ABSTRACT
Introduction: Tuberculosis promotes an acute phase response with an increase of blood reactants, such as C-reactive protein (CRP), among others, which are associated with increased erythrocyte sedimentation rate (ESR). Objective: Evaluate the ESR and the CRP as markers for diagnosis and monitoring cases of pulmonary tuberculosis. Method: Research on patients with clinical, laboratory, and imaging diagnosis of pulmonary tuberculosis, from Itajaí-SC; in which CRP and ESR were analyzed in three different times: at diagnosis, before starting treatment (T0), after three months of treatment (T1), and at the end of treatment (T2). Results: 51 patients were studied at T0 (100%), 43 (84.31%) at T1, and 32 (62.74%) at T2. ESR and CRP values presented significant differences in the three different times (p < 0.0001***). When analyzing the relationship between negative/positive sputum and altered/normal ESR and CRP at T0, ESR (p = 0.0691), CRP (p = 0.0166*). For chest imaging and sputum smear variables it was observed the following: CRP versus smear (p = 0.0002***), ESR versus smear (p = 0.3810), CRP versus chest imaging (p = 0.0097**), and ESR versus chest imaging (p = 0.0766). The correlation between ESR and CRP was: T0 (p = 0.0033**), T1 (p < 0.0001***) and T2 (p = 0.0015**). Conclusion: ESR and CRP proved to be good markers in the diagnosis and monitoring of tuberculosis cases, however, CRP achieve more significant results than ESR. .
Introdução: A tuberculose causa uma resposta de fase aguda com aumento de proteínas sanguíneas, como a proteína C reativa (PCR), entre outras, que estão envolvidas com o aumento da velocidade de hemossedimentação (VHS). Objetivo: Avaliar a VHS e a PCR como marcadores no auxílio diagnóstico e no acompanhamento dos casos de tuberculose pulmonar. Método: Pesquisa realizada com portadores de tuberculose pulmonar com diagnóstico clínico, laboratorial e imaginológico do município de Itajaí-SC, nos quais foram analisadas PCR e VHS em três tempos distintos: no momento do diagnóstico, antes do início do tratamento (T0), aos três meses de tratamento (T1) e ao término do tratamento (T2). Resultados: Foram estudados 51 pacientes em T0 (100%), 43 (84,31%) em T1 e 32 (62,74%) em T2. Os valores de VHS e PCR tiveram diferenças significativas nos três tempos (p < 0,0001***). Quando analisada as relações entre escarro positivo/negativo e VHS e PCR alterado/normal em T0, VHS (p = 0,0691), PCR (p = 0,0166*). Para as variáveis imagem de tórax e baciloscopia, obteve-se: PCR versus baciloscopia (p = 0,0002***); VHS versus baciloscopia (p = 0,3810); PCR versus imagem de tórax (p = 0,0097**); e VHS versus imagem de tórax (p = 0,0766). Correlação entre VHS e PCR: T0 (p = 0,0033**), T1 (p < 0,0001***) e T2 (p = 0,0015**). Conclusão: A VHS e a PCR mostraram-se bons marcadores no auxílio diagnóstico e no acompanhamento dos casos de tuberculose, entretanto, a PCR mostrou resultados mais significativos que a VHS. .
ABSTRACT
The prevalence of transmitted human immunodeficiency virus type 1 drug resistance in Angola in 2001 in 196 untreated patients was investigated. All subtypes were detected, along with unclassifiable and complex recombinant strains. Numerous new polymorphisms were identified in the reverse transcriptase and protease. Two (1.6%) unrelated patients harbored nucleoside reverse transcriptase inhibitor- and nonnucleoside reverse transcriptase inhibitor-resistant viruses (mutations: M41L, D67N, M184V, L210W, T215Y or T215F, and K103N). Continued surveillance of drug resistance is required for maximization of ART efficacy in Angola.
Subject(s)
Anti-HIV Agents/therapeutic use , Drug Resistance, Viral/genetics , HIV Infections/virology , HIV-1/drug effects , HIV-1/genetics , Reverse Transcriptase Inhibitors/pharmacology , Adult , Angola/epidemiology , Female , Genetic Variation , HIV Infections/drug therapy , HIV Infections/epidemiology , Humans , Male , Mutation/genetics , Peptide Hydrolases/genetics , RNA-Directed DNA Polymerase/genetics , Reverse Transcriptase Inhibitors/therapeutic use , Young AdultABSTRACT
Angola, located in South-Western Africa, has a remarkably low HIV/AIDS prevalence in the adult population (3.7%). It is bordered in the North by the Democratic Republic of Congo (DRC) and Republic of Congo that are at the origin of human HIV-1 infections. It is, therefore, likely that HIV-1 strains circulating in Angola are genetically diverse and representative of the origin of the HIV/AIDS epidemic. The aim of this work was to investigate in detail the genetic diversity and molecular epidemiology of HIV-1 in Angola. Almost 400 sequences were obtained from the gag (p17), pol (PR and RT) and/or env (C2C3) genes of 159 HIV-1 infected patients living in eight provinces of Angola (Benguela, Cabinda, Cuanza Norte, Luanda, Lunda Norte, Malange, Uíge, and Zaire) and their genotype was determined by phylogenetic analyses. Gene regions representing all HIV-1 group M clades were found as well as unclassifiable sequences. In env and pol (RT), two groups of sequences forming distinct sub-clusters within the subtype A radiation were found and may define new A5 and A6 sub-subtypes. Recombinant forms were found in almost half (47.1%) of the patients of which 36.0% were second-generation recombinants. Fifty-eight different patterns of recombination were found. The A subtype, including CRF02_AG, was represented in most recombinant viruses. Epidemiological data suggests that the AIDS epidemic in Angola has probably started as early as 1961, the major cause being the independence war, and spread to Portugal soon thereafter. The extraordinary degree of HIV-1 group M genetic diversity and evolution in Angola may pose unprecedented challenges to diagnostic, treatment and prevention of HIV-1 infection.
Subject(s)
Disease Outbreaks , Genetic Variation , HIV Infections/epidemiology , HIV Infections/virology , HIV-1/genetics , Human Immunodeficiency Virus Proteins/genetics , Molecular Epidemiology , Adolescent , Adult , Angola/epidemiology , Data Interpretation, Statistical , Female , Geography , HIV-1/classification , Humans , Male , Middle Aged , Molecular Sequence Data , Phylogeny , Recombination, GeneticABSTRACT
To investigate which HIV-1 genetic forms are circulating in Angola, we have determined the gag and/or env genotypes of 48 isolates from patients living in Cabinda and Luanda provinces. The following subtypes were identified: A1 (18 samples, 38%), C (7, 15%), H (5, 10%), J (3, 6%), G (2, 4%), A2 (2, 4%), F1 (1, 2%), and D (1, 2%). The env gene fragment was untypable in one sample. Discordant subtype classifications in the gag and env genes were found in eight (17%) samples. There were six different recombination patterns (gag/env): A1/H (3, 6%), A1/G (1, 2%), C/A2 (1, 2%), F1/B (1, 2%), G/B (1, 2%), and G/H (1, 2%). The A1/H recombinant may represent a new circulating recombinant form. The marked genetic heterogeneity of HIV-1 in Angola has important implications for vaccine development.
Subject(s)
Genes, env , Genes, gag , HIV Infections/virology , HIV-1/classification , HIV-1/genetics , Polymorphism, Genetic , Angola , Genotype , HIV-1/isolation & purification , Humans , Molecular Sequence Data , Phylogeny , RNA, Viral/genetics , RNA, Viral/isolation & purification , Recombination, Genetic , Sequence Analysis, DNA , Viral Proteins/geneticsABSTRACT
Embora näo tenha uma incidência elevada, a endoftalmite representa uma importante condiçäo patológica, devido às consequências graves que implica. O presente trabalho tem por objetivo abordar os aspectos básicos da endoftalmite, especialmente, aqueles relacionados com o seu diagnóstico e tratamento. Discutem-se as 3 formas clínicas principais de apresentaçäo, endoftalmite pós-cirúrgica, endoftalmite endógena e endoftalmite traumática, com especial ênfase à endoftalmite pós-cirúrgica, sobretudo após a facectomia
Subject(s)
Endophthalmitis/diagnosis , Endophthalmitis/drug therapyABSTRACT
Este trabalho descreve a utilizaçäo do implante de silicone sólido em forma de cunha - wedge implant - num grupo de 37 pacientes operados por descolamento regmatogênico da retina, causado por grandes rupturas em ferradura, onde uma complicaçäo transoperatória conhecida como o fenômeno da "boca de peixe" pôde ser suspeitada. Os resultados positivos de reaplicaçäo retiniana alcançado nesta série ficaram na ordem de 86,5% sem que nenhuma complicaçäo trans ou pós-operatoria pudesse ter sido atribuída ao implante utilizado
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Prostheses and Implants , Retinal Detachment/surgery , Silicones , Intraoperative Complications , Retinal Perforations/complications , Retinal Detachment/etiologyABSTRACT
Os autores estudaram as características angiofluoresceinográficas encontradas num grupo de 30 pacientes com o diagnóstico clínico e anatomopatológico de melanoma de coróide, comparando seus achados com a literatura científica. Os principais achados foram: - Presença de dupla circulaçäo 56% - Alargamento dos espaços intercapilares retinianos 26% - Zonas de näo fluorescência na superfície do tumor 70% - Múltiplos pequenos pontos hiperfluorescentes 65% - Anastomoses entre os vasos tumorais e retinianos 8% - Hiperfluorecência tardia 87%. Concluem que, apesar destes tumores näo apresentarem alteraçöes angiográficas patognomônicas, possuem determinadas características que säo muito típicas e podem ajudar no correto diagnóstico destas lesöes
