ABSTRACT
INTRODUCTION: The sputum smear or the culture are the definitive diagnosis of pulmonary tuberculosis. Only a fraction of clinical patients are culture-confirmed. METHODOLOGY: A total of 24 clinical cases (40 ± 14 years old) with positive smear and negative co-morbidity were studied. Cases were selected from 600 patients who attended the pneumology service over two years. A sputum sample was cultured in Löwenstein-Jensen medium with consequent amplification of the rrnA V2 promoter, the differentiation region 4, and the IS6110 insertion sequence of Mycobacterium tuberculosis. After the culture result, the patients were divided into negative (n = 14) or positive (n = 10) culture groups. In addition, 30 samples from healthy donors (45 ± 10 years) were studied. The numbers of CD4, CD8 and CD19 lymphocytes were determined by flow cytometry. Levels of IgA and IgG to M. tuberculosis were measured by ELISA. RESULTS: IgG and IgA levels were detected in patients with positive culture, while only IgA was found in patients with negative cultures. The lymphocyte populations in the two groups were similar. The presence of a pleural apical cap was found more frequently in patients with negative- (57%) than with positive cultures (10%). CONCLUSIONS: The isotype profile in patients with positive cultures was both IgA and IgG positive, while in patients with negative culture, only IgA was found. The results will contribute to improve the diagnostic algorithm and appropriate treatment of patients with clinical tuberculosis. Further studies are needed to determine if this profile is predictive of the outcome of isolation.
Subject(s)
Antibodies, Bacterial/blood , Immunity, Cellular , Immunity, Humoral , Mycobacterium tuberculosis/immunology , T-Lymphocyte Subsets/immunology , Tuberculosis, Pulmonary/immunology , Adolescent , Adult , Bacteriological Techniques , Enzyme-Linked Immunosorbent Assay , Female , Flow Cytometry , Humans , Immunoglobulin A/blood , Immunoglobulin G/blood , Male , Middle Aged , Molecular Diagnostic Techniques , Mycobacterium tuberculosis/isolation & purification , Young AdultABSTRACT
Rotaviruses continue being the most important pathogens responsible of diarrhea in young children worldwide. Seminested reverse transcription polymerase chain reaction (RT-PCR) is used to determine rotavirus genotype; however, this technique employs multistep procedures. The real-time RT-PCR is a fast and reliable tool that can be used as rotavirus genotyping tool, especially in rotavirus outbreaks. In this study, we tested a real-time RT-PCR to identify rotavirus genotype using a panel of 252 samples from patients with diarrheal disease caused by G9P[4] and G12P[8] genotypes, which were identified as emerging rotaviruses in 2 outbreaks in Chiapas, Mexico. Our results show that the real-time RT-PCR assay detected these rotaviruses, and it allowed us to identify mixed genotype infections, G/P combinations, and the viral abundance in some samples in which the seminested assay could not identify them. Therefore, the real-time RT-PCR is a molecular tool that can be great support during rotavirus outbreaks.
Subject(s)
Real-Time Polymerase Chain Reaction , Reverse Transcriptase Polymerase Chain Reaction , Rotavirus Infections/diagnosis , Rotavirus Infections/virology , Rotavirus/classification , Rotavirus/genetics , Feces/virology , Genes, Viral , Genotype , Humans , Molecular Epidemiology/methods , RNA, Viral , Real-Time Polymerase Chain Reaction/methods , Reproducibility of Results , Reverse Transcriptase Polymerase Chain Reaction/methods , Sensitivity and SpecificityABSTRACT
BACKGROUND: The prevalence of asthma and obesity has increased last years implying important economical and social consequences. A relationship between asthma severity and obesity grade has been found. Therefore, it is necessary to evaluate if obesity decline has a beneficial impact on asthma severity. OBJECTIVE: To evaluate the effect of obesity decline on control symptoms and asthma severity. PATIENTS AND METHODS: Ninety-six patients with obesity and moderate chronic asthma were randomized to group A or B and were maintained for 40 days on a low calorie diet. At baseline and at the end of the study, symptoms, measurement of obesity, spirometry, inflammatory cytokines and immunoglobulin's levels were assessed. Diets' safety was evaluated based on laboratory test. Data were analyzed with Student's t test. RESULTS: After 40 days on a low calorie diet, in group A, there were significant decreases of obesity (p < 0.001) and IgE, symptoms almost disappeared (cough persisted in 20%) and medication was suspended in 80%. Group B had obesity decline but IgE levels remained (> 100 UI/mL), symptoms and drug regimen remained unchanged. Both diets were not harmful for patients. CONCLUSION: These results show that asthmatic obese patients maintained for 40 days on low calorie diet A, had obesity and IgE levels decrease and symptoms and asthma severity relief.
