RESUMO
An accurate urine test for diverse populations with active tuberculosis could be transformative for preventing TB deaths. Urinary liporabinomannan (LAM) testing has been previously restricted to HIV co-infected TB patients. In this study we evaluate urinary LAM in HIV negative, pediatric and adult, pulmonary and extrapulmonary tuberculosis patients. We measured 430 microbiologically confirmed pretreatment tuberculosis patients and controls from Peru, Guinea Bissau, Venezuela, Uganda and the United States using three monoclonal antibodies, MoAb1, CS35, and A194, which recognize distinct LAM epitopes, a one-sided immunoassay, and blinded cohorts. We evaluated sources of assay variability and comorbidities (HIV and diabetes). All antibodies successfully discriminated TB positive from TB negative patients. ROAUC from the average of three antibodies' responses was 0.90; 95% CI 0.87-0.93, 90% sensitivity, 73.5% specificity (80 pg/mL). MoAb1, recognizing the 5-methylthio-D-xylofuranose(MTX)-mannose(Man) cap epitope, performed the best, was less influenced by glycosuria and identified culture positive pediatric (N = 19) and extrapulmonary (N = 24) patients with high accuracy (ROAUC 0.87, 95% CI 0.77-0.98, 0.90 sensitivity 0.80 specificity at 80 pg/mL; ROAUC = 0.96, 95% CI 0.92-0.99, 96% sensitivity, 80% specificity at 82 pg/mL, respectively). The MoAb1 antibody, recognizing the MTX-Man cap epitope, is a novel analyte for active TB detection in pediatric and extrapulmonary disease.
Assuntos
Lipopolissacarídeos/análise , Tuberculose/diagnóstico , Tuberculose/imunologia , Adulto , Coinfecção/urina , Epitopos/imunologia , Feminino , Guiné-Bissau , Infecções por HIV/urina , Humanos , Imunoensaio/métodos , Testes Imunológicos/métodos , Lipopolissacarídeos/imunologia , Lipopolissacarídeos/urina , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/imunologia , Peru , Sistemas Automatizados de Assistência Junto ao Leito , Sensibilidade e Especificidade , Tuberculose/classificação , Tuberculose Pulmonar/microbiologia , Uganda , Estados Unidos , VenezuelaRESUMO
O objetivo deste estudo foi comparar a superfície do esmalte antes e após clareamento com dois diferentes agentes. Vinte pacientes foram selecionados e divididos em dois grupos: Grupo 1 - tratados através da técnica de clareamento vital caseiro utilizando peróxido de carbamida a10% (Whiteness Perfect) e Grupo 2 - tratados através da técnica vital de consultório utilizando peróxido de hidrogênio a 35% (Whiteness HP). Réplicas em resina epóxi dos incisivos centrais de todos os pacientes foram obtidas antes, imediatamente após e trinta dias depois da conclusão dos tratamentos. Todas as réplicas foram fotografadas em microscópio eletrônico de varredura e um examinador experiente e cego as classificou nos seguintes escores: 1- superfície sem alteração 2-superfície com alteração. O estudo demonstrou que a realização do clareamento com os dois diferentes agentes causa efeitos sobre a superfície do esmalte, mas que esses são parcialmente revertidos em 30 dias.
The purpose of this study was to compare of enamel surface before and after bleaching with two different agents. Twenty subjects were selected and divided in two groups: Group 1- treated with the night guard vital bleaching using 10% carbamide peroxide (Whiteness Perfect) and Group2- treated with the in-offi ce technique using 35% hydrogen peroxide (Whiteness HP). Epoxi resin replicas obtained from the maxillary central incisors, before, immediately after and thirty days after the bleaching procedure. All replicas were hotography in scanning electron microscopy andexamined for one expert and blind examiner taken in scores: 1- surface without alteration 2- surface with alteration. This study demonstrated that bleaching treatment using both agents causes effect on namel surface, but these are partially reverted in thirty days.