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1.
Arq. ciências saúde UNIPAR ; 24(3): 133-138, set-dez. 2020.
Article in Portuguese | LILACS | ID: biblio-1129455

ABSTRACT

Quando um indivíduo é exposto a antígenos eritrocitários não próprios, ocorre uma resposta imunológica, que leva à produção de anticorpos irregulares voltados contra esses antígenos. Esse processo é conhecido como aloimunização eritrocitária e acontece em decorrência de transfusões de sangue ou gestações incompatíveis. Na medicina transfusional a pesquisa de anticorpos irregulares é fundamental, pois a falha na detecção de um aloanticorpo pode provocar reações transfusionais, aloimunizações, anemias hemolíticas autoimunes e doença hemolítica perinatal. Este estudo tem por objetivo analisar a frequência de anticorpos irregulares de pacientes atendidos no Hemocentro Regional de Francisco Beltrão, Paraná, no ano de 2017. Os dados foram coletados a partir da revisão de registros em arquivos do Laboratório de Imunohematologia do Hemonúcleo. Foram avaliados dados de 49 protocolos de pacientes que apresentaram dificuldades transfusionais no ano de 2017. Dentre os pesquisados, 37 pacientes (75,5%) apresentaram anticorpos irregulares. Dentre os anticorpos anti-eritrocitários observados neste estudo, evidenciou-se a presença de doze pacientes com anti-D (27,2%), seis pacientes com anti-K (13,6%), quatro pacientes com anti-C (9,0%) e em seis pacientes (13,6%) foi observada a presença de autoanticorpos. Este estudo indica que, nos pacientes transfundidos, os anticorpos mais frequentes foram os aloanticorpos Anti-D do Sistema Rh, provavelmente devido ao seu alto grau de imunogenicidade. A prevalência desses anticorpos é semelhante a vários estudos encontrados na literatura.


When an individual is exposed to not-self red blood cell antigens, an immune response occurs, which leads to the production of irregular antibodies directed against these antigens. This process is known as erythrocyte alloimmunization and occurs as a result of blood transfusions or incompatible pregnancies. In transfusion medicine, the search for irregular antibodies is essential, since failure to detect an alloantibody can cause transfusion reactions, alloimmunizations, autoimmune hemolytic anemias, and perinatal hemolytic disease. This study aims at analyzing the frequency of irregular antibodies of patients seen at the Regional Blood Center of Francisco Beltrão, Paraná, in 2017. The data were collected from the review of records in files of the Immunohematology Laboratory of Hemonúcleo. Data from 49 protocols of patients who had transfusion difficulties in 2017 were evaluated. Among those surveyed, 37 patients (75.5%) had irregular antibodies. Among the anti-erythrocyte antibodies observed in this study, the presence of twelve patients with anti-D (27.2%), six patients with anti-K (13.6%), four patients with anti-C (9.0 %), and in six patients (13.6%) with the presence of autoantibodies were observed. This study indicates that, in transfused patients, the most frequent antibodies were the Rh System Anti-D alloantibodies, probably due to their high degree of immunogenicity. The prevalence of these antibodies is similar to several studies found in the literature.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Autoantibodies/immunology , Isoantibodies/immunology , Autoantibodies/isolation & purification , Blood Transfusion , Retrospective Studies , Sex Distribution , Age Distribution , Erythrocytes/immunology , Transfusion Reaction/immunology , Isoantibodies/isolation & purification , Antibodies/isolation & purification , Antibodies/immunology
2.
Rev. Soc. Bras. Med. Trop ; 52: e20180473, 2019. tab
Article in English | LILACS | ID: biblio-990445

ABSTRACT

Abstract INTRODUCTION: Candidiasis is the most frequent opportunistic mycosis in humans and can cause mortality, particularly in immunodeficient patients. One major concern is the increasing number of infections caused by drug-resistant Candidas trains, as these cannot be efficiently treated with standard therapeutics. The most common mechanism of fluconazole resistance in Candida is mutation of ERG11, a gene involved in the biosynthesis of ergosterol, a compound essential for cell integrity and membrane function. METHODS: Based on this knowledge, we investigated polymorphisms in the ERG11 gene of 3 Candida species isolated from immunocompromised and immunocompetent patients. In addition, we correlated the genetic data with the fluconazole susceptibility profile of the Candida isolates. RESULTS: A total of 80 Candida albicans, 8 Candida tropicalis and 6 Candida glabrata isolates were obtained from the saliva of diabetic, kidney transplant and immunocompetent patients. Isolates were considered susceptible to fluconazole if the minimum inhibitory concentration was lower than 8 μg/mL. The amino acid mutations F105L, D116E, K119N, S137L, and K128T were observed in C. albicans isolates, and T224C and G263A were found in C. tropicalis isolates. CONCLUSIONS: Despite the high number of polymorphisms observed, the mutations occurred in regions that are not predicted to interfere with ergosterol synthesis, and therefore are not related to fluconazole resistance.


Subject(s)
Humans , Male , Female , Adult , Aged , Polymorphism, Genetic/drug effects , Candida/drug effects , Candida/genetics , Fluconazole/pharmacology , Kidney Transplantation , Diabetes Mellitus/microbiology , Antifungal Agents/pharmacology , Reference Values , Saliva/microbiology , Candida/isolation & purification , DNA, Fungal/genetics , Microbial Sensitivity Tests , Polymerase Chain Reaction , Drug Resistance, Fungal/genetics , Immunocompetence , Middle Aged , Mutation/drug effects
3.
Arq. ciências saúde UNIPAR ; 22(3): 171-175, Set-Dez. 2018.
Article in Portuguese | LILACS | ID: biblio-915548

ABSTRACT

O gênero Candida compreende leveduras redondas ou ovaladas que acarretam em uma diversidade de infecções que recebem o nome de candidíase. O curso dessas infecções depende muito do sistema imunológico do indivíduo. Candida albicans é a principal espécie envolvida em infecções no ser humano. Estudos indicam que esta espécie é responsável por 60% dos isolados de amostras clínicas. As infecções fúngicas causadas por leveduras do gênero Candida são frequentemente tratadas com antifúngicos azólicos, principalmente, o fluconazol. A resistência a agentes antifúngicos, como a que acontece com o fluconazol, pode ter diferentes origens, dentre elas cita-se a alteração da enzima alvo, que por consequência diminui a ligação do fármaco, redução dos efeitos tóxicos da droga, aumento da quantidade de enzima alvo ou também pela acumulação intracelular da droga. Neste contexto, esta pesquisa avaliou o perfil de sensibilidade de isolados de Candida albicans frente ao fluconazol, com diferentes grupos de pacientes e diferentes sítios anatômicos. A avaliação da suscetibilidade das leveduras com determinação da Concentração Inibitória Mínima (CIM) ao fluconazol foi realizada utilizando - se o E-test em ágar Mueller-Hinton suplementado, seguindo o documento M44-A2, do Clinical and Laboratory Standards Institute (CLSI). Os critérios para a classificação dos padrões de suscetibilidade seguiram o documento M27-A3. Nesta pesquisa foi constatado que 100% dos isolados de Candida albicans eram sensíveis ao fluconazol e que não houve diferença estatística nos valores de CIM, quando confrontado ao gênero, faixa etária, tipo de paciente, a única diferença encontrada nos valores de CIM, ocorreu quando se comparou ao sitio anatômico, pois os isolados de corrente sanguínea apresentaram os maiores valores de concentração inibitória mínima frente ao fluconazol.


The Candida genus comprises gram-positive round or oval yeasts, which lead to a diversity of infections known as candidiasis. The course of such infections depends greatly on the individual's immune system. Candida albicans is the main species involved in the infection in humans. Studies indicate that this species is responsible for 60% of isolates from clinical samples. Fungal infections caused by yeasts of the Candida genus are often treated with azole antifungals, mainly fluconazole. Resistance to antifungal agents such as fluconazole can have different origins, among which the alteration of the target enzyme, which consequently decreases the drug's binding, the reduction in the toxic effects of the drug, the increase in the amount of enzyme or intracellular accumulation of the drug. Within this context, this study assessed the sensitivity profile of Candida albicans isolates against fluconazole, with different patient groups and different anatomical sites. The assessment of yeast susceptibility with the Minimum Inhibitory Concentration (MIC) to fluconazole determined using the E-test on supplemented Mueller-Hinton agar, following the M44-A2 document from the Clinical and Laboratory Standards Institute (CLSI). The susceptibility patterns were classified according to criteria in document M27-A3. In this study, 100% of Candida albicans isolates were sensitive to fluconazole, and no statistical difference were presented in MIC values when compared to gender, age and patient type, with the only difference found in MIC values occurring when compared to the anatomical site, since bloodstream isolates presented the highest values of minimum inhibitory concentration against fluconazole.


Subject(s)
Candida , Fluconazole , Disease Resistance
4.
Ciênc. cuid. saúde ; 17(1)jan.-mar. 2018.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-979718

ABSTRACT

O objetivo foi identificar o conhecimento dos profissionais do pré-natal sobre o manejo da sífilis gestacionalna atenção primária. Estudo transversal, descritivo, de natureza quantitativa, realizado com 43 profissionais. A coleta realizou-se entre julho e agosto de 2017, utilizando-se um questionário autoaplicado, elaborado com base nos protocolos do Ministério da Saúde para o manejo de sífilis gestacional. Os dados foram digitados e tabulados no Microsoft Excel 2010®, e analisados no software Statistical Package for the Social Science (SPSS). A maioria dos profissionais tinha mais de cinco anos de formação (72,1%)e de atuação na área, (44,2%)e 67,4% afirmaram já ter feito treinamento em sífilis. Quanto ao medicamento alternativo em caso de alergia à penicilina, 34,8% escolheriam fármacos com alto potencial teratogênico. Para 74,4%, a principal dificuldade foi a falta de adesão do parceiro ao tratamento, e entre as estratégias sugeridas destacou-se a educação continuada para a equipe (86,0%). A partir da pesquisa, identificou-se que os profissionais apresentaram algumas dificuldades no diagnóstico e tratamento da sífilis na gestação, o que pode justificar-se pela ausência de consenso entre os profissionais e gestores de saúde quanto ao estabelecimento de um único protocolo no município, sendo a principal dificuldade apresentada na assistência pela equipe, a falta de adesão do parceiro.[AU]


The objective was to identify the knowledge of professionals on the management of prenatal syphilis dates in primary care. Cross-sectional study, descriptive, quantitative in nature, carried out with 43 professionals. The collection took place between July and August of 2017, using a self-applied questionnaire, prepared based on protocols of the Ministry of health for the management of syphilis-dates. The data were entered and tabulated in Microsoft Excel ® 2010, and analyzed in the software Statistical Package for the Social Science (SPSS). Most professionals had more than five years (72.1%) and activities in the area, (44.2%) and 67.4% said you've done training in syphilis. As for alternative medicine in case of allergy to penicillin, 34.8% would choose drugs with high potential teratogenic. To 74.4%, the main difficulty was the lack of adherence to treatment, partner and between the suggested strategies was to continuing education for the team (86.0%). From the survey, it was identified that the professionals presented some difficulties in diagnosis and treatment of syphilis in pregnancy, which can be justified by the absence of consensus among the professionals and health managers about the establishment of a single protocol on the municipality, being the main difficulty presented in assistance by the team, the lack of adhesion of the partner.[AU]


El objetivo fue identificar el conocimiento de los profesionales del prenatal sobre el control de la sífilis gestacional en la atención primaria. Estudio transversal, descriptivo, de naturaleza cuantitativa, realizado con 43 profesionales. La recolección fue realizada entre julio y agosto de 2017, utilizándose un cuestionario autoaplicado, elaborado con base en los protocolos del Ministerio de la Salud para el control de sífilis gestacional. Los datos fueron digitados y tabulados en el Microsoft Excel 2010®, y analizados en el software Statistical Package for the Social Science (SPSS). La mayoría de los profesionales tenía más de cinco años de formación (72,1%) y de actuación en el área, (44,2%) y 67,4% afirmaron ya haber hecho entrenamiento en sífilis. En cuanto al medicamento alternativo en caso de alergia a la penicilina, 34,8% eligieron fármacos con alto potencial teratogénico. Para 74,4%, la principal dificultad fue la falta de adhesión del compañero al tratamiento, y entre las estrategias sugeridas se destacó la educación continuada para el equipo (86,0%). A partir de la investigación, se identificó que los profesionales presentaron algunas dificultades en el diagnóstico y tratamiento de la sífilis en la gestación, lo que puede justificarse por la ausencia de consenso entre los profesionales y gestores de salud en cuanto al establecimiento de un único protocolo en el municipio, siendo la principal dificultad presentada en la asistencia por el equipo, la falta de adhesión del compañero.[AU]


Subject(s)
Syphilis , Clinical Protocols , Prenatal Care , Primary Health Care , Health Education , Cross-Sectional Studies
5.
Hig. aliment ; 30(258/259): 73-77, 30/08/2016. ilus, tab
Article in Portuguese | LILACS | ID: biblio-2555

ABSTRACT

Surtos de doenças de origem alimentar ocorrem constantemente e constituem um problema de saúde pública no mundo. Nos restaurantes comerciais o processo de pré-lavagem e lavagem dos utensílios é feito com o auxílio de esponjas, objetivando eliminar resíduos de alimentos. Dessa forma, as esponjas se transformam em uma fonte de micro-organismos patogênicos, promovendo contaminação cruzada entre superfícies variadas e os alimentos. Os objetivos deste estudo foram avaliar a contaminação microbiológica e a eficácia de dois procedimentos de desinfecção de esponjas utilizadas em serviços de alimentação. Assim, neste trabalho foram avaliadas, sob o aspecto microbiológico, esponjas utilizadas em 9 restaurantes comerciais da cidade de Marmeleiro - PR. As esponjas foram coletadas após terem sido naturalmente contaminadas e, em seguida, encaminhadas ao laboratório de análises microbiológicas onde foram divididas em três partes iguais. Uma das partes foi submetida à contagem de coliformes totais e coliformes termotolerantes, as outras duas foram submetidas, separadamente, à fervura em água durante cinco minutos e à desinfecção por hipoclorito de sódio 200ppm, por 10 minutos, seguida de enxágue com água potável, quando foram analisadas seguindo os critérios da primeira parte. Os resultados demonstraram que, das 9 amostras de esponjas, 77,77% estavam contaminadas por coliformes totais e 44,44% estavam contaminadas por coliformes termotolerantes, demonstrando assim o risco à saúde por contaminação cruzada. Ambos os procedimentos de desinfecção foram capazes de reduzir significativamente as contagens bacterianas, porém a fervura demonstrou redução de 100% da carga microbiológica em relação à desinfecção por hipoclorito de sódio a 200ppm. Portanto qualquer medida no sentido de higienizar essas esponjas seria de grande valia na redução do potencial de risco das mesmas quanto a possíveis contaminações.


Evaluation of the microbiologic contamination of sponges used in feeding services in the city of Marmeleiro/PR - Brazil Disease outbreaks by food-borne happen constantly and constitute a public health issue around the world. In the commercial restaurants, the cookware pre-washing and washing process is made with the assistance of sponges, in order to remove food residues. In that way, the sponges become a source of pathogenic microorganisms, promoting cross contamination among several surfaces for food. The goals of this study were evaluate the microbiologic contamination and the effectiveness of two sponge disinfection procedures used in feeding service. Therefore, in this work were evaluated, under the microbiologic aspect, sponges used in 9 commercial restaurants, located in the city of Marmeleiro/PR ­ Brazil. The sponges were collected after being naturally contaminated and then sent to the microbiologic analysis laboratory, where they were divided in tree equal shares. One part was submitted to a total and faecal coliform counting, the other two parts were submitted, separately, to water boiling during five minutes and to the 200 ppm sodium hypochlorite disinfection, for ten minutes, added with drinking water rinse, where they were analyzed following the criteria from the first part. The results demonstrated that from the nine sponge samples, 77,77% were contaminated by total coliforms and 44,44% were contaminated by faecal coliforms, showing that way the risk to the human health by cross contamination. Both disinfection procedures were capable to reduce significantly the bacterial counting, but the water boiling demonstrated 100% of microbiologic load reduction, instead of the 200 ppm sodium hypochlorite disinfection. Therefore any measure intended to sanitize those sponges would have great value in the reduction of the potential sponge contamination risks.


Subject(s)
Restaurants , Disinfection/methods , Environmental Pollution/analysis , Cooking and Eating Utensils , Food Services , Brazil , Microbiological Techniques , Health Risk , Escherichia coli/isolation & purification , Coliforms
6.
Mem. Inst. Oswaldo Cruz ; 111(7): 417-422, tab, graf
Article in English | LILACS | ID: lil-787553

ABSTRACT

Yeasts of the genus Candida have high genetic variability and are the most common opportunistic pathogenic fungi in humans. In this study, we evaluated the genetic diversity among 120 isolates of Candida spp. obtained from diabetic patients, kidney transplant recipients and patients without any immune deficiencies from Paraná state, Brazil. The analysis was performed using the ITS1-5.8S-ITS2 region and a partial sequence of 28S rDNA. In the phylogenetic analysis, we observed a consistent separation of the species C. albicans, C. dubliniensis, C. glabrata, C. tropicalis, C. parapsilosis, C. metapsilosis and C. orthopsilosis, however with low intraspecific variability. In the analysis of the C. albicans species, two clades were formed. Clade A included the largest number of isolates (91.2%) and the majority of isolates from GenBank (71.4%). The phylogenetic analysis showed low intraspecific genetic diversity, and the genetic polymorphisms between C. albicans isolates were similar to genetic divergence found in other studies performed with isolates from Brazil. This low genetic diversity of isolates can be explained by the geographic proximity of the patients evaluated. It was observed that yeast colonisation was highest in renal transplant recipients and diabetic patients and that C. albicans was the species most frequently isolated.


Subject(s)
Humans , Male , Female , Candida/genetics , Candidiasis, Invasive/genetics , Diabetes Mellitus/microbiology , Genetic Variation , Kidney Transplantation , Brazil/epidemiology , Candida/classification , Candida/isolation & purification , Candidiasis, Invasive/classification , Candidiasis, Invasive/epidemiology , Candidiasis, Invasive/microbiology , Case-Control Studies , Diabetes Complications , DNA, Fungal/analysis , DNA, Ribosomal/genetics , Microbial Sensitivity Tests
7.
Rev. bras. anal. clin ; 40(4): 293-295, 2008. tab
Article in Portuguese | LILACS | ID: lil-542217

ABSTRACT

Considerando que o sangue coletado, processado e transfundido deve apresentar o menor risco possível de contaminação, necessário se faz uma anti-sepsia com eficácia comprovada, já que pesquisas apontam falhas anti-sépticas como ponto mais crítico das contaminações bacterianas de hemocomponentes. Assim, este trabalho teve como objetivo avaliar o processo anti-séptico usado em doadores de sangue do Hemonúcleo Regional de Francisco Beltrão - PR (HRFB). Para isso foi utilizada uma metodologia que consistiu em duas coletas de microorganismos de pele de cada individuo: uma antes e outra após anti-sepsia. As amostras (165) foram divididas e avaliadas por três diferentes metodologias, colhidas com swabs estéreis embebidos em solução de cloreto de sódio a 0,9%. Os swabs foram semeados em ágar-sangue de carneiro a 5%. A incubação foi a 36º C, e a contagem foi realizada após 24 e 48 horas, respectivamente. Evidenciou-se na comparação das três metodologias que a anti-sepsia com álcool a 70%, e vigorosa fricção do algodão com técnica correta, aliada ao tempo de ação do anti-séptico sobre a pele é o ponto fundamental para a eficácia da redução de microrganismos de pele.


Considering that the collected, processed and transfused blood must present the lesser possible contamination risk, it’s necessary makes an antisepsis with proven effectiveness, since research points anti-septic imperfections as more critical point of the bacterial hemocomponents contaminations. Thus, this work had as objective to evaluate the anti-septic process used in givers of blood from the Hemonucleo Regional of Francisco Beltrao - PR (HRFB). For this, it was used a methodology that consists of two collections of skin microorganisms of each individual: one before and another one after antisepsis. The samples (165) had been divided and evaluated for three different methodologies, harvested with swabs barren absorbed in sodium chloride solution 0,9 %. The swabs had been sown in sheep agar-blood at 5 %. The incubation was at 36º C, and the counting was carried through 24 and 48 hours after, respectively. It was proven in the comparison of the three methodologies that the antisepsis with alcohol at 70%, and vigorous cotton friction with correct technique, allied to the anti-septic action time on the skin, is the basic point for the micro-organisms reduction effectivenessat skin.


Subject(s)
Humans , Antisepsis , Blood Donors
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