Abstract Piper amalago L., Piperaceae, popularly known as jaborandi-manso, is a shrub that spans a height of 2–7 m. It can be found in the regions of Southern America downward up to the south of Brazil. Traditionally it is used to treat digestive problems, heart problems, and burns. This study aims to conduct an anatomical investigation and analysis of the leaves and stems of P. amalago through electron scanning and optical micro techniques. The analysis showed that P. amalago has a hypostomatic leaf, with a subepidermal layer on its surface. There are grandular trichomes that resemble sacs, conic non-glandular trichomes, dorsiventral mesophyll, and a plano-convex midrib having a single vascular bundle in the center. The petiole is short with irregularly shaped and adaxially grooved. The stem is circular in shape and contains two circles of vascular bundles and a sclerenchymatic sheath in the perimedular region. These anatomical features of the Piper amalago's leaves and stems make it easy to pick it out among other species of the Piper genus. This is helpful when conducting quality control process.
The aim of the present study was to detect natural infection by Leishmania (Leishmania) infantum in Lutzomyia longipalpis captured in Barcarena, state of Pará, Brazil, through the use of three primer sets. With this approach, it is unnecessary to previously dissect the sandfly specimens. DNA of 280 Lu. longipalpis female specimens were extracted from the whole insects. PCR primers for kinetoplast minicircle DNA (kDNA), the mini-exon gene and the small subunit ribosomal RNA (SSU-rRNA) gene of Leishmania were used, generating fragments of 400 bp, 780 bp and 603 bp, respectively. Infection by the parasite was found with the kDNA primer in 8.6% of the cases, with the mini-exon gene primer in 7.1% of the cases and with the SSU-rRNA gene primer in 5.3% of the cases. These data show the importance of polymerase chain reaction as a tool for investigating the molecular epidemiology of visceral leishmaniasis by estimating the risk of disease transmission in endemic areas, with the kDNA primer representing the most reliable marker for the parasite.
To investigate the association of leprosy with hepatitis B virus (HBV) infection, as yet unknown for South Brazil, we assessed hepatitis B virus coinfection in 199 South Brazilian leprosy patients (119 lepromatous, 15 tuberculoid, 30 borderline, 12 undetermined and 23 unspecified) and in 681 matched blood donors by screening for the hepatitis B virus markers HBSAg and anti-HBc, using ELISA. Positive samples were retested and anti-HBc+ only samples were tested for the hepatitis B surface antibody (anti-HBs). There was a strong association between leprosy and hepatitis B virus infection (OR = 9.8, 95% CI = 6.4–14.7; p = 0.004·E−30), as well as an association between HBV infection and lepromatous leprosy, compared to other forms (OR = 2.4, 95% CI = 1.2–4.8; p = 0.017). We also found that confinement due to leprosy was associated with hepatitis B virus infection (OR = 3.9, 95% CI = 2.1–7.4; p = 0.015·E−3). Leprosy patients are susceptible to develop hepatitis B virus infection, especially lepromatous. Institutionalized patients, who probably present a stronger Th2 response, have higher risk of being exposed to hepatitis B virus. This clearly emphasizes the need for special care to leprosy patients in preventing hepatitis B virus coinfection in South Brazil.
INTRODUCTION: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease, which affects approximately 1% of the world's adult population. It is characterized by the inflammation of synovial tissue from multiple articulations, leading to tissue destruction, pain, deformities and reduced quality of life. RA etiology is complex and largely unknown, although studies support the influence of genetic and environmental factors on its pathogenesis. Due to its major genetic component, relatives from RA patients are part of the risk group, mainly as to the development of the most severe forms. In spite of its high disability risk, RA development can be affected through early diagnosis and adequate therapy. Nonetheless, its early diagnosis is still very demanding due to the heterogeneity of its clinical presentations, which delays therapeutic approach. RA treatment includes non-steroidal anti-inflammatory drugs, corticosteroids, disease-modifying antirheumatic drugs (DMARD), and immunobiologic agents. Furthermore, raising patient's awareness and developing psyco/occupational therapies are also part of the therapeutic approach. Currently, several studies focus on the identification of predictive factors for severe RA such as rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) autoantibodies, which are major immunological diagnostic and prognostic markers for RA. DISCUSSION AND CONCLUSION: Despite the fact that there has been substantial progress in the investigation, diagnosis and treatment of RA, there are still several challenges to be overcome.
INTRODUÇÃO: A artrite reumatoide (AR) é uma doença autoimune inflamatória e crônica que afeta aproximadamente 1% da população adulta mundial. A doença caracteriza-se pela inflamação do tecido sinovial de múltiplas articulações, levando a destruição tecidual, dor, deformidades e redução na qualidade de vida do paciente. Sua etiologia é complexa e em grande parte desconhecida, porém estudos demonstram a influência de fatores genéticos e ambientais em sua patogênese. Devido à forte influência genética, familiares de pacientes com AR formam um grupo de risco para o desenvolvimento da doença, principalmente em sua forma mais grave. Apesar de seu elevado potencial incapacitante, o curso da AR pode ser modificado por meio do diagnóstico precoce e do manejo adequado do paciente. No entanto, o diagnóstico precoce da AR é ainda bastante difícil diante da heterogeneidade das manifestações clínicas da doença, o que acaba retardando a implantação terapêutica. O tratamento da AR baseia-se no uso de anti-inflamatórios não esteroidais (AINEs), corticosteroides, drogas antirreumáticas modificadoras do curso da doença (DMARD) e agentes imunobiológicos. Além da terapia medicamentosa, também são adotadas medidas como educação do paciente e terapias psico-ocupacionais. Atualmente, estudos têm se voltado à identificação de fatores preditores de doença mais grave, como autoanticorpos como fator reumatoide (FR) e anticorpo antipeptídio cíclico citrulinado (anti-CCP), que constituem importantes marcadores imunológicos de diagnóstico e prognóstico da AR. DISCUSSÃO E CONCLUSÃO: Apesar dos significativos avanços tanto no entendimento como no diagnóstico e no tratamento da AR, ainda persistem inúmeros desafios a serem superados.
The objective of this study was to evaluate the susceptibility to cefepime of a large group of ESBL- producing enterobacteria recently isolated in a Brazilian teaching hospital . The study included 280 strains of ESBL-producing enterobacteria, isolated between 2005 and 2008. The presence of the genes blaCTX-M, blaTEM and blaSHV was determined by PCR and confirmed by nucleotide sequencing. Susceptibility testing for cefepime was performed by disc-diffusion, agar dilution method and E-test®. Among the isolates, 34 (12.1%) presented a cefepime inhibition zone > 21 and MIC < 8 mg/L by agar dilution and E-strip methods. The use of cefepime for the treatment of infections caused by ESBL-producing bacteria has been controversial. Some studies of PD/PK show the probability of achieving the required PD parameters for cefepime, when the MICs were < 8 mg/L, whereas others have reported therapeutic failure with the same MIC. Additional data is essential to come to terms about the report and treatment with cefepime in ESBL-producing organisms especially when these microorganisms are isolated from sterile sites and from critically ill patients.
This report describes a cross-sectional survey on the prevalence of hepatitis C antibodies (anti-HCV) in Tamboara, a small community in the northwest area from Paraná State, south of Brazil with a high rate of accumulated detection for HCV. Eight hundred and sixteen residents (17.87% from all the population), independently of the age and time living in Tamboara were included in this study by an epidemiologic questionnaire and by testing for anti-HCV. The rapid immuno-chromatographic test was applied for detection of HCV antibodies. The anti-HCV prevalence by rapid test was 4.28%. The median age for positive and negative test was 60.49 ± 14.14 and 41.67 ± 20.25, respectively (p < 0.001). By multivariate analysis, only familial history of hepatitis (p = 0.001; OR = 6.41; CI 95% = 2.08-19.78) and age (p = 0.007; OR 1.06;95% CI = 1.02-1.10) showed statistical significance for positive anti-HCV. The rapid test sensitivity and specificity were 100% and 92.7% respectively, with an accuracy of 95.8% (95% CI = 91-100). These findings demonstrated a high prevalence of anti-HCV in Tamboara. The familial history of hepatitis was a significant risk factor to the infection and HCV rapid test showed to be accurate and feasible for epidemiological survey
OBJECTIVE: To evaluate the thyroid stimulating hormone (TSH) levels and the presence of antithyroperoxidase antibody (anti-TPO) in Down’s syndrome (DS) patients from Hospital de Clínicas of Universidade Federal do Paraná (HC/UFPR). METHODS: Seventy-two DS patients, non-related and consecutively selected (mean age 6.15) were included in the study. Eighty matched healthy children were used as controls. The TSH measurement and the anti-TPO were determined by immunometric assay in all samples. RESULTS: Thirty patients with DS (42.9%) presented abnormal levels of TSH; 4.3% showed values below 0.5µIU/ml and 38.6% presented values higher than 5µIU/ml (range 5.1-22; mean 5.56 ± 4.18µIU/ml). The mean concentration of TSH in the controls was 2.76 ± 1.14µIU/ml, indicating a significant increase in TSH levels in the DS patients (p < 0.001). Similarly, a significant difference was observed in the anti-TPO positivity in the patients’ group (15.4%) when compared with the controls (0%; p < 0.001). In addition, the TSH levels of patients older than 9 years presented a significant increase (mean of 6.86 ± 4.6µIU/ml) when compared with the levels observed in patients younger than 9 years (mean of 5.24 ± 3.81µIU/ml; p = 0.006). The same pattern was observed in the positivity of anti-TPO (6/20 vs. 5/52; p = 0.041). CONCLUSIONS: The results demonstrated high prevalence of elevated TSH and anti-TPO in the patients from the DS ambulatory of HC/UFPR, with increased frequency in those older than 9 years. The data indicate that the evaluation of thyroid function in DS patients must receive special attention from health professionals who take care of these patients.
OBJETIVO: Determinar as concentrações de hormônio estimulante da tireóide (TSH) e a presença de anticorpos antitireoperoxidase (anti-TPO) em pacientes com síndrome de Down (SD) atendidos no ambulatório do Hospital de Clínicas da Universidade Federal do Paraná. MÉTODOS: Foram incluídos no estudo 72 pacientes com SD, não aparentados e selecionados consecutivamente, com média de idade de 6,15 anos. Oitenta crianças sadias, pareadas com os pacientes, foram utilizadas como controles. Em todas as amostras foram determinadas as concentrações séricas de TSH e de anti-TPO, através do método de dosagem imunométrica. RESULTADOS: Trinta pacientes com SD (42,9%) apresentaram alterações nas concentrações de TSH, sendo que 4,3% tinham valores menores que 0,5µUI/ml e 38,6%, valores superiores a 5µUI/ml (5,1 a 22) (média de 5,56 ± 4,18µUI/ml). Nos controles, a concentração média de TSH foi 2,76µUI/ml (± 1,14), evidenciando-se um aumento significativo nos níveis de TSH nos pacientes com SD (p < 0,001). De forma similar, caracterizou-se uma diferença significativa na positividade para o anti-TPO nos pacientes (15,4%) em relação aos controles (0%; p < 0,001). Observou-se ainda aumento significativo nas concentrações de TSH nos pacientes com idade superior a 9 anos (média de 6,86 ± 4,6µUI/ml) quando comparados aos menores de 9 anos (média de 5,24 ± 3,81µUI/ml; p = 0,006), bem como na positividade do anti-TPO (6/20 vs. 5/52; p = 0,041). CONCLUSÕES: Os resultados demonstraram alta prevalência de alterações das dosagens de TSH e de doença tireoidiana nos pacientes com SD, principalmente naqueles com idade superior a 9 anos. Os dados indicam que a avaliação da função tireoidiana nos pacientes com SD deve receber atenção especial dos profissionais de saúde que atendem esses pacientes.
OBJECTIVES: High prevalence rates of celiac disease in patients with Down syndrome have been reported in several countries. However, in Brazil there are no data regarding this association. In this study we report the prevalence of celiac disease in Down syndrome children and adolescents from southern Brazil. METHODS: Seventy-one patients (32 female and 39 male, 2-18 years) from Curitiba, Brazil, were studied. Eighty young people (42 male and 38 female, 2-19 years) were used as controls. All subjects were screened for the IgA-antiendomysium antibody (EmA) and IgA anti-tecidual transglutaminase (anti-tTG). EmA was measured by an immunofluorescence assay using umbilical cord as the substrate and anti-tTG by ELISA with tecidual transglutaminase as the antigen. The total IgA serum level was determined by turbidimetry. RESULTS: Five DS patients (7%) were positive for EmA-IgA, with titers from 1/5 to 1/80 and 14 (17.5%) for anti-tTG (21-340 units). All EmA positive patients also presented anti-tTG antibodies simultaneously. Clinical and histological findings of the intestinal mucosa confirmed celiac disease diagnoses in four patients. The other EmA positive patient was asymptomatic and was not submitted to duodenal biopsy. Patients only positive for anti-tTG presented borderline values (< 25 units) and were asymptomatic. None of the controls were positive for EmA or anti-tTG. No Down syndrome patients or controls presented IgA deficiency. CONCLUSIONS: These data indicate a high prevalence (5.6%) of confirmed celiac disease in Down syndrome patients from southern Brazil.
OBJETIVOS: Alta prevalência de doença celíaca em pacientes com síndrome de Down tem sido descrita em vários países. No entanto, no Brasil ainda não há relatos mostrando essa associação. O presente estudo teve como objetivo avaliar a prevalência de doença celíaca em crianças e adolescentes com síndrome de Down no sul do Brasil. MÉTODOS: Setenta e um pacientes (32 do sexo feminino e 39 masculino, 2-18 anos) provenientes de Curitiba, Brasil, foram estudados. Oitenta indivíduos (42 do sexo masculino e 38 feminino, 2-19 anos) foram utilizados como controles do estudo. Todas as amostras foram investigadas para anticorpo anti-endomísio (EmA) e anti-transglutaminase tecidual (anti-tTG). O EmA foi pesquisado através de imunofluorescência indireta usando cordão umbilical como substrato e o anti-tTG através da técnica de ELISA, utilizando transglutaminase tecidual como antígeno. As dosagens de IgA foram realizadas por turbidimetria. RESULTADOS: Cinco pacientes com síndrome de Down (7%) foram positivos para EmA-IgA, com títulos entre 1/5 e 1/80 e catorze (17,5%) para anti-tTG (21-340 unidades). Todos os pacientes positivos para EmA apresentaram simultaneamente positividade para o anti-tTG. Os achados clínicos e histológicos na mucosa intestinal confirmaram doença celíaca em quatro pacientes. O outro paciente EmA positivo não foi submetido a biópsia duodenal. Os pacientes positivos apenas para anti-tTG apresentaram valores limítrofes (< 25 unidades) e eram assintomáticos. Nenhum indivíduo do grupo controle foi positivo para EmA ou anti-tTG. Nenhuma amostra do estudo foi deficiente para IgA. CONCLUSÕES: Os dados do presente estudo mostram alta prevalência (5,6%) de doença celíaca confirmada em crianças e adolescentes com síndrome de Down da região sul do Brasil.
The microbiota from the uniforms of 31 professionals from the general intensive care unit was analyzed. The samples were collected in duplicate at the beginning and at the end of the work period. Total viable counts of microorganisms were determined; there was a significant increase in the counts at the end of the period, when compared with those obtained at the beginning. No significant difference was observed between the first and second counts obtained from the cuffs. However, differences were observed for the samples from the abdominal region. Among the isolated pathogens 11/18 were Staphylococcus aureus, 2/18 were Acinetobacter baumannii, 2/18 were Klebsiela pneumoniae and 1/18 were Serratia rubidae. Some of these isolates were multi-resistant to antibiotics. Emphasis should be placed on reducing the spread of these pathogens in the hospital, making sure that biosafety protocols are followed by the staff.
Background — Cell death by apoptosis is a fundamental biologic process involved in many physiologic and pathophysiologic processes in the liver. Objective — To review the process of apoptosis, its cellular mechanisms, its regulation by external factors, and its role in pathophysiologic process and specific diseases of the liver. Conclusion — An understanding of the cellular mechanisms of apoptosis and their dysregulation during pathophysiologic disturbances will help in understanding human liver diseases. The modulation of apoptosis may lead to novel therapeutic strategies for the treatment of a wide range of liver diseases.
Racional — A morte celular por apoptose é processo biológico fundamental envolvido em muitos eventos fisiológicos e fisiopatológicos no fígado. Objetivo — Revisar o processo da apoptose, seus mecanismos celulares, sua regulação por fatores externos e sua participação em várias doenças hepatobiliares. Conclusão — O conhecimento dos mecanismos celulares da apoptose, bem como seus desequilíbrios durante distúrbios fisiopatológicos possibilitam melhor compreensão das doenças que afetam o fígado e vias biliares. A inibição farmacológica da apoptose ou sua indução podem oferecer grandes perspectivas no tratamento de doenças nas quais ocorra desequilíbrio no processo natural de morte celular.