ABSTRACT
Screening blood donations for anti-HCV antibodies and alanine aminotransferase (ALT) serum levels generally prevents the transmission of hepatitis C virus (HCV) by transfusion. The aim of the present study was to evaluate the efficiency of the enzyme immunoassay (EIA) screening policy in identifying potentially infectious blood donors capable to transmit hepatitis C through blood transfusion. We have used a reverse transcriptase (RT)-nested polymerase chain reaction (PCR) to investigate the presence of HCV-RNA in blood donors. The prevalence of HCV-RNA positive individuals was compared with the recombinant immunoblot assay (RIBA-2) results in order to assess the usefulness of both tests as confirmatory assays. Both tests results were also compared with the EIA-2 OD/C ratio (optical densities of the samples divided by the cut off value). ALT results were expressed as the ALT quotient (qALT), calculated dividing the ALT value of the samples by the maximum normal value (53UI/l) for the method. Donors (n=178) were divided into five groups according to their EIA anti-HCV status and qALT: group A (EIA > or = 3, ALT<1), group B (EIA > or = 3, ALT>1), group C (1<=EIA<3, ALT<1), group D (1<=EIA<3, ALT>1) and group E (EIA<=0.7). HCV sequences were detected by RT-nested PCR, using primers for the most conserved region of viral genome. RIBA-2 was applied to the same samples. In group A (n=6), all samples were positive by RT-nested PCR and RIBA-2. Among 124 samples in group B, 120 (96.8 percent) were RIBA-2 positive and 4 (3.2 percent) were RIBA-2 indeterminate but were seropositive for antigen c22.3. In group B, 109 (87.9 percent) of the RIBA-2 positive samples were also RT-nested PCR positive, as well as were all RIBA-2 indeterminate samples. In group C, all samples (n=9) were RT-nested PCR negative: 4 (44.4 percent) were also RIBA-2 negative, 4 (44.4 percent) were RIBA-2 positive and 1 (11.1 percent) was RIBA-2 indeterminate. HCV-RNA was detected by RT-nested PCR in 3 (37.5 percent) out of 8 samples in group D. Only one of them was also RIBA-2 positive, all the others were RIBA-2 indeterminate. All of the group E samples (controls) were RT- nested PCR and RIBA-2 negative. Our study suggests a strong relation between anti-HCV EIA-2 ratio > or = 3 and detectable HCV-RNA by RT-nested PCR. We have also noted that blood donors with RIBA-2 indeterminate presented a high degree of detectable HCV-RNA using RT-nested PCR...
Subject(s)
Humans , Alanine Transaminase/blood , Hepatitis C/diagnosis , Immunoblotting , Immunoenzyme Techniques , Reverse Transcriptase Polymerase Chain Reaction , Case-Control Studies , Chi-Square Distribution , Hepacivirus/immunology , Hepatitis D , Prevalence , Recombinant Proteins , RNA, Viral/analysisABSTRACT
Apresenta-se um caso de angina de Ludwig em indivíduo do sexo masculino, complicada com pneumonia aspirativa, mediastinite e empiema pleural. O tratamento constou de antibioticoterapia e drenagem das coleçöes purulentas. Näo houve necessidade de traqueotomia. O paciente recuperou-se totalmente. Destaca-se a importância do diagnóstico precoce, no sentido, de se evitar complicaçöes desta doença
Subject(s)
Adult , Humans , Male , Empyema/complications , Ludwig's Angina/complications , Mediastinitis/complications , Pneumonia, Aspiration/complicationsABSTRACT
Registro de caso de paciente que três semanas após malária por Plasmodium falciparum desenvolveu forma severa de polirradiculoneurite, com tetraplegia e comprometimento de vários nervos cranianos (VI, VII, IX, X), evoluindo para a morte. A síndrome de Guillain-Barré tem sido considerada desordem imune relacionada a diversos estímulos antigênicos desencadeantes. O caso registrado sugere que protozoários podem ser um desses ffatores antigênicos
