Polimorfismo C677T do gene mthfr na susceptibilidade à hipertensão arterial: evidências baseadas em metanálise / C677T polymorphism of the mthfr gene in susceptibility to arterial hypertension: evidences based on meta-analysis

Introdução: A hipertensão arterial sistêmica (HAS) é uma doença multifatorial, e, dentre os fatores destaca-se a genética, com ênfase ao polimorfismo C677T do gene mthfr, que após codificado, regula o metabolismo da homocisteína, substância danosa aos vasos sanguíneos quando em alta concentração. Objetivo: Avaliar a associação do polimorfismo C677T do gene mthfr e a hipertensão arterial sistêmica. Métodos: Trata-se de revisão sistemática com metanálise, com busca nas bases de dados: PubMed e SciELO, de acordo com os critérios de elegibilidade. Os dados de 20 artigos foram extraídos e os testes estatísticos, considerando limite de significância igual a 5%, foram realizados com o auxílio do software RevMan® 5.4. Resultados: A avaliação genotípica do polimorfismo C677T do gene mthfr apontou relação entre os genótipos TT (mutante) e CT (heterozigoto) com a HAS (respectivamente, OR=1,21; IC95%=1,03-1,43 e OR=1,52; IC95%=1,19-1,95). Na avaliação alélica, a associação ocorreu com o alelo T (OR=1,33; IC95%=1,17-1,53). Os resultados sugerem que o genótipo CC (selvagem) e o alelo C conferem proteção contra a HAS (CC: OR=0,66; IC95%=0,54-0,81 e C: OR=0,82; IC95%=0,74-0,90). Conclusão: Existe associação entre o polimorfismo C677T do gene mthfr e a hipertensão arterial sistêmica. A presença do alelo T em homozigose ou heterozigose aumenta a suscetibilidade genética individual para o desenvolvimento da HAS.

Isolation, identification and in vitro susceptibility of fungi that cause onychomycosis

Made available in DSpace on 2014-07-29T15:30:38Z (GMT). No. of bitstreams: 1 Fabio Silvestre.pdf: 2956413 bytes, checksum: 836474631eb4bcc7cdf144ad6ffb8efb (MD5) Previous issue date: 2010-02-24Onychomycosis is the nail infection caused by a wide spectrum of fungi species, including yeasts, dermatophyte and filamentous fungi nondermatophytes (FFND). In this work, patients with lesions nails from Dermatology Department in Clinics Hospital of the Federal University of Goiás were studied. These patients were submitted to mycologic tests and the etiologic agents identified were evaluated on in vitro activity for systemic antifungal agents. During the period of March 2008 to March 2009, 114 patients clinically suspected of having onychomycosis were examinated. The nail samples collected were submitted to direct examination with potassium hydroxide 20% and grown in dextrose Sabouraud agar and specific fungal pathogens agar. The antifungal susceptibility test was performed according to the method of broth microdilution, recommended by the Clinical Laboratory Standards Institute (CLSI), through M38-A and M27-A2 documents. The onychomycosis diagnosis was established in 83.3% (95/114) patients, of which most were women between 40 to 59 years old. The isolated fungi were identified as yeasts in 54.6%; dermatophytes in 28.7%; and filamentous fungi nondermatophytes in 16.7%. Among yeasts, Candida parapsilosis was the most common etiologic agent (52.5%); among dermatophytes, Trichophyton rubrum was the most found (74.2), and among the filamentous fungi nondermatophytes, Fusarium spp was the most isolated genus (44.4%). Both distal and lateral subungual lesions were predominant in cases of onychomycosis by all the agents identified, showing that there was no correlation with the clinical presentation and etiology. Although most of the isolates have showed susceptible to several antifungal agents studied, five Candida spp strains were resistant; one to voriconazole, one species to itraconazole and three to amphotericin B. The in vitro susceptibility testing profile for dermatophytes was similar for each antifungal agent analyzed. The minimal inhibitory concentration (MIC) of itraconazole, ketoconazole and griseofulvin for 50% of isolates were lower than 1 μg/mL, and terbinafine was extremely low, with concentration 0.015 μg/mL for 90% of isolates. The MIC for itraconazole in 90% isolates of FFND was 16 g/mL, while for amphotericin B and voriconazole was 8 g/mL. In summary, this study showed a higher frequency of onychomycosis in women. Candida spp and dermatophytes with FFND emergence, especially of the genus Fusarium, were the main fungi involved. Besides, the presence of resistant fungi to some antifungal agents showed the need of using susceptibility tests for these fungi.Onicomicose é a infecção da unha causada por amplo espectro de espécies fúngicas, incluindo leveduras, dermatófitos e fungos filamentosos não dermatofíticos (FFND). Neste trabalho, foram estudados pacientes com lesões de unhas atendidos no Departamento de Dermatologia, Hospital das Clínicas da Universidade Federal de Goiás, os quais foram submetidos a exames micológicos. Os agentes etiológicos identificados foram avaliados em testes de atividade in vitro para agentes antifúngicos sistêmicos. Durante o período de março de 2008 a março de 2009, foram examinados 114 pacientes com suspeita clínica de onicomicose. As amostras de unhas coletadas foram submetidas ao exame direto com hidróxido de potássio 20% e cultivadas em ágar Sabouraud dextrose e ágar específico para fungos patogênicos. O teste de suscetibilidade antifúngico foi realizado de acordo com o método de microdiluição em caldo, preconizado pelo Clinical Laboratory Standards Institute (CLSI), através dos documentos M38-A e M27-A2. O diagnóstico de onicomicose foi estabelecido em 83,3% (95/114) dos pacientes, dos quais a maioria era constituída por indivíduos do gênero feminino e com idade entre 40-59 anos. Os fungos isolados foram identificados como leveduras em 54,6%, dermatófitos em 28,7%, e FFND em 16,7%. Entre as leveduras, Candida parapsilosis (52,5%) foi o agente etiológico mais comum; entre os dermatófitos, Trichophyton rubrum foi o mais encontrado (74,2%) e, entre os FFND, Fusarium spp foi o gênero mais frequentemente isolado (44,4%). Lesões subungueal distal e lateral foram predominantes nos casos de onicomicose por todos os agentes identificados, mostrando que não havia correlação com a clínica e a etiologia. Embora a maioria dos isolados tenha se mostrado suscetível aos diferentes antifúngicos estudados, cinco isolados de Candida foram resistentes; um ao voriconazol, um ao itraconazol e três a anfotericina B. O perfil de suscetibilidade in vitro para dermatófitos foi semelhante para cada antifúngico analisado. A concentração inibitória mínima (CIM) de itraconazol, cetoconazol e griseofulvina para 50% dos isolados foram menores do que 1 μg/mL, e para terbinafina foi extremamente baixa, com concentração 0,015 μg/mL para 90% dos isolados. A CIM para o itraconazol foi de 16 μg/mL em 90% dos isolados de FFND, e para anfotericina B e voriconazol obteve-se uma concentração de 8 μg/mL. Em resumo, este estudo demonstrou uma maior frequência de onicomicose em mulheres, sendo que os principais fungos envolvidos nesta infecção foram Candida spp e dermatófitos, com emergência de FFND, em especial do gênero Fusarium. Além disso, em decorrência da resistência observada a alguns antifúngicos, demonstrou-se a necessidade do uso dos testes de suscetibilidade para estes fungos

Molecular identification, virulence and antifungal susceptibility of Candida parapsilosis complex species

Submitted by Cláudia Bueno ([email protected]) on 2016-01-27T16:27:50Z No. of bitstreams: 2 Tese - Fábio Silvestre Ataides - 2014.pdf: 2285867 bytes, checksum: 7c53025bcd16ddc4bc411b6f0415905a (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Approved for entry into archive by Luciana Ferreira ([email protected]) on 2016-01-28T11:43:48Z (GMT) No. of bitstreams: 2 Tese - Fábio Silvestre Ataides - 2014.pdf: 2285867 bytes, checksum: 7c53025bcd16ddc4bc411b6f0415905a (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Made available in DSpace on 2016-01-28T11:43:48Z (GMT). No. of bitstreams: 2 Tese - Fábio Silvestre Ataides - 2014.pdf: 2285867 bytes, checksum: 7c53025bcd16ddc4bc411b6f0415905a (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-08-26Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPqThe Candida species are associated with clinical manifestations that can characterize from superficial infections up to systemic involvement. Non-albicans species are considered emerging, and Candida parapsilosis is the main etiological agent in several casuistics. The secondary alcohol dehydrogenase (SADH) gene amplification and restriction fragment analysis by enzyme digestion BanI allows differentiation of C. parapsilosis in a species complex formed by C. parapsilosis sensu stricto, C. orthopsilosis and C. metapsilosis that may present behaviors different virulence and response to antifungal agents. Thus, this study aims to identify the species of the C. parapsilosis complex, obtained from mycology collection of the Mycology Laboratory of the Institute of Tropical Pathology and Public Health, Federal University of Goiás, using molecular methods, as well as the characterization of factors virulence and in vitro susceptibility to different antifungal agents. For the distinction between the species, was performed a polymerase chain reaction followed by digestion with restriction enzyme BanI. After the identification of 87 isolates from blood (54) and nails (33), the determination of virulence factors such as proteases, esterase, phospholipase, hemolysins, adhesion, biofilm formation and switching phenomenon were performed. The profile of in vitro susceptibility to amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole and caspofungin were performed using the Etest® method. The results showed that C. parapsilosis sensu stricto is the most common in our region (78), followed by C.orthopsilosis (5) C. metapsilosis (4). There was no difference between the behavior of virulence by the three species, but noted that there is divergence in the susceptibility to antifungal agents. Isolates of C. parapsilosis sensu stricto were less susceptible to amphotericin B, itraconazole and caspofungin compared with the susceptibility patterns of C. orthopsilosis and C. metapsilosis. A percentage of 10.2% of the isolates of C. parapsilosis sensu stricto no were susceptible to caspofungin. This paper reports the first identification of species of the C. parapsilosis complex in the state of Goiás, Brazil, and shows the importance of determining antifungal susceptibility to appropriate therapy.As espécies do gênero Candida estão relacionadas com manifestações clínicas que podem caracterizar desde infecções superficiais até um acometimento sistêmico. Espécies não-albicans, são consideradas emergentes, sendo que Candida parapsilosis é o principal agente etiológico em várias casuísticas. A amplificação do gene Secondary Alcohol Dehydrogenase (SADH) e a análise dos fragmentos de restrição pela enzima de digestão BanI, permite a diferenciação de C. parapsilosis em um complexo de espécies formado pela C. parapsilosis sensu stricto, C. orthopsilosis e C. metapsilosis, que podem apresentar comportamentos diferentes de virulência e resposta aos antifúngicos. Deste modo, este trabalho se propõe a identificar as espécies pertencentes ao complexo C. parapsilosis, obtidas da micoteca do Laboratório de Micologia do Instituto de Patologia Tropical e Saúde Pública da Universidade Federal de Goiás, usando métodos moleculares, bem como a caracterização dos fatores de virulência, e perfil de suscetibilidade in vitro a diferentes agentes antifúngicos. Para a distinção entre as espécies foi realizado a reação em cadeia da polimerase (PCR) seguido de digestão pela enzima de restrição BanI. Após a identificação de 87 isolados obtidos de sangue (54) e de unhas (33), foi realizada a determinação dos fatores de virulência como proteinases, esterase, fosfolipase, hemolisinas, aderência, formação de biofilme e fenômeno switching. O perfil de suscetibilidade a anfotericina B, fluconazol, itraconazol, voriconazol, posaconazol e caspofungina foi realizado usando-se o método de Etest®. Os resultados mostraram que C. parapsilosis sensu stricto é a mais frequente na nossa região (78), seguido de C. orthopsilosis (5) e C. metapsilosis (4). Não se verificou diferença entre o comportamento de virulência pelas três espécies, mas foi observado que há divergência na suscetibilidade aos agentes antifúngicos. Isolados de C. parapsilosis sensu stricto foram menos suscetíveis a anfotericina B, itraconazol e caspofungina quando comparados com os padrões de suscetibilidade de C. orthopsilosis e C. metapsilosis. Um percentual de 10,2% dos isolados de C. parapsilosis sensu stricto apresentaram-se não suscetíveis a caspofungina. Este trabalho relata pela primeira vez a identificação de espécies do complexo C. parapsilosis no estado de Goiás, Brasil, e mostra a importância de determinação de suscetibilidade antifúngica para uma terapia adequada

Prevalence of Chlamydia trachomatis in women undergoing assisted reproduction in Goiânia

Submitted by Luciana Ferreira ([email protected]) on 2020-01-16T15:36:48Z No. of bitstreams: 2 Artigo - Isabela Aparecida Carvalho Proto - 2013.pdf: 602277 bytes, checksum: c4737b299fa901aeaa92053f857c88d7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira ([email protected]) on 2020-01-16T15:54:29Z (GMT) No. of bitstreams: 2 Artigo - Isabela Aparecida Carvalho Proto - 2013.pdf: 602277 bytes, checksum: c4737b299fa901aeaa92053f857c88d7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2020-01-16T15:54:29Z (GMT). No. of bitstreams: 2 Artigo - Isabela Aparecida Carvalho Proto - 2013.pdf: 602277 bytes, checksum: c4737b299fa901aeaa92053f857c88d7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2013Objetivo: identificar dentre as mulheres que recorrem à fertilizac¸ão assistida as que têm positividade para sorologia de Chlamydia trachomatis. Método: estudo retrospectivo, do tipo transversal. As informac¸ões foram obtidas por meio da avaliac¸ão de prontuários de pacientes. Para que o estudo fosse concluído foi necessária uma amostra de 120 prontuários. A coleta foi feita com a selec¸ão da primeira paciente de cada mês, a exclusão da segunda, a selec¸ão da terceira e assim consecutivamente, para constituir uma amostra significativa de forma aleatória. Por meio da análise dos prontuários foram verificados os critérios de inclusão e exclusão. Resultados: a frequência de infecc¸ão por Chlamydia trachomatis foi de 39% e uma paciente apresentou as duas sorologias positivas. A maior incidência de IgG positivo foi na faixa entre 36 e 39 anos. Conclusão: a prevalência de sorologia positiva para Chlamydia trachomatis foi de 40%. É importante o desenvolvimento de ac¸ões assistenciais e educacionais contínuas para o cuidado com a saúde, principalmente o rastreamento em mulheres jovens, para controle da disseminac¸ão e prevenc¸ão de sequelas das doenc¸as sexualmente transmissíveis.Objective: identify among women using assisted fertilization those with seropositivity for Chlamydia trachomatis. Method: was a retrospective, cross-sectional. Data were collected through evaluation of patient records, the required sample was 120 charts. The collection was made by selecting the first patient of each month and was performed after a jump from a patient, with a close third to be analyzed, and so on, constitute a significant sample randomly without giving preferences. Through the analysis of the records were checked for inclusion and exclusion criteria. Results: the frequency of Chlamydia trachomatis infection was 39%, one patient had two positive tests. The highest incidence of positive IgG was aged between 36-39 years. Conclusion: the prevalence of positive serology for Chlamydia trachomatis was 40%. It is important to develop actions and continuing educational assistance for health care, especially in screening young women for controlling the spread and prevention of sequelae of sexually transmitted diseases

Molecular analysis and dimorphism of azole-susceptible and resistant Candida albicans isolates

INTRODUCTION: Candida albicans is responsible for superficial or systemic infections known as candidiasis, which may be found in infected tissue as unicellular budding yeasts, hyphae, or pseudohyphae. In this study, the effects of both fluconazole and itraconazole antifungal agents on the hyphal formation and genotypic characterization of C. albicans isolates classified as either susceptible or resistant were investigated. METHODS: The hyphal production of five C. albicans isolates under the action of antifungal agents was investigated by culturing yeast on growth medium and on hyphal induction medium. The genotypic characterization was carried out for 13 isolates of C. albicans using the random amplified polymorphic DNA-polymerase chain reaction (RAPD-PCR) method. RESULTS: The dimorphism analysis showed that the hyphal formation was higher in resistant than in the susceptible isolates to both azoles. The RAPD-PCR method identified the formation of two different groups. In group A, four resistant and two susceptible isolates were clustered, and in group B, one resistant and six susceptible isolates were clustered. CONCLUSIONS: Considering that hyphal formation was higher in resistant isolates in the presence of azole drugs, we confirmed that the hyphal production is closely related to susceptibility to azoles. These drugs may affect the morphogenesis of C. albicans depending on their susceptibility to these drugs. In relation to RAPD-PCR, most resistant isolates classified in group A and susceptible isolates in group B demonstrated that this method presented a similar standard between the two groups, suggesting that by this technique, a strong correlation between genotypes and fluconazole-resistant samples may be found

Pimenta pseudocaryophyllus inhibits virulence factors and promotes metabolic changes in Candidayeast

IntroductionThis is the first study to examine the in vitrosusceptibility and the expression of virulence factors in Candida species in the presence of Pimenta pseudocaryophyllus (Gomes) L.R. Landrum (Myrtaceae), a Brazilian plant known as paucravo. Additionally, the mechanisms of action of the crude ethanol extract and the ethyl acetate and aqueous fractions of this plant were investigated.MethodsThe in vitro susceptibility of Candida was tested using the broth microdilution method, whereas an XTT reduction assay was used for biofilms. Adherence was determined by counting the number of yeast cells that adhered to 100 oral epithelial cells, and hyphal formation was verified in the hyphal induction medium M199. Flow cytometry with propidium iodide and FUN-1 was performed to assess the mechanism of action.ResultsThe results revealed that the crude ethanol extract and the ethyl acetate and aqueous fractions of P. pseudocaryophyllusinhibited the growth of Candida isolates at a minimal inhibitory concentration (MIC) ranging from 64 to 256µg/mL, whereas the 50% sessile minimal inhibitory concentration (SMIC50) ranged from 512 to >1,024µg/mL. Adherence and hyphal formation were significantly reduced in the presence of the crude ethanol extract and both fractions. Although cell membrane injury was detected, the predominant mechanism of action appeared to be the alteration of yeast metabolism, as demonstrated by flow cytometry.ConclusionsOur results indicated that antifungal activity reduced the expression of virulence factors in yeast via the alteration of yeast metabolism, suggesting that the crude extract of P. pseudocaryophyllus and its fractions may contain novel antifungal agents