Espectroscopia Atômica Identifica Diferenças nos Parâmetros de Elementos Traço na Saliva de Pacientes Portadores de Fibrose Cística / Atomic Spectroscopy Identifies Differences in Trace Element Parameters in the Saliva of Patients with Cystic Fibrosis

Objetivo: Determinar elementos traço na saliva de indivíduos com fibrose cística.Métodos: Trinta e cinco indivíduos com fibrose cística e trinta e nove indivíduos saudáveis participaram deste estudo. A distribuição de 24 elementos traço na saliva total estimulada foi avaliada por espectrometria de massa com plasma de argônio acoplado indutivamente (ICP-MS), espectrometria de emissão óptica com plasma de argônio acoplado indutivamente (ICP-OES) e espectrometria de absorção atômica (AAS).Resultados: Verificou-se uma diferença significativa na distribuição de elementos traço na saliva de indivíduos com fibrose cística quando comparado a indivíduos sem a doença. Sódio; Potássio; Vanádio; Cromo; Arsênio e Selênio apresentaram valores estatisticamente diferentes entre os grupos, enquanto Alumínio, Boro, Bário, Cadmo, Cobre, Ferro, Mercúrio, Magnésio, Manganês, Níquel, Titânio, Estrôncio e Zinco não apresentaram diferenças significativas entre os grupos. As análises estatísticas indicaram que os elementos Sódio e Potássio apresentaram maiores teores, enquanto que os elementos traço Vanádio, Cromo, Selênio e Arsênio apresentaram menores teores nos indivíduos com fibrose cística.Conclusões: A espectroscopia atômica mostrou um potencial considerável no desenvolvimento de metodologia destinada a detectar a fibrose cística neonatal. A saliva deve ser considerada como material biológico para análise de diagnóstico

Objective: To determine trace elements in the saliva of individuals with cystic fibrosis.Method: Thirty-five individuals with cystic fibrosis and thirty-nine healthy individuals participated in this study. The distribution of 24 trace elements in stimulated whole saliva was evaluated by inductivelycoupled plasma mass spectrometry (ICP-MS), inductively coupled plasma optical emission spectrometry (ICP-OES) and atomic absorption spectrometry (AAS).Results: There was a statistically significant difference in the distribution of trace elements in the saliva of individuals with cystic fibrosis compared with individuals without the disease. Sodium, potassium, vanadium, chromium, arsenic and selenium presented significantly different values between the groups, while no significant differences was found between the groups for aluminum, boron, barium, cadmium, copper, iron, mercury, magnesium, manganese, nickel, titanium, strontium and zinc. Statistical analyses indicated higher contents of the trace elements sodium and potassium and lower contents of the trace elements vanadium, chromium, selenium and arsenic in the individuals with cystic fibrosis.Conclusion: Atomic spectroscopy showed a considerable potential in the development of a methodology to detect a neonatal cystic fibrosis. The saliva should be considered as biological material for diagnostic analysis

Physicochemical properties of human tracheobronchial sputum maintained at room temperature.

OBJECTIVE: To evaluate the effect that maintaining tracheobronchial sputum at room temperature has on the analysis of ciliary transport and cough, as well as on the contact angle. METHODS: Hyaline sputum was collected from 30 individuals without pulmonary diseases, and purulent sputum was collected from patients with bronchiectasis. The samples were analyzed immediately after collection and again after 24 h. RESULTS: After 24 h at room temperature, the purulent sputum presented an increase in cough-induced dislodgment (96 +/- 50 vs. 118 +/- 61 mm) and a decrease in the contact angle (32 +/- 6 vs. 27 +/- 6 degrees) (p < 0.05). For the hyaline sputum, there were no alterations in the parameters analyzed. CONCLUSION: Hyaline tracheobronchial sputum can be stored in room temperature for 24 h without presenting alterations in ciliary transport or contact angle. However, purulent sputum should not be stored at room temperature for many hours, since ciliary transport and contact angle might be altered as a result.

O muco traqueobrônquico humano mantido em temperatura ambiente e suas propriedades físico-químicas / Physicochemical properties of human tracheobronchial sputum maintained at room temperature

OBJETIVO: Verificar a influência da permanência em temperatura ambiente na análise da transportabilidade por ação ciliar e por tosse e do ângulo de contato do muco traqueobrônquico. MÉTODOS: Foi coletado muco hialino de 30 indivíduos sem doença pulmonar, e purulento de vinte pacientes com bronquiectasia. As amostras foram analisadas logo após a coleta e novamente após 24 h. RESULTADOS: Para o muco purulento, após 24 h em temperatura ambiente, houve aumento no deslocamento por tosse (96 ± 50 vs. 118 ± 61 mm) e diminuição do ângulo de contato (32 ± 6 vs. 27 ± 6 graus) (p < 0,05). Para o muco hialino não houve alterações nas medidas analisadas. CONCLUSÃO: O muco traqueobrônquico hialino pode ser armazenado em temperatura ambiente por 24 h sem que haja alterações em sua transportabilidade por ação ciliar ou em seu ângulo de contato. Por outro lado, o muco purulento não deve permanecer em temperatura ambiente por muitas h para que não se altere seu ângulo de contato e sua transportabilidade por tosse.

OBJECTIVE: To evaluate the effect that maintaining tracheobronchial sputum at room temperature has on the analysis of ciliary transport and cough, as well as on the contact angle. METHODS: Hyaline sputum was collected from 30 individuals without pulmonary diseases, and purulent sputum was collected from patients with bronchiectasis. The samples were analyzed immediately after collection and again after 24 h. RESULTS: After 24 h at room temperature, the purulent sputum presented an increase in cough-induced dislodgment (96 ± 50 vs. 118 ± 61 mm) and a decrease in the contact angle (32 ± 6 vs. 27 ± 6 degrees) (p < 0.05). For the hyaline sputum, there were no alterations in the parameters analyzed. CONCLUSION: Hyaline tracheobronchial sputum can be stored in room temperature for 24 h without presenting alterations in ciliary transport or contact angle. However, purulent sputum should not be stored at room temperature for many hours, since ciliary transport and contact angle might be altered as a result.

Influência do método Reequilíbrio Toracoabdominal sobre a força muscular respiratória de pacientes com fibrose cística / Influence of the technique of re-educating thoracic and abdominal muscles on respiratory muscle strength in patients with cystic fibrosis

OBJETIVO: Avaliar o efeito do método Reequilíbrio Toracoabdominal na força dos músculos respiratórios de pacientes com fibrose cística, acompanhados no Ambulatório de Fibrose Cística da Universidade Católica de Brasília. MÉTODOS: A amostra, constituída de 29 fibrocísticos, foi caracterizada com base em dados antropométricos, genéticos e de colonização bacteriana. Espirometria, manovacuometria e antropometria foram realizadas antes e depois do tratamento fisioterapêutico, no qual se utilizou o método Reequilíbrio Toracoabdominal, duas vezes por semana, durante quatro meses. RESULTADOS: Houve aumento da pressão inspiratória máxima e da pressão expiratória máxima após o tratamento fisioterapêutico em todos os pacientes, naqueles sem distúrbio ventilatório obstrutivo e naqueles com distúrbio ventilatório obstrutivo leve (p < 0,05). Foi encontrada correlação positiva entre a idade e a pressão expiratória máxima para a maioria dos grupos. A pressão inspiratória máxima só apresentou correlação positiva com a idade no grupo com distúrbio ventilatório obstrutivo leve (p = 0,012; r = 0,817). Para o sexo feminino e para o grupo sem distúrbio ventilatório obstrutivo houve correlação negativa entre a pressão expiratória máxima e a colonização por Pseudomonas aeruginosa (p = 0,036; r = -0,585). CONCLUSÃO: Para os fibrocísticos avaliados, o método Reequilíbrio Toracoabdominal aumentou a força dos músculos respiratórios, o que reafirma a importância do tratamento fisioterapêutico para estes pacientes.

Presence of developmental defects of enamel in cystic fibrosis patients.

PURPOSES: Cystic fibrosis (CF) is an autosomal recessive hereditary disease and is the frequently common lethal genetic pathology. The purposes of this study were to: (1) determine the presence of 3 different types of enamel defects: (a) demarcated opacities; (b) diffuse opacities; and (c) hypoplasia in the deciduous and permanent dentition of CF patients; and (2) compare with a control group. METHODS: The case group was defined as 13 patients who were diagnosed with CF and enrolled in a multiprofessional project of the Catholic University of Brasília (CUB), Brasilia, Brazil. All CF subjects were compared with control subjects selected from patients at the CUB. Each CF subject was individually paired with a control subject of similar sex and age. A full-mouth examination was carried out for the developmental defects of enamel (DDE) index. RESULTS: The most prevalent enamel defect in deciduous teeth was demarcated opacities present in 16% of the case group and in 7% of the control group. Although the defects were more prevalent in the case group, the difference was not statistically significant (P=0.57). The frequency of demarcated opacities was more prevalent in permanent teeth of the case group: 39% compared to 11% in the control group. For the control group, diffuse opacities were the more prevalent defects: 17% compared to 15% in the case group. The case group had more enamel defects in permanent teeth compared to the control (P=0.0003). CONCLUSIONS: In this study, enamel defects were frequently found in the permanent teeth of CF patients. Therefore, professionals who treat children should be alerted to promoting oral health among these patients.

Influence of the technique of re-educating thoracic and abdominal muscles on respiratory muscle strength in patients with cystic fibrosis.

OBJECTIVE: To determine the effect that re-education of the thoracic and abdominal muscles has on the respiratory muscle strength of patients with cystic fibrosis evaluated over time at the Cystic Fibrosis Outpatient Clinic of the Universidade Católica de Brasília (Catholic University of Brasília). METHODS: The sample consisted of 29 cystic fibrosis patients, characterized based on anthropometric, genetic and bacterial colonization data. The patients were submitted to physical therapy sessions, involving re-education of the respiratory muscles, twice a week for four months. Spirometry, pressure manometry and anthropometry were performed before and after each session. RESULTS: Comparing baselines values to those obtained after physical therapy, increases in maximum inspiratory pressure and maximum expiratory pressure were observed in all patients, those without any obstructive respiratory disease and those with mild obstructive respiratory disease (p < 0.05). A positive correlation between age and maximum expiratory pressure was observed for most of the patients. Maximum inspiratory pressure correlated positively with age only in the group with mild obstructive respiratory disease (p = 0.012; r = 0.817). In female patients and in the group of patients without obstructive respiratory disease, a negative correlation was observed between maximum expiratory pressure and colonization with Pseudomonas aeruginosa (p = 0.036; r = -0.585). CONCLUSION: Use of the thoracic and abdominal muscle re-education technique increased respiratory muscle strength in the cystic fibrosis patients studied, a finding that underscores the importance of including physical therapy in the treatment of these patients.

A comparative evaluation of the Papanicolaou test for the diagnosis of trichomoniasis.

BACKGROUND: Trichomoniasis is the most prevalent nonviral sexually transmitted disease in humans worldwide. In addition to its pathologic implications, trichomoniasis is a risk factor for the transmission of the HIV and is associated with reproductive complications in females. Diagnosis of the disease is problematic due to inadequate accuracy of current diagnostic methods. Recently developed DNA-based techniques for detection of Trichomonas vaginalis seem to be promising alternatives. GOAL: The goal of this study was to evaluate the accuracy of the Papanicolaou test for the diagnosis of trichomoniasis by comparing polymerase chain reaction (PCR) with other current diagnostic methods. STUDY DESIGN: A total of 1008 cervicovaginal swab specimens from a randomized population attending a gynecological service were analyzed in this study. In addition to current diagnostic methods, two sets of specific primers were used for PCR detection of T vaginalis in the cervicovaginal DNA samples, with a PCR quality control. Different examiners conducted PCR and Papanicolaou analyses in a double-blind trial. RESULTS: The prevalence of trichomoniasis in this population was 6%. A considerable number of diagnostic results of the Papanicolaou test were false negative or false positive. Compared with PCR, specificity of the Papanicolaou test was 97.6%, whereas sensitivity was only 60.7%. The positive predictive value of the Papanicolaou smear was 61.7%. These results suggest that irregularly shaped parasites without clearly defined nuclei and flagella and bacteria-induced focal cytolysis limit the ability of the Papanicolaou test to detect T vaginalis. CONCLUSION: The Papanicolaou test, the most readily available cytologic method for screening sexually transmitted pathogens and cellular abnormalities in most developing countries, is inadequate for the diagnosis of trichomoniasis due to its inherent limitations. However, PCR is a highly sensitive and specific test for the diagnosis of trichomoniasis.

Six-year follow-up survey of sexually transmitted diseases in Brasilia, the Capital of Brazil.

The notification of sexually transmitted diseases (STD) is a prime component of well-designed public health policy. However, peculiar aspects of STD must be taken into account for the correct management of surveillance activities. Here, we describe the distribution of the most common sexually transmitted diseases among patients attended by the gynecological clinics of the principal public hospitals of Brasilia and the Federal District, Brazilian capital, during six years. A total of 142,158 patients had their cervicovaginal samples collected for Papanicolaou preparations and eventual biopsies. Diagnosis was made according to cytological and histological alterations, distinguishing among vaginal infections, and pre-cancerous and cancerous cervical lesions. We also looked at the annual prevalence of the various types of infections and alterations. There was a high prevalence of bacterial vaginosis, trichomoniasis and candidiasis, with suggestive changes over the years. Pre-cancerous and cancerous lesions increased 2.2 fold during the six years. A large proportion of the cases involved late stages of cervical cancer, indicating the necessity of prompt attendance of the population in a routine gynecological prevention program.

Six-year follow-up survey of sexually transmitted diseases in Brasilia, the Capital of Brazil

The notification of sexually transmitted diseases (STD) is a prime component of well-designed public health policy. However, peculiar aspects of STD must be taken into account for the correct management of surveillance activities. Here, we describe the distribution of the most common sexually transmitted diseases among patients attended by the gynecological clinics of the principal public hospitals of Brasilia and the Federal District, Brazilian capital, during six years. A total of 142,158 patients had their cervicovaginal samples collected for Papanicolaou preparations and eventual biopsies. Diagnosis was made according to cytological and histological alterations, distinguishing among vaginal infections, and pre-cancerous and cancerous cervical lesions. We also looked at the annual prevalence of the various types of infections and alterations. There was a high prevalence of bacterial vaginosis, trichomoniasis and candidiasis, with suggestive changes over the years. Pre-cancerous and cancerous lesions increased 2.2 fold during the six years. A large proportion of the cases involved late stages of cervical cancer, indicating the necessity of prompt attendance of the population in a routine gynecological prevention program.

Proteínas recombinantes da saliva de triatoma infestans / Recombinant proteins of the saliva in triatoma infestans

Insetos hematófagos transmitem doenças ao contaminar a presa durante o repasto. Acredita-se que um longo processo de evolução teria feito com que tais insetos acumulassem na secreção salivar uma gama de compostos que facilitariam a obtenção do sangue...