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For the proper functioning of the Immunohematology Area, an External Quality Control was established since 1973 through a program that evaluates the performance of the laboratories of the Blood Bank and transfusion services that carry out immunohematology tests. This program consists of sending panel cells to participating blood banks or services, which are phenotyped erythrocyte samples previously studied as problem cases but whose results are unknown by the participating laboratories. The processes in which the program is of most importance are determination of the ABO group, determination of Rh, performance of the direct and indirect Coombs test, and pre-transfusion compatibility tests. It was carried out an observational and retrospective study of the results obtained in the 2020 period from 104 units participating in the Immunohematology Quality Control Program of the National Medical Center's Blood Bank. A panel of cells was sent for external quality control of immunohematology every 45 days, resulting in 9 panels for each unit in the studied period. Compliance with the program was observed in the general result (79.6%), i.e., there was a decrease in the participation of the registered units. Of a maximum score of 100% to be obtained, it was observed a general result of 95.3% compliance of the participating units. The results obtained confirm the good general training of the immunohematology laboratories of the participating units. Yet, as in any external control program, it becomes clear that obtaining an erroneous result is a risk that can occur in any laboratory.
Para el buen funcionamiento del Área de Inmunohematología, desde 1973 se instauró el Control de Calidad Externo con un programa que evalúa los laboratorios del Banco de Sangre y los servicios de transfusión que hacen pruebas de inmunohematología. El programa consiste en enviar a los bancos de sangre, o servicios participantes, células panel, que son muestras de eritrocitos fenotipados y previamente estudiados como casos problema, pero cuyos resultados son desconocidos por los laboratorios participantes. Los procesos en los que el programa es de suma importancia son determinación del grupo ABO, determinación del Rh, realización de la prueba de Coombs directa e indirecta y las pruebas de compatibilidad pretransfusionales. Se hizo un estudio observacional y retrospectivo de los resultados de 2020 de 104 unidades participantes en el Programa de Control de Calidad de Inmunohematología del Banco de Sangre del Centro Médico Nacional Siglo XXI. Se envió un panel de células para el control de calidad externo de inmunohematología cada 45 días y dio como resultado nueve paneles para cada unidad. El cumplimiento del programa se observó en el resultado general (79.6%), es decir, disminuyó la participación de las unidades inscritas. De una calificación máxima de 100%, hubo un resultado general de las unidades participantes del 95.3% de cumplimiento. Los resultados confirman la buena capacitación general de los laboratorios de inmunohematología de las unidades participantes. Aun así, como en cualquier programa de control externo, obtener un resultado erróneo es un riesgo que puede presentarse en cualquier laboratorio.
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Bancos de Sangue , Laboratórios , Humanos , Estudos Retrospectivos , Controle de QualidadeRESUMO
Abstract Introduction Leg ulcers (LUs) are relatively common in patients with sickle cell anemia (SCA). The role of inflammation and nitric oxide (NO) pathways in the pathophysiology of the LU is not understood. Objective The aim of this study was to verify the association between inflammatory molecules and nitric oxide metabolites (NOx) and the occurrence of the LU in patients with SCA. Method It was a cross-sectional study on adult participants with SCA followed at Fundação Hemominas, a public blood center in Brazil. Eligible participants were recruited and included in one of two groups: Group 1, comprised of cases with SCA (Hb SS) and at least one LU at the time of inclusion in the study and Group 2, comprised of controls with SCA without a history of LU, matched by sex and age to cases. Participants were interviewed to obtain sociodemographic data and blood samples were collected. Clinical and laboratory data were abstracted from medical records. Nitric oxide metabolites (NOx) and inflammatory molecules were quantified using an immunoassay and Multiplex xMAP® technology, respectively. Eighty-seven individuals were included, ranging in age from 17 to 61 years (mean 40 ± 10.7 years); 30 had LU and 57 were controls without LU. Results Participants with LU had significantly higher levels of interleukin 8 (IL-8), IL-10, IL-15, NOx and platelet and white blood cell (WBC) counts, when compared to those without LU. Participants with LU had a significantly higher risk of having a history of osteomyelitis and a higher use of antiseptic soap in bathing, when compared to those without LU. Conclusion In conclusion, our results showed that NOx, inflammatory molecules and hematological features were associated with LU in Brazilian adults with SCA.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Anemia Falciforme , Úlcera da Perna , Inflamação , Óxido NítricoRESUMO
OBJECTIVES: To determine the safety, pharmacokinetics, and immunomodulatory effects of 2-6 weeks of anakinra therapy in patients with acute Kawasaki disease with a coronary artery aneurysm (CAA). STUDY DESIGN: We performed a Phase I/IIa dose-escalation study of anakinra (2-11 mg/kg/day) in 22 patients with acute Kawasaki disease with CAA. We measured interleukin (IL)-1RA concentrations after the first dose and trough levels up to study week 6. Markers of inflammation and coronary artery z-scores were assessed pretreatment and at 48 hours, 2 weeks, and 6 weeks after initiation of therapy. RESULTS: Up to 6 weeks of anakinra (up to 11 mg/kg/day) was safe and well tolerated by the 22 participants (median age, 1.1 years), with no serious adverse events attributable to the study drug. All participants were treated with intravenous immunoglobulin (IVIG), and 20 also received infliximab (10 mg/kg) before initiation of anakinra. Serum levels of IL-6, IL-8, and tumor necrosis factor α decreased similarly in patients with Kawasaki disease treated with IVIG, infliximab, and anakinra compared with age- and sex-matched patients with Kawasaki disease treated only with IVIG and infliximab. Anakinra clearance increased with illness day at diagnosis. Simulations demonstrated that more frequent intravenous (IV) dosing may result in more sustained concentrations without significantly increasing the peak concentration compared with subcutaneous (SC) dosing. CONCLUSIONS: Both IV and SC anakinra are safe in infants and children with acute Kawasaki disease and CAA. IV dosing every 8-12 hours during the acute hospitalization of patients with Kawasaki disease may result in a sustained concentration while avoiding frequent SC injections. The efficacy of a short course of IV therapy during hospitalization should be studied. TRIAL REGISTRATION CLINICALTRIALS.GOV: NCT02179853.
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Aneurisma Coronário , Proteína Antagonista do Receptor de Interleucina 1 , Síndrome de Linfonodos Mucocutâneos , Doença Aguda , Aneurisma Coronário/complicações , Aneurisma Coronário/tratamento farmacológico , Feminino , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Lactente , Infliximab/uso terapêutico , Proteína Antagonista do Receptor de Interleucina 1/efeitos adversos , Masculino , Síndrome de Linfonodos Mucocutâneos/complicações , Síndrome de Linfonodos Mucocutâneos/tratamento farmacológicoRESUMO
INTRODUCTION: Leg ulcers (LUs) are relatively common in patients with sickle cell anemia (SCA). The role of inflammation and nitric oxide (NO) pathways in the pathophysiology of the LU is not understood. OBJECTIVE: The aim of this study was to verify the association between inflammatory molecules and nitric oxide metabolites (NOx) and the occurrence of the LU in patients with SCA. METHOD: It was a cross-sectional study on adult participants with SCA followed at Fundação Hemominas, a public blood center in Brazil. Eligible participants were recruited and included in one of two groups: Group 1, comprised of cases with SCA (Hb SS) and at least one LU at the time of inclusion in the study and Group 2, comprised of controls with SCA without a history of LU, matched by sex and age to cases. Participants were interviewed to obtain sociodemographic data and blood samples were collected. Clinical and laboratory data were abstracted from medical records. Nitric oxide metabolites (NOx) and inflammatory molecules were quantified using an immunoassay and Multiplex xMAP® technology, respectively. Eighty-seven individuals were included, ranging in age from 17 to 61 years (mean 40⯱â¯10.7 years); 30 had LU and 57 were controls without LU. RESULTS: Participants with LU had significantly higher levels of interleukin 8 (IL-8), IL-10, IL-15, NOx and platelet and white blood cell (WBC) counts, when compared to those without LU. Participants with LU had a significantly higher risk of having a history of osteomyelitis and a higher use of antiseptic soap in bathing, when compared to those without LU. CONCLUSION: In conclusion, our results showed that NOx, inflammatory molecules and hematological features were associated with LU in Brazilian adults with SCA.
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ABSTRACT Background: Test-seeking is associated with HIV in Brazilian blood donors. This study sought to investigate the frequency with which three different donor groups: deferred donors, accepted donors who tested HIV positive [HIV (+)], and accepted donors who tested infectious disease markers negative [IDM (−)], came to the blood bank at the suggestion of a health care professional. Study design and methods: Donors deferred for reporting high-risk behaviors and participants in an HIV risk factor case-control study completed a confidential audio computer-assisted self-interview (ACASI) that included two questions related to health care professionals and test-seeking. Results: Of 4013 enrolled deferred donors, 468 (11.8%) reported a health care professional suggested donation as a way to be tested for infection. Of 341 HIV (+) and 791 IDM (−) participants, 43 (12.6%) and 11 (1.4%), respectively, reported a health care professional suggested donation as a way to be tested for infection. Physicians were the most frequently reported source of referral: [(61.5% of deferred, 69.1% of HIV (+), and 9.1% of IDM (−) donors)]. Conclusion: HIV (+) donors and deferred donors were 10 times more likely to report test-seeking behavior by suggestion of health care professional than IDM (−) donors. If true, efforts should be made to educate health care professionals and blood donors on how to safeguard the blood supply, emphasizing that HIV testing should be done at volunteer testing centers rather than at the blood centers.
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Doadores de Sangue , Pessoal de SaúdeRESUMO
BACKGROUND: Test-seeking is associated with HIV in Brazilian blood donors. This study sought to investigate the frequency with which three different donor groups: deferred donors, accepted donors who tested HIV positive [HIV (+)], and accepted donors who tested infectious disease markers negative [IDM (-)], came to the blood bank at the suggestion of a health care professional. STUDY DESIGN AND METHODS: Donors deferred for reporting high-risk behaviors and participants in an HIV risk factor case-control study completed a confidential audio computer-assisted self-interview (ACASI) that included two questions related to health care professionals and test-seeking. RESULTS: Of 4013 enrolled deferred donors, 468 (11.8%) reported a health care professional suggested donation as a way to be tested for infection. Of 341 HIV (+) and 791 IDM (-) participants, 43 (12.6%) and 11 (1.4%), respectively, reported a health care professional suggested donation as a way to be tested for infection. Physicians were the most frequently reported source of referral: [(61.5% of deferred, 69.1% of HIV (+), and 9.1% of IDM (-) donors)]. CONCLUSION: HIV (+) donors and deferred donors were 10 times more likely to report test-seeking behavior by suggestion of health care professional than IDM (-) donors. If true, efforts should be made to educate health care professionals and blood donors on how to safeguard the blood supply, emphasizing that HIV testing should be done at volunteer testing centers rather than at the blood centers.
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American tegumentary leishmaniasis (ATL) samples obtained from the lesions of patients with typical (n = 25, 29%), atypical (n = 60, 69%) or both (n = 2%) clinical manifestations were analysed by multilocus enzyme electrophoresis, hsp70 restriction-fragment length polymorphism (PCR-RFLP), hsp70 sequencing and phylogenetics methods. The hsp70 PCR-RFLP analysis revealed two different profiles whose the most samples differed from those expected for Leishmania braziliensis and the other Leishmania species tested: of 39 samples evaluated, two (5%) had a restriction profile corresponding to L. braziliensis, and 37 (95%) had a restriction profile corresponding to a variant pattern. A 1300-bp hsp70 gene fragment was sequenced to aid in parasite identification and a phylogenetic analysis was performed including 26 consensus sequences from the ATL patient's samples and comparing to other Leishmania and trypanosomatids species. The dendrogram allowed to observe a potential population structure of L. braziliensis complex in the studied region, emphasizing that the majority of clinical samples presented a variant genetic profile. Of interest, the L. braziliensis diversity was associated with different clinical manifestations whose parasites with hsp70 variant profile were associated with atypical lesions. The results may be helpful to improve the diagnosis, treatment and control measures of the ATL in endemic areas.
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Variação Genética , Leishmania braziliensis/genética , Leishmaniose Cutânea/epidemiologia , Pele/parasitologia , Brasil/epidemiologia , DNA de Protozoário/genética , Doenças Endêmicas , Proteínas de Choque Térmico HSP70/genética , Humanos , Filogenia , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Pele/patologiaRESUMO
OBJECTIVES: Disinfectants are widely used in food processing environments for microorganism control; their activity can vary according the microorganism and their used in the appropriated concentrations is vital. Hence, the aim of this study was determined the effectiveness and minimum inhibitory concentration (MIC) of 15 disinfectants commonly used in the food industry in Mexico. METHODS: The antimicrobial activity and the MIC were determined according to AOAC and CLSI, respectively, with approved strains. RESULTS: Most disinfectants reduced 99.999% of microorganisms in suspension after 30s of contact, so reduction rate corresponded at least 5 Log10. Only for Pseudomonas aeruginosa ATCC 15442, did all disinfectants have 99.999% effectiveness. For the MIC, only the third generation quaternary ammonium compounds (QACs) in acid medium did not have values within the range in which is used in the food industry for Staphylococcus aureus ATCC 25923. In addition, for all disinfectants the MIC at 5min was two to four times greater than the concentration with the same effect at 10min; moreover, in most cases there was no difference in the MIC at 10 and 15min (p>0.05). CONCLUSIONS: At recommended concentrations, disinfectants had bactericidal activity for at least three of the six microorganisms evaluated. However, the MIC was affected by the exposure time: it was bigger at 5min than at 10min; moreover, in the majority of the cases, it was equal at 10 and 15min; with the results we could have a better understanding of disinfectants use in food processing environments.
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Anti-Infecciosos/farmacologia , Bactérias/efeitos dos fármacos , Desinfetantes/farmacologia , Manipulação de Alimentos/normas , Indústria Alimentícia , Fatores de Tempo , Bactérias/crescimento & desenvolvimento , Contagem de Colônia Microbiana , Farmacorresistência Bacteriana/efeitos dos fármacos , Manipulação de Alimentos/métodos , Conservação de Alimentos , México , Testes de Sensibilidade Microbiana , Viabilidade Microbiana/efeitos dos fármacos , Pseudomonas aeruginosa/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacosRESUMO
BACKGROUND: There has been increased worldwide emphasis on the many benefits of human immunodeficiency virus (HIV) serostatus awareness for both infection prevention and improved treatment outcomes. Previous studies indicate that donors may use blood donation to be tested; the objectives of this analysis were to assess, among donors with previously undisclosed risk behavior in the 12 months before donation, the frequency of those who have previously been tested for HIV and the demographic and behavioral factors associated with such testing. STUDY DESIGN AND METHODS: In this secondary analysis from an HIV case-control study of blood donors in Brazil, we analyzed the response to the question, "Other than blood donation, have you ever been tested for HIV?" Demographic and disclosed risk behaviors associated with previous testing were determined. RESULTS: The study included 341 HIV-positive cases and 791 HIV-negative controls (1:2 case/control ratio). Overall, 31% of blood donors (40% of cases and 26% of controls) reported having been tested for HIV outside of blood donation. History of HIV testing varied according to sex, HIV status, and reported sexual risk behavior. CONCLUSION: Although it is encouraging that previous testing was more frequent in donors with acknowledged sexual risk behavior in Brazil, 60% still had not been tested for HIV outside of the blood donation setting. Educating donors on the importance of not using blood centers as a means to get tested for HIV in Brazil, especially if they engage in higher risk behaviors, and seeking alternate testing venues instead could improve the safety of donated blood.
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Doadores de Sangue , Infecções por HIV/diagnóstico , Autorrelato , Adolescente , Adulto , Idoso , Brasil , Estudos de Casos e Controles , Feminino , Infecções por HIV/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Assunção de Riscos , Comportamento Sexual , Adulto JovemRESUMO
BACKGROUND: Bovine vaccinia (BV) is a zoonosis caused by Vaccinia virus, a virus from Orthopoxvirus genus (OPV) that affects mainly cattle herds and humans in rural areas in Brazil. Because most studies have focused on outbreaks situations, data on BV epidemiology is limited. A cross sectional study in Brazilian rural areas during 2012-2013 was conducted to determine the neutralizing antibodies seroprevalence and risk factors for BV. METHODS: A structured questionnaire was applied to elicit demographics data and farming practices considered risk factors for BV exposure. Neutralizing anti-OPV antibodies were investigated using plaque reduction neutralization test. The neutralizing antibodies prevalence rates were calculated and the risk factor analysis was performed using multivariate logistic regression. RESULTS: Two hundred and forty participants were enrolled in this study with a prevalence of neutralizing antibodies of 30.8 % (95 % confidence interval [CI], 25.3-36.9). In multivariate analysis, age > 35 years (Odds Ratio [OR] = 18.2; CI 95 % = 7.7 - 43.2) and previous outbreak in property (OR = 3.9; C I95 % = 1.2 - 12.6) were independently associated with anti-OPV neutralizing antibodies. CONCLUSIONS: In this study, anti-OPV protective immunity (neutralizing antibody titers) was assessed in an endemic BV Brazilian rural area. Our findings indicate that epidemiological surveillance is required and should be applied by public health authorities to create interventions and/or prevention strategies to avoid viral spread causing future outbreaks among individuals who are under risk of infection.
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Anticorpos Antivirais/sangue , Orthopoxvirus/imunologia , Infecções por Poxviridae/sangue , Zoonoses/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças dos Trabalhadores Agrícolas/sangue , Doenças dos Trabalhadores Agrícolas/imunologia , Doenças dos Trabalhadores Agrícolas/virologia , Animais , Anticorpos Neutralizantes/sangue , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Gado/virologia , Masculino , Pessoa de Meia-Idade , Orthopoxvirus/genética , Orthopoxvirus/isolamento & purificação , Infecções por Poxviridae/imunologia , Infecções por Poxviridae/virologia , População Rural , Estudos Soroepidemiológicos , Adulto Jovem , Zoonoses/epidemiologia , Zoonoses/imunologia , Zoonoses/virologiaRESUMO
This study aimed to evaluate the trends of HCV seropositivity rates in first time blood donors from a reference blood centre in Southeast Brazil. Data from the period of 2007-2010 were analysed according to anti-HCV antibodies, donor demographic characteristics and type of donation. There was a marked and continuous decline in prevalence in the analysed period, and in 93,534 first time donors, the prevalence of anti-HCV was 0.09%. Anti-HCV were associated with less education and older age (≥ 35 years). The rates of anti-HCV observed in the present study were lower than in Brazil, but considerably higher than developed countries.
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Doadores de Sangue , Anticorpos Anti-Hepatite C/sangue , Hepatite C/sangue , Hepatite C/epidemiologia , Adulto , Biomarcadores/sangue , Brasil/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de RiscoRESUMO
Seis pulpas de frutas tropicales de origen colombiano: curuba (Passiflora tripartida var. Mollissima), gulupa (Passiflora edulis Sims), aguacate variedad Hass (Persea America Mill), lulo (Solanum quitoense Lam.), tomate de árbol (Cyphomandra betacea Sendt) y uchuva (Physalis peruvianaL) fueron empleadas para realizar el estudio del contenido total de fenoles, por el método de Folin Ciocalteu y la actividad antioxidante por los métodos químicos: DPPH (2,2-difenil-2-picrilhidrazilo) y FRAP (poder antioxidante para reducir iones férricos), y por los métodos biológicos: oxidación de lipoproteínas de baja densidad (LDL) e inhibición del estrés oxidativo sobre el crecimiento de Saccharomyces cerevisiae. Se encontró que el extracto de curuba presentó el mayor contenido total de fenoles con un valor de 683,48 ± 18,48 mg equivalentes de ácido gálico/100 g muestra B.H. (Base Húmeda). En cuanto a los ensayos de actividad antioxidante el extracto de aguacate presentó mayor actividad por el método DPPH con un valor de 165,10 ± 4,36 µmol Trolox/100 g muestra B.H., mientras que el extracto de curuba presentó la mayor actividad antioxidante por el método FRAP con un valor de 148,07 ± 12,07 µmol Trolox/g muestra B.H. En el ensayo de oxidación de LDL los extractos de curuba y uchuva presentaron la mayor capacidad de inhibición en la oxidación de dichas lipoproteínas con un valor de 1,61 ± 0,01 y 1,46 ± 0,06 nmol TMP (Tetrametoxipropano)/g muestra B.H., respectivamente. En el ensayo de inhibición del estrés oxidativo sobre el crecimiento de S. cerevisiae los extractos de aguacate, curuba y gulupa tuvieron el mayor efecto protector obteniéndose una concentración celular de.
Six pulp extracts of tropical fruits from Colombia: banana passion fruit (Passiflora tripartida var. Mollissima), gulupa (Passiflora edulis Sims), avocado (Persea americana Mill.), lulo (Solanum quitoense Lam.), tomate de árbol (Cyphomandra betacea Sendt.), and gooseberry (Physalis peruviana L.) were used for studying the total phenolic content by the Folin Ciocalteu method and the antioxidant activity by the chemical methods: DPPH (2,2-diphenyl-1-picrylhydrazyl) and FRAP (ferric ion reducing antioxidant power), and by the biological methods: oxidation of low density lipoproteins (LDL) and inhibition of oxidative stress on Saccharomyces cerevissiae growth. It was found that banana passion fruit extract showed the highest content of total phenolics, with a value of 683.48 ± 18.48 mg equivalents to gallic acid/100 g fresh weight (F.W.). Regarding the antioxidant activity the avocado extract exhibited the highest activity in the DPPH assay, with a value of 165.10 ± 4.36 µmol Trolox/100g F.W. whereas the banana passion fruit extract showed the highest antioxidant activity by the FRAP method, with a value of 148.07 ± 12.07 µmol Trolox/g F.W. In the LDL oxidation assay the extracts from banana passion fruit and gooseberry presented the greater ability to inhibit the oxidation of those lipoproteins, with a value of 1.61 ± 0.01 and 1.46 ± 0.06 nmol TMP (Tetrametoxipropane)/g F.W., respectively. In the assay of inhibition of oxidative stress on S. cerevissiae the avocado, banana passion fruit, and gulupa extracts exhibited the main protective effect and the obtained values for cellular concentration were 1.96 ×10(7) cells/mL, 1.86 × 10(7) cells/mL, and 1.54 × 10(7) cells/mL, respectively, as compared to 0.99 × 10(7) cells/mL found.
Seis polpa de frutas tropicais da Colômbia: maracujá (Passiflora tripartite Mollissima var.), Gulupa (Passiflora edulis Sims), Hass abacate (Persea América Mill), lulo (Solanum quitoense Lam.), tomate de árvore (Cyphomandra betacea Sendt) e uchuva (Physalis Peruviana L) foram utilizados para o estudo do teor total de fenol pelo método de Folin-Ciocalteu e actividade antioxidante por métodos químicos: DPPH (2,2-difenil-2-picrilhidrazilo) e FRAP (poder antioxidante de reduzir iões férricos), e métodos biológicos: a oxidação de lipoproteínas de baixa densidade (LDL) e inibição de estresse oxidativo no crescimento de Saccharomyces cerevisiae. Os resultados são encontrados no extrato tiveram o maior teor total maracujá de fenóis com um valor de 683,48 ± 18,48 mg equivalentes o ácvido gálico/100 g amostra de ácido BH (Base úmida). Quanto à atividade antioxidante testes abacate extrato apresentou maior atividade com o método DPPH vale 165,10 ± 4,36 µmol Trolox / 100g de amostra BH, enquanto o extrato de maracujá apresentou a maior atividade antioxidante, método FRAP com um valor de 148,07 ± 12,07 µmol Trolox/g amostra BH. No ensaio de oxidação de LDL e extrai maracujá e uchuva teve a maior capacidade para inibir a oxidação de lipoproteínas estes com um valor de 1,61 ± 0,01 e 1,46 ± 0,06 nmol TMP (tetrametoxipropano)/g BH amostra, respectivamente. No ensaio de inibição de estresse oxidativo no crescimento de S. cerevisiae de extratos de abacate, maracujá e gulupa tinha o maior efeito protector sendo obtido uma concentração de células de 1,96 ×10(7) células/mL, 1,86 × 10(7) células/ml e 1,54 × 10(7) células/mL, respectivamente, em comparação com aqueles encontrados.
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Introdução: a transfusão de sangue tem como objetivo restaurar o volume de sangue e manter a concentração de oxigênio. Pode ser um procedimento essencial para a melhoria do estado geral e preservação da vida dos pacientes, mas pode ter efeitos indesejáveis e até mesmo letais. Objetivos: avaliar o perfil de transfusão hospitalar e adesão aos protocolospesquisados. Métodos: estudo descritivo de série de casos com amostra coletada de forma sistemática, a partir dos registros de solicitações de hemocomponentes do ano de 2012. A distribuição dos dados coletados foi analisada após soma do total em número absoluto e cálculo da sensibilidade. Resultados: a proporção de solicitações foi maior para pacientes do sexo masculino (54,6%) e a faixa etária com maior prevalência de solicitações de hemotransfusão foi de 60 anos ou mais (40,4% do total). O concentrado de hemácias (CH) foi o componente do sangue com o maior número de pedidos (72,4%), seguido de plasma congelado fresco (PFC) (22,2%) e de concentrados de plaquetas (CP) (6,2%). Entre as indicações de CH, a anemia foi o mais encontrado, seguido por sangramento. O sangramento também foi a principal indicação clínica do PFC. Outras indicações do PFC foram anemia e terapia de coagulopatias/anticoagulação. Pedidos, transfusões e internações não mostraram relação direta temporal durante o ano estudado. Conclusões: o estudo das características da demanda de sangue pode auxiliar na observação e previsão de tendências e desfechos. Considerando a análise temporal da demanda de sangue, por exemplo, destaca-se a importância de manter o banco de sangue com reservas suficientespara atender às exigências. Além disso, foram encontrados registros de uso acima do esperado de PFC, com indicações não preconizadas pelo hospital e literatura nacional.
Introduction: Blood transfusion is aimed to restore blood volume and maintain the oxygen concentration. It can be an essential procedure for improving the general condition and preserve the lives of patients, but it may have unwanted and even lethal effects. Aims: To evaluate the characteristics and adherence to hospital transfusion protocols surveyed. Methods: Descriptive case series study with samples collected systematically from the records of requests for blood products of the year 2012. The distribution of the collected data was analyzed after the totalsum in absolute numbers and calculation of sensitivity. Results: The proportion of requests was higher for male patients (54.3%) and the age group with the highest prevalence of requests for blood transfusion was 60 years or more (40.4% of the total). The packed red blood cells (RBC)was the blood component with the highest number of requests (72.4%), followed by fresh frozen plasma (FFP) (22.2%) and platelet concentrates (PC) (6.2%). Among the indications for RBC, anemia was most frequently found, followed by bleeding. Bleeding was also the main clinical indication FFP. Other indications of the FFP were anemia and coagulopathies / anticoagulation therapy. Orders, transfusions and hospitalizationsdid not show a direct temporal relationship during the year studied. Conclusions: The study of the characteristics of the demand for blood can aid in the detection and prediction of trends and outcomes. Considering the temporal analysis of the demand for blood, for example, emphasize the importance of maintaining the blood bank with sufficient reserves to meet the requirements. Furthermore, usage records higher than expected FFP, with no indications recommended by the hospital and national literature were found.
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Extensive use of Vaccinia virus (VACV) in research has led to associated accidental human exposure in laboratories worldwide. In spite of the social and economic relevance of Bovine Vaccinia outbreaks in Brazil, national data concerning laboratory workers handling these infectious agents are relatively scarce. Therefore, a serological survey was conducted in a Brazilian laboratory to evaluate staff exposure to orthopoxviruses (OPVs). Information concerning direct work with OPVs, vaccination status and laboratory accidents was collected and correlated to serology results. This study presents an opportunity for discussion of routine procedures involving OPVs in laboratories and their intrinsic risks. Aspects of the live attenuated smallpox vaccine are also discussed.
Assuntos
Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , Exposição Ocupacional , Orthopoxvirus/imunologia , Adulto , Animais , Brasil , Bovinos , Feminino , Humanos , Laboratórios , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: Studies analyzing motivation factors that lead to blood donation have found altruism to be the primary motivation factor; however, social capital has not been analyzed in this context. Our study examines the association between motivation factors (altruism, self-interest, and response to direct appeal) and social capital (cognitive and structural) across three large blood centers in Brazil. STUDY DESIGN AND METHODS: We conducted a cross-sectional survey of 7635 donor candidates from October 15 through November 20, 2009. Participants completed self-administered questionnaires on demographics, previous blood donation, human immunodeficiency virus testing and knowledge, social capital, and donor motivations. Enrollment was determined before the donor screening process. RESULTS: Among participants, 43.5 and 41.7% expressed high levels of altruism and response to direct appeal, respectively, while only 26.9% expressed high levels of self-interest. More high self-interest was observed at Hemope-Recife (41.7%). Of participants, 37.4% expressed high levels of cognitive social capital while 19.2% expressed high levels of structural social capital. More high cognitive and structural social capital was observed at Hemope-Recife (47.3 and 21.3%, respectively). High cognitive social capital was associated with high levels of altruism, self-interest, and response to direct appeal. Philanthropic and high social altruism were associated with high levels of altruism and response to direct appeal. CONCLUSION: Cognitive and structural social capital and social altruism are associated with altruism and response to direct appeal, while only cognitive social capital is associated with self-interest. Designing marketing campaigns with these aspects in mind may help blood banks attract potential blood donors more efficiently.
Assuntos
Altruísmo , Bancos de Sangue/estatística & dados numéricos , Doadores de Sangue/psicologia , Doadores de Sangue/provisão & distribuição , Motivação , Valores Sociais , Adolescente , Adulto , Atitude Frente a Saúde , Doadores de Sangue/estatística & dados numéricos , Brasil/epidemiologia , Estudos Transversais , Escolaridade , Feminino , Humanos , Masculino , Análise Multivariada , Autoeficácia , Inquéritos e Questionários , Adulto JovemRESUMO
We investigated the cytokine profile of peripheral mononuclear cells from chronic osteomyelitis (OST) patients following in vitro stimulation with staphylococcal enterotoxin A (SEA). We demonstrate that stimulation with SEA induced prominent lymphocyte proliferation and high levels of tumour necrosis factor (TNF)-α, interleukin (IL)-4 and IL-10 secretion in both OST and non-infected individuals (NI). Even though stimulation with SEA had no impact on IL-6 production in either patient group, the baseline level of IL-6 production by cells from OST patients was always significantly less than that produced by cells from NI. After classifying the osteomyelitic episodes based on the time after the last reactivation event as "early" (1-4 months) or "late" osteomyelitis (5-12 months), we found that increased levels of TNF-α and IL-4 in combination with decreased levels of IL-6 were observed in the early episodes. By contrast, increased levels of IL-10, IL-2 and IL-6 were hallmarks of late episodes. Our data demonstrate that early osteomyelitic episodes are accompanied by an increased frequency of "high producers" of TNF-α and IL-4, whereas late events are characterised by increased frequencies of "high producers" of IL-10, IL-6 and IL-2. These findings demonstrate the distinct cytokine profiles in chronic osteomyelitis, with a distinct regulation of IL-6 production during early and late episodes.
Assuntos
Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Citocinas/biossíntese , Enterotoxinas/imunologia , Leucócitos Mononucleares/imunologia , Óxido Nítrico/biossíntese , Osteomielite/imunologia , Infecções Estafilocócicas/imunologia , Staphylococcus aureus/imunologia , Estudos de Casos e Controles , Doença Crônica , Interleucinas/biossíntese , Ativação Linfocitária , Osteomielite/microbiologia , Fator de Necrose Tumoral alfa/biossínteseRESUMO
We investigated the cytokine profile of peripheral mononuclear cells from chronic osteomyelitis (OST) patients following in vitro stimulation with staphylococcal enterotoxin A (SEA). We demonstrate that stimulation with SEA induced prominent lymphocyte proliferation and high levels of tumour necrosis factor (TNF)-α, interleukin (IL)-4 and IL-10 secretion in both OST and non-infected individuals (NI). Even though stimulation with SEA had no impact on IL-6 production in either patient group, the baseline level of IL-6 production by cells from OST patients was always significantly less than that produced by cells from NI. After classifying the osteomyelitic episodes based on the time after the last reactivation event as "early" (1-4 months) or "late" osteomyelitis (5-12 months), we found that increased levels of TNF-α and IL-4 in combination with decreased levels of IL-6 were observed in the early episodes. By contrast, increased levels of IL-10, IL-2 and IL-6 were hallmarks of late episodes. Our data demonstrate that early osteomyelitic episodes are accompanied by an increased frequency of "high producers" of TNF-α and IL-4, whereas late events are characterised by increased frequencies of "high producers" of IL-10, IL-6 and IL-2. These findings demonstrate the distinct cytokine profiles in chronic osteomyelitis, with a distinct regulation of IL-6 production during early and late episodes.
Assuntos
Citocinas/biossíntese , Enterotoxinas/imunologia , Leucócitos Mononucleares/imunologia , Óxido Nítrico/biossíntese , Osteomielite/imunologia , Infecções Estafilocócicas/imunologia , Staphylococcus aureus/imunologia , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Doença Crônica , Feminino , Humanos , Interleucinas/biossíntese , Ativação Linfocitária , Masculino , Pessoa de Meia-Idade , Osteomielite/microbiologia , Fator de Necrose Tumoral alfa/biossíntese , Adulto JovemRESUMO
Belo Horizonte, the capital of the southeastern state of Minas Gerais, Brazil, and the fourth-largest city in the country, has the highest incidence of human visceral leishmaniasis (VL) together with a high prevalence of canine VL. The Northeast Sanitary District (NSD) of Belo Horizonte has the largest historical average of human VL cases in the metropolitan region, and is classified as a priority area for epidemiological and entomological monitoring of the disease. The objectives of the present study were to determine the seasonal variation in phlebotomine fauna and to describe the environmental situations in the NSD through characterization of peri-domiciles and application of geographical information system analysis. Entomological captures were performed every two weeks during the period July 2006 to June 2007 using HP light traps placed at 16 locations where cases of human VL had been reported in 2005. The environmental characterization of these locations was accomplished using forms and photographic images. Spatial analyses was used to determine the influence of vegetation, hydrography, altitude and pockets of poverty on the occurrence of cases of human and canine VL, and of phlebotomine vectors. A total of 633 phlebotomines belonging to the subtribes Psychodopygina and Lutzomyina were captured and, of these, 75% were identified as Nyssomyia whitmani and 11% as Lutzomyia longipalpis. The majority of the studied peri-domiciles presented inadequate hygienic conditions that would favor the development of phlebotomines. No significant correlations could be established between biogeographical aspects and either the incidence of human and canine VL or the occurrence of phlebotomines. The proximity of areas with vegetation, villages, slums and open watercourses exerted little influence on the incidence of VL. These findings reinforce the urbanization of the VL profile since the disease occurred in locations where conditions that have been classically related to its prevalence were not present. The results reported herein will be important for implementing measures against VL in the study area.
Assuntos
Ecossistema , Insetos Vetores/fisiologia , Densidade Demográfica , Psychodidae/fisiologia , Animais , Brasil/epidemiologia , Censos , Doenças do Cão/epidemiologia , Cães , Doenças Endêmicas , Atrofia Geográfica , Sistemas de Informação Geográfica , Humanos , Leishmaniose Visceral/epidemiologia , Leishmaniose Visceral/transmissão , Leishmaniose Visceral/veterinária , Psychodidae/classificação , Características de Residência , Estações do Ano , População UrbanaRESUMO
BACKGROUND: One of the most important drawbacks in visceral leishmaniasis (VL) population studies is the difficulty of diagnosing asymptomatic carriers. The aim of this study, conducted in an urban area in the Southeast of Brazil, was to evaluate the performance of serology to identify asymptomatic VL infection in participants selected from a cohort with a two-year follow-up period. METHODOLOGY: Blood samples were collected in 2001 from 136 cohort participants (97 positive and 39 negatives, PCR/hybridization carried out in 1999). They were clinically evaluated and none had progressed to disease from their asymptomatic state. As controls, blood samples from 22 control individuals and 8 patients with kala-azar were collected. Two molecular biology techniques (reference tests) were performed: PCR with Leishmania-generic primer followed by hybridization using L. infantum probe, and PCR with specific primer to L. donovani complex. Plasma samples were tested by ELISA using three different antigens: L. infantum and L. amazonensis crude antigens, and rK39 recombinant protein. Accuracy of the serological tests was evaluated using sensitivity, specificity, likelihood ratio and ROC curve. FINDINGS: The presence of Leishmania was confirmed, by molecular techniques, in all kala-azar patients and in 117 (86%) of the 136 cohort participants. Kala-azar patients showed high reactivity in ELISAs, whereas asymptomatic individuals presented low reactivity against the antigens tested. When compared to molecular techniques, the L. amazonensis and L. infantum antigens showed higher sensitivity (49.6% and 41.0%, respectively) than rK39 (26.5%); however, the specificity of rK39 was higher (73.7%) than L. amazonensis (52.6%) and L. infantum antigens (36.8%). Moreover, there was low agreement among the different antigens used (kappa<0.10). CONCLUSIONS: Serological tests were inaccurate for diagnosing asymptomatic infections compared to molecular methods; this could lead to misclassification bias in population studies. Therefore, studies which have used serological assays to estimate prevalence, to evaluate intervention programs or to identify risk factors for Leishmania infection, may have had their results compromised.