RESUMO
STUDY DESIGN: A cross-sectional observational study was conducted. OBJECTIVE: The aim was to analyze the clinical-functional profile of patients diagnosed with HTLV-1 (human T-lymphotropic virus type 1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in the Amazon region. SETTING: Reference center for HTLV in the city of Belém, state of Pará, Brazil. METHODS: Muscle strength, muscle tone, balance and the need for gait assistance among patients with HAM/TSP were evaluated. RESULTS: Among the 82 patients infected with HTLV-1, 27 (10 men and 17 women) were diagnosed with HAM/TSP. No statistically significant difference in muscle tone or strength was found between the lower limbs. Muscle weakness and spasticity were predominant in the proximal lower limbs. Patients with HAM/TSP are at a high risk of falls (P=0.03), and predominantly use either a cane or a crutch on one side as a gait-assistance device (P=0.02). CONCLUSION: Patients with HAM/TSP exhibit a similar clinical pattern of muscle weakness and spasticity, with a high risk of falls, requiring gait-assistance devices.
Assuntos
Transtornos Neurológicos da Marcha/diagnóstico , Transtornos Neurológicos da Marcha/fisiopatologia , Debilidade Muscular/diagnóstico , Debilidade Muscular/fisiopatologia , Paraparesia Espástica Tropical/diagnóstico , Paraparesia Espástica Tropical/fisiopatologia , Adulto , Idoso , Brasil , Estudos Transversais , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Avaliação de SintomasRESUMO
BACKGROUND: Chronic urticaria (CU) is a debilitating skin disorder that affects patients' health related quality of life and the only questionnaire prepared specifically to CU is the Chronic Urticaria Quality of Life Questionnaire (CU-Q(2)oL). OBJECTIVE: The purpose of this study was to cross-culturally adapt and validate the CU-Q(2)oL Brazilian-Portuguese version. METHODS: Forward and back translation by three bilingual translators followed by pre-test was used to adapt the questionnaire. The CU-Q(2)oL was self-administered along with the Dermatology Life Quality Index (DLQI) in 112 patients with CU. Disease activity was assessed using the Urticaria Activity Score. Factor analysis was used to identify scales of the Brazilian portuguese CU-Q(2)oL. Internal consistency, convergent validity and known-group validity was determined. Reproducibility was evaluated by interclass correlation coefficient (ICC). Multiple linear regression was used to determine the predicting factors of CU-Q(2)oL results. RESULTS: Factor analysis revealed a three-dimensional structure: sleep/mental status/eating (I), pruritus/impact on life activities (II) and swelling/limits/look (III), which explained 52.49% of the total variance. All scales showed excellent internal consistency. External construct validity was supported by correlations between the CU-Q(2)oL and DLQI. The tool was found to be able to differentiate between patients with high and low levels of urticaria activity. Test-retest reliability was good to excellent (ICC = 0.69-0.86). Disease severity and urticaria type were the only factors predicting results. CONCLUSIONS: The CU-Q(2)oL Brazilian portuguese version was easily filled out, well accepted by the patients, demonstrated an acceptable validity and reliability and might be used to evaluate treatment outcomes and in clinical research.
Assuntos
Comparação Transcultural , Qualidade de Vida/psicologia , Inquéritos e Questionários , Urticária/psicologia , Adulto , Brasil , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Portugal , Urticária/fisiopatologiaRESUMO
OBJECTIVES: To evaluate the sensitization to aeroallergens determined by skin prick test (SPT) in Brazilian adolescents, and to correlate its positivity with the diagnosis of asthma and/or rhinitis based on the written questionnaire (WQ) of ISAAC phase III study. PATIENTS AND METHODS: A total of 996 adolescents (387 boys) were selected by systematic samples. A standard allergen extracts panel (positive/negative control, D pteronyssinus [Dpt], P americana [Pa], B germanica [Bg], dog, cat, fungal and grass mix) was used and its positivity compared with positive responses to asthma, rhinitis or both. RESULTS: Positive SPT to at least one allergen was observed in 466 adolescents (46.8 %), with sensitisation to Dpt in 79.1 %. Positivity to more than one allergen occurred in 232 students (49.8 %). The frequency of positive SPTs was significantly higher among adolescents with asthma (OR = 2.16), rhinitis (OR = 1.69), and asthma and rhinitis (OR = 2.03). Positive SPT to four or more allergens were higher among asthmatics (OR = 2.6) and among adolescents with asthma and rhinitis (OR = 3). CONCLUSIONS: A high sensitisation rate to aeroallergens was observed, significantly higher among those with asthma, rhinitis or a combination of both, especially in multiple sensitisations.
Assuntos
Alérgenos/efeitos adversos , Asma/epidemiologia , Rinite Alérgica Perene/epidemiologia , Rinite Alérgica Sazonal/epidemiologia , Adolescente , Animais , Asma/etiologia , Brasil/epidemiologia , Gatos , Baratas/imunologia , Dermatophagoides pteronyssinus/imunologia , Cães , Feminino , Fungos/imunologia , Humanos , Masculino , Pólen/imunologia , Pobreza , Rinite Alérgica Perene/etiologia , Rinite Alérgica Sazonal/etiologia , Testes Cutâneos , Fatores Socioeconômicos , População Suburbana , População UrbanaRESUMO
This study aims at quantifying through electromyography the actions of the biceps brachii-BB (long head), triceps brachii-TB (long head) and deltoideus-DA (clavicular portion) muscles, during the going (G) and return (R) phases in "back support" exercises. Surface electrodes were placed at the muscles, according to DELAGI (1981). It was used a specific software and a A/D plate to take the signals. After being collected, the records were processed resulting in efficient values (RMS), were normalized by maximum isometric contraction (MVIC = 100%) and statistically analysed using the Friedman, DSM and Wilcox non-parametric tests. All the muscles presented electromyographic activity of the movements. The triceps brachii was the muscle with higher activity in both phases of the movement. It was concluded that the exercise is indicated for the arm muscle strength development.
Assuntos
Braço/fisiologia , Exercício Físico/fisiologia , Músculo Esquelético/fisiologia , Adolescente , Adulto , Eletromiografia/métodos , Humanos , Masculino , Contração Muscular/fisiologia , Valores de ReferênciaRESUMO
Due to a shortage of textbooks with specific data on muscular activity concerning physical conditioning and sports, we analysed electromyographically the muscles pectoralis major and deltoideus anterior, bilaterally, in inclined "flying" exercises, during the concentric and eccentric phases, with external loads of 25, 50, 75 and 100% of the maximum load. The electromyographic analysis was performed in eleven male volunteers with MEDI-TRACE-200 surface electrodes connected to a six-channel biologic signal acquisition module coupled to a PC/AT computer. The electromyographic signals were processed and the obtained effective values were normalized through maximum voluntary isometric contraction. Statistically, the results showed that all the muscles studied presented significant differences between the concentric and the eccentric phases, with higher electromyographic activity during the concentric phase. By analysing the different loads for each muscle in both phases, significant electromyographic activity was observed for all muscles. When the effect of each load on each muscle during the concentric phase was analysed, it was noticed that the muscles on the left were more active than those on the right side, while in the eccentric phase the muscles had different behavior.
Assuntos
Eletromiografia , Exercício Físico/fisiologia , Neurônios Motores/fisiologia , Músculo Esquelético/inervação , Músculos Peitorais/inervação , Processamento de Sinais Assistido por Computador , Levantamento de Peso/fisiologia , Adolescente , Adulto , Lateralidade Funcional/fisiologia , Humanos , Masculino , Suporte de Carga/fisiologiaRESUMO
The aim of the method described here is to remove hemoglobin, the major contaminant in the bovine plasma obtained from slaughterhouses, by adding a mixture of 19 percent cold ethanol and 0.6 percent chloroform, followed by fibrinogen and globulin precipitation by the Cohn method and nonspecific hemagglutinin by thermocoagulation. The experimental volume of bovine plasma was 2,000 ml per batch. Final purification was performed by liquid chromatography using the ion-exchange gel DEAE-Sepharose FF. The bovine albumin thus obtained presented > or = 99 percent purity, a yield of 25.0 + or 1.2 g/l plasma and >71.5 percent recovery. N-acetyl-DL-tryptophan (0.04 mmol/g protein) and sodium caprylate (0.04 mmol/g protein) were used as stabilizers and the final concentration of albumin was adjusted to 22.0 percent (w/v), pH 7.2 to 7.3. Viral inactivation was performed by pasteurization for 10 h at 60 degres C. The bovine albumin for the hemagglutination tests used in immunohematology was submitted to chemical treatment with 0.06 percent (w/v) glutaraldehyde and 0.1 percent (w/v) formaldehyde at 37 degrees C for 12 h to obtain polymerization. A change in molecular distribution was observed after this treatment, with average contents of 56.0 percent monomers, 23.6 percent dimers, 12.2 percent trimers and 8.2 percent polymers. The tests performed demonstrated that this polymerized albumin enhances the agglutination of Rho(D)-positive red cells by anti-Rho(D) serum, permitting and improving visualization of the results
Assuntos
Animais , Bovinos , Cromatografia Líquida/métodos , Soroalbumina Bovina/isolamento & purificação , Testes de Aglutinação/métodos , Desinfetantes/farmacologia , Eletrocoagulação , Eletroforese em Acetato de Celulose , Formaldeído/farmacologia , Glutaral/farmacologia , Hemaglutininas , Polímeros , Soroalbumina Bovina/biossínteseRESUMO
The aim of the method described here is to remove hemoglobin, the major contaminant in the bovine plasma obtained from slaughterhouses, by adding a mixture of 19% cold ethanol and 0.6% chloroform, followed by fibrinogen and globulin precipitation by the Cohn method and nonspecific hemagglutinin by thermocoagulation. The experimental volume of bovine plasma was 2,000 ml per batch. Final purification was performed by liquid chromatography using the ion-exchange gel DEAE-Sepharose FF. The bovine albumin thus obtained presented > or =99% purity, a yield of 25.0 +/- 1.2 g/l plasma and >71.5% recovery. N-acetyl-DL-tryptophan (0.04 mmol/g protein) and sodium caprylate (0.04 mmol/g protein) were used as stabilizers and the final concentration of albumin was adjusted to 22.0% (w/v), pH 7.2 to 7.3. Viral inactivation was performed by pasteurization for 10 h at 60 degrees C. The bovine albumin for the hemagglutination tests used in immunohematology was submitted to chemical treatment with 0.06% (w/v) glutaraldehyde and 0.1% (w/v) formaldehyde at 37 degrees C for 12 h to obtain polymerization. A change in molecular distribution was observed after this treatment, with average contents of 56.0% monomers, 23.6% dimers, 12.2% trimers and 8.2% polymers. The tests performed demonstrated that this polymerized albumin enhances the agglutination of Rho(D)-positive red cells by anti-Rho(D) serum, permitting and improving visualization of the results.
Assuntos
Cromatografia Líquida/métodos , Soroalbumina Bovina/isolamento & purificação , Testes de Aglutinação/métodos , Animais , Bovinos , Desinfetantes/farmacologia , Eletrocoagulação , Eletroforese em Acetato de Celulose , Formaldeído/farmacologia , Glutaral/farmacologia , Hemaglutininas , Polímeros , Soroalbumina Bovina/químicaRESUMO
In order to obtain intravenous immunoglobulin G (iv IgG) of high quality from F-I+II+III or F-II+III pastes prepared by the Cohn method, we developed a chromatography process using ion exchange gels, Q-Sepharose FF and CM-Sepharose FF, and Sephacryl S-300 gel filtration. Viral inactivation was performed by incubating the preparation with pepsin at pH 4.0 at 35 degrees C for 18 h. The characteristics of 28 batches produced by us were: yield 4.3 +/- 0.2 g/l plasma, i.e., a recovery of 39.1 +/- 1.8%; IgG subclasses distribution: IgG1 = 58.4%, IgG2 = 34.8%, IgG3 = 4.5% and IgG4 = 2. 3%; IgG size distribution was 98.4% monomers, 1.2% dimers and 0.4% polymers and protein aggregates; anticomplement activity was less than 0.5 CH50/mg IgG, and prekallikrein activator activity (PKA) was less than 5 IU/ml. These characteristics satisfied the requirements of the European Pharmacopoea edition, and the regulations of the Brazilian Health Ministry (M.S. Portaria No. 2, 30/10/1998).
Assuntos
Cromatografia Líquida/métodos , Imunoglobulina G/isolamento & purificação , Imunoglobulinas Intravenosas/normas , Humanos , Padrões de ReferênciaRESUMO
In order to obtain intravenous immunoglobulin G (iv IgG) of high quality from F-I+II+III or F-II+III pastes prepared by the Cohn method, we developed a chromatography process using ion exchange gels, Q-Sepharose FF and CM-Sepharose FF, and Sephacryl S-300 gel filtration. Viral inactivation was performed by incubating the preparation with pepsin at pH 4.0 at 35oC for 18 h. The characteristics of 28 batches produced by us were: yield 4.3 + or - 0.2 g/l plasma, i.e., a recovery of 39.1 + or - 1.8 percent; IgG subclasses distribution: IgG1 = 58.4 percent, IgG2 = 34.8 percent, IgG3 = 4.5 percent and IgG4 = 2.3 percent; IgG size distribution was 98.4 percent monomers, 1.2 percent dimers and 0.4 percent polymers and protein aggregates; anticomplement activity was less than 0.5 CH50/mg IgG, and prekallikrein activator activity (PKA) was less than 5 IU/ml. These characteristics satisfied the requirements of the European Pharmacopoea edition, and the regulations of the Brazilian Health Ministry (M.S. Portaria No. 2, 30/10/1998)
Assuntos
Humanos , Cromatografia Líquida/métodos , Imunoglobulina G/isolamento & purificação , Imunoglobulinas Intravenosas/normas , Qualidade da Assistência à Saúde , Padrões de ReferênciaRESUMO
A paralisis geral progressiva pode se manifestar sob a forma dos mais variados quadros psiquiatricos. Apos a introduçäo da penicilinoterapia no tratamento da sifílis, sua incidencia teve grande declinio, o que fez com que clínicos de diversas especialidades progressivamente dixassem de pensar nessa patologia. Nas últimas décadas, no entanto, tem-se verificado um recrudescimento de sua incidencia devido à mudança de habitos sexuais, tratamento inadequado das formas primárias, falta de diagnostico, de tratamento precoce da doença e à associaçäo con a infecçäo pelo HIV. No presente artigo, os autores apresentam o caso de um paciente de 37 anos, HIV negativo, com uma forma clínica cciclica de neurossífilis, diagnosticada em março de 1999 no Hospital Psiquiátrico Galba Velloso e desenvolvem uma breve discussäo sobre o diagnóstico, tratamento e a psicopatologia da paralisia geral progressiva. Ressaltam, finalmente, a importância de se cogitar dessa possibilidade na prática psiquiatrica do dia-a-dia
Assuntos
Humanos , Masculino , Adulto , Neurossífilis/diagnóstico , Neurossífilis/patologia , Neurossífilis/psicologia , Neurossífilis/terapia , Paralisia , PsicopatologiaRESUMO
Immunoglobulin G (IgG) of excellent quality for intravenous use was obtained from the cryosupernatant of human plasma by a chromatographic method based on a mixture of ion-exchange, DEAE-Sepharose FF and arginine Sepharose 4B affinity chromatography and a final purification step by Sephacryl S-300 HR gel filtration. The yield of 10 experimental batches produced was 3.5 g IgG per liter of plasma. A solvent/detergent combination of 1 per cent Tri (n-butyl) phosphate and 1 per cent Triton X-100 was used to inactivate lipid-coated viruses. Analysis of the final product (5 per cent liquid IgG) based on the mean for 10 batches showed 94 per cent monomers, 5.5 per cent dimers and 0.5 per cent polymers and aggregates. Anticomplementary activity was 0.3 CH50/mg IgG and prekallikrein activator levels were less than 5 IU/ml. Stability at 37oC for 30 days in the liquid state was satisfactory. IgG was stored in flasks (2.5 g/flask) at 4 to 8oC. All the characteristics of the product were consistent with the requirements of the 1997 Pharmacopée Européenne.
Assuntos
Humanos , Imunoglobulina G/biossíntese , Imunoglobulinas Intravenosas , CromatografiaRESUMO
Large volumes of plasma can be fractionated by the method of Cohn at low cost. However, liquid chromatography is superior in terms of the quality of the product obtained. In order to combine the advantages of each method, we developed an integrated method for the production of human albumin and immunoglobulin G (IgG). The cryoprecipitate was first removed from plasma for the production of factor VIII and the supernatant of the cryoprecipitate was fractionated by the method of Cohn. The first precipitate, containing fractions (F)-I + II + III, was used for the production of IgG by the chromatographic method (see Tanaka K et al. (1998) Brazilian Journal of Medical and Biological Research, 31: 1375-1381). The supernatant of F-I + II + III was submitted to a second precipitation and F-IV was obtained and discarded. Albumin was obtained from the supernatant of the precipitate F-IV by liquid chromatography, ion-exchange on DEAE-Sepharose FF, filtration through Sephacryl S-200 HR and introduction of heat treatment for fatty acid precipitation. Viral inactivation was performed by pasteurization at 60oC for 10 h. The albumin product obtained by the proposed procedure was more than 99 per cent pure for the 15 lots of albumin produced, with a mean yield of 25.0 ñ 0.5 g/l plasma, containing 99.0 to 99.3 per cent monomer, 0.7 to 1.0 per cent dimers, and no polymers. Prekallikrein activator levels were ó5 IUml. This product satisfies the requirements of the 1997 Pharmacopée Européenne.
Assuntos
Humanos , Albumina Sérica/biossíntese , Fracionamento Químico , Cromatografia Líquida , Custos e Análise de Custo , Imunoglobulina G/biossíntese , Albumina Sérica/isolamento & purificaçãoRESUMO
Immunoglobulin G (IgG) of excellent quality for intravenous use was obtained from the cryosupernatant of human plasma by a chromatographic method based on a mixture of ion-exchange, DEAE-Sepharose FF and arginine Sepharose 4B affinity chromatography and a final purification step by Sephacryl S-300 HR gel filtration. The yield of 10 experimental batches produced was 3.5 g IgG per liter of plasma. A solvent/detergent combination of 1% Tri (n-butyl) phosphate and 1% Triton X-100 was used to inactivate lipid-coated viruses. Analysis of the final product (5% liquid IgG) based on the mean for 10 batches showed 94% monomers, 5.5% dimers and 0.5% polymers and aggregates. Anticomplementary activity was 0.3 CH50/mg IgG and prekallikrein activator levels were less than 5 IU/ml. Stability at 37 degrees C for 30 days in the liquid state was satisfactory. IgG was stored in flasks (2.5 g/flask) at 4 to 8 degrees C. All the characteristics of the product were consistent with the requirements of the 1997 Pharmacopée Européenne.
Assuntos
Imunoglobulina G/química , Imunoglobulinas Intravenosas , Cromatografia , HumanosRESUMO
Large volumes of plasma can be fractionated by the method of Cohn at low cost. However, liquid chromatography is superior in terms of the quality of the product obtained. In order to combine the advantages of each method, we developed an integrated method for the production of human albumin and immunoglobulin G (IgG). The cryoprecipitate was first removed from plasma for the production of factor VIII and the supernatant of the cryoprecipitate was fractionated by the method of Cohn. The first precipitate, containing fractions (F)-I + II + III, was used for the production of IgG by the chromatographic method (see Tanaka K et al. (1998) Brazilian Journal of Medical and Biological Research, 31: 1375-1381). The supernatant of F-I + II + III was submitted to a second precipitation and F-IV was obtained and discarded. Albumin was obtained from the supernatant of the precipitate F-IV by liquid chromatography, ion-exchange on DEAE-Sepharose FF, filtration through Sephacryl S-200 HR and introduction of heat treatment for fatty acid precipitation. Viral inactivation was performed by pasteurization at 60 degrees C for 10 h. The albumin product obtained by the proposed procedure was more than 99% pure for the 15 lots of albumin produced, with a mean yield of 25.0 +/- 0.5 g/l plasma, containing 99.0 to 99.3% monomer, 0.7 to 1.0% dimers, and no polymers. Prekallikrein activator levels were < or = 5 IU/ml. This product satisfies the requirements of the 1997 Pharmacopée Européenne.
Assuntos
Albumina Sérica/isolamento & purificação , Fracionamento Químico , Cromatografia Líquida , Custos e Análise de Custo , Humanos , Imunoglobulina G/biossínteseRESUMO
We have modified a standard column chromatography method for the preparation of albumin from human plasma. The proposed method utilizes Sephadex G-25, euglobulin precipitation, DEAE-Sepharose, ethanol heat treatment and Sephacryl S-200 HR. The procedure differs from that normally used by the introduction of Schneider's ethanol/heat treatment step and the elimination of a CM-Sepharose step, after the DEAE-Sepharose step. The proposed method was used to produce 15 batches of albumin, 100 liters of plasma per batch. Purity of more than 99% was obtained at an average yield of 26.5 g/l plasma for the albumin produced. All batches presented 99.2 to 99.9% monomer and 0.1 to 0.8% dimer, with no larger polymers detected. The utilization of the final gel filtration step eliminated highly polymerized albumin usually obtained during the process. The advantages of the proposed method are reduction in the overall process time from 6 to 5 days, elimination of the CM-Sepharose step and the reduction of 6 to 4 columns in series for the Sephacryl S-200 HR step.
Assuntos
Cromatografia em Agarose/normas , Albumina Sérica/biossíntese , Fracionamento Químico , Cromatografia/instrumentação , Humanos , Técnicas In VitroRESUMO
We have modified a standard column chromatography method for the preparation of albumin from human plasma. The proposed method utilizes Sephadex G-25, euglobulin precipitation, DEAE-Sepharose, ethanol heat treatment and Sephacryl S-200 HR. The procedure differs from that normally used by the introduction of Schneider's ethanol/heat treatment step and the elimination of a CM-Sepharose step, after the DEAE-Sepharose step. The proposed method was used to produce 15 batches of albumin, 100 liters of plasma per batch. Purity of more than 99 percent was obtained at an average yield of 26.5 g/l plasma for the albumin produced. All batches presented 99.2 to 99.9 percent monomer and 0.1 to 0.8 percent dimer, with no larger polymers detected. The utilization of the final gel filtration step eliminated highly polymerized albumin usually obtained during the process. The advantages of the proposed method are reduction in the overall process time from 6 to 5 days, elimination of the CM-Sepharose step and the reduction of 6 to 4 columns in series for the Sephacryl S-200 HR step.