Prevalência de resistência a proteína C ativada (RPCA) em pacientes atendidos no Laboratório Médico Santa Luzia / Prevalence of activated protein C resistance (APCR) in patients attended in the medical laboratory Santa Luzia

O avanço no conhecimento dos mecanismos que regulam a hemostasia possibitou a identificação de alterações na coagulação sanguínea que estão na origem dos fenômenos trombóticos. O objetivo deste trabalho foi avaliar a prevalência de RPCA em pacientes atendidos no Laboratório Médico Santa Luzia - Florianópolis, SC. Foram avaliados retrospectivamente 365 pacientes com idade variando de 5 a 81 anos, homens e mulheres com distúrbio trombótico. Os resultados mostraram que 12,9% dos pacientes tinham RPCA positivo, com uma maior prevalência em indivíduos de sexo feminino (68,1%) quando comparados com os do sexo masculino (31,9%).

Virus da Imunodeficiencia Humana: considerações gerais sobre a especificidade e sensibilidade de metodos laboratoriais para a detecção de anticorpos e antigenos especificos / Human immunodeficiency virus: general aspects concerning laboratorial methods specificity and sensitivity to detect specific antigens and antibodies

O diagnostico laboratorial da infeccao pelo virus da imunodeficiencia humana tipo 1 pode ser feito mediante a aplicacao de testes sorologicos de terceira geracao. Reatividade inespecificas podem, entretanto, ser observadas em diferentess grupos populacionais, para a deteccao de anticorpos contra HIV por metodos imunoenzimaticos, conforme observado na analise de amostras sorologicas de gestantes (3,9 porcento), hepatopatas (3,0 porcento) e populacao pediatrica (1,03 porcento). Os valores de inespecificidade reforcam o conceito de que a deteccao de anticorpos contra HIV deve ser feita pela analise e interpretacao de, ao menos, dois testes de diferentes procedencias, em uma primeira coleta. Metodos de triagem de quarta geracao, que permitem a deteccao simultanea de anticorpos e antigeno p24 do HIV, apresentam sensibilidade comparavel a das metodologias tradicionais, sendo de particular valor no diagnostico precoce da infeccao. Diferentes amostras de sangue de tres pacientes, coletadas em periodos distintos, foram analisadas comparativamente por testes imunoenzimaticos de terceira geracao (Cobas, Axsym e Ortho) e quarta geracao (ELFA HIV DUO). Os resultados demonstram a possibilidade de antecipar a deteccao dos marcadores da infeccao viral em periodos que podem variar de quatro a 12 dias, quando comparados a metodos de terceira geracao, que detectam apenas anticorpos

[Acute myocardial infarction diagnosis. The value of serum myoglobin levels, compared with creatine kinase MB fraction]. / Diagnóstico do infarto agudo do miocárdio. Valor da dosagem de mioglobina sérica comparada com a creatinofosfoquinase e sua fração MB.

PURPOSE: To compare the diagnostic performance of two traditional plasma markers of myocardial infarction (MI), creatine kinase (CK) and its MB fraction (CK-MB), with plasma myoglobin (Mgb) levels, for the diagnosis of MI. METHODS: From September of 94 to February of 95, in an observational, prospective, and non-controlled fashion, 64 patients admitted to a cardiology emergency room (ER), with non-traumatic chest pain were studied. Patients presenting with more than 6 h after the onset of symptoms, muscular trauma, cardiopulmonary resuscitation and renal insufficiency were not included. Definitive MI diagnosis was established if the patient had at least two of the three classic MI findings: ischemic chest discomfort longer than 20 min, electrocardiogram with necrosis (Q waves) and elevated CK and CK-MB levels. RESULTS: There were 18 patients with MI. The sensitivity for CK, CK-MB and Mgb were respectively 33%, 22% and 61%. The specificity was 85%, for CK, 95% for CK-MB and 97% for Mgb. The difference between Mgb and CK sensitivities was 28%, with a 95% confidence interval (CI) from -4% to 59%, the difference between Mgb and CK-MB sensitivities was 39%, (CI 9% to 69%). The difference between Mgb and CK specificities was 13%, (CI 12% to 14%) and the difference between Mgb and CK-MB specificities was 2%, (CI-5% to 9%). CONCLUSION: In the studied population, Mgb was more sensitive than CK-MB for the diagnosis of MI with similar specificity and Mgb was more specific than CK for this diagnosis.

Economical, simple method for production of the gaseous environment required for cultivation of Campylobacter jejuni.

Campylobacter jejuni is an enteric pathogen recognized worldwide as a cause of diarrhea. Its isolation from stool samples requires a microaerophilic environment that heretofore has been expensive and cumbersome to create. An economical, portable, and simple method is described which involves the production of appropriate concentrations of oxygen and carbon dioxide. Inside a plastic bag are placed two cups, one containing fine steel wool (grade 0) previously soaked in a 2.5% aqueous solution of copper sulfate and the other containing an Alka-Seltzer tablet in tap water. As suggested by Jurgensen et al. (Rev. Bras. Pat. Clin. 18:58-63, 1982), we used the effervescent antacid to generate CO2. By plate counts, we found this method to be as reliable in the cultivation of 20 isolates of C. jejuni in pure and mixed fecal culture as the reference gas method (85% N2, 10% CO2, and 5% O2). Analyses of the gas mixture inside the bag after up to 24 h of incubation confirmed the creation of an atmosphere of reduced O2 and increased CO2 concentrations. This method is eminently suitable for field situations in which more costly supplies are not available.