Yinlai Decoction Protects Microstructure of Colon and Regulates Serum Level of D-Lactic Acid in Pneumonia Mice Fed with High-Calorie and High-Protein Diet / 中国结合医学杂志

OBJECTIVE@#To investigate the effect of Yinlai Decoction (YD) on the microstructure of colon, and activity of D-lactic acid (DLA) and diamine oxidase (DAO) in serum of pneumonia mice model fed with high-calorie and high-protein diet (HCD).@*METHODS@#Sixty male Kunming mice were randomly divided into 6 groups by the random number table method: normal control, pneumonia, HCD, HCD with pneumonia (HCD-P), YD (229.2 mg/mL), and dexamethasone (15.63 mg/mL) groups, with 10 in each group. HCD mice were fed with 52% milk solution by gavage. Pneumonia mice was modeled with lipopolysaccharide inhalation and was fed by gavage with either the corresponding therapeutic drugs or saline water, twice daily, for 3 days. After hematoxylin-eosin staining, the changes in the colon structure were observed under light microscopy and transmission electron microscope, respectively. Enzyme-linked immunosorbent assay was used to detect the protein levels of DLA and DAO in the serum of mice.@*RESULTS@#The colonic mucosal structure and ultrastructure of mice in the normal control group were clear and intact. The colonic mucosal goblet cells in the pneumonia group tended to increase, and the size of the microvilli varied. In the HCD-P group, the mucosal goblet cells showed a marked increase in size with increased secretory activity. Loose mucosal epithelial connections were also observed, as shown by widened intercellular gaps with short sparse microvilli. These pathological changes of intestinal mucosa were significantly reduced in mouse models with YD treatment, while there was no significant improvement after dexamethasone treatment. The serum DLA level was significantly higher in the pneumonia, HCD, and HCD-P groups as compared with the normal control group (P<0.05). Serum DLA was significantly lower in the YD group than HCD-P group (P<0.05). Moreover, serum DLA level significantly increased in the dexamethasone group as compared with the YD group (P<0.01). There was no statistical significance in the serum level of DAO among groups (P>0.05).@*CONCLUSIONS@#YD can protect function of intestinal mucosa by improving the tissue morphology of intestinal mucosa and maintaining integrity of cell connections and microvilli structure, thereby reducing permeability of intestinal mucosa to regulate the serum levels of DLA in mice.

Pharmacological blockade of protease-Activated Receptor 2 improves airway remodeling and lung inflammation in experimental allergic asthma

Abstract Protease-activated receptors (PARs) are metabotropic G-protein-coupled receptors that are activated via proteolytic cleavage of a specific sequence of amino acids in their N-terminal region. PAR2 has been implicated in mediating allergic airway inflammation. This study aims to study the effect of PAR2 antagonist ENMD1068in lung inflammation and airway remodeling in experimental asthma. Allergic lung inflammation was induced in sensitized BALB/c mice through intranasal instillations of ovalbumin (OVA), and mice were pretreated with ENMD1068 1 hour before each OVA challenge. Bronchoalveolar lavage fluid (BALF) was collected, and the lungs were removed at different time intervals after OVA challenge to analyze inflammation, airway remodeling and airway hyperresponsiveness. Ovalbumin promoted leukocyte infiltration into BALF in a PAR2-dependent manner. ENMD1068 impaired eosinophil peroxidase (EPO) and myeloperoxidase (MPO) activity in the lung parenchyma into BALF and reduced the loss of dynamic pulmonary compliance, lung resistance in response to methacholine, mucus production, collagen deposition and chemokine (C-C motif) ligand 5 expression compared to those in OVA-challenged mice. We propose that proteases released after an allergen challenge may be crucial to the development of allergic asthma in mice, and PAR2 blockade may be useful as a new pharmacological approach for the treatment of airway allergic diseases.

Coagulopatía por SARS-CoV-2 / SARS-COV-2 COAGULOPATHY

En diciembre de 2019 se descubrió un nuevo coronavirus, asociado a pacientes que sufrían un cuadro de neumonía en Hubei provincia de China, desde ese momento se estudia las características del virus, como también de la patología que produce. En los pacientes graves, se observó un estado proinflamatorio y procoagulante que provocó la disfunción multiorgánica, y, en muchos de ellos, la muerte. El objetivo de este trabajo consiste en describir la fisiopatología de la coagulopatía que esta infección, sorprendentemente, provoca. Es importante remarcar la relación que existe entre los estados inflamatorios y la cascada de la coagulación, cuyas disfunciones ocurren en situaciones de gravedad, como es la sepsis. El SARS-CoV-2 entrara a la célula mediante el receptor de la enzima convertidora de angiotensinógeno. En los estadios avanzados o críticos de la enfermedad, el estímulo hiperinflamatorio y el ambiente protrombótico provocarán un daño multiorgánico. El enfoque de los pacientes en estadios avanzados o críticos debe ser de soporte vital, junto a una terapia anticoagulante completa

In December 2019, a new coronavirus, SARS-CoV-2, was discovered in patients suffering from pneumonia. In critically ill patients, a proinflammatory and procoagulant state was observed: this led to multiorgan dysfunction, and, in many patients, to death. The objective of this work is to describe the pathophysiology of coagulopathy that this infection, surprisingly, causes. It is important to highlight the cross-talk between inflammation and coagulation in serious situations, such as sepsis. SARS-CoV-2 will enter the cell via the angiotensinogen converting enzyme receptor. In the advanced or critical stages of the disease, the hyperinflammatory stimulus and the prothrombotic environment will cause multi-organ damage. The approach of patients in advanced or critical stages should be life support, together with full anticoagulant therapy.

Granulomatous pneumonia due to pythiosis in captive South American coatis (Nasua nasua) / Pneumonia granulomatosa decorrente de pitiose em quatis sul-americanos (Nasua nasua) de cativeiro

Pythiosis is an emerging infectious disease affecting captive and free-ranging wild animals. We report granulomatous pneumonia due to Pythium insidiosum in two South American coatis (Nasua nasua), who were found dead without any clinical records. Severe granulomatous pneumonia associated with pleural effusion was revealed in the necropsy. Microscopically, variably sized granulomas and pyogranulomas presented negative hyphae profiles at the periphery of their necrotic cores. Grocott methenamine silver stain highlighted these structures, and immunostain (anti- P. insidiosum) was strongly positive. Molecular analysis by polymerase chain reaction amplified P. insidiosum specific DNA. These findings characterized P. insidiosum as a cause of granulomatous pneumonia in coatis and proved that pythiosis needs to be considered in the differential diagnosis of respiratory diseases affecting this species in endemic areas.(AU)

A pitiose é uma doença infecciosa emergente que afeta animais silvestres de cativeiro e em vida livre. Reportamos dois casos de pneumonia granulomatosa decorrentes da infecção por Pythium Insidiosum em quatis sul-americanos (Nasua nasua), que foram encontrados mortos sem apresentar nenhum quadro clínico prévio. Pneumonia granulomatosa severa associada a efusão pleural foi observada durante a necropsia. Na microscopia, foram observados múltiplos granulomas e piogranulomas de tamanhos variados que continham imagens negativas de hifas na periferia de seus centros necróticos. A coloração de metenamina de prata (Grocott) evidenciou estas estruturas, e a imunomarcação (anti-P. insidiosum) foi fortemente positiva. A análise molecular pela reação de polimerase em cadeia amplificou o DNA específico do P. insidiousum. Estes achados caracterizaram o P. insidiosum como a causa da pneumonia granulomatosa nos quatis e provou que a pitiose deve ser considerada um diagnostico diferencial para outras doenças respiratórias que afetam esta espécie.(AU)

Enfermedad pulmonar intersticial por IgG4 / IgG4-related interstitial lung disease

Las enfermedades relacionadas con inmunoglobulina G4 (IgG4) son un grupo heterogéneo de cuadros clínicos que pueden afectar un solo órgano o tener compromiso sistémico. Se presenta el caso de una mujer de 55 años, internada por un cuadro de tos seca, fiebre, disnea progresiva e insuficiencia respiratoria. La tomografía de tórax evidenció áreas de vidrio esmerilado difusas, patrón reticular y consolidación alveolar. Recibió tratamiento habitual para neumonía de la comunidad y corticoides sistémicos, presentando buena evolución y otorgándose el alta. Al mes se reinterna por estenosis subglótica, progresión de infiltrados pulmonares y aumento del volumen palpebral y de las glándulas submaxilares. Se realizaron biopsias transbronquial y de glándulas salivales que mostraron infiltración por IgG4. También se detectó aumento de los niveles de IgG4 en plasma. Recibió tratamiento con inmunosupresores evolucionando con buena respuesta.

IgG4-related disease is a heterogeneous group of diseases that can affect a single organ or manifest as a systemic disease. We present the case of a 55-year-old female, admitted for dry cough, fever, progressive dyspnea and respiratory failure. Chest CT showed areas of diffuse ground glass, reticular pattern and alveolar consolidation. She received treatment for community acquired pneumonia and systemic corticosteroids with good response. One month later, she was admitted again due to subglottic stenosis, progression of pulmonary infiltrates, and increased palpebral and submaxillary glands volume. Transbronchial and salivary gland biopsies showed infiltration by IgG4. Increased levels of plasma IgG4 were also detected. Immunosuppressive therapy was given with good response.

Effects of hypothermia on lung inflammation in a rat model of meconium aspiration syndrome

Abstract Purpose: To evaluate the effects of hypothermia treatment on meconium-induced inflammation. Methods: Fifteen rats were instilled with human meconium (MEC, 1.5 mL/kg, 65 mg/mL) intratracheally and ventilated for 3 hours. Eight rats that were ventilated and not instilled with meconium served as a sham group. In MEC-hypothermia group, the body temperature was lowered to 33±0.5°C. Analysis of the blood gases, interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor (TNF)-α in bronchoalveolar lavage (BAL) fluid samples, and histological analyses of the lungs were performed. Results: The BAL fluid TNF-α, IL-1β, IL-6 and IL-8 concentrations were significantly higher in the MEC-hypothermia group than in the MEC-normothermia (p < 0.001, p < 0.001, p = 0.001, p < 0.001, respectively) and sham-controlled groups (p < 0.001, p < 0.001, p < 0.001, p < 0.001, respectively). Conclusion: Meconium-induced inflammatory cytokine production is affected by the body temperature control.

Efecto del sulfato de cobre en el daño pulmonar inducido por la exposición crónica intermitente a ozono / Effect of copper sulphate on the lung damage induced by chronic intermittent exposure to ozone

Background: Ozone exposure could increase lung damage induced by airborne particulate matter. Particulate matter lung toxicity has been attributed to its metallic content. Aim: To evaluate the acute effect of intratracheal administration of copper sulfate (CuSO4) on rat lungs previously damaged by a chronic intermittent ozone exposure. Material and Methods: Two-months-old male Sprague-Dawley rats were exposed to 0.5 ppm ozone four h per day, five days a week, during two months. CuSO4 was intratracheally instilled 20 h after ozone exposure. Controls breathed filtered air or were instilled with 0.9% NaCl or with CuSO4 or were only exposed to ozone. We evaluated lung histopathology. F2 isoprostanes were determined in plasma. Cell count, total proteins, γ glutamyl-transpeptidase (GGT) and alkaline phosphatases (AP) were determined in bronchoalveolar lavage fluid (BALF). Results: Ozone increased total cell count, macrophages, proteins and AP in BALF (p < 0.05), and induced pulmonary neutrophil inflammation. CuSO4 plus air increased plasma F2 isoprostane levels and total cell count, neutrophils and proteins in BALF (p < 0.05). Histopathology showed foamy macrophages. Ozone plus CuSO4 exposed animals showed a neutrophil inflammatory lung response and an increase in total cell count, proteins, GGT and AP in BALF (p < 0.05). Foamy and pigmented alveolar macrophages were detected in all lungs of these animals (p < 0.001). Conclusions: Intratracheal instillation of a single dose of CuSO4 in rats previously subjected to a chronic and intermittent exposure to ozone induces a neutrophil pulmonary inflammatory response and cytoplasmic damage in macrophages.

Effects of CpG oligodeoxynucleotide 1826 on acute radiation-induced lung injury in mice

BACKGROUND: The radiation-induced lung injury is a common complication from radiotherapy in lung cancer. CpG ODN is TLR9 activator with potential immune modulatory effects and sensitization of radiotherapy in lung cancer. This study aimed to examine the effect of CpG ODN on acute radiation-induced lung injury in mice. METHODS AND RESULTS: The mouse model of radiation-induced lung injury was established by a single dose of 20 Gy X-rays exposure to the left lung. The results showed that the pneumonia score was lower in RT+CpG group than in RT group on 15th and 30th days. Compared with RT group, CpG ODN reduced the serum concentrations of MDA (P < 0.05) and increased the serum concentrations of SOD, GSH (P < 0.05). The serum concentration of TNF-α in RT+CpG group was lower on 15th and 30th days post-irradiation (P < 0.05). CONCLUSION: The study demonstrated that CpG ODN has preventive effects of acute radiation-induced lung injury in mice. Lung inflammatory reaction and oxidative stress are promoted in the initiation of radiation-induced pneumonia. CpG ODN may reduce the injury of reactive oxygen species and adjust the serum TNF-α concentration in the mice after irradiation, which reduces the generation of the inflammatory cytokines.

Soropositividade para Mycoplasma hyopneumoniae em suínos abatidos em frigoríficos da região central do estado de São Paulo / Seropositivity for Mycoplasma hyopneumoniae in pigs at a slaughterhouse in the Central region of São Paulo

Mycoplasma hyopneumoniae is the etiologic agent of enzootic pneumonia in pigs and causes large economic losses in the swine industry. There is little data on the positivity of this disease in Brazil. The objective of this study was to evaluate the seropositivity for this agent in 200 serum samples collected from pigs in a slaughterhouse located in the central region of São Paulo. A high percentage (52%) of positivity was found indicating the presence of the agent and the need to implement control measures.

Uso de toracotomía mínima ampliada y lavado de cavidad pleural en el tratamiento del empiema / Using minimal thoracotomy enlarged cavity lavage in treating pleural empyema

El empiema se define como la acumulación patológica de líquido en el espacio pleural y es el resultado de un desequilibrio entre la formación y la reabsorción de líquido a este nivel, causado por neumonías. Evaluar el uso de la toracotomía mínima ampliada y lavado de la cavidad pleural en el tratamiento del empiema, en los pacientes que asistieron al Hospital Universitario de Caracas entre enero de 2007 y Noviembre de 2008. 20 pacientes (12 varones, 8 hembras), con edades comprendidas entre 2 y 9 años fueron tratados por presentar Neumonía complicada con Empiema. La Toracotomía mínima convencional fue realizada en 11 pacientes (5 varones, 6 hembras) y la Toracotomía mínima ampliada y lavado de cavidad pleural fue realizada en 9 pacientes (7 varones, 2 hembras). El tiempo promedio de hospitalización fue de 23,3 días en el grupo control y 23,9 días en el grupo muestra. El tiempo promedio del postoperatorio en el grupo control fue de 7,1 días y 5,9 días en el grupo de casos. Las complicaciones fueron tres en el grupo control, dos requirieron Toracotomía más decorticación, y segmentectomía del lóbulo medio adicional en uno; el grupo muestra no ameritó la realización de procedimiento quirúrgico adicional. El uso de la toracotomía mínima ampliada mas lavado de la cavidad pleural en los pacientes con empiema en etapa temprana; es una opción accesible y útil en aquellos centros en los que no se cuenta con toracoscopio para la realización de la misma, y por ende no requiere realizar decorticaciones o segmentectomias

Empyema is defined as abnormal accumulation of fluid in the pleural space and is the result of an imbalance between formation and resorption of fluid at this level, caused by pneumonia. Our goal is to evaluate the use of extended minimal thoracotomy and pleural lavage in the treatment of empyema in patients attending the Hospital Universitario de Caracas. In total 20 patients (12 males and 8 females), aged between 2 and 9 years were treated for pneumonia complicated with empyema. The conventional minimum Thoracotomy was performed in 11 patients (5 males and 6 females) and the expanded minimum Thoracotomy and pleural cavity lavage was performed in 9 patients (7 males and 2 females). The average length of hospital stay was 23.2 days in the control group and 23. 8 days in the sample group shows no difference from a statistical standpoint. The average time post-procedure hospitalization in the control group was 7 days and 5.8 days in group shows no significant differences. Complications were 3 in the control group, requiring more Thoracotomy and decortication in two cases and middle lobe segmentectomy in another, while in the sample group does not warrant the performance of additional surgical procedure, statistically significant differences exist. We conclude that the use of minimal thoracotomy extended more of the pleural lavage in patients with early-stage empyema, is a useful and accessible option, since it may avoid making decortications or segmentectomy.

The effect of Nigella sativa extract on tracheal responsiveness and lung inflammation in ovalbumin-sensitized guinea pigs

OBJECTIVE: To examine the preventive effect of a hydro-ethanolic extract of Nigella sativa on the tracheal responsiveness and white blood cell count in the lung lavage fluid of sensitized guinea pigs. METHODS: Three groups of guinea pigs sensitized to intraperitoneally injected and inhaled ovalbumin were given drinking water alone (group S), drinking water containing a low concentration of N. sativa extract (group S+LNS) or drinking water containing a high concentration of N. sativa extract (group S+HNS). The tracheal responses of control animals (group C) and the three groups of sensitized guinea pigs (n = 7 for all groups) to methacholine were measured by the assessment of the tracheal smooth muscle response to increasing concentrations of methacholine, and the effective concentration causing 50 percent of the maximum response (EC50) was determined. Tracheal responses to 0.1 percent ovalbumin and white blood cell counts in the lung lavage fluid were also examined. RESULTS: The tracheal response of the group S guinea pigs to both methacholine and ovalbumin was significantly higher than the response of the controls (p<0.01 for both cases). The tracheal responses of the S+LNS and S+HNS groups to both methacholine and ovalbumin were significantly decreased compared to those of the S group (p<0.05 to p<0.01). The total white blood cell and eosinophil counts in the lung lavage fluid of group S were significantly higher than those of group C (p<0.01). The white blood cell counts in both treated groups showed significant improvements (p<0.01 for both cases). CONCLUSIONS: These results demonstrate the preventive effect of the N. sativa extract on the tracheal response and lung inflammation in sensitized guinea pigs.

The pattern of distribution of pneumonic consolidation in experimental peste des petits ruminants virus (PPRV) and/or Mannheimia Hemolytica Infection in West African dwarf goats / Patrón de distribución de la consolidación pneumónica en infección experimental con virus peste des petits ruminants (PPRV) y/o mannheimia hemolítica en cabras enanas del Oeste Africano

The study into the pattern of distribution of the lung consolidation associated with common viral and bacterial pneumonia and their co-infection in subsaharan goats is scanty in literatures. Fifty apparently healthy West Africa Dwarf goats (WAD) six months of age were used for the experiment. The animals were divided into groups A, B, and C with 15 goats each while 5 goats served as control. Group A goats infected with 1ml of pure culture (1 X 109 CFU) of Mannheimia haemolytica MH A2, while group B with 1ml of pure cultured 106.5 TCID50 PPR virus grown in Baby hamster kidney cell lines and group C with 1 ml of PPRV and a week later 1ml of MH A2. The degree of consolidation or pneumonia as a percentage of the total lung volume was determined by visual observation, palpation and measurement of the lesion which is estimated as a percentage of each lobe. Student t-test were used to test for significant differences. The right lungs have a higher lung consolidation percentage than the left in all the treatment groups. The accessory lobe was affected in the PPRV group. The MH group has the highest lung consolidation percentage (10.1 percent). The PPRV 1-28dpi has the lowest consolidation percentage (1.06 percent). There is significant difference in the consolidation percentage and mortality between MH, PPR+MH, PPRV 28-45 dpi and PPRV 1-28dpi (P<0.05). This observation further show that the right lung and the anterior lobes were more affected in experimental viral and bacterial respiratory pathogen and their co-infection as the trachea birfucation is first to the right and the distance between the right and the left birfucation was 1.5 +/- 0.35cm. It is the first study that describes and compare the pattern of distribution and morphometry of pneumonia in experimental PPRV, MH and PPRV+MH infections in goats.

El estudio sobre el patrón de distribución de la consolidación pulmonar asociada con neumonía virales y bacterianas comunes y sus co-infección en cabras Subsaharianas, es escasa en la literatura. Cincuenta cabras enanas de África occidental (WAD) aparentemente sanas de seis meses de edad fueron utilizados para el experimento. Los animales se dividieron en grupos A, B y C con 15 cabras cada uno mientras que el 5 cabras sirvió como control. Grupo A cabras infectadas con 1 ml de cultivo puro (1 X 109 UFC) de Mannheimia haemolytica MH A2, mientras que el grupo B con 1 ml de cultivo puro 10 6,5 DICT50 PPR cultivado en líneas celulares de riñón de crías de hámsters y el grupo C con 1 ml de PPRV y un semana después de 1 ml de MH A2. El grado de consolidación o neumonía como porcentaje del volumen pulmonar total se determinó por observación visual, palpación y la medición de la lesión que se estima como un porcentaje de cada lóbulo. El test t de Student se utilizaron para probar las diferencias significativas. El pulmón derecho tiene un porcentaje de consolidación pulmonar superior a izquierdo en todos los grupos de tratamiento. El lóbulo accesorio se vio afectado en el grupo de PPRV. El grupo MH tiene el porcentaje más alto de consolidación pulmonar (10,1 por ciento). El PPRV 1-28dpi tiene el menor porcentaje de consolidación (1,06 por ciento). No hay diferencia significativa en el porcentaje de consolidación y la mortalidad entre MH, MH + PPR, PPRV 28-45 dpi y PPRV 1-28dpi (P <0,05). Esta observación muestra además que el pulmón derecho y los lóbulos anteriores se vieron más afectados en infecciones respiratorias patógenas experimentales con agentes virales y bacterianos y su co-infección como la bifurcación traqueal es primero a la derecha y la distancia entre la derecha y la bifurcación izquierda fue de 1,5 +/- 0,35 cm. Es el primer estudio que describe y compara el patrón de distribución y la morfometría de las neumonías en PPRV experimentales, MH y MH + PPRV...

Determinantes morfológicos de prognóstico em pneumonia nosocomial: um estudo em autópsias / Morphological prognostic factors in nosocomial pneumonia: an autopsy study

OBJETIVO: Determinar a prevalência de pneumonia nosocomial nas autópsias em um hospital público universitário; identificar os fatores de risco relacionados à pneumonia nosocomial e os potenciais fatores prognósticos relacionados à ocorrência de pneumonia nosocomial fatal; e correlacionar os achados anatomopatológicos com a ocorrência de pneumonia nosocomial e/ou pneumonia aspirativa. MÉTODOS: Estudo retrospectivo de 199 pacientes autopsiados, maiores de 1 ano de idade, internados no Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista entre 1999 e 2006, cuja causa de morte (causa básica ou associada) foi pneumonia nosocomial. Testou-se a associação dos dados demográficos, clínicos e anatomopatológicos com os desfechos pneumonia nosocomial fatal e pneumonia aspirativa fatal. As variáveis significativas entraram na análise multivariada. RESULTADOS: A idade média foi de 59 ± 19 anos. A prevalência de pneumonia nosocomial em autópsias foi 29 por cento, e essa foi a causa mortis de 22,6 por cento dos pacientes autopsiados. A pneumonia nosocomial fatal correlacionou-se com os achados anatomopatológicos de alterações estruturais tabágicas (OR = 3,23; IC95 por cento: 1,26-2,95; p = 0,02) e acometimento pulmonar bilateral (OR = 3,23; IC95 por cento: 1,26-8,30; p = 0,01). Não houve associações significativas entre as variáveis e pneumonia aspirativa fatal. CONCLUSÕES: Em nossa amostra, a pneumonia nosocomial teve prevalência elevada e foi responsável por quase 25 por cento das mortes. A mortalidade é favorecida por alterações estruturais tabágicas e pneumonia bilateral. Esses achados corroboram os resultados de diversos estudos clínicos sobre pneumonia nosocomial.

OBJECTIVE: To determine the prevalence of nosocomial pneumonia in autopsies at a public university hospital; to identify the risk factors for nosocomial pneumonia and the potential prognostic factors associated with fatal nosocomial pneumonia and with fatal aspiration pneumonia; and to determine whether anatomopathological findings correlate with nosocomial pneumonia or aspiration pneumonia. METHODS: A retrospective study involving 199 autopsied patients, older than 1 year of age, who had been admitted to the São Paulo State University Botucatu School of Medicine Hospital das Clínicas and died of nosocomial pneumonia (underlying or contributing cause), between 1999 and 2006. Demographic, clinical and anatomopathological variables were tested regarding their association with the outcomes (fatal nosocomial pneumonia and fatal aspiration pneumonia). The significant variables were analyzed using multivariate analysis. RESULTS: The mean age was 59 ± 19 years. The prevalence of nosocomial pneumonia in autopsies was 29 percent, and the disease was the cause of death in 22.6 percent of the autopsied patients. Fatal nosocomial pneumonia correlated with the following anatomopathological findings: tobacco-associated structural lesions (OR = 3.23; 95 percent CI: 1.26-2.95; p = 0.02) and bilateral pneumonia (OR = 3.23; 95 percent CI: 1.26-8.30; p = 0.01). None of the variables were found to be significantly associated with fatal aspiration pneumonia. CONCLUSIONS: In our sample, there was a high prevalence of nosocomial pneumonia, which was responsible for almost 25 percent of all of the deaths. Smoking-related structural lesions and bilateral pneumonia all favored mortality. These findings corroborate the results of various clinical studies on nosocomial pneumonia.

Aspectos da admissão e evolução de crianças hospitalizadas com suspeita de pneumonia adquirida na comunidade em Salvador / Aspects of admission and outcome of children hospitalized with suspected community-acquired pneumonia in Salvador

A pneumonia na infância permanece um assunto relevante, tendo em vista a sua elevada taxa de mortalidade mundial, principalmente nos países em desenvolvimento. Objetivo: Descrever o resultado da hospitalização de crianças internadas com suspeita diagnostica de pneumonia. Desenho do estudo: Coorte retrospectiva. Material e métodos: Foi realizado acompanhamento retrospectivo de pacientes internados com suspeita de pneumonia em um centro pediátrico, de outubro de 2002 a outubro de 2005. A partir dos prontuários médicos, dados demográficos, de história clínica, do exame físico, do tratamento, da evolução e do desfecho foram coletados e registrados em formulário específico para o estudo. Todos os casos incluídos tiveram as radiografias de tórax avaliadas por radiologista cego às informações clínicas, com o objetivo de definir a presença ou não de infiltrado pulmonar e avaliar a presença de alterações radiológicas outras. A população do estudo foi alocada -“m quatro grupos diferente? para que pudessem ter suas variáveis comparadas entre pacientes com características semelhantes. Resultados: No grupo das crianças > 2 meses de idade, internadas com diagnóstico clínico-radiológico de pneumonia e tratadas com penicilina cristalina, as freqüências de febre (46,4% vs. 26,3%, /’=0,002), taquipnéia (73,6% vs. 59,4%,

Agenesia pulmonar asociada a persistencia del conducto arterioso y su tratamiento percutáneo: a propósito de un caso / Pulmonary agenesis associated with patent ductus arteriosus: a case report

El presente caso describe un lactante menor femenino de 9 meses de edad con agenesia pulmonar asociada a persistencia del conducto arterioso y su tratamiento por vía percutánea. Este paciente ingreso a nuestro centro con diagnóstico de neumonía izquierda y luego de ser evaluado se confirmó el diagnóstico de agenesia pulmonar izquierda asociado a persistencia del conducto arterioso y se plantea el cierre percutáneo. En nuestro centro es el primer caso reportado de esta anomalía teniendo una evolución satisfactoria durante cuatro años.

We describe a case pulmonary agenesia associated with a patent ductus arteriosus in infant 9 month old female and its percutaneus treatment. This patient came to our center with a previous diagnosis of left pneumonia and after a complete evaluation, left pulmonary agenesis and Patent Ductus Arteriosus were diagnosed. Due to this particular condition endovascular closure was indicated and complete closure of the defect was achieved shortly after years of follow-up, the patient is cardiovascular asympthomatic.