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Navegando por Palavras-chave "infection"

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B-1 cell: the precursor of a novel mononuclear phagocyte with immuno-regulatory properties
(Acad Brasileira De Ciencias, 2009-09-01) Lopes, Jose Daniel [UNIFESP]; Mariano, Mario [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Characterization of the origin, properties, functions and fate of cells is a fundamental task for the understanding of physiological and pathological phenomena. Despite the bulk of knowledge concerning the diverse characteristics of mammalian cells, some of them, such as B-1 cells, are still poorly understood. Here we report the results obtained in our laboratory on these cells in the last 10 years. After showing that B-1 cells could be cultured and amplified in vitro, a series of experiments were performed with these cells. They showed that B1 cells reside mostly in the peritoneal and pleural cavities, migrate to distant inflammatory foci, coalesce to form giant cells and participate in granuloma formation, both in vitro and in vivo. They are also able to present antigens to immunologically responsive cells and are endowed with regulatory properties. Further, we have also shown that these cells facilitate different types of infection as well as tumor growth and spreading. These data are presently reviewed pointing to a pivotal role that these cells may play in innate and acquired immunity.
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Effect of temporary catheter and late referral on hospitalization and mortality during the first year of hemodialysis treatment
(Blackwell Publishing Inc, 2004-11-01) Goncalves, EAP; Andreoli, MCC; Watanabe, R.; Freitas, MCS; Pedrosa, A. C.; Manfredi, SR; Draibe, S. A.; Cendoroglo, M.; Canziani, MEF; Universidade Federal de São Paulo (UNIFESP)
Late referral (LR) to dialysis therapy has been associated with poor outcomes in people with end-stage renal disease. This had been ascribed to the frequent use of temporary vascular catheters (TVCs) in LR patients. the effects of LR and TVC on the outcomes of an incident hemodialysis population (n = 101) were investigated. There was a higher incidence of vascular access infection, longer period of hospitalization, and lower survival in TVC and LR groups, compared with arteriovenous fistula and early referral (ER) groups, respectively. Late referral patients had higher number of hospitalizations than ER patients. in univariate analysis, LR (hazard ratio [HR] 10.8, P = 0.02) and albumin (HR 0.23, P < 0.0001) were associated with mortality. Late referral and body mass index were associated with the increased risk of hospitalization in univariate analysis. in multivariate analysis, LR was the only risk factor associated with hospitalization (HR 3.51, P = 0.002). in conclusion, LR was associated with increased risk of mortality and increased risk of hospitalization independently of the presence of a TVC.
Acesso aberto (Open Access)
Efficacy of cytology for the diagnosis of Chlamydia trachomatis in pregnant women
(Brazilian Society of Infectious Diseases, 2006-10-01) Cornetta, Maria da Conceição de Mesquita [UNIFESP]; Gonçalves, Ana Katherine da Silveira; Bertini, Anna Maria [UNIFESP]; Federal University of Rio Grande do Norte; Universidade Federal de São Paulo (UNIFESP)
This study evaluated the effectiveness of Papanicolaou staining for the initial diagnosis of Chlamydial infection in pregnant women. A hundred thirteen patients were examined with a Papanicolaou test, independent of gestational age, parity or maternal age. Three endocervical samples were collected; the first two were collected with a brush (Cytobrush plus, Mediscand, Sweden) and the third with Ayre's spatula. The first specimen was used for McCoy cell culture and the other two were examined cytologically. Chlamydial infection was detected in 9 (7.9%) patients. Only one (0.8%) was diagnosed by cytological exam. The sensitivity and specificity of the cytological examination were 10 and 98%, respectively. The estimated positive predictive value was 33.3% and the negative predictive value was 92.7%. When Papanicolaou stain diagnosis suggests Chlamydia, a more specific complementary exam should be added to confirm infection; subsequently adequate treatment can be implemented, thereby preventing the frequent complications of untreated subclinical infections.
Acesso aberto (Open Access)
Emergence of Trichosporon mycotoxinivorans (Apiotrichum mycotoxinivorans) invasive infections in Latin America
(Fundaco Oswaldo Cruz, 2017) de Almeida, Joao Nobrega, Jr.; Francisco, Elaine Cristina [UNIFESP]; de Andrade Barberino, Maria Goreth M.; da Silva Filho, Luiz Vicente Ribeiro F.; Brandao, Oriana M.; Colombo, Arnaldo Lopes [UNIFESP]; Barbosa Padovan, Ana Carolina
We report the first two cases of Trichosporon mycotoxinivorans infections in Latin America. We also conducted a literature review and a microbiological investigation, including that of clinical and environmental isolates. A 30-year-old man with chronic renal failure had disseminated infection after dialysis and a 15-year-old boy with cystic fibrosis (CF) had pulmonary exacerbations with positive respiratory samples. A review of the relevant literature revealed that deep-seated infections were related to immunosuppression or invasive devices, while most of the CF patients showed a decline in lung function after positive cultures. Phylogenetic analyses revealed three distinct circulating genotypes. MALDI-TOF mass spectrometry analysis showed similar spectral profiles and correctly identified all strains/isolates. Biofilm production was documented in a bloodstream isolate and biofilm-producing cells showed high minimum inhibitory concentrations against antifungals.
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Epidemiology and risk factors for bloodstream infections after allogeneic hematopoietic stem cell transplantion
(Edizioni Internazionali Srl, 2007-04-01) Cappellano, Paola [UNIFESP]; Viscoli, Claudio; Bruzzi, Paolo; Van Lint, Maria Teresa; Pereira, Carlos Alberto Pires [UNIFESP]; Bacigalupo, Andrea; Univ Genoa; Universidade Federal de São Paulo (UNIFESP)
A total of 315 patients who underwent allogeneic Hematopoietic Stem Cell Transplantation (HSCT) during a 4year period were analysed with the aim of collecting information on bloodstream infections (BSI). Eighty-four patients (27%) developed 112 BSI, with a cumulative risk of 20.6% at 30 days and 27.7% at 180 days. Overall, 127 pathogens were isolated, 95 (75%) gram-positive cocci, 27 (21%) gram-negative rods and 5 (4%) fungi. Enterococcus sp. accounted for 46 of 127 (36%) isolates. In a multivariable analysis only including baseline factors, the type of transplant was the only factor significantly associated with the risk of BSI and the risk was higher for patients receiving transplant from mismatched or unrelated donors.In a case-control study aimed at evaluating the predictive role of additional factors during transplant, the risk appeared to be higher in patients with a positive CMV antigenemia (p=0.03; OR of 4.82; 95% CI, 1.21-19.17), long duration of severe granulocytopenia (p=0.015; OR 7.53; 95% CI, 1.92 - 29.58) and lower platelet count (p<0.001; OR 0.14; 95% CI, 0.05 - 0.40). By day 180 post-transplant, 87 (28%) out of 314 patients had died. The cumulative risk of death was significantly higher among patients with BSI than among other patients.
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Estudo comparativo do uso de drenos de secção e pontos de tensão progressiva na prevenção de seromas e infecções de ferida operatória após correção cirúrgica de hérnias incisionais volumosasEnsaio clínico randomizado
(Universidade Federal de São Paulo (UNIFESP), 2014-02-26) Westphalen, Andre Pereira [UNIFESP]; Lopes Filho, Gaspar de Jesus Lopes Filho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Objective: To carry out a comparative study between the use of tubular drains in closed suction system and the use of progressive tension sutures in patients with large incisional hernias, undergoing hernia repair with onlay positioned mesh, in order to evaluate the post operative seromas and wound infection as endpoints. Methods: From May to December 2012, forty two patients with incisional hernias (5 -15 cm length) underwent surgical repair with onlay placement of mesh as described by Chevrel, at Western Parana University Hospital. After mesh placement, patients were electronically randomized in two groups. In group I, closed suction subcutaneous drains were used in the patients. In group II, progressive tension stitches were used, as described by Pollock. Patients were clinically evaluated regarding seromas and wound infection during the first 30 days after surgery. Ultrasound of abdominal wall was used in the following periods: 4 -6 postoperative days (early period), 14 – 15 postoperative days (intermediary period) and 29 – 30 postoperative days (late period) to evaluate seroma formation. Results: Both groups were similar in regard to gender, age, body mass index, smoking, cardiologic risk factors, serum albumin levels, hernia size, subcutaneous thickness, hernia defect area, surgical time and seroma incidence in the early, intermediary or late periods. The highest incidence of seromas detected by ultrasound was in the intermediary period (52.4%), although 33.4% were clinically detectable. There was no statistical difference among incidences of seroma in non period between the studied groups. Wound infection rate in nine patients was 21.4%. There was no statistical difference in wound infection between the studied groups. The results of univariate tests have shown that the presence of infection on the 30th postoperative day was not associated to the use of drain or progressive tension sutures. Conclusion: There was no significant difference in incidence of seromas, either detected clinically or by ultrasound, as well as in wound infection incidence between the groups using closed suction subcutaneous drains or progressive tension sutures, in patients undergoing large incisional hernia repair using onlay technique.
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Evaluation of the prevalence and risk factors for colonization by vancomycin-resistant Enterococcus among patients on dialysis
(Elsevier B.V., 2004-08-01) Barbosa, D.; Lima, L.; Silbert, S.; Sader, H.; Cendoroglo, M.; Draibe, S.; Camargo, L.; Vianna, L.; Belasco, A.; Sesso, R.; Universidade Federal de São Paulo (UNIFESP)
Background Vancomycin-resistant Enterococcus (VRE) has been reported among long-term dialysis patients, although risk factors for VRE colonization are not well defined. This study alms to appraise the prevalence and risk factors for VRE colonization among patients on long-term dialysis therapy, as well as the mechanisms for dissemination of vancomycin resistance. Methods: This is a cross-sectional survey of 320 patients on long-term dialysis therapy at 2 hospitals of the Federal University of São Paulo from June 2001 to March 2003. Fecal samples were collected from each patient once a week for 1 month. Samples with positive test results for VRE were submitted to molecular typing through automated ribotyping. Results VRE prevalence was 14.4%. There were significant associations between VRE and dialysis type (hemodialysis, P = 0.04), number of hospitalizations (P = 0.03), low hemoglobin level (P = 0.03), and leukocytosis (P = 0.05). Among samples with VRE (n = 56), 25% were Enterococcus faecium; 10.7%, Enterococcus casseliflavus; 57.1%, Enterococcus grallinarum; and 3.6%, Enterococcus faecalis. All samples isolated were sensitive to telcoplanin, except for E faecium samples, which were strongly resistant, although 9 of 14 patients with this isolate presented the same ribogroup (111-S-4). Typing of 6 samples from 8 dialysis patients with Egallinarum was performed, showing a predominant ribogroup (112-S-4). Conclusion: Hospital environment, hemodialysis, anemia, and leukocytosis appear to be associated with VRE colonization. These results suggest that dissemination of these bacteria among patients on long-term dialysis therapy may be taking place.
Acesso aberto (Open Access)
Extracellular enolase of Candida albicans is involved in colonization of mammalian intestinal epithelium
(Frontiers Research Foundation, 2014-06-01) Silva, Richard C. [UNIFESP]; Padovan, Ana Carolina Barbosa [UNIFESP]; Pimenta, Daniel C.; Ferreira, Renata Carmona [UNIFESP]; Silva, Claudio Vieira da [UNIFESP]; Briones, Marcelo Ribeiro da Silva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Inst Butantan; Universidade Federal de Uberlândia (UFU)
Enolase is secreted by Candida albicans and is present in its biofilms although its extracellular function is unknown. Here we show that extracellular enolase mediates the colonization of small intestine mucosa by C. albicans. Assays using intestinal mucosa disks show that C. albicans adhesion is inhibited, in a dose dependent mode, either by pretreatment of intestinal epithelium mucosa disks with recombinant C. albicans enolase (70% at 0.5 mg/ml enolase) or by pretreatment of C. albicans yeasts with anti-enolase antibodies (48% with 20 mu g antiserum). Also using flow cytometry, immunoblots of conditioned media and confocal microscopy we demonstrate that enolase is present in biofilms and that the extracellular enolase is not an artifact due to cell lysis, but must represent functional secretion of a stable form. This is the first direct evidence that C. albicans' extracellular enolase mediates colonization on its primary translocation site. Also, because enolase is encoded by a single locus in C. albicans, its dual role peptide, as glycolytic enzyme and extracellular peptide, is a remarkable example of gene sharing in fungi.
Acesso aberto (Open Access)
Health and economic outcomes of the detection of Klebsiella pneumoniae-produced extended-spectrum beta-lactamase (ESBL) in a hospital with high prevalence of this infection
(Elsevier B.V., 2006-01-01) Marra, Alexandre Rodrigues; Castelo Filho, Adauto [UNIFESP]; Carmo Filho, José Rodrigues do; Cal, Ruy Guilherme Rodrigues [UNIFESP]; Sader, Helio Silva [UNIFESP]; Wey, Sergio Barsanti [UNIFESP]; Pereira, Carlos Alberto Pires [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Introduction: Klebsiella pneumoniae is of high prevalence in hospital infections, mainly in bloodstream infections (BSI), and some produce extended-spectrum beta-lactamase (ESBL). for hospitals with a high prevalence of strains producing this enzyme, there is no reference material to show whether the use of the E-test method for their detection, which can be quite expensive, is actually required.Objective: To evaluate the cost-benefit of the disk diffusion and E-test methods for the detection of ESBL-producing K. pneumoniae strains in hospitals where a high prevalence of this resistance mechanism in BSI is found.Methods: One hundred and eight patients with K. pneumoniae BSI were evaluated retrospectively. ESBL-producing strains were identified by the disk diffusion method and by the E-test method. We estimated the costs of both diagnostic methods based on antimicrobial therapy adequacy.Results: Fifty-two percent of K. pneumoniae infections were due to ESBL-producing strains. the disk diffusion method yielded a positive predictive value (PPV) of 94.7% (95% Cl: 88.9-100%) and a negative predictive value (NPV) of 96.1% (CI 95%: 90.8-101.4%) in relation to the E-test. We evaluated cost-effectiveness, i.e., we analyzed the cost of both E-test and disk diffusion methods with carbapenem and cephalosporins, and found that the use of the disk diffusion method accounts for approximately US$3300.Conclusions: in hospitals with a high prevalence of ESBL-producing strains, the disk diffusion method can be used to detect ESBL-producing K. pneumoniae without compromising the clinical progression of patients with BSI. the E-test showed higher accuracy but this method was more expensive than the disk diffusion method. However, the use of the E-test method was demonstrated to be more cost-effective, as we evaluated cost based on antimicrobial therapy adequacy. (C) 2005 International Society for Infectious Diseases. Published by Elsevier B.V. All rights reserved.
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Immune function, as assessed by the ImmuKnow (R) assay, correlates with clinical outcomes in transplant recipients
(Nature Publishing Group, 2007-04-01) Pacheco-Silva, Alvaro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hosp Israelita Albert Einstein
Acesso aberto (Open Access)
Incidência e fatores de risco para complicações infecciosas no primeiro ano após o transplante renal
(Sociedade Brasileira de Nefrologia, 2010-03-01) Sousa, Sirlei Regina de [UNIFESP]; Galante, Nelson Zocoler [UNIFESP]; Barbosa, Dulce Aparecida [UNIFESP]; Pestana, Jose Osmar Medina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
INTRODUCTION: Infectious complications significantly increase morbidity and mortality after renal transplantation. The immunosuppression used is the main risk factor and relates directly to the incidence and severity of infectious events. METHODS: This is a retrospective cohort study, which assessed the incidence of infections and their risk factors among 1,676 kidney transplant recipients during the first year of follow-up. RESULTS: Infectious events were observed in 821 (49%) patients. The mean number of infectious episodes among patients with at least one episode was 2.3 (1 -12). The most prevalent infectious complications were as follows: urinary tract infection (31.3%); cytomegalovirus infection (12%); surgical wound infection (10.3%); herpes virus infection (9.1%); pulmonary infection (5.2%); and bloodstream infection (4.3%). Cold ischemia time and the use of deceased donor grafts were important risk factors for infectious episodes. CONCLUSIONS: Infections are highly prevalent in the first year following transplantation. The main infectious complication was urinary tract infection.
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Infectious post-LASIK crystalline keratopathy caused by nontuberculous mycobacteria
(Lippincott Williams & Wilkins, 2002-05-01) Alvarenga, L.; Freitas, D.; Hofling-Lima, A. L.; Belfort, R.; Sampaio, J.; Sousa, L.; Yu, M.; Mannis, M.; Universidade Federal de São Paulo (UNIFESP); Univ Calif Davis
Purpose. To report three cases of infectious crystalline keratopathy caused by non-tuberculous mycobacteria after LASIK surgery, Methods. Interventional case reports and literature review. Results. Infectious keratitis with clinical features of crystalline keratopathy after LASIK is described. Culture revealed Mycobacterium chelonae from the corneal scrapings of the three patients, all of whom underwent medical and surgical (debridement) treatment. Conclusions. Mycobacteria may cause infectious crystalline keratopathy after LASIK. the presence of crystalline keratopathy in patients that underwent LASIK must be considered in indicator of nontuberculous mycobacteria infection. Microbiologic work-up of a corneal specimen is required for the institution of appropriate therapy.
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Influence of TNF-alpha blockers on the oral prevalence of opportunistic microorganisms in ankylosing spondylitis patients
(Clinical & Exper Rheumatology, 2012-09-01) Pereira, D. F. A.; Pinheiro, Marcelo de Medeiros [UNIFESP]; Silva, P. N. F.; Teodoro, G. R.; Brighenti, F. L.; Koga-Ito, C. Y.; Univ Estadual Paulista; Universidade Federal de São Paulo (UNIFESP)
ObjectivesTo compare the oral prevalence and antimicrobial susceptibility of candida spp. staphylococci, enterobacteriaceae, and pseudomonas spp. from ankylosing spondylitis (AS) patients receiving conventional and anti-TNF-alpha therapy.MethodsThe study included 70 AS patients, diagnosed according to the modified New York criteria (1984). The volunteers were divided into 2 groups: a biological group (AS BioG) (n=35) (on anti-TNF-a therapy) and a conventional group (AS ConvG) (n=35). The control group (ContG) (n=70) was made up of healthy individuals matched for age, gender, and oral conditions. After clinical examination, oral rinse samples were collected and plated in specific culture media. The number of colony-forming units per milliliter (cfu/ml) was obtained, and isolates were identified using the API system. Antimicrobial susceptibility tests were performed according to the NCCLS guidelines. Prevalence and counts of microorganisms were statistically compared between the 3 groups, using the Mann-Whitney and Chi-square tests. Significance level was set at 5%.ResultsIn both the AS BioG and the AS ConvG, staphylococci counts were higher than that in the ContG (p<0.0001).Candida albicans and staphylococcus epidermidis were the most commonly found species in all the groups. Serratia marcescens and klebsiella oxytoca were more prevalent in the AS BioG and the AS ConvG, respectively. Two candida isolates (2.8%) from the AS BioG and 5 (10.8%) from the AS ConvG were resistant to amphotericin B and 5-fluorocytosine. A low percentage of staphylococci isolates was resistant to amoxicillin, ciprofloxacin, and doxycycline.ConclusionHigher counts of staphylococci were observed in both AS groups, regardless of the current therapy, age, sex, and oral conditions. Anti-TNF-alpha therapy could not be correlated with increased counts of microorganisms.
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Late-onset Bloodstream Infections in Hospitalized Term Infants
(Lippincott Williams & Wilkins, 2014-09-01) Testoni, Daniela [UNIFESP]; Hayashi, Madoka; Cohen-Wolkowiez, Michael; Benjamin, Daniel K.; Lopes, Renato D.; Clark, Reese H.; Smith, P. Brian; Duke Clin Res Inst; Universidade Federal de São Paulo (UNIFESP); Duke Univ; Pediat Obstet Ctr Res & Educ; Clemson Univ
Background: the epidemiology and incidence of late-onset blood stream infections (BSIs) in premature infants have been described, but studies describing late-onset BSI in term infants are sparse. We sought to describe the pathogens, incidence, risk factors and mortality of late-onset BSI in hospitalized term infants.Methods: A cohort study was conducted of infants >= 37 weeks gestational age and <= 120 days of age discharged from Pediatrix Medical Group neonatal intensive care units from 1997 to 2010. We examined all cultures obtained from day of life 4-120 and used multivariable regression to assess risk factors for late-onset BSI.Results: We found a total of 206,019 infants cared for between day of life 4 and 120, and the incidence of late-onset BSI was 2.7/1000 admissions. We identified Gram-positive organisms in 64% of the cultures and -Gram-negative organisms in 26%. We found a decreased risk of late-onset BSI in infants with the following characteristics: small for gestational age, delivery by Cesarean, antenatal antibiotic use and discharged in the later years of the study. Late-onset BSI increased the risk of death after controlling for confounders [odds ratio 8.43 (95% confidence interval 4.42-16.07)].Conclusion: Our data highlight the importance of late-onset BSI in hospitalized term infants. We identified Gram-positive organisms as the most common pathogen, and late-onset BSI was an independent risk factor for death.
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Late-Onset Sepsis in very Low Birth Weight Infants: A Brazilian Neonatal Research Network Study
(Oxford Univ Press, 2014-12-01) Suppo de Souza Rugolo, Ligia Maria; Bentlin, Maria Regina; Mussi-Pinhata, Marisa; Branco de Almeida, Maria Fernanda [UNIFESP]; Andrade Lopes, Jose Maria de; Martins Marba, Sergio Tadeu; Fiori, Humberto Holmer; Procianoy, Renato Soibelmann; Leone, Clea Rodrigues; Brazilian Network Neonatal Res; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Fundacao Oswaldo Cruz; Pontificia Univ Catolica Rio Grande do Sul; Univ Fed Rio Grande do Sul
Background: Late-onset sepsis (LOS) is an important cause of morbidity and mortality in very low birth weight (VLBW) infants.Aim: To determine the incidence, risk factors and etiology of LOS.Methods: LOS was investigated in a multicenter prospective cohort of infants at eight public university neonatal intensive care units (NICUs). Inclusion criteria included inborn, 23-33 weeks of gestational age, 400-1499 g birth weight, who survived >3 days.Results: of 1507 infants, 357 (24%) had proven LOS and 345 (23%) had clinical LOS. Infants with LOS were more likely to die. the majority of infections (76%) were caused by Gram-positive organisms. Independent risk factors for proven LOS were use of central venous catheter and mechanical ventilation, age at the first feeding and number of days on parenteral nutrition and on mechanical ventilation.Conclusion: LOS incidence and mortality are high in Brazilian VLBW infants. Most risk factors are associated with routine practices at NICU.
Acesso aberto (Open Access)
Magnetic bead technology for viral RNA extraction from serum in blood bank screening
(Brazilian Society of Infectious Diseases, 2011-12-01) Albertoni, Guilherme Ambrozio [UNIFESP]; Arnoni, Carine Prisco; Araujo, Patricia Regina Barboza; Andrade, Sheila Siqueira [UNIFESP]; Carvalho, Fabrício Oliveira; Girão, Manoel João Batista Castello [UNIFESP]; Schor, Nestor [UNIFESP]; Barreto, José Augusto; Associação Beneficente de Coleta de Sangue; Universidade Federal de São Paulo (UNIFESP)
Nucleic acid amplification testing (NAT) was recently recommended by Brazilian legislation and has been implemented at some blood banks in the city of São Paulo, Brazil, in an attempt to reduce blood-born transmission of human immunodeficiency virus (HIV) and hepatitis C virus. OBJECTIVE: Manual magnetic particle-based extraction methods for HIV and HCV viral nucleic acids were evaluated in combination with detection by reverse transcriptase - polymerase chain reaction (RT-PCR) one-step. METHODS: Blood donor samples were collected from January 2010 to September 2010, and minipools of them were submitted to testing. ELISA was used for the analysis of anti-HCV/HIV antibodies. Detection and amplification of viral RNA was performed using real-time PCR. RESULTS: Out of 20.808 samples screened, 53 samples (29 for HCV and 24 for HIV) were confirmed as positive by serological and NAT methods. CONCLUSION: The manual magnetic bead-based extraction in combination with real-time PCR detection can be used to routinely screen blood donation for viremic donors to further increase the safety of blood products.
Acesso aberto (Open Access)
Medidas gerais no tratamento das doenças falciformes
(Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular, 2007-09-01) Braga, Josefina Aparecida Pellegrini [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
This article presents the most important measures in the care of patients with sickle cell disease, which is characterized by a high morbimortality rate. Effective preventive measures including newborn screening, education of patients and caregivers, nutrition support, protective vaccinations and prophylaxis using penicillin to prevent pneumococcal, contribute to a decrease in the morbimortality as well as to improve the quality of life of these patients.
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Molecular profiling improves diagnoses of rejection and infection in transplanted organs
(Lippincott Williams & Wilkins, 2006-06-23) Morgun, A.; Shulzhenko, N.; Perez-Diez, A.; Diniz, Rosiane Viana Zuza [UNIFESP]; Sanson, G. F.; Almeida, Dirceu Rodrigues de [UNIFESP]; Matzinger, P.; Gerbase-DeLima, Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); NIAID
The monitoring of transplanted hearts is currently based on histological evaluation of endomyocardial biopsies, a method that is fairly insensitive and that does not always accurately discriminate between rejection and infection in the heart. Accurate diagnosis of rejection and infection is absolutely crucial, however, as the respective treatments are completely different. Using microarrays, we analyzed gene expression in 76 cardiac biopsies from 40 heart recipients undergoing rejection, no rejection, or Trypanosoma cruzi infection. We found a set of genes whose expression patterns were typical of acute rejection, and another set of genes that discriminated between rejection and T cruzi infection. These sets revealed acute rejection episodes up to 2 weeks earlier, and trypanosome infection up to 2 months earlier than did histological evaluation. When applied to raw data from other institutions, the 2 sets of predictive genes were also able to accurately pinpoint acute rejection of lung and kidney transplants, as well as bacterial infections in kidneys. in addition to their usefulness as diagnostic tools, the data suggest that there are similarities in the biology of the processes involved in rejection of different grafts and also in the tissue responses to pathogens as diverse as bacteria and protozoa.
Acesso aberto (Open Access)
Non-coding RNAs in Host-Pathogen Interactions: Subversion of Mammalian Cell Functions by Protozoan Parasites
(Frontiers Media Sa, 2017) Bayer-Santos, Ethel; Marini, Marjorie M. [UNIFESP]; da Silveira, Jose F. [UNIFESP]
Pathogens have evolved mechanisms to modulate host cell functions and avoid recognition and destruction by the host damage response. For many years, researchers have focused on proteins as the main effectors used by pathogens to hijack host cell pathways, but only recently with the development of deep RNA sequencing these molecules were brought to light as key players in infectious diseases. Protozoan parasites such as those from the genera Plasmodium, Toxoplasma, Leishmania, and Trypanosoma cause life-threatening diseases and are responsible for 1000s of deaths worldwide every year. Some of these parasites replicate intracellularly when infecting mammalian hosts, whereas others can survive and replicate extracellularly in the bloodstream. Each of these parasites uses specific evasion mechanisms to avoid being killed by the host defense system. An increasing number of studies have shown that these pathogens can transfer non-coding RNA molecules to the host cells to modulate their functions. This transference usually happens via extracellular vesicles, which are small membrane vesicles secreted by the microorganism. In this mini-review we will combine published work regarding several protozoan parasites that were shown to use non-coding RNAs in inter-kingdom communication and briefly discuss future perspectives in the field.
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Paracoccidioides brasiliensis infection in domestic rabbits (Oryctolagus cuniculus)
(Wiley-Blackwell, 2014-04-01) Belitardo, Donizeti Rodrigues; Calefi, Atilio Sersun; Sbeghen, Monica Raquel; Oliveira, Gabriela Goncalves de; Ehara Watanabe, Maria Angelica; Camargo, Zoilo Pires de [UNIFESP]; Ono, Mario Augusto; Universidade Estadual de Londrina (UEL); Universidade Federal de São Paulo (UNIFESP)
The objective of this study was to evaluate the infection of domestic rabbits by Paracoccidioides brasiliensis. Initially two rabbits were experimentally infected with P. brasiliensis and the humoral immune response was evaluated by ELISA using gp43 as antigen. the two animals showed IgG response against gp43 although no signs of disease were observed. the seroepidemiological study was carried out in 170 rabbits (free range n=81 and caged n=89) living in an endemic area for human paracoccidioidomycosis and a positivity of 27% was observed in the ELISA using gp43 as antigen. the free-range rabbits showed a significantly higher positivity (34.6-51.7%) than the caged animals (11.1%). Sentinel rabbits exposed to natural infection with P. brasiliensis were followed up for 6months and a seroconversion rate of 83.3% was observed. This is the first report of paracoccidioidomycosis in rabbits and suggests that this species can be useful sentinels for P. brasiliensis presence in the environment.

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