Validation of the content of the prevention protocol for early sepsis caused by Streptococcus agalactiaein newborns / Validação de conteúdo do protocolo de prevenção da sepse precoce porStreptococcus agalactiae em recém-nascidos / Validación de contenido del protocolo de prevención de la sepsis precoz por Streptococcus agalactiaeen recién nacidos

AbstractObjective: to validate the content of the prevention protocol for early sepsis caused by Streptococcus agalactiaein newborns.Method: a transversal, descriptive and methodological study, with a quantitative approach. The sample was composed of 15 judges, 8 obstetricians and 7 pediatricians. The validation occurred through the assessment of the content of the protocol by the judges that received the instrument for data collection - checklist - which contained 7 items that represent the requisites to be met by the protocol. The validation of the content was achieved by applying the Content Validity Index.Result: in the judging process, all the items that represented requirements considered by the protocol obtained concordance within the established level (Content Validity Index > 0.75). Of 7 items, 6 have obtained full concordance (Content Validity Index 1.0) and the feasibility item obtained a Content Validity Index of 0.93. The global assessment of the instruments obtained a Content Validity Index of 0.99.Conclusion: the validation of content that was done was an efficient tool for the adjustment of the protocol, according to the judgment of experienced professionals, which demonstrates the importance of conducting a previous validation of the instruments. It is expected that this study will serve as an incentive for the adoption of universal tracking by other institutions through validated protocols.

ResumoObjetivo:validar o conteúdo do protocolo de prevenção da sepse precoce porStreptococcus agalactiaeem recém-nascidos.Método:estudo transversal, descritivo, do tipo metodológico, com abordagem quantitativa. A amostra foi composta por 15 juízes, oito médicos obstetras e sete pediatras. A validação ocorreu por intermédio da avaliação de conteúdo do protocolo pelos juízes, os quais receberam o instrumento de coleta de dados - checklist - contendo sete itens, que representam requisitos a serem contemplados no protocolo. A validação de conteúdo foi atingida mediante aplicação do Índice de Validade de Conteúdo.Resultado:no processo de julgamento, todos os itens que representam requisitos contemplados no protocolo obtiveram concordância dentro do nível estabelecido (Índice de Validade de Conteúdo >0,75). Dos sete itens, seis obtiveram concordância total, (Índice de Validade de Conteúdo 1.0) e o item exequibilidade obteve Índice de Validade de Conteúdo de 0,93. A avaliação global dos instrumentos obteve Índice de Validade de Conteúdo de 0,99.Conclusão:a validação de conteúdo realizada foi ferramenta eficaz para adequação do protocolo, de acordo com o julgamento de profissionais experientes, demonstrando a importância em se realizar validação prévia de instrumentos. Espera-se que, este estudo incentive a adoção do rastreio universal por outras instituições, mediante protocolos validados.

ResumenObjetivo:validar el contenido del protocolo de prevención de la sepsis precoz porStreptococcus agalactiaeen recién nacidos.Método:estudio transversal, descriptivo, del tipo metodológico, con un enfoque cuantitativo. La muestra fue conformada por 15 jueces, ocho obstetras y siete pediatras. La validación se dio a través de la evaluación de contenido del protocolo por los jueces, los cuales recibieron el instrumento de recolección de datos - checklist - conteniendo siete ítems, que representan los requisitos para ser incluidos en el protocolo. La validación de contenido se logró a través de la aplicación del Índice de Validez de Contenido.Resultado:en el proceso de evaluación, todos los ítems que representan los requisitos contemplados en el protocolo obtuvieron una concordancia dentro del nivel establecido (Índice de Validez de Contenido > 0,75). De los siete ítems, seis obtuvieron una concordancia total (Índice de Validez de Contenido 1,0), y el ítem viabilidad obtuvo un Índice de Validez de Contenido de 0,93. La evaluación global de los instrumentos obtuvo un Índice de Validez de Contenido de 0,99.Conclusión:la validación de contenido realizada fue una herramienta eficaz para la adecuación del protocolo, según la evaluación de profesionales expertos, demostrando así la importancia de realizar la validación previa de los instrumentos. Se espera que este estudio fomente la adopción del cribado (screening) universal por otras instituciones, mediante protocolos validados.

Coinfection with epstein barr virus in north Indian patients with HIV/AIDS.

Acquired immunodeficiency syndrome (AIDS) has emerged as a serious health problem in India. Although tuberculosis appears to be the commonest opportunistic infection, studies pertaining to opportunistic viruses are scant In the present study co infection with EBV was evaluated in patients with AIDS using a highly sensitive polymerase chain reaction besides anti Zebra antibody assays for diagnosis of an active EBV infection in 37 patients of full-blown AIDS and 32 healthy seropositives. Thirty healthy laboratory workers were used as controls. Out of 37 patients with AIDS, 12 were positive for anti Zebra antibodies and 23 were positive for EBV by the PCR reaction. Out of the 32 seropositives, 3 were positive for anti Zebra antibodies and 4 were positive by PCR assay. The difference between seropositives and AIDS was significant (p < .05). None of the controls were positive for an active EBV infection. It is concluded that active EBV infection is an important co infection in patients with AIDS and may contribute significantly to morbidity and mortality in these patients.

Ateroesclerosis : ¿por qué una enfermedad inflamatoria?. Fundamentos, marcadores, biología molecular / Atherosclerosis : Why an inflammatory disease?. Basis, markers, molecular biology

En este artículo se resume brevemente el rol de la inflamación en la patogénesis y la fisiopatología de los síndromes coronarios agudos y los avances recientes del conocimiento sobre los factores responsables de la inestabilidad. Se examina la evidencia que sostiene la aseveración de que la inflamación de la placa ateroesclerótica puede jugar un rol clave en la patogénesis de la angina inestable y también los mecanismos a través de los cuales la activación de las células inflamatorias en la placa ateroesclerótica pueden conducir a una oclusión transitoria o permanente. El proceso de aterogénesis ha sido considerado fundamentalmente como la acumulación de lípidos dentro de la pared arterial; sin embargo es mucho más que eso. Las lesiones ateroescleróticas pueden describirse como correspondientes a una enfermedad inflamatoria. De hecho, la más precoz de las lesiones, la llamada estría grasa, es una lesión puramente inflamatoria, constituída sólo por macrófagos derivados de monocitos y linfocitos T. Se discute el uso de marcadores bioquímicos para la identificación y estratificación precoz de riesgo. La evaluación temprana del riesgo es esencial para la aplicación del tratamiento apropiado y el manejo futuro de pacientes con síndromes coronarios agudos. La proteína C reactiva, un reactante de fase aguda, es un marcador sensible de inflamación, y es un buen candidato para conocer el riesgo de futuros eventos cardiovasculares. La interacción adhesiva es un prerequisito para el normal funcionamiento de todos los componentes del sistema cardiovascular, sin embargo también está involucrada en la patogénesis de la enfermedad cardiovascular. Existe creciente evidencia de que las moléculas de adhesión (integrinas, selectinas y la superfamilia de las inmunoglobulinas) juegan un importante rol en la patología cardiovascular. Datos experimentales y epidemiológicos sugieren que la disyunción endotelial, luego de una infección o una inflamación, puede ser un factor de riesgo transitorio para enfermedad cardiovascular, que podría promover una respuesta vascular anormal. La disrupción, fisura o ruptura de placa, complican el curso de la ateroesclerosis coronaria. El riesgo de disrupción de una placa depende más de su composición que del tamaño de la placa y de la severidad de la estenosis...

Expression of Th1 and Th2 type cytokines responding to HBsAg and HBxAg in chronic hepatitis B patients

The cytokine pattern on viral antigen recognition is believed to exert a profound influence on the resolution of viral infections and viral clearance. This study was initiated to investigate whether a cytokine imbalance oriented toward Th2 type response plays a role in chronic hepatitis B. Cytokine profiles of peripheral blood mononuclear cells associated with chronic hepatitis B were analysed by RT-PCR. Upon HBsAg stimulation, expression of IFN-gamma, IL-2, IL-4, and IL-10 was detected in 41%, 8%, 41%, and 50% of the patients, respectively. Among these cytokines, the expression of IFN-gamma was associated with high levels of serum AST/ALT. However, we could not prove that Th2 type cytokines had a protective effect on hepatocytes. Upon HBxAg stimulation, there was no recognizable association of cytokine patterns with AST/ALT levels. In conclusion, production of a Th1 cytokine, IFN-gamma, by HBsAg-reactive cells was associated with hepatocyte damage in chronic hepatitis B, while no counteracting effect of Th2 cytokines produced by those cells was observed.

Prevalence of serum antibodies to LA-1 oncoprotein, herpes simplex virus type-2 glycoprotein and human papillomavirus type 16 transactivator (E2) protein among Indian women with cervical neoplasia.

Prevalence of serum antibodies to synthetic peptide to oncoprotein of LA-1 known as oncogene of herpes simplex virus type-2, herpes simplex virus type-2 glycoprotein-D as an determinant of viral pathogenicity and human papillomavirus type 16 transactivator E2 protein was studied among 46 Indian women with cervical neoplasia using immunoblot assay for HSV-2 gD glycoprotein and LA-1 antibodies as well as peptide ELISA assay to detect HPV16 E2 antibodies. The seropositivity to LA-1 oncoprotein was found to be high (61%) among patients with invasive cervical carcinoma as compared to 35% in various grades of cervical intraepithelial neoplasia (CIN) and 36% in normal control women. In contrast to this, a uniformly high frequency of antibody to HPV 16 E2 was observed among women with CIN (68%), normal healthy controls (50%) and invasive cervical carcinoma (43%). However, a low frequency of seropositivity (13%) to recombinant vaccinia virus HSV-2 gD protein was found among 15 tested sera each from group of women with various grades of CIN as well as invasive cervical carcinoma as compared to 28% among seven normal healthy control. A negative correlation of LA-1 and HPV16 E2 seropositivity on patient by patient comparison among CIN and invasive cervical carcinoma group was observed which is statistically significant (P = 0.019 for CIN; P = 0.038 for invasive cervical carcinoma). However, a positive correlation (P = 0.144) was found among normal control women. The study has shown a desirable serological marker of cervical neoplasia. This serological marker could be employed as a screening tool in conjunction with cytopathological screening to diagnose women harbouring LA-1 oncogene associated cervical lesions.