2,051 research outputs found
Identification of TEM, CfxA, TetM and TetQ genes in periodontic infections
info:eu-repo/semantics/publishedVersio
Incidental Diagnosis of Bladder Cancer in a 17-year-old Patient
AbstractBladder cancer is the fourth most common type of cancer among males and the ninth most common cause of cancer death. Bladder cancer can occur at any age. This paper reports the incidental diagnosis of bladder cancer in a 17-year-old female patient. Data on bladder cancer at this age are uncommon in the literature
Evaluation of an enzyme immunoassay for hepatitis C virus antibody detection using a recombinant protein derived from the core region of hepatitis C virus genome
This study was undertaken to evaluate an enzyme immunoassay (EIA) for hepatitis C virus antibody detection (anti-HCV), using just one antigen. Anti-HCV EIA was designed to detect anti-HCV IgG using on the solid-phase a recombinant C22 antigen localized at the N-terminal end of the core region of HCV genome, produced by BioMérieux. The serum samples diluted in phosphate buffer saline were added to wells coated with the C22, and incubated. After washings, the wells were loaded with conjugated anti-IgG, and read in a microtiter plate reader (492 nm). Serum samples of 145 patients were divided in two groups: a control group of 39 patients with non-C hepatitis (10 acute hepatitis A, 10 acute hepatitis B, 9 chronic hepatitis B, and 10 autoimmune hepatitis) and a study group consisting of 106 patients with chronic HCV hepatitis. In the study group all patients had anti-HCV detected by a commercially available EIA (Abbott®), specific for HCV structural and nonstructural polypeptides, alanine aminotransferase elevation or positive serum HCV-RNA detected by nested-PCR. They also had a liver biopsy compatible with chronic hepatitis. The test was positive in 101 of the 106 (95%) sera from patients in the study group and negative in 38 of the 39 (97%) sera from those in the control group, showing an accuracy of 96%. According to these results, our EIA could be used to detect anti-HCV in the serum of patients infected with hepatitis C virus.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaInstituto BioMérieuxUNIFESP, EPMSciEL
Longitudinal Study of a Human Drug-Induced Model of Autoantibody to Cytoplasmic Rods/Rings following HCV Therapy with Ribavirin and Interferon-alpha
Background: A novel pattern in the indirect immunofluorescence antinuclear antibody assay on HEp-2 cells (IIF-HEp-2) characterized by cytoplasmic rods and rings (RR) was reported in HCV patients, but stringent disease specificity studies and longitudinal analysis are lacking. We investigated the clinical significance of anti-RR in an HCV cohort with up to a 12-month treatment follow up.Methodology/Results: 597 patients (342 HCV, 55 HCV/HIV, 200 non-HCV) were screened and titered for anti-RR. Serial samples were available from 78 of 176 treated and 27 of 166 untreated patients. Anti-RR was detected in 14.1% of 342 HCV patients, 9.1% of 55 HCV/HIV, 3.4% of 29 Hepatitis B, and none of 171 non-HCV (p47% tested positive for anti-RR. the anti-RR titer generally increased with sustained treatment and remained high in 53% of patients. After treatment, anti-RR titer was negative in 41%. Non-responders to HCV therapy were 77% in anti-RR-positive versus 64% in anti-RR-negative patients. Response to treatment was not associated with anti-RR titer or the dynamics of anti-RR reactivity during and after treatment.Conclusions: the exquisite association of anti-RR reactivity with combined interferon-a/ribavirin therapy in HCV patients represents a unique model for drug-induced autoantibody generation in humans as demonstrated by the fact that a significant fraction of patients who have anti-RR during therapy becomes anti-RR-negative after completion of therapy.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Brazilian National Council for Research and Technological DevelopmentUniversidade Federal de São Paulo, Div Rheumatol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Gastroenterol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilFleury Med & Hlth Labs, Div Immunol, São Paulo, BrazilUniv Florida, Dept Oral Biol, Gainesville, FL 32610 USAUniversidade Federal de São Paulo, Div Rheumatol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Gastroenterol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilFAPESP: 2010/50710-6Brazilian National Council for Research and Technological Development: 305064/2011-8Web of Scienc
Complementary neuropsychological assessment with computer in congenital hemiparesis
We present the neuropsychological assessment with computer aid of six cerebral palsy children. Three children had right hemiparesis and three, left hemiparesis. The tomographic examination showed parietal cavities (porencephalic cyst in 4 children, ischemic injury in 1 case and subarachnoid cyst in 1 case). We have proposed to assess the visuo-spatial function since we suspected the children could have disturbance of this function. We did not detect this disturbance. On the other hand, the children had astereognosia and the right hemiparetic children preferred to execute signs on the right part of the computer visor. We discuss and propose explanations for both findings.Apresentamos o estudo neuropsicológico de seis crianças portadoras de paralisia cerebral forma hemiplégica, com a ajuda de computador (três crianças com hemiparesia direita e três com hemiparesia esquerda). Os exames tomograficos revelaram cavidades parietais (cisto porencefálico em 4 casos, infarto isquêmico em 1 e cisto subaracnóideo em 1). O objetivo do estudo foi verificar se havia distúrbio na organização espacial, pois os pacientes apresentavam lesão estrutural em áreas parietais e não fora detectado esse distúrbio previamente. Encontramos astereognosia e preferência para o uso da hemi-tela direita do computador nas crianças com hemiparesia direita. Discutimos e propomos explicações para estes achados. Ressaltamos ainda o papel da linguagem computacional Logo, como instrumento adequado para investigação neuropsicológica.50250
Actinomycosis of the central nervous system: a rare complication of cervicofacial actinomycosis
Central nervous system actinomycosis is a rare but treatable chronic suppurative bacterial infection. The case of a young immunocompetent male with actinomycosis of the CNS is presented. The abscess originated from a primary cervico-facial infection and was located in the left parasellar region. After excision of the mass, that showed Actinomyces colonies, the patient was treated with intravenous Penicillin for 42 days followed by oral administration of the drug for 30 days. After surgery the patient was left with mild sequelae that had improved by the last follow-up, 7 months later. A new CT scan at that time revealed no residual disease or recurrence. The early diagnosis of cerebral actinomycosis relies essentially on a clinical suspicion. Hence it is imperative to be aware of the natural history of this infection and its various modes of presentation.A actinomicose do sistema nervoso central (SNC) é afecção rara, caracterizada pela formação de abscesso único e de evolução crônica. Os autores descrevem o caso de um paciente jovem, imunocompetente, com actinomicose cerebral oriunda de foco primário cervicofacial, submetido a ressecção cirúrgica e antibioticoterapia. Ressalta-se a importância do conhecimento da entidade e de suas principais formas de acometimento, como a base do diagnóstico precoce dessa enfermidade potencialmente curável e de bom prognóstico.Escola Paulista de MedicinaUNIFESP, EPMSciEL
AVALIAÇÃO DO MODELO DE ORGANIZAÇÃO DA UNIDADE DE EMERGÊNCIA DO HCFMRP-USP, ADOTANDO, COMO REFERÊNCIA, AS POLÍTICAS NACIONAIS DE ATENÇÃO
Innovative experiences directed specifically at complete care and training and professional habilitation in the urgency area are recent in Brazil and are being influenced by the French-German and Anglo-American models. The incorporation of the Mobile Emergency System (Sistema de Atendimento Móvel de Urgência, SAMU) and of Medical Regulation into the assistance network started after the 1995 French-Brazilian collaboration. In Brazil, SAMU was set up in 1996 and the Medical Regulation of the entire urgency demand was set up in 2000. In Brazil, the immediate emergency care is multidisciplinary, as is the case for the French-German model, but the systematic regulation of knowledge and of assistance practices of the health teams for advanced life support has been influenced by Anglo-American programs such as Advanced Cardiac Life Support, Advanced Trauma Life Support, Pediatric Advanced Life Support, and Basic Life Support, among others.These strategies adapted to Brazilian reality have contributed to the transformation of the old model of organization of emergency care and have led to revision of the curricular content and of academic organization. The problems of urgency care in large urban centers and some successful experiences within the Unified Health System (Sistema Único de Saúde, SUS) have helped the formulation of National Policies of Urgency Care , and of Humanization (PNH) of the Health Ministry. It is the task of the Ministry of Education, of Training Centers, of Class Councils and of Agencies for the Support of Research, in syntony with SUS, to formulate standards for training, for the exercise of the profession and for investigation in urgency care.Over the last few years, the Emergency Unit of the University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo (UE-HC), by applying the concepts contemplated by the Urgency Care Regulation and by SAMU, has participated in the configuration of a regional network for emergency care that has been arranged in hierarchical order, regulated and humanized. The clinical services of UE-HC linked to the Departments of Application of FMRP-USP and supported by the Center of Emergency Studies have helped redefine the assistential and educational mission of this Unit. Overcrowding was solved by a significant reduction in the number of consultation and in the rate of occupation and, as expected, there was an increase in mean time of permanence, in the complexity of the cases attended and in the mean costs of hospitalization. Thus, the Emergency Unit has been transformed into a reference center for care of high complexity and for the training and professional habilitation of the professionals who deal with emergencies. On this scenario, possibilities are rising for a critical reflection about practices already instituted, about the preparation for the production of new knowledge and about the bases for the creation of an academic department and of the specialty of medical emergencies.As experiências inovadoras, direcionadas para as especificidades da atenção integral, da formação e da capacitação profissional na área das urgências, no Brasil, são recentes e vêm sofrendo influências dos modelos franco-germânico e anglo-americano. A incorporação do Sistema de Atendimento Móvel de Urgência (SAMU) e da Regulação Médica(RM) à rede assistencial, no País, iniciou-se a partir da cooperação franco-brasileira, em 1995. Em nosso meio, o SAMU foi implantado em 1996 e a RM de toda a demanda de urgência para os hospitais, no ano de 2000. A atenção inicial às urgências, no Brasil, tal como no modelo franco-germânico é multidisciplinar, mas a sistematização do conhecimento e a das práticas assistenciais das equipes de saúde para o suporte avançado à vida têm sido influenciadas pelos programas anglo-americanos, tais como o Advanced Cardiac Life Support, o Advanced Trauma Life Support, o Pediatric Advanced Life Support e o Basic Life Support, dentre outros.Essas estratégias, adaptadas à realidade brasileira, têm contribuído para a transformação do velho modelo de organização da atenção às urgências, bem como proporcionado revisões dos conteúdos curriculares e da organização acadêmica. Os problemas da atenção às urgências, nos grandes centros urbanos, e algumas experiências com êxito, no âmbito do Sistema Único de Saúde(SUS), subsidiaram a formulação da Politicas Nacional de Atenção às Urgências (PNAU) e de Humanização (PNH) do Ministério da Saúde. Ao Ministério da Educação, aos Centros Formadores, aos Conselhos de Classe e às Agências de Fomento à Pesquisa cabem, em sintonia com o SUS, a formulação dos padrões para a formação, o exercício profissional e a investigação na atenção às urgências.A Unidade de Emergência do HCFMRP-USP (UE-HC), nos últimos anos, aplicando conceitos contemplados pela PNAU e pela PNH, participou da configuração de uma rede assistencial regional, hierarquizada de atenção às urgências, regulada e humanizada por meio da implantação da RM e do SAMU. Os serviços clínicos da UE-HC, vinculados aos Departamentos de Aplicação da FMRP-USP e apoiados pelo Centro de Estudos de Emergências ajudaram a redefinir a missão assistencial e educacional da unidade. A superlotação foi equacionada com a redução significativa do número de consultas e da taxa de ocupação, e, como era esperado, houve aumento da média de permanência, da complexidade dos casos atendidos e do custo médio das internações.Assim, a UE-HC tem se transformado num centro de referência para a assistência de elevada complexidade, assim como para a formação e capacitação de profissionais que lidam com as urgências. Neste cenário, estão surgindo as possibilidades para a reflexão crítica das práticas já instituídas, a sistematização das práticas e do conhecimento, a preparação para a produção de novos saberes e as bases para a criação de um departamento acadêmico e da especialidade de Urgências Médica
Phase-Separated Lipid-Based Nanoparticles:Selective Behavior at the Nano-Bio Interface
The membrane-protein interface on lipid-based nanoparticles influences their in vivo behavior. Better understanding may evolve current drug delivery methods toward effective targeted nanomedicine. Previously, the cell-selective accumulation of a liposome formulation in vivo is demonstrated, through the recognition of lipid phase-separation by triglyceride lipases. This exemplified how liposome morphology and composition can determine nanoparticle-protein interactions. Here, the lipase-induced compositional and morphological changes of phase-separated liposomes—which bear a lipid droplet in their bilayer— are investigated, and the mechanism upon which lipases recognize and bind to the particles is unravelled. The selective lipolytic degradation of the phase-separated lipid droplet is observed, while nanoparticle integrity remains intact. Next, the Tryptophan-rich loop of the lipase is identified as the region with which the enzymes bind to the particles. This preferential binding is due to lipid packing defects induced on the liposome surface by phase separation. In parallel, the existing knowledge that phase separation leads to in vivo selectivity, is utilized to generate phase-separated mRNA-LNPs that target cell-subsets in zebrafish embryos, with subsequent mRNA delivery and protein expression. Together, these findings can expand the current knowledge on selective nanoparticle-protein communications and in vivo behavior, aspects that will assist to gain control of lipid-based nanoparticles.</p
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