Hereditary angioedema with C1 inhibitor (C1-INH) deficit: the strength of recognition (51 cases)

Hereditary angioedema (HAE) is a rare autosomal dominant disease due to C1 esterase inhibitor deficiency (C1-INH). The disease is characterized by subcutaneous and submucosal edema in the absence of urticaria due to the accumulation of bradykinin. This descriptive study aimed to evaluate the clinical characteristics of patients with a confirmed diagnosis of HAE referred to our Outpatient Clinic between December 2009 and November 2017. Fifty-one patients (38 F, 13 M) with a mean age of 32 years (range: 7-70 y) were included. Family history of HAE was reported in 70% (36/51) of the cases; 33/46 patients became symptomatic by 18 years of age. The median time between onset of symptoms and diagnosis was 13 years (3 mo-50 y). The most frequent triggering factors for attacks were stress (74.4%), trauma (56.4%), and hormonal variations (56%). The main symptoms were subcutaneous edema in 93.5% (43/46) of patients, gastrointestinal symptoms in 84.8% (39/46), and obstruction in the upper airways in 34.8% (16/46). Hospitalization occurred in 65.2%, of whom 13.3% had to be transferred to the Intensive Care Unit. Prophylactic treatment was instituted in 87% (40/46) of patients, and 56.5% (26/46) required additional treatment to control attacks. Owing to our data collection over a period of 8 years, a significant number of patients were identified by this HAE reference center. Despite early recognition and prophylactic treatment, a high percentage of patients were hospitalized. HAE is still diagnosed late, reinforcing the need for more reference centers specialized in diagnosis and educational projects for health professionals.

Quality of bevacizumab (Avastin®) repacked in single-use glass vials for intravitreal administration / Avaliação da qualidade do bevacizumabe (Avastin®) fracionado em frascos de vidro de dose única para administração intravítrea

ABSTRACT Purpose: Avastin® (bevacizumab) is an anti-vascular endothelial growth factor (VEGF) monoclonal antibody given as an off-label drug by intravitreal administration for treatment of ocular diseases. The drug's clinical application and its cost-benefit profile has generated demand for its division into single-use vials to meet the low volume and low-cost doses necessary for intraocular administration. However, the safety of compounding the drug in single-use vials is still under discussion. In this study, the stability and efficacy of Avastin® repacked in individual single-use glass vials and glass ampoules by external compounding pharmacies were evaluated. Methods: Polyacrylamide gel electrophoresis (PAGE), size-exclusion chromatography (SEC), dynamic light scattering (DLS), and turbidimetry were selected to detect the formation of aggregates of various sizes. Changes in bevacizumab biological efficacy were investigated by using an enzyme-linked immunosorbent assay (ELISA). Results: Repacked and reference bevacizumab showed similar results when analyzed by PAGE. By SEC, a slight increase in high molecular weight aggregates and a reduction in bevacizumab monomers were observed in the products of the three compounding pharmacies relative to those in the reference bevacizumab. A comparison of repacked and reference SEC chromatograms showed that the mean monomer loss was ≤1% for all compounding pharmacies. Protein aggregates in the nanometer- and micrometer-size ranges were not detected by DLS and turbidimetry. In the efficacy assay, the biological function of repacked bevacizumab was preserved, with <3% loss of VEGF binding capacity relative to that of the reference. Conclusion: The results showed that bevacizumab remained stable after compounding in ampoules and single-use glass vials; no significant aggregation, fragmentation, or loss of biological activity was observed.

RESUMO Objetivos: Avastin® (bevacizumabe) é um anticorpo monoclonal inibidor do fator de crescimento endotelial de vasos (VEGF) utilizado "off-label" por meio de administração intravítrea para o tratamento de doenças oculares. A sua aplicação clínica associada ao custo-benefício do medicamento gerou uma demanda para seu fracionamento em frascos de dose única para utilização pela via intraocular. No entanto, a segurança do fracionamento do anticorpo em frascos de dose única ainda é alvo de discussão. Neste trabalho, a estabilidade e a eficácia do Avastin® fracionado em frascos ou ampolas de vidro de dose unitária por farmácias de manipulação do mercado foram avaliadas. Métodos: As técnicas de eletroforese em gel de poliacrilamida (PAGE), cromatografia por exclusão de tamanho (SEC), espalhamento dinâmico da luz (DLS) e turbidimetria foram empregadas para avaliar a formação de agregados de diferentes tamanhos. Alterações na atividade biológica do bevacizumabe foram estudadas utilizando ELISA. Resultados: Amostras referência e do bevacizumabe fracionado apresentaram resultados semelhantes quando analisado por gel de poliacrilamida. Por cromatografia por exclusão de tamanho, um pequeno aumento na quantidade de agregados de alta massa molar seguido de uma redução nos monômeros do bevacizumabe foram observados para as amostras das três farmácias de manipulação quando comparado ao referência. A comparação dos cromatogramas mostrou uma quantidade de redução do monômero inferior a 1% para todas as amostras fracionadas. Por espalhamento dinâmico da luz e turbidimetria, não foram detectados agregados de proteína na faixa de tamanho de micrômetro e nanômetro. No ensaio de eficácia, o bevacizumabe fracionado preservou sua função biológica pois apresentou menos de 3% de perda na capacidade de ligação ao VEGF quando comparado ao referência. Conclusão: Este estudo sugere que o bevacizumabe se mantem estável após fracionamento em ampolas e frascos de vidro de dose unitária pois não foram observadas agregação e/ou fragmentação de proteínas e perda de atividade biológica em quan tidades significativas.

Are bovine teeth a suitable substitute for human teeth in in vitro studies to assess endotoxin load in root canals?

The present study aimed to determine the feasibility of using bovine teeth as a suitable alternative for human teeth, in experiments involving in vitro endotoxin contamination. Twenty bovine central incisors and 20 human single-root premolars had their dental crowns removed and root lengths set at 16 mm. Root canals were prepared up to #60 K-file size and sterilized with cobalt-60 gamma irradiation (20 kGy, 6 h). The teeth were randomly divided into four groups: G1-bovine teeth (bovine negative control, n = 10), G2-human teeth (human negative control, n = 10), G3-bovine teeth, inoculated withEscherichia coli (055:B55) LPS, and G4-human teeth inoculated with E. coli LPS. The G1 and G2 groups were exposed to apyrogenic water. After the teeth had been incubated at 37 °C and atmospheric humidity for 24 h, the samples of solutions in the main canals were collected with apyrogenic absorbent paper tips. LPS levels were quantified using Limulus Amebocyte Lysate assay. The data obtained were statistically analyzed using one-way ANOVA, with a significance level of 5%. A high amount of endotoxin was detected in the inoculated human teeth (G4) when compared to the sterilized teeth (G2), as well as in the inoculated bovine teeth (G3) when compared to the inoculated human teeth (G4). However, there was no statistical difference between bovine teeth before and after the E. coli endotoxin inoculation. Therefore, under the mentioned experimental conditions, the use of bovine teeth should not be a choice for laboratory research on endotoxin contamination.

La formación y el trabajo del agente indígena de salud en el Subsistema de Salud Indígena en Brasil / Professional education and work of indigenous health agents in the Brazilian health system

Objetivo. Reflexionar sobre la figura del agente indígena de salud en Brasil y sobre el papel que éste ejerce en el modelo de atención diferenciada o intercultural. Material y métodos. Se revisó la bibliografía de investigaciones existentes en el área del trabajo y la formación de los agentes indígenas de salud, del subsistema de salud indígena en Brasil. Resultados. Existe subordinación del agente al modelo médico hegemónico. Los agentes carecen de procesos formativos iniciales, los cursos ocurren con irregularidad y los contenidos se enfocan en la biomedicina. Hay conflictos con el equipo y con la comunidad, lo que genera su desvalorización. El agente no ejerce la función de mediación que se espera entre saberes y prácticas. Conclusiones. La discusión sobre la atención diferenciada debe partir de la relación entre el sector salud y la autoatención.

Objective. To discuss the role of indigenous health agents in the implementation of the model of differentiated attention or intercultural health in Brazil. Materials and methods. We revised the scientific literature about the work and professional education of indigenous health agents in the Brazilian indigenous health system. Results. There is a subordination of the agents to the hegemonic medical model. With regards to professional education, we observe the absence and irregularity of these processes, with a general emphasis the biomedicine. There are conflicts with the health team and community, with devaluation of the agents. The agent does not plays the role of mediator between the different health knowledge and practices. Conclusions. We suggest that the discussion of the model of differentiated attention should strengthen the relationship between the health system and the selfcare.

Validation and development of an immunonephelometric assay for the determination of alpha-1 antitrypsin levels in dried blood spots from patients with COPD / Desenvolvimento e validação de um método de imunonefelometria em amostras de sangue em papel-filtro para a dosagem da alfa-1 antitripsina em pacientes com DPOC

OBJECTIVE: To validate and develop an immunonephelometric assay for the determination of alpha-1 antitrypsin (AAT) levels in dried blood spots from COPD patients in Brazil. METHODS: We determined AAT levels in serum samples and dried blood spots from 192 COPD patients. For the preparation of dried blood spots, a disk (diameter, 6 mm) was placed into a tube, eluted with 200 µL of PBS, and stored overnight at 4ºC. All of the samples were analyzed by immunonephelometry in duplicate. We used the bootstrap resampling method in order to determine a cut-off point for AAT levels in dried blood spots. RESULTS: The correlation coefficient between the AAT levels in serum samples and those in dried blood spots was r = 0.45. For dried blood spots, the cut-off value was 2.02 mg/dL (97% CI: 1.45-2.64 mg/dL), with a sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 95.7%, 27.2%, and 100%, respectively. CONCLUSIONS: This method for the determination of AAT levels in dried blood spots appears to be a reliable screening tool for patients with AAT deficiency. .

OBJETIVO: Validar e desenvolver um método de dosagem de alfa-1 antitripsina (AAT) por imunonefelometria em amostras de sangue em papel-filtro em pacientes com DPOC no Brasil. MÉTODOS: Amostras de soro e de sangue em papel-filtro de 192 pacientes com DPOC foram utilizadas para a dosagem de AAT. Para a preparação das amostras de sangue em papel-filtro, um disco do papel com diâmetro de 6 mm foi colocado em um tubo e eluído com 200 µL de PBS, permanecendo por toda a noite a 4ºC. Todas as amostras foram analisadas em duplicata por imunonefelometria. O método de reamostragem bootstrap foi utilizado para a determinação de um ponto de corte para o nível de AAT nas amostras de sangue em papel-filtro. RESULTADOS: O coeficiente de correlação entre os níveis de AAT em soro e em sangue em papel-filtro foi de r = 0,45. Para as amostras em papel-filtro, o ponto de corte foi de 2,02 mg/dL (IC97%: 1,45-2,64 mg/dL), com sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo de 100%, 95,7%, 27,2% e 100%, respectivamente. CONCLUSÕES: Este método de determinação dos níveis de AAT em sangue em papel-filtro se mostrou uma ferramenta confiável para o rastreamento de pacientes com deficiência de AAT. .

Comparative study between immunoturbidimetric and latex agglutination methods for the detection of rheumatoid factor / Estudo comparativo entre as técnicas de aglutinação em látex e de imunoturbidimetria para a detecção de fator reumatoide

INTRODUCTION: The rheumatoid factor (RF) is the most common antibody found in patients with rheumatoid arthritis. It is an inflammatory chronic disease characterized by articular involvement, inflammation of synovial fluid, tissue infiltration by leucocytes and joint destruction, which ultimately determine articular deformities. The rheumatoid factor is found in 70%-80% of the adult population and in 10% of the young population. OBJECTIVE: The aim of this research was to compare immunoturbidimetric and latex agglutination methods for the detection of RF in serum. RESULTS: The immunoturbidimetric method displayed sensitivity (95.2%), specificity (89.4%) and high positive correlation (R² = 0,8077) with the latex agglutination method in positive serum samples. CONCLUSION: The study allowed to demonstrate that both immunoturbidimetric and latex agglutination methods equally discriminate between negative and positive serum samples for RF.

INTRODUÇÃO: O fator reumatoide (FR) é o autoanticorpo mais comum encontrado em pacientes com artrite reumatoide, uma doença crônica inflamatória caracterizada pelo envolvimento articular com inflamação do líquido sinovial, infiltração de tecido por leucócitos e destruição das articulações, que acaba por determinar deformidades articulares. O FR é encontrado em 70%-80% da população adulta e em 10% da população juvenil. OBJETIVO: Comparar os métodos de imunoturbidimetria e aglutinação (prova do látex) para a determinação de FR em soro. RESULTADO: Foi possível observar que o método imunoturbidimétrico apresenta sensibilidade (95,2%), especificidade (89,4%) e correlação positiva elevada (R² = 0,8077) com o método de aglutinação pelo látex em amostras de soro positivas. CONCLUSÃO: O estudo permitiu demonstrar que o método imunoturbidimétrico e o método de aglutinação pelo látex são igualmente capazes de discriminar amostras negativas e positivas para FR.

Anti-Iipase and antioxidant properties of 30 medicinal plants used in Oaxaca, México

We report the results of in vitro anti-lipase and antioxidant assays using crude ethanolic extracts from 30 plants grown in Oaxaca, México. Anti-lipase tests were performed by using porcine pancreatic lipase (PPL) [EC 3.1.1.3] from Affymetrix/USB. The extracts of Solanum erianthum, Salvia microphylla, Brungmansia suaveolens and Cuphea aequipetala showed up to 60% PPL inhibition. The effect of these extracts on the kinetic parameters of PPL (Km= 0.36 mM, and Vmax=0.085 mM min -1) revealed that the alcoholic preparations of S. erianthum and C. aequipetala engendered a non-competitive inhibition (Vmax=0.055 mM min -1; Vmax= 0.053 mM min -1), whereas those of S. microphylla and B. suaveolens produced a mixed inhibition (Km= 0.567 mM, Vmax=0.051 mM min _1; Km=0.643 mM, Vmax= 0.042 mM min ¹). In addition to these findings, seven extracts from different plants were able to inhibit PPL in the range of 30-50%. Antioxidant tests against 2,2-Diphenyl-1-picryl hydrazyl (DPPH) confirmed that Arctostaphylos pungens, Gnaphalium roseum, Crotalaria pumila, Cuphea aequipetala, Rhus chondroloma, and Satureja laevigata possess relevant antioxidant activity (IC(5)0=50-80 μg mL¹). The general composition of the most effective ethanolic extracts was obtained in order to confirm their known chemistry reported by previous works. Comprehensive chemical analysis of the ethanolic extracts and their poisoning effects suggests that S. microphylla, C. aequipetala and A. pungens could be considered as the best sources with both desired properties.

Evaluation of the Diagnostic Performance of Fibrin Monomer in Disseminated Intravascular Coagulation / 대한진단검사의학회지

BACKGROUND: Fibrin-related markers (FRM) such as fibrin monomer (FM) and D-dimer (DD) are considered useful biological markers for the diagnosis of disseminated intravascular coagulation (DIC). However, no studies on the diagnostic performance of different FRMs have been published in Korea. The aim of this study was to evaluate the diagnostic performance of FM for DIC in comparison with DD. METHODS: The reference limit of FM was determined based on plasma sample data obtained from 210 control individuals. To evaluate diagnostic performance, FM data from the plasma samples of 139 patients with DIC-associated diseases were obtained for DIC scoring. FM was measured by immunoturbidimetry using STA-LIATEST FM (Diagnostica Stago, France). Patients were classified according to the DIC score as non-DIC, non-overt DIC, or overt DIC. ROC curve analyses were performed. RESULTS: The reference limit in the control individuals was determined to be 7.80 microg/mL. Patients with DIC-associated diseases were categorized as non-DIC (N=43), non-overt DIC (N=80), and overt DIC (N=16). ROC curve analyses showed that the diagnostic performance of FM was comparable to DD in both non-overt DIC and overt DIC (P=0.596 and 0.553, respectively). In addition, FM had higher sensitivity, specificity, positive predictive value, and negative predictive value than DD for differentiating overt DIC from non-DIC. CONCLUSIONS: This study demonstrated that the diagnostic performance of FM for DIC was comparable to DD. FM might be more sensitive and more specific than DD in the diagnosis of overt DIC, but not non-overt DIC.

Evaluation of the Diagnostic Performance of Fibrin Monomer in Disseminated Intravascular Coagulation / 대한진단검사의학회지

BACKGROUND: Fibrin-related markers (FRM) such as fibrin monomer (FM) and D-dimer (DD) are considered useful biological markers for the diagnosis of disseminated intravascular coagulation (DIC). However, no studies on the diagnostic performance of different FRMs have been published in Korea. The aim of this study was to evaluate the diagnostic performance of FM for DIC in comparison with DD. METHODS: The reference limit of FM was determined based on plasma sample data obtained from 210 control individuals. To evaluate diagnostic performance, FM data from the plasma samples of 139 patients with DIC-associated diseases were obtained for DIC scoring. FM was measured by immunoturbidimetry using STA-LIATEST FM (Diagnostica Stago, France). Patients were classified according to the DIC score as non-DIC, non-overt DIC, or overt DIC. ROC curve analyses were performed. RESULTS: The reference limit in the control individuals was determined to be 7.80 microg/mL. Patients with DIC-associated diseases were categorized as non-DIC (N=43), non-overt DIC (N=80), and overt DIC (N=16). ROC curve analyses showed that the diagnostic performance of FM was comparable to DD in both non-overt DIC and overt DIC (P=0.596 and 0.553, respectively). In addition, FM had higher sensitivity, specificity, positive predictive value, and negative predictive value than DD for differentiating overt DIC from non-DIC. CONCLUSIONS: This study demonstrated that the diagnostic performance of FM for DIC was comparable to DD. FM might be more sensitive and more specific than DD in the diagnosis of overt DIC, but not non-overt DIC.

Evaluation of Analytical Measurement Ranges of Three Full Range C-Reactive Protein Tests Using Immunoturbidimetric Assay / 대한진단검사의학회지

BACKGROUND: Recently developed full-range C-reactive protein (CRP) tests, which are based on the immunoturbidimetric method, have wider analytical measurement ranges (AMR) than previously used tests. We evaluated the AMR of 3 full-range CRP tests-2 new and 1 previously used test. METHODS: We analyzed the precision and AMR of 2 full-range CRP tests (Sekisui, Nanopia CRP, N-CRP and Iatron, IATRO CRP-EX, I-CRP) and compared the values obtained for these tests with those obtained for the conventional full-range CRP test (Sekisui, PureAuto S CRP, P-CRP). We evaluated the tests for the limit of quantification and for linearity. We also compared these results of these tests by using the comparative test (Dade Behring, cCRP) for cardiovascular risk assessment. RESULTS: Coefficients of variation (CVs) of all the full-range CRP tests were less than 10% for concentrations greater than 0.6 mg/L, and CVs of N-CRP and I-CRP were lower than those of P-CRP for concentrations less than 1 mg/L. N-CRP (0.1-467 mg/L) and I-CRP (0.1-280 mg/L) had wider AMR than P-CRP (3-233 mg/L). All the full-range CRP tests showed more than 90% agreement with the cCRP values for the assessment of cardiovascular risk. CONCLUSIONS: The 3 full-range CRP tests, by virtue of their wide AMR, may be used for the detection of acute inflammation as well as for the assessment of cardiovascular risk. N-CRP and I-CRP may be more useful than P-CRP for determining the CRP concentration, especially for the detection of concentrations close to the lower or upper limit of the analytical range, without the need for repetition of the test.

Determination of Carbohydrate-deficient Transferrin Levels by Using Capillary Electrophoresis in a Korean Population / 대한진단검사의학회지

BACKGROUND: Carbohydrate-deficient transferrin (CDT) levels have rarely been determined in an Asian population. We evaluated the analytical performance of a test for measuring CDT levels by using capillary electrophoresis (EP). METHODS: We determined the precision of CDT measurement by using capillary EP and nephelometry and compared the CDT values obtained using both the methods. We included healthy control subjects, abstinent patients with liver disease, and individuals consuming varying amounts of alcohol. RESULTS: The CDT measurement by using capillary EP were correlated well with those CDT measurement by using nephelometry, N Latex CDT assay, Y=0.5706X+1.581, R=0.930. The results obtained from both methods showed good qualitative agreement with each other (kappa coefficient=0.61). Genetic variants of transferrin isoforms were detected in 4.1% of the tested population. Both the CDT and gamma-glutamyl transpeptidase (GGT) levels in the abstinent patients with liver disease were significantly higher than those in healthy abstinent individuals (0.9% vs. 0.5%, 109.5 mg/dL vs. 28.5 mg/dL, respectively), but the difference in CDT values in the 2 groups was less pronounced for the CDT values. Individuals who had a mean daily alcohol intake of more than 60 g/day showed significantly higher CDT levels than those who had a mean daily alcohol intake of less than 60 g/day (1.9% vs. 0.7%, P=0.03). CONCLUSIONS: The CDT test using capillary EP showed good performance, and this method has several advantages such as automation and detection of variant forms. Thus, CDT can be a more useful marker than GGT for monitoring alcohol abstinence, especially in patients with liver disease.

Application of Cystatin C Reduction Ratio to High-Flux Hemodialysis as an Alternative Indicator of the Clearance of Middle Molecules

BACKGROUND/AIMS: Although high-flux (HF) dialyzers with enhanced membrane permeability are widely used in current hemodialysis (HD) practice, urea kinetic modeling is still being applied to indicate the adequacy of both low-flux (LF) and HF HD. In comparison with urea (molecular weight, 60 Da) and beta2-microglobulin (beta2MG, 12 kDa), cystatin C (CyC, 13 kDa) is a larger molecule that has attractive features as a marker for assessing solute clearance. We postulated that CyC might be an alternative for indicating the clearance of middle molecules (MMs), especially with HF HD. METHODS: Eighty-nine patients were divided into LF and HF groups. Using single pool urea kinetic modeling, the urea reduction ratio (URR) and equilibrated Kt/Vurea (eKt/Vurea) were calculated. The serum CyC concentrations were measured using particle-enhanced immunonephelometry. As indices of the middle molecular clearance, the reduction ratios of beta2MG and CyC were calculated. RESULTS: The beta2MG reduction ratio (beta2MGRR) and CyC reduction ratio (CyCRR) were higher in the HF group compared to the LF group. However, the URR and eKt/Vurea did not differ between the two groups. The CyCRR was significantly correlated with the eKt/Vurea and beta2MGRR (r = 0.47 and 0.69, respectively, both p < 0.0001). CONCLUSIONS: Compared to the LF dialyzer, the HF dialyzer removed CyC and beta2MG more efficiently. Unlike the beta2MGRR, the CyCRR was correlated with the eKt/Vurea and beta2MGRR. This study suggests a role for the CyCRR as an alternative indicator of the removal of MMs.

Características físico-químicas y determinación de plaguicidas en el agua de la laguna de Gandoca, Limón, Costa Rica / Physical-chemical features and determination of pesticides in the lagoom water in Gandoca, Limón, Costa Rica

Parámetros físico-químicos fueron determinados en tres puntos de muestreo y a dos profundidades entre noviembre 1999 y abril 2000, en la laguna de Gandoca, Refugio Nacional de Vida Silvestre Gandoca-Manzanillo, Limón, Costa Rica. Se determinó la temperatura, turbidez, salinidad, nutrimentos y clorofilas en la laguna. Se detectó una haloclina presente a 3 m de profundidad y se describió una circulación de aguas con fuerte estratificación por haloclina pero con una interfase entre la laguna y el mar de aguas parcialmente mezcladas. No se detectaron procesos de eutrofización. La fluctuación observada en los nutrimentos y clorofilas correspondería a procesos de circulación normales y complejos en la laguna, claramente influenciada por las aguas continentales. Además, durante febrero 2000, se realizó un estudio preliminar para la detección de sustancias organocloradas y organofosforadas en los puntos de muestreo. El análisis de residuos realizado mediante extracción líquido-líquido no detectó la presencia en las aguas de la laguna de ninguna de las veinte sustancias consideradas. La no detección de éstas podría indicar que no están llegando a la laguna a través del agua de escorrentía, o bien que una vez presentes en la laguna han sido lavadas por las fuertes lluvias durante el muestreo

Nutrients and chlorophylls concentrations, as well as salinity, temperature and Secchi disk depth were determined from November 1999 to April 2000, at three stations and two depths, at Gandoca lagoon, Gandoca-Manzanillo National Wildlife Refuge, Limón, Costa Rica. Salinity profiles indicated that the lagoon was a salt wedge estuary with a partially mixed region near the mouth. No processes of eutrophication were found. The distribution and abundance of nutrients and chlorophylls showed a slight influence of continental water and water circulation patterns in the lagoon. A preliminary study was done in order to analyze the presence of 20 organochlorated and organophosphorated pesticides along the Gandoca lagoon in February 2000. None of the pesticides were detected by the analysis of residues from liquid-liquid extractions. The absence of the pesticides may be due to the fact that they did not reach the lagoon or, if they did, they were washed away by the strong rains during the sampling period

Proteína C Reactiva: inmunoturbidimetría potenciada por látex, adaptación y validación de un método / C Reactive Protein: latex enhanced immunoturbidimetry, method adaptation and validation

Los niveles elevados de Proteína C Reactiva (PCR) son considerados sensibles marcadores inespecíficos de la respuesta inflamatoria aguda y desempeñan un papel importante en el desarrollo y evolución de la lesión aterosclerótica. La sensibilidad de los ensayos disponibles para PCR es amplia y dependiente de la metodología empleada en la detección. Se presenta una modificación de un reactivo comercial para la determinación manual, semicuantitativa de PCR a un ensayo de alta sensibilidad. Las partículas de látex se diluyeron en buffer glicina pH 8,2 y para potenciar la inmunoaglutinación, se empleó Polietilenglicol (PEG) en el tampón de reacción. La cinética turbidimétrica fue registrada en un analizador Aeroset (Abbott) previamente programado. El rango dinámico de concentraciones de PCR medibles, sin dilución de las muestras, fue de 0-14 mg/L. El Límite Mínimo de Detección (LMD) y el Límite Biológico de Detección (LBD) resultaron 0,071 y 0,55 mg/L respectivamente. El coeficiente de variación entre ensayos fue de 5,63 por ciento con una curva estable de al menos 20 días. Se observó interferencia negativa por plasma, hemólisis (> 0,4 g/dL) y lipemia (triglicéridos > 3,8 g/L). La económica modificación del reactivo permitirá acceder a estudios poblacionales y establecer valores de referencia en las concentraciones de PCR

Methodology evaluation of a new immunoturbidimetric method for measuring serum soluble transferrin receptor.

The value of soluble transferrin receptor (sTfR) detected in serum is closely related to erythroid TfR turnover rate. An increased erythropoietic activity causes an increase in the sTfR level. Therefore, it is a useful test for monitoring the erythropoiesis. In this study, a new immunoturbidimetric method for automated measurement of sTfR was evaluated for its performance characteristics. Imprecision studies on patients' sera with 1.01 mg/l and 2.94 mg/l concentrations yielded within-run CVs of 1.16% and 1.27%. Accuracy analysis of the test by using the low and high control kit sera with 1.45 mg/l and 5.41 mg/l concentrations were 89.06% and 95.41%, respectively. The evaluation was also performed in 60 individual pediatric subjects, 30 beta-thalassemia/HbE and 30 control pediatric subjects. There is a statistically significant difference of sTfR between both groups (p < 0.0005, 95% Cl = 9.457-14.124). Ninety-five percent of matched pediatric subjects had sTfR level < or = 2.670 mg/l and 93.33% of patients diagnosed beta-thalassemia/HbE had values > 2.670 mg/l. In conclusion, this immunoturbidimeteric test yields good laboratory performance characteristics in terms of precision and accuracy.

Evaluation of microalb immunoturbidimetric test for albuminuria screening.

Microalb, an immunoturbidimetric test for screening urinary albumin levels was evaluated for its potential as a screening test for microalbuminuria in diabetic patients. It was compared with the current standard, the radioimmunoassay (RIA). The results showed that the test lacks sensitivity while its specificity was acceptable. Therefore, it can not replace the RIA as the screening method. This study also showed that the first early morning urine could be used if a 24- hour collection was not possible, as its albumin content fairly correlated (r = 0.78) with the 24-hour urine collection of the diabetic patients.

Estudio inmunológico del humor acuoso normal / Immunological study of the normal aqueous humor

El ojo funciona como un compartimiento aislado del resto del organismo desde el punto de vista inmunológico, lo que explica que. ante la presencia de enfermedades inflamatorias y/o infecciosas dentro del globo ocular, muchas veces no se encuentra evidencia de estas a nivel plamático. Es necesario conocer entonces las características inmunológicas normales en los fluidos intraoculares para un mejor entendimiento y manejo de las enfermedades oculares inflamatorias y/o infecciosas. En este trabajo se logró evaluar y comprobar la idemnidad de la barrera hematoocular a través de la determinación de la relación IgG/albúmina tanto en humor acuoso como en plasma cuyo coeficiente resultó ser 0,59. Además, ante la presencia de títulos positivos en sangre para toxocariasis y toxoplasmosis, no se encontró presencia de anticuerpos contra estas en los fluidos intraoculares. Finalmente los títulos de anticuerpos para lúes fueron negativos en ambos compartimentos