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1.
Support Care Cancer ; 32(5): 327, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38702458

RESUMO

PURPOSE: This study is to conduct a comprehensive scoping review to map scientific evidence and clarify concepts regarding the commonly recommended preventive and restorative dental treatments for patients diagnosed with head and neck cancer (HNC) and subjected to radiotherapy. MATERIAL AND METHODS: This systematic scoping review was performed under the PRISMA-ScR guidelines. The study's experimental design was registered in the Open Science Framework. In vitro studies that evaluated preventive and restorative dental treatment over 50 Gy radiation doses were included. The search was conducted in November 2023 in five electronic databases (PubMed, Scopus, Web of Science, Cochrane Library, and Embase) without language or date restriction. A search strategy was applied based on keywords, MeSh terms, or synonyms. A descriptive analysis was conducted. RESULTS: A total of 49 studies, out of 3679 original articles identified, were included and reviewed. Of the included studies, three evaluated saliva stimulants and 35 evaluated fluoride-based preventive materials: gel (n = 18) toothpaste (n = 11) mouth rinse (n = 8) and varnish (n = 5) while 14 evaluated restorative materials: resin composite (n = 12) glass ionomer cement (n = 6) and amalgam (n = 1) Of those studies, 36 were clinical trials and 13 were in vitro studies. CONCLUSION: Fluoride gel was the most frequently recommended preventive material for preventing radiation caries with supportive clinical evidence. Resin composite and glass ionomer were the most frequently used restorative materials, respectively. However, there is not yet clinical evidence to support the use of resin composite in irradiated teeth.


Assuntos
Cárie Dentária , Neoplasias de Cabeça e Pescoço , Humanos , Cárie Dentária/prevenção & controle , Neoplasias de Cabeça e Pescoço/radioterapia , Restauração Dentária Permanente/métodos
2.
Respir Res ; 24(1): 281, 2023 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-37964271

RESUMO

BACKGROUND: Lung fibrosis is a major concern in severe COVID-19 patients undergoing mechanical ventilation (MV). Lung fibrosis frequency in post-COVID syndrome is highly variable and even if the risk is proportionally small, many patients could be affected. However, there is still no data on lung extracellular matrix (ECM) composition in severe COVID-19 and whether it is different from other aetiologies of ARDS. METHODS: We have quantified different ECM elements and TGF-ß expression in lung tissue of 28 fatal COVID-19 cases and compared to 27 patients that died of other causes of ARDS, divided according to MV duration (up to six days or seven days or more). In COVID-19 cases, ECM elements were correlated with lung transcriptomics and cytokines profile. RESULTS: We observed that COVID-19 cases presented significant increased deposition of collagen, fibronectin, versican, and TGF-ß, and decreased decorin density when compared to non-COVID-19 cases of similar MV duration. TGF-ß was precociously increased in COVID-19 patients with MV duration up to six days. Lung collagen was higher in women with COVID-19, with a transition of upregulated genes related to fibrillogenesis to collagen production and ECM disassembly along the MV course. CONCLUSIONS: Fatal COVID-19 is associated with an early TGF-ß expression lung environment after the MV onset, followed by a disordered ECM assembly. This uncontrolled process resulted in a prominent collagen deposition when compared to other causes of ARDS. Our data provides pathological substrates to better understand the high prevalence of pulmonary abnormalities in patients surviving COVID-19.


Assuntos
COVID-19 , Fibrose Pulmonar , Síndrome do Desconforto Respiratório , Humanos , Feminino , Fibrose Pulmonar/metabolismo , COVID-19/metabolismo , Matriz Extracelular/metabolismo , Colágeno/metabolismo , Pulmão/metabolismo , Fator de Crescimento Transformador beta/farmacologia , Síndrome do Desconforto Respiratório/metabolismo
3.
J Pathol ; 254(3): 239-243, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33834497

RESUMO

The ability of the new coronavirus SARS-CoV-2 to spread and contaminate is one of the determinants of the COVID-19 pandemic status. SARS-CoV-2 has been detected in saliva consistently, with similar sensitivity to that observed in nasopharyngeal swabs. We conducted ultrasound-guided postmortem biopsies in COVID-19 fatal cases. Samples of salivary glands (SGs; parotid, submandibular, and minor) were obtained. We analyzed samples using RT-qPCR, immunohistochemistry, electron microscopy, and histopathological analysis to identify SARS-CoV-2 and elucidate qualitative and quantitative viral profiles in salivary glands. The study included 13 female and 11 male patients, with a mean age of 53.12 years (range 8-83 years). RT-qPCR for SARS-CoV-2 was positive in 30 SG samples from 18 patients (60% of total SG samples and 75% of all cases). Ultrastructural analyses showed spherical 70-100 nm viral particles, consistent in size and shape with the Coronaviridae family, in the ductal lining cell cytoplasm, acinar cells, and ductal lumen of SGs. There was also degeneration of organelles in infected cells and the presence of a cluster of nucleocapsids, which suggests viral replication in SG cells. Qualitative histopathological analysis showed morphologic alterations in the duct lining epithelium characterized by cytoplasmic and nuclear vacuolization, as well as nuclear pleomorphism. Acinar cells showed degenerative changes of the zymogen granules and enlarged nuclei. Ductal epithelium and serous acinar cells showed intense expression of ACE2 and TMPRSS receptors. An anti-SARS-CoV-2 antibody was positive in 8 (53%) of the 15 tested cases in duct lining epithelial cells and acinar cells of major SGs. Only two minor salivary glands were positive for SARS-CoV-2 by immunohistochemistry. Salivary glands are a reservoir for SARS-CoV-2 and provide a pathophysiological background for studies that indicate the use of saliva as a diagnostic method for COVID-19 and highlight this biological fluid's role in spreading the disease. © 2021 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.


Assuntos
COVID-19/virologia , SARS-CoV-2/patogenicidade , Saliva/virologia , Glândulas Salivares/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reino Unido , Adulto Jovem
4.
Clin Infect Dis ; 73(Suppl_5): S442-S453, 2021 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-34910174

RESUMO

BACKGROUND: Minimally invasive autopsies, also known as minimally invasive tissue sampling (MITS), have proven to be an alternative to complete diagnostic autopsies (CDAs) in places or situations where this procedure cannot be performed. During the coronavirus disease 2019 (COVID-19) pandemic, CDAs were suspended by March 2020 in Brazil to reduce biohazard. To contribute to the understanding of COVID-19 pathology, we have conducted ultrasound (US)-guided MITS as a strategy. METHODS: This case series study includes 80 autopsies performed in patients with COVID-19 confirmed by laboratorial tests. Different organs were sampled using a standardized MITS protocol. Tissues were submitted to histopathological analysis as well as immunohistochemical and molecular analysis and electron microscopy in selected cases. RESULTS: US-guided MITS proved to be a safe and highly accurate procedure; none of the personnel were infected, and accuracy ranged from 69.1% for kidney, up to 90.1% for lungs, and reaching 98.7% and 97.5% for liver and heart, respectively. US-guided MITS provided a systemic view of the disease, describing the most common pathological findings and identifying viral and other infectious agents using ancillary techniques, and also allowed COVID-19 diagnosis confirmation in 5% of the cases that were negative in premortem and postmortem nasopharyngeal/oropharyngeal swab real-time reverse-transcription polymerase chain reaction. CONCLUSIONS: Our data showed that US-guided MITS has the capacity similar to CDA not only to identify but also to characterize emergent diseases.


Assuntos
COVID-19 , Autopsia , Brasil/epidemiologia , Teste para COVID-19 , Humanos , Pandemias , SARS-CoV-2 , Ultrassonografia de Intervenção
5.
Respir Res ; 22(1): 32, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33514373

RESUMO

BACKGROUND: Pulmonary involvement in COVID-19 is characterized pathologically by diffuse alveolar damage (DAD) and thrombosis, leading to the clinical picture of Acute Respiratory Distress Syndrome. The direct action of SARS-CoV-2 in lung cells and the dysregulated immuno-coagulative pathways activated in ARDS influence pulmonary involvement in severe COVID, that might be modulated by disease duration and individual factors. In this study we assessed the proportions of different lung pathology patterns in severe COVID-19 patients along the disease evolution and individual characteristics. METHODS: We analysed lung tissue from 41 COVID-19 patients that died in the period March-June 2020 and were submitted to a minimally invasive autopsy. Eight pulmonary regions were sampled. Pulmonary pathologists analysed the H&E stained slides, performing semiquantitative scores on the following parameters: exudative, intermediate or advanced DAD, bronchopneumonia, alveolar haemorrhage, infarct (%), arteriolar (number) or capillary thrombosis (yes/no). Histopathological data were correlated with demographic-clinical variables and periods of symptoms-hospital stay. RESULTS: Patient´s age varied from 22 to 88 years (18f/23 m), with hospital admission varying from 0 to 40 days. All patients had different proportions of DAD in their biopsies. Ninety percent of the patients presented pulmonary microthrombosis. The proportion of exudative DAD was higher in the period 0-8 days of hospital admission till death, whereas advanced DAD was higher after 17 days of hospital admission. In the group of patients that died within eight days of hospital admission, elderly patients had less proportion of the exudative pattern and increased proportions of the intermediate patterns. Obese patients had lower proportion of advanced DAD pattern in their biopsies, and lower than patients with overweight. Clustering analysis showed that patterns of vascular lesions (microthrombosis, infarction) clustered together, but not the other patterns. The vascular pattern was not influenced by demographic or clinical parameters, including time of disease progression. CONCLUSION: Patients with severe COVID-19 present different proportions of DAD patterns over time, with advanced DAD being more prevalent after 17 days, which seems to be influenced by age and weight. Vascular involvement is present in a large proportion of patients, occurs early in disease progression, and does not change over time.


Assuntos
COVID-19/patologia , Lesão Pulmonar/patologia , Pulmão/patologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Autopsia , COVID-19/complicações , Demografia , Progressão da Doença , Feminino , Humanos , Infarto/epidemiologia , Infarto/patologia , Lesão Pulmonar/etiologia , Masculino , Pessoa de Meia-Idade , Alvéolos Pulmonares/patologia , Trombose/etiologia , Trombose/patologia , Adulto Jovem
6.
Histopathology ; 77(2): 186-197, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32443177

RESUMO

AIMS: Brazil ranks high in the number of coronavirus disease 19 (COVID-19) cases and the COVID-19 mortality rate. In this context, autopsies are important to confirm the disease, determine associated conditions, and study the pathophysiology of this novel disease. The aim of this study was to assess the systemic involvement of COVID-19. In order to follow biosafety recommendations, we used ultrasound-guided minimally invasive autopsy (MIA-US), and we present the results of 10 initial autopsies. METHODS AND RESULTS: We used MIA-US for tissue sampling of the lungs, liver, heart, kidneys, spleen, brain, skin, skeletal muscle and testis for histology, and reverse transcription polymerase chain reaction to detect severe acute respiratory syndrome coronavirus 2 RNA. All patients showed exudative/proliferative diffuse alveolar damage. There were intense pleomorphic cytopathic effects on the respiratory epithelium, including airway and alveolar cells. Fibrinous thrombi in alveolar arterioles were present in eight patients, and all patients showed a high density of alveolar megakaryocytes. Small thrombi were less frequently observed in the glomeruli, spleen, heart, dermis, testis, and liver sinusoids. The main systemic findings were associated with comorbidities, age, and sepsis, in addition to possible tissue damage due to the viral infection, such as myositis, dermatitis, myocarditis, and orchitis. CONCLUSIONS: MIA-US is safe and effective for the study of severe COVID-19. Our findings show that COVID-19 is a systemic disease causing major events in the lungs and with involvement of various organs and tissues. Pulmonary changes result from severe epithelial injury and microthrombotic vascular phenomena. These findings indicate that both epithelial and vascular injury should be addressed in therapeutic approaches.


Assuntos
Autopsia/métodos , COVID-19/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Ultrassonografia
7.
J Esthet Restor Dent ; 32(7): 699-706, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32627364

RESUMO

OBJECTIVE: To evaluate the effect of different surface treatments on the retention between zirconia crowns and tooth structure after in vitro aging. MATERIALS AND METHODS: Human third molars (n = 44) received crown preparations and CAD/CAM zirconia crowns were manufactured. Specimens were divided into two groups: no aging, control (NAC, n = 11) or aging (A, n = 33). NAC were bonded with universal adhesive (UA). Aged specimens were divided into three subgroups (n = 11) according to surface treatment: Control: no abrasion + UA; Alumina: alumina abrasion + UA; Silica: tribochemical silica coating + UA. The crowns were cemented with dual-cure resin cement. Specimens in group A were aged by a combination of mechanical, thermal, and pH cycling. Retention strength values were obtained by tensile tests and results were analyzed by one-way analysis of variance (ANOVA) and Tukey test (P < .05). RESULTS: Aging decreased the retention strength in control specimens (P < .001). Surface treatment improved the retention strength of aged specimens (P < .001), with similar results between alumina and tribochemical silica coating. CONCLUSION: The chemical interaction between the universal bonding system and zirconia's surface was not sufficient to withstand artificial aging. Tribochemical silica coating did not promote additional retention in comparison to alumina blasting. CLINICAL SIGNIFICANCE: The long-term retention of translucent zirconia crowns to tooth structure using phosphate-based materials is improved by means of mechanical surface treatments such as alumina blasting and tribochemical silica coating.


Assuntos
Colagem Dentária , Coroas , Análise do Estresse Dentário , Humanos , Teste de Materiais , Cimentos de Resina , Dióxido de Silício , Propriedades de Superfície , Zircônio
8.
J Nanobiotechnology ; 17(1): 100, 2019 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-31542052

RESUMO

Pesticides and fertilizers are widely used to enhance agriculture yields, although the fraction of the pesticides applied in the field that reaches the targets is less than 0.1%. Such indiscriminate use of chemical pesticides is disadvantageous due to the cost implications and increasing human health and environmental concerns. In recent years, the utilization of nanotechnology to create novel formulations has shown great potential for diminishing the indiscriminate use of pesticides and providing environmentally safer alternatives. Smart nano-based pesticides are designed to efficiently delivery sufficient amounts of active ingredients in response to biotic and/or abiotic stressors that act as triggers, employing targeted and controlled release mechanisms. This review discusses the current status of stimuli-responsive release systems with potential to be used in agriculture, highlighting the challenges and drawbacks that need to be overcome in order to accelerate the global commercialization of smart nanopesticides.


Assuntos
Preparações de Ação Retardada/química , Nanoestruturas/química , Praguicidas/química , Agricultura/métodos , Animais , Sistemas de Liberação de Medicamentos/métodos , Humanos , Nanotecnologia/métodos , Praguicidas/efeitos adversos , Estresse Fisiológico
9.
Gen Dent ; 67(5): 40-44, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31454321

RESUMO

In general, patients' dissatisfaction with the appearance of their smile is mainly influenced by the color of their teeth. Darkening of a single anterior tooth negatively impacts the appearance of the smile. Tooth bleaching is considered a conservative treatment option for darkened nonvital teeth, and, whenever possible, must be considered the first choice of treatment. This article describes the successful use of the internal-external home bleaching technique in 2 patients, each of whom had a single darkened nonvital tooth. In this technique, the bleaching agent is applied simultaneously to both the internal and external surfaces of the tooth. The bleaching agent of choice is 10% carbamide peroxide. This technique is simple, low cost, and conservative and provides excellent esthetic results.


Assuntos
Clareamento Dental , Descoloração de Dente , Dente não Vital , Estética Dentária , Humanos , Peróxido de Hidrogênio , Peróxidos , Ureia
10.
Am J Dent ; 31(5): 239-242, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30346669

RESUMO

PURPOSE: To evaluate the bleaching efficacy and time required for color stability immediately after dental office bleaching. METHODS: 40 subjects were randomly divided into two groups, according to the bleaching agent used:GHP - 35% hydrogen peroxide gel and GCP - 37% carbamide peroxide gel. The color was measured with a spectrophotometer before and immediately, 24 hours, 72 hours, 7 days and 15 days after the bleaching procedure. The color parameters were evaluated and the ΔE*, ΔL*, Δa* and Δb* values were calculated for each evaluation period. The data was statistically analyzed with Student's T-test, one-way ANOVA and Tukey's post hoc test (P ≤ 0.05). RESULTS: Regarding the ΔE* values, in the assessed periods there were no significant differences between groups (P≥ 0.05). However, the luminosity (ΔL*) decreased considerably in both groups in the first 72 hours (P≤ 0.05), followed by an increase at 15 days (P≤ 0.05) in the hydrogen peroxide group. Regarding the Δb* values, the GHP showed higher negative alterations in the b* axis in the first 24 hours. The 37% carbamide peroxide gel and the 35% hydrogen peroxide gel were effective and there was no reversal of tooth color within 15 days; however a more accentuated bleaching effect was observed immediately after bleaching. CLINICAL SIGNIFICANCE: Rapid bleaching was observed immediately after the in-office bleaching treatment.


Assuntos
Clareadores , Clareadores Dentários , Clareamento Dental , Cor , Humanos , Peróxido de Hidrogênio , Teste de Materiais , Peróxidos , Clareadores Dentários/uso terapêutico , Ureia
12.
Arch Latinoam Nutr ; 66(2): 129-134, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29737669

RESUMO

The objective of this study was to evaluate the prevalence of risk behaviors related to eating disorders and body image satisfaction among Brazilian dietitians and undergraduate Nutrition students. The national representative sample was composed of 427 undergraduate students of Nutrition and 318 dietitians. Data were collected via an online questionnaire. Body image satisfaction was assessed by the Body Shape Questionnaire, and attitudes suggestive of an eating disorder (called positive EAT) were assessed by the Eating Attitudes Test. Adjusted Prevalence Ratios were performed by Poisson's regression. More than 50.0% of women were dissatisfied with their body image, but severe dissatisfaction was more prevalent among students (26.7% versus 16.0%). There was no difference in the prevalence of positive EAT test between both groups. Students with positive EAT had more chance of body dissatisfaction (PRadj 1.31; 95%CI 1.03-1.66). Dietitians with positive EAT had 35% more chance of being dissatisfied with their body image (PRadj 1.35; 95%IC 1.01-1.80). Undergraduate Nutrition students and dietitians are likely to develop attitudes suggestive of an eating disorder and being dissatisfied with'their body image. The susceptibility of developing an eating disorder might have a relation with their professional field.


Assuntos
Imagem Corporal/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Nutricionistas/psicologia , Satisfação Pessoal , Estudantes de Ciências da Saúde/psicologia , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Estado Nutricional , Nutricionistas/estatística & dados numéricos , Prevalência , Fatores de Risco , Estudantes de Ciências da Saúde/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
13.
Cureus ; 16(2): e54621, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38524026

RESUMO

Infectious sacroiliitis is a rare and challenging diagnosis. Sacroiliac joint changes related to pregnancy and puerperium can predispose to this condition. However, its clinical presentation can often mimic common causes of lower back pain and delay the diagnosis. We report the case of a 31-year-old pregnant woman with twins who presented at 29 weeks of gestation with lower back and right buttock pain that radiated down to the thigh. Although initially interpreted as sciatica pain, the diagnosis of psoas hematoma complicated with infectious sacroiliitis was made. With this case, we aim to bring awareness to this condition in order to raise suspicion among clinicians for an earlier diagnosis.

14.
Eur J Radiol Open ; 12: 100546, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38293283

RESUMO

Objectives: Performing autopsies in a pandemic scenario is challenging, as the need to understand pathophysiology must be balanced with the contamination risk. A minimally invasive autopsy might be a solution. We present a model that combines radiology and pathology to evaluate postmortem CT lung findings and their correlation with histopathology. Methods: Twenty-nine patients with fatal COVID-19 underwent postmortem chest CT, and multiple lung tissue samples were collected. The chest CT scans were analyzed and quantified according to lung involvement in five categories: normal, ground-glass opacities, crazy-paving, small consolidations, and large or lobar consolidations. The lung tissue samples were examined and quantified in three categories: normal lung, exudative diffuse alveolar damage (DAD), and fibroproliferative DAD. A linear index was used to estimate the global severity of involvement by CT and histopathological analysis. Results: There was a positive correlation between patient mean CT and histopathological severity score indexes - Pearson correlation coefficient (R) = 0.66 (p = 0.0078). When analyzing the mean lung involvement percentage of each finding, positive correlations were found between the normal lung percentage between postmortem CT and histopathology (R=0.65, p = 0.0082), as well as between ground-glass opacities in postmortem CT and normal lungs in histopathology (R=0.65, p = 0.0086), but negative correlations were observed between ground-glass opacities extension and exudative diffuse alveolar damage in histological slides (R=-0.68, p = 0.005). Additionally, it was found is a trend toward a decrease in the percentage of normal lung tissue on the histological slides as the percentage of consolidations in postmortem CT scans increased (R =-0.51, p = 0.055). The analysis of the other correlations between the percentage of each finding did not show any significant correlation or correlation trends (p ≥ 0.10). Conclusions: A minimally invasive autopsy is valid. As the severity of involvement is increased in CT, more advanced disease is seen on histopathology. However, we cannot state that one specific radiological category represents a specific pathological correspondent. Ground-glass opacities, in the postmortem stage, must be interpreted with caution, as expiratory lungs may overestimate disease.

15.
Epidemiol Serv Saude ; 33: e2024008, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-38808901

RESUMO

OBJECTIVE: To create a protocol for performing minimally invasive autopsies (MIA) in detecting deaths from arboviruses and report preliminary data from its application in Ceará state, Brazil. METHODS: Training was provided to medical pathologists on MIA. RESULTS: A protocol was established for performing MIA, defining criteria for sample collection, storage methods, and diagnoses to be carried out according to the type of biological sample; 43 MIAs were performed in three months. Of these, 21 (48.8%) arrived at the Death Verification Service (SVO) with arboviruses as a diagnostic hypothesis, and seven (16.3%) were confirmed (six chikungunya cases and one dengue case); cases of COVID-19 (n = 9), tuberculosis (n = 5), meningitis (n = 4), cryptococcosis (n = 1), Creutzfeldt-Jakob disease (n = 1), breast cancer (n = 1), and human rabies (n = 1) were also confirmed. CONCLUSION: The protocol implemented enabled identification of a larger number of suspected arbovirus-related deaths, as well as confirmation of other diseases of interest for surveillance. MAIN RESULTS: A protocol was developed to perform minimally invasive autopsies (MIAs) in Death Verification Services (SVO), capable of expanding the system's capacity to identify a greater number of deaths suspected to be due to arboviruses. IMPLICATIONS FOR SERVICES: The experience suggests that in-service trained health professionals are able to perform MIA, and that use of this technique in SVOs has been shown to be capable of increasing the system's sensitivity in detecting deaths of interest to public health. PERSPECTIVES: Trained professionals will be able to collect biological material in hospitals, through MIA, in cases of interest for health surveillance and when family members do not allow a complete conventional autopsy to be performed.


Assuntos
Infecções por Arbovirus , Autopsia , Humanos , Brasil/epidemiologia , Autopsia/métodos , Infecções por Arbovirus/epidemiologia , Infecções por Arbovirus/diagnóstico , Infecções por Arbovirus/patologia , Feminino , Sensibilidade e Especificidade , Masculino , Pessoa de Meia-Idade , Adulto , Adolescente , Adulto Jovem , Arbovírus/isolamento & purificação , Idoso , Vigilância da População/métodos , Monitoramento Epidemiológico , Causas de Morte , Criança , Pré-Escolar
16.
Cureus ; 15(8): e43901, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37746379

RESUMO

Extrahepatic metastasis of hepatocellular carcinoma is usually associated with extensive intrahepatic lesions. Hepatoid adenocarcinoma is a rare variant of extrahepatic malignant adenocarcinoma that exhibits remarkable histological and immunohistochemical similarity to hepatocellular carcinoma, which can result in an underestimated diagnosis. This case report describes a patient with a newly found gallbladder polyp. Following cholecystectomy, the initial histological and immunohistochemical evaluation suggested a metastasis of hepatocellular carcinoma. However, after multiple scans, no primary intrahepatic lesion was found. A subsequent review of the gallbladder specimens showed negative staining for CK7 and CK19, leading to a diagnosis of hepatoid carcinoma of the gallbladder.

17.
Front Med (Lausanne) ; 10: 1327415, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38259848

RESUMO

Introduction: COVID-19 affects patients of all ages. There are few autopsy studies focusing on the younger population. We assessed an autopsy cohort aiming to understand how age influences pathological outcomes in fatal COVID-19. Methods: This study included autopsied patients, aged 6 months to 83 years, with confirmed COVID-19 in 2020-2021. We collected tissue samples from deceased patients using a minimally invasive autopsy protocol and assessed pathological data following a systematic approach. Results: Eighty-six patients were included, with a median age of 55 years (IQR 32.3-66.0). We showed that age was significantly lower in patients with acute heart ischemia (p = 0.004), myocarditis (p = 0.03) and lung angiomatosis (p < 0.001), and significantly higher in patients with exudative diffuse alveolar damage (p = 0.02), proliferative diffuse alveolar damage (p < 0.001), lung squamous metaplasia (p = 0.003) and lung viral atypia (p = 0.03), compared to patients without those findings. We stratified patients by their age and showed that cardiovascular findings were more prevalent in children and young adults. We performed principal component analysis and cluster of pathological variables, and showed that cardiovascular variables clustered and covariated together, and separated from pulmonary variables. Conclusion: We showed that age modulates pathological outcomes in fatal COVID-19. Younger age is associated with cardiovascular abnormalities and older age with pulmonary findings.

18.
Braz Dent J ; 34(6): 1-9, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38133082

RESUMO

In this study, we aimed to evaluate the halitosis and pain threshold of the peri-implant soft tissues in individuals rehabilitated with implant-supported prostheses. Forty-eight subjects were divided into four groups (n = 12) according to their prosthetic rehabilitation: single-tooth fixed prosthesis, multi-tooth fixed prosthesis, overdentures, and the Brånemark protocol. Halitosis was measured using a halimeter, whereas the pain threshold was measured using Von Frey monofilaments. Measurements were taken before (t0) and 30 days after (t1) placement of healing caps, and at the time of (t2) and 30 days after (t3) prosthetic placement. Halitosis data were analyzed using the chi-square test and Bonferroni correction (p < 0.05). Two-way ANOVA and Tukey's test (p < 0.05) were used to analyze pain threshold data. We noted an association between halitosis and time for the Brånemark protocol [X2(6) = 18.471; p = 0.005] and overdenture groups [X2(6) = 17.732; p = 0.007], and between halitosis and type of prosthesis only at t0 [X2(6) = 12.894; p = 0.045]. The interaction between time and the type of prosthesis significantly interfered with the mean pain threshold values (p = 0.001). At most time points, the majority of participants in each group had clinically unacceptable halitosis. After 30 days of using the prostheses, the overdenture group had a lower pain threshold compared to the Brånemark protocol group.


Assuntos
Implantes Dentários , Halitose , Dente , Humanos , Limiar da Dor , Estudos de Coortes , Prótese Dentária Fixada por Implante
19.
Artigo em Inglês | MEDLINE | ID: mdl-37283411

RESUMO

Visceral leishmaniasis (VL) is a chronic vector-borne zoonotic disease caused by trypanosomatids, considered endemic in 98 countries, mainly associated with poverty. About 50,000-90,000 cases of VL occur annually worldwide, and Brazil has the second largest number of cases in the world. The clinical picture of VL is fever, hepatosplenomegaly, and pancytopenia, progressing to death in 90% of cases due to secondary infections and multi-organ failure, if left untreated. We describe the case of a 25-year-old female who lived in the metropolitan area of Sao Paulo, who had recently taken touristic trips to several rural areas in Southeastern Brazil and was diagnosed post-mortem. During the hospitalization in a hospital reference for the treatment of COVID-19, the patient developed acute respiratory failure, with chest radiographic changes, and died due to refractory shock. The ultrasound-guided minimally invasive autopsy diagnosed VL (macrophages containing amastigote forms of Leishmania in the spleen, liver and bone marrow), as well as pneumonia and bloodstream infection by gram-negative bacilli.


Assuntos
COVID-19 , Leishmaniose Visceral , Insuficiência Respiratória , Feminino , Humanos , Adulto , Leishmaniose Visceral/complicações , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/tratamento farmacológico , Diagnóstico Diferencial , Autopsia , COVID-19/diagnóstico , Brasil , Insuficiência Respiratória/diagnóstico , Teste para COVID-19
20.
Artigo em Inglês | MEDLINE | ID: mdl-36554616

RESUMO

The social act of eating together has been influenced and mediated by technologies in recent decades. This phenomenon has been investigated in different academic fields, but the topic is still in an incipient dimension, and there is a lack of consensus regarding terminology and definitions. The study aimed to characterize the main scientific findings regarding digital forms of commensality in the 21st century and to identify possible relationships between these practices and public health. A scoping review was conducted to identify papers published in different languages between 2001 and 2021. A total of 104 publications that combined commensality and technology in all contexts were included. Most studies were qualitative; from the Design and Technology field; used social media and video platforms or prototypes/augmented reality gadgets; and used different terms to refer to digital forms of commensality, allowing the analysis of the construction of field definitions over time. The intersections with health were observed from impacts on family/community engagement, culinary skills development, and mental health and eating habits. These practices also structured specific social interactions, such as virtual food communities and commensality, during the COVID-19 pandemic. This paper indicates the consistent growth of these practices and recommends the development of future research for theoretically and longitudinally deeper evaluations of the impacts of these new ways of eating together, especially regarding their effects on human health.


Assuntos
COVID-19 , Pandemias , Humanos , COVID-19/epidemiologia , Comportamento Alimentar/psicologia , Alimentos , Publicações
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