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Carditis in childhood is a rare disease with several etiologies. We report a case of infant death due to pericarditis and myocarditis after the mRNA vaccine against COVID-19 (COVIDmRNAV). A 7-year-old male child received the first dose of the COVIDmRNAV and presented with monoarthritis and a fever non-responsive to oral antibiotics. The laboratory investigation showed signs of infection (leukocytosis, high levels of c-reactive protein). His condition rapidly deteriorated, and the patient died. The autopsy identified pericardial fibrin deposits, hemorrhagic areas in the myocardium, and normal valves. A diffuse intermyocardial inflammatory infiltrate composed of T CD8+ lymphocytes and histiocytes was identified. An antistreptolysin O (ASO) dosage showed high titers. The presence of arthritis, elevated ASO, and carditis fulfills the criteria for rheumatic fever. However, valve disease and Aschoff's nodules, present in 90% of rheumatic carditis cases, were absent in this case. The temporal correlation with mRNA vaccination prompted its inclusion as one of the etiologies. In cases of myocardial damage related to COVID-19mRNAV, it appears to be related to the expression of exosomes and lipid nanoparticles, leading to a cytokine storm. The potential effects of the COVID-19mRNAV must be considered in the pathogenesis of this disease, whether as an etiology or a contributing factor to a previously initiated myocardial injury.
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BACKGROUND: The emergence of new SARS-CoV-2 variants and the global COVID-19 pandemic spurred urgent vaccine development. While common vaccine side effects are well-documented, rare adverse events necessitate post-marketing surveillance. Recent research linked messenger RNA vaccines to thrombotic microangiopathy (TMA), a group of syndromes characterized by microvascular hemolytic anemia and thrombocytopenia. This report describes a new-onset atypical hemolytic-uremic syndrome (aHUS) occurring after COVID-19 vaccination and complements recent literature. CASE PRESENTATION: A previously healthy 25-year-old woman developed malaise, nausea, edema, and renal dysfunction 60 days postvaccination. Laboratory findings confirmed TMA diagnosis. Genetic testing for complement system mutations was negative. Kidney biopsy supported the diagnosis, and the patient required hemodialysis. CONCLUSION: This case illustrates the rare occurrence of aHUS following COVID-19 vaccination, with unique characteristics compared to previous reports. Despite the critical role of vaccination in pandemic control, emerging adverse events, such as vaccine-related TMA, must be recognized and investigated. Additional clinical trials are imperative to comprehend the clinical features and pathophysiological mechanisms underlying TMA associated with COVID-19 vaccination.
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Síndrome Hemolítico-Urêmica Atípica , Vacinas contra COVID-19 , COVID-19 , SARS-CoV-2 , Humanos , Feminino , Adulto , Síndrome Hemolítico-Urêmica Atípica/diagnóstico , COVID-19/prevenção & controle , COVID-19/imunologia , SARS-CoV-2/imunologia , Vacinas contra COVID-19/efeitos adversos , Diálise Renal , Vacinação/efeitos adversosRESUMO
The Verbal Autopsy (VA) is a questionnaire about the circumstances surrounding a death. It was widely used in Brazil to assist in postmortem diagnoses and investigate excess mortality during the Coronavirus Disease 2019 (COVID-19) pandemic. This study aimed to determine the accuracy of investigating acute respiratory distress syndrome (ARDS) using VA. This is a cross-sectional study with prospective data collected from January 2020 to August 2021 at the Death Verification Service of Sao Luis city, Brazil. VA was performed for suspected COVID-19 deaths, and one day of the week was randomly chosen to collect samples from patients without suspected COVID-19. Two swabs were collected after death and subjected to reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 detection. Of the 250 cases included, the VA questionnaire identified COVID-19-related ARDS in 67.2% (52.98% were positive for COVID-19). The sensitivity of the VA questionnaire was 0.53 (0.45-0.61), the specificity was 0.75 (0.64-0.84), the positive predictive value was 0.81 (0.72-0.88), and the negative predictive value was 0.44 (0.36-0.53). The VA had a lower-than-expected accuracy for detecting COVID-19 deaths; however, because it is an easily accessible and cost-effective tool, it can be combined with more accurate methods to improve its performance.
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Autopsia , COVID-19 , Humanos , COVID-19/mortalidade , COVID-19/diagnóstico , Estudos Transversais , Masculino , Feminino , Brasil/epidemiologia , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto , Sensibilidade e Especificidade , Idoso , SARS-CoV-2 , Estudos Prospectivos , Adulto Jovem , Síndrome do Desconforto Respiratório/mortalidade , Síndrome do Desconforto Respiratório/diagnóstico , Causas de Morte , AdolescenteRESUMO
Large-scale COVID-19 vaccination has been one of the most effective strategies to control the spread of the SARS-CoV-2 virus. However, several cases of glomerular injury related to the COVID-19 vaccine have been described in the literature. We report two cases of a tip lesion variant of focal segmental glomerulosclerosis (FSGS), which presented with significant proteinuria and improved after immunosuppression. In our literature review, the tip lesion variant of FSGS is currently the most frequent variant associated with vaccination against COVID-19. Prognosis is favorable and without significant alterations in the tubulointerstitial or vascular compartments. Adverse effects of vaccines need to be recognized early and will help us to understand the immune and pathological mechanisms of kidney damage.
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The main goal of the present study was to analyze the expression profile of cyclin D1 in patients with PC, and to determine possible correlations with clinical and histopathological features. A survey was conducted with 100 patients diagnosed with PC, who were treated at two reference hospitals in São Luís, Maranhão, Brazil, between 2013 and 2017. A review of clinical, epidemiological, and histopathological data was performed, Human Papillomavírus (HPV) DNA was detected using polymerase chain reaction (PCR) and cyclin D1 expression analysis was performed using immunohistochemical techniques. The data revealed that the absence of cyclin D1 expression was significantly associated with HPV-positive histological subtypes (p = 0.001), while its expression was associated with high-grade tumors (p = 0.014), histological subtype (p = 0.001), presence of sarcomatoid transformation (p = 0.04), and perineural invasion (p = 0.023). Patients with cyclin D1 expression exhibited lower disease-free survival compared to the cyclin D1-negative group, although the difference was not statistically significant. The results suggest that cyclin D1 may be a potential biomarker for PC, especially for poorer prognosis.
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Biomarcadores Tumorais , Ciclina D1 , Neoplasias Penianas , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Biomarcadores Tumorais/metabolismo , Biomarcadores Tumorais/genética , Brasil/epidemiologia , Ciclina D1/metabolismo , Ciclina D1/genética , Intervalo Livre de Doença , Imuno-Histoquímica , Infecções por Papillomavirus/virologia , Infecções por Papillomavirus/metabolismo , Neoplasias Penianas/genética , Neoplasias Penianas/patologia , Neoplasias Penianas/virologia , PrognósticoRESUMO
Cervical Cancer (CC) is one of the most prevalent neoplasms among women, considered the leading cause of gynecological death worldwide, and the fourth most common type of cancer. Regional metastasis is closely related to the low effectiveness of treatment, and validating biomarkers can optimize accuracy in diagnosis and prognosis. Among the potential biomarkers associated with disease metastasis are circular RNAs (circRNAs), whose altered expression has been linked to CC progression. In this context, this systematic review aims to compile information on the clinical-pathological significance and describe the biological function of circRNAs. Inclusion and exclusion criteria were used to include relevant literature, followed by in silico analysis. Additionally, we employed the UALCAN tools to search for host genes of circRNAs and expression data, miRTargetLink 2.0 to predict interactions of microRNA target genes and the Cytoscape software to predict possible interactions of microRNA target genes. According to the research, most circRNAs were found to be overexpressed and described as regulators of processes such as invasion, cell proliferation, apoptosis and migration. They were also implicated in clinical significance, including metastasis, TNM staging and microRNA interactions. CircRNAs may participate in critical processes in tumorigenesis; therefore, understanding the underlying molecular mechanisms of gene regulation in CC can contribute to the accuracy of diagnosis, prognosis and therapy.
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With the coverage of COVID-19 vaccination, it has been possible to observe the potential side effects of SARS-CoV-2 vaccines, with the most common ones being fever, myalgia, headache, and fatigue. However, an association has been observed between new and recurrent kidney injuries, mainly glomerulonephritis and lupus nephritis associated with ANCA, with the Pfizer-BioNTech, Moderna, Sinovac, and AstraZeneca vaccines, although the relationship between them is not clear. We report a case of ANCA-related vasculitis and lupus glomerulonephritis after the second dose of the AstraZeneca vaccine. The elderly patient presented significant worsening of kidney function after immunosuppression and complications after a new onset COVID-19 infection that led to death. We provide a literature review about kidney damage related to ANCA vasculitis after COVID-19 vaccine, aiming for a better understanding of the pathophysiological mechanism of kidney injury, its presentation, and treatment.
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COVID-19 , Glomerulonefrite , Nefrite Lúpica , Vasculite , Idoso , Humanos , Nefrite Lúpica/etiologia , Vacinas contra COVID-19/efeitos adversos , Anticorpos Anticitoplasma de Neutrófilos , SARS-CoV-2 , Glomerulonefrite/etiologia , Vacinação/efeitos adversosRESUMO
ABSTRACT The Verbal Autopsy (VA) is a questionnaire about the circumstances surrounding a death. It was widely used in Brazil to assist in postmortem diagnoses and investigate excess mortality during the Coronavirus Disease 2019 (COVID-19) pandemic. This study aimed to determine the accuracy of investigating acute respiratory distress syndrome (ARDS) using VA. This is a cross-sectional study with prospective data collected from January 2020 to August 2021 at the Death Verification Service of Sao Luis city, Brazil. VA was performed for suspected COVID-19 deaths, and one day of the week was randomly chosen to collect samples from patients without suspected COVID-19. Two swabs were collected after death and subjected to reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 detection. Of the 250 cases included, the VA questionnaire identified COVID-19-related ARDS in 67.2% (52.98% were positive for COVID-19). The sensitivity of the VA questionnaire was 0.53 (0.45-0.61), the specificity was 0.75 (0.64-0.84), the positive predictive value was 0.81 (0.72-0.88), and the negative predictive value was 0.44 (0.36-0.53). The VA had a lower-than-expected accuracy for detecting COVID-19 deaths; however, because it is an easily accessible and cost-effective tool, it can be combined with more accurate methods to improve its performance.
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Resumo: Introdução: O ensino híbrido pode ser utilizado como recurso pedagógico às formas tradicionais de ensinar. A ausência de um laboratório de patologia renal pode gerar uma lacuna na formação de médicos residentes em nefrologia. Este estudo descreve como a complementação do conteúdo com o uso de um atlas on-line de patologia renal foi descrita por médicos residentes. Relato de experiência: Um atlas virtual de patologia renal elaborado por preceptores das residências médicas de nefrologia e patologia foi apresentado a oito médicos residentes matriculados no serviço, que, durante 15 dias, incluíram os estudos desse conteúdo em suas atividades. Os residentes avaliaram a experiência de ensino-aprendizagem por meio de um grupo focal. Discussão: Estratégias de ensino on-line podem ser utilizadas para complementar o conhecimento adquirido durante a residência médica. No entanto, é importante que essa etapa da estratégia de ensino híbrido seja motivadora na visão do estudante e se adapte ao momento vivenciado pelos médicos residentes, os quais já possuem carga de trabalho determinada. Esses pontos estiveram entre os temas emergentes na análise temática do conteúdo do grupo focal, que também incluiu sugestões dos alunos em como modificar a apresentação do conteúdo. Conclusão: A inserção de estratégias de ensino híbrido pode auxiliar a formação dos médicos residentes, bem como abrir espaço para a produção discente. Parcerias interinstitucionais devem ser desenvolvidas para suprir barreiras à elaboração de e-learning pelos formadores médicos.
Abstract: Introduction: Blended Learning can be used as a pedagogical resource to the traditional ways of teaching. The lack of a Renal Pathology laboratory can result in a gap in the training of resident physicians in Nephrology. This study describes how complementing the content with the use of an online Renal Pathology atlas was described by resident physicians. Experience report: A virtual atlas of Renal Pathology prepared by preceptors of the Medical Residencies of Nephrology and Pathology was presented to eight resident physicians enrolled in the service, who, for fifteen days, included the studies of this content in their activities. The residents evaluated the teaching-learning experience through a focus group. Discussion: Online teaching strategies can be used to complement the knowledge acquired during Medical Residency. However, it is important that this stage of the blended learning strategy be motivating in the students' view, adapting to the moment experienced by resident physicians, who already have a pre-determined workload. These points were among the emerging topics in the thematic analysis of the content of the focus group, which also included suggestions from the students on how to modify the content presentation. Conclusion: The inclusion of blended learning strategies can help the training of resident physicians, as well as open space for student production. Inter-institutional partnerships should be developed to overcome barriers to e-learning development by medical trainers.
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ABSTRACT Purpose To compare tissue inflammatory response, foreign body reaction, fibroplasia, and proportion of type I/III collagen between closure of abdominal wall aponeurosis using polyglactin suture and intraperitoneal implant of polypropylene, polypropylene/polyglecaprone, and polyester/porcine collagen meshes to repair defects in the abdominal wall of rats. Methods Forty Wistar rats were placed in four groups, ten animals each, for the intraperitoneal implant of polypropylene, polypropylene/polyglecaprone, and polyester/porcine collagen meshes or suture with polyglactin (sham) after creation of defect in the abdominal wall. Twenty-one days later, histological analysis was performed after staining with hematoxylin-eosin and picrosirius red. Results The groups with meshes had a higher inflammation score (p < 0.05) and higher number of gigantocytes (p < 0.05) than the sham group, which had a better fibroplasia with a higher proportion of type I/III collagen than the tissue separating meshes (p < 0.05). There were no statistically significant differences between the three groups with meshes. Conclusions The intraperitoneal implant of polypropylene/polyglecaprone and polyester/porcine collagen meshes determined a more intense tissue inflammatory response with exuberant foreign body reaction, immature fibroplasia and low tissue proportion of type I/III collagen compared to suture with polyglactin of abdominal aponeurosis. However, there were no significant differences in relation to the polypropylene mesh group.
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Animais , Ratos , Polipropilenos/efeitos adversos , Parede Abdominal/cirurgia , Poliglactina 910/efeitos adversos , Telas Cirúrgicas/efeitos adversos , Suturas , Suínos , Teste de Materiais , Reação a Corpo Estranho/etiologia , Colágeno , Ratos Wistar , AponeuroseRESUMO
Abstract Visceral leishmaniasis (VL) is an infectious disease caused by Leishmania spp. The recurrence of the disease occurs, in general, in patients with decreased or loss of T-cell function, whether due to the use of corticosteroids, immunosuppressive disease, or another cause. In some cases, splenectomy may be a therapeutic option. However, the effectiveness of splenectomy is not well defined. This report describes the evolution of a pediatric patient with seven recurrences of VL, who relapsed post-surgery after drug therapy and splenectomy.
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Humanos , Criança , Leishmania , Leishmaniose Visceral/tratamento farmacológico , Recidiva , EsplenectomiaRESUMO
Abstract Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune inflammatory disease. However, some patients may exhibit a histological pattern of kidney injury, with characteristics indistinguishable from lupus nephritis, but without presenting any extrarenal symptoms or serologies suggestive of SLE. Such involvement has recently been called non-lupus full-house nephropathy. The objective is to report a series of clinical cases referred to the Laboratory of the Federal University of Maranhão that received the diagnosis of "full-house" nephropathy unrelated to lupus, upon immunofluorescence and to discuss its evolution and outcomes. Non-lupus full-house nephropathy represents a diagnostic and therapeutic challenge, because it is a new entity, which still needs further studies and may be the initial manifestation of SLE, isolated manifestation of SLE or a new pathology unrelated to SLE.
Resumo O lúpus eritematoso sistêmico (LES) é uma doença inflamatória crônica autoimune multissistêmica. Alguns pacientes, contudo, podem exibir um padrão histológico de lesão renal, com características indistinguíveis da nefrite lúpica, porém sem apresentar quaisquer sintomas extrarrenais ou sorologias sugestivas de LES. Tal acometimento tem sido recentemente denominado nefropatia "full-house" não relacionada ao lúpus. O objetivo é relatar uma série de casos clínicos encaminhados ao Laboratório da Universidade Federal do Maranhão que receberam o diagnóstico de nefropatia "full-house" não relacionada ao lúpus à imunofluorescência e discutir sua evolução e desfechos. A nefropatia "full-house" não relacionada ao lúpus representa um desafio diagnóstico e terapêutico por ser uma entidade nova, que ainda necessita de maiores estudos e pode ser a manifestação inicial do LES, manifestação isolada do LES ou uma patologia nova não relacionada ao LES.
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Humanos , Nefrite Lúpica/diagnóstico , Nefropatias , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Imunofluorescência , RimRESUMO
It was evaluated the different methodologies for glomerular enumeration described in the literature in a quantitative, double-blind study on the number of glomeruli present in kidney biopsy specimens obtained using a Tru-cut-type biopsy needle. Eighteen samples were taken (n=18) from various regions of canine kidneys harvested immediately after euthanasia. Sample collection was carried out using Tru-cut-type, semi-automated, 16 gauge needles. Reading and evaluation of the specimens were performed independently by four researchers by means of eye loupe inspection, light microscopy, light microscopy with a reduced condenser aperture, and dissection microscopy. Samples were also subjected to histopathological evaluation for comparison purposes. There was no inter-researcher variation for any of the tested methods. The glomerular counts obtained using light microscopy with reduced condenser aperture were similar to those reported in the histopathological evaluation (P=0.44);whereas, the other glomerular enumeration methods yielded significantly lower counts when compared to the histopathological analysis (eye loupe inspection: P<0.01; conventional light microscopy: P=0.02; dissection microscopy: P<0.01).Light microscope with lowering of the condenser lens delivers better results than conventional light microscopy and eye loupe inspection. Results obtained using dissection microscopy and eye loupe inspection did not correlate well with those provided by histopathological evaluation; consequently, these two methods should be avoided.(AU)
Avaliou-se as diferentes metodologias de quantificação glomerular descritas na literatura em um estudo quantitativo, duplo-cego, sobre o número de glomérulos presentes em amostras de biópsias renais obtidas com agulha de biópsia tipo Tru-cut. Dezoito amostras foram coletadas (n=18) de várias regiões de rins caninos colhidos imediatamente após a eutanásia. A coleta das amostras foi realizada com agulhas semi-automáticas de calibre 16, tipo Tru-cut. A leitura e avaliação das amostras foram realizadas de forma independente por quatro pesquisadores por meio de inspeção visual, microscopia de luz, microscopia de luz com redução da lente condensadora e microscopia de dissecção. As amostras também foram submetidas à avaliação histopatológica para fins de comparação e variação do pesquisador para qualquer um dos métodos testados. As contagens glomerulares obtidas por microscopia de luz com redução da lente condensadora foram semelhantes àquelas encontradas na avaliação histopatológica (P=0.44), enquanto que os outros métodos de quantificação glomerular produziram contagens significativamente mais baixas a análise histopatológica (inspeção da lupa dos olhos: P<0.01; microscopia de luz convencional: P=0.02; microscopia dissecação: P<0.01). Microscópio de luz com abaixamento da lente condensadora fornece melhores resultados do que microscopia de luz convencional e inspeção da lupa. As contagens obtidas usando microscopia de dissecção e inspeção de lupa de olho não se correlacionaram bem com aqueles fornecidos pela avaliação histopatológica; consequentemente, estes dois métodos devem ser evitados.(AU)
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Animais , Cães , Glomerulonefrite/diagnóstico , Glomerulonefrite/veterinária , Glomérulos Renais , Microscopia/veterináriaRESUMO
ABSTRACT: It was evaluated the different methodologies for glomerular enumeration described in the literature in a quantitative, double-blind study on the number of glomeruli present in kidney biopsy specimens obtained using a Tru-cut-type biopsy needle. Eighteen samples were taken (n=18) from various regions of canine kidneys harvested immediately after euthanasia. Sample collection was carried out using Tru-cut-type, semi-automated, 16 gauge needles. Reading and evaluation of the specimens were performed independently by four researchers by means of eye loupe inspection, light microscopy, light microscopy with a reduced condenser aperture, and dissection microscopy. Samples were also subjected to histopathological evaluation for comparison purposes. There was no inter-researcher variation for any of the tested methods. The glomerular counts obtained using light microscopy with reduced condenser aperture were similar to those reported in the histopathological evaluation (P=0.44);whereas, the other glomerular enumeration methods yielded significantly lower counts when compared to the histopathological analysis (eye loupe inspection: P<0.01; conventional light microscopy: P=0.02; dissection microscopy: P<0.01).Light microscope with lowering of the condenser lens delivers better results than conventional light microscopy and eye loupe inspection. Results obtained using dissection microscopy and eye loupe inspection did not correlate well with those provided by histopathological evaluation; consequently, these two methods should be avoided.
RESUMO: Avaliou-se as diferentes metodologias de quantificação glomerular descritas na literatura em um estudo quantitativo, duplo-cego, sobre o número de glomérulos presentes em amostras de biópsias renais obtidas com agulha de biópsia tipo Tru-cut. Dezoito amostras foram coletadas (n=18) de várias regiões de rins caninos colhidos imediatamente após a eutanásia. A coleta das amostras foi realizada com agulhas semi-automáticas de calibre 16, tipo Tru-cut. A leitura e avaliação das amostras foram realizadas de forma independente por quatro pesquisadores por meio de inspeção visual, microscopia de luz, microscopia de luz com redução da lente condensadora e microscopia de dissecção. As amostras também foram submetidas à avaliação histopatológica para fins de comparação e variação do pesquisador para qualquer um dos métodos testados. As contagens glomerulares obtidas por microscopia de luz com redução da lente condensadora foram semelhantes àquelas encontradas na avaliação histopatológica (P=0.44), enquanto que os outros métodos de quantificação glomerular produziram contagens significativamente mais baixas a análise histopatológica (inspeção da lupa dos olhos: P<0.01; microscopia de luz convencional: P=0.02; microscopia dissecação: P<0.01). Microscópio de luz com abaixamento da lente condensadora fornece melhores resultados do que microscopia de luz convencional e inspeção da lupa. As contagens obtidas usando microscopia de dissecção e inspeção de lupa de olho não se correlacionaram bem com aqueles fornecidos pela avaliação histopatológica; consequentemente, estes dois métodos devem ser evitados.
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Abstract Objective: To investigate the reproducibility and interobserver agreement for R.E.N.A.L. nephrometry scoring system. Materials and Methods: Two independent radiologists retrospectively analyzed 46 consecutive patients with renal masses, between 2008 and 2012, using the R.E.N.A.L. nephrometry score (RENAL-NS), which is based on the evaluation of five anatomical features of the tumor, as evaluated with computed tomography or magnetic resonance imaging: Radius, Exophytic/endophytic properties, Nearness to the collecting system, Anterior or posterior descriptor, and Location relative to the polar line. Tumor complexity was graded as low, intermediate, or high. The interobserver agreement was calculated for the total score and for the score for each parameter. Surgical excision of the tumors was used as the standard of reference. Results: The interobserver agreement for each of the RENAL-NS parameters, respectively, a hilar location, and the total score was 98%, 80%, 100%, 89%, 85%, 89%, and 93% of patients, corresponding to kappa values of 0.96, 0.65, 1.00, 0.75, 0.72, 0.78, and 0.88, respectively. The Nearness, Radius, and total score showed the best agreement. For the cases that were discordant in terms of the final score, no major implications in surgical planning were observed. Conclusion: The RENAL-NS is a structured, useful system to assess the anatomical features of renal tumors. It is easily applicable and reproducible, even for less experienced radiologists.
Resumo Objetivo: Investigar a concordância interobservador e a reprodutibilidade do sistema de pontuação nefrométrico R.E.N.A.L. nephrometry score (RENAL-NS) usando imagens de tomografia computadorizada e ressonância magnética. Materiais e Métodos: Dois observadores independentes analisaram, retrospectivamente, 46 pacientes com massas renais, consecutivos, de 2008 a 2012. Cinco características anatômicas foram avaliadas: raio (R); localização exofítico/endofítico (E); proximidade do tumor ao sistema coletor (N, nearness); posição anterior (A) ou posterior e de localização em relação à linha polar (L). Os tumores foram classificados em baixo, intermediário ou alto grau de complexidade. A concordância foi calculada para cada parâmetro do escore e para o valor global. A excisão cirúrgica das lesões foi utilizada como padrão de referência. Resultados: A concordância para cada um dos parâmetros renais, para a característica de "h", e para a pontuação final foi 98%, 80%, 100%, 89%, 85%, 89% e 93% dos pacientes, o que corresponde a valores de kappa de 0,96, 0,65, 1,00, 0,75, 0,72, 0,78 e 0,88, respectivamente. Os parâmetros "N", "R" e o escore global mostraram as melhores concordâncias. Entre os casos discordantes na pontuação final, não foram observadas grandes mudanças no planejamento cirúrgico. Conclusão: O RENAL-NS é um sistema estruturado, útil para avaliar características anatômicas do tumor renal. É de fácil aplicação, reprodutível, mesmo entre os radiologistas menos experientes.
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PURPOSE:To evaluate macro and microscopically, changes following the use of the aqueous extract of babassu (Orbignya phalerata) in the lung parenchyma and pleura of rats.METHODS:Sixty adult male rats with average weight of 350 g, were randomized into two groups of 30 animals (experimental and control) further divided into sub-groups of 10 to be sacrificed at 48 h, 72 h and 21 days. The substance was injected into the right pleura of the animals.RESULTS:There was intense pleuropulmonary macroscopic reaction with statistically significant differences between groups respectively (p<0.05, p<0.02, p<0.03). Microscopically, no statistically significant difference was evident (p>0.05).CONCLUSION:The aqueous extract of babassu (Orbignya phalerata) was found to be highly irritating to the pleura and lung of rats, evidenced macroscopically by numerous adhesions and inflammation while no major changes were evident microscopically.(AU)
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Animais , Ratos , Arecaceae/química , Extratos Vegetais/uso terapêutico , Pleura , Tecido Parenquimatoso , Pulmão/citologia , Fitoterapia/veterináriaRESUMO
PURPOSE: To evaluate macro and microscopically, changes following the use of the aqueous extract of babassu (Orbignya phalerata) in the lung parenchyma and pleura of rats. METHODS: Sixty adult male rats with average weight of 350 g, were randomized into two groups of 30 animals (experimental and control) further divided into sub-groups of 10 to be sacrificed at 48 h, 72 h and 21 days. The substance was injected into the right pleura of the animals. RESULTS: There was intense pleuropulmonary macroscopic reaction with statistically significant differences between groups respectively (p<0.05, p<0.02, p<0.03). Microscopically, no statistically significant difference was evident (p>0.05). CONCLUSION: The aqueous extract of babassu (Orbignya phalerata) was found to be highly irritating to the pleura and lung of rats, evidenced macroscopically by numerous adhesions and inflammation while no major changes were evident microscopically.