Background
The screening of
Trypanosoma cruzi
-infected blood donors using two serological techniques frequently leads to conflicting results. This fact prompted us to evaluate the diagnostic performance of four “in-house” immunodiagnostic tests and two commercially available enzyme-linked immunosorbent assays (ELISAs).
Material and Methods
One hundred and seventy-nine blood donors, whose screening for Chagas disease was doubtful, underwent three in-house ELISAs, one in-house immunoblotting test (TESA-blot), and two commercial ELISAs (bioMérieux and Wiener) in an attempt to define the presence or absence of infection. Simultaneously, 29 donors with previous positive results from three conventional serological tests and 30 donors with constant negative results were evaluated.
Results
The ELISA-Wiener showed the highest rate in sensitivity (98.92%) and the ELISA-bioMérieux, the highest specificity (99.45%), followed by the TESA-blot, which showed superior performance, with lower false-negative (2.18%) and false-positive (1.12%) rates. In series, the combination composed of the TESA-blot and ELISA-bioMérieux showed slightly superior performance, with trifunctional protein deficiency (TFP) = 0.01%.
Conclusion
Our study confirms the high sensitivity and specificity of commercial kits. To confirm the presence or absence of
T. cruzi
infection, the combination of TESA-blot and ELISA-bioMérieux may be suggested as the best alternative. Individually, the TESA-blot performed the closest to the gold standard; however, it is not commercially available.
Background: Surgical trauma triggers an important postoperative stress response characterized
by significantly elevated levels of cytokines, an event that can favor the
emergence of immune disorders which lead to disturbances in the patient's body
defense. The magnitude of postoperative stress is related to the degree of
surgical trauma. Aim: To evaluate the expression of pro-inflammatory (TNF-α, IFN-γ, IL-1β, and IL-17)
and anti-inflammatory (IL-4) cytokines in patients submitted to conventional and
single-port laparoscopic cholecystectomy before and 24 h after surgery. Methods: Forty women with symptomatic cholelithiasis, ranging in age from 18 to 70 years,
participated in the study. The patients were divided into two groups: 21 submitted
to conventional laparoscopic cholecystectomy and 19 to single-port laparoscopic
cholecystectomy. Results: Evaluation of the immune response showed no significant difference in IFN-γ and
IL-1β levels between the groups or time points analyzed. With respect to TNF-α and
IL-4, serum levels below the detection limit (10 pg/ml) were observed in the two
groups and at the time points analyzed. Significantly higher postoperative
expression of IL-17A was detected in patients submitted to single-port
laparoscopic cholecystectomy when compared to preoperative levels (p=0.0094). Conclusions: Significant postoperative expression of IL-17 was observed in the group submitted
to single-port laparoscopic cholecystectomy when compared to preoperative levels,
indicating that surgical stress in this group was higher compared to the
conventional laparoscopic cholecystectomy.
Background : Immunological and inflammatory mechanisms play a key role in the development and
progression of type 2 diabetes mellitus. Aim : To raise the hypothesis that alterations in immunological parameters occur after
duodenojejunal bypass surgery combined with ileal interposition without
gastrectomy, and influences the insulin metabolism of betacells.Methods : Seventeen patients with type 2 diabetes mellitus under clinical management were
submitted to surgery and blood samples were collected before and six months after
surgery for evaluation of the serum profile of proinflammatory (IFN-γ, TNF-α,
IL-17A) and anti-inflammatory cytokines (IL-4, IL-10). In addition, anthropometric
measures, glucose levels and insulin use were evaluated in each patient. Results : No changes in the expression pattern of proinflammatory cytokines were observed
before and after surgery. In contrast, there was a significant decrease in IL-10
expression, which coincided with a reduction in the daily insulin dose, glycemic
index, and BMI of the patients. Early presentation of food to the ileum may have
induced the production of incretins such as GLP-1 and PYY which, together with
glycemic control, contributed to weight loss, diabetes remission and the
consequent good surgical prognosis of these patients. In addition, the control of
metabolic syndrome was responsible for the reduction of IL-10 expression in these
patients. Conclusion : These findings suggest the presence of low-grade inflammation in these patients
during the postoperative period, certainly as a result of adequate glycemic
control and absence of obesity, contributing to a good outcome of surgery.
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