Aspergillus fumigatus: aspectos gerais e importância na medicina contemporânea / Aspergillus fumigatus: general aspects and importance in contemporany medicine

Micro-organismos do gênero Aspergillus são fungos filamentosos, ubíquos, amplamente distribuídos na natureza com grande importância no setor agrícola, industrial, na medicina veterinária e na saúde humana, sobretudo como agente de infecção fúngica invasiva em ambientes nosocomiais. A espécie que mais ocasiona doenças em humanos é Aspergillus fumigatus, considerado um agente oportunista, responsável por cerca de 90% dos casos de aspergilose descritos no mundo. As taxas de mortalidade da forma mais grave de aspergilose, a Aspergilose Invasiva (AI), variam entre 80 a 100% em pacientes seriamente imunocomprometidos. A infecção ocasionada por A. fumigatus é diagnosticada por métodos histológicos, cultura e análise macro e micromorfológica, o que limita a identificação no nível de espécie e consequentemente, o correto diagnóstico e tratamento oportuno. A incidência de AI no Brasil é incerta, devido à ausência de dados oficiais de notificação. As investigações conduzidas no país ocorreram em hospitais terciários, mais especificamente em unidades de transplantados (células tronco hematopoiéticas de órgãos sólidos). Dados de resistência a antifúngicos em isolados de A. fumigatus são descritos em coortes europeias e estão correlacionados com falhas terapêuticas. A presente revisão tem como objetivo descrever o impacto da aspergilose ocasionada por A. fumigatus nos dias atuais e a importância do correto diagnóstico laboratorial na prática clínica

Microorganisms of the genus Aspergillus are filamentous, ubiquitous fungi, widely distributed in nature with great importance in agriculture, industry, veterinary medicine and human health, especially as an agent of invasive fungal infection in nosocomial environments. Aspergillus fumigatus, considered an opportunistic agent, accounts for about 90% of the cases of aspergillosis described in the world. Mortality rates of the most severe form of aspergillosis, Invasive Aspergillosis (IA), range from 80 to 100% in severely immunocompromised patients. The infection caused by A. fumigatus is diagnosed by histological methods, culture and macromorphological and micromorphological analysis, which limits the identification at the species level and, consequently, the correct diagnosis and timelytreatment. The incidence of IA in Brazil is uncertain because of the absence of official reporting data. Investigations conducted in thecountry occurred in tertiary hospitals, more specifically in transplant units (hematopoietic stem cells and solid organ). Antifungal resistance data in A. fumigatus isolates are described in european cohorts and are correlated with therapeutic failures. The present reviewaims to describe the impact of aspergillosis caused by A. fumigatus nowadays and the importance of correct laboratory diagnosis in clinical practice

Laboratory developed tests in the development of modern medicine: opportunities and challenges / 中华检验医学杂志

Translational medicine and personalized medicine are becoming the new power in modem medical development.Laboratory Developed Tests (LDTs) based on molecular biology and bioinformatics technology play a vital role in the development process of translational medicine and personalized medicine.Nowadays,LDTs consist of a broad range of in vitro diagnositc tests performed to analyze nucleic acid,chromosomes,proteins,certain metabolites and cell surface molecules using immunological technique,cytogenetic or molecular methods or a combination of these methods.These LDTs are used to detect heritable or acquired disease-related genotypes,mutations,or phenotypes,and also used to classify the pathological changes of cells for clinical purposes.New generation LDTs,present some unique regulatory questions still remain to be discussed.Clinicians should capture the opportunity to establish and continuously improve the detection platforms of LDTs,the quality control system and management standards.On this basis,transformation bridges between scientific research and clinical application will be truly built.

Comprehensive Analysis of the Testing Techniques Used in Blood Bank Laboratories in Korea for the Past Six Years / 임상검사와정도관리

BACKGROUND: The results of a particular test can be affected by the techniques used for testing. However, limited data is available on the testing techniques used in blood bank laboratories in Korea. The aim of this study was to evaluate the various testing techniques used in blood bank laboratories using the data obtained during the past six years from the Korean external quality assessment (KEQA) of blood bank laboratories. METHODS: Data was collected from all KEQA respondents via the KEQA website on the testing techniques used in blood bank laboratories from 2008 to 2013. The survey included questions on ABO grouping, D typing, crossmatching tests, direct antiglobulin tests (DAT), antibody (Ab) screening, and Ab identification (ID) tests. RESULTS: Based on the data obtained from 2008 to 2013 (ABO grouping data obtained from 2011 to 2013), the most frequently used techniques are as follows: slide agglutination (60.7% and 60.8%) for ABO cell typing; tube agglutination (78.2% and 81.2%) for ABO serum typing; slide agglutination (50% and 54.6%) for D typing; tube agglutination (91.9% and 83.8%) for crossmatching tests; tube agglutination (63.6% and 52.8%) for DAT; column agglutination technique (CAT; 74.5% and 89.4%) for Ab screen; and CAT (83.9% and 94.2%) for Ab ID. CONCLUSIONS: The findings reveal a steady increase in the use of CAT from 2008 to 2013 for crossmatching tests, DAT, Ab screen, and Ab ID and a decreasing use of the tube agglutination technique for the past six years. Since the slide agglutination technique accounted for a significant percentage of the tests conducted, further education is warranted on the improvement in the techniques used for ABO and D typing.

Digestibilidade in vitro de leguminosas do semiárido com inóculo cecal de avestruzes / In vitro digestibility of legumes from semi-arid with caecal inoculum liquor of ostriches

Para avaliar a digestibilidade in vitro de leguminosas do semiárido nordestino usando inóculo cecal de avestruzes por meio da técnica Tilley e Terry Reversa, usou-se o feno de alfafa (Medicago sativa) como referência aos fenos de canafístula (Senna multijuga), de cunhã (Clitoria ternatea), de leucena (Leucaena leucocephala), de mata-pasto (Senna obtusifolia) e de sabiá (Mimosa caesalpiniifolia). Verificou-se, pelo teste de Duncan (P<0,05), diferença significativa na digestibilidade in vitro das frações nutricionais entre os fenos de leguminosas, obtendo-se média geral para a matéria seca de 49,62 por cento (DIVMS), de 23,38 por cento para proteína bruta (DIVPB), de 17,88 por cento para proteína insolúvel em detergente neutro (DIVPIDN), de 34,52 por cento para fibra em detergente neutro (DIVFDN) e de 42,07 por cento para fibra em detergente neutro corrigida para cinzas e proteína (DIVFDNcp). A composição nutricional intrínseca a cada uma das leguminosas influenciou a magnitude da atividade fermentativa dos micro-organismos do ceco-cólon de avestruzes incubados in vitro, observando-se melhores valores de digestibilidade para feno de alfafa, seguido dos fenos de mata-pasto e de leucena, os quais foram superiores às demais leguminosas do semiárido.

To evaluate the in vitro digestibility of forage legume from semi-arid northeast region using caecal inoculum liquor of ostriches with Reverse Tilley and Terry technique, the alfalfa hay (Medicago sativa) was used as reference food for comparison between hays of canephori (Senna multijuga), clitoria (Clitoria ternatea), leucaena (Leucaena leucocephala), kills pasture (Senna obtusifolia) and thrush (Mimosa caesalpiniifolia). There was, by Duncan test (P<0.05), significant difference to in vitro digestibility of the nutritional fractions among the legume hays resulting in general mean value of 49.62 percent for dry matter (DIVMS), of 23.38 percent for crude protein (DIVPB), of 17.88 percent for insoluble protein in neutral detergent fiber (DIVPIDN), of 34.52 percent for neutral detergent fiber (DIVFDN) and of 42.07 percent for neutral detergent fiber corrected for ash and protein (DIVFDNcp). The nutritional composition of feedstuffs influenced the fermentative activity of microorganisms from cecum-colon of ostriches in these in vitro incubations, and the better digestibility values were observed for alfalfa hay, followed by kills pasture and leucaena hays, wich were higher than other legumes from semi-arid.

Analysis of the red blood cell in urine after kidney puncture / 中国基层医药

Objective To investigate the red blood cell in urine after kidney puncture and know the best detection method.Methods Collected three urines of 31 patients after kidney puncture and detected the red blood cell by UF-100 and the hemoglobin by urine dipstick test.At the same time,detect the conductivity of the urine by UF-100.Results Both the UF-100 and urine dipstick test could reflect the decrease of red blood cell after kidney puncture.But both of them had some limits.Sometimes the results of the two method were not relative(κ=0.148).The agreement of two methods was 0.538.Neither of them could reflect the bleeding of the kidney accuracy.Conclusion By the best,we should use both the UF-100 and the urine dipstick test to detect the red blood cell in urine after kidney puncture,at the same time we should consider the conductivity of the UF-100.

Effects of silencing survivin gene by RNA interference on cell apoptosis using ultrasound targeted microbubble destruction techniques / 肿瘤

Objective:To transfect genes using ultrasound targeted microbubble destruction (UTMD) techniques and observe the effects of RNA interference on cervical cancer (HeLa) cell line in silencing survivin gene and inducing apoptosis. Methods: Recombinant expression plasmid of short hairpin RNA (shRNA) targeting survivin gene was constructed. It was co-treated with microbubbles and transfected to cultured HeLa cells followed by exposure to ultrasound (P+UTMD group). Moreover, blank control group (C), plasmid group (P), ultrasound exposure group (US), plasmid and ultrasound exposure group (P+US), plasmid+ Lipofectamine group (P+L) were used as controls, respectively. Transfection efficacy was evaluated by observing the red fluorescence in the cells by fluorescent microscopy and flow cytometry(FCM). Ultrasound intensity and exposure time were optimized. Cell apoptosis was investigated using flow cytometry analysis, Hoechst staining, and DNA ladder method. Expression of survivin mRNA was assessed by RT-PCR. Results: Restrictive enzyme digestion and sequencing analysis verified that the recombinant plasmid was successfully constructed. UTMD significantly increased gene transfection efficacy in cultured HeLa cells (P<0.01). Gene transfer was the most prominent at ultrasound intensity of 1.0 W/cm2 and exposure time of 3 min (P<0.01). RT-PCR showed that the expression of survivin mRNA in P+UTMD group was inhibited by (83.33±2.73)%. The differences were significant compared with any other groups (P<0.01). FCM analysis showed that the apoptosis ratio in P+UTMD group was significantly increased as compared with other groups (P<0.01). Hoechst staining and DNA ladder showed that apparent apoptosis and DNA ladder were detected only in P+UTMD and P+L groups. Conclusions:UTMD effectively enhances the transfection efficacy of expression plasmid. It is a novel and effective non-viral gene transfer system and has promising foreground. UTMD mediates RNA interference silenced survivin gene and induces significant cell apoptosis, which provides a new method for tumor research and gene therapy.

Prótese parcial removível destacável com sistemas MK1: descrição de técnica laboratorial / Dettachable removable partial denture with MK1 system: description of laboratory technique

A reabilitação oral através de próteses parciais removíveis ainda é uma constante na clínica odontológica apesar do grande avanço técnico-científico da Odontologia Restauradora. Dentro da reabilitação com próteses parciais removíveis, os attachments merecem especial destaque, e o sistema MK1 representa um tipo de attachment de precisão do tipo trava e com funcionamento rígido, que pode ser utilizado sobre dentes, raízes e implantes. Na reabilitação de desdentados parciais, esse sistema pode ser empregado conjugado a próteses fixas convencionais, servindo-se de retenção para próteses parciais removíveis. Em virtude da pouca visibilidade do sistema MK1 perante os protesistas e os técnicos em prótese dental e das dificuldades de execução da técnica laboratorial, esse trabalho tem o objetivo de retratar os mais relevantes aspectos relacionados à execução laboratorial desse sistema. Os autores concluem que a utilização do sistema MK1 constitui-se uma alternativa protética satisfatória, apesar de exigir experiência e uma rigorosa execução dos procedimentos laboratoriais.

Oral rehabilitation removable partial denture has been a very common clinical treatment although it may be seen a great technical and scientific increasing of restorative dentistry. Considering the use of removable partialenture, attachments are in ividence, and MK1 system reoresents a precision locked attachment with rigid working, and it may be used over teeth, roots and implants. That system can be used together fixed partial dentures, offering retention for removable partial dentures in the partially edentulous patients. Because of the little use of MK1 system by prosthodontists and dental technicians, and the difficulties that characterizes its laboratory technique, this work has an aim to present the more important aspects about the MK1 technique. Authors conclude the use of MK1 attachment together removable partial denture represents a satisfactory prosthetic options, although that technique requires experience and a meticulous execution of the laboratory procedures.