RESUMO
Hereditary angioedema (HAE) is a rare autosomal dominant disease due to C1 esterase inhibitor deficiency (C1-INH). The disease is characterized by subcutaneous and submucosal edema in the absence of urticaria due to the accumulation of bradykinin. This descriptive study aimed to evaluate the clinical characteristics of patients with a confirmed diagnosis of HAE referred to our Outpatient Clinic between December 2009 and November 2017. Fifty-one patients (38 F, 13 M) with a mean age of 32 years (range: 7-70 y) were included. Family history of HAE was reported in 70% (36/51) of the cases; 33/46 patients became symptomatic by 18 years of age. The median time between onset of symptoms and diagnosis was 13 years (3 mo-50 y). The most frequent triggering factors for attacks were stress (74.4%), trauma (56.4%), and hormonal variations (56%). The main symptoms were subcutaneous edema in 93.5% (43/46) of patients, gastrointestinal symptoms in 84.8% (39/46), and obstruction in the upper airways in 34.8% (16/46). Hospitalization occurred in 65.2%, of whom 13.3% had to be transferred to the Intensive Care Unit. Prophylactic treatment was instituted in 87% (40/46) of patients, and 56.5% (26/46) required additional treatment to control attacks. Owing to our data collection over a period of 8 years, a significant number of patients were identified by this HAE reference center. Despite early recognition and prophylactic treatment, a high percentage of patients were hospitalized. HAE is still diagnosed late, reinforcing the need for more reference centers specialized in diagnosis and educational projects for health professionals.
Assuntos
Proteína Inibidora do Complemento C1/análise , Angioedema Hereditário Tipos I e II/sangue , Angioedema Hereditário Tipos I e II/etiologia , Adolescente , Adulto , Idade de Início , Idoso , Antifibrinolíticos/uso terapêutico , Criança , Antagonistas de Estrogênios/uso terapêutico , Feminino , Angioedema Hereditário Tipos I e II/tratamento farmacológico , Angioedema Hereditário Tipos I e II/prevenção & controle , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Nefelometria e Turbidimetria/métodos , Profilaxia Pós-Exposição/métodos , Fatores Desencadeantes , Trauma Psicológico/complicações , Fatores de Risco , Estresse Psicológico/complicações , Resultado do Tratamento , Adulto JovemRESUMO
Eucalyptus plantations can be affected by species of defoliating caterpillars. The integrated management of this group primarily involves a monitoring system, natural enemies, and biological products. Alternative control methods, including the use of conventional light traps, have not been adopted, mostly because of their low efficiency. Therefore, a more efficient light trap model was developed. The new model allowed the capture of 3.6 times as many insects as the conventional model, with a 261% gain in control efficiency. The use of this new model represents another integrated management alternative for lepidopteran pests of eucalyptus plantations and other cultured plants.
Assuntos
Eucalyptus , Controle de Insetos/instrumentação , Controle de Insetos/métodos , Insetos , Luz , Animais , Feminino , MasculinoRESUMO
Hereditary angioedema (HAE) is a rare autosomal dominant disease due to C1 esterase inhibitor deficiency (C1-INH). The disease is characterized by subcutaneous and submucosal edema in the absence of urticaria due to the accumulation of bradykinin. This descriptive study aimed to evaluate the clinical characteristics of patients with a confirmed diagnosis of HAE referred to our Outpatient Clinic between December 2009 and November 2017. Fifty-one patients (38 F, 13 M) with a mean age of 32 years (range: 7-70 y) were included. Family history of HAE was reported in 70% (36/51) of the cases; 33/46 patients became symptomatic by 18 years of age. The median time between onset of symptoms and diagnosis was 13 years (3 mo-50 y). The most frequent triggering factors for attacks were stress (74.4%), trauma (56.4%), and hormonal variations (56%). The main symptoms were subcutaneous edema in 93.5% (43/46) of patients, gastrointestinal symptoms in 84.8% (39/46), and obstruction in the upper airways in 34.8% (16/46). Hospitalization occurred in 65.2%, of whom 13.3% had to be transferred to the Intensive Care Unit. Prophylactic treatment was instituted in 87% (40/46) of patients, and 56.5% (26/46) required additional treatment to control attacks. Owing to our data collection over a period of 8 years, a significant number of patients were identified by this HAE reference center. Despite early recognition and prophylactic treatment, a high percentage of patients were hospitalized. HAE is still diagnosed late, reinforcing the need for more reference centers specialized in diagnosis and educational projects for health professionals.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Proteína Inibidora do Complemento C1/análise , Angioedema Hereditário Tipos I e II/etiologia , Angioedema Hereditário Tipos I e II/sangue , Estresse Psicológico/complicações , Fatores Desencadeantes , Fatores de Risco , Resultado do Tratamento , Idade de Início , Antagonistas de Estrogênios/uso terapêutico , Angioedema Hereditário Tipos I e II/prevenção & controle , Angioedema Hereditário Tipos I e II/tratamento farmacológico , Profilaxia Pós-Exposição/métodos , Trauma Psicológico/complicações , Hospitalização , Antifibrinolíticos/uso terapêutico , Nefelometria e Turbidimetria/métodosRESUMO
Carbon nanotubes are highly versatile materials; new applications using them are continuously being developed. Special attention is being dedicated to the possible use of multiwalled carbon nanotubes in biomaterials contacting with bone. However, carbon nanotubes are also controversial in regards to effects exerted on living organisms. Carbon nanotubes can be used to improve the tribological properties of polymer/composite materials. Ultrahigh molecular weight polyethylene (UHMWPE) is a polymer widely used in orthopedic applications that imply wear and particle generation. We describe here the response of human osteoblast-like MG63 cells after 6 days of culture in contact with artificially generated particles from both UHMWPE polymer and multiwalled carbon nanotubes (MWCNT)/UHMWPE nanocomposites. This novel composite has superior wear behavior, having thus the potential to reduce the number of revision hip arthroplasty surgeries required by wear failure of acetabular cups and diminish particle-induced osteolysis. The results of an in vitro study of viability and proliferation and interleukin-6 (IL-6) production suggest good cytocompatibility, similar to that of conventional UHMWPE (WST-1 assay results are reported as percentage of control +/- SD: UHMWPE = 96.19 +/- 7.92, MWCNT/UHMWPE = 97.92 +/- 8.29%; total protein: control = 139.73 +/- 10.78, UHMWPE = 137.07 +/- 6.17, MWCNT/UHMWPE = 163.29 +/- 11.81 microg/mL; IL-6: control = 90.93 +/- 10.30, UHMWPE = 92.52 +/- 11.02, MWCNT/UHMWPE = 108.99 +/- 9.90 pg/mL). Standard cell culture conditions were considered as control. These results, especially the absence of significant elevation in the osteolysis inductor IL-6 values, reinforce the potential of this superior wear-resistant composite for future orthopedic applications, when compared to traditional UHMWPE.
Assuntos
Proliferação de Células/efeitos dos fármacos , Teste de Materiais , Nanocompostos , Osteoblastos/citologia , Polietilenos/farmacologia , Técnicas de Cultura de Células , Humanos , Osteoblastos/fisiologiaRESUMO
Carbon nanotubes are highly versatile materials; new applications using them are continuously being developed. Special attention is being dedicated to the possible use of multiwalled carbon nanotubes in biomaterials contacting with bone. However, carbon nanotubes are also controversial in regards to effects exerted on living organisms. Carbon nanotubes can be used to improve the tribological properties of polymer/composite materials. Ultrahigh molecular weight polyethylene (UHMWPE) is a polymer widely used in orthopedic applications that imply wear and particle generation. We describe here the response of human osteoblast-like MG63 cells after 6 days of culture in contact with artificially generated particles from both UHMWPE polymer and multiwalled carbon nanotubes (MWCNT)/UHMWPE nanocomposites. This novel composite has superior wear behavior, having thus the potential to reduce the number of revision hip arthroplasty surgeries required by wear failure of acetabular cups and diminish particle-induced osteolysis. The results of an in vitro study of viability and proliferation and interleukin-6 (IL-6) production suggest good cytocompatibility, similar to that of conventional UHMWPE (WST-1 assay results are reported as percentage of control ± SD: UHMWPE = 96.19 ± 7.92, MWCNT/UHMWPE = 97.92 ± 8.29 percent; total protein: control = 139.73 ± 10.78, UHMWPE = 137.07 ± 6.17, MWCNT/UHMWPE = 163.29 ± 11.81 µg/mL; IL-6: control = 90.93 ± 10.30, UHMWPE = 92.52 ± 11.02, MWCNT/UHMWPE = 108.99 ± 9.90 pg/mL). Standard cell culture conditions were considered as control. These results, especially the absence of significant elevation in the osteolysis inductor IL-6 values, reinforce the potential of this superior wear-resistant composite for future orthopedic applications, when compared to traditional UHMWPE.
Assuntos
Humanos , Proliferação de Células/efeitos dos fármacos , Teste de Materiais , Nanocompostos , Osteoblastos/citologia , Polietilenos/farmacologia , Técnicas de Cultura de Células , Osteoblastos/fisiologiaRESUMO
OBJECTIVE: To evaluate the accuracy of Amsel's criteria individually or in combinations of two for the clinical diagnosis of bacterial vaginosis. METHODS: This cross-sectional study enrolled 135 women at UNICAMP, and evaluated Amsel's four clinical criteria. Sensitivity, specificity, positive and negative predictive values were calculated for each criterion individually, in combinations of two, and for the classic test with at least three criteria present. The Nugent method was used as gold standard. RESULTS: The most sensitive individual criteria were pH and vaginal discharge (97%), the latter having lowest specificity (26%). The criterion with highest specificity was the presence of clue cells (86%). The combination of two criteria showed sensitivity of 83% to 93%, and specificity of 82% to 94%. CONCLUSION: The accuracy of Amsel's clinical criteria individually or in combinations of two was as accurate as the presence of at least three criteria for the diagnosis of bacterial vaginosis.
Assuntos
Vaginose Bacteriana/diagnóstico , Adolescente , Adulto , Líquidos Corporais/citologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Esfregaço VaginalRESUMO
OBJECTIVE: Predisposing factors influencing recurrences of bacterial vaginosis (BV) or vaginitis from Candida remain unidentified for most women. As a component of studies to determine host susceptibility factors to genital tract infections in women, we measured expression of the 60-kDa and 70-kDa heat shock proteins (hsp60 and hsp70, respectively) in the circulation of women with or without a history of recurrent BV or candidal vaginitis and with or without a current lower genital tract infection. Heat shock protein expression is associated with a down-regulation of pro-inflammatory immune responses that would inhibit microbial infection. METHOD: The investigators measured hsp60 and hsp70, antibodies to these proteins, the pro-inflammatory cytokine tumor necrosis factor-alpha (TNF-alpha), and the anti-inflammatory cytokine interleukin-10 (IL-10) in sera by ELISA. The study population consisted of 100 women who attended a gynecology clinic in Campinas, Brazil. Of those, 55 had a history of recurrent vulvovaginitis (RV), while 45 were controls with no such history. Only women who were asymptomatic for at least 1 month were studied. RESULTS: Although all were asymptomatic, clinical and microbiological examination revealed that five of the women with a history of RV and two controls had a current candidal vaginal infection; 16 RV patients and 12 controls had BV; and six RV patients had both BV and candidiasis. Twenty-eight RV patients and 31 controls had no clinical or microbiological detectable vaginal infection. Among the RV patients, hsp60 and hsp70 were more prevalent in those with current BV (40.9% and 50.0%, respectively) or a candidal infection (45.5% and 54.5%) than in women with no current infection (21.4% and 17.9%). In the women with no history of RV, BV was not associated with a high prevalence of hsp60 (8.3%) or hsp70 (8.3%). Interleukin-10 and TNF were not more prevalent in vaginitis patients or controls with a current candidal infection or BV than in uninfected subjects. CONCLUSION: The high prevalence of circulating hsp60 and hsp70 in women with a history of RV and current BV or vaginal candidiasis, but not in women with no history of RV, suggests that differences in heat shock protein induction may be related to susceptibility to recurrent vaginal infections.
Assuntos
Candidíase Vulvovaginal/imunologia , Chaperonina 60/sangue , Proteínas de Choque Térmico HSP70/sangue , Vaginose Bacteriana/imunologia , Adulto , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , RecidivaRESUMO
OBJECTIVES: The aim of this study was to establish the prevalence of cervicovaginal infections in normal third-trimester pregnant women and evaluate the accuracy of clinical diagnosis. METHOD: A total of 328 pregnant women were followed at the Prenatal Outpatient Clinic of the Department of Obstetrics and Gynecology at the School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Brazil, from October 1991 to February 1993. The clinical diagnosis was based on the characteristics of the vaginal discharge, and the etiological diagnosis was based on bacterioscopy of the vaginal secretion and direct immunofluorescence for Chlamydia trachomatis. The data were analyzed statistically, determining the sensitivity, specificity, and positive and negative predictive value of the clinical diagnosis related to the laboratory diagnosis of the different infections. RESULTS: The prevalence of infection was 39.6% (Candida albicans, 19.2%; bacterial vaginosis, 9.5%; intermediate vaginal flora, 6.7%; Chlamydia trachomatis, 2.1%; and vaginal trichomoniasis, 2.1%). The accuracy of clinical diagnosis was low, with sensitivity between 50% and 65% and specificity around 60%, with the exception of trichomoniasis, which showed a sensitivity of 100% and chlamydia, with a sensitivity of 0% and a specificity of 100%. CONCLUSION: The accuracy of the clinical diagnosis of infections was low, specifically with respect to the positive predictive value. The results demonstrate the need for specific testing of cervicovaginal infections at prenatal visits. Reliance on simple vaginal examination results in a low yield for detection of vaginal infections.