Persistent Inflammatory Activity in Blood Cells and Artery Tissue from Patients with Previous Bare Metal Stent.

BACKGROUND: Studies have pointed out a higher mortality after coronary artery bypass surgery (CABG) in patients with stent. OBJECTIVE: To evaluate inflammatory markers in peripheral blood cells and in coronary artery tissue samples obtained during CABG in patients with stent compared to controls. METHODS: The case series consisted of two groups, one with previous stent implantation (n = 41) and one control (n = 26). The expression of the LIGHT, IL-6, ICAM, VCAM, CD40, NFKB, TNF, IFNG genes was analyzed in peripheral blood cells collected preoperatively. The coronary artery was evaluated for: interleukin-6, ICAM, VCAM, CD40, NFKB, TNF-alpha and IFN-gamma by immunohistochemistry. A total of 176 tissue samples were grouped for analysis in: A1- arteries with stent (n = 38); A2- native arteries from patients with stent in another artery (n = 68); and A3- arteries without stent from controls undergoing routinely CABG surgery (n = 70). A significance level of 0.05 was adopted. RESULTS: Patients with stent showed higher TNF (p = 0.03) and lower CD40 gene expression (p = 0.01) in peripheral blood cells than controls without stent. In coronary artery samples, the TNF-alpha protein staining was higher in the group A1, not only in the intima-media layer (5.16 ± 5.05 vs 1.90 ± 2.27; p = 0.02), but also in the adipose tissue (6.69 ± 3.87 vs 2.27 ± 4.00; p < 0.001). Furthermore, group A1 had a higher interleukin-6 protein staining in adipose tissue than group A3 (p = 0.04). CONCLUSION: We observed a persistently higher systemic TNF expression associated with exacerbated TNF-alpha and interleukin-6 local production in patients with stents. This finding may contribute to a worse clinical outcome.

Proliferative arteriopathy of the nasal philtrum in two Brazilian Mastiff dogs

Proliferative arteritis of the canine nasal philtrum is an unusual disease with an unknown etiology and very few cases described in literature to date. Two patients with characteristic lesions underwent biopsy and confirmation by histopathological assessment. The first case was treated with oral prednisolone once daily and topical tacrolimus twice daily. The second case was treated twice daily with pentoxifylline and topical tacrolimus. Both treatments were successfully used by other authors previously. In result, clinical improvement varied among patients. The lesion of the first case showed no clinical improvement after 15 days of treatment. The second case showed a mild improvement of the initial lesion. In conclusion, treatment with tracolimus, pentoxifylline, and prednisonole appears to have a good effect in mild and early lesions. The objective of this paper was to describe the clinical findings, treatment options and histopathological aspects in two Brazilian Mastiff dogs, not previously reported.(AU)

Proliferative arteriopathy of the nasal philtrum in two Brazilian Mastiff dogs

Proliferative arteritis of the canine nasal philtrum is an unusual disease with an unknown etiology and very few cases described in literature to date. Two patients with characteristic lesions underwent biopsy and confirmation by histopathological assessment. The first case was treated with oral prednisolone once daily and topical tacrolimus twice daily. The second case was treated twice daily with pentoxifylline and topical tacrolimus. Both treatments were successfully used by other authors previously. In result, clinical improvement varied among patients. The lesion of the first case showed no clinical improvement after 15 days of treatment. The second case showed a mild improvement of the initial lesion. In conclusion, treatment with tracolimus, pentoxifylline, and prednisonole appears to have a good effect in mild and early lesions. The objective of this paper was to describe the clinical findings, treatment options and histopathological aspects in two Brazilian Mastiff dogs, not previously reported.

Calciphylaxis of the temporal artery masquerading as temporal arteritis: a case presentation and review of the literature.

An 82-year-old woman came to consultation with sudden visual loss in her left eye. Fifteen days before, she complained of diplopia. She had doubtful symptoms of giant cell arteritis and showed a normal physical exam. Lab results showed erythrosedimentation rate (ESR) = 62 mm/1°h; uremia = 0.56 g/dl (normal <0.45); serum creatinine = 1.7 mg% (normal <1.4); low calcium and phosphorus; and normal urine calcium and serous PTH. Fundus exam and brain magnetic resonance imaging (MRI) showed normality of optic nerves, chiasma, retrochiasmatic area, ocular muscles, eyeballs, lacrimal glands, periorbital fat, cavernous sinuses, and occipital cortex. A temporal arteritis was suspected; therefore, a biopsy was carried on. It showed the presence of large calcium deposits in the artery's tunica media and internal elastic lamina, with narrowing of the lumen, with no inflammation and multinuclear giant cells. Histological diagnosis is calciphylaxis. Although calciphylaxis is a well-described entity that occurs in end-stage renal patients, many cases are due to non-uremic causes. To date, there are only six cases described in literature of calciphylaxis mimicking GCA.

Aspectos anatomopatológicos do parasitismo por nematódeos da superfamília Filarioidea em capivaras (Hydrochoerus hydrochaeris) de vida livre no Centro-Oeste brasileiro / Anatomic pathology aspects of the parasitism by Cruorifilaria tuberocauda in capybaras (Hydrochoerus hydrochaeris) in Midwestern Brazil

São descritos dois casos de parasitismo por Cruorifilaria tuberocauda em capivaras de vida livre no Distrito Federal, Brasil. Macroscopicamente, observou-se nas superfícies de corte dos rins espessamento acentuado de vasos das regiões cortical e córtico-medular. Microscopicamente, havia arterite proliferativa e granulomatosa acentuada associada a filarídeos intralesionais consistentes com Cruorifilaria tuberocauda. Esse é o primeiro relato do parasitismo por esse filarídeo em capivaras no Distrito Federal.(AU)

This report describes two cases of parasitism by Cruorifilaria tuberocauda in wild capybaras (Hydrochoerus hydrochaeris) from Distrito Federal, Brazil. Grossly, there was marked thickening of vessels wall of the cortical and corticomedullary regions of both kidneys. Microscopically, there was severe proliferative and granulomatous arteritis associated with intralesional filarids, consistent with Cruorifilaria tuberocauda. For the first time this filarid is reported parasitizing capybaras in Distrito Federal, Brazil.(AU)

Aspectos anatomopatológicos do parasitismo por nematódeos da superfamília filarioidea em capivaras (hydrochoerus hydrochaeris) de vida livre no Centro-Oeste brasileiro / Anatomic pathology aspects of the parasitism by cruorifilaria tuberocauda in capybaras (hydrochoerus hydrochaeris) in midwestern Brazil

São descritos dois casos de parasitismo por Cruorifilaria tuberocauda em capivaras de vida livre no Distrito Federal, Brasil. Macroscopicamente, observou-se nas superfícies de corte dos rins espessamento acentuado de vasos das regiões cortical e córtico-medular. Microscopicamente, havia arterite proliferativa e granulomatosa acentuada associada a filarídeos intralesionais consistentes com Cruorifilaria tuberocauda. Esse é o primeiro relato do parasitismo por esse filarídeo em capivaras no Distrito Federal.

This report describes two cases of parasitism by Cruorifilaria tuberocauda in wild capybaras (Hydrochoerus hydrochaeris) from Distrito Federal, Brazil. Grossly, there was marked thickening of vessels wall of the cortical and corticomedullary regions of both kidneys. Microscopically, there was severe proliferative and granulomatous arteritis associated with intralesional filarids, consistent with Cruorifilaria tuberocauda. For the first time this filarid is reported parasitizing capybaras in Distrito Federal, Brazil.

Training improves walking capacity and cardiovascular function in arteritis.

Patients with arteritis have a high risk of mortality from cardiovascular disorders. However, whether these patients benefit from an intervention involving exercise remains unclear. In this study, we assessed the effects of an unsupervised exercise program on walking capacity, quality of life, and cardiovascular parameters of a patient with arteritis. A 33-year-old man reporting symptoms of claudication during walking was studied. Imaging tests revealed severe atherosclerosis and arteritis was diagnosed. Five weekly sessions of walking for 16 weeks increased claudication distance and total walking distance, produced improvements in six out of the eight health-related quality-of-life domains, decreased systolic blood pressure, and changed cardiac autonomic modulation toward parasympathetic modulation. This case report showed that unsupervised exercise training improved walking capacity, quality of life, and cardiovascular parameters in a patient with arteritis.

Arteritis de celulas gigantes: clásicos y novedades que vale la pena recordar / Giant cells arteritis: classics and innovations for remember

La Arteritis de Células Gigantes (ACG) es una vasculitis frecuente que ocurre en personas mayores y que afecta principalmente vasos craneanos. Generalmente se acompaña de síntomas sistémicos, claudicación mandibular y alteraciones visuales. La Polimialgia Reumática (PMR) se caracteriza por dolor y rigidez de cintura escapular y pelviana que presenta síntomas constitucionales y reacciones sistémicas. En los últimos años, ha aparecido evidencia que relaciona ambas entidades como componentes de una misma enfermedad. En este artículo se revisan aspectos nuevos en diagnóstico, terapia y etiopatogenia de la ACG y sus relaciones con PMR.

The Giant cell arteritis (GCA) is a common vasculitic syndrome occurring in older persons and it preferentially affects cranial arteries. Generally accompanied by constitutional symptoms and typical findings like jaw claudication and vision disorder.Polymyalgia Rheumatica (PMR) is caracterized by pain and stiffness involving shoulder and pelvic girdless with constitutional symptoms and findings of a systemic reaction. In recents years, evidence linking both conditions as components of asingle disease process has been accumulated. In the present article, we review new aspects of the diagnosis, therapy and pathogenesis of the GCA, and their relationship.

Frequency of cerebral arteritis in subarachnoid cysticercosis: an angiographic study.

BACKGROUND AND PURPOSE: Subarachnoid cysticercosis is a well-recognized cause of cerebral infarction. However, few patients with this infection develop cerebral infarction, and the reason for this is not known. The aim of this study was to determine the frequency of cerebral arteritis in these patients. METHODS: Using cerebral arteriography, we studied 28 patients with subarachnoid cysticercosis admitted to our hospital from July 1993 to February 1996. All patients underwent MRI to detect the presence of basal arachnoiditis. We analyzed demographic data, time to cysticercosis since the first symptom onset, mode of onset, stroke syndromes, neuroimaging features of cysticercosis and cerebral infarction, and arteriographic findings for each patient. RESULTS: Of the 28 patients (mean age, 37 years), 15 patients had angiographic evidence of cerebral arteritis (53%); 12 of the 15 had a stroke syndrome (P=.02). Eight of the 15 patients (53%) with cerebral arteritis had evidence of cerebral infarction on MRI, whereas only one patient without cerebral arteritis had cerebral infarction (P=.05). The most commonly involved vessels were the middle cerebral artery and the posterior cerebral artery. CONCLUSIONS: The frequency of cerebral arteritis in subarachnoid cysticercosis is higher than previously reported, and middle-size vessel involvement is a common finding, even in those patients without clinical evidence of cerebral ischemia.

Arteritis segmentaria y focal de arterias intracraneanas: Informe de cuatro casos de autopsia / Segmental and focal arteritis of intracranial arteries: A report of four autopsy cases

El sistema nervioso central puede ser afectado por diversos tipos de vasculitis, ya sea como parte de una afección sistémica o de manera aislada. Se informan cuatro casos de arteritis segmentarias y focales de arterias intracraneanas, todos los pacientes fueron jóvenes y no presentaron datos clínicos de afección, ni lesiones en arterias extracraneanas. La afección de las arterias cerebrales fue focal y segmentaria y produjo trombosis con el consiguiente infarto isquémico en el territorio irrigado por el vaso afectado. Se revisan los conceptos sobre patogenía y clasificación de las vasculitis que afectan al sistema nervioso central, con especial atención de aquellas producidas por complejos inmunes circulantes

Arteritis de Takayasu: prueba seroinmunologica de su relación con infección por micobacterias / Mycobacterial infections in Takayasu's arteritis

La aorto-arteritis inespecífica de Takayasu (AT) es una vasculitis idiopática que afecta la aorta, sus ramas principales y a veces la arteria pulmonar. Es una enfermedad prevalente en todo el mundo -pero con predilección en razas orientales y mestizos hispanoamericanos- que afecta mujeres jóvenes y su causa es desconocida. Desde hace 50 años se ha sospechado su relación con tuberculosis. En este trabajo se encontró que el suero de los pacientes con AT tiene un anticuerpo IgG específico para una glicoproteína de 38 kDa, que es un marcador serológico de infección por mycobacterium tuberculosis. Es probable que la AT sea una vasculitis postinfecciosa con patogenia de base inmunológica.