Frequência de anticorpos antiparvovírus B19 em artrite reumatoide e lúpus eritematoso sistêmico

AbstractObjectiveTo determine the frequency of antiparvovírus B19 (B19) antibodies in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), and the possible correlation of anti-B19 seropositivity with disease activity and quality of life.Patients and methodsSerum samples from 57 patients with RA, 45 with SLE and 65 healthy controls were used. We applied protocol with clinical data, and the Disease Activity Score 28 (DAS 28), Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Health As- sessment Questionnaire (HAQ) indexes. The anti-B19 serology was done by enzyme-linked immunosorbent assay (ELISA).ResultsThe mean age of patients was 42.74 ± 14.09 years, and of controls was 38.38 ± 13.42 years. 79 patients had active disease (77.5%), and 23 had inactive disease (22.5%). Anti-B19 (IgG) was positive in 49 (86.0%; CI 95% 77.0 – 95.0) RA patients, 38 (84.4%; CI 95% 73.9 – 95.0) SLE patients, and 40 (61.5%; CI 95% 49.7 – 73.4) controls (p = 0.002). Anti-B19 (IgM) was posi-tive in 3 (5.3%; CI 95% 0.0 – 11.1) RA patients, in 7 (15.6%; CI 95% 5.0 – 26,2) SLE patients, and in 1 (1.5%; CI 95% 0.0 – 4.5) control (p = 0.011). There was no correlation of anti-B19 reactivity with disease activity and with DAS 28, HAQ and SLEDAI indexes.ConclusionThis study demonstrated that the studied population is exposed to infection by B19, which demands attention with its manifestations, especially among patients at great- est risk, such as those immunosuppressed

Pseudomonas aeruginosa Isolated from the Environment of a Veterinary Academic Hospital in Brazil - Resistance Profile

Background: The presence of resistant and potentially virulent bacterial strains in a veterinary hospital environment is a neglected problem.  Pseudomonas aeruginosa is an opportunistic microorganism present and circulating in the veterinary hospital environment, of clinical importance and zooanthroponotic transmission of P. aeruginosa has also been reported. The aim of this study was to characterize the population of P. aeruginosa present in a veterinary hospital environment by evaluating their resistance profile and biofilm production.Materials, Methods & Results: A total of 306 samples were collected from the veterinary hospital environment (swabs from consultation tables, surgical tables, door handles, hospitalization cages, stethoscopes, thermometers, and muzzles). The isolates were biochemically identified as belonging to the species Pseudomonas aeruginosa through nitrate to nitrite reduction, motility and oxidase test, growth at 42°C, pigment production, and alkalinization of acetamide. Antimicrobial resistance was tested using the minimum inhibitory concentration (MIC) test. Twenty seven isolates of P. aeruginosa were obtained, with a frequency of 8.8%. The detection of beta-lactamase production and biofilm formation genes by polymerase chain reaction (PCR). Two multidrug resistant (MDR) and 3 single-drug resistant (SDR) strains of P. aeruginosa were identified. Furthermore, it was observed that the strains carried genes related to beta-lactamase production (TEM and CTX-M group 25) and biofilm production (pelA, pslA, ppyR).Discussion: Pseudomonas aeruginosa is considered a major cause of opportunistic hospital infections, as it causes significant morbidity and mortality in immunosuppressed individuals, both in animals and in humans. Veterinary hospitals can harbor microorganisms that cause infections, as well as multiresistant agents. Normally, these environments have a large circulation of people and animals, which particularly enables a facilitated dissemination of these resistant microorganisms. Recently, the World Health Organization (WHO) listed carbapenem-resistant P. aeruginosa as one of 3 bacterial species in critical need for the development of new antibiotics to treat their infections. The data found in this work strengthen the knowledge on the antimicrobial resistance capacity that P. aeruginosa exhibits. The presence of 3 multiresistant strains further highlights the advanced stage of resistance of this bacterial species. The characterization of strains of this species in a veterinary hospital environment is crucial for the control of this population circulating in this environment, and the consequent adoption of more effective measures aimed at controlling its proliferation. The study of this bacterial species in a veterinary hospital environment has a direct impact on human health, due to the mechanisms of resistance and genetic variability that can occur between infections in different animal species and in humans. In view of that, professionals working in veterinary hospitals should be aware of the importance of controlling these microorganisms. Correct measures must be taken to sanitize the environment and utensils between animal care sessions, besides frequent hand washing by all employees and the use of protective equipment such as masks and gloves. The presence of potentially biofilm-producing MDR and SDR strains indicates the free circulation of these bacteria in the veterinary hospital environment. Thus, as a potentially pathogenic microorganism to humans and animals, containment measures must be taken to prevent this possible transmission.Keywords: bacteria, antimicrobial resistance, multidrug resistant, beta-lactamase, biofilm, veterinary care

Escherichia coli produtora de toxina Shiga resistentes a antimicrobianos isoladas de ovinos

A presença de Escherichia coli produtora de toxina Shiga (STEC) e resistente a beta-lactâmicos em ovinos saudáveis, representa um risco potencial para a saúde pública. O objetivo deste estudo foi caracterizar isolados STEC presentes em fezes de ovinos, quanto a produção de toxina, bem como a resistência aos antibióticos beta-lactâmicos. No presente estudo, dentre os quarenta isolados, foi observada a predominância do subtipo Stx1 (22/40), seguido do subtipo Stx1+ Stx2 (11/40), enquanto o grupo menos prevalente foi Stx2 (7/40). A resistência fenotípica aos antibióticos beta-lactâmicos foi observada em 50% (20/40) das cepas analisadas, formando dois grupos, um com isolados resistentes e outro de isolados não resistentes. A citotoxicidade dos isolados não variou entre os grupos. Alguns isolados multirresistentes, além de possuírem essa característica, produziram quantidades significativas de toxinas. Isto conclui, que os mecanismos de resistencia antimicrobiana, por meio de beta lactamases estão presentes em STEC de ovinos, e que a citotoxicidade desses isolados é variável com relação a esta resistência.The presence of Shiga toxin-producing Escherichia coli (STEC) and resistance to beta-lactams in healthy sheep represents a potential public health risk. This study aimed to characterize STEC isolates in sheep feces for toxin production and resistance to beta lactam antibiotics. In the present study, among the 40 isolates, we found a predominance of subtype Stx1 (22/40), followed by subtype Stx1 + Stx2 (11/40), while the less prevalent group was Stx2 (7/40). Also, we found phenotypical resistance to beta-lactam antibiotics in 50% (20/40) of the strains analyzed, forming two groups, one with resistant isolates and the other with non-resistant isolates. The cytotoxicity of the isolates did not vary among the groups. In addition to having this characteristic, some multiresistant isolates produced significant amounts of toxins. This leads to the conclusion that the mechanisms of antimicrobial resistance via beta lactamases are present in sheep STEC and that the cytotoxicity of those isolates is variable regarding such resistance

Antimicrobial resistance of Shiga toxin‐producing Escherichia coli isolated from sheep

The presence of Shiga toxin-producing Escherichia coli (STEC) and resistance to beta-lactams in healthy sheep represents a potential public health risk. This study aimed to characterize STEC isolates in sheep feces for toxin production and resistance to beta lactam antibiotics. In the present study, among the 40 isolates, we found a predominance of subtype Stx1 (22/40), followed by subtype Stx1 + Stx2 (11/40), while the less prevalent group was Stx2 (7/40). Also, we found phenotypical resistance to beta-lactam antibiotics in 50% (20/40) of the strains analyzed, forming two groups, one with resistant isolates and the other with non-resistant isolates. The cytotoxicity of the isolates did not vary among the groups. In addition to having this characteristic, some multiresistant isolates produced significant amounts of toxins. This leads to the conclusion that the mechanisms of antimicrobial resistance via beta lactamases are present in sheep STEC and that the cytotoxicity of those isolates is variable regarding such resistance

Contribuições da musicoterapia para Recém-Nascidos na Unidade de Terapia Intensiva Neonatal: revisão integrativa da literatura / Contributions of music therapy to newborns in the Neonatal Intensive Care Unit: an integrative literature review

A imaturidade de órgãos e de sistemas vitais torna os recém-nascidos (RNs) vulneráveis e mais susceptíveis ao desenvolvimento de complicações na sua saúde. Sendo assim, a musicoterapia vem sendo explorada como método não farmacológico e não convencional de induzir nos seres humanos alterações psicológicas e fisiológicas, contribuindo positivamente no desenvolvimento cognitivo, melhorando as condições de saúde de maneira holística, além de minimizar os efeitos deletérios de alguns procedimentos invasivos e enfermidades. Nesse sentido, o presente estudo teve como objetivo descrever os benefícios da musicoterapia para os RN na unidade de terapia intensiva. Trata-se de um estudo descritivo, do tipo revisão integrativa de literatura, de caráter qualitativo. Entre os resultados do estudo, destacam-se: recuperação da auto confiança e auto estima, alívio do estresse, conforto, redução da ansiedade e angústia, melhora no humor. A musicoterapia e a estimulação musical vêm se destacando nas últimas décadas por revelar benefícios para os bebês pré-termo e suas famílias. A internação na Unidade de Terapia Intensiva Neonatal (UTI) impacta de forma negativa o RN. O uso da musicoterapia em uma UTIN é um processo importante para a melhoria da qualidade no atendimento ao prematuro, pois estão aliadas com segurança e cuidados prestados da atuação profissional. Diante disso, notou-se no estudo que a musicoterapia reduz as variáveis relacionadas à dor e estresse em recém-nascidos prematuros. No entanto, vale ressaltar que há necessidade de novos estudos com metodologias criteriosas, a fim de contribuir para o bem-estar e o conforto neonatal

Possível papel das adipocinas no lúpus eritematoso sistêmico e na artrite reumatoide

Nos últimos anos têm sido descritos mediadores sintetizados no tecido adiposo, chamados adipocinas. Eles apresentam ação hormonal, regulando o apetite e o metabolismo da glicose, mas também atuam como citocinas, com efeitos sobre o sistema imune, incluindo efeitos na autoimunidade. As adipocinas mais importantes são: leptina, adiponectina, visfatina e resistina. Algumas delas vêm sendo estudadas nas doenças autoimunes reumáticas, particularmente no lúpus eritematoso sistêmico (LES) e na artrite reumatoide (AR). Estudos mostram níveis elevados de leptina e de adiponectina no LES, porém a correlação com a atividade da doença ainda é discutida. Na AR, os estudos também mostram aumento dos níveis de leptina e de adiponectina, observando-se correlação com a atividade da doença e a erosão articular; os resultados, porém, são conflitantes. Esta revisão descreve os papéis da leptina e da adiponectina no sistema imune e suas atuações no LES e na AR

Leptina e adiponectina no lúpus eritematoso sistêmico: correlações clínicas e laboratoriais

Objetivo: Avaliar os n&#237;veis s&#233;ricos de leptina e adiponectina em pacientes com l&#250;pus eritematoso sist&#234;mico (LES) e correlacionar seus n&#237;veis com atividade inflamat&#243;ria, presen&#231;a de autoanticorpos e manifesta&#231;&#245;es cl&#237;nicas. M&#233;todos: Foram avaliadas 52 mulheres com LES e 33 mulheres saud&#225;veis. As pacientes foram divididas em dois grupos, o primeiro com LES ativo e o segundo com LES inativo. Foram consideradas em atividade as paciente com Sledai &#8805; 3. Os n&#237;veis s&#233;ricos de leptina (ng/mL) e adiponectina (ug/mL) foram medidos por ensaio imunoenzim&#225;tico. Resultados: Houve diferen&#231;a significativa nos n&#237;veis de leptina entre LES e controle (20,7 &#177; 17,1 vs. 8,0 &#177; 5,0 ng/mL, p < 0,001), mas n&#227;o houve diferen&#231;a significativa nos n&#237;veis de adiponectina (87,5 &#177; 69,7 vs. 118,1 &#177; 70,6 ug/mL, p = 0,053). Entre LES inativo e ativo, n&#227;o houve diferen&#231;a significativa dos n&#237;veis de leptina e adiponectina. Houve uma associa&#231;&#227;o significativa entre os baixos n&#237;veis de leptina e positividade para anticardiolipina (aCL) (p = 0,025) eanticoagulante l&#250;pico (LA) (p = 0,003) e uma associa&#231;&#227;o significativa entre n&#237;veis elevados deleptina e da presen&#231;a de manifesta&#231;&#227;o renal (p < 0,001). No entanto, n&#227;o houve associa&#231;&#227;oentre adiponectina com autoanticorpos e caracter&#237;sticas cl&#237;nicas nas pacientes. Conclus&#227;o: Pacientes com LES apresentaram n&#237;vel elevado de leptina, com associa&#231;&#227;o aoenvolvimento renal. A leptina e a adiponectina n&#227;o se correlacionaram com a atividade dadoen&#231;a. Baixos n&#237;veis de leptina foram associados com a presen&#231;a de LA e aCL

Soroprevalência e genótipos do vírus da hepatite C em pacientes com lúpus eritematoso sistêmico (LES) em Goiânia, Brasil Hepatitis C virus seroprevalence and genotypes in patients with systemic lupus erythematosus (SLE) in Goiânia, Brazil

A infecção pelo vírus da hepatite C (HCV) desperta grande interesse em reumatologia por apresentar várias manifestações extra-hepáticas. Diversos estudos mostram associação elevada da infecção pelo HCV com manifestações reumáticas como dores musculares, crioglobulinemia mista, síndrome reumatóide, síndrome de Sjögren, vasculite, glomerulonefrite, fenômeno de Raynaud, poliarterite nodosa, miopatia, auto-anticorpos e outras manifestações de doença difusa do tecido conjuntivo. Em estudos anteriores realizados em nosso meio verificou-se a prevalência de 0,9% em gestantes, 1,4% em doadores de sangue, 1,8% em paciente com hanseníase e 2,0% em trabalhadores da área da saúde. OBJETIVO: determinar a prevalência da infecção pelo HCV em pacientes com lúpus eritematoso sistêmico (LES) atendidos no Serviço de Reumatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade Federal de Goiás (HC-FM-UFG). MÉTODOS: foram entrevistados 175 pacientes com LES e amostras sangüíneas coletadas. Inicialmente, pesquisou-se a presença de anticorpos para o HCV (anti-HCV). As amostras anti-HCV positivas foram submetidas à detecção do RNA viral, pela reação em cadeia da polimerase (PCR) com primers complementares à região 5' não codificante do HCV. As amostras positivas foram genotipadas por line probe assay. RESULTADOS: a prevalência encontrada foi de 2,3% (4/175), e a identificação dos genótipos nas amostras RNA-HCV positivas revelou a presença do tipo 1 do HCV em três pacientes (75%) e do tipo 3 em um paciente (25%). Das quatro pacientes infectadas, três apresentaram evolução clínica favorável e uma evoluiu para óbito em razão de insuficiência renal por nefrite lúpica. CONCLUSÕES: a prevalência de HCV em pacientes com LES revelou-se um pouco maior que a encontrada anteriomente em gestantes, doadores de sangue e em hansenianos, comparável à encontrada em trabalhadores da saúde.<br>The hepatitis C virus (HCV) infection is a source of concern in rheumatology because of its extrahepatic manifestations. Many studies have reported association between HCV infection and rheumatological manifestations such as: musculoskeletal pain, essential mixed cryoglobulinemia, rheumatoid arthritis, Sjögren's syndrome, vasculitis, glomerulonephritis, Raynaud's phenomenon, polyarteritis nodosa, myositis, autoantibody and other connective tissue diseases. In previous studies developed in our region, prevalences of 0.9%, 1.4%, 1.8% and 2.0% were detected among pregnant women, blood donors, leprosy patients and health professionals, respectively. OBJECTIVE: to investigate the prevalence of hepatitis C virus infection among patients with systemic lupus erythematosus (SLE) in Goiânia, Brazil. METHODS: 175 patients were interviewed and had blood samples tested for HCV antibodies (anti-HCV) by a third generation enzyme linked immunosorbant assay (ELISA). RNA-HCV was detected by polymerase chain reaction (PCR) with primers complementary the 5' non-coding region of the HCV genoma, in all anti-HCV positive serum samples and genotyped by a line probe assay. RESULTS: an overall HCV infection prevalence of 2.3% (4/175) was found. Genotyping of RNA-HCV positive samples revealed HCV type 1 in 3 (75%) and type 3 in 1 (25%) patient. Clinical course was favorable in all HCV positive patients, except one, who died due to renal insuficiency related to lupus nephritis. CONCLUSIONS: anti-HCV prevalence among patients with SLE was slitghly higher than the prevanlence observed in pregnant women, healthy blood donors and leprosy patients, and similar to health professionals

Pseudomonas aeruginosa Isolated from the Environment of a Veterinary Academic Hospital in Brazil - Resistance Profile

Background: The presence of resistant and potentially virulent bacterial strains in a veterinary hospital environment is a neglected problem.  Pseudomonas aeruginosa is an opportunistic microorganism present and circulating in the veterinary hospital environment, of clinical importance and zooanthroponotic transmission of P. aeruginosa has also been reported. The aim of this study was to characterize the population of P. aeruginosa present in a veterinary hospital environment by evaluating their resistance profile and biofilm production.Materials, Methods &amp; Results: A total of 306 samples were collected from the veterinary hospital environment (swabs from consultation tables, surgical tables, door handles, hospitalization cages, stethoscopes, thermometers, and muzzles). The isolates were biochemically identified as belonging to the species Pseudomonas aeruginosa through nitrate to nitrite reduction, motility and oxidase test, growth at 42°C, pigment production, and alkalinization of acetamide. Antimicrobial resistance was tested using the minimum inhibitory concentration (MIC) test. Twenty seven isolates of P. aeruginosa were obtained, with a frequency of 8.8%. The detection of beta-lactamase production and biofilm formation genes by polymerase chain reaction (PCR). Two multidrug resistant (MDR) and 3 single-drug resistant (SDR) strains of P. aeruginosa were identified. Furthermore, it was observed that the strains carried genes related to beta-lactamase production (TEM and CTX-M group 25) and biofilm production (pelA, pslA, ppyR).Discussion: Pseudomonas aeruginosa is considered a major cause of opportunistic hospital infections, as it causes significant morbidity and mortality in immunosuppressed individuals, both in animals and in humans. Veterinary hospitals can harbor microorganisms that cause infections, as well as multiresistant agents. Normally, these environments have a large circulation of people and animals, which particularly enables a facilitated dissemination of these resistant microorganisms. Recently, the World Health Organization (WHO) listed carbapenem-resistant P. aeruginosa as one of 3 bacterial species in critical need for the development of new antibiotics to treat their infections. The data found in this work strengthen the knowledge on the antimicrobial resistance capacity that P. aeruginosa exhibits. The presence of 3 multiresistant strains further highlights the advanced stage of resistance of this bacterial species. The characterization of strains of this species in a veterinary hospital environment is crucial for the control of this population circulating in this environment, and the consequent adoption of more effective measures aimed at controlling its proliferation. The study of this bacterial species in a veterinary hospital environment has a direct impact on human health, due to the mechanisms of resistance and genetic variability that can occur between infections in different animal species and in humans. In view of that, professionals working in veterinary hospitals should be aware of the importance of controlling these microorganisms. Correct measures must be taken to sanitize the environment and utensils between animal care sessions, besides frequent hand washing by all employees and the use of protective equipment such as masks and gloves. The presence of potentially biofilm-producing MDR and SDR strains indicates the free circulation of these bacteria in the veterinary hospital environment. Thus, as a potentially pathogenic microorganism to humans and animals, containment measures must be taken to prevent this possible transmission.Keywords: bacteria, antimicrobial resistance, multidrug resistant, beta-lactamase, biofilm, veterinary care