RESUMO
BACKGROUND: Ultrasound (US)-guided fine-needle aspiration cytology (US-FNAC) has improved the diagnosis of many malignancies, infections and other diseases as it is safe, simple, quick and accurate. In mycetoma, it is assumed that this technique may have a better diagnostic yield than the conventional FNAC as it can accurately identify the optimal site for the aspiration. OBJECTIVE: To compare the diagnostic yield of conventional FNAC with US-FNAC. METHODS: This descriptive cross-sectional hospital-based study included 80 patients with clinically suspected mycetoma. RESULTS: Of the 80 patients included, 35 proved to have actinomycetoma, and 37 had eumycetoma based on surgical biopsies, histopathological examination and the culture of grains. Eight patients appeared to have no mycetoma. For actinomycetoma diagnosis, the US-guided FNAC improved sensitivity to 97% and negative predictive value (NPV) to 83% compared to the conventional FNAC, which had 63% sensitivity; and NPV of 28%. No improvement was found for specificity. For eumycetoma, the conventional FNAC had 86.5% sensitivity, 100% specificity, 100% PPV and 37.5% NPV. The US-FNAC for the diagnosis of eumycetoma had 100% sensitivity and specificity. CONCLUSIONS AND RELEVANCE: The obtained results showed that US-FNAC is better than the conventional FNAC with lower false-negative results. It can accurately distinguish between the two types of mycetoma, allowing rapid initiation of proper treatment. The technique can be used in rural areas with low resources and for epidemiological surveys as a quick screening tool for patients suspected of mycetoma.
Assuntos
Micetoma , Biópsia por Agulha Fina , Estudos Transversais , Humanos , Micetoma/diagnóstico por imagem , Sensibilidade e Especificidade , Ultrassonografia de IntervençãoRESUMO
OBJECTIVE: The present study was designed to discover novel biomarkers involved in voriconazole resistance in clinical isolates of Aspergillus flavus. MATERIALS AND METHODS: Two voriconazole non-wild-type and two voriconazole-wild-type A. flavus clinical isolates were selected to evaluate possible molecular mechanism involved in A. flavus resistance to voriconazole using the mutation assessment, Quantitative real- time PCR of cyp51A and cyp51C genes and complementary DNA- amplified fragment length polymorphism technique. RESULTS: No mutations were seen in the cyp51A and cyp51C genes in voriconazole non-wild-type isolates compared to wild- type and reference strains. Regarding to mRNA expression results, no changes were observed in expression fold of cyp51A and cyp51C mRNA expression level in first non- wild- type isolate compared to wild-type isolate. For second isolate cyp51C mRNA expression level was down regulated (5.6 fold). The set of genes including ABC fatty acid transporter XM- 002375835 and aldehydereductase XM- 002376518 and three unknown functional genes were identified. Based on results, the over-expression of AKR1 and ABC fatty acid transporter in the voriconazole non- wild- type isolates suggests these genes could represent a novel molecular marker linked to the voriconazole resistance in A. flavus. CONCLUSION: The results obtained in this study showed a novel finding as the authors identified AKR1 and ABC fatty acid transporter genes as possible voriconazole target genes in Iranian clinical isolates of A. flavus.
Assuntos
Aspergilose/microbiologia , Aspergillus flavus/genética , Farmacorresistência Fúngica/genética , Proteínas Fúngicas/genética , Voriconazol/uso terapêutico , Análise do Polimorfismo de Comprimento de Fragmentos Amplificados , Antifúngicos/uso terapêutico , Aspergilose/tratamento farmacológico , Aspergilose/genética , Aspergillus flavus/efeitos dos fármacos , Aspergillus flavus/isolamento & purificação , Biomarcadores/análise , Sistema Enzimático do Citocromo P-450/genética , Análise Mutacional de DNA/métodos , Regulação Fúngica da Expressão Gênica , Humanos , Testes de Sensibilidade Microbiana , Técnicas de Tipagem Micológica , Mutação Puntual , Esterol 14-Desmetilase/genéticaRESUMO
The study was conducted in Saudi Arabia to assess the nutritional status of primary school Sudanese pupils and explore its' correlates. Anthropometric measurements of 400 (200 males and 200 females) students of age 6-12 were taken. Their daily food intake was assessed using food frequency and 24 h recall method. Data about the socio-economic characteristics of the students' families was collected through personal interview using a questionnaire. The study revealed that 31 and 8.75 % of the respondents suffer from underweight and overweight, respectively. The respondents' average daily intake of calories and fiber was significantly lower than that of the DRI, while their intake of protein, carbohydrates, unsaturated fat, some vitamins and iron was significantly higher than that of the DRI (unbalanced meals). Apart from the family monthly income none of the hypothesized predictors of the respondents' nutritional status were found to be significantly correlated with the students' nutritional status indicators.
Assuntos
Estado Nutricional , Pesos e Medidas Corporais , Criança , Dieta , Ingestão de Energia , Feminino , Humanos , Masculino , Sobrepeso/epidemiologia , Instituições Acadêmicas , Fatores Socioeconômicos , Magreza/epidemiologiaRESUMO
Fine needle aspiration (FNA) is a diagnostic technique that has become widely used. The procedure may be performed by interventional radiologists, endoscopists, pathologists and cytotechnologists; diagnostic interpretation of FNA samples is performed by pathologists and cytotechnologists. I provide here an introduction to the technique and applications of FNA with a review of current practice parameters and recent developments in the molecular application of FNA.
