Placental and umbilical cord macroscopic changes associated with fetal and maternal events in the hypertensive disorders of pregnancy.

AIM: The purpose of this study was to identify placental and umbilical cord macroscopic changes and correlate them to maternal and fetal clinical events in hypertensive disorders of pregnancy (HDP). MATERIALS AND METHODS: The authors examined 150 placentas, 30 from each HDP group, totaling 120, and 30 from the control group. All placentas and umbilical cords were examined, recorded, and photographed. RESULTS: The mean placental weight in the control group (526.3 +/- 95.6 g) was greater than in the HDP (435.5 +/- 43.1 g). Calciphylaxis was the most common macroscopic change found in the control and HDP groups in 27 (90%) and 118 cases (98.3%), respectively. DISCUSSION: Pregnant women with HDP were relatively younger. In addition, due to low blood flow seen in HDP, the macroscopic changes found included lower placental weight, calciphylaxis in the maternal surface, and fibrin in the fetal surface. Because of all complications associated, most women with HDP had preterm infants who developed respiratory problems and had shorter umbilical cords.

[Human accidents with stings from Africanized bees]. / Acidente humano por picadas de abelhas africanizadas.

It is report five cases of stings of africanized bees (AB). Four of them were victims of multiple stings, varying from 25 to 60, that presented severe headache, nauseas and vomits, related to the clinic effect of the toxicity of the venom, with good evolution. The other case was victim of a single sting of AB and died after probable anaphylaxis.

Correlation between adrenal central vein parasitism and heart fibrosis in chronic chagasic myocarditis.

The correlation between Trypanosoma cruzi parasitism of the adrenal central vein (ACV) wall and fibrous connective tissue neoformation in the left ventricular myocardium (LVM) of patients with chronic Chagas' disease who were autopsied was evaluated using the following procedures: 1) a comparison of the incidence of fibrosis in the LVM among 18 chagasic patients with ACV parasitism and 18 individuals without phleboparasitism; 2) a determination of fibrosis intensity in the LVM in 12 cases with ACV parasites and in 12 cases without phleboparasitism, matched with respect to age, sex, race, and anatomoclinical form of the disease (indeterminant, cardiac, and digestive forms); and 3) in the cases with ACV parasitism, a calculation of Pearson's correlation coefficient between T. cruzi nests in the vessel and the intensity of fibrous connective tissue neoformation in the LVM. Among chagasic individuals with adrenal phleboparasitism, there was an increased incidence and intensity of fibrous connective tissue neoformation in the LVM, both highly significant, compared with patients without adrenal phleboparasitism. Furthermore, there was a positive, though nonsignificant, correlation (r = +0.19) between the density of nests in the ACV and the intensity of myocardial fibrosis. These results are consistent with previous data showing a higher intensity of the leukocyte exudate in the LVM and increased heart weight in individuals with T. cruzi nests in the ACV, suggesting a role of parasitism at that site in terms of the development of chronic chagasic cardiopathy.

[Cardiac weight in patients with chronic Chagas disease with Trypanosoma cruzi nests in the central vein of the adrenal glands]. / Peso cardíaco em chagásicos crônicos com ninhos de Trypanosoma cruzi na veia central da supra-renal.

PURPOSE: Comparative analysis of cardiac weight (CW) in patients with chronic Chagas disease, with or without parasitism by Trypanosoma cruzi in the central vein of the adrenal gland (CVAG). METHODS: The CW has been studied in 96 necropsied individuals with chronic Chagas disease. Among them, 48 of them had Trypanosoma cruzi nests on the wall of the CVAG and the other 48 patients did not have nests in the CVAG. Later, this sample was paired for sex, age and anatomo-clinical form, resulting in 60 patients. Among these patients, 30 of them had Trypanosoma cruzi nests on the walls of the CVAG and the other 30 did not have. RESULTS: The CW of Chagas patients which had nests of T. cruzi in the CVAG, was 484.8 +/- 146.0g, while in the ones that did not have the nests on the walls of the CVAG, the CW weight was 415.8 +/- 125.3g. This difference was statistically significant. In the first group it had a prevail of congestive heart failure. Subsequently to the pairing for sex, age and anatomo-clinical form, the CW was respectively 464.3 +/- 146.2g and 436.0 +/- 108.9g. This difference was not statistically significant. CONCLUSION: These data suggest that the parasitism in the central vein of the adrenal gland, combined with other possible events intrinsic to the chronic Chagas disease patients' hearts, carries a supporting role in the increasing of the cardiac weight and in the congestive cardiac insufficiency.