Despite the high sensitivity and specificity of PCR for infectious disease diagnostics, it has presented low sensitivity for Mycobacterium leprae DNA detection in the tuberculoid pole (TT and BT) of leprosy. In order to demonstrate the effect of amplicon size on the efficacy of PCR detection of M. leprae DNA in skin lesions of leprosy patients, two pairs of primers targeting the M. leprae genomic DNA, RLEP3 (X17153), were used to amplify fragments of 372 and 130-bp until their PCR end-points were reached after 40 reaction cycles. Skin biopsies of leprosy lesions in 110 non-treated patients were used for bacilloscopy index (BI) analysis and PCR tests. The 130-bp fragment was detected in 73.6% of samples (81/110), and classified as TT (40%), BT (55.5%), and 100% of BB, BL and LL. The 372-bp fragment was detected in 52.7% and classified as TT (13.3%), BT (33.3%), BB (64.7%), BL (83.3%), and LL (95.2%). The BI of biopsies was positive in 39.1% of samples, classified as TT (0%), BT (2.2%), BB (64.7%), BL (91.6%), and LL (95.2%). The shorter amplicon (130-bp) has improved diagnosis by 20.9 and 34.5% in relation to the 372-bp fragment and the BI, respectively, and has shown a superior sensitivity (73.6%), specificity (100%) and accuracy (86.2%). The 130-bp amplicon could not detect % of positive BI of biopsies in BT cases. Therefore, for confirmatory diagnosis, we propose the use of PCR detection of the 130-bp genomic target, especially when the tuberculoid pole forms are considered, which has reached 51.6% of positivity in this group.
-In order to analyze the clinical features, approach and treatment of patients with acute primary headaches seen at the Clinics Hospital of the Federal University of Uberlândia (HC-UFU) throughout 2005, the medical charts of 109 patients were evaluated through a standardized questionnaire as to age, gender, main diagnosis, characteristics of the headache attacks, diagnostic tests and treatment. Probable migraine was the most common type of primary headache (47.7%), followed by probable tension-type headache (37.6%), unspecified headache (11.9%), and headache not elsewhere classified (2.8%). As to characteristics of the crisis, the location of the pain was described in 86.2% of the patients. The most commonly used drugs for treatment of acute headache attacks were dipyrone (74.5%), tenoxicam (31.8%), diazepam (20.9%), dimenhydrate (10.9%), and metochlopramide (9.9%). The data collected are in agreement with those reported in literature. In most cases, treatment was not what is recommended by consensus or clinical studies with appropriate methodology. Therefore, we suggest the introduction of a specific acute headache management protocol which could facilitate the diagnosis, treatment and management of these patients.KEY WORDS: headaches, diagnostic approach, treatment. Características clínicas, diagnóstico e tratamento das cefaléias primárias agudas em um serviço de emergência. Por que ainda negligenciamos as evidências?RESUMO -Com o objetivo de avaliar as características clínicas, abordagem e tratamento das cefaléias agudas primárias atendidas no Hospital de Clínicas da Universidade Federal de Uberlândia (HC-UFU) no ano de 2005, 109 prontuários foram analisados através de questionário padronizado, segundo idade, sexo, diagnós-tico principal, características das crises, propedêutica e tratamento. A distribuição dos pacientes quanto ao tipo de cefaléia foi a seguinte: provável enxaqueca 47,7%, provável cefaléia tensional 37,6%, cefaléia não classificada 11,9% e cefaléia não classificada em outro local 2,8%. No que tange às características da crise, a localização da dor foi descrita em 86,2% dos pacientes. No tratamento dos pacientes com crise aguda de cefaléia, as drogas mais utilizadas foram: dipirona (74,5%), seguido de tenoxicam (31,8%), diazepam (20,9%), dramin ® (10,9%) e metoclopramida (9,9%). Os dados levantados são condizentes com os relatados na literatura. O tratamento efetuado, na maioria dos casos, não foi o recomendado por consensos ou estudos clíni-cos com metodologia aceitável. Recomendamos, portanto, a introdução de um protocolo específico para o atendimento das cefaléias agudas, o que facilitará o diagnóstico, tratamento e manejo destes pacientes.
Este artigo apresenta os resultados do projeto Novos Empreendedores do Amanhã o qual teve por objetivo efetuar ações de desenvolvimento da cultura do empreendedorismo para professores e alunos dos anos iniciais e finais do ensino fundamental das escolas de Santo Ângelo. A sua implementação foi baseada no programa JEPP (Jovens Empreendedores Primeiros Passos) do SEBRAE. Foram capacitados 50 professores de 4 escolas do município para agirem como multiplicadores do conhecimento em suas turmas. Esses professores atuaram como multiplicadores do conhecimento adquirido em suas escolas proporcionando que um total de 643 alunos do 1º ao 9º ano tivessem contato com cultura empreendedora. Ao final das atividades cada escola realizou uma feira onde os produtos gerados por cada turma foram apresentados para a comunidade. Os resultados, demonstraram que os alunos, apesar da pouca idade, conseguiram compreender os conceitos desenvolvidos.
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