Changes and significance of type 2 innate lymphoid cells and their related factors in bronchopulmonary dysplasia / 中国当代儿科杂志

OBJECTIVES@#To investigate the changes and significance of type 2 innate lymphoid cells (ILC2), interleukin-33 (IL-33), interleukin-25 (IL-25), thymic stromal lymphopoietin (TSLP), interleukin-5 (IL-5), and interleukin-13 (IL-13) in peripheral blood of preterm infants with bronchopulmonary dysplasia (BPD).@*METHODS@#A total of 76 preterm infants with a gestational age of <32 weeks and a length of hospital stay of ≥14 days who were admitted to the Department of Pediatrics of the Affiliated Hospital of Jiangsu University from September 2020 to December 2021 were enrolled. According to the diagnostic criteria for BPD, they were divided into a BPD group with 30 infants and a non-BPD group with 46 infants. The two groups were compared in terms of the percentage of ILC2 and the levels of IL-33, IL-25, TSLP, IL-5, and IL-13 in peripheral blood on days 1, 7, and 14 after birth.@*RESULTS@#The BPD group had significantly lower birth weight and gestational age than the non-BPD group (P<0.05). On days 7 and 14 after birth, the BPD group had significantly higher levels of ILC2, IL-33, TSLP, and IL-5 than the non-BPD group (P<0.05), and these indices had an area under the curve of >0.7 in predicting the devolpment of BPD (P<0.05). Multivariate logistic regression analysis showed that after adjusting for gestational age and birth weight, peripheral blood IL-33, TSLP and IL-5 on days 7 and 14 after birth were closely related to the devolpment of BPD (P<0.05).@*CONCLUSIONS@#Early innate immune activation and upregulated expression of related factors may be observed in preterm infants with BPD. ILC2, IL-33, TSLP, and IL-5 may be used as biological indicators for early diagnosis of BPD.

Hemogram index parameters in the evaluation of male breast cancer and inflammatory response: a case-control study

SUMMARY OBJECTIVE: Our aim was to investigate the hemogram index parameters and their clinical significance in the evaluation of the inflammatory response of patients with male breast cancer, who are rarely observed in the literature. METHODS: In total, 22 (n=22) healthy male and 28 (n=28) male breast cancer patients without synchronous/metachronous tumors were included in this study. They were grouped as the healthy male control group (Group 1) and the male breast cancer patient group (Group 2). The male breast cancer was divided into two subgroups, namely, early stage [(stage: 0/I/II) (Group 2A)] and late stage [(stage: III/IV) (Group 2B)], and their hemogram index parameters were compared. RESULTS: A significant (p>0.05) increase was observed in neutrophil/lymphocyte ratio (NLR) and·platelet/lymphocyte ratio (PLR) values in the late stage (Group 2B: stage III/IV) compared to the early stage (Group 2A: stage 0/I/II) and healthy control (Group 1) groups. CONCLUSIONS: In male breast cancer patients, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio values were significantly higher as the stage of cancer increased. These readily available simple tests can be used to evaluate the host's inflammatory response in male breast cancer.

Validation of an algorithm based on clinical, histopathological and immunohistochemical data for the diagnosis of early-stage mycosis fungoides

Abstract Background: Diagnosis of mycosis fungoides is challenging due to the non-specificity of clinical and histopathological findings. The literature indicates an average delay of 4-6 years for a conclusive diagnosis. Refinement of the histopathological criteria for the diagnosis of patients in early stages of the disease is considered of interest. Objectives: To study the histopathological aspects of early-stage mycosis fungoides and the applicability, in a retrospective form, of the diagnostic algorithm proposed by Pimpinelli et al. Methods: Observational, retrospective, transversal study based on revision of histopathological exams of patients with suspected mycosis fungoides. Medical records were reviewed, and complementary immunohistochemistry performed. Results: Sixty-seven patients were included. The most frequent histopathological features were superficial perivascular lymphoid infiltrate (71.6%), epidermotropism (68.7%), lymphocytic atypia (63.8%), hyperkeratosis (62.7%) and acanthosis (62.7%). Forty-three patients scored 4 points at the algorithm, by clinical and histological evaluation. Immunohistochemistry was performed on 23 of the 24 patients with less than 4 points. Of those 23, 22 scored 1 point, allowing a total of 61 patients (91%) with the diagnosis of early-stage mycosis fungoides. Study limitations: Its retrospective character, reduced sample size and incomplete application of the algorithm. Conclusions: Application of the Pimpinelli et al. algorithm, even in an incomplete form, increased the percentage of cases diagnosed as mycosis fungoides. Routine application of the algorithm may contribute to earlier and specific management and improvement of the patients' outcome.

Función predictiva del índice de neutrófilos/linfocitos y del volumen plaquetario medio en la púrpura de Henoch-Schönlein relacionada con compromiso renal y gastrointestinal / Predictive role of neutrophil to lymphocyte ratio and mean platelet volume in Henoch-Schönlein purpura related gastrointestinal and renal involvement

Antecedentes: La púrpura de Henoch-Schönlein (PHS) es una vasculitis sistémica de vasos pequeños. El objetivo fue evaluar el índice de neutrófilos/linfocitos (INL) en sangre y el volumen plaquetario medio (VPM) en la PHS e investigar la relación con el compromiso renal y gastrointestinal.Métodos: Se incluyeron niños con PHS y controles sanos. Se evaluaron concentración de hemoglobina, recuento de leucocitos, recuento de trombocitos, INL, VPM, velocidad de sedimentación globular y proteína C-reactiva.Resultados: El INL fue significativamente mayor en los pacientes con PHS con hemorragia gastrointestinal (p < 0,001). El valor ideal de corte del INL para predecir la hemorragia gastrointestinal fue 2,05, con 93 % de sensibilidad y 62 % de especificidad. El VPM fue significativamente mayor en los pacientes con PHS con compromiso renal (p = 0,027).Conclusiones: El INL en sangre y el VPM podrían ser útiles para identificar el compromiso renal y gastrointestinal en la PHS

Background: Henoch-Schönlein purpura (HSP) is a systemic small-vessel vasculitis that occurs mainly in children. The aim was to evaluate the blood neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV) in patients with HSP and to investigate the relationship with gastrointestinal and renal involvement.Methods: Children with HSP and healthy individuals as controls were included. Hemoglobin level, white blood cell count, platelet count, NLR, MPV erythrocyte sedimentation rate and C-reactive protein were evaluated.Results: There were 71 HSP children and 74 controls. NLR was significantly higher in HSP patients with gastrointestinal bleeding than without gastrointestinal bleeding (p < 0,001). The optimal cutoff value of NLR for predicting gastrointestinal bleeding was 2.05, with 93 % sensitivity and 62 % specificity. MPV was significantly higher in HSP patients with renal involvement than without renal involvement (p = 0,027).Conclusions:Blood NLR and MPV may be useful markers to identify gastrointestinal and renal involvement in HSP patients.

Is macular lymphocytic arteritis limited to the skin? Long-term follow-up of seven patients

Abstract Background: Macular lymphocytic arteritis most commonly presents as hyperpigmented macules on the lower limbs. The pathogenesis of this disease is still unclear and there is an ongoing debate regarding whether it represents a new form of cutaneous vasculitis or an indolent form of cutaneous polyarteritis nodosa. Objective: To describe clinical, histopathological, and laboratory findings of patients with the diagnosis of macular lymphocytic arteritis. Methods: A retrospective search was conducted by reviewing cases followed at the Vasculitis Clinic of the Dermatology Department, School of Medicine, University of São Paulo, between 2005 and 2017. Seven patients were included. Results: All cases were female, aged 9-46 years, and had hyperpigmented macules mainly on the legs. Three patients reported symptoms. Skin biopsies evidencing a predominantly lymphocytic infiltrate affecting arterioles at the dermal subcutaneous junction were found, as well as a typical luminal fibrin ring. None of the patients developed necrotic ulcers, neurological damage, or systemic manifestations. The follow-up ranged from 18 to 151 months, with a mean duration of 79 months. Study limitations: This study is subject to a number of limitations: small sample of patients, besides having a retrospective and uncontrolled study design. Conclusions: To the best of the authors' knowledge, this series presents the longest duration of follow-up reported to date. During this period, none of the patients showed resolution of the lesions despite treatment, nor did any progress to systemic vasculitis. Similarities between clinical and skin biopsy findings support the hypothesis that macular lymphocytic arteritis is a benign, incomplete, and less aggressive form of cutaneous polyarteritis nodosa.

Neutrophil-lymphocyte ratio change after curative gastrectomy for gastric cancer: a subgroup analysis / Evolução da relação neutrófilo-linfócito após gastrectomia curativa por câncer gástrico: análise de subgrupos

ABSTRACT Objective: To evaluate the impact of neutrophil-lymphocyte ratio change after curative surgery for gastric cancer. Methods: A retrospective analysis of patients with gastric cancer who underwent curative surgery between 2009 and 2017 was performed. A cutoff value was established for the neutrophil-lymphocyte ratio in the pre- and postoperative periods, according to the median value, and four subgroups were formed (low-low/low-high/high-low/high-high). Clinical-pathological and survival data were analyzed and related to these subgroups. Results: A total of 325 patients were included in the study. The cutoff values of the neutrophil-lymphocyte ratio were 2.14 and 1.8 for the pre and postoperative periods, respectively. In patients with stages I and II, the high-high subgroup presented worse overall survival (p=0.016) and disease-free survival (p=0.001). Complications were higher in the low-high subgroup of patients. Conclusion: The neutrophil-lymphocyte ratio is a low cost, efficient and reproducible marker. The prognosis individualization can be performed according to the identification of subgroups at a higher risk of complications and worse prognosis.

RESUMO Objetivo: Avaliar o impacto da alteração da relação neutrófilo-linfócito após ressecção curativa por câncer gástrico. Métodos: Realizou-se análise retrospectiva de pacientes com câncer gástrico submetidos à gastrectomia curativa entre 2009 e 2017. Foi estabelecido valor de corte para a relação neutrófilo-linfócito nos períodos pré e pós-operatório de acordo com a mediana, e quatro subgrupos foram formados (baixo-baixo/baixo-alto/alto-baixo/alto-alto). Dados clínicos e patológicos e de sobrevida foram analisados e relacionados com estes subgrupos. Resultados: Foram incluídos no estudo 325 pacientes. Os valores de corte para a relação neutrófilo-linfócito foram 2,14 e 1,8 para os períodos pré e pós-operatório, respectivamente. Em pacientes com estádios I e II, o subgrupo alto-alto apresentou pior sobrevida global (p=0,016) e sobrevida livre de doença (p=0,001). As complicações ocorreram mais em pacientes do subgrupo baixo-alto. Conclusão: A relação neutrófilo-linfócito é um marcador de baixo custo, eficiente e reprodutível. A individualização do prognóstico pode ser realizada de acordo com a identificação de subgrupos com maior risco de complicações e pior prognóstico.

Relationship between neutrophil-to-lymphocyte ratio and systemic lupus erythematosus: a meta-analysis

Systemic lupus erythematosus (SLE) is a chronic systematic autoimmune disease. Current methods of diagnosing SLE or evaluating its activity are complex and expensive. Numerous studies have suggested that neutrophil-to-lymphocyte ratio (NLR) is closely correlated with the presence of SLE and its activity, suggesting that it may serve as a diagnostic and monitoring indicator for SLE. Therefore, we performed a meta-analysis to systematically assess the association between NLR and SLE. We performed a literature search until 12 April 2019 in the PubMed, Web of Science, and China National Knowledge Infrastructure databases. Cross-sectional studies comparing the NLR of SLE patients versus those of healthy controls, of active versus inactive SLE patients, and of SLE patients with versus without lupus nephritis were considered for inclusion. Mean intergroup NLR differences were estimated using standardized mean differences and their 95% confidence intervals. Study quality was assessed using the Agency for Healthcare Research and Quality instrument for cross-sectional studies. Fourteen studies with 1,781 SLE patients and 1,330 healthy controls were included in this meta-analysis. The pooled results showed that the NLR was significantly higher in SLE patients than in healthy controls, in active SLE patients than in inactive SLE patients, and in SLE patients with lupus nephritis than in those without lupus nephritis. NLR may be an indicator for monitoring disease activity and reflecting renal involvement in SLE patients. Nevertheless, more high-quality studies are warranted to further validate our findings.

Can Neutrophil-to-Lymphocyte ratio predict the response to BCG in high-risk non muscle invasive bladder cancer?

ABSTRACT Objectives: To evaluate the neutrophil-to-lymphocyte ratio (NLR) as a prognostic factor for response of high risk non muscle invasive bladder cancer (HRNMIBC) treated with BCG therapy. Materials and Methods: Between March 2010 and February 2014 in a tertiary center 100 consecutive patients with newly diagnosed HRNMIBC were retrospectively analyzed. Patients were divided according to NLR value: 46 patients with NLR value less than 3 (NLR < 3 group), and 54 patients with NLR value more than 3 (NLR ≥ 3 group). At the end of follow-up 52 patients were high grade disease free (BCG-responder group) and 48 patients underwent radical cystectomy for high grade recurrence or progression to muscle invasive disease (BCG non-responder group). The average follow-up was 60 months. Intervention: analysis and correlation of preoperative NLR value with response to BCG in terms of recurrence and progression. Results: The optimal cut-off for NLR was ≥ 3 according to the receiver operating characteristics analysis (AUC 0.760, 95% CI, 0.669-0.850). Mean NLR value was 3.65 ± 1.16 in BCG non-responder group and 2.61 ± 0.77 in BCG responder group (p = 0.01). NLR correlated with recurrence (r = 0.55, p = 0.01) and progression risk scores (r = 0.49, p = 0.01). In multivariate analysis, NLR (p = 0.02) and EORTC recurrence risk groups (p = 0.01) were associated to the primary endpoint. The log-rank test showed statistically significant difference between NLR < 3 and NLR ≥ 3 curves (p < 0.05). Conclusions: NLR value preoperatively evaluated could be a useful tool to predict BCG response of HRNMIBC. These results could lead to the development of prospective studies to assess the real prognostic value of NLR in HRNMIBC.

Prognostic role of neutrophil/lymphocyte ratio in resected gastric cancer: a systematic review and meta-analysis

High levels of inflammatory markers and the neutrophil-lymphocyte ratio appear to be associated with worse overall survival in solid tumors. However, few studies have analyzed the role of the neutrophil-lymphocyte ratio in gastric cancer patients scheduled to undergo curative resection. In the present study, a systematic review and meta-analysis was performed to analyze the relationship between the neutrophil-lymphocyte ratio and overall survival in patients with gastric cancer submitted to curative resection and to identify the clinicopathological features (age, gender, tumor depth, nodal involvement and tumor differentiation) that are correlated with high neutrophil-lymphocyte ratios. A literature search of PubMed, Scopus, Cochrane and EMBASE through November 2017 was conducted. Articles that included gastric cancer patients submitted to curative resection and preoperatory neutrophil-lymphocyte ratio values were included. A total of 7 studies comprising 3264 patients from 5 different countries were included. The meta-analysis revealed an association of high neutrophil-lymphocyte ratios with older age, male gender, lower 5-year overall survival, increased depth of tumor invasion, positive nodal involvement but not with histological differentiation. Evaluation of the neutrophil-lymphocyte ratio is a cost-effective method that is widely available in preoperatory settings. Furthermore, it can effectively predict prognosis, as high values of this biomarker are related to more aggressive tumor characteristics. This ratio can also be used to stratify risk in patients within the same disease stage and may be used to assist in individualized follow-up and treatment.

Doença Relacionada à IgG4: relato de um desafio diagnóstico / IgG4-Related Disease: report of a diagnostic challenge

Esta exposição justifica-se pela escassez de material científico sobre a doença relacionada à IgG4 e por suas várias formas de apresentação clínica. O objetivo deste estudo foi relatar um caso de doença relacionada à IgG4 apresentando certas peculiaridades. Paciente do sexo masculino, 37 anos, admitido com quadro de perda ponderal significativa (de 70kg a 44kg), iniciada há 6 meses da internação, associada ao surgimento de nodulações subcutâneas em membros superiores, e a tumefações em região de cabeça e pescoço. Apresentava, também, quadro de hiporexia, adinamia e astenia, e dosagem sérica de IgG 4 elevada. Laudos histopatológicos evidenciaram duas amostras de pele e tecido subcutâneo palpebral com lesão esclerosante de partes moles, permeada por células histiocitoides, linfoides e eosinófilos. O perfil imuno-histoquímico em conjunto com os achados morfológicos foi consistente com doença relacionado à IgG4. O paciente foi submetido à corticoterapia com prednisona oral, evoluindo com melhora clínica. A patogênese da doença relacionado à IgG4 ainda é pouco compreendida, sendo a autoimunidade e os agentes infecciosos considerados potenciais gatilhos imunológicos. Diversas citocinas contribuem para o aumento na produção de IgG4 e, em menor escala, de IgE, eosinofilia e a progressão da fibrose, que são características da doença. O surgimento de nódulos e massas, focais ou difusas, descobertos no exame físico ou radiológico é o principal sinal clínico da doença O início é geralmente subagudo, e os sintomas constitucionais são incomuns. Os critérios diagnósticos da doença ainda não estão bem estabelecidos, pois as manifestações clínicas e as alterações patológicas dependem dos órgãos acometidos. Ainda não existe um consenso sobre seu tratamento, mas, atualmente, a droga de escolha são os glicocorticoides. Se não tratada, o paciente evolui com fibrose e disfunção orgânica.

This expository study is warranted by the lack of scientific material about IgG4 Related Disease (IgG4-RD) and its various forms of clinical presentation. The objective of this study was to report a case of IgG4-RD that has certain peculiarities. A male patient, 37 years old, admitted with significant weight loss (from 70kg to 44kg), begun six months of hospitalization, associated with the appearance of subcutaneous nodules in the upper limbs, and swellings on the head and neck region. Had also hyporexia, adynamia and asthenia. High IgG4 serum levels. Histopathological reports showing two samples of skin and eyelid subcutaneous tissue with sclerosing soft tissue injury, permeated by histiocytes, lymphocytes and eosinophils. The immunohistochemical profile in conjunction with the morphological findings are consistent with IgG4-RD. The patient underwent corticosteroid therapy with oral prednisone, evolving to clinical improvement. The pathogenesis of IgG4-RD is still poorly understood, being autoimmunity and infectious agentes considered potential immunological triggers. Several cytokines contribute to the increased production of IgG4, and to a lesser extent, IgE, eosinophilia and the progression of fibrosis, which are characteristic of diseases. The emergence of nodules and masses,focal or diffuse, discovered through physical or radiological examination are the main clinical signs of disease. The onset is usually subacute and constitutional symptoms are uncommon. The disease diagnostic criteria are not well established, because the clinical manifestations and pathological changes depend on organs affected. There is still no consensus on treatment, but glucocorticoids are the currently drug of choice. If untreated, the patient progresses with fibrosis and organ dysfunction

Caracterização fenotípica e funcional das células T CD4+ e CD8+ VB12 na resposta imune em paciente com Leishmaniose Cutânea Localizada / Phenotypic and functional characterization of CD4 + and CD8 + VB12 T cells in the immune response in a patient with Localized Cutaneous Leishmaniasis

As leishmanioses constituem um complexo de doenças causada pelo protozoário intracelular, do gênero Leishmania, sendo a resposta imune celular essencial para controle, eliminação e proteção contra a infecção. A teoria clonal da imunidade celular propõe que as respostas imunológicas são estabelecidas através do aumento na frequência de clones específicos ao antígeno. Para avaliar a resposta das células T à infecção por Leishmania, investigamos, por citometria de fluxo, a expressão de cadeias Vβ de receptores de células T (TCRs), estado de ativação, capacidade de adesão ao endotélio e potencial funcional de clones específico. Em um grupo de pacientes com Leishmaniose Cutânea Localizada (LCL), avaliamos diferentes subpopulações de células T através da expressão da região Vβ, no sangue periférico e na biópsia da lesão. Utilizamos células mononucleares de sangue periférico (CMSPs), de pacientes LCL e controles saudáveis, nas quais avaliamos, ex vivo, a expressão de moléculas de ativação (CD25, CD69 e HLA-DR), adesão (LFA-1, VLA-4 e CD62L), co-estimulatória (CD27 e CD28)...

Leishmaniasis is a desease caused by infection with the Leishmania protozoan parasite. The cellular immune response is essential for controlling, eliminating and protection of the Leishmania infection. The clonal theory of cellular immunity proposes that immunological responses are established by increasing the frequency of antigen-specific clones. In order to measure the host T cell response to Leishmania infection, we have investigated by flow cytometry, the expression of Vβ chains of T-cell receptors (TCRs), activation state, adhesion to endothelium of capacity and functional potential of specific T. In a group of localized cutaneous leishmaniasis (LCL) patients, we evaluated different T cell subpopulations as identified by their Vβ region expression, in peripheral blood and biopsy. We used peripheral blood mononuclear cells (PBMCs), from CL patients and healthy volunteers, in which we evaluate, ex vivo, the expression of activation molecules (CD25, CD69 and HLA-DR), adhesion (LFA-1, VLA-4 and CD62L), co-stimulatory (CD27 and CD28)...

Prognostic value of the neutrophil to lymphocyte ratio in lung cancer: A meta-analysis

Recently, a series of studies explored the correlation between the neutrophil to lymphocyte ratio and the prognosis of lung cancer. However, the current opinion regarding the prognostic role of the neutrophil to lymphocyte ratio in lung cancer is inconsistent. We performed a meta-analysis of published articles to investigate the prognostic value of the neutrophil to lymphocyte ratio in lung cancer. The hazard ratio (HR) and its 95% confidence interval (CI) were calculated. An elevated neutrophil to lymphocyte ratio predicted worse overall survival, with a pooled HR of 1.243 (95%CI: 1.106-1.397; Pheterogeneity=0.001) from multivariate studies and 1.867 (95%CI: 1.487-2.344; Pheterogeneity=0.047) from univariate studies. Subgroup analysis showed that a high neutrophil to lymphocyte ratio yielded worse overall survival in non-small cell lung cancer (NSCLC) (HR=1.192, 95%CI: 1.061-1.399; Pheterogeneity=0.003) as well as small cell lung cancer (SCLC) (HR=1.550, 95% CI: 1.156-2.077; Pheterogeneity=0.625) in multivariate studies. The synthesized evidence from this meta-analysis of published articles demonstrated that an elevated neutrophil to lymphocyte ratio was a predictor of poor overall survival in patients with lung cancer. .

Estigma e discriminação: experiências de mulheres HIV positivo nos bairros populares de Maputo, Moçambique / Stigma and discrimination: the experiences of HIV-positive women in poor neighborhoods of Maputo, Mozambique / Estigma y discriminación: las experiencias de las mujeres VIH positivas en los barrios populares de Maputo, Mozambique

A epidemia de HIV/AIDS é um sério problema de saúde pública em Moçambique, que convive com altas taxas de prevalência do HIV. O impacto da epidemia é agravado pelo forte estigma que atinge as pessoas soropositivas. O objetivo deste estudo foi investigar, com base em uma perspectiva socioantropológica, a experiência de mulheres HIV positivo nos bairros populares de Maputo e como lidam com o estigma e a discriminação. Foram realizadas entrevistas semiestruturadas com dez mulheres HIV positivo, residentes nos bairros populares de Maputo. Os resultados mostram como a desigualdade de gênero atua de forma importante na construção da vulnerabilidade das mulheres ao HIV, assim como em sua estigmatização e discriminação. No enfrentamento do estigma, as mulheres procuram preservar o sigilo do diagnóstico buscando apoio na reunião em grupos de pares HIV positivo. É fundamental que se implementem políticas públicas voltadas para o empoderamento das mulheres e redução do estigma associado ao HIV/AIDS.

The HIV/AIDS epidemic is a serious public health problem in Mozambique. The country has high prevalence rates, and the epidemic's impact is aggravated by the stigma affecting HIV-positive persons. This study takes a socio-anthropological perspective to analyze the experience of HIV-positive women in poor neighborhoods of Maputo and the ways they cope with stigma and discrimination. Semi-structured interviews were conducted with 10 HIV-positive women. The results show how gender inequalities increase women's vulnerability to HIV and contribute to their stigmatization and discrimination. In dealing with stigma, women try to keep their diagnosis confidential, seeking support in group meetings with others living with HIV. Public policies should focus on women's empowerment and the reduction of HIV/AIDS-related stigma.

El VIH/SIDA es un problema de salud pública grave en Mozambique, que convive con altas tasas de prevalencia del VIH. El impacto de la epidemia se ve agravada por el fuerte estigma que afecta a las personas con VIH. El objetivo de este estudio fue investigar, desde una perspectiva antropológica, la experiencia de las mujeres VIH positivas en los barrios populares de Maputo y cómo enfrentan el estigma y la discriminación. Se realizaron entrevistas semi-estructuradas con 10 mujeres VIH positivas que viven en barrios pobres de Maputo. Los resultados muestran cómo la desigualdad de género juega un papel importante en la construcción de la vulnerabilidad de las mujeres frente al VIH, así como en la estigmatización y discriminación. Para hacer frente el estigma, las mujeres buscan preservar la confidencialidad del diagnóstico y buscar apoyo en la reunión de grupos de pares con VIH. Es imprescindible implementar políticas públicas enfocadas al empoderamiento de las mujeres y a la reducción del estigma asociado con el VIH/SIDA.

Concentrações plasmáticas de citocinas e quimiocinas na infecção pelo HTLV-1 / Plasma concentrations of cytokines and chemokines in HTLV-1

INTRODUÇÃO: O vírus linfotrópico das células T humano tipo 1 (HTLV-1) é endêmico na Bahia e está associado com doenças graves, como a Paraparesia Espástica Tropical/Mielopatia associada ao HTLV-1 (HAM/TSP) e a Dermatite Infecciosa associada ao HTLV-1 (DIH). Escassos trabalhos tem sido reportados com a avaliação de citocinas e quimiocinas em indivíduos jovens infectados pelo HTLV-1 e não existem dados sobre a manifestação simultânea DIH e HAM/TSP na faixa infanto-juvenil. OBJETIVO: Avaliar as concentrações plasmáticas de citocinas e quimiocinas na infecção pelo HTLV-1 em indivíduos infanto-juvenis. MÉTODO: Foram incluídos 61 indivíduos portadores do HTLV-1 distribuídos nos grupos Portadores assintomáticos, pacientes com a DIH, pacientes com DIH/HAM/TSP, pacientes com a HAM/TSP e 20 indivíduos saudáveis sem a infecção pelo HTLV-1, todos na faixa infanto-juvenil. As concentrações plasmáticas foram comparadas através do método de Elisa e de Cytometric Bead Array (CBA)...

INTRODUCTION: The lymphotropic virus of cells T human type 1 (HTLV ) is endemic in Bahia and it is associated with serious diseases such as Tropical Spastic Paraparesis/associated myelopathy with HTLV-1 and Infectious Dermatitis associated with HTLV -1 (IDH). Very little work has been reported with the evaluation of cytokines and chemokines in the IDH and there has been no data on the manifestation simultaneous IDH and HAM/TSP in children and youth range. OBJECTIVE: To evaluate the plasma concentrations of cytokines and chemokines in HTLV-1 infection in children and young individuals. METHOD: We included 61 individuals HTLV-1 spread in groups Asymptomatic Carriers, patients with IDH, patients with IDH/HAM/TSP, patients with HAM/TSP and 20 healthy individuals without HTLV-1, all in children's range. Plasma concentrations were compared using the ELISA method and Cytometric Bead Array (CBA)...

Distress do paciente oncológico: prevalência e fatores associados na opinião de familiares / Distress of cancer patients: prevalence and associated factors in the opinion of family / Angustia de los pacientes con cáncer: prevalencia y factores asociados en la opinión de la familia

Este estudo verificou a prevalência e fatores associados ao distress de pacientes oncológicos, na opinião de familiares. Foram entrevistados 140 familiares responsáveis pelo cuidado de pacientes com câncer. O Termômetro de Distress foi adaptado para uso em familiares. Estes consideraram que 72,9% dos pacientes estavam com distress relacionado a preocupações (80,4%), nervosismo (78,4%), tristeza (74,5%), dor (67,6%), fadiga (67,6%) e problemas com alimentação (57,8%). Modelos de regressão logística hierárquica mostraram que, enquanto familiares do sexo masculino (OR=0,025) e idades mais avançadas (OR=0,006 a 0,059) tiveram menor risco de perceber o distress, indivíduos protestantes, comparados a católicos, tiveram chance 12,77 vezes maior de percebê-lo. Quanto aos fatores associados, nervosismo (OR=10,8) contribuiu significativamente mais com a percepção de distress pelos familiares quando comparado a fadiga (OR=3,38) ou ter plano de saúde privado (OR=2,55). Familiares podem ser grandes aliados na avaliação e acompanhamento do distress de pacientes com câncer.

The study aimed to verify the opinion of family members about distress on cancer patients and the factors associated with it. Interviews with 140 family members of cancer patients were conducted. The Distress Thermometer was adapted to be used with family members. Approximately 72.9% of patients were considered in distress, related to concern (80.4%), nervousness (78.4%), sadness (74.5%), pain (67.6%), fatigue (67.6%) and problems with eating (57.8%). The hierarchical logistic regression models showed that while male (OR=0.025) and older ages (OR=0.006 to 0.059) had lower risk of perceiving the distress, individuals Protestants, compared to Catholics, were 12.77 times more likely to perceive it. About the associated factors, nervousness (OR=10.8) contributed significantly more to the perception of distress for family members when compared to fatigue (OR=3.38) or have private health insurance (OR=2.55). Family can be great allies in the evaluation and monitoring of distress in patients with cancer.

Este estudio examinó la prevalencia y los factores asociados con el distress de los pacientes de cáncer, de acuerdo con los familiares. Fueran entrevistados 140 cuidadores familiares de pacientes con cáncer. El Termómetro de Distress fue adaptado para el uso en los familiares. Ellos encontraron que el 72,9% de los pacientes estaban con distress relacionado con preocupaciones (80,4%), nerviosismo (78,4%), tristeza (74,5%), dolor (67,6%), fatiga (67, 6%) y problemas con la alimentación (57,8%). Modelos de regresión logística jerárquica mostraran que, mientras los familiares de sexo masculino (OR=0,025) y de edades más avanzadas (OR=0,006 a 0,059) tuvieron un menor riesgo de percibir el distress, los individuos protestantes, comparados a los católicos, tuvieron oportunidad 12,77 veces mayor para percibirlo. En cuanto a los factores asociados, el nerviosismo (OR=10,8) contribuyó significativamente más a la percepción del distress de los familiares, en comparación con la fatiga (OR=3,38) o tener un seguro de salud privado (OR=2,55). Familiares pueden ser grandes aliados en la evaluación y el seguimiento de sufrimiento en los pacientes con cáncer.

Immunohistochemical profile of stromal constituents and lymphoid cells over the course of wound healing in murine model

PURPOSE: To assess the evolution profile of the immunohistochemical expression of stromal constituents over the time-course of wound healing in a murine model. METHODS: Surgical wounds were performed in the back of 24 Wistar rats. After three, seven, 14 and 21 days, six rats were euthanized and the wounded histologically processed to assess the immunohistochemical expression of CD3, CD20, CD31, α-SMA and type-I collagen. Non-injured skin samples (NSS) were used as control. Data were subjected to statistical analysis using ANOVA and Tukey test. RESULTS: The mean of CD3 and CD20 positive cells in the wounds was significantly higher than in NSS at seven and 14 days (p<0.001). The blood vessels content was significantly lower than in NSS (p<0.05) at three days, but increased at seven and 14 days (p<0.01). The mean of α-SMA positive cells at seven, 14 and 21 days was higher than in NSS (p<0.05). The relative content of type I collagen increased from three to 21 days, but remained lower than in NSS (p<0.05). CONCLUSIONS: Lymphoid cells, myofibroblasts and microvessels contents varied over the time-course of wound healing, with peak at seven days and progressive reduction until 21 days. The type I collagen content increased over time. .

Epstein-Barr virus associated lymphoepithelioma-like carcinoma at the lesser curvature of the upper gastric body: a Case Report / El virus de Epstein-Barr asociado al carcinoma de tipo linfoepitelioma en la curvatura menor de la parte superior del cuerpo gástrico: Reporte de Caso

Lymphoepithelioma-like gastric carcinoma (LELGC) is a rare neoplasm of the stomach with dense lymphocytic infiltration. More than 80% of LELGCs are positive for the Epstein-Barr virus (EBV). Here, we report a 64-year old Chinese man with swallowing discomfort while eating food. Endoscopy and computed tomography both showed a submucosal lesion at the lesser curvature of the upper gastric body. The first diagnostic impression was a gastrointestinal stromal tumour. Subsequently, the patient received a wedge resection of the stomach. On histopathological examination, the tumour was found to consist of small nests of neoplastic cells within dense lymphocytic infiltration. Additionally, most of the neoplastic cells were positive for cytokeratin and Epstein-Barr virus-encoded RNA (EBER). Subsequently, the diagnosis of LELGC was made. We believe that physicians should be aware of the diagnosis of submucosal gastric lesions, particularly in older male patients.

El carcinoma gástrico de tipo linfoepitelioma (CGLE) es una neoplasia rara del estómago con una infiltración linfocítica densa. Más del 80% de los CGLEs son positivos al virus de Epstein-Barr (EBV). Aquí reportamos el caso de un paciente chino de 64 años, que sentía malestar al efectuar la deglución de alimentos. Tanto la endoscopia como la tomografía computarizada mostraron una lesión submucosa en la curvatura menor de la parte superior del cuerpo gástrico. La primera impresión diagnóstica fue de un tumor del estroma gastrointestinal Posteriormente, al paciente se le hizo una resección en cuña del estómago. En el examen histopatológico, se halló que el tumor consistía de pequeños nidos de células neoplásicas dentro de una infiltración linfocítica densa. Además, la mayoría de las células neoplásicas eran positivas a la citoqueratina y al ARN codificado por el virus de Epstein-Barr (EBER). Posteriormente, se realizó el diagnóstico de CGLE. Creemos que los médicos deben tomar conciencia del diagnóstico de las lesiones submucosas gástricas, especialmente en los pacientes mayores hombres.

Análise da integração viral e clonalidade de linfócitos T na dermatite infecciosa associada ao HTLV-1 / Analysis of viral integration and T lymphocyte clonality in infective dermatitis associated with HTLV-1

A dermatite infecciosa associada ao vírus linfotrópico de células T humanas tipo 1 (HTLV-1), DIH, é uma forma de eczema grave e recidivante que incide principalmente em crianças que em geral foram verticalmente infectadas pelo HTLV-1, ocorrendo lesões eritematosas, escamativas e crostosas, sendo geralmente localizadas nas regiões do couro cabeludo e retroauriculares, assim como pescoço, virilha, região paranasal, axilas, ouvido externo e narinas. Inicia-se após os 18 meses de vida e raramente persiste até a vida adulta. No Brasil, muitos casos têm sido diagnosticados na Bahia, estado brasileiro que atualmente conta com a maior casuística da literatura depois da Jamaica. Acompanhando uma coorte de 31 pacientes da faixa etária infanto-juvenil com DIH em Salvador, observou-se em esfregaço do sangue periférico, em 11 dos indivíduos, o aparecimento de linfócitos atípicos (LA) e/ou células em flor (CF), que não são comumente observados em pacientes com DIH, mas ocorrem com frequência em pacientes com leucemia/linfoma de células T do adulto (ATL). Submetemos amostras dos 31 pacientes a reações em cadeia da polimerase (PCR)...

Infective dermatitis associated with human T lymphotropic cells virus type 1 (HTLV-1), IDH, is a form of severe and recurrent dermatitis that occurs mostly in children who were mainly vertically infected with HTLV-1, occurring erythematous, desquamative and crusty, being generally located in regions of the scalp and retroauricular, neck, groin, paranasal region, armpits, outer ear and nostrils. It begins after 18 months of life and rarely persists into adulthood. In Brazil, several cases have been diagnosed in Bahia, the Brazilian state that currently has the highest incidence after Jamaica. Tracking a cohort of 31 patients in the juvenile age group with IDH in Salvador, we observed the appearance of atypical lymphocytes (AL) and/or flower cells (FC), which are not commonly observed in patients with IDH, but occur frequently in patients with adult T cell leukemia/lymphoma (ATL), in peripheral blood smear in 11 of the subjects. Samples of 31 patients underwent tests of PCR...