Efeitos protetores da glutamina e dieta elementar na enterocolite actínica aguda: avaliaçäo histológica / Protective effects of glutamine and elemental diet in acute actinic enterocolitis: histological evaluation

O emprego da radioterapia abdominal pode ocasionar a enterite actínica aguda. A utilizaçäo de formulaçöes nutricionais especiais tem sido proposta a fim de proteger o intestino durante e após a irradiaçäo. OBJETIVO. Avaliar histologicamente o efeito protetor de dietas polimétricas e elementares enriquecidas com glutamina na prevençäo da enterite actínica aguda. MÉTODOS. Foram estudados 65 ratos machos, adultos, da raça Wistar, monitorizados diariamente quanto à ingestäo e às variaçöes de peso corpóreo. Os animais foram randomizados em três grupos e alimentados com dietas isocalóricas e isonitrogenadas: 1) CRt - dieta polimérica com caseína enriquecida com glutamina a 2 por cento; e 3) ERt - dieta elementar enriquecida com glutamina a 2 por cento. O experimento constou de períodos de adaptaçäo (7 dias), de irradiaçäo (5 dias) e de recuperaçäo (3 dias). Após a adapataçäo alimentar, todos os ratos receberam irradiaçäo abdominal fracionada em 5 doses diárias de 300cGy.quatro dias após o término da irradiaçäo, os ratos foram operados para ressecar o intestino delgado e o cólon para estudo histopatológico. RESULTADOS. Os grupos ERt e GRt apresentaram número significativamente maior de ratos com aumento da celularidade, do número de mitoses e médias superiores de altura das vilosidades em comparaçäo à CRt no intestino delgado. O grupo ERt apresentou, ainda maior número de ratos com relaçäo das alturas vilosidade-cripta normal do que os grupos CRt ou GRt, que näo apresentaram diferença estatística entre si. No intestino grosso, as médias de altura das criptas dos grupos ERt e GRt foram iguais e superiores às de CRt; os três grupos näo apresentaram, porém, diferença significante em relaçäo à celularidade epitelial e ao número de mitoses nas criptas do cólon. CONCLUSAO. Nas condiçöes do presente trabalho, a suplementaçäo alimentar com glutamina antes, durante e após a irradiaçäo abdominal em ratos, em dieta polimérica ou elementar, determinou efeitos protetores sobre o intestino irradiado, preservando sua arquitetura morfológica e a capacidade de recuperaçäo, sobretudo no intestino delgado

[Protective effects of glutamine and elemental diet in acute actinic enterocolitis: histological evaluation]. / Efeitos protetores da glutamina e dieta elementar na enterocolite actínica aguda: avaliação histológica.

Radiotherapy plays nowadays an important role in malignancies treatment. However, collateral effects and severe complications owing to cellular damage of peritumoral tissues may occur. Different nutritional resources have been recently indicated to achieve intestinal protection during cancer irradiation. PURPOSE--The aim of this study was to set the role of glutamine and elemental diets in acute actinic enteritis prevention. METHOD--Sixty-five adult male Wistar rats with average weight of 200g were maintained in individual metabolic cages; daily body weight and food ingestion were carefully monitored. The animals were randomized into three groups and fed isocaloric and isonitrogenous diets: 1) CRt-polymeric-casein diet; 2) GRt-polymeric-casein diet supplemented with 2% glutamine and 3) ERt-elemental diet supplemented with 2% glutamine. After an adaptation period (seven days), all rats received abdominal radiation in five daily doses of 300cGy. Four days after the rats were operated on to resect the small intestine and colon for histological evaluation. RESULTS--Small intestine histological data in ERt and GRt rats were better than CRt rats, by preserving mucosal cellularity and increasing mitosis number and villi length. Simultaneously, ERt group had greater number of rats with normal villus-crypt relation than CRt or GRt groups. Large intestine histological data showed that the average crypts length in ERt and GRt rats were greater than in CRt ones. CONCLUSION--Glutamine-supplemented polymeric or elemental diets given to rats before, during and after abdominal radiotherapy showed protective effects against radiation injury, by supporting mucosal structure and recovery.

[Acute abdomen in childhood caused by intestinal angiostrongylus infection: a case report]. / Abdome agudo na infância por angiostrongilíase intestinal: relato de um caso.

A case of acute abdomen in a one-year-old infant with abdominal angiostrongyliasis is reported. The main clinical and pathologic features of this disease are discussed. The diagnosis is made only through a biopsy that shows maturing stages of the worm within the intestinal wall and/or mesentery. Neither eggs nor larvae have been found in human feces. Treatment has been by surgical resection of the inflammatory mass. The prevalence of this illness is underestimated because of the difficult diagnosis. The main purpose of the present article is to attract attention to this diagnostic possibility as a cause of abdominal pain and acute abdomen in childhood.

Pathology of the human pulmonary paracoccidioidomycosis.

Lungs of twelve patients with chronic paracoccidioidomycosis (Pb) were studied in an attempt to understand the pathogenesis of the pulmonary disease. Ribbons of the lung parenchyma including the hilar region and directed towards apical, basal and lateral regions were subdivided into sections from the hilar, intermediate and peripheral segments. The following histopathological reactions directly or indirectly related to P. brasiliensis were described and analysed in relation to the number of slides studied and the pulmonary region involved: pneumonic reaction; early granulomatous formation; mature and healed granulomata; mixed pattern (early and mature granuloma in the same pulmonary area visualized in the slide); pulmonary fibrosis. It was concluded that chronic pulmonary Pb is a recurrent disease affecting equally both lungs. Fibrosis was connected mainly with the progressive evolution of the granulomata towards cicatrization and to a lesser degree probably to a direct induction by the fungi. Based chiefly on the tendency of the fibrosis to run around bronchi and to make up septa interconnecting bronchi and vessels it was hipothesized that these findings were the result of a previous chronic specific lymphangitis by the fungi. Hilar fibrosis would be the result of this lymphangitis and/or of the progression of the specific granulomatous reaction seen in the hilar lymph nodes. Non specific forms of arteritis and areas of destructive emphysema related to granulomatous inflammation and fibrosis were described. Three cases developed pulmonary hypertension.

Histoplasmose disseminada em transplantado renal. / Disseminated histoplasmosis in renal transplant patients

Os Autores registram caso de histoplasmose generalizada em paciente transplantado com rim de doador nao aparentado. Alem da infeccao fungica diagnosticada sorologicamente e pela histopatologia, a autopsia revelou cirrose hepatica macro e micronodular, de provavel etiologia viral (virus B), hepatocarcinoma, deplecao linfoide do baco e glomerulopatia de transplante. Revendo a literatura sobre o assunto, chegam a conclusao de que, provavelmente, com a imunodepressao medicamentosa, as lesoes pulmonares por reinfeccao endogena foram as primeiras a aparecer sob a forma de uma histoplasmose pulmonar cronica