RESUMO
Introdução: O objetivo deste estudo foi avaliar as características das práticas de telemedicina (TM) entre médicos alergistas/ imunologistas (A/I) brasileiros e avaliar seu conhecimento sobre as recomendações regulatórias. Métodos: Uma pesquisa eletrônica autorreferida foi enviada por e-mail uma vez por semana entre agosto e outubro/2021 a 2.600 médicos A/I brasileiros. Resultados: 205 (7,9%) participantes preencheram os formulários. 143 (70,2%) médicos usaram TM em sua prática clínica, e 184 (89,9%) nunca o usaram antes da pandemia de COVID-19. Dentre os médicos, 192 (93,8%) utilizaram a TM para consultas de acompanhamento, 186 (91%) para verificação de exames complementares e 136 (66,7%) nas primeiras consultas. Cento e quarenta e três médicos A/I (70,2%) sentiram-se seguros em seu diagnóstico por meio da TM, e 7 (3,5%) responderam que não conseguiram encontrar um diagnóstico correto usando a TM. Os principais benefícios da TM relatados foram: maior acessibilidade, principalmente em áreas mais distantes 159 (77,6%), redução dos custos de deslocamento 158 (77,1%) e segurança quanto à transmissão do COVID-19 145 (71,2%). Por outro lado, algumas desvantagens da TM foram listadas pelos participantes: ausência de exame físico 183 (89,7%), relação médico-paciente fragilizada 59 (28,8%) e problemas de Internet 45 (22%). Em relação ao campo jurídico/ético, 105 (51,4%) dos especialistas aplicaram o termo de consentimento e 34 (16,7%) registraram a teleconsulta, ambas as etapas exigidas em uma consulta de TM, conforme recomendações regulatórias locais. Além disso, plataformas online inadequadas para TM, como aplicativos de mídia social e programas de reuniões online não específicos, foram relatadas como sendo usadas por 131 (64,1%) dos participantes. Oitenta (40%) não leram as declarações e recomendações oficiais que regulamentam a prática da TM no Brasil. Conclusões: Observouse um uso crescente de TM no Brasil, influenciado principalmente pela pandemia de COVID-19. Apesar de ser ferramenta útil na pandemia, com vantagens e desvantagens, há necessidade de conhecer as recomendações regulatórias.
Introduction: The aim of this study was to evaluate the characteristics of telemedicine (TM) practices among Brazilian allergists/immunologists (A/I) and to assess their knowledge of regulatory recommendations. Methods: A self-report electronic survey was sent by email once a week between August and October 2021 to 2,600 Brazilian A/I physicians. Results: A total of 205 (7.9%) participants completed the survey. TM was used in clinical practice by 143 (70.2%) physicians, and 184 (89.9%) had never used it before the COVID-19 pandemic. Among participants, 192 (93.8%) used TM for follow-up consultations, 186 (91%) for checking complementary exams, and 136 (66.7%) for first consultations. The number of A/I physicians (70.2%) that felt confident in their diagnosis using TM was 143, and 7 (3.5%) reported that they could not reach the correct diagnosis using TM. Participants reported that the main benefits of TM were greater accessibility, especially in more distant areas (159, 77.6%), reduced travel costs (158, 77.1%), and safety regarding the transmission of COVID-19 (145, 71.2%). Conversely, the lack of physical examination (183, 89.7%), poor doctor-patient relationship (59, 28.8%), and internet connection problems (45, 22%) were mentioned as disadvantages. Regarding legal/ethical aspects, 105 (51.4%) physicians reported applying a consent form and 34 (16.7%) reported making a record of the teleconsultation, both of which are required for TM consultations, according to local regulatory recommendations. The use of inappropriate online platforms for TM, such as social media applications and nonspecific online meeting programs, was reported by 131 (64.1%) participants. Eighty (40%) participants did not read the official statements and recommendations that regulate the practice of TM in Brazil. Conclusions: An increasing use of TM was observed in Brazil, mainly influenced by the COVID-19 pandemic. Despite being a useful tool in the pandemic, with advantages and disadvantages, physicians should have knowledge of regulatory recommendations.
Assuntos
Humanos , Telemedicina , Consulta Remota , Alergistas , COVID-19 , Pacientes , Exame Físico , Relações Médico-Paciente , Médicos , Sociedades Médicas , Estudos Transversais , Inquéritos e Questionários , Internet , Diagnóstico , Alergia e Imunologia , Mídias SociaisRESUMO
Men ignore self-care, displaying low frequency in health services. Aging increases the prevalence of LUTS and BPE, impacting the quality of life. The objective is to understand how the advancement of age can be determinant for men's health in Natal, Brazil. Then, 503 men aged between 43 and 83 attended the Blue November Campaign of 2015. All subjects were submitted to anamnesis, clinical and laboratorial evaluation including measuring their blood pressure, waist circumference, glucose, total cholesterol, HDL-C, LDL-C, triglycerides and BMI was calculated. In addition, IPSS, PSA, IIEF-5 and DRE data were collected. The mean IPSS presented an increase with age, 43-59 years (6.28 ± 6.02) and 70-80 years or more (8.65 ± 5.80). PSA dosages increase with aging (adult group 1.63 ± 2.70), being more accentuated in the older group (4.66 ± 5.70), while the mean IIFE-5 showed a decrease with aging in 43-59 years (21.79 ± 4.67) and an important decrease at 70-80 years or more (16.24 ± 6.71). The number of DRE > 30 g showed significant growth in the older group. All presented statistical significance (p < .05) and were associated with aging. The Blue November Campaign creates an annual self-care opportunity for aging men as their health is gradually affected.
Assuntos
Envelhecimento Saudável , Hiperplasia Prostática , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Prevalência , Qualidade de Vida , AutocuidadoRESUMO
The purpose of this study was to evaluate the safety of Kalanchoe brasiliensis extract, followed by the development of an oil in water emulsion containing the K. brasiliensis leaves extract and evaluating its clinical moisturizing efficacy. The formulations containing sodium acrylates/ Beheneth-25 methacrylate Crosspolymer (and) hydrogenated polydecene (and) lauryl glucoside and 0.5% of extract were prepared. The extract was considered as non-irritating through skin irritant tests. The stability testing was carried out in different conditions for 90 days. The skin hydration was measured by capacitance measurement and transepidermal water loss using biophysical techniques. The results indicate that the formulation containing 0.5% of extract increased the hydration of the stratum corneum up to 5 h after application on the forearm. The transepidermal water loss was reduced when compared to the untreated area and placebo area. Therefore, we can conclude that the increased skin hydration and protection of barrier function can be attributed to the K. brasiliensis extract. This research presents a new raw material from the Brazilian Caatinga biome and shows its possible application in the development of cosmetic products.
Assuntos
Agentes Molhantes/farmacologia , Kalanchoe/anatomia & histologia , Emulsões , Extratos Vegetais/efeitos adversos , Estabilidade de CosméticosRESUMO
PURPOSE: To quantify the number of defense cells and immunoglobulin E (IgE) levels in peripheral blood sampled from women with recurrent vulvovaginal candidiasis. METHODS: A cross-sectional study was conducted on 60 women, 40 with vulvovaginal candidiasis and 20 controls. The defense cells were identified using an impedance system combined with flow cytometry and total and specific IgE was measured by chemiluminescence. The Mann-Whitney test was used for nominal variables and the Spearman test was used to determine the correlation of IgE concentration and eosinophils in peripheral blood. RESULTS: The number of eosinophils in peripheral blood from patients with recurrent vulvovaginal candidiasis, 302.60 (± 253.07), was significantly higher compared to control, 175.75 (± 109.24) (p=0.037). Serum levels of total and specific IgE were similar in the groups of women with and without recurrent vulvovaginal candidiasis (p=0.361). However, there was a moderate positive correlation between eosinophils and total serum IgE in the candidiasis group (r=0.25). CONCLUSION: Women with recurrent vulvovaginal candidiasis are more likely to have eosinophils in peripheral blood.
Assuntos
Candidíase Vulvovaginal/sangue , Eosinofilia/sangue , Eosinofilia/microbiologia , Candidíase Vulvovaginal/complicações , Estudos Transversais , Feminino , Humanos , Imunoglobulina E/sangue , RecidivaRESUMO
OBJETIVO: Quantificar o número de células de defesa e os níveis de imunoglobulina E (IgE) no sangue periférico em amostra de mulheres com candidíase vaginal recorrente. MÉTODOS: Estudo de corte transversal com 60 mulheres, 40 com candidíase vulvovaginal e 20 do grupo controle (sem doença). As células de defesa foram identificadas utilizando um sistema de impedância combinada com a citometria de fluxo, os níveis de IgE total e específica foram medidos por meio de técnicas de quimiluminescência, o teste de Mann-Whitney foi utilizado para variáveis nominais e do teste de Spearman para correlações das concentrações de IgE e de eosinófilos no sangue periférico. RESULTADOS: O número de eosinófilos no sangue periférico de pacientes com candidíase vulvovaginal, 302,60 (±253,07), foi significativamente maior do que o grupo controle, 175,75 (±109,24) (p=0,037). Os níveis séricos de IgE total e específica foram semelhantes em ambos os grupos de mulheres com e sem candidíase vulvovaginal recorrente (p=0,361). Entretanto, observou-se uma correlação positiva moderada entre eosinofilia e níveis de IgE total no sangue periférico de mulheres com candidíase vaginal recorrente (r=0,25). CONCLUSÃO: Mulheres com candidíase vaginal recorrente parecem ter maior concentração de eosinófilos no sangue periférico que as assintomáticas.
PURPOSE: To quantify the number of defense cells and immunoglobulin E (IgE) levels in peripheral blood sampled from women with recurrent vulvovaginal candidiasis. METHODS: A cross-sectional study was conducted on 60 women, 40 with vulvovaginal candidiasis and 20 controls. The defense cells were identified using an impedance system combined with flow cytometry and total and specific IgE was measured by chemiluminescence. The Mann-Whitney test was used for nominal variables and the Spearman test was used to determine the correlation of IgE concentration and eosinophils in peripheral blood. RESULTS: The number of eosinophils in peripheral blood from patients with recurrent vulvovaginal candidiasis, 302.60 (±253.07), was significantly higher compared to control, 175.75 (±109.24) (p=0.037). Serum levels of total and specific IgE were similar in the groups of women with and without recurrent vulvovaginal candidiasis (p=0.361). However, there was a moderate positive correlation between eosinophils and total serum IgE in the candidiasis group (r=0.25). CONCLUSION: Women with recurrent vulvovaginal candidiasis are more likely to have eosinophils in peripheral blood.
Assuntos
Feminino , Humanos , Candidíase Vulvovaginal/sangue , Eosinofilia/sangue , Eosinofilia/microbiologia , Estudos Transversais , Candidíase Vulvovaginal/complicações , Imunoglobulina E/sangue , RecidivaRESUMO
The authors conducted a flow cytometry immunophenotyping study in patients with acute lymphoblastic leukemia (ALL) from Natal, Rio Grande do Norte, Brazil. The patients (n = 126) were newly diagnosed using a panel of monoclonal antibodies: CD1a, CD2, CD3, CD4, CD7, CD8, CD10, CD13, CD33, CD14, CD19, CD22, CD79a, CD117, CD34, anti-IgM, anti-TdT, anti-HLA-Dr, and anti-human kappa and lambda light chains. Additional data, such as patients' age and gender, clinical and laboratory findings such as presence of tumor masses, lymphadenopathy, hepatomegaly, splenomegaly, leukemic infiltration in the central nervous system (CNS) were also investigated. Results showed that 56.7% of the cases were B-lineage ALL and 55% were T-cell ALL. Also, we found that males were more affected by the disease, regardless of immunological classification. The correlation between age and immunological subtypes showed that the B-lineage ALL occurred more frequently in patients aged under 15 while the T-cell ALL subtype was more frequent in adults. Immunophenotypic profiles and morphological subtypes showed a direct correlation between L3 subtype and B-lineage ALL, while L1 and L2 subtypes correlated more often with B-cell lineage and T-cell ALL, respectively. Correlation analysis between immunophenotypic and clinical profiles showed that T-cell ALL was more associated with a higher incidence of lymphadenopathy, hepatomegaly, splenomegaly and CNS leukemic infiltration, also showing a greater blast cell count in peripheral blood than the other subgroups. The presented data suggest that immunophenotyping is an important method in the diagnosis, monitoring and prognostic assessment in determining the pathological mechanisms of evolution of ALL.
Assuntos
Leucemia-Linfoma Linfoblástico de Células Precursoras/classificação , Adolescente , Adulto , Antígenos CD/sangue , Antígenos CD/química , Antígenos CD/classificação , Criança , Pré-Escolar , Citometria de Fluxo/métodos , Humanos , Imunofenotipagem/métodos , Lactente , Masculino , Pessoa de Meia-Idade , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/imunologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/metabolismo , Prognóstico , Resultado do TratamentoRESUMO
A toxoplasmose é uma parasitose prevalente em todo o mundo, quando adquirida durante a gestação pode ser transmitida ao feto e causar, entre outros problemas, atraso no desenvolvimento neuropsicomotor, déficit visual e de audição. A prevenção da transmissão vertical deve ser iniciada antes da concepção ou o mais precocemente possível durante o exame pré-natal. Neste trabalho, foi realizado um estudo objetivando a avaliação da soroprevalência da toxoplasmose em parturientes e seus recém-natos (RN),atendidos na Maternidade Escola Januário Cicco da UFRN, através de um estudo comparativo entre as técnicas da hemaglutinação indireta (HAI) e a imunofluorescência indireta (IFI). Paralelamente, também, se procurou padronizar a técnica de IFI, utilizando-se a coleta de sangue capilar com impregnação em papel de filtro. Das amostras sanguíneas de 63 parturientes e respectivos RN avaliadas por IFI, obteve-se uma reatividade para toxoplasmose de 30,2% e de 3,2%, respectivamente. A utilização da IFI empregando-se a coleta de sangue capilar com impregnação em papel de filtro apresentou baixa sensibilidade (71,4%), mostrando a necessidade de se intensificar os estudos para completar a padronização desse método. No entanto, foi observada uma boa correlação entre a IFI e a HAI. Os casos de IFI para cadeia pesada das imunoglobulina humana (IgH) apresentaram elevados títulos para IgG específica na maioria dos casos, sendo que três destes apresentaram reatividade para a IgM. Estes dados mostram a importância da investigação sorológica para toxoplasmose nesse grupo e pacientes
Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Adolescente , Adulto , Pessoa de Meia-Idade , Técnica Indireta de Fluorescência para Anticorpo , Recém-Nascido , Gestantes , Estudos Soroepidemiológicos , Toxoplasmose , Toxoplasmose CongênitaRESUMO
Introdução: Treponema pallidun é o agente etiológico da sífilis uma doença sexualmente transmissível. No imunodiagnóstico dessa doença utilizam-se dois diferentes tipos de testes sorológicos. Inicialmente, as amostras são triadas qualitativamente e quantitativamente por um teste não treponêmico como o veneral disease research laboratory (VDRL) e, em seguida, os soros reagentes são testados para a detecção de anticorpos específicos para o treponema pallidun, como a reação de imunofluorescência indireta através do fluorescent treponemal antibory absorption assay (FTA-ABS). Objetivos e Metodologia: Avaliar através do VDRL quantidativo a sororeatividade de 40 pacientes com sífilis e comparar com a presença do fenômeno pro-zona e resultados obtidos pelo FTA-ABS. Resultados e Discussão: Os níveis de reatividade das amostras testadas pelo VDRL variam de 1:2 a 1:256. O fenômeno pró-zona foi observado em 8/40 soros (20) se correlacionando com altos títulos de reatividade na maioria dos casos. O FTA-ABS foi reagente em 39/40 amostras (97,5).
Assuntos
Masculino , Feminino , Humanos , Epidemiologia , Sorologia , Sífilis , Treponema pallidum , Imunofluorescência , Infecções Sexualmente TransmissíveisRESUMO
PURPOSE: CD5 is a T cell marker, aberrantly express in B cell chronic lymphocytic leukemia (B-CLL) and mantle cell lymphoma (MCL). Other chronic B cell malignancies including hairy cell leukemia (HCL) and B cell prolymphocytic leukemia (B-PLL) are CD5 negative or express this antigen in a weak way. In this study, CD5 expression was investigated in leukemic cells from 42 patients with chronic B cell lymphoproliferative disease. METHODS: We studied the CD5 expression in leukemic cells from 42 patients with chronic B-cell malignancies by flow cytometry. Demographic features such as age, sex and clinical date were also analyzed. RESULTS: There were 22 males and 20 females. The immunophenotyping showed that 35 cases were B-CLL, 3 B-PLL and HCL and one patient was MCL. CD5 expression was present in all B-CLL and MCL. Low expression of CD5 was observed in one patient with B-PLL and negative in all cases of HCL. CONCLUSION: Our date demonstrated that CD5 expression can help distinguish among B-CLL from HCL and B-PLL, but is similar expressed in MCL.
Assuntos
Antígenos CD5/sangue , Citometria de Fluxo/métodos , Imunofenotipagem , Leucemia Linfocítica Crônica de Células B/diagnóstico , Linfoma de Células B/diagnóstico , Transtornos Linfoproliferativos/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Diagnóstico Diferencial , Feminino , Humanos , Leucemia de Células Pilosas/sangue , Leucemia de Células Pilosas/diagnóstico , Leucemia Linfocítica Crônica de Células B/sangue , Contagem de Linfócitos , Linfoma de Células B/sangue , Linfoma de Célula do Manto/sangue , Linfoma de Célula do Manto/diagnóstico , Transtornos Linfoproliferativos/sangue , Masculino , Pessoa de Meia-IdadeRESUMO
PURPOSE: To evaluate the nutritious state in children of low social-economic class in order to look over a possible corelationship among this status and the infections caused by enteroparasites. METHODS: 103 children were submitted to a nutritions evolution and to accomplish a exam of serial samples. The method employed searched protozoan cystos, helmints eggs and larvae and it counted helmint eggs when presented through 4 different methods of diagnosis. RESULTS: The results obtained show that the poor environmental and social-economic conditions helped create a high infectious frequency caused by enteroparasites, mainly by Trichuris trichiura and Ascaris lumbricoides, among the helminthes, and Endolimax nana and Giardia lamblia, among the protozoans. light malnutrition without protein deficit was found in 93.55% and moderate malnutrition in 6.45% of the children malnutrition (30.7%). CONCLUSION: Then, it is possible to suggest that children besides bearing many parasitosis were not weth their nutritional state deeply compromised.