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1.
Braz. j. biol ; 84: e251367, 2024. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1355884

ABSTRACT

Abstract This study aimed to evaluate the effect of atmospheric plasma application on the inactivation of fungi on the surface of Erythrina velutina seeds and on isolated fungal colonies. Two experiments were conducted using a completely randomized design. First, plasma was applied to the surface of the seeds using helium gas and atmospheric plasma for 3, 6, and 9 min in addition to the control (untreated seeds), constituting seven treatments with five repetitions each. In the second experiment, Petri dishes containing the inoculum of different fungi were treated with atmospheric air plasma for 3, 6, and 9 min (Air-3, Air-6, and Air-9) and were compared with untreated fungi in Petri dishes without treatment (control), totaling four treatments and five repetitions each. We found that the application of atmospheric air plasma to E. velutina seeds for 9 min had an antimicrobial effect on the fungi Aspergillus niger, Aspergillus flavus, Fusarium sp., Brachysporium sp., and Rhizopus sp. The formation of fungal colonies isolated from E. velutina seeds was also inhibited by 3 min of exposure to atmospheric air plasma, except for A. niger, whose inhibition occurred after 6 min of exposure to atmospheric plasma.


Resumo Este trabalho teve como objetivo avaliar o efeito da aplicação de plasma atmosférico na inativação de fungos na superfície de sementes de Erythrina velutina e em colônias fúngicas isoladas. Dois experimentos foram realizados em delineamento inteiramente casualizado: no primeiro, o plasma foi aplicado na superfície das sementes usando gás hélio e plasma atmosférico por três, seis e nove minutos, além do controle (sementes sem tratamento), constituindo sete tratamentos com cinco repetições cada; no segundo experimento, placas de Petri contendo o inóculo de diferentes fungos foram tratadas com plasma atmosférico por três, seis e nove minutos (Air-3, Air-6 e Air-9) e comparadas com fungos não tratados em placas de Petri sem tratamento (controle), totalizando quatro tratamentos e cinco repetições cada. Descobrimos que a aplicação de plasma atmosférico nas sementes de E. velutina por nove minutos teve efeito antimicrobiano sobre os fungos Aspergillus niger, Aspergillus flavus, Fusarium sp., Brachysporium sp. e Rhizopus sp. A formação de colônias fúngicas isoladas de sementes de E. velutina também foi inibida por três minutos de exposição à aplicação de plasma atmosférico, exceto para A. niger, cuja inibição ocorreu a partir de 6 minutos de exposição à aplicação de plasma atmosférico.


Subject(s)
Erythrina , Fungi
2.
Odovtos (En línea) ; 24(2)ago. 2022.
Article in English | LILACS-Express | LILACS | ID: biblio-1386588

ABSTRACT

Abstract Langerhans cells histiocytosis is a rare disease characterized by monoclonal proliferation and migration of special dendritic cells in a variety of organs, most commonly appears eosinophilic granuloma localized, often solitary, and bone lesions that occurs predominantly in pediatric patients. Although is most prevalent in children under the age of 15, this disorder presents in all ages and occurs at a rate of 2 to 5 cases per million per year. LCH is a complex entity; the clinic manifestations can mimic other common conditions and therefore a comprehensive evaluation is indicated. Since oral manifestations are frequent, the early diagnose of this pathology could be detected by dental professionals. The aim of this case report is to describe a case of LCH who initially was misdiagnosed and treated for a dental infection. This disease requires accurate histopathological diagnosis and timely treatment; hence it is necessary to raise awareness among dentists to avoid misdiagnose of oral manifestations of LCH.


Resumen La histiocitosis de las células de Langerhans es una enfermedad poco frecuente que se caracteriza por la proliferación monoclonal y la migración de células dendríticas especiales en una variedad de órganos; lo más común es que aparezca un granuloma eosinofílico localizado, a menudo solitario, así como lesiones óseas que se producen predominantemente en pacientes pediátricos. Aunque es más frecuente en los niños menores de 15 años, este trastorno se presenta en todas las edades y se produce a una tasa de 2 a 5 casos por millón al año. La HCL es una entidad compleja; las manifestaciones clínicas pueden imitar otras afecciones comunes y, por lo tanto, se indica una evaluación exhaustiva. Dado que las manifestaciones orales son frecuentes, el diagnóstico precoz de esta patología podría ser detectado por los profesionales de la odontología. El objetivo de este reporte de caso es describir un caso de HCL que inicialmente fue mal diagnosticado y tratado por una infección dental. Esta enfermedad requiere un diagnóstico histopatológico preciso y un tratamiento oportuno; por lo tanto, es necesario sensibilizar a los dentistas para evitar un diagnóstico erróneo de las manifestaciones orales de la HCL.

3.
Radiol. bras ; 55(4): 216-224, Aug. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1394568

ABSTRACT

Abstract Objective: To promote advanced research using magnetic resonance imaging (MRI) in the diagnosis of and screening for osteoporosis by looking for correlations among the T-scores measured by dual-energy X-ray absorptiometry (DEXA), the apparent diffusion coefficient (ADC) values on diffusion-weighted imaging (DWI), and the T1-weighted signal intensity values. Materials and Methods: This was a prospective study of postmenopausal women with no contraindications to MRI and no history of cancer who underwent DEXA within 30 days before or after the MRI examination. A 3.0-T scanner was used in order to acquire sagittal sequences targeting the lumbar spine. Results: Thirteen women underwent DEXA and MRI. In two cases, the MRI was discontinued early. Therefore, the final sample comprised 11 patients. The ADC values and T1-weighted signal intensity were found to be higher in patients with osteoporosis. However, among the patients > 60 years of age with osteoporosis, ADC values were lower and T1-weighted signal intensity was even higher. Conclusion: It is unlikely that MRI will soon replace DEXA for the diagnostic workup of osteoporosis. Although DWI and ADC mapping are useful for understanding the pathophysiology of osteoporosis, we believe that T1-weighted sequences are more sensitive than is DWI as a means of performing a qualitative analysis of vertebral alterations.


Resumo Objetivo: Promover pesquisas avançadas usando ressonância magnética (RM) no diagnóstico e rastreamento de osteoporose, procurando correlações entre os escores T medidos por absorciometria de raios-X de dupla energia (DEXA), valores de coeficiente de difusão aparente (ADC) na difusão e valores de intensidade de sinal ponderado em T1. Materiais e Métodos: Estudo prospectivo de mulheres na pós-menopausa sem contraindicações para RM e sem histórico de câncer que foram submetidas a DEXA 30 dias antes ou após o exame de RM. Um scanner 3.0-T foi utilizado para adquirir sequências sagitais direcionadas à coluna lombar. Resultados: Treze mulheres foram submetidas a DEXA e RM. Em dois casos, a RM foi interrompida precocemente. Portanto, a amostra final foi composta por 11 pacientes. Os valores de ADC e intensidade de sinal ponderado em T1 foram mais elevados nas pacientes com osteoporose. No entanto, no subgrupo de pacientes > 60 anos de idade com osteoporose, os valores de ADC foram menores e a intensidade do sinal ponderado em T1 foi ainda maior. Conclusão: É improvável que a RM substitua DEXA para a investigação diagnóstica da osteoporose no futuro próximo. Embora a difusão e o mapeamento ADC sejam úteis para a compreensão da fisiopatologia da osteoporose, acreditamos que as sequências ponderadas em T1 são mais sensíveis do que a difusão como meio de realizar uma análise qualitativa das alterações vertebrais.

4.
Int. braz. j. urol ; 48(3): 406-455, May-June 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1385126

ABSTRACT

ABSTRACT Introduction: There is an ongoing need to identify various pathological factors that can predict various survival parameters in patients with upper tract urothelial carcinoma (UTUC). With this review, we aim to scrutinize the impact of several pathological factors on recurrence free survival (RFS), cancer-specific survival (CSS) and overall survival (OS) in patients with UTUC. Materials and Methods: Systematic electronic literature search of various databases was conducted for this review. Studies providing multivariate hazard ratios (HR) for various pathological factors such as tumor margin, necrosis, stage, grade, location, architecture, lymph node status, lymphovascular invasion (LVI), carcinoma in situ (CIS), multifocality and variant histology as predictor of survival parameters were included and pooled analysis of HR was performed. Results: In this review, 63 studies with 35.714 patients were included. For RFS, all except tumor location (HR 0.94, p=0.60) and necrosis (HR 1.00, p=0.98) were associated with worst survival. All the pathological variables except tumor location (HR 0.95, p=0.66) were associated with worst CSS. For OS, only presence of CIS (HR 1.03, p=0.73) and tumor location (HR 1.05, p=0.74) were not predictor of survival. Conclusions: We noted tumor grade, stage, presence of LVI, lymph node metastasis, hydronephrosis, variant histology, sessile architecture, margin positivity and multifocality were associated with poor RFS, CSS and OS. Presence of CIS was associated with poor RFS and CSS but not OS. Tumor necrosis was associated with worst CSS and OS but not RFS. Tumor location was not a predictor of any of the survival parameters.

5.
Int. j. morphol ; 40(3)jun. 2022.
Article in English | LILACS-Express | LILACS | ID: biblio-1385682

ABSTRACT

SUMMARY: From 1984 stereology was added to unbiased methods and procedures, i.e., counts became more reliable studying morphological images in a random and uniform isotropic way. Therefore, the orientation and sectioning methods adapted to stereological quantification are essential. A critical quantitative subject in practical pathology concerns diagnosing and classifying neoplasias. Pathologists evaluated different types of tumors by determining the nuclear roundness factor (NRF). NRF is calculated by the ratio between the nuclear radius obtained from the area and the perimeter. However, NRF is biased data because it depends on the sectioning orientation, nuclei shape, and section thickness. The stereology proposed an unbiased alternative to assess the nucleus from tumor cells, counteracting NRF quantitatively. Therefore, the volume-weighted mean nuclear volume has been used to prognostic tumors in several organs. In urology, this was used, for example, to study primary carcinoma of the bladder, renal and prostatic carcinomas.


RESUMEN: A partir de 1984 se agregó la estereología a los métodos y procedimientos sin distorción, es decir, los conteos se volvieron más confiables al estudiar imágenes morfológicas de forma aleatoria e isotrópica uniforme. Por tanto, los métodos de orientación y seccionamiento adaptados a la cuantificación estereológica son fundamentales. Un tema cuantitativo crítico en la patología práctica se refiere al diagnóstico y clasificación de las neoplasias. Los patólogos evaluaron diferentes tipos de tumores determinando el factor de redondez nuclear (NRF). NRF se calcula por la relación entre el radio nuclear obtenido del área y el perímetro. Sin embargo, NRF son datos distorsionados debido a que dependen de la orientación de la sección, la forma de los núcleos y el grosor de la sección. La estereología propuso una alternativa imparcial para evaluar el núcleo de las células tumorales, contrarrestando cuantitativamente el NRF. Por lo tanto, el volumen nuclear medio ponderado se ha utilizado para pronosticar tumores en varios órganos. En urología, esto se utilizó, por ejemplo, para estudiar el carcinoma primario de vejiga, carcinomas renales y prostáticos.

6.
Rev. Assoc. Med. Bras. (1992) ; 68(6): 847-852, June 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1387151

ABSTRACT

SUMMARY OBJECTIVE: Rescuing severe trauma cases is extremely demanding. The present study purposed to analyze the efficiency of trauma management at Emergency Centre, University Clinical Centre of Serbia, Belgrade, included outcome within 28 days. METHODS: This retrospective study involved 131 intensive care unit trauma cases with total Injury Severity Score ≥16, in terms of administrating the two strategies: (i) definitive surgical repair and (ii) damage control laparotomy. RESULTS: The damage control laparotomy cases revealed statistically higher Injury Severity Score and APACHE II scores, significant brain dysfunction, and hemorrhagic shock on arrival (p<0.001). In addition, the damage control laparotomy had a higher rate of respiratory complications, multiple organ deficiency syndrome, and surgical wound complications (p=0.017, <0.001, and 0.004, respectively), with more days on mechanical ventilation (p=0.003). Overall mortality was 29.8%. Although higher early mortality within ≤24 h in the damage control laparotomy (p=0.021) had been observed, no difference between groups (p=0.172) after the 4th day of hospitalization was detected. CONCLUSIONS: Trauma patients have a high mortality rate in the 1st hours after the incident. Compelling evidence linking host and pathogen factors, such as mitochondrial apoptosis pathways, appears to correlate with loss of organ dysfunction, both cytopathologically and histopathologically. Adequate selection of patients necessitating damage control laparotomy, allowed by the World Society of Emergency Surgery, abdominopelvic trauma classifications, and improvements in resuscitation, may improve the results of severe trauma treatment.

8.
Rev. bras. ortop ; 57(3): 521-523, May-June 2022. graf
Article in English | LILACS | ID: biblio-1388024

ABSTRACT

Abstract Idiopathic hypertrophic pachymeningitis is rare cause of neurological symptoms with myelopathy due to spinal cord compression. We report a case of pachymeningitis, which was manifested primarily by tetraparesis after low-energy trauma and recurrence the myelopathy symptoms after 5 years of surgery. The patient, a 19-year-old woman, was subjected to extensive investigation without evidence of any underlying disease. A meningeal biopsy was performed and showed an unspecific inflammatory process with extensive fibrosis of the dura mater. These findings, associated with the exclusion of other causes, suggest idiopathic hypertrophic pachymeningitis.


Resumo A paquimeningite hipertrófica idiopática é uma causa rara de sintomas neurológicos apresentando mielopatia por compressão da medula espinhal. Relatamos um caso de paquimeningite com manifestação primária de tetraparesia após trauma de baixa energia e recorrência dos sintomas de mielopatia 5 anos após a cirurgia. A paciente, uma mulher de 19 anos, foi submetida a extensa investigação sem evidências de qualquer doença de base. Uma biópsia da meninge revelou processo inflamatório inespecífico com extensa fibrose da dura máter, também visualizado no período perioperatório. Esses achados, associados à exclusão de outras causas, sugerem o diagnóstico de paquimeningite hipertrófica idiopática.


Subject(s)
Humans , Female , Adult , Spinal Cord/pathology , Spinal Cord Compression , Hypertrophy , Meningitis/physiopathology
9.
Arq. bras. oftalmol ; 85(3): 286-293, May-June 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1383794

ABSTRACT

ABSTRACT Purpose: To evaluate the radial peripapillary capillary density using optical coherence tomography angiography in patients with and without Helicobacter pylori infection. Methods: This prospective, cross-sectional study comprised 52 patients (52 eyes: Group 1) and 38 patients (38 eyes: Group 2) with and without H. pylori infections, respectively. The radial peripapillary capillary density and retinal nerve fiber layer thickness in 4 equal quadrants and 2 equal hemispheres in the peripapillary region were calculated using optical coherence tomography angiography. The optic nerve head parameters of the patients were also assessed. Results: The groups were similar in terms of age, gender, and the optic nerve head parameters. The radial peripapillary capillary densities in the superior hemisphere and quadrant were significantly lower in Group 1 than in Group 2 (p=0.039 and p=0.028, respectively) and were positively correlated with the superior hemisphere's retinal nerve fiber layer thickness (p<0.001 and p<0.001, respectively). Similarly, the radial peripapillary capillary densities in the inferior hemisphere and quadrant were also significantly lower in Group 1 compared to Group 2 (p=0.03 and p=0.017, respectively) and were positively correlated with the inferior hemisphere's retinal nerve fiber layer thickness (p<0.001 and p<0.001, respectively). The retinal nerve fiber layer thickness in the nasal and temporal quadrants were significantly decreased in Group 1 when compared to Group 2 (p=0.013 and p=0.022) and were positively correlated with the corresponding radial peripapillary capillary densities of the 2 quadrants (p=0.002 and p=0.022). Conclusion: The decreased radial peripapillary capillary density in the H. pylori-positive patients suggests that H. pylori may play a role in the etiopathogenesis of glaucoma.


RESUMO Objetivos: Avaliar a densidade capilar peripapilar radial de pacientes com e sem infecção por Helicobacter pylori (H. pylori) por meio de angiotomografia de coerência óptica. Métodos: Cinquenta e dois olhos de 52 pacientes com infecção por H. pylori (Grupo 1) e 38 olhos de 38 pacientes sem infecções por H. pylori (Grupo 2) foram incluídos neste estudo prospectivo e transversal. A densidade capilar peripapilar radial (%) e a espessura da camada de fibra nervosa retiniana (μm) em 4 setores iguais e 2 hemisférios iguais foram calculados automaticamente na região peripapilar por angiotomografia de coerência óptica. Os parâmetros da cabeça do nervo óptico dos pacientes também foram avaliados. Resultados: Os grupos foram semelhantes em relação aos parâmetros: idade, sexo e cabeça do nervo óptico. As densidades capilares peripapilares radiais no hemisfério superior, hemisfério inferior, quadrante superior e quadrante inferior foram significativamente menores no Grupo 1 do que no Grupo 2 (p=0,039, p=0,03, p=0,028 e p=0,017 respectivamente). As densidades capilares peripapilares radiais, tanto no hemisfério superior quanto no quadrante superior, foram correlacionadas positivamente com a espessura da camada de fibra nervosa da retina do hemisfério superior (p<0,001 e p<0,001). As densidades capilares peripapilares radiais no hemisfério inferior e no quadrante inferior foram positivamente correlacionadas com a espessura da camada do nervo retiniano do hemisfério inferior (p<0,001 e p<0,001). A espessura da camada da fibra nervosa retiniana nos quadrantes nasal e temporal diminuiu significativamente no Grupo 1 quando comparado ao Grupo 2 (p=0,013 e p=0,022), e esses valores foram positivamente correlacionados com as densidades capilares peripapilares radiais correspondentes nos quadrantes nasal e temporal (p=0,002 e p=0,022). Conclusão: A diminuição das densidades capilares peripapilares radiais nos olhos de indivíduos positivos para H. pylori sugere que H. pylori pode desempenhar um papel na etiopatogenia do glaucoma.

10.
Radiol. bras ; 55(3): 188-192, May-june 2022. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1387090

ABSTRACT

Abstract A doença de von Hippel-Lindau (VHL) é uma síndrome hereditária autossômica dominante rara que afeta a linha germinativa do gene VHL, um gene supressor tumoral. A doença de VHL é caracterizada pelo desenvolvimento multissistêmico de uma variedade de tumores benignos e malignos, especialmente no sistema nervoso central (SNC). Dentre eles, destacam-se hemangioblastomas retinianos e do SNC, e o tumor do saco endolinfático. Os diferentes locais dos tumores justificam a diversidade de sinais e sintomas relacionados à doença, que usualmente se manifestam com a idade média de 33 anos. Apesar dos avanços da medicina, a expectativa de vida média desses pacientes é de 49 anos. Exames de imagem têm papel fundamental no diagnóstico e são essenciais no seguimento dos pacientes com doença de VHL. Este ensaio iconográfico descreve as manifestações características dos tumores do SNC relacionados à doença de VHL que todos os residentes de radiologia devem saber.


Abstract Von Hippel-Lindau (VHL) disease is a rare, autosomal dominant inherited syndrome that affects the germline of the VHL gene, a tumor suppressor gene. VHL disease is characterized by the multisystemic development of a variety of benign and malignant tumors, especially in the central nervous system (CNS). Such tumors include retinal and CNS hemangioblastomas, as well as endolymphatic sac tumors. The various tumor sites are responsible for the diversity of signs and symptoms related to the disease. The mean age at symptom onset is 33 years. Despite medical advances, the average life expectancy of patients with VHL disease is 49 years. Imaging plays a pivotal role in the clinical diagnosis and is essential to the follow-up of patients with VHL disease. This pictorial essay describes characteristic CNS manifestations of VHL disease-related tumors that all radiology residents should be aware of.

11.
Medicina (B.Aires) ; 82(2): 210-216, mayo 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1375863

ABSTRACT

Abstract The pathological diagnosis of diffuse pleural mesothelioma (DPM) contributes to treatment selection and clinical trials interpretation. To know its characteristics and evaluate the viability of comprehensive pathological diagnosis of DPM in Argentina we did a retrospective descriptive study of DPM cases reported from 2009 to 2018. We analyzed 398 cases corresponding to 238 (60%) men and 160 (40%) women, median age 66 years, from surgical biopsies (78%), small biopsies (16.5%) and surgical resections (5.5%). The 77% were epithelioid (E-DPM), 12% biphasic, 10% sarcomatoid, and 4 cases transitional variant. In E-DPM the main pattern was tubular in 36% and solid in 33%. There was a second pattern in 179 cases. Considering the main pattern and the second together, 48% presented tubular subtype and 48% solid subtype. Stroma, necrosis, and nuclear score showed significant differences between E-DPM and non-epithelioid mesotheliomas. Overall tumor grade was predominantly low in E-DPM, except for 42% of the solid main pattern. We recognized the transitional variant extensively in 4 cases and focally in 8. The immunohistochemical antibody panel used included pan-cytokeratin, calretinin, WT-1, cytokeratin 5, CEA and TTF-1. The expression of cytokeratin 5, calretinin and WT-1 was lower in the sarcomatoid type (43%, 87 and 37%) than in the epithelioid type (92%, 98% and 93%). This study highlights the tumor heterogeneity of DPM that shows the diagnostic difficulty, and the feasibility of evaluating histological aggressiveness in E-DPM, B-DPM and S-DPM in our country.


Resumen El diagnóstico patológico del mesotelioma pleural difuso (MPD) contribuye a la selección del tratamiento y a la interpretación de los ensayos clínicos. Para conocer sus características y evaluar la viabilidad del diagnóstico patológico de MPD en Argentina se realizó un estudio descriptivo retros pectivo de los casos de MPD informados de 2009 a 2018. Se analizaron 398 casos correspondientes a 238 (60%) hombres y 160 (40%) mujeres, mediana de edad de 66 años, a partir de biopsias quirúrgicas (78%), biopsias pequeñas (16.5%) y resecciones quirúrgicas (5.5%). El 77% fue epitelioide (E-MPD), 12% bifásicos, 10% sarcomatoides y 4 casos variante transicional. En E-MPD se encontró como patrón principal el tubular en 36% y el sólido en 33%. Hubo un segundo patrón en 179 casos. Considerando el principal y el segundo patrón en conjunto, el 48% presentó subtipo tubular y el 48% subtipo sólido. El estroma, la necrosis y el score nuclear mostraron diferencias significativas entre E-MPD y mesoteliomas no epitelioides. El grado general del tumor fue predominantemente bajo en E-MPD, a excepción del 42% del patrón principal sólido. Reconocimos la variante transicional en forma extensa en 4 casos y focalmente en 8. La expresión de citoqueratina 5, calretinina y WT-1 fue menor en el tipo sarcomatoide (43%, 87 y 37%) que en el tipo epitelioide (92%, 98% y 93%). Este estudio destaca la heterogeneidad tumoral de MPD que evidencia la dificu ltad en el diagnóstico y la viabilidad de evaluar la agresividad histológica en E-MPD, B-MPD y S-MPD en nuestro país.

12.
CES med ; 36(1): 79-81, ene.-abr. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1384222

ABSTRACT

Resumen La segunda edición del Glosario ilustrado de dermatología y dermatopatología es un texto escrito por el médico especialista en Dermatopatología, Gerzaín Rodriguez Toro. El doctor Rodríguez fue docente de la Universidad Nacional de Colombia, en Bogotá, donde llegó a ser profesor titular y maestro universitario. Actualmente es profesor destacado de la Facultad de Medicina de la Universidad de La Sabana. Este texto constituye una sucesión de la labor que ha realizado el doctor Gerzaín durante décadas en el campo de la docencia médica, mediante sus múltiples publicaciones en el ámbito de la Dermatopatología.


Abstract The second edition of the Illustrated Glossary of Dermatology and Dermatopathology is a text written by the specialist in Dermatopathology, Gerzaín Rodriguez Toro. Dr. Rodríguez was a professor at the National University of Colombia, in Bogotá, where he became a full professor and university teacher. He is currently a prominent professor at the Faculty of Medicine of the University of La Sabana. This text constitutes a succession of the work that Dr. Gerzaín has carried out for decades in the field of medical teaching, through his multiple publications in the field of Dermatopathology.

13.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1385255

ABSTRACT

RESUMEN: El eritema multiforme es una enfermedad autoinmune vesicular-ampollosa y autolimitada, se presenta de forma aguda afectando la piel y mucosa. En 2015, Lee E. y Freer J., incluyeron esta enfermedad dentro de los síndromes dermatológicos paraneoplásicos, pero actualmente no existen muchas publicaciones de esta entidad como manifestación a una neoplasia subyacente. El objetivo de esta investigación es presentar el eritema multiforme como una manifestación paraneoplásica inusual. En este caso una paciente de 64 años de edad que cursaba con adenocarcinoma de colon exhibió el eritema multiforme oral; cuyas manifestaciones bucales involucionaron gracias a la farmacoterapia local y sistémica en conjunto con la excéresis de la lesión cancerosa en el colon. Es importante reconocer la presencia de eritema multiforme como una manifestación paraneoplásica cuando no se exhiben los factores etiológicos frecuentes de esta patología y, por lo tanto, centrarse en la búsqueda subyacente de neoplasias malignas que no son muy evidentes.


ABSTRACT: Erythema multiforme is a self-limiting, blistering, autoimmune disease that presents acutely, affecting the skin and mucosa. In 2015, Lee E. and Freer J. included this disease in paraneoplastic dermatological syndromes, but there are currently not many publications about this entity as a manifestation of an underlying malignancy. The objective of this research is to present the erythema multiforme as an unusual paraneoplastic manifestation. In this case, a female 64-year-old patient with colon adenocarcinoma exhibited oral multiform erythema; whose oral manifestations regressed thanks to local and systemic pharmacotherapy in conjunction with the exeresis of the cancerous lesion in the colon. It is important to recognize the presence of erythema multiforme as a paraneoplastic manifestation when the frequent etiological factors of this pathology are not exhibited and, therefore, to focus on the underlying search for malignant neoplasms that are not very evident.

14.
Arq. gastroenterol ; 59(1): 58-64, Jan.-Mar. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1374453

ABSTRACT

ABSTRACT Background Viral hepatitis C is a significant public health challenge. The disease may remain clinically silent in both acute and chronic forms, and chronic infections may progress to advanced disease such as cirrhosis and hepatocellular carcinoma, requiring costly treatment, compromising the patient's quality of life and even leading to death. For this reason, it is one of the most frequent indications for liver transplantation. Although treatment with direct-acting antivirals represents remarkable progress, many patients are still infected and even those who cleared the viral infection must be followed due to their previous hepatic lesions, especially regarding the disturbances of lobular architecture and the sanguineal and lymphatic vessels. Objective To assess immunohistochemical aspects of lymphatic sprouts and mature lymphatic vascularity with histological variables of liver injury attributable to hepatitis C virus (HCV) and fatty disease. Methods The present study included 72 liver biopsies of cases with chronic hepatitis C. Morphologic changes reflecting "staging" and "activity" were analyzed. Immunohistochemical reactions were performed with monoclonal antibody D2-40 anti-podoplanin. Major histological variables were also semiquantified so as to enable the search for possible associations among histological and Immunohistochemical criteria, as well as with genotypes 1 and 3 of HCV. Results Histological findings showed that the different degrees of strutural changes were well represented in this casuistic. Intralobular/parenchymal necro-inflammatory activity was predominantly mild to moderate. Most cases did not show major evidences of fatty disease, which was found significantly higher in cases infected with HCV genotype 3. The amount of portal lymphatic sprouts increased along with the progression of structural changes, maximal at cirrhosis. Portal lymphatic sprouts as well as portal mature lymphatic vessels also showed an increase parallel to the increase in the degree of portal/septal inflammatory infiltrate. In the present study, no significant association was found between the proportion of portal lymphatic sprouts or portal mature lymphatic vessels and the degree of periportal/periseptal activity. No significant relations were detected between lymphatic sprouts/mature vessels and periportal or parenchymal inflammatory activity, nor with infections due to HCV genotype 1 or 3. Conclusion Visualization and semiquantitation of sprouts and mature lymphatic vessels were clearly yielded by Immunohistochemical staining with monoclonal antibody D2-40. The amount of lymphatics was increased along fibrogenic process, significantly related to progression of liver disease and maximal at cirrhosis. No significant relations were detected with necro-inflammatory activity at interface or in the parenchyma.


RESUMO Contexto A hepatite C é um relevante problema de saúde pública. A doença pode permanecer clinicamente silenciosa tanto na forma aguda como na crônica e as infecções crônicas podem progredir para doenças avançadas, tais como cirrose e carcinoma hepatocelular (CHC), requerendo tratamentos dispendiosos, comprometendo a qualidade de vida do paciente e até mesmo levando à morte. Por esta razão, é uma das indicações mais frequentes para o transplante hepático. Apesar da introdução do tratamento com antivirais de ação directa (AAD) representar um progresso notável, muitos pacientes não receberam o tratamento e continuam infectados, e mesmo aqueles que eliminaram a infecção viral devem ser seguidos devido às lesões hepáticas anteriores, especialmente no que diz respeito às alterações da arquitetura lobular e dos vasos sanguíneos e linfáticos. Objetivo Avaliar os aspectos imuno-histoquímicos dos brotos linfáticos e dos vasos linfáticos "maduros" com variáveis histológicas de lesão hepática atribuíveis ao vírus da hepatite C (VHC) e à doença gordurosa. Métodos O presente estudo incluiu 72 biópsias hepáticas em pacientes com hepatite C crônica. Foram analisadas alterações estruturais relativas a "estadiamento" e "atividade". Reações imuno-histoquímicas foram realizadas com anticorpo D2-40 anti-podoplanina. As principais variáveis histológicas também foram semiquantificadas, de modo a permitir a procura de possíveis associações entre os critérios histológicos e imunohistoquímicos, bem como com os genótipos 1 e 3 do VHC. Resultados Os achados histológicos mostraram que os diferentes graus de alterações estrutural estavam bem representados nesta casuística. A atividade necro-inflamatória lobular/parenquimatosa foi predominantemente leve à moderada. A maioria dos casos não apresentava grandes evidências de doença gordurosa, que foi encontrada significativamente mais elevada nos casos infectados com o genótipo 3 do VHC. A quantidade de brotos linfáticos portais aumentou com a progressão de alterações estruturais, sendo máxima na cirrose. Os brotos linfáticos portais, bem como os vasos linfáticos "maduros" portais também mostraram um aumento paralelo ao aumento do grau de infiltrado inflamatório portal/septal. No presente estudo, não foi encontrada qualquer associação significativa entre a proporção de brotos linfáticos portais ou vasos linfáticos maduros portais e o grau de atividade periportal/periseptal. Não foram detectadas relações significativas entre os brotos linfáticos/vasos maduros e a atividade inflamatória periportal ou atividade inflamatória parenquimatosa, nem com infecções devido ao genótipo 1 ou 3 do VHC. Conclusão A reação imunohistoquímica com anticorpo monoclonal D2-40 possibilitou a visualização e a semiquantitação de brotos e vasos linfáticos "maduros" nas amostras obtidas por biópsia hepática. A quantidade de linfáticos aumentou ao longo do processo fibrogênico, significativamente relacionada com a progressão da doença hepática e máxima na cirrose. Não foram detectadas relações significativas com a atividade necro-inflamatória periportal ou parenquimatosa.

15.
Surg. cosmet. dermatol. (Impr.) ; 14: e20220074, jan.-dez. 2022.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1369138

ABSTRACT

O microagulhamento tem sido tradicionalmente usado para induzir a formação de colágeno. No couro cabeludo, foi observado que estimula a fase anágena e o ciclo capilar, mas faltam estudos que demonstrem as alterações histopatológicas após o procedimento. Relatamos o caso de uma mulher de 37 anos com história de alopecia de padrão feminino há 15 anos, com rarefação difusa proeminente na região fronto-parietal e miniaturização capilar observada à dermatoscopia. A condição permaneceu estável por 7 anos com uso de espironolactona e minoxidil tópico. A paciente foi submetida a três sessões de microagulhamento no couro cabeludo em intervalos mensais. A análise histopatológica foi realizada antes das sessões e um mês após a última sessão. O padrão de alopecia permaneceu o mesmo, sem alterações significativas na contagem de folículos após as intervenções, apesar de discreta melhora clínica e dermatoscópica. Não foram observados tratos fibrosos ou inflamação após o procedimento. A análise histopatológica é importante para avaliar a segurança do microagulhamento do couro cabeludo em curto e longo prazo, para investigar sinais como inflamação e fibrose, bem como para determinar a eficácia deste procedimento no tratamento da alopecia, e estudos com maior número de casos são necessários


Microneedling has traditionally been used to induce collagen formation. Scalp microneedling has been seen to stimulate the capillary cycle and anagen phase, but studies demonstrating histopathological changes after this procedure are lacking. Here we present the case of a 37-year-old woman with a 15-year history of female pattern alopecia, with diffuse hair thinning prominent in the frontoparietal region and hair miniaturization seen in dermoscopy. The patient's condition remained stable for seven years with use of spironolactone and topical minoxidil. The patient underwent three scalp microneedling sessions at monthly intervals. Histopathological analysis was conducted before the sessions and one month after the last session. Despite slight clinical and dermoscopic improvement, the alopecia pattern remained the same, without significant changes in follicle count after the interventions. Neither inflammation nor fibrous tracts were observed after the procedure. The histopathological analysis is essential to assess the safety of scalp microneedling in the short and long term, investigate signs such as inflammation and fibrosis, and determine the effectiveness of this procedure in treating alopecia. Studies with a more significant number of cases are necessary

16.
Article in English | LILACS | ID: biblio-1368616

ABSTRACT

RESUMO: Introdução: A pandemia pelo novo coronavírus (SARS-CoV-2) trouxe muitas incertezas sobre quais parâmetros laboratoriais seriam mais adequados durante a evolução da COVID 19. Objetivos: Correlacionar os resultados do hemograma (HGM), da relação neutrófilos/linfócitos (R N/L), da proteína C reativa (PCR) e dos achados morfológicos de indivíduos diagnosticados com infecção por SARS-CoV-2 através de Reação em Cadeia da Polimerase em Tempo Real (RT-PCR) em um laboratório particular de Belém, Pará, no período de março a setembro de 2020. Materiais e Métodos: Estudo retrospectivo com 30 indivíduos, de ambos os sexos, qualquer idade e queixa clínica, de origem domiciliar ou hospitalar que realizaram HGM, PCR e RT-PCR para COVID 19 até o 8o dia de infecção. As alterações morfológicas foram analisadas após a seleção das lâminas desses pacientes. Resultados:Amostra composta por 15 homens e 15 mulheres, com idades entre 7 e 92 anos. Desses, 12/30 indivíduos estavam em domicílio e 18/30 internados. As principais queixas foram febre, mal-estar geral, diarreia e desconforto respiratório. O estudo estatístico mostrou a existência de relação de dependência direta entre os aumentos da R N/L, PCR e necessidade de internação (p=0,0005). A análise morfológica mostrou neutrófilos hipossegmentados com granulações tóxicas, monócitos vacuolizados e linfócitos reativos com citoplasma basofílico. Conclusão: Nossos resultados associam os níveis intermediários e elevados da R N/L com o aumento de PCR e a gravidade da doença, porém, sem relação com os achados morfológicos em neutrófilos, linfócitos e monócitos que foram comuns a todos os pacientes diagnosticados até o 8o dia de infecção. (AU)


ABSTRACT: Morphological changes in leukocytes of acute SARS-CoV-2 infection patients, Amazon, BrazilORIGINAL ARTICLEIntroduction: The pandemic for the new coronavirus (SARS-CoV-2) brought many uncertainties about which laboratory parameters would be most suitable during the evolution of COVID 19. Objectives: Correlate the results of the blood count (BC), the neutrophil/lymphocyte ratio (N/LR), the C-reactive protein (CRP) and morphological findings of individuals diagnosed with SARS-CoV-2 infection through Polymerase Chain Reaction in Real Time (RT-PCR) in a private laboratory in Belém, Pará, from March to September 2020. Materials and Methods: Retrospective study with 30 individuals, of both sexes, any age and clinical complaint, of home or hospital origin who underwent BC, CRP and RT-PCR for COVID 19 until the 8th day of infection. Morphological changes were analyzed after selecting the slides for these patients. Results: Sample composed of 15 men and 15 women, aged between 7 and 92 years. Of these 12/30 individuals were at home and 18/30 were hospitalized. The main complaints were fever, malaise, diarrhea and respiratory distress. The statistical study showed a direct dependency relationship between increases in N/LR, CRP and the need for hospitalization (p = 0.0005). Morphological analysis showed hyposegmented neutrophils with toxic granulations, vacuolated monocytes, and reactive lymphocytes with basophilic cytoplasm. Conclusion: Our results associate intermediate and elevated levels of N/LR with increased CRP and disease severity, however, unrelated to the morphological findings in neutrophils, lymphocytes and monocytes that were common to all patients diagnosed up to the 8th day of infection. (AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Lymphocytes , Monocytes , Coronavirus Infections/diagnosis , SARS Virus/pathogenicity , COVID-19/blood , Neutrophils
17.
Journal of Clinical Hepatology ; (12): 653-655, 2022.
Article in Chinese | WPRIM | ID: wpr-922974

ABSTRACT

Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease accompanied by cholestasis, with the histological feature of non-purulent cholangitis. This article briefly describes the advantages and limitations of the traditional pathological staging systems such as Rubin stage, Scheuer stage, and Ludwig stage and the latest Nakanuma stage. Among them, Nakanuma stage refines the histological grading and staging standards to reduce the chance of missed diagnosis due to sampling errors, thus providing more adequate diagnostic and prognostic information for the clinic. A combination of new and traditional staging systems can provide guidance to the diagnosis, treatment, and research of PBC.

18.
Journal of Clinical Hepatology ; (12): 617-621, 2022.
Article in Chinese | WPRIM | ID: wpr-922964

ABSTRACT

Objective To investigate the expression of the E3 ubiquitin ligase neural precursor cell expressed developmentally downregulated 4-1 (NEDD4-1) in pancreatic cancer tissue and its clinical significance. Methods Clinical data were collected from 58 patients who underwent surgical treatment in Xuzhou Central Hospital from January 2017 to December 2019 and were diagnosed with pancreatic ductal adenocarcinoma based on pathological examination. Immunohistochemistry was used to measure the expression of NEDD4-1 in pancreatic cancer tissue samples, and the association between the expression of NEDD4-1 and the clinicopathological features of pancreatic cancer was analyzed. Western blot was used to measure the protein expression level of NEDD4-1 in normal pancreatic ductal epithelial HPDE6-C7 cells and pancreatic cancer SW1990, BxPC-3, and PANC-1 cells. The t -test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to plot survival curves, and the log-rank test was used for survival analysis. The Cox proportional-hazards regression model was used to investigate the factors associated with prognosis. Results The expression level of NEDD4-1 in pancreatic cancer tissue was significantly higher than that in adjacent tissue (79.31% vs 19.05%, χ 2 =35.614, P < 0.01), and the protein expression of NEDD4-1 in pancreatic cancer cells was significantly higher than that in normal pancreatic ductal epithelial cells ( P < 0.01). In the patients with pancreatic cancer, the expression of NEDD4-1 was associated with distant metastasis ( χ 2 =5.089, P =0.040), tumor differentiation ( χ 2 =9.071, P =0.003), and TNM stage ( χ 2 =8.882, P =0.003). The patients with high NEDD4-1 expression had a significantly shorter mean survival time than those with low expression (13.61±0.95 months vs 22.22±2.20 months, P =0.001). The Cox regression analysis showed that NEDD4-1 expression (hazard ratio [ HR ]=2.312, 95% confidence interval [ CI ]: 1.010-5.295, P =0.047), degree of tumor differentiation ( HR =2.981, 95% CI : 1.556-5.712, P =0.001), and lymph node metastasis ( HR =2.144, 95% CI : 1.155-3.979, P =0.016) were independent risk factors for the prognosis of patients with pancreatic cancer. Conclusion There is a significant increase in the expression of NEDD4-1 in pancreatic cancer tissue and cells, and the high expression of NEDD4-1 is associated with poor prognosis. Therefore, it can be used as a prognostic biomarker and a therapeutic target for pancreatic cancer.

19.
Article in Chinese | WPRIM | ID: wpr-907143

ABSTRACT

@#Along with the popularity of low-dose computed tomography lung cancer screening, an increasing number of lung ground-glass opacity (GGO) lesions are detected. The pathology of GGO could be benign, but persistent GGO indicates early-stage lung cancer. Distinct from traditional lung cancer, GGO-featured lung cancer is more common in the young, nonsmokers and females. GGO-featured lung cancer represents an indolent type of malignancy with a long time to intervene. However, there is still no consensus on the screening, pathology, surgical procedure, and postoperative surveillance of GGO-featured lung cancer. Therefore, we proposed a personalized treatment strategy for GGO-featured lung cancer. The screening for GGO-featured lung cancer should be conducted at young age and low frequency. Adenocarcinoma in situ, minimally invasive adenocarcinoma, lepidic, and non-lepidic growth patterns could present as GGO. The following issues should be taken into consideration while determining the treatment of GGO-featured lung cancer: avoiding treating benign disease as malignancies, avoiding treating early-stage disease as advanced-stage disease, avoiding treating indolent malignancy as aggressive malignancy, and choosing appropriate timing to receive surgery without affecting life tracks and career developments. Bronchoscope and bone scan are not necessary for preoperative examinations of GGO-featured lung adenocarcinoma. For selected patients, sublobar resection without mediastinal lymph node dissection might be sufficient. Intraoperative frozen section is an effective method to guide resection strategy. Given the excellent survival of GGO-featured lung cancer, a less intensive postoperative surveillance strategy may be sufficient.

20.
Article in Chinese | WPRIM | ID: wpr-928861

ABSTRACT

Advances in digital pathology technology have enabled pathologists and laboratory physicians to perform quick, easy, accurate and reproducible analysis of digital images of tissues and cells with the aid of electronic screens and software tools, rather than relying solely on traditional optical microscopy observations. The conventional clinical cytology testing practice is to be replaced by a digital workflow, which includes both digital imaging and image analysis. This article provides an overview of the basic principles of digital pathology techniques, the advances of development of device in cytology digital pathology, and their clinical applications in bone marrow morphology, and existing problems and prospects of digital pathology application in hematology.


Subject(s)
Bone Marrow , Image Processing, Computer-Assisted , Microscopy , Software , Technology
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