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R Duarte

Publications and source records attributed to R Duarte.

44 records · Page 3Linked to original sources
PubMedDate not supplied

[Standardization of enzyme-linked immunosorbent assay ELISA to detect anti-Toxoplasma gondii IgM and IgG antibodies, and comparison with the indirect immunofluorescence technique].

Serology has been the most popular method to diagnose toxoplasmosis. Accordingly, this study standardizes an enzyme-linked immunosorbent assay (ELISA) and compares its results with the IFI technique. In the IgG detection test, the standardized technique presented a sensibility (S) of 96.77%, a specificity (SP) of 75%, with a positive predictive value (PPV) of 83.33%, a negative predictive value (NPV) of 94.74%, and an adjusted concordance (K) of 73.50%. The IFI exhibited 83.87% for S, 79.16% for SP, 83.81% for PPV, 79. 16% for NPV, and 63% for K. The rough concordance between these two tests (ELISA/IFI) was 88.35% for the IgG detection test and 81.55% for the IgM detection test. K was 70.82% and 1.31% for IgG and IgM, respectively, the correlation index (r) being 0.556 for IgG and -0. 023 for IgM. We can conclude that standardized ELISA-IgG is indicated in serologic selection processes, whereas the ELISA-IgM is not recommended for presenting low values for the adjusted concordance with the reference technique, which suggests not very reliable results.

Animals↗
PubMedDate not supplied

[Intestinal necrosis in children].

The term intestinal necrosis is nothing but a clinical and pathological concept and always includes intestinal ischemia, whether or not occlusive. In a broad sense, necrotizing enterocolitis involves intestinal ischemia associated to an infectious entity. The precipitating factor for necrosis is very often difficult to identify. Necrotizing enterocolitis occurs in 90% of cases in premature neonates and is less frequent amongst other neonates, being rare in older children and adults. The authors present two clinical cases: one 7 year-old with a history of chronic neutropenia and an eleven-year old with severe cognitive impairment, dysmorphic features and behavioural disturbances. They were both admitted to hospital due to an acute abdominal condition and shock. The necrosis implied the resection of a jejunal segment in one of the cases, and a subtotal colonic resection in the other. Despite the surgery and medical support therapy, they both died due to multiple system organ failure--3 hours and fourteen days after surgery, respectively. In the second case, death occurred subsequent to a second surgery for resection of a segment of necrotic ileum. Necropsy showed an extensive necrosis of the remaining intestine in both cases. These two cases evolved as necrotizing enterocolitis of the child. In one of the cases it was possible to establish the exclusion diagnosis of neutropenic enterocolitis. The etiopathogenic mechanisms are reviewed, including thrombotic, obstructive (both extrinsic and endoluminal), inflammatory, non-occlusive ischemic and infectious. The authors stress the general therapeutic measures, the relevance of early surgical intervention and the use of subsidiary diagnostic/therapeutic technologies, such as serum and urine title of intestinal fatty acid binding protein or selective arteriography.

Child↗
PubMedDate not supplied

[Serological and epidemiological features of canine American tegumentary Leishmaniasis from Maricá, Rio de Janeiro, Brazil].

A sample of 261 dogs from 134 households located in a periurban area of Maricá, Rio de Janeiro, Brazil, was studied to evaluate serologic reactions and active infection of american tegumentary leishmaniasis (ATL). Eight dogs presented lesions suggestive of ATL, but this was isolated in only three. Using ELISA, 24.5% (64/261) of the dogs studied were positive (sensitivity = 66% and specificity = 76%), associated with isolation in 2 animals and 0.4% (1/261) by indirect immunofluorescence assay (IIF) with no association with isolation. In order to reduce the unspecific reactions to ELISA, a second criterion was used to obtain the cutoff (sensitivity = 33% and specificity = 93%), resulting in a reactivity of 6.9 % (18/261) associated to isolation in a single animal. As observed in this study, serologic results by IIF were not associated with active infection and ELISA showed high unspecific reactions, indicating that the serologic reactions alone are not recommended for ATL diagnosis. ATL scars were been observed in 7 persons in the region and active lesion, under treatment, was observed in one patient. The finding of active lesions, either in dogs or humans, confirmed the existence of active tegumentary leishmaniasis in Maricá, indicating the need for further studies to evaluate the importance of this infection in the municipality.

Animals↗
PubMedDate not supplied

[Electrical burns in children. 3 years of case histories].

The Burn Unit of Dona Estefânia Hospital admitted a total of 454 patients from January 1992 to January 1995, 24 of these patients suffered from electric shock. Of these 24 patients 3 suffered burns in the mouth, 15 in one or both hands and 6 multiple burns. In 19 patients the burns were up to 1%. A description is made of 5 cases, male children between the ages of 9 and 13 years, which were deemed severe. The incidents occurred outdoors with different voltages and in activities considered of ludic or experimental nature: two on the roof of a house, two with railway cables and one with an electrical cable in a port zone. The burnt areas vary between 4% and 70%, all of them 2nd and 3rd degree, with hospitalization lasting from 36 to 116 days. In addition to early and coordinated medical and rehabilitative treatment, according to individual needs, a description is also made of the cutaneous sequelae (deforming cicatrices, bridles), neurologic and psychologic sequelae, with emphasis on a patient who underwent amputation of the lower left leg and 4th and 5th ranges of the right foot. It was concluded that measures should be taken in education and legislation to prevent these accidents. Relevance is given to the need for a multidisciplinary team and specialized center for the treatment of these patients.

Adolescent↗
PubMedDate not supplied

[The prevention of insulin-dependent diabetes mellitus].

At the present time, there are markers which we can use to identify individuals with a high susceptibility of developing insulin-dependent diabetes mellitus (IDDM) years before the onset of the disease. Insulin-dependent diabetes mellitus is an autoimmune disease strongly associated with HLA antigens DR3 and DR4. In this manuscript, we discuss the usefulness of several markers, such as islet cell antibodies, insulin autoantibodies and glutamic acid decarboxylase antibodies, to identify individuals with a high susceptibility to IDDM before the disease is clinically evident. Monitoring first phase insulin release during intravenous glucose administration is a useful index of residual beta cell function that can be used to detect individuals who are close to insulin dependence. Several drugs have been used to prevent the development of IDDM. These include immunodepressors, anti-inflammatory agents, non-specific immunomodulators and free radical scavengers. Due to their toxicity, studies employing aziothioprine and cyclosporin were discontinued. Other agents, such as tetrandrin and lymphotoxin, are now restricted to non-human trials. Currently, two large-scale multicentric human trials, one in Europe using nicotinamide (European Nicotinamide Diabetes Intervention Trial, ENDIT) and the other in the USA using insulin (Diabetes Prevention Trial), are now in full activity and will test the benefits of these drugs in the prophylaxis of IDDM in highly susceptible individuals.

Animals↗