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1.
BMC Neurol ; 23(1): 338, 2023 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-37749503

RESUMO

BACKGROUND: Focal cortical dysplasia (FCD) is a malformation of cortical development that causes medical refractory seizures, and one of the main treatments may be surgical resection of the affected area of the brain. People affected by FCD may present with seizures of variable severity since childhood. Despite many medical treatments available, only surgery can offer cure. The pathophysiology of the disease is not yet understood; however, it is known that several gene alterations may play a role. The WNT/ß-catenin pathway is closely related to the control and balance of cell proliferation and differentiation in the central nervous system. The aim of this study was to explore genes related to the WNT/ß-catenin pathway in lesional and perilesional brain tissue in patients with FCD type II. METHODS: Dysplastic and perilesional tissue from the primary dysplastic lesion of patients with FCD type IIa were obtained from two patients who underwent surgical treatment. The analysis of the relative expression of genes was performed by a qRT-PCR array (super array) containing 84 genes related to the WNT pathway. RESULTS: Our results suggest the existence of molecular alteration in some genes of the WNT pathway in tissue with dysplastic lesions and of perilesional tissue. We call this tissue of normal-appearing adjacent cortex (NAAC). Of all genes analyzed, a large number of genes show similar behavior between injured, perilesional and control tissues. However, some genes have similar characteristics between the perilesional and lesional tissue and are different from the control brain tissue, presenting the perilesional tissue as a molecularly altered material. CONCLUSION: Our results suggest that the perilesional area after surgical resection of tissue with cortical dysplasia presents molecular changes that may play a role in the recurrence of seizures in these patients. The perilesional tissue should receive expanded attention beyond the somatic mutations described and associated with FCD, such as mTOR, for example, to new signaling pathways that may play a crucial role in seizure recurrence.


Assuntos
Epilepsia Resistente a Medicamentos , Displasia Cortical Focal , Humanos , Criança , Epilepsia Resistente a Medicamentos/genética , Epilepsia Resistente a Medicamentos/cirurgia , Via de Sinalização Wnt/genética , beta Catenina , Convulsões
2.
Exp Parasitol ; 230: 108158, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34534534

RESUMO

Our aim was to evaluate the impact of immunosuppression on the development of giardiasis. Thirty-six gerbils (4-6 weeks old) were distributed in four groups containing nine animals each: Control (CT); Control-Infected by Giardia lamblia (CTIn), Immunosuppressed (IS), and Immunosuppressed-Infected by G. lamblia (ISIn). Animals in the IS and ISIn groups received intramuscular dexamethasone solution for 25 days. On the 11th day, the animals in the CTIn and ISIn groups were inoculated with G. lamblia. After 14 days of infection, the 25th day of the experiment, all groups were euthanized. Four hours after euthanasia, the intestinal permeability was evaluated and sections of the duodenum and spleen were harvested for morphometric and histopathological analyses. Immunosuppressed groups showed a significant increase in intestinal permeability compared to control and infected groups. Considering that the infection can become chronic in immunosuppressed groups, we should be alert to the possibilities of chronic inflammatory changes, both locally and systemically, due to the loss of the intestinal barrier. Lesions were observed in the duodenal mucosa of the gerbils of the CTIn group, with reduced villi size, crypt hyperplasia, edema, and the presence of inflammatory infiltrate in the lamina propria. In the ISIn group, we observed no inflammation, long and intact villi, and a significant increase in the area of intestinal mucins, despite the large number of trophozoites identified. Our results suggest that exacerbation of the immune response has a direct relationship with the appearance of lesions during enteritis produced by G. lamblia in the assessed model.


Assuntos
Dexametasona/uso terapêutico , Enterite/tratamento farmacológico , Enterite/parasitologia , Giardíase/tratamento farmacológico , Glucocorticoides/uso terapêutico , Animais , Dexametasona/farmacologia , Modelos Animais de Doenças , Duodeno/parasitologia , Duodeno/patologia , Enterite/imunologia , Feminino , Gerbillinae , Giardia lamblia/efeitos dos fármacos , Giardia lamblia/imunologia , Giardia lamblia/patogenicidade , Giardíase/imunologia , Giardíase/parasitologia , Glucocorticoides/farmacologia , Terapia de Imunossupressão , Mucosa Intestinal/parasitologia , Mucosa Intestinal/patologia , Masculino , Carga Parasitária , Permeabilidade , Baço/patologia
3.
J Tissue Eng Regen Med ; 12(2): e648-e656, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-27688159

RESUMO

Temporal lobe epilepsy (TLE) is a highly prevalent syndrome among people with epilepsy, and is usually refractory to drug treatment. Structural and physiological changes, such as hippocampal sclerosis, are often present in TLE patients. The objective of this study is to evaluate the feasibility and safety of intra-arterial infusion of autologous bone marrow mononuclear cells (BMMC) in adults with medically refractory mesial TLE (MTLE) and unilateral hippocampal sclerosis (HS). We enrolled 20 patients who had been diagnosed with MTLE-HS and were refractory to medical treatment. All patients underwent a neurological evaluation, magnetic resonance imaging with hippocampal volumetry, video-electroencephalography (EEG) with ictal recording, and a neuropsychological test battery focusing on verbal and nonverbal memory domains. After bone marrow aspiration and subsequent cell preparation, the BMMC were infused by selective posterior cerebral artery catheterization. Patients were followed for 6 months. Safety of the procedure, seizure frequency, neuropsychological evaluation, EEG variables, routine brain magnetic resonance imaging and hippocampal volumetry were considered measurements of outcome. Any serious intercurrent clinical event or adverse effects related to the procedure were reported. No additional lesions and no significant hippocampal volumetric changes were observed. EEG recordings showed a decrease in theta activity and spike density. At 6 months, eight patients (40%) were seizure free. A significant increase in the memory scores over time was observed. The BMMC autologous transplant for the treatment of temporal lobe epilepsy is feasible and safe. The seizure control achieved in this novel study supports the therapeutic potential of stem cell transplants in MTLE-HS patients. Copyright © 2016 John Wiley & Sons, Ltd.


Assuntos
Células da Medula Óssea/citologia , Transplante de Medula Óssea/efeitos adversos , Epilepsia do Lobo Temporal/terapia , Leucócitos Mononucleares/transplante , Convulsões/terapia , Adulto , Eletroencefalografia , Epilepsia do Lobo Temporal/fisiopatologia , Feminino , Seguimentos , Humanos , Processamento de Imagem Assistida por Computador , Injeções Intra-Arteriais , Masculino , Memória , Pessoa de Meia-Idade , Convulsões/patologia , Convulsões/fisiopatologia , Transplante Autólogo , Gravação em Vídeo , Adulto Jovem
4.
Nutr Cancer ; 67(3): 486-93, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25803482

RESUMO

Beneficial effects of L-arginine on immune responses and bowel function have been reported. Mucositis is a side effect of chemotherapy treatment that affects approximately 40% of patients. This complication is characterized by inflammation that affects the gastrointestinal tract, increasing permeability and causing abdominal pain, nausea, vomiting, and diarrhea, which worsen the patient's nutritional status and increases morbimortality. The aim of this study was to evaluate the effect of pretreating with 2% L-arginine supplementation in water on mucositis as induced by 5-fluorouracil (5-FU; a single dose of 200 mg/kg body weight) in Swiss male mice. The effect of L-arginine on weight, intestinal permeability, morphology, and the histopathological score of the small intestine (from 0 to 12), oxidative stress, myeloperoxidase (MPO), and N-acetylglucosaminidase (NAG) activities were evaluated. Intestinal length improvement was observed, in addition to the partial recovery of the mucosal architecture. L-arginine attenuated the histopathological score and MPO activity. There was also an improvement in intestinal permeability, despite weight loss after 5-FU administration. In conclusion, L-arginine can positively impact intestinal mucositis by promoting partial mucosal recovery, reducing inflammation and improving intestinal permeability.


Assuntos
Antimetabólitos Antineoplásicos/toxicidade , Arginina/farmacologia , Fluoruracila/toxicidade , Mucosa Intestinal/efeitos dos fármacos , Mucosite/prevenção & controle , Animais , Masculino , Camundongos , Mucosite/induzido quimicamente , Estresse Oxidativo , Peroxidase/metabolismo
6.
Seizure ; 19(2): 84-92, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20080419

RESUMO

In this study, we investigated the therapeutic potential of bone marrow mononuclear cells (BMCs) in a model of epilepsy induced by pilocarpine in rats. BMCs obtained from green fluorescent protein (GFP) transgenic mice or rats were transplanted intravenously after induction of status epilepticus (SE). Spontaneous recurrent seizures (SRS) were monitored using Racine's seizure severity scale. All of the rats in the saline-treated epileptic control group developed SRS, whereas none of the BMC-treated epileptic animals had seizures in the short term (15 days after transplantation), regardless of the BMC source. Over the long-term chronic phase (120 days after transplantation), only 25% of BMC-treated epileptic animals had seizures, but with a lower frequency and duration compared to the epileptic control group. The density of hippocampal neurons in the brains of animals treated with BMCs was markedly preserved. At hippocampal Schaeffer collateral-CA1 synapses, long-term potentiation was preserved in BMC-transplanted rats compared to epileptic controls. The donor-derived GFP(+) cells were rarely found in the brains of transplanted epileptic rats. In conclusion, treatment with BMCs can prevent the development of chronic seizures, reduce neuronal loss, and influence the reorganization of the hippocampal neuronal network.


Assuntos
Transplante de Medula Óssea/métodos , Convulsões/prevenção & controle , Estado Epiléptico/cirurgia , Análise de Variância , Animais , Antígenos CD/metabolismo , Movimento Celular/fisiologia , Modelos Animais de Doenças , Estimulação Elétrica , Potenciais Pós-Sinápticos Excitadores/fisiologia , Citometria de Fluxo , Proteína Glial Fibrilar Ácida/metabolismo , Proteínas de Fluorescência Verde/genética , Hipocampo/patologia , Técnicas In Vitro , Lítio , Potenciação de Longa Duração/fisiologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Neurônios/fisiologia , Técnicas de Patch-Clamp/métodos , Pilocarpina , Ratos , Ratos Wistar , Convulsões/etiologia , Estado Epiléptico/induzido quimicamente , Estado Epiléptico/complicações , Estado Epiléptico/patologia , Fatores de Tempo
7.
Angle Orthod ; 79(5): 939-44, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19705945

RESUMO

OBJECTIVE: To test the null hypothesis that the silver soldering employed in orthodontics is not cytotoxic for fibroblasts. MATERIALS AND METHODS: This in vitro study was performed using a culture of mice fibroblasts (lineage NIH/3T3), divided into four groups (n = 10 each): control, negative control (stainless steel archwire), positive control (amalgam disks), and test group (silver soldering). After cell culture in complete Dulbecco modified eagle medium and achievement of confluence in 80%, the suspension was added to the plates of 24 wells containing the specimens and incubated in an oven at 37 degrees C for 24 hours. The plates were analyzed on an inverted light microscope, photomicrographs were obtained, and the results were recorded as response rates based on modifications of the parameters of Stanford according to the size of the diffusion halo of the toxic substance and quantity of cell lysis. RESULTS: The results revealed a maximum response rate for the silver soldering group, as well as severe inhibition of cell proliferation and growth, more round cells with mostly darkened and granular aspects, suggesting lysis with cell death. A similar response was seen in the positive control group. CONCLUSION: The hypothesis is rejected. The silver soldering used in orthodontics represents a highly cytotoxic material for the cells analyzed.


Assuntos
Células 3T3/efeitos dos fármacos , Soldagem em Odontologia/efeitos adversos , Aparelhos Ortodônticos/efeitos adversos , Prata/toxicidade , Animais , Proliferação de Células/efeitos dos fármacos , Camundongos
8.
Respirology ; 13(4): 594-8, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18410256

RESUMO

BACKGROUND AND OBJECTIVE: Pulmonary aspiration (PA) is a significant respiratory disease in children. However, the diagnosis of aspiration is often difficult owing to the poor efficacy of currently available diagnostic tests. The aim of this study was to assess in a mouse model the specificity of starch granule detection in BAL as a new method for detecting PA in children. METHODS: Twenty BALB/c mice were divided into the following groups according to the solution instilled into the airways: corn flour milk 7.5%-a source of starch (CM), Pseudomonas aeruginosa, normal saline and a control group. BAL was performed 2 days after instillation. Detection of starch granules and lipid-laden macrophages were compared in BAL. RESULTS: Starch granules were detected in BAL fluids from all mice in the CM group (food aspiration model), whereas no starch granules were detected in the other three groups, demonstrating a sensitivity and specificity of 100%. On the other hand, lipid-laden macrophages were found in all mice from all the groups studied. CONCLUSIONS: The detection of starch granules in BAL is a simple and highly specific method for the diagnosis of PA in an experimental model. Clinical studies using the starch granule detection method in BAL should be tested in at risk patients to evaluate the utility of this method for investigating PA.


Assuntos
Lavagem Broncoalveolar , Modelos Animais de Doenças , Pneumonia Aspirativa/diagnóstico , Animais , Técnicas de Diagnóstico do Sistema Respiratório , Feminino , Lipídeos , Macrófagos Alveolares , Camundongos , Camundongos Endogâmicos BALB C , Sensibilidade e Especificidade , Amido
9.
Dig Dis Sci ; 53(5): 1370-4, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-17932764

RESUMO

Hepatitis B virus (HBV) infection leaves serological markers that indicate prior contact with the virus or an occult infection. The aim of this study was to determine the profile of HBV markers of individuals from a region of low HBV endemicity excluded from blood donation due to the presence of total anti-HBc antibodies but who tested negative for HBV surface antigen (HBsAg). The profile of 244 subjects exclusively anti-total hepatitis B core (anti-total HBc) reactive was determined. Markers such as anti-HBsAg, HBeAg (HBV core antigen) and anti-HBe (antibody to hepatitis Be antigen) were determined, and HB viral DNA (HBV-DNA) was identified by PCR analysis. Overall, 85.7% of the subjects had an anti-HBs (hepatitis B surface antigen antibody) titer higher than 10 IU/L; 154 samples were negative for HBeAg and 66.5% were reactive for anti-HBe. All samples were negative for HBV-DNA (n = 241). We found a significant association between the anti-HBe and anti-HBs titers (P = 0.026). Most individuals from a low endemic area for HBV have shown anti-HBs titers that confer immunity against HBV, even though they were negative for HBV-DNA. In the light of a shortage of donated blood worldwide, we suggest that special measures should be considered that would facilitate the possible use of these rejected blood units in areas of low endemicity for HBV.


Assuntos
Doadores de Sangue , Anticorpos Anti-Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/sangue , Vírus da Hepatite B/metabolismo , Hepatite B/sangue , Biomarcadores/sangue , Bancos de Sangue , Transfusão de Sangue , Brasil/epidemiologia , Distribuição de Qui-Quadrado , DNA Viral , Feminino , Hepatite B/epidemiologia , Hepatite B/transmissão , Humanos , Masculino , Reação em Cadeia da Polimerase , Estudos Soroepidemiológicos
10.
Arq Neuropsiquiatr ; 64(1): 125-7, 2006 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16622568

RESUMO

HTLV-I and HTLV-II are endemic in some areas of Brazil, where an associated disease, HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) have been diagnosed in significant number of infected individuals. Tuberculosis has been demonstrated among those individuals, with higher prevalence than in the general population, suggesting that there is an increased risk for this comorbidity. We report the case of an individual coinfected with HTLV-I and HTLV-II, suffering from an insidious meningoencephalomyelitis caused by Mycobacterium tuberculosis. The patient was a 44 years old man successfully treated with steroids and antituberculous drugs, improving clinically and turning to a negative PCR and to a normal blood-cerebrospinal fluid barrier.


Assuntos
Encefalomielite/complicações , Infecções por HTLV-I/complicações , Infecções por HTLV-II/complicações , Tuberculose Meníngea/complicações , Adulto , Proteínas do Líquido Cefalorraquidiano/análise , Encefalomielite/microbiologia , Infecções por HTLV-I/microbiologia , Infecções por HTLV-II/microbiologia , Humanos , Hospedeiro Imunocomprometido , Masculino , Mycobacterium tuberculosis/isolamento & purificação , Paraparesia Espástica Tropical/complicações , Paraparesia Espástica Tropical/microbiologia
11.
Arq. neuropsiquiatr ; 64(1): 125-127, mar. 2006. tab
Artigo em Inglês | LILACS | ID: lil-425286

RESUMO

Os vírus HTLV-I e HTLV-II são endêmicos em algumas regiões do Brasil, onde uma das doenças associadas, a paraparesia espástica tropical/mielopatia associada ao HTLV (PET/MAH), tem sido diagnosticada em significativo número de pacientes infectados. Nesses indivíduos, a prevalência de tuberculose é maior que na população geral, sugerindo que possa haver um maior risco para esta comorbidade. Relatamos o caso de um homem de 44 anos coinfectado HTLV-I + HTLV-II que desenvolveu meningoencefalomielite por Mycobacterium tuberculosis. O paciente apresentou recuperação clínica parcial, correção da disfunção de barreira hemato-liquórica e negativação no PCR, mediante o tratamento com corticoesteróides e tuberculostáticos.


Assuntos
Adulto , Humanos , Masculino , Encefalomielite/complicações , Infecções por HTLV-I/complicações , Infecções por HTLV-II/complicações , Tuberculose Meníngea/complicações , Proteínas do Líquido Cefalorraquidiano/análise , Encefalomielite/microbiologia , Infecções por HTLV-I/microbiologia , Infecções por HTLV-II/microbiologia , Hospedeiro Imunocomprometido , Mycobacterium tuberculosis/isolamento & purificação , Paraparesia Espástica Tropical/complicações , Paraparesia Espástica Tropical/microbiologia
12.
Parasitol Res ; 98(4): 295-8, 2006 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16362342

RESUMO

Epidemiological and experimental studies have demonstrated an association between parasitic infections and the allergic diseases. A protective effect in asthma was shown in animals infected with helminths. The aim of this study was to determine the effect of Angiostrongylus costaricensis extract on inflammatory lung response to ovalbumin (OVA) in mice. Four BALB/c mice received A. costaricensis extract by intraperitoneal (i.p.) injection on the first day. Mice were immunised against OVA by i.p. injection on day (D) 5 and D12 and received a daily intranasal OVA challenge (40 microl) between the D19 and D21. On D23, we performed a bronchoalveolar lavage (BAL) on the mice. Four BALB/c mice (control group) were immunised against OVA using the same protocol, but did not receive parasite extract. Total cell counts (TCC) and differential cell counts were performed in BAL fluid samples. Eosinophil cell counts in BAL fluid were lower in the group that received A. costaricensis extract when compared with the control group (0.04 x 10(6) cells/ml and 0.01 x 10(6) cells/ml, respectively; p=0.04). TCC were not different between the groups studied. A. costaricensis extract in mice decreases eosinophilic response to OVA in BAL fluid.


Assuntos
Angiostrongylus/química , Antígenos de Helmintos/administração & dosagem , Eosinófilos/efeitos dos fármacos , Pulmão/citologia , Eosinofilia Pulmonar/induzido quimicamente , Extratos de Tecidos/administração & dosagem , Angiostrongylus/imunologia , Animais , Líquido da Lavagem Broncoalveolar/química , Líquido da Lavagem Broncoalveolar/citologia , Eosinófilos/patologia , Contagem de Leucócitos , Camundongos , Camundongos Endogâmicos BALB C , Ovalbumina/imunologia , Eosinofilia Pulmonar/imunologia , Eosinofilia Pulmonar/patologia
13.
Ann Trop Paediatr ; 25(4): 261-6, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16297300

RESUMO

BACKGROUND: Post-infectious bronchiolitis obliterans (BO) is a chronic obstructive airway disease associated with inflammation and fibrosis of the small airways; it is more common in children who have had acute viral bronchiolitis. No previous studies have reported the immune response of BO. Unbalanced Th1/Th2 immune response might be one of the risk factors for developing this illness. AIM: To compare the production of interferon (IFN)-gamma, interleukin (IL)-4 and IL-10 in peripheral blood mononuclear cell cultures in children with BO and in healthy children. METHODS: From March 2003 to October 2003, children with BO and healthy children were selected from the paediatric outpatient clinics in our centre. Peripheral blood was collected and mononuclear cells were separated and cultured (96 hours) with 1% phytohaemagglutinin stimulation. The supernatant was stored and cytokine levels were measured through ELISA. RESULTS: IFN-gamma, IL-4 and IL-10 levels were not significantly different between the groups studied. Family history of atopy was significantly associated with subjects with BO (p=0.02). CONCLUSIONS: Our results suggest that unbalanced peripheral blood Th1/Th2 immune response of children with post-infectious BO might not be associated with its pathophysiology. Further studies are required to better understand the role of risk factors, including viral genotype, viral load or tissue repair abnormalities in the development of post-infectious BO.


Assuntos
Bronquiolite Obliterante/imunologia , Interferon gama/sangue , Interleucina-10/sangue , Interleucina-4/sangue , Linfócitos T Auxiliares-Indutores/imunologia , Doença Aguda , Bronquiolite Obliterante/sangue , Bronquiolite Obliterante/virologia , Bronquiolite Viral/imunologia , Células Cultivadas , Pré-Escolar , Feminino , Humanos , Leucócitos Mononucleares/imunologia , Pulmão/diagnóstico por imagem , Masculino , Tomografia Computadorizada por Raios X/métodos
14.
J Pediatr Surg ; 40(7): 1106-10, 2005 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16034753

RESUMO

PURPOSE: Most pleural effusions are associated with bacterial pneumonia, and the identification of the pathogen will assist the therapeutic decision. A specific method that is not affected by previous antibiotic therapy is sought to detect the main causative agents of pneumonia in infants and children (Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus). The aim of the present study was to compare the polymerase chain reaction (PCR) technique with standard culture methods in identifying bacterial infections in infants' and children's pleural effusion. METHODS: Samples obtained from pediatric patients (n = 37) with a diagnosis of pneumonia associated to pleural effusion, submitted to thoracentesis, were analyzed by PCR with specific primers. RESULTS: The PCR technique identified the presence of bacterial infection in a larger proportion (95.2%) than the standard culture method (33.3%) on complicated pleural effusion samples. The microorganism detection on uncomplicated pleural effusion samples was positive only by the PCR method (31.3%). The frequencies of microorganisms identified on complicated pleural effusion were 57.1% of all patients for methicillin-resistant Staphylococcus; 52.4%, S pneumoniae; 28.6%, S aureus; and 23.8%, H influenzae. The previous use of antibiotics interferes with standard culture method, but it did not interfere with the PCR results. CONCLUSIONS: The molecular diagnosis by PCR method could improve the etiologic diagnosis and might help to guide the treatment of parapneumonic effusion in children.


Assuntos
DNA Bacteriano/genética , Derrame Pleural/etiologia , Derrame Pleural/microbiologia , Pneumonia Bacteriana/complicações , Pneumonia Bacteriana/diagnóstico , Reação em Cadeia da Polimerase/métodos , Criança , Pré-Escolar , Estudos Transversais , Primers do DNA , Feminino , Infecções por Haemophilus/diagnóstico , Infecções por Haemophilus/genética , Humanos , Lactente , Masculino , Infecções Pneumocócicas/diagnóstico , Infecções Pneumocócicas/genética , Sensibilidade e Especificidade , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/genética
15.
J Pediatr (Rio J) ; 80(4): 315-20, 2004.
Artigo em Português | MEDLINE | ID: mdl-15309234

RESUMO

OBJECTIVE: To assess interleukin-2 concentrations in nasopharyngeal secretion of children (0-24 months) with acute respiratory syncytial virus bronchiolitis, within the first 12 hours of hospital admission, and compare the levels of IL-2 with the severity of the illness. METHODS: Prospective study performed between June and August 1999. The study included 62 patients, previously healthy, hospitalized with acute viral bronchiolitis characterized by recent prodromes of coryza and/or nasal obstruction, which evolved to at least two of the following signs: respiratory dysfunction, tachypnea, wheezing or rales, and detection of respiratory syncytial virus in nasopharyngeal aspirate. The nasopharyngeal specimens were collected within 12 hours of hospital admission. The interleukin-2 levels were obtained by enzyme immunoassay. Severity of illness was assessed through oxygen saturation by pulse oximetry, Modified Clinical Score System, time of supplemental oxygen required, length of hospital stay, and mechanical ventilation. Spearman's correlation and Kruskal-Wallis test were used to compared these variables in relation to the median of interleukin-2. The chi-square test was used for categorical analysis of interleukin-2. RESULTS: The mean age of patients was 2.2 (1.3-4) months. Males comprised 54% of cases. Hemoglobin oxygen saturation by pulse oximetry at hospital admission was below 95% in 66.1% of patients. The mean time of supplemental oxygen use was 4.7 days (+/-3.54). The mean length of hospital stay was 4.25 days (+/-1.76). Mechanical ventilation was used in 4.8% of patients. The values of interleukin-2 in nasopharyngeal aspirates varied from 0 to 40,256 ng/ml with median of 86 ng/ml (4.4 - 457.3). The study showed no statistical difference between levels of IL-2 and severity of illness. CONCLUSIONS: The interleukin-2 levels showed a heterogeneous behavior. We found no association between interleukin-2 levels in nasopharyngeal secretion and respiratory syncytial virus bronchiolitis.


Assuntos
Bronquiolite Viral/metabolismo , Interleucina-2/análise , Nasofaringe/metabolismo , Infecções por Vírus Respiratório Sincicial/metabolismo , Vírus Sincicial Respiratório Humano/isolamento & purificação , Doença Aguda , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Nasofaringe/virologia , Oxigênio/uso terapêutico
16.
J. pediatr. (Rio J.) ; 80(4): 315-320, jul.-ago. 2004. tab, graf
Artigo em Português | LILACS | ID: lil-391645

RESUMO

OBJETIVO: Avaliar as concentrações de interleucina-2 (IL-2) na secreção nasofaríngea de crianças (0-24 meses) acometidas de bronquiolite viral aguda pelo vírus respiratório sincicial nas primeiras 12 horas de hospitalização e correlacionar os níveis encontrados com a gravidade da doença. MÉTODOS: Estudo prospectivo com amostragem seqüencial realizado no período de junho a agosto de 1999. Foram incluídos 62 pacientes previamente hígidos, internados com diagnóstico de bronquiolite viral aguda caracterizado por pródromos recentes de coriza e/ou obstrução nasal que evoluíram com pelo menos dois dos seguintes sinais: disfunção respiratória, taquipnéia, sibilos ou crepitações. Todos os pacientes tiveram a presença de vírus respiratório sincicial detectada no aspirado nasofaríngeo. As amostras de secreção nasofaríngea foram obtidas nas primeiras 12 horas de hospitalização. As dosagens de IL-2 foram realizadas por ensaio imunoenzimático. A gravidade da doença foi avaliada por: medida da saturação de oxigênio da hemoglobina por oximetria de pulso, sistema de escore clínico modificado, tempo de uso de oxigênio, tempo de hospitalização e necessidade de ventilação mecânica, sendo estas variáveis comparadas em relação às medianas de IL-2 através dos testes de Spearman e Kruskal-Wallis e, para a análise categorizada da interleucina, através do teste de qui-quadrado. RESULTADOS: A mediana de idade dos pacientes foi 2,2 (1,3-4) meses. O sexo masculino foi observado em 54 por cento dos casos. Saturação de oxigênio da hemoglobina por oximetria de pulso na hospitalização foi < 95 por cento em 66,1 por cento dos pacientes. A média do tempo de uso de oxigênio foi 4,7 dias (±3,54). A média do tempo de hospitalização foi de 4,25 dias (±1,76). Ventilação mecânica foi utilizada em 4,8 por cento dos casos. Os níveis de IL-2 na secreção nasofaríngea variaram de 0 a 40.256 ng/ml, com mediana de 86 ng/ml (4,4-457,3). Não houve diferença estatisticamente significativa entre os níveis de IL-2 e a gravidade da doença. CONCLUSÕES: Os níveis de IL-2 apresentaram valores com grande dispersão. Não houve associação entre bronquiolite viral aguda pelo vírus respiratório sincicial e aumento nos níveis de IL-2 na secreção nasofaríngea.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Bronquiolite Viral/metabolismo , /análise , Nasofaringe , Infecções por Vírus Respiratório Sincicial/metabolismo , Vírus Sincicial Respiratório Humano/isolamento & purificação , Doença Aguda , Estudos de Coortes , Nasofaringe/virologia , Oxigênio/uso terapêutico , Estudos Prospectivos
17.
J Pediatr (Rio J) ; 79(5): 443-8, 2003.
Artigo em Português | MEDLINE | ID: mdl-14557845

RESUMO

OBJECTIVE: To analyze the cellular pattern of nasopharyngeal secretions in infants with acute bronchiolitis (AB), focusing on the presence or absence of neutrophils and eosinophils. METHOD: Hospitalized children with AB admitted to Hospital São Lucas, Porto Alegre, Brazil, between May and July 2002 were recruited. Nasopharyngeal aspirates were collected during the first 48 hours after admission. Slides were stained with May Grunwald and Giemsa. Total cell count and cellular viability were obtained in all samples. RESULTS: Thirty-eight infants with AB were enrolled. The mean age was 2.2 months (interquartile range: 1.2-3.5), and 21 subjects were male. Neutrophils were the predominant cells in the nasopharyngeal aspirates (median 95%, interquartile: 94-97). No eosinophils were found in the samples studied. CONCLUSION: Our results suggest that eosinophils do not play a significant role in the pathophysiogenesis of AB. Infants with AB present a specific inflammatory response to viral infections, which is distinct from the immune response observed in asthma.


Assuntos
Bronquiolite/patologia , Eosinófilos , Líquido da Lavagem Nasal/citologia , Nasofaringe/patologia , Neutrófilos , Mucosa Respiratória/patologia , Doença Aguda , Asma/patologia , Contagem de Células , Feminino , Humanos , Lactente , Masculino , Escarro/citologia , Estatísticas não Paramétricas
18.
Rev Panam Salud Publica ; 14(2): 112-8, 2003 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-14577934

RESUMO

OBJECTIVES: This study had two objectives: (1) to investigate the socioeconomic and cultural characteristics of HIV-infected children and their families in relation to the presence of oral manifestations of AIDS and (2) to identify the most frequent oral manifestations of AIDS in the sample of children studied. METHODS: The sample consisted of a total of 184 children - both boys and girls - from 0 to 13 years old. The children were receiving care at two hospitals in the city of Porto Alegre, Brazil (the Hospital de Clínicas de Porto Alegre and the Hospital São Lucas da Pontifícia Universidade Católica), and at Stony Brook University Hospital, which is in the state of New York, United States. Data were analyzed using the chisquare test, Student's t test, and analysis of variance. RESULTS: Of the 184 patients, 117 of them (63.59%) were receiving care at the Hospital de Clínicas de Porto Alegre, 26 (14.13%) at the Hospital São Lucas, and 41 (22.28%) at Stony Brook University Hospital. In the Brazilian sample (the two hospitals in Porto Alegre) 42.66% of the children were living with their natural parents (mostly with the mother), while in the United States 56.10% of the children were living with foster families. Concerning income, 39.86% of the Brazilian families had a monthly income ranging from US$ 180 to US$ 450, and 33.57% had no income or did not provide information. With the United States sample, we were not allowed to ask about income, but all the families were classified by the social workers as having a monthly income below US$ 1 000. HIV was acquired through vertical transmission by 97.20% of the Brazilian children and by 97.56% of the children in the United States sample. Oral manifestations were more frequent in the Brazilian children (72.73%) than in the children in the United States sample (53.66%) (P = 0.01). CONCLUSIONS: The frequency of oral manifestations in the samples in both Brazil and the United States was influenced by socioeconomic and cultural conditions, family structure and income, access to information concerning AIDS, and adherence to treatment.


Assuntos
Infecções por HIV/epidemiologia , Doenças da Boca/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Adolescente , Brasil/epidemiologia , Criança , Pré-Escolar , Comorbidade , Cultura , Feminino , Infecções por HIV/transmissão , Hospitais Universitários/estatística & dados numéricos , Humanos , Renda , Lactente , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Masculino , New York/epidemiologia , Fatores Socioeconômicos
19.
J. pediatr. (Rio J.) ; 79(5): 443-448, set.-out. 2003. tab, graf
Artigo em Português | LILACS | ID: lil-351226

RESUMO

OBJETIVO: O objetivo deste estudo é analisar o exame citológico do aspirado nasofaríngeo de lactentes com bronquiolite aguda, especificamente em relaçäo à presença de neutrófilos e eosinófilos MÉTODOS: Foram recrutados lactentes hospitalizados com diagnóstico de bronquiolite aguda, no Hospital Säo Lucas da PUCRS, no período entre maio e julho de 2002. O aspirado nasofaríngeo foi coletado nas primeiras 48 horas de internaçäo hospitalar. O exame citológico diferencial foi realizado com coloraçäo de May Grunwald Giemsa. Foram realizadas também contagem total de células e viabilidade celular nas amostras estudadas. RESULTADOS: Foram selecionados 38 lactentes com bronquiolite aguda. A idade mediana foi de 2,2 meses (interquartil: 1,2-3,5), sendo 21 pacientes do sexo masculino. O exame citológico diferencial demonstrou um predomínio absoluto de neutrófilos, com mediana de 95 por cento (interquartil: 94-97). Näo foi detectada a presença de eosinófilos nas amostras estudadas. CONCLUSÖES: O aspirado nasofaríngeo de lactentes hospitalizados com bronquiolite aguda apresenta um predomínio absoluto de neutrófilos. Näo foram encontrados eosinófilos nessas amostras. Esses achados demonstram que lactentes com bronquiolite aguda apresentam uma resposta inflamatória neutrofílica, nas vias aéreas, aos vírus respiratórios, distinta daquela eosinofílica, encontrada em quadros de asma


Assuntos
Humanos , Masculino , Feminino , Lactente , Bronquiolite , Eosinófilos , Líquido da Lavagem Nasal , Nasofaringe , Neutrófilos , Mucosa Respiratória , Doença Aguda , Asma , Bronquiolite , Contagem de Células , Eosinófilos , Líquido da Lavagem Nasal , Nasofaringe , Neutrófilos , Mucosa Respiratória , Escarro , Estatísticas não Paramétricas
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