Pathogenetic aspects of sepsis and possible targets for adjunctive therapy.

The outcome of patients with sepsis arises from multiple factors affecting both the host and the invading microorganisms. Age, presence of underlying disease, source of infection and some specific etiological agents have been related to prognosis. Appropriateness of antimicrobial therapy, considering the in vitro susceptibility tests for the infecting bacteria, has been strongly associated with the outcome.

Induction of interleukin-10 by HIV antigens in peripheral mononuclear cells of health care workers after occupational exposure to HIV-1-positive blood.

Evaluation of HIV-induced IL-2 production by peripheral blood mononuclear cells (PBMC) and HIV-specific T helper and cytotoxic T lymphocyte (CTL) responses in health care workers (HCW) occupationally exposed to HIV reveals a high rate of response to HIV among non-seroconverters. IL-10 is also known to interfere with HIV infection in vitro. To evaluate the induction of IL-10 by HIV antigens in HCW occupationally exposed to HIV, 18 HCW with percutaneous injury were enrolled in this study, 9 of them exposed to HIV-contaminated blood, and 9 exposed to HIV-negative blood.

[Epidemiology of dengue infection in Ribeirão Preto, SP, Brazil].

Objective: To assess dengue transmission in a correctional facility for juvenile delinquents in Ribeirão Preto, state of São Paulo, Brazil.

Methods: A serological and virology investigation was carried out among inmates and employees of a correctional facility for juvenile delinquents in Ribeirão Preto, Brazil. The study population consisted of 105 inmates and 91 employees representing 89% of the exposed.

Immunophenotypic characterization of peripheral T lymphocytes in Mycobacterium tuberculosis infection and disease.

The cellular immune response probably plays a pivotal role in determining the clinical outcome after exposure to Mycobacterium tuberculosis. We used multi-parameter flow-cytometry to evaluate the distribution of T-lymphocyte subsets during infection and disease caused by M. tuberculosis.

Peripheral blood mononuclear cell activation induced by Leptospira interrogans glycolipoprotein.

Leptospira interrogans glycolipoprotein (GLP) has been implicated in pathological and functional derangement seen in leptospirosis. The goal of this study was to evaluate GLP's ability to induce cellular activation, as assessed by cytokine production and expression of surface activation markers. GLP extracted from either pathogenic L.

Influence of EDTA and heparin on lipopolysaccharide binding and cell activation, evaluated at single-cell level in whole blood.

Background: The use of whole blood (WB) in studying lipopolysaccharide (LPS)-induced cellular activation preserves the milieu in which LPS-cell interaction occurs in vivo. However, little information is available on using such a system at a single-cell level. We evaluated LPS binding and cell activation in WB by using flow cytometry.

Ventilation with high tidal volume induces inflammatory lung injury.

Mechanical ventilation with high tidal volumes (V(T)) has been shown to induce lung injury. We examined the hypothesis that this procedure induces lung injury with inflammatory features. Anesthetized male Wistar rats were randomized into three groups: group 1 (N = 12): V(T) = 7 ml/kg, respiratory rate (RR) = 50 breaths/min; group 2 (N = 10): V(T) = 21 ml/kg, RR = 16 breaths/min; group 3 (N = 11): V(T) = 42 ml/kg, RR = 8 breaths/min.

Internal carotid artery stenosis: comparison of duplex scan and magnetic resonance angiography with digital subtraction angiography.

Objective: We compare duplex scan (DS) and magnetic resonance angiography (MRA) with digital angiography (DGA) in respect to accuracy in measuring internal carotid artery (IC) stenosis in symptomatic patients.

Method: Ten symptomatic patients with IC stenosis greater than 70% previously diagnosed by DS were submitted to another DS and to both MRA and DGA. Both ICs from each patient (total 20 ICs) were evaluated by physicians blinded for the results of other tests.

Cytokines and pediatric open heart surgery with cardiopulmonary bypass.

It is well known that, subsequent to cardiopulmonary bypass, and particularly in children, an inflammatory response within the body can often result in a characteristic syndrome. Recently, it has been suggested that this phenomenon is due to a systemic inflammatory response, with significant involvement of cytokines. With this in mind, we investigated the behavior of tumour necrosis factor-alpha and interleukin-6 during the operative and in the immediate postoperative period in a group of children submitted to open heart surgery.

Circulating levels of sTNFR and discrepancy between cytotoxicity and immunoreactivity of TNF-alpha in patients with visceral leishmaniasis.

Objectives: To study the influence of soluble tumour necrosis factor (TNF) receptors (sTNFR) on bioactivity and immunoreactivity of TNF-alpha in patients with visceral leishmaniasis (Kala-azar) and to examine the association between circulating levels of sTNFR type I and type II with clinical manifestations of the disease.

Methods: Ten patients with Kala-azar were enrolled. Plasma samples for TNF-alpha and sTNFR were obtained on days 0, 7 and 21-28 of antimonial therapy.

Production of IFN-gamma is impaired in patients with paracoccidioidomycosis during active disease and is restored after clinical remission.

Cellular immunity is usually suppressed during paracoccidioidomycosis (PCM) and is restored after treatment. In this study we evaluated the induction of a type 1 (interferon gamma (IFN-gamma)), a type 2 (interleukin (IL)-10) and a primarily macrophage derived cytokine (tumor necrosis factor (TNF)-alpha) in peripheral blood mononuclear cells (PBMC) from patients with PCM. Eight male patients with active PCM, nine male patients with clinical remission of the disease and 10 healthy control subjects were enrolled in the study.

High rate of non-albicans candidemia in Brazilian tertiary care hospitals.

In order to evaluate the epidemiology of candidemia in Brazil, we performed a prospective multicenter study conducted in six general hospitals from São Paulo and Rio de Janeiro, We enrolled a total of 145 candidemic patients (85 males) with a median age of 32 years. Non-albicans species accounted for 63% of all episodes and the species most frequently causing candidemia were C. albicans (37%), C.

Risk factors for death in patients with candidemia.

Objective: To analyze possible risk factors for death among patients with nosocomial candidemia. To identify risk factors for death in patients with candidemia, we analyzed demographic, clinical, and microbiological data.

Setting: Six tertiary hospitals in Brazil.

Presence of circulating levels of interferon-gamma, interleukin-10 and tumor necrosis factor-alpha in patients with visceral leishmaniasis.

Experimental murine L. major infection is characterized by the expansion of distinct CD4+ T cell subsets. The Th1 response is related to production of IFN-gamma and resolution of infection, whereas Th-2 response with production of IL-4 and IL-10 and dissemination of infection.

Inflammatory response after myocardial revascularization with or without cardiopulmonary bypass.

Background: Tumor necrosis factor-alpha has been implicated in complications seen after cardiac operations with cardiopulmonary bypass. The release of tumor necrosis factor-alpha and its possible effects were studied in patients undergoing coronary artery bypass grafting with and without cardiopulmonary bypass.

Methods: Twenty patients were studied, 10 with (group 1) and 10 without cardiopulmonary bypass (group 2).

The ratio of plasma levels of IL-10/TNF-alpha and its relationship to disease severity and survival in patients with leptospirosis.

Twelve patients with leptospirosis were enrolled in a study to evaluate whether a correlation exists between disease severity and plasma levels of TNF-alpha and IL-10 as determined by enzyme-linked immunoassay. Six patients had less severe disease by analysis of liver, kidney and lung involvement, and 6 patients had severe disease, 2 of whom died. The results of the study confirm an association between high levels of TNF-alpha and poor outcome in leptospirosis.

Tumor necrosis factor alpha (TNF-alpha) and sepsis: evidence for a role in host defense.

Serum levels of TNF-alpha were evaluated in 29 patients with sepsis, using TNF-alpha sensitive L929 cells (sensitivity = 15 pg/ml). Blood samples were collected serially at the first 24-36 h of symptoms. Seventeen patients had severe underlying disease and 12 patients had mild or no underlying disease.

Plasma levels of tumor necrosis factor-alpha in patients with visceral leishmaniasis (Kala-azar). Association with activity of the disease and clinical remission following antimonial therapy.

Evaluation of TNF-alpha in patients with Kala-azar has drawn increasing interest due to its regulatory role on the immune system, in addition to its cachetizing activity. The objective of this study was to examine the association between plasma levels of TNF-alpha, measured by immunoreactivity (ELISA) and bioactivity (cytotoxicity assay with L-929 cells), and clinical manifestations of visceral leishmaniasis. Plasma samples from 19 patients with Kala-azar were obtained before, during and at the end of antimonial therapy.