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1.
Autops. Case Rep ; 7(1): 13-15, Jan.-Mar. 2017. ilus
Article in English | LILACS | ID: biblio-905123

ABSTRACT

Dialysis-related amyloidosis predominantly occurs in osteo-articular structures and dialysis-related amyloid (DRA) substances also deposit in extra-articular tissues. Clinical manifestations of DRA include odynophagia, gastrointestinal hemorrhage, intestinal obstruction, kidney stones, myocardial dysfunction, and subcutaneous tumors. The pathological characteristics of DRA in the heart of hemodialysis patients have rarely been reported. We report the case of a 73-year-old female with a history of cerebral palsy and end-stage renal disease status post two failed renal transplants who had been on hemodialysis for 30 years. The patient was admitted with the working diagnosis of pneumonia. An echocardiography showed markedly reduced biventricular function manifested by low blood pressure with systolic in the 70s and elevated pulmonary artery pressure of 45 mmHg, which did not respond to therapy. Following her demise, the autopsy revealed bilateral pulmonary edema and pleural effusions. There was cardiac amyloid deposition exclusively in the coronary arteries but not in the perimyocytic interstitium. Amyloids were also found in pulmonary and intrarenal arteries and the colon wall. Previous case reports showed that beta 2-microglobulin amyloid deposits in various visceral organs but less frequently in the atrial and/or the ventricular myocardium. In the present case, amyloids in the heart were present in the intramural coronary arteries causing myocardial ischemia and infarction, which was the immediate cause of death.


Subject(s)
Humans , Female , Aged , Amyloidosis/pathology , Coronary Vessels/pathology , Myocardial Ischemia/pathology , Pleural Effusion/pathology , Pulmonary Edema/pathology , Renal Dialysis/adverse effects , Autopsy , Cause of Death , Infarction/pathology , Pneumonia/diagnosis
5.
Rev. bras. ginecol. obstet ; 31(1): 10-16, jan. 2009. ilus, tab
Article in Portuguese | LILACS | ID: lil-509877

ABSTRACT

OBJETIVO: determinar a prevalência de alterações histopatológicas em placentas humanas, relacionadas às síndromes hipertensivas. MÉTODOS: estudo de corte transversal, que comparou as alterações histopatológicas identificadas em 43 placentas oriundas de gestantes do grupo de hipertensas (GrHip) com as de 33 placentas de gestantes do grupo de normotensas (GrNor). Foram analisados o peso, volume e ocorrência macro e microscópica de infartos, coágulos, hematomas, aterose (obliteração parcial, espessamento de camadas e presença de vasos hialinizados) e alterações de Tenney-Parker (ausentes, discretas e proeminentes), bem como a localização de infartos e coágulos (central, periférico ou associação de ambos). Para a análise estatística foram usados os testes do χ2 e t de Student, bem como médias, desvios padrões e percentuais. Considerou-se como significante um p<0,05. RESULTADOS: o estudo macroscópico revelou que as placentas do GrHip, se comparadas às do GrNor, apresentaram menor peso (461,1 versus 572,1 g) e volume (437,4 versus 542,0 cm³) e percentuais aumentados de infartos (51,2 versus 45,5 por cento; p<0,05; OR=1,15) e de coágulos (51,2 versus 15,1 por cento; p<0,05; OR=5,4). Nos GrHip e GrNor, os infartos microscópicos ocorreram em 83,7 e 45,5 por cento; p<0,05; OR=4,3, respectivamente. A aterose e as alterações de Tenney-Parker associaram-se estatisticamente às síndromes hipertensivas (p<0,05). CONCLUSÕES: os dados obtidos permitem associar menor peso e volume placentário, maior percentual de infartos macro e microscópicos, coágulos, aterose e alterações de Tenney-Parker às placentas relacionadas com gestações que cursaram com síndromes hipertensivas.


PURPOSE: to determine the prevalence of histopathological changes, in human placentas, related to hypertensive syndromes. METHODS: a transversal study that compares histopathological changes identified in 43 placentae from hypertensive pregnant women (HypPr), with the ones from 33 placentae from normotensive pregnant women (NorPr). The weight, volume and macroscopic and microscopic occurrence of infarctions, clots, hematomas, atherosis (partial obliteration, thickness of layers and presence of blood vessels hyalinization) and Tenney-Parker changes (absent, discreet and prominent), as well as the locating of infarctions and clots (central, peripheral or the association of both) have been analyzed. The χ2 and t Student tests have been used for the statistical analysis, as well as medians, standard deviations and ratios. It has been considered as significant, p<0.05. RESULTS: the macroscopic study of HypPr placentae have presented lower weight (461.1 versus 572.1 g) and volume (437.4 versus 542.0 cm³), higher infarction (51.2 versus 45.5 percent; p<0.05: OR=1.15) and clots (51.2 versus 15.1 percent; p<0.05; OR=5.4) ratios, as compared to the NorPr's. In the HypPr and NorPr, microscopic clots have occurred in 83.7 versus 45.5 percent (p<0.05; OR=4.3), respectively. Atherosis and Tenney-Parker changes have been statistically associated to the hypertensive syndromes (p<0.05). CONCLUSIONS: the obtained data allow us to associate lower placentary weight and volume, higher ratio of macro and microscopic infarction, clots, atherosis and Tenney-Parker changes to placentae of gestations occurring with hypertensive syndromes.


Subject(s)
Female , Humans , Pregnancy , Hypertension/pathology , Placenta Diseases/pathology , Placenta/pathology , Pregnancy Complications, Cardiovascular/pathology , Cross-Sectional Studies , Infarction/pathology , Organ Size , Placenta/blood supply , Thrombosis/pathology
7.
Indian J Pathol Microbiol ; 2007 Oct; 50(4): 698-701
Article in English | IMSEAR | ID: sea-74506

ABSTRACT

Remarkable changes are seen on gross and microscopic examination of placenta of patients with sickle cell disorders, hence the present study was undertaken to find out the pathological changes seen in the placenta of sickle cell disorder patients, as compared to control and to study the effect of maternal sickling on the fetus. It includes total 73 cases, of which 10 were of control group and 63 were from patients with sickle cell disorders, which included 47 sickle cell trait (AS) and 16 sickle cell disease (SS) patients. In group II, 9 (14.28%) patients with SS pattern developed complications during pregnancy, in the form of vaso-occlusive and hemolytic crises. Pregnancy induced hypertension was seen in 4 (25%) out of 16 SS and 11 (23.40%) of the 47 AS patients. Urinary tract infection (UTI) was seen in 6 (37.5%) out of 16 SS and 8 (17.02%) out of 47 AS patients. Placentae in sickle cell disorders showed pathological changes in the form of infarction, calcification, sickled red blood cells and hemorrhage in intervillous spaces, increased syncytial knots, fibrinoid necrosis, stromal fibrosis, hyalinised villi and compensatory proliferation of trophoblastic cells.


Subject(s)
Anemia, Sickle Cell/complications , Calcinosis , Cell Proliferation , Female , Fibrosis/pathology , Giant Cells/pathology , Hemorrhage/pathology , Humans , Infarction/pathology , Necrosis/pathology , Placenta/pathology , Placenta Diseases/pathology , Pregnancy , Pregnancy Complications, Hematologic/pathology , Sickle Cell Trait/complications
8.
Arq. bras. endocrinol. metab ; 50(5): 957-962, out. 2006. ilus, tab
Article in Portuguese, English | LILACS | ID: lil-439081

ABSTRACT

Em diabéticos, síndromes dolorosas devidas o comprometimento do músculo esquelético sem neuropatia são complicações raras. Neste relato são apresentados dois casos: Caso 1 (piomiosite em panturrilhas) e Caso 2 (infarto muscular em coxa), sendo comentadas as características clínicas e os procedimentos diagnósticos. É necessário um alto índice de suspeita, uma vez que o tratamento de ambas difere significativamente. Além disso, o diagnóstico pode ser inicialmente confundido com tromboflebite, rabdomiólise ou neoplasia, retardando o tratamento correto. O atraso no tratamento da piomiosite com antibiótico e em alguns casos com cirurgia, pode evoluir para infecção sistêmica e até óbito, enquanto o infarto muscular requer apenas repouso e analgesia. Exames de imagem e de laboratório são úteis no diagnóstico diferencial, porém pode haver superposição dos achados. É enfatizada a importância de incluir estas doenças no diagnóstico diferencial de síndromes dolorosas do membro inferior em diabéticos.


Progressive painful syndromes due to skeletal muscle injuries rather than diabetic neuropathy are unusual complications of diabetes mellitus (DM). Two clinical cases are presented: Case 1 (pyomyositis: leg location) and Case 2 (muscle infarction: thigh location). Discussion on how to proceed the diagnosis based on clinical features are included as it is critical for early and proper treatment since approaches highly differ in the two situations. These complications can mimic thrombophlebitis, rabdomyolises or a neoplasm, therefore the diagnosis of a diabetes-related disorder may be overlooked. If pyomyositis is not correctly treated with antibiotics and in some cases with surgery, systemic infection and even death may occur, whereas muscle infarction only requires rest and analgesia. Image and laboratorial investigations can be of help to differentiate these syndromes, although some findings can overlap. Thus, the present report emphasizes the importance to include these diseases when limb painful syndromes are to be investigated in a diabetic patient.


Subject(s)
Humans , Female , Adult , Middle Aged , Diabetes Mellitus, Type 1/complications , /complications , Infarction/pathology , Muscle, Skeletal/blood supply , Pain/pathology , Pyomyositis/pathology , Diagnosis, Differential , Diabetes Mellitus, Type 1/pathology , /pathology , Diabetic Ketoacidosis/pathology , Infarction/etiology , Magnetic Resonance Imaging , Muscle, Skeletal/pathology , Pain/etiology , Pyomyositis/etiology , Syndrome
9.
Indian J Pathol Microbiol ; 2003 Oct; 46(4): 551-4
Article in English | IMSEAR | ID: sea-74038

ABSTRACT

Gross and microscopic examination was conducted on one hundred placentas. These included twenty five normal controls and seventy five from intrauterine growth retardation (IUGR) pregnancies. Weight of the placentas from IUGR pregnancies were less than those of normal placentas. The incidence of infarction, intervillous fibrin deposition were much higher in IUGR placentas on gross examination. Highly significant increase in the incidence of infarction, intervillous fibrin deposition, stromal fibrosis and syncytial knotting were found in IUGR placentas compared to full term normal placentas on microscopic examination. The incidence of basement membrane thickening and cytotrophoblastic hyperplasis were also higher in IUGR placentas. All the major histologic findings pointed towards reduced blood flow to the placentas resulting in the restriction of blood flow to fetus. The information obtained from their examination can be a useful adjunct in planning and management of future pregnancies.


Subject(s)
Basement Membrane/pathology , Case-Control Studies , Female , Fetal Growth Retardation/metabolism , Fibrin/metabolism , Humans , Hyperplasia , Infarction/pathology , Organ Size , Placenta/blood supply , Pregnancy , Trophoblasts/pathology
10.
Article in Spanish | LILACS | ID: lil-230893

ABSTRACT

Se realizó un estudio retrospectivo, de corte transversal entre los años 1992-1997, con la finalidad de investigar las distribución de acuerdo al sexo, grupo etáreo, tiempo (en horas), motivo de ingreso y tasa de mortalidad, de los pacientes hospitalizados en la Unidad de Cuidados Intensivos (UCI) del Hopital Pérez de León de Petare, Caracas. Se obtuvo que las primeras causas de ingreso, en orden decreciente, a la Unidad de Cuidados Intensivos fueron las siguientes: Infarto Agudo del Miocardio, Heridas por arma de Fuego, Traumatismo Craneoencefálico, Laparotomías Exploratorias, Craneotomías, Politraumatismos, Sepsis abdominales, Accidente Cerebrovascular de tipo Hemorrágico, Cetoacidosis Diabética y las Quemaduras. El sexo masculino predominó sobre el sexo femenino en una relación aproximada de 2,5:1. La distribución de acuerdo a la edad fue muy homogénea en todos los grupos etáreos, predominando ligeramente el grupo entre los 20 y 30 años de edad con un 21,4 por ciento y el de menos de 20 años de edad con un 18,33 por ciento. La tasa de mortalidad promedio de las 10 principales patologías ingresadas en la UCI entre 1992 y 1997 fue 35,56 por ciento, mientras que la tasa de mortalidad promedio asociada a todas las patologías fue 41,80 por ciento


Subject(s)
Humans , Male , Female , Infarction/pathology , Intensive Care Units
11.
Rev. Soc. Bras. Med. Trop ; 29(6): 571-4, nov.-dez. 1996. tab
Article in Portuguese | LILACS | ID: lil-191184

ABSTRACT

Renal infarction (RI) is usually secondary to arterial obstruction due to emboli originating from the heart. Chronic chagasic patients may present cardiac alterations originating from intracavitary thrombi, even without congestive heart failure (CHF). In this study RI incidence was comparatively evaluated in chronic chagasic individuals, in different anatomoclinic forms and in non chagasic individuals. There has been a review on necropsy reports of individuals aged 20 or over. In 259 necropsies, 78 (30.1 per cent) were chagasics, and 19 of them (24.4 per cent) developed RI, while 27 (15.0 per cent) of the non chagasic individuals presented RI. The ages of chagasics with RI were similar to those of non chagasic individuals. A significant prevalence of RI and thrombosis among chronic chagasic individuals has been found. A significantly higher prevalence of RI among chronic chagasics having CHF (52.6 per cent) was observed when they were compared to other forms of chronic Chagas disease and when compared to non chagasic individuals. It was concluded that RI was more frequent in chronic chagasic individuals, specially those who developed CHF, which probably played a role in the renal manifestations and systemic hemodynamic changes in those patients.


Subject(s)
Female , Humans , Male , Adult , Chagas Disease/complications , Infarction/epidemiology , Kidney/blood supply , Chagas Disease/pathology , Infarction/pathology , Sex Distribution
12.
Rev. SOCERJ ; 9(3): 101-4, jul.-set. 1996.
Article in Portuguese | LILACS | ID: lil-281827

ABSTRACT

A doença aterosclerótica coronariana (DAC) é a principal causa de mortalidade nos países desenvolvidos e em desenvolvimento. Os fatores envolvidos na sua gênese säo multifatoriais e de interaçäo complexa. O tabagismo tem sido imputado como um dos principais fatores de risco de DAC. Contudo, o risco atribuído à exposiçäo da fumaça ambiental do cigarro (FAT), na condiçäo de tabagista passivo (TP), ainda está envolvido em grande controvérsia. Após a implementaçäo de novos métodos epidemiológicos sofisticados e a introduçäo de exames bioquímicos sensíveis permitiram uma melhor compreençäo do impacto ambiental da FAT na saúde do indivíduo TP. Evidências epidemiológicas apontam para um risco de cerca de 20 'por cento' de que o TP possa desenvolver DAC.


Subject(s)
Humans , Animals , Male , Female , Coronary Artery Disease/mortality , Infarction/pathology , Smoking/adverse effects , Smoking/mortality , Smoking/pathology , Animal Testing Alternatives , Environmental Research , Mortality , Risk Factors , Tobacco Smoke Pollution
13.
Arequipa; UNSA; abr. 1996. 62 p. ilus.
Thesis in Spanish | LILACS | ID: lil-192173

ABSTRACT

Presentamos los casos de 8 pacientes varones catalogados como portadores de hemoglobina S,2 del Ex-Hospital Base de Juliaca y 6 pacientes del Hospital Regional "Manuel Núñez Butrón" de Puno, que presentaron infarto esplénico por falciformación de hematíes al ascender a regiones de gran altura, contando 4 de ellos con demostración electroforética de Hb As y los 4 restantes con positividad del test de falciformación realizada con Bisulfito de Sodio al 2 por ciento. 6 pacientes tenían ancestro negroide (2 mestizos, 2 mulatos y 2 negros), un mestizo de ascendencia blanca y finalmente el último de raza blanca. Clínicamente se observa dolor en abdomen superior izquierdo con predominancia en hipocondrio izquierdo, aunque en 2 casos este dolor estaba localizado al principio en abdomen inferior izquierdo; la esplenomegalia, fiebre y leucocitosis con desviación izquierda son hallazgos frecuentes; compromiso pleural izquierdo, ileo paralítico,irritación peritoneal franca o signos de anemia nos indican complicación del infarto de bazo. Tres pacientes fueron intervenidos quirúrgicamente y se les realizó esplenectomía, en dos casos porque presentaban signos compatibles con hemorragia interna, y en el otro caso por infarto masivo de bazo. El bazo infartado en los tres casos estuvo aumentado de tamaño, en más de 5 veces su peso en un caso, y hasta 2 veces su tamaño, lográndose observar necrosis masiva de bazo con compromiso de hasta el 85 por ciento del parénquima. Todos los pacientes, incluídos los intervenidos quirúrgicamente, evolucionaron satisfactoriamente sin presentar complicaciones; las medidas como reposo absoluto, oxigenación contínua y evacuación a regiones de menor altitud, fueron las realizadas.


Subject(s)
Humans , Hemoglobin, Sickle , Infarction/complications , Infarction/diagnosis , Infarction/pathology , Infarction/therapy , Cardiology , Hematology
14.
Indian J Cancer ; 1989 Dec; 26(4): 233-9
Article in English | IMSEAR | ID: sea-51162

ABSTRACT

Lymphnode infarction is seen in two sets of situations viz. spontaneous banal infarction of non-neoplastic nodes, and in association with lymphoma. It needs to be differentiated from other causes of lymphnode as a phenomenon occurring synchronous with and occasionally preceding diagnosis of lymphoma is significant.


Subject(s)
Aged , Female , Humans , Infarction/pathology , Lymph Nodes/blood supply , Lymphoma/pathology , Middle Aged
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