Analysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidism

Primary hyperparathyroidism is an endocrine disorder with variable clinical expression, frequently presenting as asymptomatic hypercalcemia in Western countries but still predominantly as a symptomatic disease in developing countries. The objective of this retrospective study was to describe the diagnostic presentation profile, parathyroidectomy indication and post-surgical bone mineral density follow-up of patients with primary hyperparathyroidism seen at a university hospital. We found 115 patients (92 women, median age 56 years) with primary hyperparathyroidism diagnosed during the last 20 years. We defined symptomatic patients based on the presence of any classical symptom affecting bone, kidney or the neuromuscular system. Surgical criteria followed the guidelines of the National Institutes of Health regarding asymptomatic primary hyperparathyroidism. Symptomatic patients and patients meeting surgical criteria for parathyroidectomy were 66 and 93 percent of the sample, respectively. Median calcium and parathyroid hormone values were 11.9 mg/dL and 189 pg/mL, respectively. After surgical treatment, 97 percent of patients were cured, with increases in bone mineral density of 19.4 percent in the lumbar spine and 15.7 percent in the femoral neck 3 years after surgery. Greater bone mass increases were detected in pre-menopausal women, men, and in symptomatic and younger patients, both in the lumbar spine and femoral neck. Our results support the previous findings of a predominantly symptomatic disease with a presentation profile that could be mainly related to a delayed diagnosis. Nevertheless, genetic and racial backgrounds, and nutritional factors such as calcium and vitamin D deficiency may play a role in the clinical presentation of primary hyperparathyroidism of Brazilian patients.

Role of Tamm-Horsfall protein in the binding and in vivo phagocytosis of type 1 fimbriated Escherichia coli by mouse peritoneal macrophages

Tamm-Horsfall glycoprotein (THP) contains manno-oligosaccharides that are recognized by type 1 fimbriae (F1) of Escherichia coli. In the present study, we examined the in vivo phagocytic activity of mouse peritoneal macrophages after treatment of bacteria with THP. At low THP concentrations (12.5 æg/ml and 50 æg/ml) no significant difference was observed in the phagocytosis of E. coli F1+. However, at high THP concentrations (500 æg/ml and 1250 æg/ml) we obtained a reduction of bacterial phagocytosis by mouse peritoneal macrophages

Panorama global da bacteriologia das amígdalas palatinas de crianças / Children palatine tonsils bacteriology: a comprehensive view

A microbiologia das amígdalas continua sendo assunto de muita discussäo. Este trabalho investiga a flora amigdaliana abrangendo-a em praticamente todas as situaçöes patogênicas e também normais. Foram colhidos swabs da superfície de amígdalas de 132 crianças normais (sem AR) em meses quentes (Q> (61 crianças) e frios (F) (71 crianças), de 64 crianças na fase aguda de amigdalite (AA) e de 76 com amigdalite recorrente (com AR, fora da fase aguda). Neste último grupo ainda foi realizado o estudo do core (interior) das amígdalas. Imediatamente após a coleta, o material era introduzido em meio específico e a cultura era realizada no máximo em 8 horas, seguindo padröes da microbiologia clínica. Como resultados, obtivemos uma alta prevalência de Streptococcus viridans nos três grupos. Entre o grupo Q e F foi notado que realmente existem diferenças sazonais, sendo Streptococcus viridans, Neisseria sp e enterobactérias mais freqüentes no grupo F. Comparando-se o grupo com AR e o sem AR vimos que Neisseria sp e enterobactérias säo mais freqüentes no sem AR. No grupo AA, Neisseria sp foi mais freqüente que no grupo normal (sem AR). Este trabalho é importante, pois traz a microbiologia das amígdaIas estudada de forma ampla, melhorando assim a interpretaçäo dos swabs e direcionando a um correto tratamento das afecçöes amigdalianas