Efecto de los corticoesteroides intranasales tópicos en los valores de eosinófilos en mucosa nasal en pacientes adultos con rinitis alérgica / Effect of topical intranasal corticosteroids on eosinophil values in nasal mucosa in adult patients with allergic rhinitis / Efeito dos corticosteróides intranasais tópicos nos valores de eosinófilos na mucosa nasal em pacientes adultos com rinite alérgica

INTRODUCCIÓN: La citología nasal es utilizada como método complementario diagnóstico de la rinitis y el hallazgo de eosinófilos; en la misma aumenta la sensibilidad para confirmar una alergia a casi el 80%. Los corticoesteroides intranasales tópicos se utilizan actualmente como primera línea de tratamiento de la rinitis porque reducen la inflamación de la mucosa que subyace a los signos y síntomas de la enfermedad. MATERIAL Y MÉTODOS: Estudio observacional, retrospectivo y analítico. Se incluyeron pacientes entre 16 a 65 años edad inclusive, que consultaron al Servicio de Otorrinolaringología y Alergia e Inmunología de la Clínica Universitaria Reina Fabiola entre agosto de 2016 y julio de 2017 con diagnóstico de rinitis alérgica. La información de las variables cuantitativas se sometió a una comprobación estadística realizada mediante el test de Wilcoxon apareado. Se consideró significativo un valor de p<0,05…

INTRODUCTION: Nasal cytology is used as a complementary diagnostic method of rhinitis and the finding of eosinophils in it increases the sensitivity to confirm an allergy to almost 80%. Topical intranasal corticosteroids are currently used as the first line of treatment for rhinitis because they reduce the inflammation of the mucosa that underlies the signs and symptoms of the disease. MATERIAL AND METHODS: Observational, retrospective and analytical study. Patients between the ages of 16 and 65 years were included, who consulted the Otorhinolaryngology and Allergy and Immunology Department of the Reina Fabiola University Clinic between August 2016 and July 2017 with a diagnosis of allergic rhinitis. The information of the quantitative variables was subjected to a statistical check carried out by means of the paired Wilcoxon test. A value of p...

Use of fine needle aspirate from peripheral nerves of pure-neural leprosy for cytology and PCR to confirm the diagnosis: A pilot study.

Background: The diagnosis of pure neural leprosy (PNL) remained subjective because of over-dependence of clinical expertise and a lack of simple yet reliable diagnostic tool. The criteria for diagnosis, proposed by Jardim et al., are not routinely done by clinicians in developing country as it involves invasive nerve biopsy and sophisticated anti-PGL-1 detection. We conducted a study using fi ne needle aspiration cytology (FNAC) coupled with Ziehl Neelsen staining (ZN staining) and Multiplex- Polymerase Chain Reaction (PCR) specifi c for M. leprae for an objective diagnosis of pure neural leprosy (PNL), which may be simpler and yet reliable. Aim: The aim of the study is to couple FNAC with ZN staining and multiplex PCR to diagnose pure neural leprosy patients rapidly, in simpler and yet reliable way. Methods: Thirteen patients of PNL as diagnosed by two independent consultants were included as case, and 5 patients other than PNL were taken as control in the study. Fine needle aspiration was done on the affected nerve, and aspirates were evaluated for cytology, ZN staining and multiplex- PCR. Results: Out of the 13 cases where fi ne needle aspiration was done, M. leprae could be elicited in the nerve tissue aspirates in 5 cases (38.4%) with the help of conventional acid-fast staining and 11 cases (84.6%) with the help of multiplex PCR. On cytological examination of the aspirates, only 3 (23%) cases showed specifi c epithelioid cells, whereas 8 (61.5%) cases showed non-specifi c infl ammation, and 2 (15.3%) cases had no infl ammatory cells. Conclusion: Our study demonstrates that in the fi eld of laboratory diagnosis of PNL cases, FNAC in combination with ZN staining for acid-fast bacilli (AFB) and Multiplex-PCR can provide a rapid and defi nitive diagnosis for the majority of PNL cases. FNAC is a less-invasive, outdoor-based and simpler technique than invasive nerve biopsy procedure. Thus, this study may enlighten the future path for easy and reliable diagnosis of PNL.

A retrospective study of oral manifestations in patients with paracoccidioidomycosis

South American blastomycosis, paracoccidioidomycosis (Pb mycosis) or Lutz disease is an endemically fungal infection in Latin America. It is caused by the dimorphic fungus Paracoccidioides brasiliensis and may cause oral mucosal lesions. The incidence of Pb mycosis oral lesions was evaluated in patients assisted at a Brazilian Dental School's Specialized Oral Diagnosis Service with special focus on the different clinical forms of these lesions, its location, patients' occupation, deleterious habits, and diagnosis methodology. Students' and professionals' initial diagnoses were compared with the definitive diagnosis. Lesions were detected 31 cases (18 patients). The results show that 88.8% of the patients were male with a mean age of 50 years and 39% work(ed) with activities related to agriculture. As much as 88.9% were smokers and 72.2% were alcohol users. Exfoliative cytology was performed in 66.6% of the patients. Oral mucosa (30%), gingiva (16.6%) and lips 16.6% were the most common sites of Pb mycosis oral lesions. Comparing the initial with the definitive diagnosis made by the professionals their accuracy was 33% (6 out of 18 patients). Students' diagnosis was more accurate demonstrating 72.5% of initial correct diagnosis (13 out of 18). Statistical analysis by ANOVA (α=0.05, SPSS WIN) demonstrated a significant difference between the diagnosis of Pb mycosis made by students and professionals when considering initial diagnosis and final diagnosis (after histopathological analysis) (p=0.25). Incisional biopsy and exfoliate cytology are efficient for an early diagnosis of this disease in mouth. Students' training in diagnosis of oral pathologies to recognize lesions is urgent to improve public health.

A blastomicose sul americana, paracoccidiodomicose (Pb micose) ou doença de Lutz é uma infecção fúngica endêmica na América Latina. É causada pelo fungo dimórfico Paracoccidiodes brasiliensis, e pode causar lesões na mucosa oral. Nós avaliamos a incidência de lesões orais de Pb micose nos pacientes atendidos em um Centro Especializado em Diagnóstico Oral com foco principal nas diferentes formas clinicas das lesões, suas localidades, ocupação dos pacientes, hábitos deletérios e diagnóstico e metodologia, e foram detectados 31 casos (18 pacientes). Os resultados mostraram que 88,8% dos pacientes eram do sexo masculino com idade média de 50 anos de idade, e 39% trabalham, ou trabalhavam, com atividades relacionadas à agricultura. Observou-se que 88,9% eram fumantes e 72,2% ingeriam álcool. Citologia esfoliativa foi feita em 66,6%. Mucosa jugal foi acometida em 30%, gengiva, e lábios 16% (cada um) foram os locais mais comuns de lesões orais da Pb micose. Comparando o diagnóstico inicial com o definitivo feito pelos profissionais, a acurácia foi de 33%; o diagnóstico dos estudantes foi mais preciso demonstrando 72,5% do diagnóstico inicial correto com diferença estatística significante (p=0,25) através do teste ANOVA do SPSS WIN com nível de significância de 5%. Biópsia incisonal e citologia esfoliativa são eficientes para um diagnóstico precoce desta doença na boca; o treinamento dos estudantes em diagnóstico para reconhecer as patologias orais é urgente para melhorar a saúde pública.

Perfil dos laboratórios de citopatologia do sistema único de saúde / Assessment of cytology laboratory performance within the Brazilian unified health system

OBJETIVO: Conhecer o perfil dos laboratórios de citopatologia que prestam serviços ao Sistema Unico de Saúde (SUS) e elaborar indicadores de qualidade dos exames citopatológicos. MÉTODOS: Foi realizada uma enquete postal dirigida aos 1.028 laboratórios que prestaram serviço ao SUS e participaram do Sistema de Informação do Câncer do Colo do Utero (SISCOLO) em 2002. As informações referentes aos exames citopatológicos constantes do SISCOLO e disponibilizadas na página do Departamento de Informática do Sistema Unico de Saúde (DATASUS) na Internet (www.datasus.gov.br) para o mesmo ano foram analisadas. RESULTADOS: Dos 1.028 laboratórios que informaram os resultados dos exames citopatológicos cervicovaginais ao DATASUS, em 2002, 739 responderam à enquete (71,9 por cento). Desses, 18,9 por cento processaram 15 mil exames ou mais no ano; 70,2 por cento eram privados; 50,2 por cento encontravam-se vinculados à gestão municipal; e 48,7 por cento realizavam exames histopatológicos. Em 74,8 por cento dos casos o responsável técnico pelo laboratório era médico. Dos 10.505.773 exames incluídos no SISCOLO em 2002, uma parcela das amostras (1,66 por cento) foi considerada insatisfatória. As alterações detectadas foram: células escamosas atípicas de significado indeterminado (ASCUS), 1,26 por cento; papilomavírus humano (HPV), 0,93 por cento; neoplasia intra-epitelial cervical I (NIC I), 0,84 por cento; NIC II, 0,20 por cento; NIC III, 0,17 por cento; carcinoma escamoso invasivo, 0,05 por cento; células glandulares atípicas de significado indeterminado (AGUS), 0,14 por cento; adenocarcinoma in situ, 0,01; e adenocarcinoma invasivo, 0,01 por cento. CONCLUSÃO: Este estudo permitiu avaliar o perfil dos laboratórios de citopatologia que prestaram serviço ao SUS em 2002, e o SISCOLO se mostrou um excelente instrumento para o monitoramento da qualidade dos exames citopatológicos realizados no país.

OBJECTIVE: To assess the profile of cytopathology laboratories which render services to the Brazilian Unified Health System (SUS), and to create quality indicators for cytopathological exams. METHODS: A postal survey of 1,028 laboratories that render services to the SUS and participated in the Cervix Cancer Information System (SISCOLO) in the year 2002. Information concerning cytopathological exams from the SISCOLO, available on the Internet (www.datasus.gov.br) for the same year was analyzed. RESULTS: Out of the 1,028 laboratories which reported results of cervix-vaginal cytopathology exams to DATASUS in 2002, 739 answered the survey (71.9 percent). From these, 18.9 percent processed 15,000 exams or more in that year; 70.2 percent were private; 50.2 percent were vinculated to municipal administrations; and 48.7 percent performed histopathological exams. In 74.8 percent of cases, a physician was in charge of the technical responsibility. Out of 10,505.773 exams included in the SISCOLO in 2002, 1.66 percent of samples were considered unsatisfactory. The following alterations were detected: atypical squamous cells of undetermined significance (ASCUS), 1.26 percent; human papillomavirus (HPV), 0.93 percent; cervical intraepithelial neoplasia I (CIN I), 0.84 percent, CIN II = 0.20 percent, CIN III = 0.17 percent; invasive squamous carcinoma, 0.05 percent, atypical glandular cells of undetermined significance (AGUS), 0.14 percent, in situ adenocarcinoma, 0.01; and invasive adenocarcinoma, 0.01 percent. CONCLUSION: This study made it possible to assess the profile of cytopathology laboratories, which rendered services to the SUS in 2002, and the SISCOLO proved to be an excellent tool to assess the quality of cytopathological exams performed in Brazil.

Colo do Útero: alterações citológicas mais freqüentes e fatores de risco predisponentes em uma população de São José do Rio Preto – SP / Uterine Cervical: more frequently atipias and risk factors in a population of São José do Rio Preto – SP

Com o objetivo de identificar os fatores de risco e a faixa etária mais acometida por alterações pré-malignas ou malignas em mulheres que realizaram citologias cervicais no período de 15 de março a 30 de abril de 2002, foi aplicado um questionário em 72,41 das mulheres com colpocitologia alterada, de São José do Rio Preto, identificando dados epidemiológicos e sócio-econômicos. As alterações foram encontradas em mulheres com média de idade de 42,1 anos (mediana 36 anos), sendo 33,34

Fine needle aspiration biopsy in diagnosis and treatment of breast pathology. A review

Seventy-eight women with breast disease were studied aiming to evaluate the importance of the fine needle aspiration biopsy for its diagnosis and forwarding treatment. Our data showed a high diagnostic accuracy with a low level of false negative results and no false positive. The macroscopic appearance of samples is an important aspect. Clear material prevailed in benign pathology (90%) and the presence of blood was usual in malignant tumors (78.3%)