference intervals (RI) for serum levels of IgG, IgM, and IgE in healthy children aged 1–10 years living in central Brazil. Method: A sample of 1743 healthy children was randomly selected from kindergartens and public schools. Reference intervals were defined by non-parametric rank (Clinical Laboratory Standards Institute, USA), bootstrapping, and Horn’s robust methods. Results: By the rank method, the IgG RI was 792–1771 mg/dL for children of both sexes aged 1–10 years. IgM RI were different for gender and age groups, being 45–196 mg/dL and 34–190 mg/dL for boys aged 1–2 years and 3–10 years, respectively. For girls, the IgM RI were 50–212 mg/dL and 39–212 mg/dL, for ages 1–4 and 5–10 years, respectively. The IgE RI for both sexes and ages 1–10 years was 6–1005 mg/dL. The bootstrap method showed RI similar to the rank method but with slightly different confidence intervals. Horn’s robust method determined RI different from those obtained by previous methods. Conclusion: RI for serum concentrations of IgG, IgM, and IgE were established for Brazilian children aged 1–10 years. This definition will be useful for Brazilian physicians, who will have more adequate parameters for their clinical decision-making. Objective (RI 110 1 10 1–1 Brazil Method 174 schools nonparametric non parametric Clinical Institute USA, USA , USA) bootstrapping Horns Horn s methods Results 7921771 792 1771 792–177 mgdL mg dL groups 45196 45 196 45–19 34190 34 190 34–19 12 2 1– 310 3 3–1 respectively girls 50212 50 212 50–21 39212 39 39–21 14 4 510 5 5–1 61005 6 1005 6–100 Conclusion physicians decisionmaking. decisionmaking decision making. making decision-making 11 17 792177 79 177 792–17 4519 19 45–1 3419 34–1 31 3– 5021 21 50–2 3921 39–2 51 5– 6100 100 6–10 79217 7 792–1 451 45– 341 34– 502 50– 392 39– 610 6–1 7921 792– 61 6–

https://doi.org/10.1016/j.jped.2023.11.006

Reference intervals for serum TSH concentrations of healthy children from the Central Region of Brazil
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Meirelles-Cardoso, Tula Beatriz Brandão Caldas

; Slhessarenko, Natasha

; Fontes, Cor Jesus Fernandes

Archives of Endocrinology and Metabolism

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2023, Volume 67 N. 6 elocation e220499

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: The objective of this study was to determine the serum thyroid-stimulating hormone (TSH) concentration reference intervals (RIs) of healthy children aged 1 to 10 years of both sexes, living in the Central Region of Brazil. Subjects and methods: 1,735 children [869 (50.1%) female; 866 (49.9%) male] enrolled in the morning shift of 47 pre- and 83 public elementary schools in the municipality of Cuiabá, Mato Grosso, were studied by gathering anthropometric and social data and their medical history. A blood sample was collected from each child to determine the TSH concentration using the electrochemiluminescence method on a Cobas® 6000 modular analyzer (Analyzer series, Roche Diagnostics). Results: The RIs were determined using the 2.5 and 97.5 percentile and the mean ± 2 standard deviations methods. After identifying the homoscedastic groups by age and sex, outliers higher or lower than three standard deviations were excluded. The distribution of serum TSH concentrations showed no significant age or sex differences. Based on the percentile method, TSH RI ranged from 0.93 to 5.86 μIU/mL. Based on the mean ± 2 standard deviations, TSH RI ranged from 0.30 to 5.29 μIU/mL. Conclusion: The normal serum TSH concentration of the Brazilian children evaluated in this study differ from those of populations from other countries. Other regional population studies may validate the RIs found in this study and enable its safer use in pediatric clinical practice. Objective thyroidstimulating thyroid stimulating (TSH (RIs sexes Brazil methods 1735 735 1,73 869 [86 50.1% 501 50 (50.1% female 86 49.9% 499 49 9 (49.9% male 4 pre 8 Cuiabá Grosso history Cobas 600 Analyzer series Diagnostics. Diagnostics . Diagnostics) Results 25 5 2. 975 97 97. excluded differences 093 0 93 0.9 586 5.8 μIUmL μIU mL μIU/mL 030 30 0.3 529 29 5.2 Conclusion countries practice 173 73 1,7 [8 50.1 (50.1 49.9 (49.9 60 09 0. 58 5. 03 3 52 17 7 1, [ 50. (50. 49. (49. 6 (50 (49 (5 (4 (

https://doi.org/10.20945/2359-4292-2022-0499

Reference intervals for serum immunoglobulin A levels in Brazilian children aged 1 to 10 years: a population-based study years populationbased population based
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Assis, Sandra Breder

; Slhessarenko, Natasha

; Fontes, Cor Jesus Fernandes

Jornal de Pediatria

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2023, Volume 99 N. 5 Pages 492 - 499

Abstract: En | Text: En | PDF: En

Abstract Objective: To determine reference intervals (Rl) for serum immunoglobulin A (IgA) levels in healthy children aged 1 to 1 0 years residing in the central region of Brazil. Methods: This cross-sectional study was conducted on 1,743 healthy children randomly selected from kindergartens and public schools in Cuiabá, MT, Brazil. The IgA RIs were defined using the statistical methods postulated by the guidelines of the United States Clinical and Laboratory Standards Institute, the nonparametric bootstrap method, and Horn's robust method after the correction of discrepancies by Tukey's, Dixon's, and Horn's methods, respectively. The results were defined based on the values contained between the 2.5th and 97.5th percentiles and their respective 95% confidence intervals. Results: Partition by sex was not necessary to determine the IgA Rl of the studied children. Homogeneous subgroups were identified among children aged 1-<2, 2-<5, and 5-<11 years, whose IgA-specific RIs were determined. Conclusion: The serum IgA RIs were established for three groups of Brazilian children aged 1-11 years, which differed from those currently applied in Brazilian pediatric practice and from those defined by international studies. This definition will help Brazilian pediatricians formulate an accurate diagnosis and facilitate decision-making. Objective (Rl (IgA Brazil Methods crosssectional cross sectional 1743 743 1,74 Cuiabá MT Institute Horns Horn s Tukeys, Tukeys Tukey s, Tukey's Dixons, Dixons Dixon Dixon's respectively 25th th 2 5th 975th 97 95 Results 1<2, 12 <2, 1-<2 2<5, 25 <5, 5 2-<5 5<11 511 <11 11 5-<1 IgAspecific specific determined Conclusion 111 1-1 studies decisionmaking. decisionmaking decision making. making decision-making 174 74 1,7 9 1<2 <2 1-< 2<5 <5 2-< 5<1 51 <1 5-< 1- 17 7 1, 1< < 2< 2- 5< 5-

https://doi.org/10.1016/j.jped.2023.03.007

Proposition of decision limits for serum lipids in Brazilian children aged one to 13 years,
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Slhessarenko, Natasha

; Fontes, Cor J.F.

; Slhessarenko, Maria Eduarda

; Azevedo, Raymundo S.

; Andriolo, Adagmar

Jornal de Pediatria

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apr 2019, Volume 95 N. 2 Pages 173 - 179

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo: Determinar limites de decisão (LD) para o colesterol total (CT), LDL-colesterol (LDL-c), colesterol não-HDL (c-NHDL), HDL-colesterol (HDL-c) e triglicérides (TG) em crianças e adolescentes saudáveis de Cuiabá. Método: Estudo transversal envolvendo 1.866 crianças e adolescentes saudáveis de creches e escolas municipais públicas de Cuiabá, aleatoriamente selecionadas. Os LD desejáveis dos lipídeos séricos foram definidos pelos critérios clássicos, isto é, níveis de CT, LDL-c, c-NHDL, TG abaixo do percentil 75, e de HDL-c acima do percentil 10. Resultados: Os P75 para CT foram: 160 mg/dL para a faixa etária de 1 a < 3 anos, 170 mg/dL para ≥ 3 a < 9 anos e 176 mg/dL para ≥ 9 a < 13 anos. Para o c-NHDL, de 122 mg/dL na faixa etária de 1 a < 13 anos. LDL-c: 104 mg/dL na faixa etária de 1 a < 9 anos e 106 mg/dL de ≥ 9 a < 13 anos. TG: 127 mg/dL entre 1 a < 2 anos; 98 mg/dL de ≥ 2 a < 6 anos; e 92 mg/dL de ≥ 6 a < 13 anos. Quanto ao HDL-c, o P10, foi de 24 mg/dL, 28 mg/dL, 32 mg/dL e 36 mg/dL, para as faixas etárias de 1 a < 2 anos, ≥ 2 a < 3 anos, ≥ 3 a < 4 anos e ≥ 4 a < 13 anos, respectivamente. Conclusão: Os LD dos níveis séricos de lipídeos definidos neste estudo diferem daqueles apresentados nas diretrizes brasileiras e americanas atuais, especialmente por fazer a diferenciação entre as idades. Utilizar tais LD em nossa prática clínica certamente contribuirá para melhorar a acurácia do diagnóstico de dislipidemia nesse grupo populacional.

Abstract Objective: To determine decision limits for total cholesterol, LDL-cholesterol, non-HDL cholesterol, HDL-cholesterol, and triglycerides in healthy children and adolescents from Cuiabá, Brazil. Methods: This was a cross-sectional study of 1866 healthy children and adolescents randomly selected from daycare centers and public schools in Cuiabá. The desirable levels of serum lipids were defined using the classic criteria, i.e., total cholesterol, LDL-cholesterol, non-HDL cholesterol, and triglycerides levels below the P75 percentile, and HDL-c above the P10 percentile. Results: For CT, P75 was: 160 mg/dL for the age range of 1 to <3 years, 170 mg/dL for ≥3 to <9 years, and 176 mg/dL for ≥9 to <13 years. For non-HDL cholesterol, it was 122 mg/dL for the age range of 1 to <13 years. For LDL-c, it was 104 mg/dL at the age range of 1 to <9 years and 106 mg/dL from ≥9 to <13 years. For TG, it was 127 mg/dL from 1 to <2 years; 98 mg/dL from ≥2 to <6 years; and 92 mg/dL from ≥6 to <13 years. As for HDL-cholesterol, P10 was 24 mg/dL, 28 mg/dL, 32 mg/dL, and 36 mg/dL, for the age ranges of 1 to <2 years, ≥2 to <3 years, ≥3 to <4 years, and ≥4 to <13 years, respectively. Conclusion: The decision limits for the serum lipid levels defined in this study differed from those observed in the current Brazilian and North-American guidelines, especially because it differentiates between the age ranges. Using these decision limits in clinical practice will certainly contribute to improve the diagnostic accuracy for dyslipidemia in this population group.

https://doi.org/10.1016/j.jped.2018.01.003 1614 downloads

V Brazilian consensus guidelines for detection of anti-cell autoantibodies on hep-2 cells
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Cruvinel, Wilson de Melo

; Andrade, Luis Eduardo Coelho

; von Mühlen, Carlos Alberto

; Dellavance, Alessandra

; Ximenes, Antônio Carlos

; Bichara, Carlos David

; Bueno, Cleonice

; Mangueira, Cristóvão Luis Pitangueira

; Bonfá, Eloísa

; Brito, Fabiano de Almeida

; Flumian, Fernanda Bull

; Silva, Glaucielen Gomes da

; Rêgo, Jozelia

; Anjos, Lisiane Maria Ericoni dos

; Slhessarenko, Natasha

; Pasoto, Sandra Gofinet

; Neves, Suzane Pretti Figueiredo

; Valim, Valéria

; Santos, Wilton Silva dos

; Francescantonio, Paulo Luiz Carvalho

Advances in Rheumatology

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2019, Volume 59 elocation 28

Abstract: En | Text: En | PDF: En

Abstract Background: The V Brazilian Consensus for determination of autoantibodies against cellular constituents on HEp-2 cells, held in Brasilia (DF, Brazil) on August 27, 2016, discussed the harmonization between the Brazilian Consensus on ANA (BCA) guidelines and the International Consensus on ANA Patterns (ICAP) recommendations (www.anapatterns.org). Initial guidelines were formulated by the group of Brazilian experts with the purpose of guiding and enabling Brazilian clinical laboratories to adopt recommendations and to provide a common standard for national and international consensuses. Mainbody: Twenty Brazilian researchers and experts from universities and clinical laboratories representing the various geographical regions of the country participated in the meeting. Three main topics were discussed, namely the harmonization between the BCA guidelines and latest recommendations of the ICAP initiative, the adjustment of the terminology and report on HEp-2 patterns, and a reassessment of quality assurance parameters. For the three topics, our aim was to establish specific guidelines. All recommendations were based on consensus among participants. There was concrete progress in the adjustment of the BCA guidelines to match the ICAP guidelines. To a certain extent, this derives from the fact that ICAP recommendations were largely based on the algorithm and recommendations of the IV Brazilian ANA Consensus, as consistently recognized in the ICAP publications and presentations. However, although there is great overlap between the two Consensuses, there are some point divergences. These specific items were individually and extensively discussed, and it was acknowledged that in several points ICAP improved recommendations previously issued by the Brazilian ANA Consensus and these changes were readily implemented. Regarding some specific topics, the BCA panel of experts felt that the previously issued recommendations remained relevant and possibly will require further discussion with ICAP. The term anti-cell antibodies was adopted as the recommended designation, recognizing that the assay addresses antibodies against antigens in the nucleus and in other cell compartments. However, the acronym ANA HEp-2 was maintained due to historical and regulatory reasons. It was also signalized that the latest trend in ICAP is to adopt the term Indirect Immunofluorescent Assay on HEp-2 cell substrate (HEp-2 IIFA). In addition, the quality assurance strategies previously presented were ratified and emphasized. Conclusion: The V BCA edition was successful in establishing an overall harmonization with the ICAP recommendations for interpretation of the HEp-2 IIFA test, pinpointing the perspectives in filling the remaining gaps between both initiatives.

https://doi.org/10.1186/s42358-019-0069-5 1618 downloads

Transference of CALIPER total alkaline phosphatase reference interval to a Brazilian pediatric population
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Slhessarenko, Natasha

; Andriolo, Adagmar

Jornal Brasileiro de Patologia e Medicina Laboratorial

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jul 2018, Volume 54 N. 4 Pages 204 - 205

Abstract: En | Text: En | PDF: En

https://doi.org/10.5935/1676-2444.20180035 207 downloads

The importance of determining reference intervals for Laboratory Medicine
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Slhessarenko, Natasha

; Andriolo, Adagmar

Jornal Brasileiro de Patologia e Medicina Laboratorial

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apr 2016, Volume 52 N. 2 Pages 68 - 69

Abstract: En | Text: En | PDF: En

https://doi.org/10.5935/1676-2444.20160019 1679 downloads

Let's reduce the blood volume collected for laboratorial exams?
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Carneiro-Sampaio, Magda

; Slhessarenko, Natasha

Revista Paulista de Pediatria

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jun 2014, Volume 32 N. 2 Pages 291 - 292

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/0103-058220143221613 11273 downloads

III Consenso Brasileiro para Pesquisa de Autoanticorpos em Células HEp-2: perspectiva histórica, controle de qualidade e associações clínicas
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Francescantonio, Paulo Luiz Carvalho

; Andrade, Luis Eduardo Coelho

; Cruvinel, Wilson de Melo

; Araújo, Flávia Ikeda e

; Dellavance, Alessandra

; Gabriel Júnior, Alexandre

; Nuccitelli, Barbara

; Taliberti, Ben Hur

; von Mühlen, Carlos Alberto

; Bichara, Carlos David Araújo

; Santos, Cláudio Henrique Ramos dos

; Bueno, Cleonice

; Yano, Cristiane Martinez

; Mangueira, Cristóvão Luis Pitangueira

; Carvalho, Darlene Gonçalves

; Cardoso, Elizângela

; Bonfá, Eloísa

; Rassi, Gustavo Gabriel

; Mundim, Hugo Mendonça

; Bendet, Izidro

; Rego, Jozélia

; Vieira, Lisiane Maria Enriconi dos Anjos

; Barbosa, Maria Ordália Ferro

; Sugiyama, Mitiko

; Santiago, Mittermayer Barreto

; Slhessarenko, Natasha

; Silva, Nilzio Antônio da

; Jarach, Renata

; Suda, Roberto

; Levy, Roger Abramino

; Sampaio, Silvia Oliveira

; Neves, Suzane Pretti Figueiredo

; Santos, Wilton Silva dos

; Nóbrega, Yanna K. de M.

Jornal Brasileiro de Patologia e Medicina Laboratorial

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jun 2009, Volume 45 N. 3 Pages 185 - 199

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: O III Consenso Brasileiro para Pesquisa de Autoanticorpos em Células HEp-2 (FAN) objetivou discutir estratégias para controlar a qualidade do ensaio, promover a atualização das associações clínicas dos diversos padrões e avaliar as dificuldades de implantação do II Consenso ocorrido no ano de 2002. MÉTODOS: Nos dias 13 e 14 de abril de 2007 participaram do encontro em Goiânia pesquisadores e especialistas de diversos centros universitários e laboratórios clínicos de diferentes regiões do Brasil, com o propósito de discutir e aprovar as recomendações que visam a melhores padronização, interpretação e utilização do ensaio pelos clínicos. Foram convidados como ouvintes representantes comerciais de diferentes empresas produtoras de insumos para realização do teste de FAN. RESULTADOS E CONCLUSÃO: Dada a heterogeneidade de microscópios e reagentes disponíveis no mercado, o III Consenso enfatizou a necessidade do controle de qualidade em ensaios de imunofluorescência indireta. Foram também feitas algumas adequações na terminologia utilizada para classificar os diferentes padrões. Finalmente, foi realizada uma atualização das associações clínicas com finalidade de facilitar cada vez mais o melhor uso do ensaio pelos clínicos.

OBJECTIVE: The Third Brazilian Consensus for Autoantibodies Screening in HEp-2 Cells (ANA) had as purpose the evaluation of difficulties in the accomplishment of the 2nd Consensus recommendations that took place in the year of 2002, the discussion of strategies for quality control of the assay and the discussion of an update of the clinical associations of the several immunofluorescent patterns. METHODS: Several ANA experts from university centers and private laboratories in different areas in Brazil joined the workshop in Goiânia on 2007 April 13 and 14 with the purpose of discussing and approving the recommendations for standardization, interpretation and use of the test by physicians. Commercial representatives of different ANA slide brands were also invited as listeners to the workshop. RESULTS AND CONCLUSION: The 3rd ANA Consensus emphasized the need for quality control in indirect immunofluorescent assays since there is a considerable heterogeneity of available microscopes and reagents. It also promoted adaptations in the previously approved terminology used to classify the different patterns and finally updated the clinical associations of the several patterns with the purpose of providing guidance for interpretation of the assay by clinical pathologists and assistant physicians.

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3º Consenso Brasileiro para pesquisa de autoanticorpos em células HEp-2 (FAN): recomendações para padronização do ensaio de pesquisa de autoanticorpos em células HEp-2, controle de qualidade e associações clínicas
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Dellavance, Alessandra

; Gabriel Júnior, Alexandre

; Nuccitelli, Barbara

; Taliberti, Ben Hur

; von Mühlen, Carlos Alberto

; Bichara, Carlos David Araújo

; Santos, Cláudio Henrique Ramos dos

; Bueno, Cleonice

; Yano, Cristiane Martinez

; Mangueira, Cristóvão Luis Pitangueira

; Carvalho, Darlene Gonçalves

; Cardoso, Elizângela

; Bonfá, Eloísa

; Araújo, Flávia Ikeda e

; Rassi, Gustavo Gabriel

; Mundim, Hugo Mendonça

; Bendet, Izidro

; Rego, Jozélia

; Vieira, Lisiane Maria Enriconi dos Anjos

; Andrade, Luis Eduardo Coelho

; Barbosa, Maria Ordália Ferro

; Sugiyama, Mitiko

; Santiago, Mittermayer Barreto

; Slhessarenko, Natasha

; Silva, Nilzio Antônio da

; Francescantonio, Paulo Luiz Carvalho

; Jarach, Renata

; Suda, Roberto

; Levy, Roger Abramino

; Sampaio, Silvia Oliveira

; Neves, Suzane Pretti Figueiredo

; Cruvinel, Wilson de Melo

; Santos, Wilton Silva dos

; Nóbrega, Yanna K. de M.

Revista Brasileira de Reumatologia

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apr 2009, Volume 49 N. 2 Pages 89 - 98

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO:O 3º Consenso Brasileiro para pesquisa de autoanticorpos em Células HEp-2 (FAN) teve como propósito avaliar as dificuldades de implantação do 2º Consenso ocorrido no ano de 2002, discutir estratégias para controlar a qualidade do ensaio e promover a atualização das associações clínicas dos diversos padrões. MÉTODOS:Participaram do encontro em Goiânia nos dias 13 e 14 de abril de 2008 pesquisadores e especialistas de diversos centros universitários e laboratórios clínicos de diferentes regiões do Brasil, com o propósito de discutir e aprovar as recomendações que visam à melhor padronização, interpretação e utilização do ensaio pelos clínicos. Representantes comerciais de diferentes empresas produtoras de insumos para realização do teste de FAN foram convidados como ouvintes. RESULTADOS E CONCLUSÕES: O 3º Consenso enfatizou a necessidade do controle de qualidade em imunofluorescência dada a heterogeneidade de microscópios e reagentes disponíveis no mercado, promoveu adequações na terminologia utilizada para classificar os diferentes padrões e, finalmente, atualizou as associações clínicas com finalidade de facilitar cada vez mais o melhor uso do ensaio pelos clínicos.

OBJECTIVE: The Third Brazilian Consensus for autoantibodies Screening in HEp-2 cells had as purpose the evaluation of difficulties in the accomplishment of the 2nd Consensus recommendations that took place in the year of 2002, the discussion of strategies for quality control of the assay and the promotion of an update of the clinical associations of the several immunofluorescent patterns. METHODS:Several ANA experts from university centers and private laboratories in different areas in Brazil joined the workshop in Goiânia on 2008 April 13 and 14 with the purpose of discussing and approving the recommendations for standardization, interpretation and use of the test by physicians. Commercial representatives of different ANA slide brands were also invited as listeners to the workshop. RESULTS AND CONCLUSIONS: The 3rd Consensus emphasized the need for quality control in indirect immunofluorescent since there is a considerable heterogeneity of available microscopes and reagents. It also promoted adaptations in the previously approved terminology used to classify the different patterns and finally updated the clinical associations of the several patterns with the purpose of providing guidance for interpretation of the assay by clinical pathologists and assistant physicians.

63793 downloads

11.

Efficacy of National Nosocomial Infection Surveillance score, acute-phase proteins, and interleukin-6 for predicting postoperative infections following major gastrointestinal surgery
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Aguilar-Nascimento, José Eduardo de

; Marra, Jair Gimenez

; Slhessarenko, Natasha

; Fontes, Cor Jesus Fernandes

Sao Paulo Medical Journal

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jan 2007, Volume 125 N. 1 Pages 34 - 41

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

CONTEXTO E OBJETIVO: Melhores resultados são esperados quando infecção pós-operatória é diagnosticada precocemente. Este estudo investigou a eficácia do escore NNIS (National Nosocomial Infection Surveillance score), interleucina-6 (IL-6) e proteínas de fase aguda na predição de infecções pós-operatórias. TIPO DE ESTUDO E LOCAL: Estudo tipo serie de casos na enfermaria de cirurgia geral do Hospital Universitário Julio Muller. MÉTODOS: 32 pacientes submetidos a operações gastrointestinais de grande porte entre junho de 2004 e fevereiro de 2005 foram estudados. Correlacionou-se o escore NNIS, a evolução da IL-6 e varias proteínas de fase aguda (proteína C reativa [CRP], albumina, pré-albumina e transferrina) com a ocorrência de infecção e tempo de permanência hospitalar (LOS). RESULTADOS: O escore NNIS > 1 (p = 0.01) e a hipoalbuminemia pré-operatória (p = 00.02) significantemente correlacionaram com infecção. Ocorreu uma elevação maior de IL-6 e CRP nos pacientes com infecção. Análise multivariada mostrou maior risco de infecção em paciente com NNIS > 1 (razão de chances, RC = 10,6 [IC 95%, 1,1-102,2]; p = 0.04), albumina pré-operatória < 3 g/dl (RC = 8,77 [IC 95%, 1,13-67,86]; p = 0,03); CRP > 30 mg/l no 2º (RC = 8,27 [IC 95%, 1,05-64,79]; p = 0,03) e > 12 mg/l no 5º pós-operatória (RC = 25,92 [IC 95%, 2,17-332,71]; p < 0,01), e com IL-6 > 25 pg/ml no 5º PO (RC = 15,46 [IC 95%, 1,19-230,30]; p = 0,03). LOS associou-se com câncer transferrina, IL-6 e albumina (p < 0,05). CONCLUSÃO: NNIS, albumina, CRP e IL-6 podem ser úteis como preditores de infecção pós-operatória. Na predição do LOS, a condição de doença maligna e a evolução de albumina, transferrina e IL-6 são úteis.

CONTEXT AND OBJECTIVE: Postoperative infections should be detected earlier. We investigated the efficacy of the National Nosocomial Infection Surveillance (NNIS) score, interleukin-6 (IL-6) and various acute-phase proteins for predicting postoperative infections. DESIGN AND SETTING: Case series study at the Júlio Müller University Hospital. METHODS: Thirty-two patients who underwent major gastrointestinal procedures between June 2004 and February 2005 were studied. The NNIS score and the evolution of serum IL-6 and various acute-phase proteins (C-reactive protein [CRP], albumin, prealbumin and transferrin) were correlated with postoperative infections and length of hospital stay (LOS). RESULTS: NNIS > 1 (p = 0.01) and low preoperative albumin (p = 0.02) significantly correlated with infection. IL-6 and CRP increased significantly more in patients with infections. Multivariate analysis showed greater risk of infection when NNIS > 1 (odds ratio, OR = 10.66; 95% confidence interval, CI: 1.1-102.0; p = 0.04); preoperative albumin < 3 g/dl (OR = 8.77; 95% CI: 1.13-67.86; p = 0.03); CRP > 30 mg/l on the second postoperative day (OR = 8.27; 95% CI: 1.05-64.79; p = 0.03) and > 12 mg/l on the fifth postoperative day (OR = 25.92; 95% CI: 2.17-332.71; p < 0.01); and IL-6 > 25 pg/ml on the fifth postoperative day (OR = 15.46; 95% CI: 1.19-230.30; p = 0.03). Longer LOS was associated with cancer, transferrin, IL-6 and albumin (p < 0.05). CONCLUSIONS: NNIS, albumin, CRP and IL-6 may be useful as predictive markers for postoperative infections. For predicting LOS, malignant condition, transferrin, albumin and IL-6 are useful.

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12.

II Consenso Brasileiro de Fator Antinuclear em Células HEp-2: Definitions for standardization of autoantibody testing against the nucleus (ANA HEp-2), nucleolus, cytoplasm and mitotic apparatus, as wel as its clinical associations
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Dellavance, Alessandra

; Gabriel Júnior, Alexandre

; Cintra, Alice F. U.

; Ximenes, Antônio Carlos

; Nuccitelli, Barbara

; Taliberti, Ben Hur

; Moreira, Caio

; von Mühlen, Carlos Alberto

; Bichara, Carlos David

; Santos, Cláudio Henrique Ramos dos

; Yano, Cristiane Martinez

; Mangueira, Cristóvão Luis Pitangueira

; Carvalho, Darlene Gonçalves

; Bonfá, Eloísa Silva Dutra de O.

; Doi, Elvira M.

; Guimarães, Fabiana Nunes de Carvalho

; Araújo, Flávia Ikeda e

; Mundim, Hugo Mendonça

; Rego, Jozelia

; Vieira, Lisiane Ericonio dos Anjos

; Poli, Luciana

; Andrade, Luís Eduardo Coelho

; Callado, Maria Roseli

; Mesquita, Mauro Meira

; Sugiyama, Mitiko

; Slhessarenko, Natasha

; Silva, Nilzio Antônio da

; Carballo, Orlando Gabriel

; Leser, Paulo Guilherme

; Francescantonio, Paulo Luiz Carvalho

; Jarach, Renata

; Xavier, Ricardo Machado

; Levy, Roger Abramino

; Neves, Suzane P. F.

; Cruvinel, Wilson de Melo

; Santos, Wilton Silva dos

Revista Brasileira de Reumatologia

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jun 2003, Volume 43 N. 3 Pages 129 - 140

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: O Segundo Consenso Brasileiro de Fator Antinuclear (FAN) em Células HEp-2 ratificou os algoritmos de decisão para leitura dos padrões do FAN na imunofluorescência indireta vistos na primeira edição do Consenso Brasileiro, adicionando ainda um novo algoritmo relacionado com os padrões mistos. MÉTODOS: Tendo em vista a habilidade do teste em detectar autoantígenos nos distintos compartimentos celulares, e não apenas no núcleo, propõe-se novas denominações para este exame laboratorial. RESULTADOS E CONCLUSÕES: Como novas denominações algumas sugestões foram igualmente aceitas, dentro do tema "pesquisa de auto-anticorpos contra constituintes do núcleo (FAN HEp-2), nucléolo, citoplasma e aparelho mitótico". Foram abordadas as principais relevâncias clínicas com os padrões de FAN descritos, facilitando o melhor uso do ensaio pelo médico.

OBJECTIVE: The Second Brazilian Consensus on Antinuclear Antibodies (ANA) in HEp-2 Cells approved and extended the decision trees developed during the First Brazilian Consensus in order to also offer information about mixed patterns of fluorescence. METHODS: Since this test elicits reactions not only to nuclear autoimmune antigens but also to different cell compartments, new denominations for the test were approved. Results and CONCLUSIONS: These new denominations encompass variations on the "autoantibody testing against the nucleus (ANA HEp-2), nucleolus, cytoplasm, and mitotic apparatus" issue. Furthermore, major clinical associations were described for each immunofluorescent pattern, facilitating the interpretation of laboratory results in the clinical practice.

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13.

Parinaud syndrome caused by Bartonella henselae: case report
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Yamashita, Carlos Alberto

; Mielle, Adriana

; Slhessarenko, Natasha

; Nascimento, Sérgio

; Gilio, Alfredo

; Pahl, Márcia

; Ejzenberg, Bernardo

; Baldacci, Evandro

; Okay, Yassuhiko

Revista do Instituto de Medicina Tropical de São Paulo

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dec 1996, Volume 38 N. 6 Pages 437 - 440

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Os autores relatam um caso do Síndrome de Parinaud (conjuntivite com adenite satélite pré-auricular) causada por Bartonella henselae, o agente etiológico da Doença da Arranhadura do Gato. O esclarecimento etiológico deste caso foi feito através da reação de imunofluorescência indireta o que permitiu um adequado enfoque terapêutico e acompanhamento do paciente, evitando o uso de antibióticos inadequados e intervenções cirúrgicas.

The authors report a case of Parinaud syndrome (conjunctivitis with pre-auricular satellite adenitis) caused by Bartonella henselae, the etiologic agent of Cat Scratch Disease. The etiologic assessment of this case was performed by serum indirect immunofluorescence reaction and allowed for a better therapeutics and follow up, avoiding ineffective antibiotics and surgical interventions.

2237 downloads Cited 3 times in SciELO

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