RESUMO
The WHO criterion of defering any donation of blood by a confirmed case of malaria for three years after cessation of therapy can not be applied in areas where malaria is endemic. For this reason we developed an immunoenzymatic assay for the detection of plasmodial antigens for blood screening in malarial endemic areas. So, we tested sera from 191 individuals. Among patients with active disease 100% of the cases of Plasmodium falciparum or mixed infections and 91.7% of those with P. vivax were positive for the presence of plasmodial antigens. The lower parasitaemia detected was 0.0003% for P. falciparum and 0.001% for P. vivax malária. When the frequency of positive circulating malarial antigens was evaluated among asymptomatic and symptomatic individuals with negative TBS, positive results were found in respectively 38.7% and 17.7% of the individuals studied in the 30 days after confirmed malaria attack. Data provide by these assays have shown that ELISA seemed to be more sensitive than parasitological examination for malaria diagnosis. This test by virtue of its high sensitivity and the facilities in processing a large number of specimens, can prove to be useful in endemic areas for the recognition of asymptomatic malaria and screening of blood donors.
Assuntos
Anticorpos Monoclonais/imunologia , Anticorpos Antiprotozoários/imunologia , Ensaio de Imunoadsorção Enzimática , Malária Falciparum/diagnóstico , Malária Vivax/diagnóstico , Plasmodium falciparum/imunologia , Plasmodium vivax/imunologia , Proteínas de Protozoários/imunologia , Animais , Anticorpos Antiprotozoários/sangue , Doadores de Sangue , Imunofluorescência , Humanos , Malária Falciparum/imunologia , Malária Falciparum/prevenção & controle , Malária Vivax/imunologia , Malária Vivax/prevenção & controle , Programas de Rastreamento , Proteínas de Protozoários/sangue , Recidiva , Sensibilidade e EspecificidadeAssuntos
Sistema Digestório , Esôfago , Corpos Estranhos , Orofaringe , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Endoscopia , Feminino , Corpos Estranhos/terapia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The experience in upper G.I. tract hemorrhage accumulated during the first 30 months in the Emergency Hemorrhage Unit at the Hospital Posadas is here reported over a total of 428 endoscopies, we found 518 lesions. Ninety one (21%) presented with active bleeding, and 317 (76%) were considered as the probable cause of the bleeding. In 37 cases (8.6%) the site of bleeding was detected, but the diagnosis wasn't done. The most frequent lesions were erosive gastritis (21.2%), gastric ulcer (20%), erosive duodenitis (12.6%), duodenal ulcer (12.15%) and esophageal varices (12.12%) the diagnosis was normal 14.7% of the cases. One hundred and sixty one patients were admitted to the hospital; on 143 (88.82%) patients the original diagnosis was confirmed but it was modified in 18 patients (11.18%) by surgery or repeated endoscopy. During the last 20 months of the period the accuracy diagnostic of the endoscopy increased 95%. When compared with the first 10 months (76%) this fact shows, the importance of the experience acquired by the endoscopist. Most of the patients received medical treatment with a mortality of 9.02% and 25 patients received surgical treatment with a mortality of 28%.
Assuntos
Emergências , Endoscopia , Hemorragia Gastrointestinal/diagnóstico , Adolescente , Adulto , Idoso , Duodenite/complicações , Varizes Esofágicas e Gástricas/complicações , Feminino , Gastrite/complicações , Hemorragia Gastrointestinal/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica/complicaçõesRESUMO
The experience in upper G.I. tract hemorrhage accumulated during the first 30 months in the Emergency Hemorrhage Unit at the Hospital Posadas is here reported over a total of 428 endoscopies, we found 518 lesions. Ninety one (21
) presented with active bleeding, and 317 (76
) were considered as the probable cause of the bleeding. In 37 cases (8.6
) the site of bleeding was detected, but the diagnosis wasnt done. The most frequent lesions were erosive gastritis (21.2
), gastric ulcer (20
), erosive duodenitis (12.6
), duodenal ulcer (12.15
) and esophageal varices (12.12
) the diagnosis was normal 14.7
of the cases. One hundred and sixty one patients were admitted to the hospital; on 143 (88.82
) patients the original diagnosis was confirmed but it was modified in 18 patients (11.18
) by surgery or repeated endoscopy. During the last 20 months of the period the accuracy diagnostic of the endoscopy increased 95
. When compared with the first 10 months (76
) this fact shows, the importance of the experience acquired by the endoscopist. Most of the patients received medical treatment with a mortality of 9.02
and 25 patients received surgical treatment with a mortality of 28
.
