Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 870
Filter
1.
Journal of Integrative Medicine ; (12): 185-190, 2021.
Article in English | WPRIM | ID: wpr-881006

ABSTRACT

After one-month of oral treatment with traditional Chinese medicine decoction, without using other drugs, the lung inflammatory exudate, pulmonary fibrosis and quality of life of a 61-year-old female patient with corona virus disease 2019 (COVID-19) were significantly improved. No recurrence or deterioration of the patient's condition was found within seven weeks of treatment and follow-up, and no adverse events occurred, indicating that oral Chinese medicine decoction was able to improve the pulmonary inflammation and fibrosis in a patient recovering from COVID-19, but further research is still needed.


Subject(s)
Administration, Oral , COVID-19/virology , Drugs, Chinese Herbal/therapeutic use , Exudates and Transudates , Female , Humans , Inflammation/etiology , Lung/pathology , Magnoliopsida , Medicine, Chinese Traditional , Middle Aged , Phytotherapy , Pulmonary Fibrosis/etiology , SARS-CoV-2
2.
Autops. Case Rep ; 11: e2021246, 2021. graf
Article in English | LILACS | ID: biblio-1153187

ABSTRACT

Extranodal NK/T-cell lymphoma, nasal type (ENKTL-NT) is a rare type of Non-Hodgkin's lymphoma, which usually presents with extranodal involvement and affects the nasal/upper aerodigestive tract in the classical presentation. Herein, we report the case of a 31-year-old, previously healthy, male patient diagnosed with ENKTL-NT with the involvement of the lung parenchyma and heart. Unfortunately, due to the rapid disease progression, the diagnosis was performed only at the autopsy. The authors highlight the rare clinical presentation of this type of lymphoma, as well as the challenging anatomopathological diagnosis in necrotic samples.


Subject(s)
Humans , Male , Adult , Nose Neoplasms/pathology , Lymphoma, Extranodal NK-T-Cell/pathology , Nasal Cavity/pathology , Autopsy , Lymphoma, T-Cell , Fatal Outcome , Herpesvirus 4, Human , Disease Progression , Heart , Lung/pathology
3.
Autops. Case Rep ; 11: e2021268, 2021. graf
Article in English | LILACS | ID: biblio-1249029

ABSTRACT

Background Neonatal acute liver failure (NALF) is a rare and life-threatening condition. It causes bilirubin to accumulate to a dangerous level in the body, causing permanent damage to vital organs such as the brain and lungs. In many cases, the etiology of NALF remains unknown. Case presentation We described a case of an 8-day-old baby girl who presented with poor oral intake, lethargy, and jaundice. Her clinical condition rapidly deteriorated with progression to multi-organ failure, and despite intensive resuscitation efforts, she expired. At autopsy, the most significant findings were liver necrosis, yellow hyaline membrane deposition in the lungs, and bilirubin deposition in the brain (kernicterus). Conclusions NALF is a rare and potentially fatal condition necessitating prompt recognition and disease-specific treatment approaches. Toxic accumulation of bilirubin in the lungs can lead to hypoxia and precipitate further ischemic injury to the liver.


Subject(s)
Humans , Female , Child , Hyaline Membrane Disease/pathology , Kernicterus/pathology , Autopsy , Rare Diseases , Cerebrum/pathology , Lung/pathology
4.
Int. j. morphol ; 38(5): 1250-1257, oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134433

ABSTRACT

SUMMARY: Residential heating with wood is an important source of ambient air pollution. Evidence links air pollution to serious health effects such as respiratory and cardiovascular mortality and morbidity. We hypothesized that prenatal exposure to wood smoke pollution causes morphological changes in the development of the rat lung, leading to altered lung structure and function during later life. We presumed that analysis of the fetal lung stereology provides novel insights into the underlying processes mediating particulate matter associated developmental changes and damage. The objective of the study was to investigate the effects of exposure during gestational period to wood smoke pollution on lung fetal morphology. To test this, pregnant rats were exposed during pregestational and gestational periods to wood smoke pollution. Complete lungs samples were obtained from 24 fetus from healthy female G3 rats subjected to cesarean at 19 days post-fecundation. The lungs were prepared for histological and stereological analysis. The volume fraction of terminal bronchioles VV [tb, lung] and volume fraction of parenchyma VV [par, lung], surface density of terminal bronchioles SV [tb, lung] as well as numerical density of bronchiolar exocrinocytes NA [ec,lung] were calculated by light microscopy. Statistical analysis detected significant differences between groups in volume density VV [tb, lung; %] (p=0.0012) and surface density SV [tb, lung; mm2/mm3] (p<0.0001) of the terminal bronchioles. However, it did not show differences between groups in the stereological parameter volume density VV [par, lung; %] (p=0.0838) and numerical density of bronchiolar exocrinocytes NA [ec,lung; nº/mm2] (p=0.0705). The analysis of the evidence obtained indicates that exposure to environmental pollution was affects lung maturation, and particularly the proportion and area of terminal bronchioles in the fetal lung. In conclusion, maternal exposure to wood smoke pollution during pregnancy was associated with a decrease in the lower conducting airways of lungs, which, according to urban pollution studies, could be related to early childhood lower respiratory illness. The public health implications of this study are that reducing or avoiding exposure to wood smoke is important before and during pregnancy.


RESUMEN: La calefacción residencial con leña es una fuente importante de contaminación ambiental. La evidencia vincula la contaminación del aire con graves efectos sobre la salud, como la mortalidad y la morbilidad respiratoria y cardiovascular. Hipotetizamos que la exposición prenatal a la contaminación por humo de leña causa cambios en el desarrollo del pulmón de rata, lo que conduce a una morfo-función pulmonar alteradas durante la vida posterior, creemos que el análisis de la estereología pulmonar fetal proporcionará nuevos conocimientos sobre los procesos subyacentes que median esos cambios. El objetivo del estudio fue investigar los efectos de la exposición prenatal a la contaminación ambiental por humo de leña sobre la morfología pulmonar fetal. Ratas preñadas fueron expuestas durante los períodos pregestacional y gestacional a la contaminación por humo de leña. En fetos de 19 días post-fecundación fue obtenido el pulmón para análisis histológico y estereológico. Fue determinado la fracción de volumen de bronquiolos terminales VV [tb, pulmón], fracción de volumen del parénquima VV [par, pulmón], densidad superficial de los bronquiolos terminales SV [tb, pulmón] así como la densidad numérica de exocrinocitos NA [ec, pulmón]. El análisis estadístico detectó diferencias significativas entre grupos en la densidad de volumen V [tb, pulmón; %] (p=0,0012) y densidad superficial SV [tb, pulmón; mm2/mm3] (p<0,0001) de los bronquiolos terminales. Sin embargo, no demostró diferencias entre grupos en la densidad de volumen VV [par, pulmón; %] (p=0,0838) y numérica de exocrinocitos bronquiolares NA [ec, pulmón; nº / mm ] (p=0,0705). El análisis de la evidencia obtenida indica que la exposición a la contaminación ambiental afectó la maduración pulmonar, y particularmente la proporción y área de bronquiolos terminales en el pulmón fetal. En conclusión, la exposición materna a la contaminación por humo de leña durante la gestación se asoció a una disminución de las vías respiratorias conductoras de aire en pulmón, lo que, según estudios de contaminación urbana, podría estar relacionado con enfermedades de las vías respiratorias inferiores en la primera infancia. Las implicaciones para la salud pública de este estudio son que reducir o evitar la exposición al humo de leña es importante previo y durante la gestación. Por otro lado, la contaminación por humo de leña tiene un gran impacto en la salud pública que, en teoría, es posible prevenir.


Subject(s)
Animals , Female , Pregnancy , Rats , Air Pollutants/toxicity , Air Pollution/adverse effects , Lung/drug effects , Smoke/adverse effects , Wood , Analysis of Variance , Maternal Exposure/adverse effects , Disease Models, Animal , Environmental Exposure , Particulate Matter/toxicity , Fetus/drug effects , Heating , Lung/pathology
5.
Rev. cuba. med. mil ; 49(3): e456, jul.-set. 2020. fig
Article in Spanish | LILACS, CUMED | ID: biblio-1144486

ABSTRACT

Introducción: La aspergilosis es una infección micótica oportunista que se presenta fundamentalmente en pacientes inmunodeprimidos y su principal fuente de transmisión lo constituyen las esporas presentes en el aire de salones de operaciones y unidades de cuidados intensivos. Objetivo: Presentar un caso de una micosis pulmonar masiva por una variante angioinvasiva de Aspergillus. Caso clínico: Se presenta un paciente con aspergilosis pulmonar grave, diagnosticada después de la resección de un tumor mediastinal. Se describen las características de la primera intervención, la evolución postoperatoria que condujo a la segunda, se muestran las imágenes tomográficas, quirúrgicas, microbiológicas y anátomo-patológicas que permitieron definir el diagnóstico. Conclusiones: La posibilidad de una micosis pulmonar debe tenerse en cuenta, aun cuando sea una afección rara y de manejo difícil, en pacientes inmunodeprimidos, con condensación pulmonar rebelde al tratamiento(AU)


Introduction: Aspergillosis is an opportunistic fungal infection that occurs mainly in immunosuppressed patients and its main source of transmission is the spores present in the air of operating rooms and intensive care units. Objective: To present a case of a massive pulmonary mycosis due to an angioinvasive variant of Aspergillus. Clinical case: A patient with severe pulmonary aspergillosis, diagnosed after resection of a mediastinal tumor, is presented. The characteristics of the first intervention are described, the postoperative evolution that led to the second one, the tomographic, surgical, microbiological and anatomo-pathological images that allowed to define the diagnosis are shown. Conclusions: The possibility of a pulmonary mycosis should be taken into account, even when it is a rare and difficult-to-handle condition, in immunocompromised patients, with pulmonary condensation that is rebellious to treatment. Aspergillosis is an opportunistic fungal infection that occurs mainly in immunosuppressed patients and its main source of transmission is the spores present in the air of operating rooms and intensive care units(AU)


Subject(s)
Humans , Male , Adult , Pulmonary Aspergillosis/drug therapy , Mycoses , Necrosis/diagnostic imaging , Teratocarcinoma/surgery , Teratocarcinoma/therapy , Invasive Pulmonary Aspergillosis/complications , Lung/pathology
6.
Arq. bras. med. vet. zootec. (Online) ; 72(3): 794-798, May-June, 2020. ilus
Article in Portuguese | ID: biblio-1129180

ABSTRACT

Meningiomas são os principais tumores primários do sistema nervoso central (SNC) que afetam cães e gatos. Na maioria dos casos, são neoplasias benignas, geralmente expansivas, causando compressão do SNC, e raramente fazem metástase para outros órgãos. O presente trabalho tem como objetivo relatar a ocorrência de um meningioma microcístico com metástase pulmonar em um canino de 11 anos de idade, com sinais clínicos de andar cambaleante, compressão da cabeça contra objetos, agitação, salivação e agressividade. Na necropsia, foram observadas, no encéfalo, massas bem delimitadas pardo-avermelhadas, firmes, de aspecto granular, localizadas no córtex parietal e nos núcleos da base. Inúmeras micronodulações de aspecto semelhante foram observadas no pulmão. Histologicamente observaram-se nódulos formados por células neoplásicas fusiformes, com núcleos grandes e alongados e nucléolos evidentes, dispostas de forma frouxa, formando vacúolos e microcistos. À imuno-histoquímica, o meningioma apresentou marcação fortemente positiva para citoqueratina e negativa para vimentina. Por meio da histopatologia e da imuno-histoquímica, foi possível estabelecer a classificação histológica de meningioma microcístico, bem como diferenciá-lo de outras doenças que cursam com sinais nervosos.(AU)


Meningiomas are the main tumors of the central nervous system (CNS) affecting dogs and cats. In most of the cases they are benign neoplasms, usually expansive, causing compression of the CNS and rarely metastasize to other organs. We describe the occurrence of a microcystic meningioma with pulmonary metastasis in an 11 - year - old canine with clinical signs of staggering gait, head compression against objects, agitation, salivation and aggressiveness. At necropsy, well-defined, firm, granular-looking masses located in the parietal cortex and nuclei of the base were observed in the encephalon. Numerous micronodulations of similar appearance were observed in the lung. Histologically, nodules formed by spindle neoplastic cells with large, elongated nuclei and evident nuclei were loosely arranged, forming vacuoles and microcysts. Immunohistochemistry were strongly positive for cytokeratin and negative for vimentin. Through the histopathology and immunohistochemistry, it was possible to establish the histological classification of microcystic meningioma, as well as to differentiate from other diseases that present with nervous signals.(AU)


Subject(s)
Animals , Dogs , Lung/pathology , Meningioma/complications , Meningioma/veterinary , Neoplasm Metastasis , Immunohistochemistry/veterinary , Central Nervous System Neoplasms/veterinary , Lung Neoplasms/veterinary
7.
Arq. bras. cardiol ; 114(2): 234-242, Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1088869

ABSTRACT

Abstract Background: Chronic heart failure (CHF) is a complex syndrome which comprises structural and functional alterations in the heart in maintaining the adequate blood demand to all tissues. Few investigations sought to evaluate oxidative DNA damage in CHF. Objective: To quantify the DNA damage using the comet assay in left ventricle (LV), lungs, diaphragm, gastrocnemius and soleus in rats with CHF. Methods: Twelve male Wistar rats (300 to 330 g) were selected for the study: Sham (n = 6) and CHF (n = 6). The animals underwent myocardial infarction by the ligation of the left coronary artery. After six weeks, the animals were euthanized. It was performed a cell suspension of the tissues. The comet assay was performed to evaluate single and double strand breaks in DNA. Significance level (p) considered < 0.05. Results: The CHF group showed higher values of left ventricle end-diastolic pressure (LVEDP), pulmonary congestion, cardiac hypertrophy and lower values of maximal positive and negative derivatives of LV pressure, LV systolic pressure (p < 0.05). CHF group showed higher DNA damage (% tail DNA, tail moment and Olive tail moment) compared to Sham (p < 0.001). The tissue with the highest damage was the soleus, compared to LV and gastrocnemius in CHF group (p < 0.05). Conclusion: Our results indicates that the CHF affects all tissues, both centrally and peripherically, being more affected in skeletal muscle (soleus) and is positively correlated with LV dysfunction.


Resumo Fundamento: A insuficiência cardíaca crônica (ICC) é uma síndrome complexa que compreende alterações estruturais e funcionais no coração, mantendo demanda sanguínea adequada a todos os tecidos. Poucas investigações procuraram avaliar o dano oxidativo ao DNA na ICC. Objetivo: Quantificar o dano ao DNA utilizando o ensaio cometa no ventrículo esquerdo (VE), pulmões, diafragma, gastrocnêmio e sóleo em ratos com ICC. Métodos: Doze ratos Wistar machos (300 a 330 g) foram selecionados para o estudo: placebo (n = 6) e ICC (n = 6). Os animais foram submetidos a infarto do miocárdio através de ligadura da artéria coronária esquerda. Após seis semanas, os animais foram sacrificados. Foi realizada uma suspensão celular dos tecidos. O ensaio cometa foi realizado para avaliar as quebras de fita simples e dupla no DNA. Nível de significância (p) < 0,05. Resultados: O grupo ICC apresentou maiores valores de pressão diastólica final do ventrículo esquerdo (PDFVE), congestão pulmonar, hipertrofia cardíaca e menores valores de derivados máximos positivos e negativos da pressão do VE, pressão sistólica do VE (p < 0,05). O grupo ICC apresentou maior dano ao DNA (% de DNA da cauda, momento da cauda e momento da cauda de Olive) em comparação ao placebo (p < 0,001). O tecido com maior dano foi o sóleo, comparado ao VE e ao gastrocnêmio no grupo ICC (p < 0,05). Conclusão: Nossos resultados indicam que a ICC afeta todos os tecidos, de maneira central e periférica, sendo mais afetada no músculo esquelético (sóleo) e está positivamente correlacionada com a disfunção do VE.


Subject(s)
Animals , Male , DNA Damage/genetics , Heart Failure/genetics , Reference Values , Rats, Wistar , Oxidative Stress , Muscle, Skeletal/pathology , Comet Assay , Single-Cell Analysis , Heart Failure/pathology , Heart Ventricles/pathology , Hemodynamics , Liver/pathology , Lung/pathology , Myocardial Infarction/genetics , Myocardial Infarction/pathology
8.
Biol. Res ; 53: 51, 2020. tab, graf
Article in English | LILACS | ID: biblio-1142418

ABSTRACT

BACKGROUND: Hyperoxia at resuscitation increases oxidative stress, and even brief exposure to high oxygen concentrations during stabilization may trigger organ injury with adverse long-term outcomes in premature infants. We studied the long-term effects of short-term perinatal oxygen exposure on cell cycle gene expression and lung growth in adult mice. METHODS: We randomized mice litters at birth to 21,40, or 100%O2 for 30 min and recovered in room air for 4 or 12 weeks. Cell cycle gene expression, protein analysis, and lung morphometry were assessed at 4 and 12 weeks. RESULTS: The principal component analysis demonstrated a high degree of correlation for cell cycle gene expression among the three oxygen groups. Lung elastin was significantly lower in the 100%O2 groups at 4 weeks. On lung morphometry, radial alveolar count, alveolar number, and septal count were similar. However, the mean linear intercept (MLI) and septal length significantly correlated among the oxygen groups. The MLI was markedly higher in the 100%O2 groups at 4 and 12 weeks of age, and the septal length was significantly lower in the 100%O2 groups at 12 weeks. CONCLUSION: Short-term exposure to high oxygen concentrations lead to subtle changes in lung development that may affect alveolarization. The changes are related explicitly to secondary crest formation that may result in alteration in lung elastin. Resuscitation with high oxygen concentrations may have a significant impact on lung development and long-term outcomes such as BPD in premature infants.


Subject(s)
Animals , Female , Pregnancy , Mice , Oxygen/adverse effects , Hyperoxia/pathology , Lung/pathology , Elastin/metabolism , Oxidative Stress , Lung/growth & development
9.
Article in Spanish | LILACS | ID: biblio-1292488

ABSTRACT

INTRODUCCIÓN: En 6 meses se notificaron más de 400 mil fallecidos por COVID-19. Han surgido múltiples investigaciones para comprender su etiopatogenia, siendo la autopsia médica uno de los mejores procedimientos para obtener información. Presentamos una revisión respecto a hallazgos post mortem publicados hasta mayo, 2020. RESULTADOS: Se recolectaron 12 estudios, de un total de 109 pacientes cuyo deceso fue por complicación respiratoria, predominó el sexo masculino, edad avanzada y con múltiples comorbilidades. El estudio PCR se realizó principalmente para diagnóstico. Se demostró ARN viral en riñón, hígado, corazón, cerebro y otros órganos. Los autores relataron presencia de micro y/o macro trombosis, en 50 de 109 casos, sobre todo a nivel pulmonar y renal, de tipo microscópica y relacionados a signos de shock. Desde la perspectiva anatomopatológica, se centra en alteraciones pulmonares y renales: daño alveolar difuso, injuria tubular aguda, microtrombos y otros signos de alteración microcirculatoria. Los estudios inmunohistoquímicos, de inmunofluoresencia y microscopía electrónica sugieren tropismo del virus por células epiteliales y estromales a nivel pulmonar y renal. En otros órganos se encuentran elementos morfológicos inespecíficos, atribuibles a patologías de base o shock. CONCLUSIÓN: El patrón histopatológico de daño alveolar difuso es frecuente, principalmente en fase exudativa o temprana. En el tejido renal destaca la injuria tubular aguda y daño microcirculatorio. El número y la descripción de muestras en otros órganos es reducida, siendo necesaria mayor casuística. La trombosis, es un trastorno prevalente en pulmones y riñones de pacientes con signos de shock. El tipo de trombo con más frecuencia descrito, es el microtrombo. Si bien se puede explicar como gatillante del fenómeno trombótico la interacción entre agente y huésped, otros factores deben ser estudiados para dilucidar la patogenia.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Thrombosis/pathology , COVID-19/pathology , Autopsy , Thrombosis/diagnosis , RNA, Viral/analysis , Polymerase Chain Reaction , COVID-19/diagnosis , COVID-19/mortality , Kidney/pathology , Kidney/virology , Liver/pathology , Liver/virology , Lung/pathology , Lung/virology
10.
Rev. chil. pediatr ; 90(6): 657-661, dic. 2019. graf
Article in Spanish | LILACS | ID: biblio-1058197

ABSTRACT

INTRODUCCIÓN: La Neumonía Eosinofílica (NE) es una entidad muy poco frecuente en pediatría y se caracteriza por infiltración de eosinófilos en el intersticio pulmonar y alveolar, pudiendo ser primaria o secundaria, así como también presentar un curso agudo o crónico. OBJETIVO: Presentar dos casos clínicos de NE diagnosticados en el período 2014-2017 en una Unidad de Cuidados Intensivos pediátricos. CASOS CLÍNICOS: Dos lactantes mayores, ambos con antecedente de madre asmática, hospitalizados por in suficiencia respiratoria y diagnóstico de neumonía viral en Clínica Indisa, Santiago, Chile. Ambos presentaron síndrome febril, imágenes de condensación persistentes en la radiografía de tórax y eosinofilia periférica en el transcurso de su enfermedad. Uno de ellos con requerimiento de oxígeno por más de un mes, sin eosinofilia en el lavado broncoalveolar (LBA), al que se le hizo el diagnóstico de NE por biopsia pulmonar. El otro niño requirió ventilación mecánica por 28 días y se hizo diag nóstico de NE por eosinofilia mayor a 20% en LBA. Los dos casos presentaron excelente respuesta a corticoides sistémicos. CONCLUSIÓN: La NE se debe sospechar en el niño con diagnóstico de neumonía con síntomas persistentes sin respuesta al tratamiento, habiéndose descartado otras causas, sobre todo si se asocia a eosinofilia periférica. El diagnostico de NE en pediatría se confirma por eosinofilia mayor a 20% en LBA y en algunos casos es necesaria la biopsia pulmonar.


INTRODUCTION: Eosinophilic Pneumonia (EP) is a very rare disorder in Pediatrics. It is characterized by the infiltra tion of eosinophils in the pulmonary and alveolar interstitium, and may be primary or secondary as well as present an acute or chronic progress. OBJECTIVE: to present 2 pediatric EP clinical cases which were diagnosed at the pediatric intensive care unit of Clinica Indisa in Santiago, Chile between 2014 and 2017. CLINICAL CASES: Two older infants, who were hospitalized due to respiratory failure with a diagnosis of viral pneumonia. Both have asthmatic mothers. Additionally, they both had febrile syn drome, persistent condensation images in the chest x-rays, and peripheral eosinophilia throughout the course of the disease. One of the infants required oxygen for more than one month, and there was no eosinophilia in the bronchoalveolar lavage (BAL). In this case, the diagnosis of EP was reached via pulmonary biopsy. The other infant required mechanic ventilation for 28 days, and was diagnosed due to eosinophilia greater than 25% in the bronchoalveolar lavage. Both patients had excellent res ponse to systemic corticosteroids. CONCLUSION: After ruling out other causes, EP should be suspected in children with pneumonia diagnosis, and persistent symptoms that do not respond positively to treatment, especially if associated with peripheral eosinophilia. The diagnosis of EP in pediatrics is confirmed with eosinophilia greater than 20% in BAL and, in some cases, it is necessary to perform a lung biopsy.


Subject(s)
Humans , Male , Infant , Pulmonary Eosinophilia/diagnosis , Oxygen/therapeutic use , Pneumonia, Viral/diagnosis , Pulmonary Eosinophilia/pathology , Pulmonary Eosinophilia/diagnostic imaging , Respiration, Artificial , Respiratory Insufficiency/etiology , Biopsy , Bronchoalveolar Lavage , Lung/pathology
11.
Autops. Case Rep ; 9(4): e2019119, Oct.-Dec. 2019. ilus
Article in English | LILACS | ID: biblio-1024159

ABSTRACT

Congenital acinar dysplasia is a lethal, developmental lung malformation resulting in neonatal respiratory insufficiency. This entity is characterized by pulmonary hypoplasia and arrest in the pseudoglandular stage of development, resulting in the absence of functional gas exchange. The etiology is unknown, but a relationship with the disruption of the TBX4-FGF10 pathway has been described. There are no definitive antenatal diagnostic tests. It is a diagnosis of exclusion from other diffuse embryologic lung abnormalities with identical clinical presentations that are, however, histopathologically distinct.


Subject(s)
Humans , Female , Infant, Newborn , Respiratory Insufficiency/etiology , Lung/abnormalities , Lung Diseases/congenital , Autopsy , Fatal Outcome , Lung/pathology
12.
Int. j. morphol ; 37(3): 908-911, Sept. 2019. graf
Article in Spanish | LILACS | ID: biblio-1012374

ABSTRACT

Periodos extensos de hipoxia provocan cambios adaptativos que permiten responder a las demandas impuestas por el ambiente. Sin embargo, existen casos donde esta exposición es intermitente, como es el caso de los trabajadores en zonas andinas. El objetivo de esta comunicación fue comprobar los efectos morfológicos y mecánicos en diafragma y pulmones de ratas sometidas a la hipoxia intermitente. Se utilizaron 4 ratas Sprague Dawley de 6 meses de edad. Dos ratas fueron sometidas a 10 ciclos de hipoxia hipobárica intermitente (HHI) de 96 h (~428 torr; PO2 90 mm Hg), seguidos de 96 h de normoxia normobárica, durante 80 días. Se realizaron pruebas tracción uniaxial y de tinción con HematoxilinaEosina y Picrosirius red de Junqueira. Al comparar las curvas de los diafragmas, los sometidos a hipoxia reducen levemente su esfuerzo respecto a la condición de normoxia, en el tejido pulmonar la hipoxia afecta negativamente su resistencia, estas muestran una pendiente menor respecto a las normóxicas. En el análisis histológico, el parénquima pulmonar presentó menor cantidad de vasos sanguíneos y celularidad, como una mayor fracción de área de los espacios alveolares y cantidad de colágeno total en el grupo HHI. En el diafragma, el grupo HHI presentó menor cantidad de miocitos distribuidos irregularmente y de colágeno total. En conclusión, los principales hallazgos indican que el diafragma y el tejido pulmonar sometido a HHI sufren cambios estructurales, que se traducen en una disminución en su capacidad de resistencia tensil.


Extensive periods of hypoxic cause adaptive changes that make it possible to respond to the demands imposed by the environment. However, there are cases where this exposure is intermittent, as is the case of workers in andean areas. The objective of this communication was to verify the morphological and mechanical effects on diaphragm and lungs of rats subjected to intermittent hypoxic. Four 6-monthold Sprague Dawley rats were used. Two rats were subjected to 10 cycles of intermittent hypobaric hypoxic (IHH) of 96 h (~428 torr, PO2 90 mm Hg), followed by 96 h of normobaric normoxia, for 80 days. Uniaxial traction and staining tests were performed with Hematoxylin-Eosin and Picrosirius red de Junqueira. When comparing the curves of the diaphragms, those subjected to hypoxic slightly reduce their effort with respect to the condition of normoxia, in the lung tissue the hypoxic negatively affects its resistance, these show a lower slope with respect to the normoxics. In the histological analysis, the pulmonary parenchyma had a lower number of blood vessels and cellularity, such as a greater area fraction of alveolar spaces and amount of total collagen in IHH group. In the diaphragm, IHH group had a lower number of irregularly distributed myocytes and a lower amount of total collagen. In conclusion, the main findings indicate that the diaphragm and lung tissue subjected to IHH undergo structural changes, which result in a decrease in tensile strength.


Subject(s)
Animals , Rats , Diaphragm/pathology , Lung/pathology , Hypoxia/complications , Rats, Sprague-Dawley , Hypoxia/pathology
13.
Rev. Assoc. Med. Bras. (1992) ; 65(9): 1193-1200, Sept. 2019. graf
Article in English | LILACS | ID: biblio-1041079

ABSTRACT

SUMMARY OBJECTIVES This study was conducted to reveal the possible protective effects of ticagrelor and enoxaparin pretreatment against ischemia-reperfusion (IR)-induced injury on the lung tissue of a rat model. METHODS Wistar albino rats were randomly divided into 4 groups as follows: group-1 (control-sham), group-2 (control-saline+IR), group-3 (ticagrelor+IR), group-4 (enoxaparin+IR). Before the ischemic period, saline, ticagrelor, and enoxaparin were administered to the 2nd-4th groups, respectively. In these groups, IR injury was induced by clamping the aorta infrarenally for 2 h, followed by 4 h of reperfusion except group-1. After the rats were euthanized, the lungs were processed for histological examinations. Paraffin sections were stained with Haematoxylin&Eosin (H&E) for light microscopic observation. Apoptosis was evaluated by caspase-3 immunoreactivity. Data were statistically analyzed using the SPSS software. RESULTS In the lung sections stained with H&E, a normal histological structure was observed in group-1, whereas disorganized epithelial cells, hemorrhage, and inflammatory cell infiltration were seen in the alveolar wall in group-2. The histologic structure of the treatment groups was better than that of group-2. Caspase-3(+) apoptotic cells were noticeable in sections of group-2 and were lower in the treatment groups. In group-4, caspase-3 immunostaining was lower than in group-3. In group-2, apoptotic cells were significantly higher than in the other groups (p<0.001). CONCLUSION Based on the histological results, we suggested that both therapies ameliorated the detrimental effects of IR. Caspase-3 immunohistochemistry results also revealed that pre-treatment with enoxaparin gave better results in an IR-induced rat injury model. In further studies, other parameters such as ROS and inflammatory gene expressions should be evaluated for accurate results.


RESUMO OBJETIVOS Este estudo foi realizado para revelar os possíveis efeitos protetores do ticagrelor e do pré-tratamento da enoxaparina no tecido pulmonar contra o modelo de lesão induzida por isquemia-reperfusão (IR). MÉTODOS Ratos albinos Wistar foram randomizados e divididos em quatro grupos: grupo 1 (controle-sham), grupo 2 (controle-salina + IR), grupo 3 (ticagrelor + IR), grupo 4 (enoxaparina + IR). Antes do período isquêmico, salina, ticagrelor e enoxaparina foram administrados nos grupos 2-4, respectivamente. Nesses grupos, a lesão de IR foi induzida pelo clampeamento da aorta na região da infrarrenal por duas horas, seguida por quatro horas de reperfusão, exceto no grupo 1. Após a sacrificação, os pulmões foram processados para exames histológicos. Secções de parafina foram coradas com hematoxilina e eosina (H&E) para observação microscópica de luz. A apoptose foi avaliada pela imunorreatividade da caspase-3. Os dados foram analisados estatisticamente pelo programa SPSS. RESULTADOS Nas secções pulmonares coradas com H&E, estrutura histológica normal foi observada no grupo 1, enquanto células epiteliais desorganizadas, hemorragia e infiltração de células inflamatórias foram observadas na parede alveolar no grupo 2. A estrutura histológica dos grupos de tratamento foi melhor que o grupo 2. Células apoptóticas caspase-3 (+) foram notadas em secções do grupo 2, e essas células foram mais baixas nos grupos de tratamento. No grupo 4, a imunocoloração com caspase-3 foi menor que no grupo 3. No grupo 2, as células apoptóticas foram significativamente maiores que nos outros grupos (p<0,001). CONCLUSÃO Com base nos resultados histológicos, sugerimos que ambas as terapias atenuaram os efeitos prejudiciais da RI. Resultados de imuno-histoquímica com caspase-3 também revelaram que o pré-tratamento com enoxaparina proporcionou melhores resultados no modelo de lesão induzida por IR. Em estudos posteriores, outros parâmetros, como ROS e expressões gênicas inflamatórias, devem ser avaliados quanto a resultados precisos.


Subject(s)
Animals , Male , Aorta, Abdominal/surgery , Reperfusion Injury/prevention & control , Enoxaparin/pharmacology , Protective Agents/pharmacology , Ticagrelor/pharmacology , Lung/drug effects , Reperfusion Injury/pathology , Random Allocation , Rats, Wistar , Apoptosis/drug effects , Disease Models, Animal , Caspase 3/metabolism , Lung Injury/prevention & control , Lung/pathology
14.
Neumol. pediátr. (En línea) ; 14(2): 95-99, jul. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1015014

ABSTRACT

The diagnosis of primary ciliary dyskinesia (PCD) is complex and requires high clinical suspicion. The findings in the diagnostic images are nonspecific and can be seen in other conditions of the airway. In this review, we will describe the findings of PCD in chest radiography and computed tomography, with emphasis on some of the characteristics that differentiate it from cystic fibrosis and we will review the role of CT in the monitoring of changes of the PCD, since the CT findings correlate very well with the structural changes that occur in the course of PCD, especially bronchiectasis. However, using serial CTs should be decided on a case-by-case basis to avoid unnecessary radiation because they are pediatric patients.


El diagnóstico de la Discinesia ciliar primaria (DCP) es complejo y requiere alta sospecha clínica. Los hallazgos en la imágenes diagnósticas son inespecíficos y se pueden ver en otras afecciones de la vía aérea. En esta revisión describiremos los hallazgos de la DCP en Radiología simple y en Tomografía computada (TC), con énfasis en algunas de las características que permiten diferenciarla de la Fibrosis quística (FQ) y revisaremos el rol de la TC en la monitorización de la DCP ya que los hallazgos en la TC se correlacionan muy bien con los cambios estructurales que ocurren en el curso de la DCP, en especial las bronquiectasias. Sin embargo usar TC seriadas se debe decidir caso por caso para evitar la radiación innecesaria por ser pacientes pediátricos.


Subject(s)
Humans , Child , Respiratory System/metabolism , Kartagener Syndrome/physiopathology , Lung/diagnostic imaging , Respiratory System/physiopathology , Respiratory System/pathology , Magnetic Resonance Spectroscopy , Tomography, X-Ray Computed/methods , Kartagener Syndrome/metabolism , Kartagener Syndrome/microbiology , Lung/metabolism , Lung/pathology
15.
Rev. bras. ter. intensiva ; 31(2): 113-121, abr.-jun. 2019. graf
Article in Portuguese | LILACS | ID: biblio-1013758

ABSTRACT

RESUMO Objetivo: Descrever a transferência de energia do ventilador mecânico para os pulmões; o acoplamento entre a transferência de oxigênio por oxigenação por membrana extracorpórea venovenosa (ECMO-VV) e o consumo de oxigênio do paciente; a remoção de dióxido de carbono com ECMO; e o efeito potencial da oxigenação venosa sistêmica na pressão arterial pulmonar. Métodos: Modelo matemático com cenários hipotéticos e utilização de simulações matemáticas por computador. Resultados: A transição de ventilação protetora para ventilação ultraprotetora em um paciente com síndrome da angústia respiratória aguda grave e complacência respiratória estática de 20mL/cmH2O reduziu a transferência de energia do ventilador para os pulmões de 35,3 para 2,6 joules por minuto. Em um paciente hipotético, hiperdinâmico e ligeiramente anêmico com consumo de oxigênio de 200mL/minuto, é possível atingir saturação arterial de oxigênio de 80%, ao mesmo tempo em que se mantém o equilíbrio entre a transferência de oxigênio pela ECMO e o consumo de oxigênio do paciente. O dióxido de carbono é facilmente removido e a pressão parcial de dióxido de carbono normal é facilmente obtida. A oxigenação do sangue venoso, por meio do circuito da ECMO, pode direcionar o estímulo da pressão parcial de oxigênio na vasoconstrição pulmonar por hipóxia para valores normais. Conclusão: A ventilação ultraprotetora reduz amplamente a transferência de energia do ventilador para os pulmões. A hipoxemia grave no suporte com ECMO-VV pode ocorrer, a despeito do acoplamento entre a transferência de oxigênio, por meio da ECMO, e o consumo de oxigênio do paciente. A faixa normal de pressão parcial de dióxido de carbono é fácil de atingir. O suporte com ECMO-VV potencialmente alivia a vasoconstrição pulmonar hipóxica.


ABSTRACT Objective: To describe (1) the energy transfer from the ventilator to the lungs, (2) the match between venous-venous extracorporeal membrane oxygenation (ECMO) oxygen transfer and patient oxygen consumption (VO2), (3) carbon dioxide removal with ECMO, and (4) the potential effect of systemic venous oxygenation on pulmonary artery pressure. Methods: Mathematical modeling approach with hypothetical scenarios using computer simulation. Results: The transition from protective ventilation to ultraprotective ventilation in a patient with severe acute respiratory distress syndrome and a static respiratory compliance of 20mL/cm H2O reduced the energy transfer from the ventilator to the lungs from 35.3 to 2.6 joules/minute. A hypothetical patient, hyperdynamic and slightly anemic with VO2 = 200mL/minute, can reach an arterial oxygen saturation of 80%, while maintaining the match between the oxygen transfer by ECMO and the VO2 of the patient. Carbon dioxide is easily removed, and normal PaCO2 is easily reached. Venous blood oxygenation through the ECMO circuit may drive the PO2 stimulus of pulmonary hypoxic vasoconstriction to normal values. Conclusion: Ultraprotective ventilation largely reduces the energy transfer from the ventilator to the lungs. Severe hypoxemia on venous-venous-ECMO support may occur despite the matching between the oxygen transfer by ECMO and the VO2 of the patient. The normal range of PaCO2 is easy to reach. Venous-venous-ECMO support potentially relieves hypoxic pulmonary vasoconstriction.


Subject(s)
Humans , Female , Adult , Oxygen/metabolism , Respiratory Distress Syndrome/therapy , Extracorporeal Membrane Oxygenation/methods , Models, Theoretical , Oxygen Consumption , Computer Simulation , Carbon Dioxide/metabolism , Pulmonary Gas Exchange , Energy Transfer , Hypertension, Pulmonary/physiopathology , Lung/metabolism , Lung/pathology
16.
Rev. méd. Chile ; 147(5): 663-667, mayo 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1014276

ABSTRACT

We report a 64 years old female admitted with fever, cough, dyspnea and lung opacities in the chest X ray. A chest tomography scan (CTS) showed multiple-bilateral ring-shaped opacities and the reversed halo sign (RHS). The patient did not improve with antimicrobial therapy (AT). Infection and rheumatologic causes were excluded, therefore Cryptogenic organizing pneumonia (COP) was suspected with compatible percutaneous biopsy. Systemic steroids were started with a good clinical response. The patient was discharged four weeks after admission in good general conditions and practically no lungs opacities.


Subject(s)
Humans , Female , Middle Aged , Cryptogenic Organizing Pneumonia/pathology , Cryptogenic Organizing Pneumonia/diagnostic imaging , Biopsy , Prednisone/therapeutic use , Radiography, Thoracic , Tomography, X-Ray Computed , Cryptogenic Organizing Pneumonia/drug therapy , Glucocorticoids/therapeutic use , Lung/pathology , Lung/diagnostic imaging
17.
Rev. Asoc. Méd. Argent ; 132(1): 7-19, Mar. 2019. ilus, tab, graf
Article in Spanish | LILACS | ID: biblio-1009926

ABSTRACT

Se presenta el caso clínico de un lactante fallecido a los siete meses de edad con cuadro intersticial persistente. Objetivos: describir detalladamente el camino diagnóstico; alertar sobre posibles confusiones en recién nacidos con diagnósticos más frecuentes; detallar los hallazgos clínicos, radiológicos y de anatomía patológica (consultas en el exterior). Metodología: sumatoria de estudios complejos para descartar causas más frecuentes de patología intersticial en el lactante; consultas radiológicas, de anatomía patológica y genética en el exterior del país. Resultado: con diagnóstico de PAP (proteinosis alveolar pulmonar) se encontró una duplicación de material genético a nivel de cromosoma X, correspondiente al gen CSF2RA (colony stimulating factor 2-subunidad a). Este gen codifica al receptor CSF2 cuya citoquina controla la producción, diferenciación y función de granulocitos/macrófagos. (AU)


A clinical case of a deceased seven month old infant presenting persistent interstitial lung compromise is presented. Objectives. Detailed description of the diagnostic pathway used; to alert about possible confusion with other ­ more frequent ­ pathologies in the new borninfant age; to present clinical, radiological, genetic and pathology findings (consultations abroad). Methodology. A complete description of complex studies to rule out other more frequent pathologies is presented together with radiological, pathological and genetic results from consultations abroad. Results. A diagnosis of PAP (pulmonary alveolar proteinosis) was confirmed with duplication of genetic material at CSF2RA gene (colony stimulating factor 2-subunit a). This gene codifies the CSF2 receptor whose cytokine controls production, differentiation and function of granulocytes/macrophages. (AU)


Subject(s)
Humans , Male , Infant, Newborn , Infant , Lung Diseases, Interstitial/diagnosis , Lung Diseases/diagnosis , Lung Diseases/genetics , Lung Diseases/pathology , Lung Diseases/diagnostic imaging , Sex Chromosome Aberrations , Pulmonary Surfactants , Tomography, X-Ray Computed , Follow-Up Studies , Genetic Techniques , Lung Diseases, Interstitial/genetics , Diagnosis, Differential , Lung/pathology , Mutation/genetics
18.
Acta cir. bras ; 34(8): e201900805, 2019. tab, graf
Article in English | LILACS | ID: biblio-1038124

ABSTRACT

Abstract Purpose To investigate the effect of sevoflurane preconditioning on ischemia/reperfusion (I/R)-induced pulmonary/hepatic injury Methods Fifty-one Wistar rats were randomly grouped into sham, I/R, and sevoflurane groups. After reperfusion, the structural change of the lung was measured by Smith score, the wet and dry weights (W/D) were determined, malondialdehyde (MDA) myeloperoxidase (MPO) content was determined colorimetrically and by fluorescence, respectively, and matrix metalloprotein-9 (MMP-9) mRNA was quantified by RT-PCR. Biopsy and morphological analyses were performed on liver tissue, activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were determined, and tumor necrosis factor-alpha (TNF-α) level was determined. Results The sham group showed no changes in tissue structure. Structural lesions in the sevoflurane and I/R groups were mild and severe, respectively. Smith score, W/D, MDA, MPO, and MMP mRNA showed the same trend, and were increased in the I/R group and recovered in the sevoflurane group, compared with the sham group (both P<0.05). AST and ALT were significantly increased compared to the sham group (AST: 655±52.06 vs . 29±9.30 U/L; ALT: 693±75.56 vs . 37±6.71 U/L; P<0.05). In the sevoflurane group, AST and ALT levels were significantly decreased (464±47.71 and 516±78.84 U/L; P<0.001). TNF-α presented similar results. Conclusion The protection of lung and liver by sevoflurane may be mediated by inhibited leukocyte recruitment and MMP-9 secretion.


Subject(s)
Animals , Male , Rats , Reperfusion Injury/prevention & control , Anesthetics, Inhalation/therapeutic use , Ischemic Preconditioning/methods , Liver/blood supply , Lung/blood supply , Aspartate Aminotransferases/blood , Reperfusion Injury/drug therapy , Tumor Necrosis Factor-alpha/blood , Peroxidase/analysis , Alanine Transaminase/blood , Disease Models, Animal , Sevoflurane/therapeutic use , Ischemia/prevention & control , Liver/drug effects , Liver/pathology , Lung/drug effects , Lung/pathology , Malondialdehyde/analysis
19.
J. bras. pneumol ; 45(1): e20170438, 2019. graf
Article in English | LILACS | ID: biblio-984618

ABSTRACT

ABSTRACT Objective: To determine the incidence of the reversed halo sign (RHS) in patients with pulmonary infarction (PI) due to acute pulmonary embolism (PE), detected by computed tomography angiography (CTA) of the pulmonary arteries, and to describe the main morphological features of the RHS. Methods: We evaluated 993 CTA scans, stratified by the risk of PE, performed between January of 2010 and December of 2014. Although PE was detected in 164 scans (16.5%), three of those scans were excluded because of respiratory motion artifacts. Of the remaining 161 scans, 75 (46.6%) showed lesions consistent with PI, totaling 86 lesions. Among those lesions, the RHS was seen in 33 (38.4%, in 29 patients). Results: Among the 29 patients with scans showing lesions characteristic of PI with the RHS, 25 (86.2%) had a single lesion and 4 (13.8%) had two, totaling 33 lesions. In all cases, the RHS was in a subpleural location. To standardize the analysis, all images were interpreted in the axial plane. Among those 33 lesions, the RHS was in the right lower lobe in 17 (51.5%), in the left lower lobe in 10 (30.3%), in the lingula in 5 (15.2%), and in the right upper lobe in 1 (3.0%). Among those same 33 lesions, areas of low attenuation were seen in 29 (87.9%). The RHS was oval in 24 (72.7%) of the cases and round in 9 (27.3%). Pleural effusion was seen in 21 (72.4%) of the 29 patients with PI and the RHS. Conclusions: A diagnosis of PE should be considered when there are findings such as those described here, even in patients with nonspecific clinical symptoms.


RESUMO Objetivo: Verificar a incidência do sinal do halo invertido (SHI) associado a infartos pulmonares (IP) relacionados ao tromboembolismo pulmonar (TEP) agudo, identificado por angiotomografia (angio-TC) de artérias pulmonares, e demonstrar as principais características morfológicas do SHI. Métodos: Foram avaliadas 993 angio-TCs, após estratificação de risco clínico para TEP entre janeiro de 2010 e dezembro de 2014. TEP foi encontrado em 164 pacientes (16,5%), sendo que três exames foram descartados devido a artefatos de movimentação respiratória. Dos 161 exames restantes, em 75 (46,6%) foram identificadas imagens compatíveis com IP, totalizando 86 lesões; o SHI foi observado em 33 (38,4% dos pacientes) dessas lesões. Resultados: Dos 29 pacientes com lesões características de IP com o SHI, 25 pacientes (86,2%) apresentavam lesão única e 4 (13,8%), lesão dupla. Todas as imagens compatíveis com SHI eram de localização subpleural. Para padronizar a análise, todas as imagens foram interpretadas no plano axial. Em relação à distribuição lobar das 33 lesões, o SHI estava localizado no lobo inferior direito, em 17 (51,5%); no lobo inferior esquerdo, em 10 (30,3%); na língula, em 5 (15,2%) e no lobo superior direito, em 1 (3,0%). Áreas de baixa atenuação no interior dos IPs com o SHI foram observadas em 29 das 33 lesões (87,9%). O SHI apresentava formato ovalado em 24 (72,7%) dos casos e formato arredondado, em 9 (27,3%). Derrame pleural foi encontrado associado aos IP com o SHI em 21 pacientes (72,4%). Conclusões: O achado de imagens com essas características, mesmo em pacientes com sintomatologia inespecífica, deve alertar para a possibilidade do diagnóstico de TEP.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Pulmonary Artery/diagnostic imaging , Pulmonary Embolism/epidemiology , Pulmonary Embolism/diagnostic imaging , Pulmonary Infarction/epidemiology , Pulmonary Infarction/diagnostic imaging , Computed Tomography Angiography/methods , Pleural Effusion/epidemiology , Pulmonary Artery/pathology , Pulmonary Embolism/pathology , Brazil/epidemiology , Acute Disease , Incidence , Cross-Sectional Studies , Retrospective Studies , Pulmonary Infarction/pathology , Lung/pathology , Lung/diagnostic imaging
SELECTION OF CITATIONS
SEARCH DETAIL