To calculate the sensitivity and specificity of multifocal electroretinography (mfERG) in detection of chloroquine and hydroxychloroquine retinal toxicity, 120 eyes of 63 patients were evaluated using the currently recommended diagnostic tests. The results were compared to those of 54 eyes of 28 control subjects. The sensitivity and specificity of mfERG relative to the combination of automated visual fields and optical coherence tomography (the reference test) were calculated to be 87% and 86.5% respectively. However, analysis of the “false positive” cases proved that mfERG was more sensitive than the reference test and the actual sensitivity and specificity values were higher than the results of this study. Reduction of mfERG amplitude was a strong and reliable sign of early retinal toxicity and was correlated with the cumulative dose of hydroxychloroquine. This correlation was not observed with the reference test quantitative values.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-10-21T10:51:58Z No. of bitstreams: 1 ushavashist.pdf: 630186 bytes, checksum: 745a558bec12dae7850947a507e2f344 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-10-25T12:31:34Z (GMT) No. of bitstreams: 1 ushavashist.pdf: 630186 bytes, checksum: 745a558bec12dae7850947a507e2f344 (MD5) / Made available in DSpace on 2016-10-25T12:31:34Z (GMT). No. of bitstreams: 1 ushavashist.pdf: 630186 bytes, checksum: 745a558bec12dae7850947a507e2f344 (MD5) Previous issue date: 2007-02-23 / Plasmodium juxtanucleare é o agente causador da malária aviária que ocorre em alguns estados do Brasil. Esta malária está relacionada a diversos sinais clínicos e pode causar danos em criações rústicas de aves. O modelo aviário já foi utilizado para a investigação de drogas no combate à malária e hoje em dia o modelo mais utilizado é o Plasmodium berghei em roedores. A busca por anti-maláricos e malaricidas é de extrema relevância. O objetivo deste trabalho foi verificar o efeito da 4-(6-MERCAPTOPURINA)-7-CLOROQUINOLINA, uma substância recém sintetizada a partir da cloroquina, sobre a malária aviária em Gallus gallus e aprimorar o modelo aviário para testes de potenciais malaricidas. Para o encontro de uma ave doadora, foram visitadas no município de Juiz de Fora duas granjas e feitos esfregaços sangüíneos de 30 aves. A prevalência foi de 100%. Dentre as 30 aves examinadas, as seis com os maiores valores de parasitemia foram adquiridas e levadas para o laboratório. Para verificar qual o melhor dia para a retirada de sangue de aves infectadas e imunossuprimidas pelo acetato de metilprednisolona, cinco das seis aves receberam em dose única este imunossupressor e uma serviu como controle. A parasitemia das aves foi acompanhada por 26 dias após o dia da imunossupressão, por meio de esfregaços sangüíneos preparados a cada dois dias. Também foram aferidos o peso e temperatura corporal e feitos microhematócritos sangüíneos. Verificou-se que ao 10º dia pós-imunossupressão ocorreu pico de parasitemia. Houve queda de peso corporal e correlação com a parasitemia. Ocorreu pouca variação na temperatura corporal e hematócrito e não houve correlação destes com a parasitemia. Em outras oito aves adquiridas em casa comercial com 15 dias de idade, foram realizadas infecções experimentais com sangue inoculado via intramuscular e via intraperitonial nas doses de 0,3mL e 0,5mL para as duas vias. Durante um mês as aves tiveram o valor médio de parasitos acompanhado para comparar qual a via mais efetiva e se havia diferença entre as doses testadas no estabelecimento da infecção. Não foi observada diferença entre as xv dosagens, mas foi possível verificar que a infecção via intraperitonial atinge mais rapidamente o pico de parasitemia, com médias de parasitos mais altas, entretanto ao fim do experimento o número total de parasitos quase não diferiu entre as doses e vias. Para testar o efeito malaricida da 4-(6-MERCAPTOPURINA)-7-CLOROQUINOLINA, uma droga derivada da cloroquina, recém sintetizada, foram infectados 45 pintos, Leghorn branco, via intramuscular. As aves foram separadas em quatro grupos experimentais com 15 aves por grupo (Grupo1- não infectado, Grupo 2- infectado e sem tratamento, Grupo 3- infectado e tratado com a cloroquina e grupo 4- infectado e tratado com o derivado da cloroquina). A droga foi administrada via gavagem por 4 dias consecutivos na dose de 100mg/Kg de peso vivo. Para a avaliação do efeito malaricida da droga, as aves tiveram o número médio de parasitos encontrados acompanhados por esfregaços sangüíneos feitos a cada dois dias após o décimo dia da inoculação. Também foram aferidos o peso e temperatura corporal a cada dois dias e hematócrito a cada quatro dias. O derivado da cloroquina teve atividade malaricida, mantendo a parasitemia mais baixa em relação ao grupo controle não tratado e ao grupo controle tratado com a cloroquina. Entretanto em todos os grupos a parasitemia se manteve baixa. Sugere-se a investigação da ação malaricida desta droga em modelos com P. berghei ou culturas com P. falciparum. / Plasmodium juxtanucleare is the agent of the avian malaria that occurs in some states of Brazil. This malaria is related to several clinical signs and it can cause damages in the poultry section. The aviary model was already used for the investigation of drugs in the combat to the malaria and nowadays the model more used is the Plasmodium berghei in rodents. The search for anti-malarial drugs is of extreme importance. The aim of this study was to accomplish experimental infections of Plasmodium juxtanucleare in Gallus gallus and to test a substance recently synthesized, the 4-(9H-purin-6-ylthio)-7-cloroquinoline, derived of the cloroquine, to verify their effects on the avian malaria and to improve the aviary model for these types of tests. For a bird donor's encounter, two chicken farms were visited in the Juiz de Fora city and blood smears made in 30 hens. The prevalence was 100%. Among the 30 examined hens, six with the largest parasitemia values had been acquired and taken to the laboratory. To verify which the best day to retreat the blood to infected hens, five of the six hens received only dose of the imunossupressor substance (metilprednisolon acetate) and one served as control. The parasitaemia of the hens was accompanied by 26 days after the day of the imunossupression, through blood smears prepared each two days. The weight and corporal temperature were checked and made blood hematocrits. It was verified that to the 10th day powder-imunossupression it happened parasitaemia pick. There were fall of body weight and correlation with the parasitaemia. There was a little variation in the body temperature and hematocrite and there was not correlation of these with the parasitaemia. In other eight acquired hens in commercial house with 15 days old, experimental infections were accomplished with blood inoculated through intramuscle and intraperitoneally in the 0,3mL and 0,5mL for the two routes. During one month the hens had the value of parasites accompanied to compare which the most effective route and difference among the doses tested in the establishment of the infection. Significant difference was not observed among the xvii doses but it was possible to verify that the infection through intraperitonial reaches the parasitemia pick more quickly, with higher averages of parasites, however to the end of the experiment the total number of parasites differed hardly between the doses and routes. To test the effect a derived drug of the cloroquine, 45 chicks were infected, white Leghorn, through intramuscle route . The hens were separate in four experimental groups, 15 chicks for group (Group1 - no infected, Group 2 - infected and without treatment, Group 3 - infected and treated with the cloroquine and Group 4 - infected and treated with derived of the cloroquine) The drug was administered four consecutive days in the 100mg/Kg of alive weight dose. For the evaluation of the antimalarial effect of the drug, the hens had the number of parasites accompanied by blood smears done each two days after the tenth day of the inoculation. Also the weight and corporal temperature were checked each two days and hematocrit four days. Derived of the cloroquine had antimalarial activity, reducing the number of parasites and maintaining the lowest parasitaemia in relation to the group not treated and to the group treated with cloroquine.