RESUMO
INTRODUCCIÓN: La inmunoquimioluminiscencia de micropartículas (CMIA), no es recomendada en el día de hoy para el tamizaje ni confirmación de sífilis en pacientes, las guías chilenas recomiendan tamizaje con V.D.R.L y confirmación con hemaglutinación. OBJETIVO: Determinar la especificidad, sensibilidad y correlación diagnóstica de esta técnica respecto a la prueba treponémica de uso habitual. MATERIALES Y MÉTODOS: De 815 muestras obtenidas en un periodo de 6 meses, a todas las cuales se les aplicó las pruebas de VDRL, MHA-TP y CMIA, 484 muestras fueron positivas para MHA-TP. Se determinó el rendimiento, se graficaron las curvas ROC, índice de correlación y punto de corte óptimo. RESULTADOS: La CMIA. demostró una sensibilidad de 100%, especificidad: 94,6%, VPN: 100% y VPP: 96.4% y una eficiencia de 97,8% con respecto al MHA-TP, con un índice de correlación: 0,97 y un punto de corte de 7.665, de modo que toda muestra con una CMIA. sobre este valor no necesitaría de una segunda prueba treponémica para su confirmación. El 7,11% tuvo valores intermedios de CMIA (1.0 a 7.664). CONCLUSIÓN: La CMIA. es una técnica automatizada altamente sensible y específica, equiparable al MHA-TP. Aplicada como prueba inicial de testeo para sífilis incrementa la certeza diagnóstica y podría permitir el diagnóstico precoz de la enfermedad.
BACKGROUND: The chemiluminescent microparticle immunoassay (CMIA) is not recommended for screening or confirmation of syphilis in patients, Chilean guidelines recommend screening with VDRL and confirmation with hemagglutination. AIM: To determine the specificity, sensitivity, and diagnostic correlation of this technique compared to the usual treponemal test. METHODS: Of the 815 samples obtained over a period of 6 months, all of which were subjected to VDRL, MHATP, and CMIA. testing, 484 samples were positive for MHA-TP. The performance was determined, ROC curves were graphed, correlation index and optimal cutoff point were determined. RESULTS: CMIA showed a sensitivity of 100%, specificity of 94.6%, NPV of 100%, PPV of 96.4%, and an efficiency of 97.8% compared to MHA-TP, with a correlation index of 0.97 and a cutoff point of 7.665, such that any sample with a CMIA. value above this value would not require a second treponemal test for confirmation. 7.11% had intermediate CMIA. values (1.0 to 7.664). CONCLUSION: CMIA. is a highly sensitive and specific automated technique comparable to MHA-TP. When applied as an initial screening test for syphilis, it increases diagnostic certainty and may allow for early diagnosis of the disease.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Imunoensaio , Sífilis/diagnóstico , Medições Luminescentes/métodos , Algoritmos , Testes de Hemaglutinação , Sorodiagnóstico da Sífilis , Valor Preditivo dos Testes , Curva ROC , Sensibilidade e Especificidade , Reações Falso-PositivasRESUMO
OBJECTIVE: To establish whether human fallopian tube (FT) epithelium can induce apoptosis in T lymphocytes and endometrial cells. DESIGN: Laboratory-based study. SETTING: Hospital. PATIENT(S): Women undergoing abdominal hysterectomy for FT samples, and women volunteers with and without endometriosis for endometrial biopsies. INTERVENTION(S): FT samples obtained at time of surgery performed in reproductive-aged women with normal menstrual cycles. MAIN OUTCOME MEASURE(S): T lymphocytes or endometrial cells coincubated with FT epithelial cells and assayed for apoptosis by DNA nick-end labeling and caspase-3 activity, with the presence of Fas ligand (FasL) and Fas receptor (FasR) assessed by indirect immunostaining. RESULT(S): The epithelium of the FT-induced apoptosis in T cells as well as in human endometrial cells. The mechanism probably involves the FasL/FasR system; accordingly, we observed FasL at the apical surface of the epithelium and in the stroma of the FT at all phases of the menstrual cycle except during the early proliferative phase. The endometrial samples from patients with endometriosis did not express FasR and were resistant to apoptosis. CONCLUSION(S): In both FasR(+) T lymphocytes and endometrial cells, FasL(+) FT cells induce apoptosis. Data suggest that the FT epithelium acts as a barrier to limit the influx of lymphocytes as well as endometrial cells ascending the tube. Failure of these regulatory mechanisms may be related to the development of endometriosis.
Assuntos
Apoptose , Endométrio/fisiologia , Tubas Uterinas/fisiologia , Proteína Ligante Fas/metabolismo , Linfócitos T/fisiologia , Receptor fas/metabolismo , Adulto , Apoptose/genética , Apoptose/imunologia , Apoptose/fisiologia , Caspase 3/metabolismo , Células Cultivadas , Endometriose/genética , Endometriose/metabolismo , Endometriose/patologia , Endométrio/citologia , Endométrio/metabolismo , Endométrio/patologia , Epitélio/metabolismo , Epitélio/patologia , Epitélio/fisiologia , Feminino , Humanos , Doenças Peritoneais/genética , Doenças Peritoneais/metabolismo , Doenças Peritoneais/patologia , Linfócitos T/metabolismo , Doenças Uterinas/genética , Doenças Uterinas/metabolismo , Doenças Uterinas/patologiaRESUMO
Campylobacter jejuni, uno de los principales agentes causales de síndrome diarreico en seres humanos, es una bacteria que a bajas temperaturas y en condiciones de estrés forma células cocoides no cultivables. Para determinar las condiciones en las que cepas de C. jejuni se conserven viables y cultivables independiente de la morfología, se sometió a dos cepas de este a tres diversas condiciones de laboratorio evaluando morfología mediante tinción de Gram, viabilidad celular mediante pruebas bioquímicas y Citometría de Flujo. Ambas cepas lograron mantenerse viables y cultivables en dichas condiciones, tanto en la forma bacilar como en la cocoide, siendo la condición mas desfavorable para ambas cepas la temperatura ambiente (sobrevida de 4 días y 6 días), y mas favorable la bolsa hermética a 4° C (15 Y 22 días de sobrevida). La citometría de flujo resulto ser una buena herramienta para medir viabilidad de las cepas ensayadas, mostrando que las células cocoides presentaban alteraciones en la continuidad de su membrana, indicativo de perdida de viabilidad celular.
Campylobacter jejuni, a major causative agent of diarrhoeal syndrome in humans, is a bacterium that at low temperatures and under conditions of stress, coccoid cells form non-arable. To determine the conditions under which strains of C. jejuni is kept viable and cultivable, independent of the morphology, underwent two strains of C. jejuni three different laboratory conditions, and morphology was assessed by Gram stain, and cell viability by biochemical tests and flow cytometry. Both strains were able to remain viable and culturable in the three laboratory conditions, both in the form of bacilli in the coccoid form, being the most unfavourable condition for both strains, room temperature (survival of 4 days and 6 days), and the most favourable airtight bag 4 0 C (75 and 22 days of survival). The flow cytometry proved to be a good tool for measuring viability of the strains tested, showing that cells coccoid, showed alterations in the continuity of its membrane, indicative of loss of cell viability.
Assuntos
Campylobacter jejuni/citologia , Campylobacter jejuni/crescimento & desenvolvimento , Citometria de Fluxo , Viabilidade Microbiana , Técnicas de Cultura de Células , Coloração e Rotulagem , Temperatura , Fatores de TempoRESUMO
OBJECTIVES: On December 1905 Darling, resident histopathologist on the Panama Channel area, observed a parasite in the large mononuclear cells of different organs. Negroni in 1914 described the first Argentinean case. Lung, oral, nasal, and laryngeal involvement are common. On the other hand, genital involvement is uncommon. The objective of this war is to communicate the case of a patient with genital histoplasmosis. METHODS/RESULTS: A 60-year-old Argentinian male started two years before with penile lesions and pruritus. Two partial penile resections had been performed in 1999, but pathology reports were not available. The lesions evolved towards ulceration and bleeding. Surgical toilette was carried out. A partial penectomy and glanuloplasty with an original technique were performed. Pathology revealed intracellular and extracellular spherical microorganisms. Morphologically it was histoplasma capsulatum. The histoplasmosis is an endemic mycosis. The infection takes place when inhaling the microconidiae of the fungus filamentous phase. Only a small number of people develop the disease after infection. Diagnosis is made by discovering of 2-3 micron yeasts with Giemsa stain. CONCLUSIONS: If a patient from the histoplasmosis endemic area has a granular lesion, a mycotic disease should be considered.