RESUMO
The goal of this study was to analyse the vertical structure of the phytoplankton community at the Mundaú reservoir, located in the semi-arid region of northeastern Brazil, and to correlate it to environmental conditions over two distinct seasons, dry and rainy. Samples were collected bimonthly at eight depths in the dry and rainy season for analyses of the physical and chemical variables of the water, as well as density, abundance, dominance, species diversity index and equitability of the community. Analysis of variance (ANOVA-two way) was used to analyse the vertical and seasonal differences, and Canonical Correspondence Analysis (CCA) was used to assess associations between phytoplankton and environmental variables Cylindrospermopsis raciborskii (Woloszynska) Seenaya and Subba Raju was the only dominant species and Geitlerinema amphibium (C. Agardh) Anagnostidis, Merismopedia punctata Meyen and Synedra rumpens Kützing. Others six taxa were abundant in at least one of the samples. Distinct vertical distribution patterns were observed for the abundant taxa between depths and seasons. The cyanobacteria, with the exception of C. raciborskii, showed similar seasonal patterns, with higher densities in the dry season. The CCA showed a strong correlation between the density of the phytoplanktonic species and abiotic variables. The vertical changes in abundant taxa revealed distinct patterns regulated by the variation in the environmental factors that were directly linked to seasonality, with the success of one or more species being dependent on their life strategies and ecological needs. The present study restates the importance of environmental and seasonal factors for phytoplankton composition and distribution in a freshwater tropical reservoir through a vertical gradient.(AU)
O objetivo deste estudo foi avaliar a estrutura vertical da comunidade fitoplanctônica no reservatório Mundaú localizado na região semiárida do nordeste do Brasil e correlacioná-la com as condições ambientais durante dois períodos sazonais distintos, seca e chuva. Amostras foram coletadas bimensalmente em oito profundidades em duas estações climáticas, seca e chuvosa para análises de variáveis físicas e químicas da água, bem como, da densidade, abundância, dominância, índice de diversidade especifica e equitabilidade da comunidade. Análise de variância (ANOVA - dois critérios) foi usada para avaliar as diferenças vertical e sazonal e Análise de Correspondência Canônica (CCA) as associações entre o fitoplâncton e variáveis ambientais. Cylindrospermopsis raciborskii (Woloszynska) Seenaya and Subba Raju foi a única espécie dominante e Geitlerinema amphibium (C. Agardh) Anagnostidis, Merismopedia punctata Meyen e Synedra rumpens Kützing, foram abundantes em ambas as estações. Outros seis táxons foram abundantes em, pelo menos, uma das amostras. Distintos padrões de distribuição vertical foram observados para os táxons abundantes entre as profundidades e estações. As cianobactérias, com exceção de C. raciborskii, apresentaram padrão sazonal similar com maiores densidades no período seco. A CCA mostrou uma correlação entre a densidade das espécies fitoplanctônicas e as variáveis ambientais. As mudanças verticais nos táxons abundantes revelaram distintos padrões regulados pela variação nos fatores ambientais que estiveram diretamente ligados à sazonalidade, sendo assim, o sucesso de uma ou mais espécie está ligado à sazonalidade, às suas estratégias de vida e às suas necessidades ecológicas. O presente estudo corrobora a importância de fatores ambientais e sazonal na composição e distribuição do fitoplâncton ao longo de um gradiente vertical em um reservatório de água doce de região tropical.(AU)
Assuntos
Biodiversidade , Monitoramento Ambiental , Fitoplâncton/classificação , Biomassa , Brasil , Água Doce , Densidade Demográfica , Dinâmica Populacional , Estações do AnoRESUMO
The goal of this study was to analyse the vertical structure of the phytoplankton community at the Mundaú reservoir, located in the semi-arid region of northeastern Brazil, and to correlate it to environmental conditions over two distinct seasons, dry and rainy. Samples were collected bimonthly at eight depths in the dry and rainy season for analyses of the physical and chemical variables of the water, as well as density, abundance, dominance, species diversity index and equitability of the community. Analysis of variance (ANOVA-two way) was used to analyse the vertical and seasonal differences, and Canonical Correspondence Analysis (CCA) was used to assess associations between phytoplankton and environmental variables Cylindrospermopsis raciborskii (Woloszynska) Seenaya and Subba Raju was the only dominant species and Geitlerinema amphibium (C. Agardh) Anagnostidis, Merismopedia punctata Meyen and Synedra rumpens Kützing. Others six taxa were abundant in at least one of the samples. Distinct vertical distribution patterns were observed for the abundant taxa between depths and seasons. The cyanobacteria, with the exception of C. raciborskii, showed similar seasonal patterns, with higher densities in the dry season. The CCA showed a strong correlation between the density of the phytoplanktonic species and abiotic variables. The vertical changes in abundant taxa revealed distinct patterns regulated by the variation in the environmental factors that were directly linked to seasonality, with the success of one or more species being dependent on their life strategies and ecological needs. The present study restates the importance of environmental and seasonal factors for phytoplankton composition and distribution in a freshwater tropical reservoir through a vertical gradient.
Assuntos
Biodiversidade , Monitoramento Ambiental , Fitoplâncton/classificação , Biomassa , Brasil , Água Doce , Densidade Demográfica , Dinâmica Populacional , Estações do AnoRESUMO
The signaling lymphocytic activation molecule (SLAM), present on the surface of hematopoietic cells, can regulate some events of the immune responses. This modulatory action is associated with the capacity of SLAM to interact with an intracytoplasmic adapter, such as SLAM-associated protein (SAP). SLAM is constitutively expressed in most of these cells, is rapidly induced after antigenic or inflammatory stimuli, and participates in the immunological synapse. Defects in the function of the SLAM-SAP pathway contribute to immunological abnormalities, resulting in autoimmune diseases, tumors of the lymphoid tissues and inadequate responses to infectious agents. Initially, the role of SLAM was investigated using an anti-SLAM monoclonal antibody (α-SLAM mAb) identified as an agonist of the SLAM-SAP pathway, which could induce the production of interferon-γ and could redirect the immune response to a T helper 1 (Th1) cell profile. However, in this review we postulate that the SLAM-SAP pathway primarily induces a Th2 response and secondarily suppresses the Th1 response.
Assuntos
Humanos , Antígenos CD/fisiologia , /metabolismo , Peptídeos e Proteínas de Sinalização Intracelular/fisiologia , Ativação Linfocitária , Receptores de Superfície Celular/fisiologia , Transdução de Sinais/fisiologia , Anticorpos Monoclonais , Células Th1/imunologia , Células Th1/metabolismo , /imunologia , /metabolismoRESUMO
The signaling lymphocytic activation molecule (SLAM), present on the surface of hematopoietic cells, can regulate some events of the immune responses. This modulatory action is associated with the capacity of SLAM to interact with an intracytoplasmic adapter, such as SLAM-associated protein (SAP). SLAM is constitutively expressed in most of these cells, is rapidly induced after antigenic or inflammatory stimuli, and participates in the immunological synapse. Defects in the function of the SLAM-SAP pathway contribute to immunological abnormalities, resulting in autoimmune diseases, tumors of the lymphoid tissues and inadequate responses to infectious agents. Initially, the role of SLAM was investigated using an anti-SLAM monoclonal antibody (α-SLAM mAb) identified as an agonist of the SLAM-SAP pathway, which could induce the production of interferon-γ and could redirect the immune response to a T helper 1 (Th1) cell profile. However, in this review we postulate that the SLAM-SAP pathway primarily induces a Th2 response and secondarily suppresses the Th1 response.
Assuntos
Antígenos CD/fisiologia , Linfócitos T CD4-Positivos/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular/fisiologia , Ativação Linfocitária , Receptores de Superfície Celular/fisiologia , Transdução de Sinais/fisiologia , Anticorpos Monoclonais , Humanos , Proteína Associada à Molécula de Sinalização da Ativação Linfocitária , Membro 1 da Família de Moléculas de Sinalização da Ativação Linfocitária , Células Th1/imunologia , Células Th1/metabolismo , Células Th2/imunologia , Células Th2/metabolismoRESUMO
The Schistosoma mansoni fatty acid binding protein (FABP), Sm14, is a vaccine candidate against, S. mansoni and F. hepatica. Previously, we demonstrated the importance of a correct fold to achieve protection in immunized animals after cercariae challenge [[10]. C.R.R. Ramos, R.C.R. Figueredo, T.A. Pertinhez, M.M. Vilar, A.L.T.O. Nascimento, M. Tendler, I. Raw, A. Spisni, P.L. Ho, Gene structure and M20T polymorphism of the Schistosoma mansoni Sm14 fatty acid-binding protein: structural, functional and immunoprotection analysis. J. Biol. Chem. 278 (2003) 12745-12751.]. Here we show that the reduction of vaccine efficacy over time is due to protein dimerization and subsequent aggregation. We produced the mutants Sm14-M20(C62S) and Sm14-M20(C62V) that, as expected, did not dimerize in SDS-PAGE. Molecular dynamics calculations and unfolding experiments highlighted a higher structural stability of these mutants with respect to the wild-type. In addition, we found that the mutated proteins, after thermal denaturation, refolded to their active native molecular architecture as proved by the recovery of the fatty acid binding ability. Sm14-M20(C62V) turned out to be the more stable form over time, providing the basis to determine the first 3D solution structure of a Sm14 protein in its apo-form. Overall, Sm14-M20(C62V) possesses an improved structural stability over time, an essential feature to preserve its immunization capability and, in experimentally immunized animals, it exhibits a protection effect against S. mansoni cercariae infections comparable to the one obtained with the wild-type protein. These facts indicate this protein as a good lead molecule for large-scale production and for developing an effective Sm14 based anti-helminthes vaccine.
Assuntos
Feminino , Animais , Camundongos , Esquistossomose , Schistosoma mansoni , Proteínas de TransporteRESUMO
Os objetivos da presente investigação foram os de reavaliar resultados anteriores obtidos através de infecções experimentais de camundongos SW com cercarias e esquistossômulos da cepa LE de Schistosoma mansoni mantida em laboratório. Três grupos de camundongos foram considerados: animais do primeiro grupo foram infectados com cercarias pela via percutânea (método do anel), os do segundo inoculados pela via subcutânea com cercarias e os do terceiro inoculados pela mesma via com esquistossômulos obtidos "in vitro". Os dados obtidos mostraram que a via de infecção mais eficiente é a injeção subcutânea de esquistossômulos transformados "in vitro", com média de recuperação de vermes adultos de 54.1%, quando comparada às vias percutânea abdominal e subcutânea, com médias de 36,7% e 32,4%, respectivamente, sugerindo que em infecções experimentais de camundongos SW com S. mansoni da cepa LE, a pele pode ser considerada um eficaz sítio de atrito na via percutânea, enquanto no caso da inoculação de cercarias, um pequeno número de larvas não se transforma em esquistossômulos viáveis, talvez pelo fato de a barreira da pele haver sido evitada. Breves considerações a respeito dos sítios de atrito e eliminação de formas larvares do S. mansoni em camundongos, são apresentadas.
Assuntos
Animais , Masculino , Camundongos , Modelos Animais de Doenças , Schistosoma mansoni/fisiologia , Esquistossomose mansoni/parasitologia , Schistosoma mansoni/crescimento & desenvolvimentoRESUMO
The present investigation involves a reevaluation of previous results obtained after experimental infection of Swiss Webster mice with cercariae and schistosomula of the Schistosoma mansoni LE strain maintained under laboratory conditions. Three experimental groups of mice were considered: the animals of the first group were percutaneously (ring method) infected with cercariae, those of the second were subcutaneously inoculated with cercariae and the mice of the third were inoculated by the same route with schistosomula transformed in vitro. The data obtained so far indicated that the most effective method of infection is the subcutaneous injection with schistosomula, with a mean adult worm burden recovery of 54.1% when compared to the abdominal percutaneous and subcutaneous routes of infection with cercariae, in which the values were 36.7% and 32.4%, respectively. This suggests that, in experimental infections of SW mice with a LE S. mansoni strain, the skin is to be considered an effective attrition site in the percutaneous route, whereas in the case of inoculation with cercariae, a small amount of larvae fails to be transformed into viable schistosomula, possibly due to skin phase avoidance. A brief discussion about attrition sites and elimination of larval S. mansoni worms in mice is presented.
Assuntos
Modelos Animais de Doenças , Schistosoma mansoni/fisiologia , Esquistossomose mansoni/parasitologia , Animais , Masculino , Camundongos , Schistosoma mansoni/crescimento & desenvolvimentoRESUMO
The present investigation involves a reevaluation of previous results obtained after experimental infection of Swiss Webster mice with cercariae and schistosomula of the Schistosoma mansoni LE strain maintained under laboratory conditions. Three experimental groups of mice were considered: the animals of the first group were percutaneously (ring method) infected with cercariae, those of the second were subcutaneously inoculated with cercariae and the mice of the third were inoculated by the same route with schistosomula transformed in vitro. The data obtained so far indicated that the most effective method of infection is the subcutaneous injection with schistosomula, with a mean adult worm burden recovery of 54.1% when compared to the abdominal percutaneous and subcutaneous routes of infection with cercariae, in which the values were 36.7% and 32.4%, respectively. This suggests that, in experimental infections of SW mice with a LE S. mansoni strain, the skin is to be considered an effective attrition site in the percutaneous route, whereas in the case of inoculation with cercariae, a small amount of larvae fails to be transformed into viable schistosomula, possibly due to skin phase avoidance. A brief discussion about attrition sites and elimination of larval S. mansoni worms in mice is presented.
Os objetivos da presente investigação foram os de reavaliar resultados anteriores obtidos através de infecções experimentais de camundongos SW com cercarias e esquistossômulos da cepa LE de Schistosoma mansoni mantida em laboratório. Três grupos de camundongos foram considerados: animais do primeiro grupo foram infectados com cercarias pela via percutânea (método do anel), os do segundo inoculados pela via subcutânea com cercarias e os do terceiro inoculados pela mesma via com esquistossômulos obtidos "in vitro". Os dados obtidos mostraram que a via de infecção mais eficiente é a injeção subcutânea de esquistossômulos transformados "in vitro", com média de recuperação de vermes adultos de 54.1%, quando comparada às vias percutânea abdominal e subcutânea, com médias de 36,7% e 32,4%, respectivamente, sugerindo que em infecções experimentais de camundongos SW com S. mansoni da cepa LE, a pele pode ser considerada um eficaz sítio de atrito na via percutânea, enquanto no caso da inoculação de cercarias, um pequeno número de larvas não se transforma em esquistossômulos viáveis, talvez pelo fato de a barreira da pele haver sido evitada. Breves considerações a respeito dos sítios de atrito e eliminação de formas larvares do S. mansoni em camundongos, são apresentadas.
RESUMO
The Schistosoma mansoni Sm14 antigen belongs to the fatty acid-binding protein family and is considered a vaccine candidate against at least two parasite worms, Fasciola hepatica and S. mansoni. Here the genomic sequence and the polymorphism of Sm14 have been characterized for the first time. We found that the conserved methionine at position 20 is polymorphic, being exchangeable with threonine (M20T). To evaluate the function of the amino acid residue at this position, we have also constructed the mutant Sm14-A20 besides the two native isoforms (Sm14-M20 and Sm14-T20). The three purified recombinant His6-tagged Sm14 proteins (rSm14-M20, rSm14-T20, and rSm14-A20) present a predominant â-barrel structure as shown by CD spectroscopy. Thermal and urea unfolding studies evidenced a higher structural stability of rSm14-M20 over the other forms (rSm14M20>rSm14-T20>rSm14-A20). All of the Sm14 proteins were able to bind 11-(dansylamino)undecanoic acid (DAUDA) without substantial difference in the binding affinity. However, rSm14-M20 exhibited a higher affinity for natural fatty acids than the rSm14-T20 and rSm14-A20 proteins as judged by competitive experiments against DAUDA (rSm14-M20>rSm14-T20> rSm14-A20). The rSm14-M20 or rSm14-T20 isoforms but not the rSm14-A20 mutant was able to induce significant protection against S. mansoni cercariae challenge in immunized mice. The level of protection efficacy correlates with the extent of structure stability of the recombinant Sm14 isoforms and mutant.
Assuntos
Humanos , Proteínas de Helminto/genética , Proteínas de Helminto/metabolismo , Proteínas de Helminto/química , Schistosoma mansoni/genética , Dicroísmo Circular , Polimorfismo Genético , Primers do DNA , Proteínas de Ligação a Ácido Graxo , Proteínas de Neoplasias , Proteínas de Transporte de Ácido Graxo , Sequência de AminoácidosRESUMO
Fasciola hepatica is the causative agent of fasciolosis in many areas in America, Europe, Africa, Asia and Australia. There is an urgent need for improved methods to control the parasite's transmission. We describe the use of an experimental vaccine based on a recombinant antigen cloned from another parasite, Schistosoma mansoni (Sm14), that induces high levels of cross protection in mice against both S. mansoni and F. hepatica. Sheep and mice vaccinated with Sm14 were significantly protected against challenge infection with metacercariae of Fasciola hepatica and were completely free of the histopathological hepatic damage related to liver fluke infection. The vaccine will provide a valuable new tool to aid in transmission control of this economically important disease
Assuntos
Animais , Fasciola hepatica/imunologia , Fasciolíase/imunologia , Fasciolíase/prevenção & controle , Fígado/patologia , Schistosoma mansoni/imunologia , Ovinos , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/imunologia , Proteínas de Helminto/administração & dosagem , Proteínas de Helminto/imunologia , Vacinas Sintéticas/administração & dosagem , Vacinas Sintéticas/genética , VacinaçãoRESUMO
The objective of the study was to evaluate the incidence of Systemic Lupus Erythematosus (SLE) in a tropical urban community (Natal city, Brazil). Only patients living in Natal, a city in the northeastern area of Brazil, older than 15 years, and who fulfilled at least four of the American College of Rheumatology criteria between 1 January 2000 and 31 December 2000, were included. Four sources were used to identify new cases of SLE: (1) the University Hospital; (2) 'health units' and hospitals of the public health network; (3) specialists at private hospitals and outpatient clinics; and (4) three laboratories performing antinuclear antibody (ANA) determination. Census data from 2000 for Brazilian population was used to calculate incidence rate. The standardized mortality ratio (SMR) method and 95% confidence intervals (95% CI) were calculated. Forty-three patients were diagnosed as new SLE cases in 2000. The calculated incidence was 8.7/100,000/year (95% CI 6.3-11.7). Thirty-eight patients were female 14.1/100,000/year (95% CI 10.0-19.3) and five were male 2.2/100,000/year (95% CI 0.7-5.2). The mean age of new SLE cases was 31.8 years old. (95% CI 27.8-35.8). The mean age for females was 31.4 and for males was 35.0 years old. The median of disease duration (time between onset of the first ACR criterion for SLE and diagnosis) was 10 months (1-72 months). This study demonstrated a high incidence of SLE in Natal, apparently higher than reported in other places. The mean age at diagnosis seems lower than referred by other studies. The observed differences may be due to ethnic and/or environmental factors.
Assuntos
Lúpus Eritematoso Sistêmico/etnologia , Adolescente , Adulto , Idoso , População Negra , Brasil/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , População Urbana/estatística & dados numéricos , População BrancaRESUMO
In previous studies it was shown that the recombinant molecule, r-Sm14, induces high levels of protection against Schistosoma mansoni infection in two outbred animal models and immune crossprotection against infection by Fasciola hepatica in Swiss outbred mice. r-Sm14 was derived from a living worm extract, called SE, and is being developed as the molecular basis of an anti-helminth bivalent vaccine against the two parasites, for medical and veterinary application. Present data refer to SDS-PAGE and Western Blotting analysis of four different preparations of S. mansoni adult worms focusing Sm14 identification. The extracts correspond to the initial fraction of the SE extraction process, containing products released by living worms (SEi); SE2, reextraction of adult worms in PBS; and SE of separated male and female adult worms. In all extracts it was possible to detect the component of 14 kDa, that was recognized by specific anti-rSm14 antibody raised in rabbits.
Assuntos
Proteínas de Helminto/análise , Proteínas de Membrana Transportadoras , Proteínas de Neoplasias , Proteínas do Tecido Nervoso , Schistosoma mansoni/química , Esquistossomose mansoni/imunologia , Animais , Anticorpos Anti-Helmínticos/imunologia , Western Blotting , Proteínas de Transporte/imunologia , Eletroforese em Gel de Poliacrilamida , Proteínas de Transporte de Ácido Graxo , Proteína 7 de Ligação a Ácidos Graxos , Proteínas de Ligação a Ácido Graxo , Feminino , Proteínas de Helminto/imunologia , Masculino , Camundongos , Schistosoma mansoni/imunologia , Vacinas/imunologiaRESUMO
Previous studies carried out with Sm14 in experimental vaccination against Schistosoma mansoni or Fasciola hepatica infections were performed with recombinant Sm14 (rSm14) produced in Escherichia coli by the pGEMEX system (Promega). The rSm14 was expressed as a 40 kDa fusion protein with the major bacteriophage T7 capsid protein. Vaccination experiments with this rSm14 in animal models resulted in consistent high protective activity against S. mansoni cercariae challenge and enabled rSm14 to be included among the vaccine antigens endorsed by the World Health Organization for phase I/II clinical trials. Since the preparation of pGEMEX based rSm14 is time consuming and results in low yield for large scale production, we have tested other E. coli expression systems which would be more suitable for scale up and downstream processing. We expressed two different 6XHis-tagged Sm14 fusion proteins in a T7 promoter based plasmids. The 6XHis-tag fusions allowed rapid purification of the recombinant proteins through a Ni+2-charged resin. The resulted recombinant 18 and 16 kDa proteins were recognized by anti-Sm14 antibodies and also by antiserum against adult S. mansoni soluble secreted/excreted proteins in Western-Blot. Both proteins were also protective against S. mansoni cercariae infection to the same extent as the rSm14 expressed by the pGEMEX system.
Assuntos
Anticorpos Anti-Helmínticos/imunologia , Proteínas de Transporte , Proteínas de Helminto/imunologia , Proteínas de Membrana Transportadoras , Schistosoma mansoni/imunologia , Vacinas/imunologia , Animais , Western Blotting , Eletroforese em Gel de Poliacrilamida , Escherichia coli/imunologia , Escherichia coli/metabolismo , Proteínas de Transporte de Ácido Graxo , Feminino , Proteínas de Helminto/metabolismo , Camundongos , Modelos Animais , Plasmídeos/imunologia , Plasmídeos/metabolismo , Proteínas Recombinantes/imunologia , Proteínas Recombinantes/metabolismo , Schistosoma mansoni/metabolismo , VacinaçãoRESUMO
BACKGROUND: Cyclosporine (CsA) use has been associated to the development of cholelithiasis in transplant recipients. We herein explored the role of time under CsA on this association in asymptomatic adult kidney transplant recipients (KTR). METHODS: A cross-sectional study was conducted in 140 KTR with variable post-transplant follow-up (PTFU), and without history of symptomatic biliary disease. Upper abdominal ultrasound was performed in all patients. According to the immunosuppressive schedule, patients were classified in three groups: Azathioprine + prednisone (group 1, n = 37), azathioprine + prednisone < 24 months CsA (group 2, n = 58), or azathioprine + prednisone > or = 24 months CsA (group 3, n = 45). Age at time of ultrasound performance, gender, PTFU, chronic viral liver disease, parity, oral contraceptives, serum lipids, diabetes and body mass index were analyzed concomitantly. RESULTS: Median age was 38, 31, and 36 years in groups 1, 2, and 3, respectively. The male:female ratio in the same groups was 1.5:1, 1:1, and 2:1. Mean PTFU was 130, 48, and 53 months, respectively (p = 0.0001). Gallstones were found in three (8%) group 1 KTR, in nine (16%) group 2 KTR, and in 10 (22%) group 3 KTR (p = 0.214). Adjusting for PTFU, the association between length of CsA and prevalence of lithiasis was significantly stronger among those with longer use of CsA (odds ratio = 6.1, p = 0.046). No significant differences were found among groups in the other variables. CONCLUSIONS: KTR receiving CsA for more than two years show increased prevalence of gallstones.
Assuntos
Colelitíase/induzido quimicamente , Ciclosporina/efeitos adversos , Imunossupressores/efeitos adversos , Transplante de Rim , Azatioprina/uso terapêutico , Bile/metabolismo , Colelitíase/diagnóstico por imagem , Colelitíase/epidemiologia , Comorbidade , Fatores de Confusão Epidemiológicos , Anticoncepcionais Orais/efeitos adversos , Estudos Transversais , Ciclosporina/administração & dosagem , Ciclosporina/farmacocinética , Ciclosporina/uso terapêutico , Diabetes Mellitus/epidemiologia , Quimioterapia Combinada , Seguimentos , Rejeição de Enxerto/prevenção & controle , Hepatite Viral Humana/epidemiologia , Humanos , Hiperlipidemias/epidemiologia , Imunossupressores/administração & dosagem , Imunossupressores/farmacocinética , Imunossupressores/uso terapêutico , México/epidemiologia , Obesidade/epidemiologia , Paridade , Prednisona/uso terapêutico , Prevalência , Fatores de Tempo , UltrassonografiaRESUMO
Pseudomelanosis duodeni is a rare entity characterized by dark pigmentation of duodenal mucosa of uncertain etiology and clinical significance. We report a case with endoscopic and pathologic correlation. Some aspects about etiology, clinical and histopathologic characteristics are discussed.
Assuntos
Duodenopatias/patologia , Melanose/patologia , Adulto , Duodenoscopia , Duodeno/patologia , Feminino , HumanosRESUMO
Ogilvie's syndrome or acute colonic pseudo-obstruction is a motility disorder characterized by acute and progressive colonic distension. This syndrome occurs in hospitalized patients with several medical or surgical diseases with an unclear pathophysiology. Diagnosis is established by the clinical history, physical examination and radiological findings on plain abdominal X-ray. Treatment includes: 1. general measures to reduce colonic distension, 2. drugs that improve colon motility, 3. endoscopic colonic decompression and 4. surgery. Age, associated diseases, elapsed time and diameter of cecal dilatation, presence of necrosis and perforation are the main prognostic factors. Recurrence after medical treatment is 20-50 percent; intrahospital mortality is 30 percent. A practical algorithm for the management of these patients is proposed.
Assuntos
Pseudo-Obstrução do Colo/diagnóstico , Pseudo-Obstrução do Colo/terapia , Algoritmos , Pseudo-Obstrução do Colo/etiologia , Pseudo-Obstrução do Colo/fisiopatologia , HumanosRESUMO
Renal abnormalities have been reported in Ankylosing Spondylitis (AS) patients. Possible mechanisms include the effects of nonsteroidal anti-inflammatory drugs (NSAIDs), an increased incidence of glomerulonephritis, particularly the ones associated with deposition of IgA-containing immune complexes and the renal deposition of amyloid. These observations prompted us to evaluate in detail the frequency and severity of renal dysfunction in 40 AS patients, consecutively selected attending the rheumatology disease unit outpatient clinic at Escola Paulista de Medicina, using sensitive tests of glomerular and tubular function. Fourteen of the 40 patients presented one or more signs of renal involvement: microscopic hematuria (9 patients), microalbuminuria (4 patients), decreased renal function assessed by serum creatinine (2 patients), and creatinine clearance (4 patients). None of the patients presented increased urinary excretion of retinol binding protein (RBP). The finding of renal abnormalities in 35% of our patients suggests that in this illness evidence of renal involvement should be actively investigated.
Assuntos
Rim/fisiopatologia , Espondilite Anquilosante/complicações , Espondilite Anquilosante/fisiopatologia , Adolescente , Adulto , Idoso , Albuminúria/etiologia , Anti-Inflamatórios não Esteroides/efeitos adversos , Creatinina/sangue , Creatinina/urina , Feminino , Hematúria/etiologia , Humanos , Rim/patologia , Nefropatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Espondilite Anquilosante/patologiaRESUMO
OBJECTIVE: To evaluate the sensitivity and specificity of the ESSG criteria when applied to Brazilian patients with SpA and control patients with other rheumatic diseases. METHODS: Seventy patients with spondylarthropathies and 62 patients with other rheumatic diseases were interviewed, examined and had their charts reviewed. The diagnoses of the diseases were based on published diagnostic guidelines or classification criteria. Data were also collected according to the ESSG criteria. RESULTS: The sensitivity and specificity of the ESSG classification criteria were 98.5% and 88.7%, respectively. The sensitivities of the criteria in the different subgroups of SpA ranged from a low of 97.7% in AS to a high of 100% in other SpA studied. CONCLUSION: Despite differences in the socio-cultural and geographic characteristics and in individual disease frequencies, the ESSG preliminary classification criteria performed well when applied to Brazilian patients.