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Doctoral Thesis
DOI
10.11606/T.5.2000.tde-14072014-114006
Document
Author
Full name
Jussara Bianchi Castelli
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2000
Supervisor
Committee
Higuchi, Maria de Lourdes (President)
Dulley, Frederico Luiz
Loterio, Hélio Alvimar
Racz, Maria Lucia Barbosa de Oliveira
Sesso, Antonio
Title in Portuguese
Diagnóstico de vírus por microscopia eletrônica em urina de pacientes com hematúrias/cistite hemorrágica após transplante de medula óssea: associação com aspectos clínicos
Keywords in Portuguese
Cistite/virologia
Doença enxerto-hospedeiro/complicações
Hematúria/virologia
Infecções por adenoviridae/diagnóstico
Infecções por polyomavirus/diagnóstico
Microscopia eletrônica/métodos
Polyomaviridae
Transplante de medula óssea/efeitos adversos
Abstract in Portuguese
Pacientes submetidos ao transplante de medula óssea, apresentando hematúria/cistite hemorrágica, tiveram amostras de urina analisadas pela microscopia eletrônica. Esta foi a técnica escolhida de pesquisa viral pela sua confiabilidade. Noventa em 402 pacientes submetidos ao transplante de medula óssea neste serviço apresentaram hematúria/cistite hemorrágica (incidência de 22%). O estudo por microscopia eletrônica foi realizado em 72 destes pacientes com hematúria/cistite hemorrágica (grupo de estudo), identificando 55,6% (40/72) de positividade viral. Foram também estudadas amostras de urina de 12 pacientes submetidos ao transplante de medula óssea sem hematúria/cistite hemorrágica (grupo controle); houve associação significante entre a presença de vírus e hematúria/cistite hemorrágica (p<0,01 - Teste exato de Fisher). No grupo com hematúria/cistite hemorrágica, 65% (26/40) dos vírus detectados pertenciam à família Poliomaviridae, 30% (12/40) à Adenoviridae, e 5% (2/40) foram positivos para ambas as famílias. Houve associação entre a positividade para vírus e a presença da doença enxerto-contra-hospedeiro (p=0,05-x2) e o de início tardio (>dia+21) da H/CH (P=0,04-x2), bem como entre a doença enxerto-contra-hospedeiro e a severidade da H/CH (p=0,04-x2). O presente estudo mostra que a microscopia eletrônica é uma ferramenta útil para detecção de vírus na urina de pacientes submetidos ao transplante de medula óssea apresentando hematúria/cistite hemorrágica e que o vírus provavelmente tem um papel no desenvolvimento do sangramento urinário, o qual é agravado pelo doença enxerto-contra-hospedeiro. A microscopia eletrônica deveria ser realizada rotineiramente para guiar as outras técnicas de detecção viral, como a imunocitoquímica e biologia molecular.
Title in English
Electron microscopic viral diagnosis in urine of patients with hematuria/hemorrhagic cystitis after bone marrow transplantation: association with clinical aspects
Keywords in English
Adenoviridae infections/diagnosis
Bone marrow transplantation/adverse effects
Cystitis/virology
Grafts vs host disease/complications
Hematuria/virology
Microscopy electro/methods
Palyomavirus infections/diagnosis
Polyomaviridae
Abstract in English
Patients submitted to bone marrow transplantation presenting hematuria/hemorrhagic cystitis had the urine analyzed by electron microscopy. It was the elected technique for viral search because its reliability. Ninety from 402 patients submitted to bone marrow transplantation at this service showed hematuria/hemorrhagic cystitis (incidence of 22%). Electron microscopy study was performed in 72 of these patients with hematuria/hemorrhagic cystitis (study group), identifying 55.5% (40/72) of viral positivity. It was also study the urine of 12 patients submitted to bone marrow transplantation without hematuria/hemorrhagic cystitis (control group); there was a significant association between the presence of virus and hematuria/hemorrhagic cystitis (p<0.01). In the hematuria/hemorrhagic cystitis group, 65% (26/40) of the virus belonged to Poliomaviridae family, 30% (12/40) to Adenoviridae, and 5% (2/40) to both families. There was association between the status of graft-versus-host disease and positivity for virus (p=0.05), as well as between graft-versus-host disease and the severity of hematuria/hemorrhagic cystitis (p=0.04). The present study shows that electron microscopy is a useful tool for detection of virus in urine of patients submitted to bone marrow transplantation presenting hematuria/hemorrhagic cystitis and that the virus probably play a role in the development of the urinary bleeding, which is aggravated by graft-versus-host disease. Electron microscopy should be performed routinely to guide the other techniques for viral detection, like immunocitochemistry and molecular biology.
 
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Publishing Date
2014-07-14
 
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