Myeloid Sarcomas Causing Unilateral Cranial Nerve Palsies in a Patient with Relapsed Acute Myeloblastic Leukemia.

Myeloid sarcomas (MS) are a rare manifestation of myeloid malignancies and can often be misdiagnosed, leading to a delay in treatment. The objective of this clinical case is to highlight the challenges of the clinical presentation and to emphasize the importance of this manifestation ensuring timely diagnosis and therapy. Here, we present a 43-year-old man who was diagnosed with acute myeloblastic leukemia (AML) after being evaluated for unintentional weight loss, subcutaneous nodules, thrombocytopenia, and anemia. The patient underwent chemotherapy with complete remission and presented 4 months later with dysphagia and cranial nerve palsies. Appropriate imaging and biopsy led to a diagnosis of myeloid sarcoma, and a decision was made to begin reinduction chemotherapy for AML achieving a second complete remission although his neurological deficits did not improve. Our case illustrates the protean presentation of myeloid sarcomas; clinicians should have a high suspicion for MS and remain vigilant when unexplained signs and symptoms arise in the background of a myeloid malignancy although challenges still remain when presentation is de novo. Advancements in understanding the pathophysiology of MS have been performed but remain not completely understood. High clinical suspicion, appropriate imaging, biopsy techniques, and expertise are paramount for timely diagnosis and treatment.

Effects of prolonged treatment with Syzygium cumini on the salivary glands of spontaneously diabetic mice

It is estimated that 190 million people worldwide have diabetes mellitus. Several attempts have been made to elucidate the deleterious effects of diabetes on various organ systems, as well as the reversal of these effects by treatment and/or diet. Thus, the objective of the present study was to analyze the effects of prolonged treatment with Syzygium cumini (Jambolan) sheet aqueous extract on the structure of cells responsible for secretory processes in the parotid and submandibular salivary glands of spontaneously diabetic mice. Ten female mice, including five diabetic Nod mice (group I) and five BALB/c mice (group II), were used. After characterization of the diabetic state, animals of group I received Syzygium cumini extract and group II animals received water ad libitum. After the experimental period, the salivary glands were collected from the animals for stereological analysis. The results showed structural alterations in the salivary glands of diabetic animals characterized by nuclear and cytoplasmic atrophy and the occurrence of inflammatory cells, as well as elevated glycemia levels. We conclude that no recovery of normal glycemia levels or glandular tissue structure occurs in diabetic animals even when treated with Syzygium cumini extract, a fact that might result in changes in the functional mechanisms of these organs.

Prostatic stromal microenvironment and experimental diabetes.

The diabetes causes alterations in various organ systems, including the male accessory sex glands. The prostate is very important in the reproductive process and it is a frequent target of malignant changes. The aim of this work was to demonstrate the histochemical and ultrastructural alterations in the prostate of diabetic animals. Two groups of animals were utilized: control and non-obese diabetic mice (NOD). Twelve days after the characterization of diabetic status the ventral prostate was collected, fixed in Karnovsky and paraformaldehyde, processed for histochemistry and TEM associated to stereology. The results showed reduction of the epithelial area and increasing of the stromal area with muscular and collagen hypertrophy in the prostatic gland. It was characterized the development of prostatic intraepithelial neoplasia, inflammatory processes and dilation of the organelles involved in the secretory process. It was concluded that diabetes besides damaging the reproductive process, affects the glandular homeostasis favoring the development of prostatic pathologies.

II Fórum Nacional da SBACV recentes avanços em cirurgia de varizes tronculares primárias dos MMII: uma nova visäo / Recent advances in the surgical treatment of primary varicose veins

No presente artigo säo apresentados os resultados do II Fórum Nacional da Sociedade Brasileira de Angiologia e Cirurgia Vascular, que versou sobre: "Recentes avanços em cirurgia de varizes tronculares primárias do MMII", compilados por uma Comissäo de Síntese, a partir de discussöes realizadas em 8 Regionais da SBACV. As principais conclusöes foram: 1. Existe, atualmente, um consenso sobre o valor de se preservar a veia safena magna, sem prejuízo do resultado cirúrgico funcional e estético, devendoe avaliar a capacidade de recuperaçäo da sefena em direçäo à normalidade, informando o paciente sobre a técnica utilizada. 2. Que talvez a técnica CHIVA seja muito complicada para tal preservaçäo e que ainda necessite de melhores estudos para justificar seu emprego, podendo ser substituídas por outras técnicas, sendo sugerida como uma alteranativa a técnica de Hammarsten et al. 3. Foi considerado de grande importância o uso de Duplex Scan pré e pós operatório na cirurgia de varizes, sendo entretanto umatcnica observador e aparelho dependente, podendo ainda, encarecer o custo do tratamento. 4. A cirurgia ambulatorial dentro de critérios aprovados no I Fórum Nacional da SBACV pode ter um melhor custo/benefício no tratamento das varizes e tem melhor aceitaçäo por parte do doente. 5. Näo existe ainda um consenso sobre a melhor técnica para tratamento da veia safena parva insuficiente, (com ou sem fleboextraçäo) e no tratamento das varizes relacionadas às veias pudendas. 6. Existe a necessidade de um maiornúero de publicaçöes e divulgaçäo dos trabalhos que estäo sendo realizados no Brasil sobre o assunto.

Complicacoes vasculares nos transplantes renais. / Vascular complications in renal transplantation

Os autores apresentam analise de 115 casos de transplantes renais realizados pelo Grupo de Transplantes Renais do Hospital Felicio Rocho e Hospital das Clinicas da Faculdade de Medicina da Universidade Federal de Minas Gerais, com enfase as complicacoes vasculares. Dos 115 casos operados, tivemos 7 complicacoes vasculares.Dos valentes a uma percentagem de 6,0%. De maneira geral, os problemas vasculares quando aparecem no pos-operatorio imediato ou tardio, simulam um quadro de rejeicao. Encontramos frequentemente queda do volume urinario associado ou nao a elevacao ou estabelecimento de niveis tensionais altos A complicacao mais frequente em nosso estudo foi exatamente a oclusao da arteria renal (tres casos), seguida por ruptura renal (um caso), estenose de arteria renal (um caso), ruptura espontanea da arteria iliaca (um caso) e hemorragia hilar (um caso). As complicacoes vasculares estao en intima relacao a problemas tecnicos peroperatorios tais como a manipulacao renal durante a sua retirada, a perfusao renal e a confeccao das anastomoses. A atencao a estes detalhes nos proporcionara um numero reduzido de problemas pos-operatorios