Caracterização e correlação do fenômeno pró-zona com títulos de sororeatividade do VDRL e reação de imuno- fluorescência indireta em soros de pacientes com sífilis

AZEVEDO, Luciana Karla Araújo de, et al. Caracterização e correlação do fenômeno pró-zona com títulos de sororeatividade do VDRL e reação de imuno-fluorescência indireta em soros de pacientes com sífilis. Revista Brasileira de Análises Clínicas, Rio de Janeiro, v. 38, n. 2, p. 183-187, 2006.Introdução: Treponema pallidun é o agente etiológico da sífilis uma doença sexualmente transmissível. No imunodiag-nóstico dessa doença utilizam-se dois diferentes tipos de testes sorológicos. Inicialmente, as amostras são triadas qualitativamente e quantitativamente por um teste não treponêmico como o veneral disease research laboratory (VDRL) e, em seguida, os soros reagentes são testados para a detecção de anticorpos específicos para o Treponema pallidum, como a reação de munofluorescência indireta através do fluorescent treponemal antibody absorption assay (FTA-ABS). Objetivos e Metodologia: Avaliar através do VDRL quantitativo e qualitativo a sororeatividade de 40 pacientes com sífilis e comparar com a presença do fenômeno pro-zona e resultados obtidos pelo FTA-ABS. Resultados e Discussão: Os níveis de reatividade das amostras testadas pelo VDRL variaram de 1:2 a 1:256. O fenômeno pró-zona foi observado em 8/40 soros (20%) se correlacionando com altos títulos de reatividade na maioria dos casos. O FTA- ABS foi reagente em 39/40 amostras (97,5%) apresentando forte e moderada reatividade independente dos títulos obtidos pelo VDRL e a presença ou ausência do fenômeno pró-zona na maioria dos casos, demonstrando uma maior sensibilidade desse exame quando comparado com o VDRL. Conclusão: Nossos resultados mostraram a importância da realização do VDRL quantitativo e qualitativo na investigação seguida pelo FTA-ABS na investigação sorológica da sífilis. ABSTRACT: Introduction: Treponema pallidum is the aetiological agent of syphilis, a sexually transmitted disease and the serology is essential for screening and diagnosis. In the immunediagnosis of this disease, two different sorts of serological tests are used. First the sera are screened in a quantitative and qualitative manner by a nontreponemal test such as the veneral disease research labora- tory test (VDRL), then the reactive sera are tested for specific treponemal antibodies using the fluorescent treponemal antidody ab- sorption assay (FTA-ABS). Objecitves and Methodology: To evaluate, using quantitative and qualitative VDRL, the sera reactivity of 40 patients bearing syphilis and compare these results to presence of prozone phenomenon and FTA-ABS. Results and discussion: The levels of sera reactivity in the VDRL test ranged from 1:2 to 1:256. The prozone phenomenon was observed in 8/40 amples (20%) and was correlated with high levels of VDRL in most of the cases. The FTA-ABS test was reactive in 39/40 cases (97,5%) with strong and moderate fluorescence intensity in most of the samples and it was independent of the VDRL reactivity levels and the presence or ab- sence of prozone phenomenon in mos of the cases, demonstrating a higher sensibility of this method when compared to the VDRL test. Conclusion: Our results showed the importance of qualitative and quantitative VDRL assay in the serological investigation of syphilis

Breathing pattern and muscle activity using different inspiratory resistance devices in children with mouth breathing syndrome

Aim The aim of this study was to evaluate the acute effects of different inspiratory resistance devices and intensity of loads via nasal airway on the breathing pattern and activity of respiratory muscles in children with mouth breathing syndrome (MBS). Methods Children with MBS were randomised into two groups based on inspiratory load intensity (20% and 40% of the maximal inspiratory pressure). These subjects were assessed during quiet breathing, breathing against inspiratory load via nasal airway and recovery. The measurements were repeated using two different devices (pressure threshold and flow resistance). Chest wall volumes and respiratory muscle activity were evaluated by optoelectronic plethysmography and surface electromyography, respectively. Results During the application of inspiratory load, there was a significant reduction in respiratory rate (p<0.04) and an increase in inspiratory time (p<0.02), total time of respiratory cycle (p<0.02), minute ventilation (p<0.03), tidal volume (p<0.01) and scalene and sternocleidomastoid muscles activity (root mean square values, p<0.01) when compared to quiet spontaneous breathing and recovery, regardless of load level or device applied. The application of inspiratory load using the flow resistance device showed an increase in the tidal volume (p<0.02) and end-inspiratory volume (p<0.02). Conclusion For both devices, the addition of inspiratory loads using a nasal interface had a positive effect on the breathing pattern. However, the flow resistance device was more effective in generating volume and, therefore, has advantages compared to pressure threshold

Low CCL2 and CXCL8 Production and High Prevalence of Allergies in Children with Microcephaly Due to Congenital Zika Syndrome

Congenital Zika Syndrome (CZS) is associated with an increased risk of microcephaly in affected children. This study investigated the peripheral dysregulation of immune mediators in children with microcephaly due to CZS. Gene expression quantified by qPCR in whole blood samples showed an increase in IFNγ and IL-13 transcripts in children affected with microcephaly compared to the control group. The microcephaly group exhibited significantly decreased CCL2 and CXCL8 levels in serum, quantified by CBA assay. An allergic profile questionnaire revealed a high prevalence of allergies in the microcephaly group. In accordance, elevated serum IgE level measured by the Proquantum Immunoassay was observed in children affected with microcephaly compared to the control group. Altogether, these findings show a persistent systemic inflammation in children with microcephaly due to CZS and suggest a possible impairment in leukocyte migration caused by low production of CCL2 and CXCL8, in addition to high levels of IgE associated with high prevalence of allergies. The dysregulation of inflammatory genes and chemokines underscores the importance of understanding the immunological characteristics of CZS. Further investigation into the long-term consequences of systemic inflammation in these children is crucial for developing appropriate therapeutic strategies and tailored vaccination protocols

Ataxia-telangiectasia : epidemiological survey in latin america

Ataxia-telangiectasia (AT) is a rare neurodegenerative disorder characterized by ataxia, telangiectasia, and immunodeficiency. We aimed to evaluate the multisystem involvement in AT by describing clinical features and outcomes of Latin American (LA) patients. cross-sectional and multicenter study. Referral centers from all over LA filled in a questionnaire with clinical and laboratory data based on patients’ records. 228 patients from 10 LA countries were evaluated. Mean ages at the time of symptom onset and diagnosis were 1.63±1.09 and 5.66±3.48 years, respectively. The most common immunodeficiency was IgA deficiency (60.8%), followed by IgG deficiency (28.6%). IgA and IgM showed a tendency to decrease as the patient grew older (p=0.001 and 0.048). IgA deficiency was associated with recurrent airway infections (p=0.038). 120 (79,5%) patients presented with low CD3+CD4+ count and 115 (92%) with low CD19+ count. Regarding nutritional status, as patients grow older there is an increase in severe thinness (p=0.016). Median survival was 23 years and Kaplan-Meier 20-year-survival rate was 52,6%. IgG deficiency and female gender were associated with a decrease in estimated survival function (p=0.02 and 0.049). There is a high prevalence of laboratory immunologic abnormalities and recurrent infections in AT patients. Knowledge of specific regional characteristics and variables which can be related with survival allows for suitable patient follow-up and may increase quality of life143