RESUMO
Trichomonas vaginalis causes trichomoniasis, an inflammatory process related to an increased rate of HIV transmission. In order to study T. vaginalis infection response in a microorganism-free environment, an infection model was established providing a hostparasite interaction system useful to study the interplay between immune cells and the parasite. Infected mice peritoneal cells were immunophenotyped at different times after infection using flow cytometry. Neutrophils and macrophages showed the most relevant increase from third to 12th day post-infection. A high number of B lymphocytes were present on 15th day post-infection, and an increase in memory T cells was observed on sixth day post-infection. The levels of NO increased at day 10 post-infection; no significant influence was observed on T. vaginalis clearance. Increased viability of T. vaginalis was observed when the NETs inhibitors, metformin and Cl− amidine, were administrated, highlighting the importance of this mechanism to control parasite infection (43 and 86%, respectively). This report presents a comprehensive cell count of the immune cells participating against trichomoniasis in an in vivo interaction system. These data highlight the relevance of innate mechanisms such as specific population changes of innate immune cells and their impact on the T. vaginalis viability.
Assuntos
Tricomoníase , Trichomonas vaginalis , Animais , Cinética , Camundongos , Neutrófilos , PeritônioRESUMO
Vulvovaginal candidiasis (VVC) is an inflammatory disease of the vulva and vagina caused by different yeasts of the genus Candida which is responsible for infection in pregnant patients who attended Maternidade Escola Januário Cicco, Rio Grande do Norte, Brazil. From 41 samples, 19 yeasts were identified phenotypically as Candida albicans and one as Candida glabrata which is reported as the non-albicans species most frequently isolated from vulvovaginitis. The susceptibility to selected antifungal agents (flucytosine, fluconazole, voriconazole, amphotericin B, caspofungin and micafungin) was determined, and the association between patient-related signs and symptoms aided the construction of an epidemiological profile. Antifungal susceptibility testing performed by automated method showed that all strains were sensitive to the drugs tested, including the C. glabrata specimen despite its known resistance or dose-dependent susceptibility to azole derivatives. Regarding patient signs and symptoms, no statistically significant association between these and the establishment of VVC was found. It can be concluded that the laboratorial diagnosis of VVC is necessary prior to the administration of treatment, since only 48·78% of the patients had VVC but for all of them antifungal therapy were prescribed. SIGNIFICANCE AND IMPACT OF THE STUDY: Vulvovaginal candidiasis (VVC) is a problem that affects a significant number of pregnant women worldwide. This type of fungal infection generates great discomfort due to the symptomatology and difficulties of diagnosis and treatment. In view of the scarcity of data in the State of Rio Grande do Norte, Brazil, regarding studies carried out on fungal populations of the genus Candida associated with VVC in pregnant women, this study considered relevant, the phenotypic and genotypic identification of the species, to estimate the prevalence, to determine their susceptibility to the antifungal and to correlate with signs and symptoms.
Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candidíase Vulvovaginal/microbiologia , Complicações na Gravidez/microbiologia , Adolescente , Adulto , Anfotericina B/farmacologia , Brasil/epidemiologia , Candida/genética , Candida/isolamento & purificação , Candida glabrata/isolamento & purificação , Candidíase Vulvovaginal/epidemiologia , Equinocandinas/farmacologia , Feminino , Fluconazol/farmacologia , Humanos , Lipopeptídeos/farmacologia , Micafungina , Testes de Sensibilidade Microbiana , Gravidez , Complicações na Gravidez/epidemiologia , Prevalência , Instituições Acadêmicas/estatística & dados numéricos , Adulto JovemRESUMO
PURPOSE: To show the clinical results of the treatment of brain metastases via radiosurgery using Volumetric Modulated Arc Therapy (VMAT). MATERIALS AND METHODS: 52 patients having lung (62 %), breast (17 %), colorectal (8 %) and other cancers (13 %) with one to three brain metastases were treated with 5 non-coplanar VMAT arcs. The treatment dose varied from 12 to 20 Gy, administered in one single session. The volume of metastases ranged from 0.04 to 24.92 cc. Radiosurgery alone was used for 54 % of cases, while 19 % received whole brain radiotherapy due to relapse. Patients were classified according to the Disease-specific graded prognostic assessment (DS-GPA) index and survival was assessed via the Kaplan-Meier model. RESULTS: The median survival time was 7.2 months from the date of radiosurgery. The Karnofsky and DS-GPA indices were the most significant with regard to survival. Patients with a Karnofsky performance status (KPS) over 70 had a longer survival time of 9.2 months, as opposed to those with a KPS below 70 of 3.5 months. No significant differences were found with regard to the type of cancer or the number of lesions. Local tumour control was achieved for 42 metastases (82 %), of which a complete response was achieved for 7 lesions, a partial response for 21; 15 lesions were stabilized. Local progression was observed in 8 lesions (15 %). The median treatment time per patient was 29 min. CONCLUSIONS: The VMAT technique proves to be safe and effective for treating brain metastases via radiosurgery.
Assuntos
Neoplasias Encefálicas/cirurgia , Neoplasias/cirurgia , Radiocirurgia/mortalidade , Radioterapia de Intensidade Modulada/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Encefálicas/mortalidade , Neoplasias Encefálicas/secundário , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias/mortalidade , Neoplasias/patologia , Prognóstico , Planejamento da Radioterapia Assistida por Computador/métodos , Taxa de SobrevidaRESUMO
Introducción: la reacción inflamatoria (RI) es una secuencia compleja de acontecimientos que ocurren en los tejidos de los seres vivos luego de lesión celular. Se puede manifestar objetivamente para el cirujano mediante la presencia de hallazgos macroscópicos abdominales observados durante la cirugía (1,2,3). El objetivo del presente estudio fue evidenciar la reacción inflamatoria en el abdomen de la rata expuesta a: bilis, clips de titanio y fragmentos de gasa. Material y métodos: se realizó un modelo experimental en el Laboratorio de Cirugía de la Universidad Francisco Marroquín. Se utilizaron 100 ratas de la especie Wistar a las cuales les fueron asignadas en forma aleatoria cifras numéricas para clacificarlas así...
Assuntos
Animais , Ratos , Abdome , Bile , Corpos Estranhos/complicações , Complicações Pós-Operatórias , Ratos , Reação a Corpo Estranho/etiologia , Pesos e MedidasRESUMO
A cross-sectional epidemiological study of two communities in Guatemala, El Jocote and Quesada, was conducted to determine the prevalence of epilepsy and epileptic seizures. An initial screening questionnaire was applied to detect individuals who had possibly suffered seizures in the past. These individuals were then examined more thoroughly by a neurologist, to confirm or reject them as cases of epilepsy. The crude prevalences of epilepsy so revealed were 28 cases/1000 in El Jocote and 29 cases/1000 in Quesada. The prevalence of active epilepsy in each community was approximately 18 cases/thousand. The most common type of seizure suffered was of the generalised tonic--clonic type. Seventy-six of the individuals who had a history of epileptic seizures and 51 individuals from the same communities with no such history were then given brain scans, using computerized axial tomography. These neuro-imaging studies revealed some form of abnormal image in 33% (17) of the subjects with no history of seizures and 70% (53) of those with a history of seizures (chi(2) = 12.2; P < 0.00006). The frequency of detected brain abnormalities in the individuals who had suffered a single episode of seizures was similar to that in those who were classified as epileptic. The most commonly observed type of abnormality was punctate calcification, followed by cerebral oedema and hypodensities. The reasons for the high prevalences of epilepsy, epileptic seizures and abnormal neuro-images observed in the present study merit further investigation. Although neurocysticercosis caused by Taenia solium was thought to be a significant cause of the epilepsy occurring in the study communities, many apparently non-epileptic individuals have brain lesions indicative of this disease.
Assuntos
Epilepsias Parciais/epidemiologia , Epilepsia Tônico-Clônica/epidemiologia , Adolescente , Adulto , Idade de Início , Idoso , Criança , Pré-Escolar , Estudos Transversais , Diagnóstico Diferencial , Epilepsias Parciais/diagnóstico por imagem , Epilepsias Parciais/etiologia , Epilepsia Tônico-Clônica/diagnóstico por imagem , Epilepsia Tônico-Clônica/etiologia , Feminino , Guatemala/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Neurocisticercose/complicações , Neurocisticercose/diagnóstico por imagem , Fatores Sexuais , Tomografia Computadorizada por Raios XRESUMO
There is relatively little epidemiological information on human intestinal taeniasis, particularly that due to Taenia solium. The current study involved analysis of data collected from four, rural communities in the Department of Jutiapa, Guatemala, between 1991 and 1994. Overall, 92 cases of intestinal taeniasis were identified, giving a mean prevalence of 2.7% (92/3399). Almost all (98%) of the 56 worms identified to species level were T. solium. Female subjects were significantly more likely to be infected than males, with a relative risk of 1.21 (95% confidence interval = 1.04-1.42; P < 0.04). Mean prevalence rose with age until the 30-39-year age cohort and declined thereafter. Cases were significantly clustered in households (P < 0.001). Most infections appeared to correspond to single worms. Only one multiple-worm infection was definitely detected, in an individual with at least seven T. solium tapeworms, all of which appeared to be sexually immature. To determine potential movements of infected subjects out of the villages, adult subjects in two of the villages were asked about their main place of employment; 9.7% (94/968) were recorded as working either in Guatemala City or the U.S.A. The possible epidemiological implications of these findings are discussed.