Silvia Fernandes Ribeiro da Silva

Determination of urinary stone composition based on stone morphology: a prospective study of 325 consecutive patients in an emerging country.

Abstract Background: Urolithiasis is a common disease that is increasing throughout the world. This study aimed at determining the composition of urinary stones in patients with renal lithiasis in an emerging country. Methods: A morphological analysis was performed on 340 urinary stones from 325 consecutive patients from Brazil with lithiasis. Results and conclusions: Among the 340 stones analyzed, 34.7% were pure. The most frequent stone was calcium oxalate (CaOx) (59.3%), followed by uric acid (23.7%). CaOx was more frequently seen in women (p=0.024), while uric acid was more common in men (p<0.001). Among the mixed stones, CaOx (67.1%) was the most frequent major component, followed by carbapatite (11.2%) and struvite (7.9%). CaOx (p<0.001) and uric acid (p=0.014) were more frequently the major components in men, while carbapatite (p<0.001) and struvite (p=0.011) were more frequent in women. The major component of both pure and mixed stones was CaOx (65.1%), followed by uric acid (10.9%), carbapatite (10%), struvite (6.7%), ammonium urate (5.1%), cystine (1.8%) and protein (0.4%). These findings may be related to regional factors, such as weather and nutritional habits. Clin Chem Lab Med 2009;47:561–4.

O oleo essencial de Lippia gracilis Schauer, Verbenaceae, em ratos diabeticos

The essential oil from Lippia gracilis Schauer (Verbenaceae) leaves was examined by GC and GC-MS. Fifteen constituents were identified. Carvacrol, p-cymene and γ-terpinene were found to be the major components. In the in vitro study, 5% solution of the Lippia gracilis Schauer oil presented antibacterial activity against Staphylococcus aureus isolated from diabetic patients with infected ulcers. The study evaluated the antibacterial activity of the 5% solution of the Lippia gracilis Schauer oil on the experimental model of diabetic adult male albino Wistar rats with leaft pelvic limb infected by Staphylococcus aureus strain. In this experiment, 28 diabetic Wistar rats were used, randomly distributed in four different groups of seven rats, (G1-white; G2-negative control; G3-positive control and G4-test). When comparing group G4 with G3, it was observed that the 5% solution presented a reduced CFU/mL level showing the antibacterial effect of the oil 24 hours after the administration of the inoculum (S .aureus without Lippia gracilis Schauer 108 ±313 versus S.aureus with Lippia gracilis Schauer 13.28±4.03). The results were expressed as mean±S.E.M. One-way analysis of the variance (ANOVA) was used. The differences between the minimum inhibitory concentration in vitro test were determined by the Tukey test (p<0.05). The Newman-Keuls test with level of significance (p<0.05) was used to measure the results in vivo. The findings have shown that 5% solution of the Lippia gracilis Schauer oil presented antibacterial activity in vitro and in vivo.

Growth inhibition of Walker carcinosarcoma 256 with alcoholic extract of green tea leaves (Camellia sinensis)

PURPOSE To evaluate the antitumor activity of alcoholic extracts of green tea (Camella sinensis). METHODS Four groups of six Wistar rats were inoculated intramuscularly with 10(6) Walker tumor cells/mL. During 10 days, the animals received by gavage either 0.9% saline solution (Group I; negative control), solution containing 20 mg/Kg of tamoxifen (Group II; positive control), solution containing 0.07 g/Kg alcoholic extract of C. sinensis (Group III), or solution containing 0.14 g/Kg alcoholic extract of C. sinensis (Group IV). Following euthanasia on the tenth day, the tumor, liver, kidneys and spleen were excised and weighed, and tumor volume and tumor growth inhibition were quantified. RESULTS The average weight of the animals was greater in Group IV than in Group II (p=0.0107). Tumor weight was smaller in Group IV than in Group I (p=0.0062), but did not differ from Group II. Tumor volume was smaller in Groups II and IV than in Group I (p=0.0131). Tumor growth inhibition was observed in Groups II (44.67% ± 32.47), III (16.83% ± 53.02) and IV (66.4% ± 25.82) (p>0.05). The groups did not differ with regard to the weight of the excised organs. CONCLUSION Alcoholic extracts of green tea have antitumor activity.

Aloimunidade contra antígenos HLA de classe I em pacientes com síndromes mielodisplásicas e anemia aplástica

As sindromes mielodisplasicas (SMD) e a anemia aplastica (AA) apresentam citopenias perifericas necessitando, com frequencia, de reposicoes transfusionais continuas de concentrados de hemacias e/ou de concentrados de plaquetas. O objetivo do presente estudo foi verificar a ocorrencia de anticorpos anti-HLA de classe I em pacientes portadores das SMD e AA atendidos no ambulatorio de Hematologia do Hemoce/UFC. Foram analisados 110 pacientes, sendo 70 com SMD e 40 com AA. A pesquisa de anticorpos anti-HLA de classe I foi realizada frente a um painel (PRA), utilizando-se a tecnica de microlinfocitotoxicidade dependente do complemento. Vinte (28,6%) dos 70 pacientes com as SMD e 18 (45%) dos 40 pacientes com AA desenvolveram anticorpos anti-HLA contra o PRA. Esses pacientes que receberam uma carga de antigenos estranhos advindos de multiplas transfusoes de varios doadores de CH e/ou CP, geralmente desenvolvem aloanticorpos contra os antigenos HLA presentes na superficie das plaquetas e dos leucocitos que contaminam esses concentrados. A producao desses anticorpos pode trazer serias complicacoes para o tratamento dos pacientes com SMD e AA. As avaliacoes sistematicas para deteccao de anticorpos anti-HLA apos a reposicao transfusional podem ser valiosas para adocao de estrategias transfusionais mais adequadas para esta populacao de pacientes.

Composition of kidney stone fragments obtained after extracorporeal shock wave lithotripsy.

Background: The objective of this study was to determine the composition of kidney stone fragments obtained after extracorporeal shock wave lithotripsy (ESWL). Methods: Kidney stone fragments from 25 patients with urolithiasis treated with ESWL were submitted for morphological analysis. The composition was determined for all the recovered fragments. Results: Thirteen patients (52%) had pure stones. The most common type of pure stone was calcium oxalate (61.6%), of which half was the monohydrate type (COM) and half was the dihydrate type (COD). The other pure stones consisted of either uric acid (30.8%) or struvite (7.6%). For mixed stones, the most frequently observed component was COM or COD (50%), followed by a mixture of COD and carbapatite (25.1%). Conclusions: Our findings indicate that the composition of kidney stone fragments recovered after ESWL can be determined. Knowledge of stone composition is fundamental to understand the etiology of lithogenesis.BACKGROUND The objective of this study was to determine the composition of kidney stone fragments obtained after extracorporeal shock wave lithotripsy (ESWL). METHODS Kidney stone fragments from 25 patients with urolithiasis treated with ESWL were submitted for morphological analysis. The composition was determined for all the recovered fragments. RESULTS Thirteen patients (52%) had pure stones. The most common type of pure stone was calcium oxalate (61.6%), of which half was the monohydrate type (COM) and half was the dihydrate type (COD). The other pure stones consisted of either uric acid (30.8%) or struvite (7.6%). For mixed stones, the most frequently observed component was COM or COD (50%), followed by a mixture of COD and carbapatite (25.1%). CONCLUSIONS Our findings indicate that the composition of kidney stone fragments recovered after ESWL can be determined. Knowledge of stone composition is fundamental to understand the etiology of lithogenesis.

Interleukin-10 gene polymorphism (-1082G/A) and allergy to efavirenz in patients infected with human immunodeficiency virus

The aim of the present study was to investigate the association between polymorphism in the interleukin-10 gene promoter at position -1082 in human immunodeficiency virus-infected patients who had presented allergic reaction due to efavirenz. The study included 63 patients treated at the Hospital São José de Doenças Infecciosas, Fortaleza, Ceará, Brazil. Twenty-one patients who had presented allergic reaction to efavirenz were compared to 42 patients with no allergic reaction following exposure to this drug. Blood samples were collected for DNA extraction and submitted to the restriction fragment length polymorphism - polymerase chain reaction technique. The -1082AA genotype was significantly more frequent in allergic patients as compared to non-allergic patients (p=0.019; χ(2)=5.534; OR=3.625; 95% CI=1.210-10.860). Likewise the allele IL-10 -1082A was identified significantly more often among efavirenz allergic patients than in the non-allergic group (p=0.009; χ(2)=6.787; OR=3.029; 95% CI=1.290-7.111). These findings suggest that the polymorphism in the interleukin-10 gene promoter -1082G/A can be related to the development of allergic reactions to efavirenz.

Um novo modelo de isolamento do tumor de Walker utilizando o gradiente de Ficoll-Hypaque

PURPOSE The purpose was to evaluate a novel technique for isolation of Walkers tumoral cells using a Ficoll-Hypaque gradient and its further influence on tumor development. METHODS Twenty male Wistar rats have been divided in 2 groups: G1= without ficoll, G2= with ficoll. Tumor was excised, homogenized and suspended in lactate ringer. A sample of the cell suspension was adjusted at a concentration of 1x10(6) cells/ml (G1). A second sample was centrifuged on a Ficoll-Hypaque gradient and the cell concentration was then adjusted (G2). Tumor was implanted by subcutaneous injection of 1.0 ml in the right armpit of rats. Tumor volume (TV) and tumor weight (TW) were compared in two groups. RESULTS There were no differences between the two groups in TV (G1=17.9+/-3.8 cm3 vs. G2=17.2+/-4.4 cm3; p=0.190) and TW (G1=7.0+/-1.8 g vs. G2=7.3+/-2.8 g; p=0.569). The histological analysis showed similar patterns of infiltration by small-undifferentiated cells and necrosis in both groups. However, a mild to moderate granulocytic exudate was more frequent in the animals whose tumors derived from Ficoll-isolated cells. Hemorrhage from slight to moderate was only observed in this group. CONCLUSION A Ficoll-Hypaque gradient can provide more adequate isolation of Walkers tumor and the cell suspension obtained by this technique has lower contamination by other cell types.

CD38+CD8+ and CD38+CD4+ T Cells and IFN Gamma (+874) Polymorphism Are Associated with a Poor Virological Outcome.

ABSTRACT The main objective of the work was to evaluate the use of CD38 on T lymphocytes, IFNγ (+874 A/T), and IL-10 (−1082 A/G) polymorphisms in HIV-infected patients under antiretroviral (ARV) therapy. Sixty-one patients were selected at the outpatient clinic for HIV infection at the Hospital São José de Doenças Infecciosas, Fortaleza, Ceará, Brazil. The patients were classified into two groups, according to viral load after one year of ARV therapy. In the aviremic group (group I), a reduction of 35.5% of CD38+CD4+ T cells was observed (p = 0.02) and 49.3% of CD38+CD8+ T cells (p = 0.001). In the viremic group (group II), a reduction of 37.2% of CD38+CD4+ T cells (p = 0.067), and 21.4% of CD38+CD8+ T cells (p = 0.60) occurred. No association was found between IL-10 (−1082) polymorphism and the type of response to ARV therapy. Regarding the gene polymorphism on IFNγ (+874 T/A), 73.34% of group I and 33.3% of group II presented the AA genotype. The relative risk of the individuals carrying AA genotype or the A allele and not being able to suppress the viral load level after one year of ARV therapy was 3.44 (1.25–9.45; p = 0.014) or 2.35 (1.05–5.26; p = 0.027), respectively. Our data suggested that an augmented frequency of activated CD38+CD8+ T cells as well as the presence of the A allele of IFNγ polymorphism could contribute to a reduced virological suppression in patients under antiretroviral therapy.

Evaluation of the anti-inflammatory and analgesic effects of green tea (Camellia sinensis) in mice

PURPOSE To evaluate the anti-inflammatory and analgesic effects of green tea (Camellia sinensis) in mice. METHODS The anti-inflammatory effect of alcoholic extracts of green tea (AE) was evaluated in a cell migration assay with four groups of six Swiss mice receiving 0.07 g/Kg or 0.14 g/Kg EA (treatment groups), saline (negative control) or 10mg/Kg indomethacin (positive control) by gavage. One hour later 300 µg carrageen an was administered intraperitoneally or subcutaneously. The analgesic effect was evaluated using four groups of six animals receiving 0.07 g/Kg or 0.14 g/Kg EA, saline or 10mg/Kg indomethacin subcutaneously, followed 30 minutes later by 1% acetic acid. RESULTS When administered subcutaneously at either dose (0.07 g/Kg and 0.14 g/Kg), AE inhibited carrageenan-induced cell migration (p<0.05). However, when administered by gavage, only the latter (0.14 g/Kg) was efficient (p<0.05). AE at both doses (0.07 g/Kg and 0.14 g/Kg) inhibited abdominal contortions (p<0.05), but the effect was not dose-dependent. CONCLUSION Green tea was shown to have analgesic and anti-inflammatory properties and may constitute a natural treatment option in chronic inflammatory disorders.

Red blood cell and leukocyte alloimmunization in patients awaiting kidney transplantation

Objective To determine the rates of red blood cell and leukocyte alloimmunization in patients with chronic kidney disease awaiting kidney transplantation. Methods In this cross-sectional and prospective study, the serum of 393 chronic kidney disease patients on a transplant waiting list in Ceará, Northeastern Brazil were tested for red cell and leukocyte antibodies. In addition, demographic, clinical and laboratory data were collected. Results The average age in the sample of 393 patients was 34.1 ± 14 years. Slightly more than half (208; 52.9%) were male. The average numbers of transfusions and gestations were 3.1 ± 3.3 and 1.6 ± 6, respectively. One third (33.6%) were alloimmunized: 78% with leukocyte antibodies, 9.1% with red cell antibodies and 12.9% with both. Red cell antibodies were detected in 29 cases (7.4%), 17 of whom were women, who had received more transfusions than the males (p-value < 0.0001). The most frequently detected red cell antibodies belonged to the Rh (24.1%) and Kell (13.8%) blood group systems. Leukocyte antibodies were detected in 30.5% of cases, 83 of whom were women, who had received more transfusions than the males (p-value < 0.0001) and were more reactive to panel reactive antibodies (p-value < 0.0001). The mean alloreactivity to panel reactive antibodies was 47.7 ± 31.2%. Conclusion Chronic kidney disease patients on the transplant waiting list in Ceará, Brazil, display high rates of red cell (7.4%) and leukocyte (30.5%) alloimmunization. In this sample, alloimmunization was significantly associated with the number of transfusions and gender.