Comparación de la reacción inflamatoria inducida por implantes faciales de silicona y politetrafluoroetileno. Estudio en conejos / Comparison of the inflammatory reaction induced by facial implants os silicone and polytetrafluoroethylene. Study in rabbits

Introducción y Objetivo: Existen diferentes tipos de injertos autólogos y materiales aloplásticos para el tratamiento de las diversas deformidades faciales. El politetrafluoroetileno (PTFE) tiene varias ventajas debido a su propiedad hidrofóbica, que induce menor reacción inflamatoria. Presentamos un estudio que evalúa y compara la reacción inflamatoria inducida por los implantes faciales de silicona y de PTFE. Material y Método: Colocamos fragmentos de implantes de silicona y de PTFE en orejas de conejos mediante incisión y disección de un bolsillo subcutáneo. Realizamos análisis histológico a las 8 semanas: tinción de las muestras con hematoxilina / eosina y calificación del grado de reacción inflamatoria crónica, presencia de neutrófilos, linfocitos, eosinófilos, neoangiogénesis, fibroblastos y edema, presencia o no de hemorragia y valoración de la cicatriz. Hicimos la recolección de muestras para análisis microbiológico y evaluación de la presencia de hematoma y absceso en el momento del sacrificio. Resultados: La prevalencia de abscesos en el sacrificio, el hematoma y el edema durante las primeras semanas, fueron significativamente menores (p <0.05) en el grupo de PTFE. Conclusiones: El PTFE indujo reacción inflamatoria crónica al igual que la silicona, pero con menos absceso, edema y formación de hematomas

Background and Objective: The treatment for many facial deformities uses many kinds of autologous grafts or alloplastic materials. Polytetrafluoroethylene (PTFE) has several advantages due to its hydrophobic properties, inducing less inflammatory reaction. Our study evaluates and compares the inflammatory reaction induced by silicone and PTFE stripes. Methods: Fragments of silicone and PTFE implants were placed in rabbits ears using an incision and a subcutaneous gap. The histological analysis was made 8 weeks later. The samples were stained with hematoxylin/eosin and classified as chronic inflammatory reaction graduation, the presence of neutrophils, lymphocytes, eosinophils, neoangiogenesis, fibroblasts, edema and presence of bleeding and scar. Samples to microbiological analysis and evaluation of bruise and abs- cess were collected at the moment of sacrifice. Results: Prevalence of abscess at sacrifice and hematoma during the first weeks were significantly higher (p>0.05) in the silicon group. Conclusions: PTFE induced as much inflammatory reaction as the silicon but with less abscess and hematoma formation

Acute lymphoblastic leukemia: primary bone manifestation with hypercalcemia in a child / Leucemia linfoblástica aguda: manifestação óssea primária com hipercalcemia em criança

ABSTRACT Primary bone manifestation associated with hypercalcemia is an infrequent presentation of acute lymphoblastic leukemia (ALL) in children. An 8-year-old girl was admitted with bone and abdomen pain, vomiting, fever, headache, anemia, elevated serum calcium and normal parathyroid hormone levels. Bone radiographs: osteolytic lesions. Bone marrow biopsy showed an infiltration by ALL with immunohistochemical positivity for CD45, CD20, CD79a, TdT and CD10, clinically characterized by hypercalcemia, multifocal osteolytic lesions and single cytopenia. Bone marrow biopsy was a relevant aid in establishing the diagnosis of multifocal osteolytic lesions, associated with hypercalcemia.

RESUMO Apresentação óssea primária associada à hipercalcemia é manifestação clinicolaboratorial infrequente de leucemia linfoblástica aguda (LLA) em crianças. Relatamos o caso de uma criança do sexo feminino, 8 anos, admitida com dores ósseas e no abdômen associadas a vômitos, febre, cefaleia, anemia, hipercalcemia e níveis de paratormônio normais. Radiografias ósseas apresentaram lesões osteolíticas. Biópsia de medula óssea demonstrou infiltração por LLA com positividade imuno-histoquímica para CD45, CD79a, TdT e CD10, clinicamente caracterizada por hipercalcemia, lesões osteolíticas multifocais e citopenia única. A biópsia de medula óssea é importante ferramenta no estabelecimento do diagnóstico de lesões osteolíticas multifocais associada à hipercalcemia.

Integrative miRNA and mRNA analysis in penile carcinomas reveals markers and pathways with potential clinical impact.

Penile carcinoma (PeCa) is an important public health issue in poor and developing countries, and has only recently been explored in terms of genetic and epigenetic studies. Integrative data analysis is a powerful method for the identification of molecular drivers involved in cancer development and progression. miRNA and mRNA expression profiles followed by integrative analysis were investigated in 23 PeCa and 12 non-neoplastic penile tissues (NPT). Expression levels of eight miRNAs and 10 mRNAs were evaluated in the same set of samples used for microarray and in a validation set of cases (PeCa = 36; NPT = 27). Eighty-one miRNAs and 2,697 mRNAs were identified as differentially expressed in PeCa. Integrative data analysis revealed 255 mRNAs potentially regulated by 68 miRNAs. Using RT-qPCR, eight miRNAs and nine transcripts were confirmed as altered in PeCa. We identified that MMP1, MMP12 and PPARG and hsa-miR-31-5p, hsa-miR-224-5p, and hsa-miR-223-3p were able to distinguish tumors from NPT with high sensitivity and specificity. Higher MMP1 expression was detected as a better predictor of lymph node metastasis than the clinical-pathological data. In addition, PPARG and EGFR were highlighted as potential pathways for targeted therapy in PeCa. The analysis based on HPV positivity (7 of 23 cases) revealed five miRNA and 13 mRNA differentially expressed. Although in a limited number of cases, HPV positive PeCa presented less aggressive phenotype in comparison with negative cases. Overall, an integrative analysis using mRNA and miRNA profiles revealed markers related with tumor development and progression. Furthermore, MMP1 expression level was a predictive marker for lymph node metastasis in patients with PeCa.

Pierre Robin sequence: case report, the relevance of autopsy / Sequência de Pierre Robin: relato de caso, a relevância da autópsia

ABSTRACTPierre Robin sequence is a neonatal disorder characterized by micrognathism, glossoptosis and cleft palate. We reported an autopsy case of a child whose malformations of the oropharynx were identified only at birth. The child was extremely preterm with severe neonatal depression and poor recovery, and the orofacial alterations prevented the correct treatment. There was facial disorder characterized by micrognathia associated with cleft palate and posterior displacement of the tongue, compressing the vallecula, structurally compatible with glossoptosis. This autopsy surpassed the scientific and epidemiological relevance, allowing the family genetic counseling and close monitoring of a subsequent pregnancy.

RESUMOSequência de Pierre Robin é uma doença neonatal caracterizada por micrognatismo, glossoptose e fenda palatina. Relatamos um caso de autópsia de uma criança cujas malformações da orofaringe somente foram identificadas ao nascimento. A criança era pré-termo extremo com depressão neonatal grave e má recuperação, e as malformações orofaciais impediram o correto tratamento. Havia alteração facial caracterizada por micrognatia associada a fenda palatina e posteriorização da língua, comprimindo a valécula, estruturalmente compatível com glossoptose. A autópsia extrapola as relevâncias científica e epidemiológica, permitindo o aconselhamento genético familiar e o monitoramento adequado da gestação subsequente.

STEAP1 protein overexpression is an independent marker for biochemical recurrence in prostate carcinoma.

AIMS: To investigate the prognostic value of expression levels of the genes STEAP1 and STEAP2, and of STEAP1 protein, in prostate carcinomas (PCa). METHODS AND RESULTS: STEAP1 and STEAP2 transcript levels were evaluated by RT-qPCR in samples from 35 PCa, 24 adjacent non-neoplastic prostate (AdjP) tissues, five cases of benign prostatic hyperplasia (BPH), and two histologically normal prostates (N). STEAP1 expression was assessed by immunohistochemistry in samples from 198 PCa, 76 AdjP, 22 BPH, and two N. The findings were compared with clinical and pathological parameters and patient outcome. STEAP1 and STEAP2 transcript analysis showed no differences between the groups tested. Although not significant, higher STEAP1 mRNA levels were detected in tumours with high Gleason scores and in patients who presented with biochemical recurrence (BCR). STEAP1 overexpression was detected in PCa, and was significantly associated with high-grade Gleason scores, seminal vesicle invasion, BCR, and worse outcome (metastasis or PCa-specific death). STEAP1 overexpression was significantly associated with shorter BCR-free survival. Multivariate analysis revealed that STEAP1 is an independent marker for BCR. CONCLUSIONS: These findings provide evidence that STEAP1 is a biomarker of worse prognosis in PCa patients.

A retrospective study of 40 victims of Crotalus snake bites: analysis of the hepatic necrosis observed in one patient

Os autores avaliaram 40 doentes com diagnóstico de acidente crotálico, atendidos no Serviço de Moléstias Infecciosas e parasitárias da Faculdade de Medicina de Botucatu. Desses, 30 eram do sexo masculino e 10 do feminino, com idades variando entre 16 e 70 anos. Todos eream lavradores e 35 deles foram atingidos nos membros inferiores. A maioria dos doentes (31) foi atendida antes de 6 horas do acidente. Dos 9 que receberam atendimento médico após 6 horas, 2 deles evoluíram para o óbito. Os resultados observados revelaram que o baixo índice de mortalidade (5%) verificado pode eventualmente ser explicado pelo atendimento precoce, uso de doses adequadas de soro anticrotálico, hidrataçäo parenteral, alcalinizaçäo da urina com bicarbonato de sódio e induçäo da diurese osmótica com soluçäo de manitol. O exame anatomopatológico de um dos casos que evoluiu para o óbito apresntou extensa necrose hepática. Os autores discutem a possibilidade de interaçäo entre alcoolismo crônico e a açäo eventual de um fator hepatóxico do veneno da serpente na gênese da necrose hepática e no aumento dos níveis de transaminases