a multicenter study

(1) Background: The Commercial Kit SIRE Nitratase® PlastLabor, is a drug susceptibility test kit used to detect Mycobacterium tuberculosis resistance to first-line TB treatment drugs. The present study aimed at evaluating its performance in a multicenter study. (2) Methods: To determine its accuracy, the proportion methods in Lowenstein Jensen medium or the BACTECTMMGITTM960 system was used as a gold standard. (3) Results: The study revealed that the respective accuracies of the kit with 190 M. tuberculosis clinical isolates, using the proportion methods in Lowenstein Jensen medium or BACTECTMMGITTM960 system as a gold standard, were 93.9% and 94.6%, 96.9% and 94.6%, 98.0% and 97.8%, and 98.0% and 98.9%, for streptomycin, isoniazid, rifampicin, and ethambutol, respectively. (4) Conclusion: Thus, the kit can rapidly screen resistance to streptomycin, isoniazid, rifampicin, and ethambutol. Additionally, it does not require sophisticated equipment; hence, it can be easily used in the laboratories of low and middle income countries.publishersversionpublishe

AVALIAÇÃO FITOQUÍMICA, ANTIBACTERIANA E MODULATÓRIA DOS EXTRATOS METANÓLICO E HEXÂNICO DA FOLHA DE Eugenia uniflora L.

Eugenia uniflora L. pertence à família Myrtaceae, no qual é originária da mata atlântica brasileira, é popularmente conhecida como pitangueira sendo muito utilizada no combate de diarréias, reumatismo, febres, distúrbios gastrointestinais, na atividade anti-inflamatória, antimicrobiana e também atua na estratégia hipoglicemiante. Este estudo tem como principal objetivo avaliar a prospecção fitoquímica, antibacteriana e moduladora dos extratos metanólico e hexânico das folhas de E. uniflora L. frente a cepas de bactérias padrões e multirresistentes. Para a análise da atividade antibacteriana dos extratos metanólico e hexânico, foi realizado o teste de microdiluição em caldo para determinação da concentração inibitória mínima (CIM), e a modulação de aminoglicosídeos por meio de gentamicina e amicacina. Os resultados obtidos da CIM pelas bactérias Escherichia coli e Staphylococcus aureus, foram ≥ 1024µg/mL para os dois extratos. Na modulação, houve antagonismo tanto para o extrato metanólico, quanto para o hexânico, frente as bactérias multirresistentes SA 358 e EC 27. Desse modo é essencial realizar novos estudos sobre os produtos naturais utilizados pela população e suas ações sobre os antimicrobianos testados, pois podem apresentar os mesmos efeitos como este, em que, reduz o efeito do antibiótico e assim podendo dificultar o tratamento de diversas doenças

Terapias voltadas para o tratamento do transtorno dissociativo de identidade

O transtorno dissociativo de identidade compreende uma condição psicológica complexa provavelmente causada por inúmeros fatores, envolvendo trauma grave na primeira infância, como abuso sexual, físico ou emocional repetitivo e extremo e repetitivo. Este estudo teve como objetivo identificar as terapias voltadas para o tratamento do transtorno dissociativo de identidade. Para isso, foi realizada uma revisão integrativa de literatura, selecionando fontes a partir das bases de dados Medline e Lilacs. A partir da análise qualitativa de dados, concluiu-se que há vários tipos de terapias para o tratamento de pessoas transtorno dissociativo de identidade, devendo essas serem aplicadas conforme cada realidade. Nos estudos, foram identificados os modelos de tratamento psicanalítico relacional, fásico, psicoativo e psicotraumatológico. Em todos esses, foram registrados resultados satisfatórios, tais como a diminuição na dissociação e o aumento do funcionamento adaptativo do paciente, revelando a possibilidade de desconstruir crenças solidamente cultivadas e trazendo esperança aos pacientes no sentido de amenizar ou superar esse transtorno e garantir uma boa interação social

Alterações musculares e esqueléticas cervicais em mulheres disfônicas

Termo clínico, a disfonia envolve a todas as transformações e dificuldades durante a emissão vocal, as quais resultam no impedimento da produção normal da voz. Pacientes como esse problema, podem apresentar desequilíbrio da musculatura crâniocervical e laríngea e lesão orgânica subjacente. A disfonia resulta em modificações fonatórias, limitando atividades diárias relacionadas ao uso da voz, impactando na vida social e na qualidade de vida do indivíduo. Este estudo teve como objetivo analisar alterações musculares e esqueléticas cervicais em mulheres com disfonia, conforme identificado na literatura científica sobre o tema. Para isso, realizou-se uma revisão integrativa de literatura, selecionando estudos nas bases de dados Literatura Latino-americana e do Caribe em Ciências da Saúde (Lilacs) e Medical Literature Analysis and Retrieval System Online (Medline). A partir da análise qualitativa dos resultados, concluiu-se que dor intensa na região posterior do pescoço e na laringe se manifestam em mulheres disfônicas. Contribuem para isso a função prejudicada da articulação cervical e alterações da amplitude de movimento cervical. Com isso, compreende-se que o abuso vocal e o mau uso da voz como fatores mais comuns para a disfonia

ELISA versus PCR for diagnosis of chronic Chagas disease: systematic review and meta-analysis

<p>Abstract</p> <p>Background</p> <p>Most current guidelines recommend two serological tests to diagnose chronic Chagas disease. When serological tests are persistently inconclusive, some guidelines recommend molecular tests. The aim of this investigation was to review chronic Chagas disease diagnosis literature and to summarize results of ELISA and PCR performance.</p> <p>Methods</p> <p>A systematic review was conducted searching remote databases (MEDLINE, LILACS, EMBASE, SCOPUS and ISIWeb) and full texts bibliography for relevant abstracts. In addition, manufacturers of commercial tests were contacted. Original investigations were eligible if they estimated sensitivity and specificity, or reliability -or if their calculation was possible - of ELISA or PCR tests, for chronic Chagas disease.</p> <p>Results</p> <p>Heterogeneity was high within each test (ELISA and PCR) and threshold effect was detected only in a particular subgroup. Reference standard blinding partially explained heterogeneity in ELISA studies, and pooled sensitivity and specificity were 97.7% [96.7%-98.5%] and 96.3% [94.6%-97.6%] respectively. Commercial ELISA with recombinant antigens studied in phase three investigations partially explained heterogeneity, and pooled sensitivity and specificity were 99.3% [97.9%-99.9%] and 97.5% [88.5%-99.5%] respectively. ELISA's reliability was seldom studied but was considered acceptable. PCR heterogeneity was not explained, but a threshold effect was detected in three groups created by using guanidine and boiling the sample before DNA extraction. PCR sensitivity is likely to be between 50% and 90%, while its specificity is close to 100%. PCR reliability was never studied.</p> <p>Conclusions</p> <p>Both conventional and recombinant based ELISA give useful information, however there are commercial tests without technical reports and therefore were not included in this review. Physicians need to have access to technical reports to understand if these serological tests are similar to those included in this review and therefore correctly order and interpret test results. Currently, PCR should not be used in clinical practice for chronic Chagas disease diagnosis and there is no PCR test commercially available for this purpose. Tests limitations and directions for future research are discussed.</p

Detection of drug resistant Mycobacterium Tuberculosis strains using kit SIRE Nitratase®: a multicenter study

This research was funded by MINAS GERAIS STATE RESEARCH SUPPORT FOUNDATION (FAPEMIG), grants numbers 65/10 and CDS-APQ-03266-13, and by NATIONAL COUNCIL FOR SCIENTIFIC AND TECHNOLOGICAL DEVELOPMENT (CNPQ) grants numbers 310174/2014-7 and 446796/2014-0.Federal University of Minas Gerais. Faculty of Medicine. Mycobacteria Research Laboratory. Belo Horizonte, MG, Brazil.Federal University of Minas Gerais. Faculty of Medicine. Mycobacteria Research Laboratory. Belo Horizonte, MG, Brazil.Federal University of Minas Gerais. Faculty of Medicine. Mycobacteria Research Laboratory. Belo Horizonte, MG, Brazil.Federal University of Minas Gerais. Faculty of Medicine. Mycobacteria Research Laboratory. Belo Horizonte, MG, Brazil.Federal University of Minas Gerais. Faculty of Pharmacy. Department of Social Pharmacy. Belo Horizonte, MG, Brazil.Federal University of Minas Gerais. Veterinary School. Department of Preventive Veterinary Medicine. Belo Horizonte, MG, Brazil.Federal University of Rio Grande. Faculty of Medicine. Laboratory of Mycobacteria. Rio Grande, RS, Brazil.Federal University of Rio Grande. Faculty of Medicine. Laboratory of Mycobacteria. Rio Grande, RS, Brazil.Federal University of Rio Grande. Faculty of Medicine. Laboratory of Mycobacteria. Rio Grande, RS, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Tropical Medicine Foundation Dr. Heitor Vieira Dourado. Manaus, AM, Brazil.Tropical Medicine Foundation Dr. Heitor Vieira Dourado. Manaus, AM, Brazil.Federal University of Rio de Janeiro. Institute of Chest Diseases. Clementino Fraga Filho University Hospital. Rio de Janeiro, RJ, Brazil.Federal University of Rio de Janeiro. Institute of Chest Diseases. Clementino Fraga Filho University Hospital. Rio de Janeiro, RJ, Brazil.Federal University of Grande Dourados. Faculty of Health Sciences. Dourados, MS, Brazil / Oswaldo Cruz Foundation. Campo Grande, Mato Grosso do Sul, MS, Brazil.Adolfo Lutz Institute. Bacteriology Center. Tuberculosis and Mycobacteriosis Center. São Paulo, SP, Brazil.Adolfo Lutz Institute. Bacteriology Center. Tuberculosis and Mycobacteriosis Center. São Paulo, SP, Brazil.Adolfo Lutz Institute. Bacteriology Center. Tuberculosis and Mycobacteriosis Center. São Paulo, SP, Brazil.State Secretariat of Health of Rio Grande do Sul. State Center for Health Surveillance. Center for Scientific and Technological Development. Porto Alegre, RS, Brazil.State Secretariat of Health of Rio Grande do Sul. State Center for Health Surveillance. Center for Scientific and Technological Development. Porto Alegre, RS, Brazil.Oswaldo Cruz Foundation. National Institute of Infectology Evandro Chagas. Laboratory of Bacteriology and Bioassays of Rio de Janeiro. Rio de Janeiro, RJ, Brazil.Sergio Arouca National Public Health School. Professor Hélio Fraga Reference Center. Rio de Janeiro, RJ, Brazil.Sergio Arouca National Public Health School. Professor Hélio Fraga Reference Center. Rio de Janeiro, RJ, Brazil.Nova University of Lisbon. Institute of Hygiene and Tropical Medicine. Medical Microbiology Unit, Global Health and Tropical Medicine. Lisboa, Portugal.Nova University of Lisbon. Institute of Hygiene and Tropical Medicine. Medical Microbiology Unit, Global Health and Tropical Medicine. Lisboa, Portugal.Federal University of Rio de Janeiro. Faculty of Medicine. Tuberculosis Research Center. Rio de Janeiro, RJ, Brazil.Background: The Commercial Kit SIRE Nitratase® PlastLabor, is a drug susceptibility test kit used to detect Mycobacterium tuberculosis resistance to first-line TB treatment drugs. The present study aimed at evaluating its performance in a multicenter study. (2) Methods: To determine its accuracy, the proportion methods in Lowenstein Jensen medium or the BACTECTMMGITTM960 system was used as a gold standard. (3) Results: The study revealed that the respective accuracies of the kit with 190 M. tuberculosis clinical isolates, using the proportion methods in Lowenstein Jensen medium or BACTECTMMGITTM960 system as a gold standard, were 93.9% and 94.6%, 96.9% and 94.6%, 98.0% and 97.8%, and 98.0% and 98.9%, for streptomycin, isoniazid, rifampicin, and ethambutol, respectively. (4) Conclusion: Thus, the kit can rapidly screen resistance to streptomycin, isoniazid, rifampicin, and ethambutol. Additionally, it does not require sophisticated equipment; hence, it can be easily used in the laboratories of low and middle income countries