ABSTRACT
Early diagnosis plays a vital role in controlling tuberculosis. The conventional methodology is slow, with results taking several weeks, in addition to having low sensitivity, especially in clinical paucibacillary samples. The objective of this study was to evaluate the use of polymerase chain reaction (PCR) on solid medium culture for a rapid diagnosis of tuberculosis, mainly in cases of negative sputum smears. Forty sputum samples were collected from inpatients with tuberculosis treated for less than 2 days. Bacilloscopy, PCR for sputum, culture on Lõwestein-Jensen (LJ) solid medium, and daily PCR from culture were performed on each sample. DNA extracted from the BCG vaccine, which contains attenuated bacillus Calmette-Guérin, was used as the positive control. Smear microscopy showed 68.6 percent sensitivity, 80 percent specificity, 96 percent positive predictive value, and 26.7 percent negative predictive value, with culture on LJ medium as the gold standard. Culture at day 28 showed 74.3 percent sensitivity and 100 percent specificity. PCR of DNA extracted from sputum amplified a 1027-bp fragment of the 16s RNA gene, showing 22.9 percent sensitivity and 60 percent specificity. PCR performed with DNA extracted from daily culture showed that, from the 17th to the 40th day, the sensitivity (85.7 percent) and specificity (60 percent) were constant. We conclude that a 17-day culture is a good choice for rapid diagnosis and to interfere with the transmission chain of tuberculosis.
Subject(s)
Humans , DNA, Bacterial/analysis , Mycobacterium tuberculosis/genetics , Polymerase Chain Reaction/methods , Sputum/microbiology , Tuberculosis, Pulmonary/diagnosis , Culture Media , Early Diagnosis , Predictive Value of Tests , Sensitivity and Specificity , Time FactorsABSTRACT
Aluminum (Al3+) overload is frequently associated with lipid peroxidation and neurological disorders. Aluminum accumulation is also reported to be related to renal impairment, anemia and other clinical complications in hemodialysis patients. The aim of the present study was to determine the degree of lipid peroxidation, platelet aggregation and serum aluminum in patients receiving regular hemodialytic treatment. The level of plasma lipid peroxidation was evaluated on the basis of thiobarbituric acid reactive substances (TBARS). Mean platelet peroxidation in patients undergoing hemodialysis was significantly higher than in normal controls (2.7 ± 0.03 vs 1.8 ± 0.06 nmol/l, P<0.05). Platelet aggregation and serum aluminum levels were determined by a turbidimetric method and atomic absorption spectrophotometry, respectively. Serum aluminum was significantly higher in patients than in normal controls (44.5 ± 29 vs 10.8 ± 2.5 æg/l, P<0.05). Human blood platelets were stimulated with collagen (2.2 æg/ml), adenosine diphosphate (6 æM) and epinephrine (6 æM) and showed reduced function with the three agonists utilized. No correlation between aluminum levels and platelet aggregation or between aluminum and peroxidation was observed in hemodialyzed patients
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aluminum , Kidney Failure, Chronic , Platelet Aggregation , Aluminum , Case-Control Studies , Lipid Peroxidation , Lipid Peroxides , Renal Dialysis , Thiobarbituric Acid Reactive SubstancesABSTRACT
Os autores relatam um caso de histoplasmose em indivíduo com suspeita clínica de leishmaniose mucosa. A infecção por Leishmania foi descartada, pela negatividade do teste de Montenegro e ausência do parasita. O diagnóstico de histoplasmose foi confirmado pelo encontro do fungo na lesão e o seu isolamento em Ágar-Sabouraud. O tratamento do paciente com anfotericina B resultou na remissão da lesão.
A case of histoplasmosis at the oral cavity simulating mucocutaneous leishmaniasis is reported. The initial suspicion of leishmaniasis was not confirmed due to lack of amastigotes and no reactivity of the Montenegro's skin test. Diagnosis of histoplasmosis was done by Grocott's stained smears and isolation of Histoplasma capsulatum in Sabouraud's-agar slants. Treatment with Amphoterecin B led to complete remission of the lesion.
Subject(s)
Humans , Male , Middle Aged , Histoplasmosis/diagnosis , Leishmaniasis, Mucocutaneous/diagnosis , Palate , Diagnosis, Differential , Mouth Diseases/diagnosisABSTRACT
Introducción. las infecciones nosocomiales (IN) por bacilos gramnegativos no fermentadores (BGNNF) son un problema creciente, por lo que es importante el conocimiento de sus características epidemiológicas, así como su patrón de resistencia. Material y métodos. Se realizó un estudio descriptivo que incluyó 52 episodios de infecciones nosocomiales por BGNNF durante 1994; los patrones de resistencia antimicrobiana se determinaron por la técnica de Kirby-Bauer. Resultados. Se encontró que de las 870 infecciones nosocomiales reportadas durante 1994, 52 correspondieron a BGNNF (5.9 por ciento). Los principales agentes involucrados fueron Pseudomona aeruginosa en 45 casos, seguido de B. cepacia en 4, P. fluorescens en 3 y Acinetobacter spp. en 3 casos. Las neumonías representaron el principal tipo de infección en el 34 por ciento de los casos. Se encontró una resistencia importante para antibióticos de primera elección. Conclusiones. Los BGNNF, principalmente Pseudomonas, son causa frecuente de neumonía nosocomial. Dado su patrón de resistencia, pueden ser de difícil manejo clínico. Es necesario diseñar un estudio para determinar su pronóstico.
Subject(s)
Humans , Infant , Child, Preschool , Child , Drug Resistance, Microbial , Gram-Negative Bacterial Infections/epidemiology , Gram-Negative Bacteria/pathogenicity , Cross Infection/epidemiology , Cross Infection/etiology , Cross Infection/microbiology , MexicoABSTRACT
Com o objetivo de avaliar a prevalência de infecçäo pelo HTLV-I e sua associaçäo a paraparesia espática tropical na Bahia, foram estudadas amostras de líquido céfalorraqueano (LCR) e/ou soro de pacientes com esta doença e de outros grupos de indivíduos. Os resultados indicam que mulheres säo mais afetadas pela doença associada à infecçäo pelo HTLV-I que os homens. Algumas alteraçöes do exame do LCR podem sugerir infecçäo pelo HTLV-I em pacientes com paraparesia espática tropical
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Human T-lymphotropic virus 1/pathogenicity , Paraparesis, Tropical Spastic , Black People , Brazil , Paraparesis, Tropical Spastic/cerebrospinal fluid , Paraparesis, Tropical Spastic/blood , Prevalence , Sex FactorsABSTRACT
Os soros de 472 brasileiros, confirmados como sendo positivos ou negativos em relacao a presenca de anticorpos anti-HIV e compreendendo todo o espectro clinico da infeccao, foram utilizados na avaliaco de seis ensaios imunoenzimaticos comerciais (ELISA), bem como de quatro testes alternativos tais como imunofluorescencia indireta (IFI), hemaglutinacao passiva (HP), dot blot e Karpas AIDS cell test. As sensibilidades variaram de 100 por cento (ELISA Abbott e Roche) a 84,2 por cento (HP) e as especificidades variaram de 99,3 por cento (IFI) a 80,2 por cento (HP). A sensibilidade e especificidade da HP e a sensibilidade do Karpas AIDS cell test foram significativamente menores que os outros ensaios. Embora a IFI e o dot blot tivessem apresentado uma boa sensibilidade e especificidade, os ensaios imunoenzimaticos (ELISA) foram mais adequados para serem utilizados em triagem quando outros parametros tais como facilidade de leitura e interpretacao dos resultados e duracao dos ensaios foram considerados