RESUMO
BACKGROUND: Acute kidney injury (AKI) is a manifestation of SARS-CoV-2 infection. The evidence in kidney transplant (KT) is limited, as there are scarce data about the histologic features in graft biopsies of these patients. MATERIAL AND METHODS: A retrospective cohort study of KTs with SARS-CoV-2 infection from August 28, 2020, to April 23, 2021. We collected the incidence of AKI and the presence of urinary and histopathological disorders. Both groups were compared (AKI vs no AKI). Immunohistochemical and reverse transcription-polymerase chain reaction studies were performed on the anatomopathological samples. RESULTS: In our study, 72 KTs had SARS-CoV-2 infection and, among them, 27 patients (35.1%) developed AKI related to increased severity and a worse evolution of the infection, defined by a greater presence of pneumonia (P < .001), hospitalization (P < .001), admission to the intensive care unit (P < .001), the need for ventilation support (P < .001), and continuous renal replacement therapy (P < .001). In the multivariable analysis, pneumonia behaved as an independent predictor for AKI development (P = .046). No differences were observed between proteinuria a month before and after infection (P = .224). In addition, 5 patients showed microhematuria and 2 patients presented transient glycosuria without hyperglycemia. Of the 5 kidney biopsies performed, 1 biopsy (20%) showed positive reverse transcription polymerase chain reaction for SARS-CoV-2. CONCLUSIONS: AKI is a frequent and potentially serious complication in KT patients. Occasionally it could be accompanied by abnormalities in the urinary sediment. Of 5 biopsied patients, 1 patient had positive reverse transcription polymerase chain reaction in renal tissue, which suggests the systemic spread of the virus and the tropism for the renal graft.
Assuntos
Injúria Renal Aguda , COVID-19 , Transplante de Rim , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/patologia , COVID-19/complicações , Humanos , Transplante de Rim/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2RESUMO
The increasing comorbidity of kidney transplant (KT) donors make it necessary to develop scores to correctly assess the quality of kidney grafts. This study analyzes the usefulness of the preimplantation biopsy and the Kidney Donor Profile Index (KDPI) as indicators of KT survival from expanded criteria donors (ECD). Retrospective study of KT in our center between January 2010 to June 2019 who received a kidney from an ECD and underwent a preimplantation biopsy. 266 KT were included. Graft survival was categorized by KDPI quartiles: Q1 = 86%, Q2 = 95%, Q3 = 99% and Q4 = 100%. KT from KDPI Q1 presented better survival (p = 0.003) and Q4 donors had worse renal function (p = 0.018) and poorer glomerular filtration rate (3rd month; p = 0.017, 1st year; p = 0.010). KT survival was analyzed according to KDPI quartile and preimplantation biopsy score simultaneously: Q1 donors with biopsy score ≤3 had the best survival, especially comparing against Q3 with a biopsy score >3 and Q4 donors (p = 0.014). In multivariable analysis, hyaline arteriopathy, glomerulosclerosis, and KDPI Q4 were predictors for graft survival. High KDPI and a greater histological injury in the preimplantation biopsy, especially glomerular and vascular lesions, were related to a higher rate of KT loss from ECD.
Assuntos
Transplante de Rim , Biópsia , Sobrevivência de Enxerto , Humanos , Rim/patologia , Estudos Retrospectivos , Doadores de TecidosRESUMO
The study was carried out to determine the current levels of mercury, cadmium, and lead in fish and seafood from the market of Comunitat Valenciana, Spain. Levels of total mercury ranged from 0.02 to 3.15 mg kg⻹ w.w. (average = 0.073 mg kg⻹ w.w.). Cadmium concentrations ranged from 0.003 to 0.66 mg kg⻹ w.w. (average = 0.27 mg kg⻹ w.w.) for seafood, and between 0.003 and 0.71 mg kg⻹ w.w. (average = 0.01 mg kg⻹ w.w.) for marine fish. Concerning lead, concentrations from 0.02 to 0.36 mg kg⻹ w.w (average = 0.04 mg kg⻹ w.w.) were found in fish, and from 0.02 to 1.02 mg kg⻹ w.w. in seafood (average = 0.147 mg kg⻹ w.w.). The levels found were, in general, lower than maximum levels proposed by European legislation. The estimated weekly intake of mercury, cadmium and lead through fish and seafood consumption was found to be about 43%, 10% and 3% of the established provisional tolerable weekly intake, respectively.
Assuntos
Cádmio/toxicidade , Dieta/efeitos adversos , Contaminação de Alimentos , Chumbo/toxicidade , Mercúrio/toxicidade , Alimentos Marinhos/efeitos adversos , Frutos do Mar/efeitos adversos , Adolescente , Adulto , Idoso , Animais , Cádmio/análise , Criança , Crustáceos , Dieta/etnologia , União Europeia , Peixes , Inspeção de Alimentos , Fidelidade a Diretrizes , Humanos , Chumbo/análise , Mercúrio/análise , Pessoa de Meia-Idade , Moluscos , Medição de Risco , Alimentos Marinhos/análise , Alimentos Marinhos/economia , Alimentos Marinhos/normas , Frutos do Mar/análise , Frutos do Mar/economia , Frutos do Mar/normas , Espanha , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/toxicidade , Adulto JovemRESUMO
The presence of heterotopic salivary gland tissue (HSGT) in rather uncommon in the neck. Usually it has been located in its lower third. HSGT in the upper neck is believed to be a rare entity. Two cases of HSGT in the upper neck are presented, with a review of their clinical and histopathological characteristics. The embryologic derivation of salivary tissue and close association with the branchial apparatus are discussed. The possibility of neoplastic transformation must always be considered in these uncommon lesions.
Assuntos
Coristoma/diagnóstico , Pescoço , Glândulas Salivares , Adolescente , Branquioma/diagnóstico , Coristoma/diagnóstico por imagem , Coristoma/patologia , Diagnóstico Diferencial , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , RadiografiaRESUMO
The presence of heterotopic brain tissue in the head and neck region is exceptional. Most reported cases have been observed in the nasal region and are called nasal gliomas. The case of a 10-month-old boy with heterotopic brain tissue on the soft palate and nasopharynx is reported. Surgical treatment was successful and no complications or recurrences have been observed in 7 years of follow-up. The main pathogenic theories and nomenclature are analyzed.
Assuntos
Coristoma/patologia , Faringe , Coristoma/cirurgia , Humanos , Lactente , Masculino , Nasofaringe , Palato Mole , Terminologia como Assunto , Resultado do TratamentoRESUMO
Although tympanic membrane perforations continue to be a significant source of otologic morbidity in the pediatric population, myringoplasty in children still elicits debate. The records of 76 patients under 18 who underwent 90 myringoplasties at the 12 de Octubre University Hospital (Madrid, Spain) over a recent 8-year period were reviewed. The overall short-term surgical success rate was 64.8%. The overall success rate evaluated at least one year after surgery was 58%. The audiological threshold improved in 68% per cent of successful cases. Surprisingly, females had lower graft take rates than males. The outcome of surgery was unrelated to age at operation, duration, mechanism, size, and location of the perforation, or condition of the opposite ear.
Assuntos
Miringoplastia/métodos , Perfuração da Membrana Timpânica/cirurgia , Feminino , Humanos , Lactente , Masculino , Prognóstico , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Granular cell tumors (GCT) are rare and usually benign tumors whose histogenesis is debated. The skin, subcutaneous tissues, and mucosae of the head and neck are areas of predilection for GCT. Laryngeal involvement is uncommon, but may create diagnostic and therapeutic problems when it occurs. Laryngeal GCT are decidedly uncommon in children, only 17 cases having been reported in the literature. A case of GCT of the larynx in an 11-year-old girl is reported. The presenting symptom was hoarseness. The macroscopic tumor and hoarseness disappeared after chemotherapy (EVAIA) for Ewing sarcoma of the knee.
Assuntos
Tumor de Células Granulares/complicações , Neoplasias Laríngeas/complicações , Distúrbios da Voz/etiologia , Biópsia , Criança , Feminino , Tumor de Células Granulares/patologia , Humanos , Neoplasias Laríngeas/patologia , Prega Vocal/patologia , Distúrbios da Voz/diagnósticoRESUMO
Nasoalveolar cysts, also known as Klestadt's or nasolabial cysts, are uncommon midfacial lesions. Ten cases treated at the 12 de Octubre University Hospital are reported, describing the most relevant clinical and pathological findings are reported. The main theories of the origin of these developmental, non-odontogenic cysts are discussed. A review of the literature is included.
Assuntos
Processo Alveolar/diagnóstico por imagem , Processo Alveolar/patologia , Cistos/diagnóstico , Cavidade Nasal/diagnóstico por imagem , Cavidade Nasal/patologia , Adulto , Cistos/embriologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
Heterotopic salivary gland tissue (HSGT) represents an uncommon lesion, usually presenting as a discharging sinus in the base of the neck. Diagnostic criteria and embryogenesis of this entity still remain unclear. For the purpose of clarifying both subjects, all lateral cervical anomalies undergoing surgery during a 12-year period were examined. Histological study showed salivary tissue in 10 out of 119 patients. However, only 5 of them accomplished HSGT criteria. This study presents the second largest series to date of undisputed HSGT in the lower neck. Both accessory glands and branchial cleft anomalies should be distinguished from this lesion. Neoplastic transformation in HSGT, although extremely rare, should also be considered.
Assuntos
Coristoma , Pescoço , Glândulas Salivares , Criança , Pré-Escolar , Coristoma/patologia , Feminino , Humanos , Lactente , Masculino , Pescoço/patologia , Glândulas Salivares/patologiaRESUMO
The nasolabial cyst is a rare condition of the midline with an uncertain pathogenesis. This case report describes a 44-year-old woman in which the clinicopathologic findings were consistent with nasolabial cyst. On histologic examination, extensive apocrine change was noticed. To our knowledge, this feature has not been mentioned in previous papers. In addition, cases reported during the last decade are summarized.
Assuntos
Glândulas Apócrinas/patologia , Apolipoproteínas , Proteínas de Membrana Transportadoras , Cistos não Odontogênicos/patologia , Doenças Nasais/patologia , Adulto , Apolipoproteínas D , Biomarcadores/análise , Proteínas de Transporte/análise , Tecido Conjuntivo/patologia , Cistadenoma/diagnóstico , Citoplasma/ultraestrutura , Epitélio/patologia , Feminino , Glicoproteínas/análise , Humanos , Lábio/patologia , Muco , Neoplasias Nasais/diagnósticoRESUMO
Primary malignant melanoma of the mucosa of the nasal and paranasal sinuses is rare, difficult to treat, and usually has a poor prognosis. Seven cases, six women and one man (mean age 76.5 years), were treated at the Hospital 12 de Octubre (Madrid, Spain) during the period 1982-1994. The presenting symptoms, diagnostic evaluation, morphology, therapeutic modalities, histological evaluation, and clinical course were reviewed. Three patients were treated surgically and three received palliative irradiation. All had local recurrence or distant metasfases within 15 months after concluding treatment. The seventh patient refused treatment.
Assuntos
Melanoma/patologia , Neoplasias dos Seios Paranasais/patologia , Seios Paranasais/patologia , Idoso , Feminino , Humanos , Masculino , Melanoma/ultraestrutura , Neoplasias dos Seios Paranasais/ultraestrutura , Seios Paranasais/ultraestruturaRESUMO
The evaluation and management of thyroid nodules is a common problem in medicine. In a review of 250 cases of thyroid disease seen at the 12 de Octubre Hospital (Madrid, Spain), 191 cases of solitary nodules and multinodular goiter were analyzed. The clinical findings, complementary studies, and postoperative histology were analyzed to determine the parameters most closely related to malignant thyroid processes. The overall rate of malignancy was 22.5%. Major clinical factors associated with malignancy were fixation to deep structures, cervical lymph node enlargement, and paralysis of the vocal cords. None of the complementary tests was absolutely reliable in excluding malignancy, but fine needle aspiration biopsy, in spite of its limitations, was the best diagnostic tool. Surgery is indicated if the benignity of a nodule cannot be confirmed.
Assuntos
Neoplasias da Glândula Tireoide/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgiaRESUMO
Three primary cartilaginous tumors of the larynx are reported: two chondrosarcomas (including an undifferentiated chondrosarcoma with prolonged survival) and one chondroma. The need for accurate histological staging, only possible after surgery, is emphasized. Surgery is teh preferred initial treatment.
Assuntos
Condroma/radioterapia , Condroma/cirurgia , Condrossarcoma/radioterapia , Condrossarcoma/cirurgia , Neoplasias Laríngeas/radioterapia , Neoplasias Laríngeas/cirurgia , Idoso , Condroma/diagnóstico , Condrossarcoma/diagnóstico , Terapia Combinada , Feminino , Humanos , Neoplasias Laríngeas/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios XRESUMO
A giant juvenile nasopharyngeal fibroma in a 29-year-old male was removed by hinge maxillotomy. The diagnosis and treatment of these tumors is discussed.