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1.
Rev. Assoc. Med. Bras. (1992) ; 65(3): 326-329, Mar. 2019. graf
Article in English | LILACS | ID: biblio-1003043

ABSTRACT

SUMMARY Eosinophilic fasciitis, or Shulman's disease, is a rare disease of unknown etiology. It is characterized by peripheral eosinophilia, hypergammaglobulinemia, and high erythrocyte sedimentation rate. The diagnosis is confirmed by a deep biopsy of the skin. The first line of treatment is corticotherapy. We present a rare case of eosinophilic fasciitis in a 27-year-old woman with an atypical presentation with symmetrical peripheral edema and a Groove sign. The patient responded well to treatment with corticosteroids at high doses and, in this context, was associated with hydroxychloroquine and azathioprine. After two and a half years, peripheral eosinophilia had increased, and more of her skin had hardened. At that time, the therapy was modified to include corticoids, methotrexate, and penicillamine. It is of great importance to publicize these cases that allow us to gather experience and better treat our patients.


RESUMO A fasciite eosinofílica ou doença de Shulman é uma doença rara de etiologia desconhecida. É caracterizada por eosinofilia periférica, hipergamaglobulinemia e velocidade de sedimentação eritrocitária elevada. O diagnóstico é confirmado por biópsia profunda da pele. O tratamento de primeira linha é a corticoterapia. Apresentamos um caso raro de fasciite eosinofílica numa mulher de 27 anos com uma apresentação atípica com edema periférico simétrico e sinal de Groove. A paciente respondeu bem ao tratamento com corticoides, mas em doses elevadas, e, nesse contexto, associou-se hidroxicloroquina e azatioprina. Ao fim de dois anos e meio verificou-se aumento de eosinofilia e novamente pele mais endurecida. Nessa altura alterou-se a terapêutica para corticoides, metrotexato e penicilamina. É de grande importância a divulgação desses casos que nos permitem reunir experiência e assim melhor tratar os nossos doentes.


Subject(s)
Humans , Female , Adult , Eosinophilia/pathology , Fasciitis/pathology , Skin/pathology , Biopsy , Magnetic Resonance Imaging , Treatment Outcome , Rare Diseases , Edema/pathology , Eosinophilia/drug therapy , Eosinophilia/diagnostic imaging , Fasciitis/drug therapy , Fasciitis/diagnostic imaging
2.
Rev. Soc. Bras. Med. Trop ; 52: e20180526, 2019. tab, graf
Article in English | LILACS | ID: biblio-1020439

ABSTRACT

Abstract INTRODUCTION: Crotalus envenomations cause serious complications and can be fatal without appropriate treatment. Venom isoforms present and inter/intraspecific variations in the venom composition can result in different symptoms presented by bites by snakes from the same species but from different geographical regions. We comparatively evaluated the local and systemic effects caused by Crotalus durissus terrificus (Cdt), C.d. collilineatus (Cdcolli), and C.d. cascavella (Cdcasc) envenomation. METHODS: Venom chromatography was performed. Proteolytic, phospholipase, and LAAO activities were analyzed. Edema, myotoxicity, hepatotoxicity, nephrotoxicity, and coagulation alterations were evaluated. RESULTS: The venom SDS-PAGE analyses found the presence of convulxin, gyroxin, crotoxin, and crotamine in Cdt and Cdcolli venoms. Crotamine was not present in the Cdcasc venom. Cdt, Cdcollli, and Cdcasc venoms had no proteolytic activity. Only Cdcasc and Cdt venoms had phospholipase activity. LAAO activity was observed in Cdcolli and Cdcasc venoms. Cdcolli and Cdcasc venoms caused 36.7% and 13.3% edema increases, respectively. Cdt venom caused a 10% edema induction compared to those by other venoms. All venoms increased TOTAL-CK, MB-CK, and LDH levels (indicating muscle injury) and ALT, AST, GGT, and ALP levels (markers of liver damage) and were able to induce a neuromuscular blockade. Urea and creatinine levels were also altered in both plasma and urine, indicating kidney damage. Only Cdcolli and Cdcasc venoms increased TAPP and TAP. CONCLUSIONS: Together, these results allow us to draw a distinction between local and systemic effects caused by Crotalus subspecies, highlighting the clinical and biochemical effects produced by their respective venoms.


Subject(s)
Animals , Crotalus/classification , Crotalid Venoms/toxicity , Edema/chemically induced , Kidney/drug effects , Liver/drug effects , Urea/blood , Creatine Kinase/drug effects , Creatine Kinase/blood , Creatinine/blood , Models, Animal , Edema/pathology , Electrophoresis, Polyacrylamide Gel , Alkaline Phosphatase/drug effects , Alkaline Phosphatase/blood , Transaminases/drug effects , Transaminases/blood , Kidney/pathology , L-Lactate Dehydrogenase/drug effects , L-Lactate Dehydrogenase/blood , Liver/pathology , Mice
3.
Braz. oral res. (Online) ; 32: e42, 2018. tab, graf
Article in English | LILACS | ID: biblio-889494

ABSTRACT

Abstract: Based on aroeira's (Myracrodruon urundeuva) antimicrobial activity and a future trend to compose intracanal medication, the aim of this study was to assess in vivo inflamatory tissue response to the extracts by edemogenic and histological analysis containing inactivated facultative and anaerobic microorganisms. For edema quantification, eighteen animals were divided into three groups (n = 3, periods: 3 and 6 hours) and 0.2 mL of 1% Evans blue per 100 g of body weight was injected into the penile vein under general anesthesia. After 30 min the animals received a subcutaneous injection in the dorsal region of aqueous or ethanolic extract of aroeira or saline (control) containing inactivated bacteria. Samples were collected, immersed in formamide for 72h, and evaluated by spectrophotometry (630 m). For histological analysis, polyethylene tubes with the extracts were implanted in the dorsal of 30 male rats. Analysis of the fibrous capsule and inflammatory infiltrate were performed after 7 and 30 days. The aqueous extract group induced less edema in both postoperative periods compared to the other groups, but the differences were not significant (p > 0.05). Tissue repair was significantly better after 30 days than after 7 days (p < 0.01). The aqueous solution showed less inflammatory response than the ethanolic solution (p < 0.05), with tendency for better results than control after 7 days. After 30 days, the response to both extracts was similar to control. The aqueous and ethanolic aroeira extracts containing inactivated microorganisms showed a trend for better results than saline, even when associated with microorganisms, and facilitated the tissue repair process.


Subject(s)
Animals , Male , Rats , Anacardiaceae/chemistry , Edema/prevention & control , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Inflammation/prevention & control , Plant Extracts/pharmacology , Subcutaneous Tissue/microbiology , Edema/pathology , Gram-Negative Bacteria/classification , Gram-Positive Bacteria/classification , Inflammation/pathology , Rats, Wistar , Subcutaneous Tissue/drug effects , Subcutaneous Tissue/pathology , Time Factors
4.
Einstein (Säo Paulo) ; 15(4): 457-464, Oct.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-891430

ABSTRACT

ABSTRACT Objective: Translate to brazilian portuguese, culturally adapt and test the rating and classification scales of cervicofacial lymphedema of the MD Anderson Cancer Center Head and Neck Lymphedema Protocol (MDACC HNL) in patients undergoing treatment for head and neck cancer. Methods: The process followed international guidelines and translation stages by two head and neck surgeons, and back translation independently by two native Americans. The test of final version was based on the evaluation of 18 patients by one speech pathologist and one physical therapist who applied the scales in Portuguese. Results: The translation of the three scales was carried out independently and the translators reached a consensus for the final version. Minor modifications were made by translating two terms into the Assessment of the Face. Versions of back-translation were similar to each other. The instrument was successfully applied to patients independently. Conclusion: The translation and cultural adaptation of the assessment and rating scale of the cervicofacial lymphedema of the MD Anderson Cancer Center Head and Neck Lymphedema Protocol to the Brazilian Portuguese were successful.


RESUMO Objetivo: Traduzir, para o português brasileiro, adaptar culturalmente e testar as escalas de avaliação e classificação do linfedema cérvico-facial do MD Anderson Cancer Center Head and Neck Lymphedema Protocol (MDACC HNL) em pacientes submetidos ao tratamento para o câncer de cabeça e pescoço. Métodos: O processo seguiu as diretrizes internacionais e as etapas de tradução por dois cirurgiões de cabeça e pescoço, além de retrotradução de forma independente por dois nativos norte-americanos. O teste da versão final foi realizado a partir da avaliação de 18 pacientes por um fonoaudiólogo e um fisioterapeuta, por meio da aplicação das escalas em português. Resultados: A tradução das três escalas foi realizada de forma independente, e os tradutores chegaram a um consenso para a versão final. Foram feitas pequenas modificações, ao serem traduzidos dois termos em Assessment of the Face . As versões da retrotradução foram semelhantes entre si. O instrumento foi aplicado com sucesso nos pacientes de forma independente. Conclusão: A tradução e a adaptação das escalas de avaliação e classificação do linfedema cérvico-facial do MD Anderson Cancer Center Head and Neck Lymphedema protocol para o português foram bem sucedidas.


Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , Surveys and Questionnaires/standards , Head and Neck Neoplasms/therapy , Lymphedema/etiology , Neck Dissection/adverse effects , Translations , Fibrosis , Brazil , Cross-Cultural Comparison , Reproducibility of Results , Edema/etiology , Edema/pathology , Head and Neck Neoplasms/complications , Head and Neck Neoplasms/pathology , Language , Lymphedema/surgery , Lymphedema/diagnosis , Lymphedema/pathology , Middle Aged , Neoplasm Staging
5.
Rev. méd. Chile ; 145(12): 1624-1625, dic. 2017. graf
Article in Spanish | LILACS | ID: biblio-902488

ABSTRACT

The main adverse effects of dopaminergic drugs used in Parkinson's disease are hypotension, somnolence, hallucinations and impulse control disorder. Less common is leg edema. We report on a 68-year-old male receiving levodopa and pramipexole consulting for severe leg edema lasting two years, whose etiology was not ascertained with multiple lab tests. This edema subsided substantially when pramipexole was discontinued and the dose of levodopa was increased to treat motor symptoms.


Subject(s)
Humans , Male , Aged , Parkinson Disease/drug therapy , Dopamine Agonists/adverse effects , Edema/chemically induced , Edema/pathology , Benzothiazoles/adverse effects , Leg/pathology , Levodopa/adverse effects , Pramipexole , Antiparkinson Agents/adverse effects
7.
An. acad. bras. ciênc ; 89(3,supl): 2433-2443, 2017. tab, graf
Article in English | LILACS | ID: biblio-886814

ABSTRACT

ABSTRACT The focus of this study was to test the hypothesis that there would be no difference between the biocompatibility of resin-modified glass ionomer cements. Sixty male Wistar rats were selected and divided into four groups: Control Group; Crosslink Group; RMO Group and Transbond Group. The materials were inserted into rat subcutaneous tissue. After time intervals of 7, 15 and 30 days morphological analyses were performed. The histological parameters assessed were: inflammatory infiltrate intensity; reaction of multinucleated giant cells; edema; necrosis; granulation reaction; young fibroblasts and collagenization. The results obtained were statistically analyzed by the Kruskal-Wallis and Dunn test (P<0.05). After 7 days, Groups RMO and Transbond showed intense inflammatory infiltrate (P=0.004), only Group RMO presented greater expression of multinucleated giant cell reaction (P=0.003) compared with the control group. After the time intervals of 15 and 30 days, there was evidence of light/moderate inflammatory infiltrate, lower level of multinucleated giant cell reaction and thicker areas of young fibroblasts in all the groups. The hypothesis was rejected. The Crosslink cement provided good tissue response, since it demonstrated a lower level of inflammatory infiltrate and higher degree of collagenization, while RMO demonstrated the lowest level of biocompatibility.


Subject(s)
Animals , Male , Rats , Biocompatible Materials/pharmacology , Materials Testing , Subcutaneous Tissue/drug effects , Glass Ionomer Cements/pharmacology , Time Factors , Double-Blind Method , Rats, Wistar , Subcutaneous Tissue/pathology , Edema/pathology , Fibroblasts/drug effects , Necrosis/pathology
8.
An. bras. dermatol ; 91(5,supl.1): 157-159, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-837948

ABSTRACT

Abstract Morbihan syndrome is a rare entity that more commonly affects women in the third or fourth decade of life. It is considered a special form of rosacea and its pathogenesis is not fully known. It is clinically characterized by the slow appearance of erythema and solid edemas on the upper portion of the face, with accentuation in the periorbital region, forehead, glabella, nose, and cheeks. We report the case of a patient presented with edema on the upper eyelid for a year. These findings suggested the diagnosis of Morbihan syndrome. We aim to report a rare, particularly refractory and chronic form of rosacea, which has received little attention in the literature.


Subject(s)
Humans , Male , Adult , Rosacea/pathology , Edema/pathology , Erythema/pathology , Syndrome , Biopsy , Chronic Disease , Dermis/pathology , Eyelid Diseases/pathology
9.
Acta cir. bras ; 31(4): 278-285, Apr. 2016. tab, graf
Article in English | LILACS | ID: lil-781333

ABSTRACT

PURPOSE: To investigate gender differences in the evolution of the inflammatory process in rats subjected to brain death (BD). METHODS: Adult Wistar rats were divided into three groups: female; ovariectomized female; and male rats. BD was induced using intracranial balloon inflation and confirmed by maximal pupil dilatation, apnea, absence of reflex, and drop of mean arterial pressure. Six hours after BD, histological evaluation was performed in lungs, heart, liver and kidneys, and levels of inflammatory proteins, estrogen, progesterone, and corticosterone were determined in plasma. RESULTS: In the lungs, females presented more leukocyte infiltration compared to males (p<0.01). Ovariectomized female rat lungs were more hemorrhagic compared to other groups (p<0.001). In the heart, females had higher leukocyte infiltration and tissue edema compared to males (p<0.05). In the liver and kidneys, there were no differences among groups. In female group estradiol and progesterone were sharply reduced 6 hours after BD (p<0.001) to values observed in ovariectomized females and males. Corticosterone levels were similar. CONCLUSIONS: Sex hormones influence the development of inflammation and the status of organs. The increased inflammation in lungs and heart of female rats might be associated with the acute reduction in female hormones triggered by BD.


Subject(s)
Animals , Male , Female , Brain Death/pathology , Sex Characteristics , Kidney/pathology , Liver/pathology , Lung/pathology , Myocardium/pathology , Organ Specificity , Progesterone/blood , Reference Values , Time Factors , Ovariectomy , Sex Factors , Rats, Wistar , Edema/pathology , Estradiol/blood , Chemokine CXCL1/analysis , Chemokine CXCL2/analysis , Inflammation/pathology
10.
Arch. argent. dermatol ; 66(1): 5-8, ene.-feb. 2016. ilus
Article in Spanish | LILACS | ID: biblio-913733

ABSTRACT

Se presenta a un paciente de 18 años de edad, con antecedentes de hipotiroidismo y acné leve. Consulta por edema facial persistente, a predominio de la mitad superior del rostro, de 7 meses de evolución. El mismo es indoloro, con un leve eritema, principalmente en párpados, y con temperatura local conservada. Se le solicitan estudios complementarios y se lo trata con antihistamínicos sin mejoría. Se toma biopsia de piel y con el diagnóstico de enfermedad de Morbihan se inicia tratamiento con isotretinoína a dosis de 20 mg/día durante seis meses, con respuesta muy favorable (AU)


An 18-year-old male patient with hypothyroidism and mild acne is reported. He consults for a 7-month history of persistent facial edema, predominantly on the upper half of the face. Edema is painless, with eyelids mild erythema and local temperature preserved. Additional tests are requested and treatment with antihistamines is unsuccessful. Skin biopsy is undertaken with Morbihan disease diagnosis. Patient is treated with oral isotretinoin in a daily dose of 20 mg/day for six months, with significant clinical improvement (AU)


Subject(s)
Humans , Male , Adolescent , Edema/pathology , Erythema/diagnosis , Facial Dermatoses , Biopsy , Isotretinoin/therapeutic use , Rosacea/diagnosis
11.
An. bras. dermatol ; 90(6): 909-911, Nov.-Dec. 2015. graf
Article in English | LILACS | ID: lil-769508

ABSTRACT

Abstract: Morbihan Syndrome is a rare entity with unknown etiology. It is clinically characterized by chronic erythematous edema on the face - especially in the middle and upper third of the face - and creates abnormal facial contours that are initially intermitent but become permanent with the development of the syndrome. The histopathology is nonspecific and its therapy is a major challenge due to poor response to the various treatment options. We present the case of a male patient with a five-month-history of disease.


Subject(s)
Humans , Male , Adult , Edema/pathology , Erythema/pathology , Facial Dermatoses/pathology , Syndrome , Blepharitis/pathology , Chronic Disease
12.
Article in English | IMSEAR | ID: sea-159497

ABSTRACT

Neurofibromas (NF) are seen either as a solitary lesion or as part of the generalized syndrome of NF (NF-1, also known as Von Recklinghausen disease of the skin). In plexiform neurofibroma (PN), there is proliferation of Schwann cells from the inner aspect of the nerve sheath, thereby resulting in an irregularly thickened, distorted, tortuous structure. Oral involvement by a solitary and peripheral PN in patients with no other signs of NF is rarely seen. It is reported that only 4-7% of patients affected by NF display oral manifestations. A solitary PN in a patient with no other symptoms is a diagnostic challenge, more so when the location of the lesion is one of the rarest sites.


Subject(s)
Child , Edema/diagnosis , Edema/etiology , Edema/pathology , Humans , Lip/pathology , Male , Neurofibroma, Plexiform/anatomy & histology , Neurofibroma, Plexiform/complications , Neurofibroma, Plexiform/diagnosis , Neurofibroma, Plexiform/pathology , Neurofibromatosis 1/anatomy & histology , Neurofibromatosis 1/complications , Neurofibromatosis 1/diagnosis , Neurofibromatosis 1/pathology
13.
Salud colect ; 11(1): 49-65, ene.-mar. 2015.
Article in Spanish | LILACS | ID: lil-746684

ABSTRACT

Desde el año 1931 y, especialmente, desde el Código de Núremberg de 1947, un creciente número de declaraciones, regulaciones, normas, guías, leyes, resoluciones y disposiciones pretenden generar condiciones para una mejor protección de los sujetos que participan en estudios de investigación, aunque también algunas implican retrocesos en el respeto a los derechos de poblaciones vulnerables. Sin embargo, todavía no se ha podido evitar la violación de la dignidad de los sujetos de experimentación en ensayos clínicos. Lo que se investiga, cómo se investiga, la calidad y transparencia de los datos obtenidos, el análisis y la publicación de los resultados (tanto de los datos crudos como de los ya elaborados) están sometidos a la lógica del lucro, la cual presenta una tensión permanente con los principios bioéticos y las necesidades de la sociedad. Es necesario el protagonismo activo de los pueblos para que la investigación farmacológica, sus resultados y aplicaciones avancen en un rumbo que subordine el beneficio económico a la protección de los derechos humanos.


Since 1931, and especially since the Nuremberg Code of 1947, an increasing number of declarations, regulations, norms, guidelines, laws, resolutions, and rules intended to create conditions for better protection of subjects participating in research studies have been published, although some have meant setbacks in the human rights of vulnerable populations. As such, violations of the dignity of experimental subjects in clinical trials continue. What researchers investigate and how the research is done, the quality and transparency of the data, and the analysis and the publication of results (of both raw and processed data) respond to the financial interests of the pharmaceutical companies, coming into permanent tension with bioethical principles and the needs of society. The active participation of civil society is necessary to make it so that pharmaceutical research, results and applications subordinate economic benefits to the protection of human rights.


Subject(s)
Adult , Humans , Male , Arrhythmogenic Right Ventricular Dysplasia/diagnosis , Cardiomyopathy, Dilated/diagnosis , Heart Aneurysm/diagnosis , Atrophy/pathology , Edema/pathology , Fibrosis/pathology , Magnetic Resonance Angiography/methods , Myocardium/pathology
15.
Article in English | WPRIM | ID: wpr-183062

ABSTRACT

OBJECTIVE: We aimed to describe radiologic signs and time-course of imatinib-associated fluid retention (FR) in patients with gastrointestinal stromal tumor (GIST), and its implications for management. MATERIALS AND METHODS: In this Institutional Review Board-approved, retrospective study of 403 patients with GIST treated with imatinib, 15 patients with imaging findings of FR were identified by screening radiology reports, followed by manual confirmation. Subcutaneous edema, ascites, pleural effusion, and pericardial effusion were graded on a four-point scale on CT scans; total score was the sum of these four scores. RESULTS: The most common radiologic sign of FR was subcutaneous edema (15/15, 100%), followed by ascites (12/15, 80%), pleural effusion (11/15, 73%), and pericardial effusion (6/15, 40%) at the time of maximum FR. Two distinct types of FR were observed: 1) acute/progressive FR, characterized by acute aggravation of FR and rapid improvement after management, 2) intermittent/steady FR, characterized by occasional or persistent mild FR. Acute/progressive FR always occurred early after drug initiation/dose escalation (median 1.9 month, range 0.3-4.0 months), while intermittent/steady FR occurred at any time. Compared to intermittent/steady FR, acute/progressive FR was severe (median score, 5 vs. 2.5, p = 0.002), and often required drug-cessation/dose-reduction. CONCLUSION: Two distinct types (acute/progressive and intermittent/steady FR) of imatinib-associated FR are observed and each type requires different management.


Subject(s)
Adult , Aged , Aged, 80 and over , Antineoplastic Agents/adverse effects , Ascites/pathology , Benzamides/adverse effects , Echocardiography/methods , Edema/pathology , Female , Gastrointestinal Stromal Tumors/drug therapy , Gastrointestinal Tract/pathology , Heart Failure/diagnostic imaging , Humans , Male , Middle Aged , Molecular Targeted Therapy/adverse effects , Pericardial Effusion/pathology , Peritoneal Neoplasms/diagnosis , Piperazines/adverse effects , Pleural Effusion/pathology , Pyrimidines/adverse effects , Radiology , Retrospective Studies , Tomography, X-Ray Computed
16.
Braz. j. med. biol. res ; 47(12): 1075-1084, 12/2014. tab, graf
Article in English | LILACS | ID: lil-727668

ABSTRACT

In this study, we investigated the potential role of high-mobility group box 1 (HMGB1) in severe acute pancreatitis (SAP) and the effects of growth hormone (G) and somatostatin (S) in SAP rats. The rats were randomly divided into 6 groups of 20 each: sham-operated, SAP, SAP+saline, SAP+G, SAP+S and SAP+G+S. Ileum and pancreas tissues of rats in each group were evaluated histologically. HMGB1 mRNA expression was measured by reverse transcription-PCR. Levels of circulating TNF-α, IL-1, IL-6, and endotoxin were also measured. In the SAP group, interstitial congestion and edema, inflammatory cell infiltration, and interstitial hemorrhage occurred in ileum and pancreas tissues. The levels of HMGB1, TNF-α, IL-1, IL-6 and endotoxin were significantly up-regulated in the SAP group compared with those in the sham-operated group, and the 7-day survival rate was 0%. In the SAP+G and SAP+S groups, the inflammatory response of the morphological structures was alleviated, the levels of HMGB1, TNF-α, IL-1, IL-6, and endotoxin were significantly decreased compared with those in the SAP group, and the survival rate was increased. Moreover, in the SAP+G+S group, all histological scores were significantly improved and the survival rate was significantly higher compared with the SAP group. In conclusion, HMGB1 might participate in pancreas and ileum injury in SAP. Growth hormone and somatostatin might play a therapeutic role in the inflammatory response of SAP.


Subject(s)
Animals , Male , Growth Hormone/metabolism , HMGB1 Protein/metabolism , Pancreas/pathology , Pancreatitis, Acute Necrotizing/etiology , Somatostatin/metabolism , Edema/pathology , Endotoxins/blood , Gene Expression , HMGB1 Protein/genetics , Hematoma/pathology , Ileum/injuries , Ileum/pathology , Interleukin-1beta/blood , /blood , Microscopy, Electron, Transmission , Neutrophil Infiltration/physiology , Pancreas/injuries , Pancreas/metabolism , Pancreatitis, Acute Necrotizing/metabolism , Pancreatitis, Acute Necrotizing/pathology , Random Allocation , Rats, Sprague-Dawley , Reverse Transcriptase Polymerase Chain Reaction , RNA, Messenger/isolation & purification , Survival Rate , Tumor Necrosis Factor-alpha/blood
17.
Indian J Dermatol Venereol Leprol ; 2014 Spt-Oct ; 80 (5): 402-408
Article in English | IMSEAR | ID: sea-154917

ABSTRACT

Background: Leprosy remains an important health problem mainly in the African and South-East Asia regions. Type 1 reaction is an immune-mediated phenomenon known to complicate at least 30% of patients of leprosy. Diagnosing type 1 reaction correctly is important for timely institution of therapy to prevent and treat neuropathy-associated disability and morbidity. There is paucity of literature on definitive criteria for histologic diagnosis of type 1 reaction. This study was conducted to determine the key histologic variables for diagnosing type 1 reaction. Methods: This was a prospective study recruiting 104 patients with borderline leprosy. Three pathologists blinded to the clinical diagnosis independently assessed the cases. The agreement between each histological variable and clinical diagnosis was then calculated by using Cohen's kappa (Κ) coefficient. Results: Histological diagnosis of type 1 reaction was given to 27 (67.5%) of 40 clinically diagnosed cases of type 1reaction cases. Histological variables chosen as key variables for histological diagnosis of type 1 reaction were presence of giant cells, dermal edema, intragranuloma edema, granuloma fraction 31-50%, and presence of medium to large giant cells. Conclusion: This study has shown that T1R are still underdiagnosed histologically in comparison with clinical assessments. The key variables for diagnosing type 1 reaction were proposed


Subject(s)
Adult , Apoptosis , Biopsy , Case-Control Studies , Edema/pathology , Female , Giant Cells/pathology , Granuloma/pathology , Humans , Leprosy, Borderline/pathology , Male , Prospective Studies , Skin/pathology
18.
Indian J Exp Biol ; 2014 Aug; 52(8): 763-772
Article in English | IMSEAR | ID: sea-153757

ABSTRACT

Nanoscience and Nanotechnology have found their way in the fields of pharmacology and medicine. The conjugation of drug to nanoparticles combines the properties of both. In this study, gold nanoparticle (GNP) was conjugated with NKCT1, a cytotoxic protein toxin from Indian cobra venom for evaluation of anti-arthritic activity and toxicity in experimental animal models. GNP conjugated NKCT1 (GNP-NKCT1) synthesized by NaBH4 reduction method was stable at room temperature (25±2 °C), pH 7.2. Hydrodynamic size of GNP-NKCT1 was 68–122 nm. Arthritis was developed by Freund's complete adjuvant induction in male albino rats and treatment was done with NKCT1/GNP-NKCT1/standard drug. The paw/ankle swelling, urinary markers, serum markers and cytokines were changed significantly in arthritic control rats which were restored after GNP-NKCT1 treatment. Acute toxicity study revealed that GNP conjugation increased the minimum lethal dose value of NKCT1 and partially reduced the NKCT1 induced increase of the serum biochemical tissue injury markers. Histopathological study showed partial restoration of toxic effect in kidney tissue after GNP conjugation. Normal lymphocyte count in culture was in the order of GNP-NKCT1>NKCT1>Indomethacine treatment. The present study confirmed that GNP conjugation increased the antiarthritic activity and decreased toxicity profile of NKCT1.


Subject(s)
Animals , Arthritis, Experimental/drug therapy , Arthritis, Experimental/pathology , Edema/drug therapy , Edema/pathology , Elapid Venoms/administration & dosage , Elapid Venoms/chemistry , Elapidae , Gold/administration & dosage , Gold/chemistry , Humans , Lymphocyte Count , Metal Nanoparticles/administration & dosage , Metal Nanoparticles/chemistry , Mice , Rats
19.
Indian J Dermatol Venereol Leprol ; 2014 May-Jun; 80(3): 250-253
Article in English | IMSEAR | ID: sea-154825

ABSTRACT

Adult onset Still's disease is a rare but potentially serious disease. We present five cases of adult-onset Still's disease seen by us over a period of one year. The patients were all females and 28-39 years of age. Symptoms had been present for 2-6 weeks in three patients. The other two had been on a few years' follow-up for rheumatoid arthritis before the onset of rashes and fever. The patients had persistent erythematous maculopapular eruptions on face, body and extremities, with moderate to severe pruritus and/or a burning sensation that decreased their quality of life. The typical evanescent rash was not observed. High ferritin values were detected in all the patients and total serum IgE was increased in two. All the patients were started on oral prednisolone (0.5-1.0 mg/kg/day), and methotrexate (10-15 mg/week) had to be added in three patients. One patient was started on tocilizumab due to recalcitrant disease and one was lost to follow-up. Further investigation and classification of the various atypical cutaneous findings in adult-onset Still's disease is necessary.


Subject(s)
Adult , Edema/pathology , Erythema/pathology , Exanthema/pathology , Female , Humans , Skin/pathology , Still's Disease, Adult-Onset/pathology
20.
An. bras. dermatol ; 89(2): 250-258, Mar-Apr/2014. tab, graf
Article in English | LILACS | ID: lil-706983

ABSTRACT

BACKGROUND: Fractional non-ablative lasers keep the epidermis intact, while fractional ablative lasers remove it, making them theoretically more effective. OBJECTIVES: To evaluate the clinical and histological alterations induced by fractional photothermolysis for treating photoaging, comparing the possible equivalence of multiple sessions of 1540nm Erbium, to one session of 2940nm Erbium. METHODS: Eighteen patients (mean age 55.9) completed the treatment with three sessions of 1540nm fractional Erbium laser on one side of the face (50 mJ/mB, 15ms, 2 passes), and one session of 2940nm on the other side (5mJ/mB, 0.25ms, 2 passes). Biopsies were performed before and 3 months after treatment. Clinical, histological and morphometric evaluations were carried out. RESULTS: All patients presented clinical improvement with no statistically significant difference (p> 0.05) between the treated sides. Histopathology revealed a new organization of collagen and elastic fibers, accompanied by edema, which was more evident with the 2940nm laser. This finding was confirmed by morphometry, which showed a decrease in collagen density for both treatments, with a statistical significance for the 2940nm laser (p > 0.001). CONCLUSIONS: Three 1540nm sessions were clinically equivalent to one 2940nm session. The edema probably contributed to the positive results after three months, togheter with the new collagen and elastic fibers organization. The greater edema after the 2940nm session indicates that dermal remodeling takes longer than with 1540nm. It is possible that this histological superiority relates to a more prolonged effect, but a cohort longer than three months is needed to confirm that supposition. .


Subject(s)
Female , Humans , Middle Aged , Dose Fractionation, Radiation , Laser Therapy/methods , Lasers, Solid-State/therapeutic use , Skin Aging/radiation effects , Biopsy , Collagen/radiation effects , Edema/pathology , Elastic Tissue/radiation effects , Face/radiation effects , Pain Measurement , Psychometrics , Skin/pathology , Skin/radiation effects , Time Factors , Treatment Outcome
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