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1.
Rev. medica electron ; 43(4): 900-909, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1341524

ABSTRACT

RESUMEN Introducción: el conocimiento de la fisiopatología de la enfermedad ha revolucionado el enfoque tradicional en el tratamiento de las enfermedades causadas por virus respiratorios. Actualmente, se utilizan marcadores de la respuesta inflamatoria para diagnosticar, estratificar y predecir en muchos casos el comportamiento futuro del enfermo de covid-19. Objetivo: caracterizar la naturaleza de la relación entre el índice PO2/FiO2 y los parámetros inflamatorios y de coagulación en pacientes graves por la covid-19, en la región de Lombardía, Italia. Materiales y métodos: se realizó un estudio analítico, longitudinal, retrospectivo con 191 pacientes graves y críticos, que ingresaron con diagnóstico de covid-19 del 1 de abril al 20 mayo de 2020, en el Hospital Mayor de Crema, en la región de Lombardía, Italia. Resultados: las correlaciones evidenciadas fueron las siguientes: proteína C reactiva (-0,417) p = 0; procalcitonina (-0,152) p = 0,018; dímero D (-0,112) p = 0,061; fibrinógeno (-0,272) p = 0,000; creatinina plasmática (-0,320) p = 0,000; conteo de linfocitos (0,028) p = 0,000; troponina (-0,028) p = 0,142, y lactato (-0,191) p = 0,288. Conclusiones: los marcadores inflamatorios en la patogenia de la enfermedad juegan un rol capital, y el enfoque hacia este renglón del tratamiento médico antiinflamatorio de cualquier tipo es mandatorio. Se debe realizar un correcto monitoreo de la coagulación, usar heparinas de bajo peso molecular, así como mantener un adecuado soporte hemodinámico capaz de evitar las disoxias celulares que progresen al fallo multiorgánico (AU).


ABSTRACT Introduction: the knowledge of disease physiopathology has revolutionized the traditional approach in the treatment of diseases caused by respiratory viruses. Currently, the markers of inflammatory answer are used to diagnose, stratify and predict in many cases the future behavior of COVID-19 patients. Objective: to characterize the nature of the relationship between PO2/FiO2 (PAFI, Spanish acronym of PA= presión arterial [arterial pressure], FI=fracción inspirada [inspired fraction]) and coagulation and inflammatory parameters in seriously-ill patients with COVID-19, in the region of Lombardy, Italy. Materials and methods: a retrospective, longitudinal, analytic study was carried out in 191 severe and critical patients who were admitted in Hospadale Maggiori di Crema, in the region of Lombardy, Italy, with the diagnosis of COVID-19, in the period April 1st-May 20, 2020. Results: the evidenced correlations were the following: reactive C protein (-0.417) p=0; procalcitonin (PCT) (-0.152) p=0.018. D dimer (-0.112) p=0.061; Fibrinogen (-0.272) p=0.000; Plasma creatinine (-0.320) p=0.000; lymphocytes count (0,028) p=0,000; troponin (-0.028) p=0.142; and lactate (-0.191) p=0.288. Conclusions: inflammatory markers play a capital role in the disease pathogenesis, and approaching this item of the medical anti-inflammatory treatment is mandatory. It is useful to keep a correct coagulation screening, using low molecular weight heparins, and also keeping an adequate hemodynamic support able to avoid cell dysoxia progressing to multiorgan failure (AU).


Subject(s)
Humans , Male , Female , Coronavirus Infections , Index , Blood Coagulation , /methods , Patient Acuity , Inflammation/complications , Inflammation/diagnosis
2.
Rev. cuba. hematol. inmunol. hemoter ; 37(1): e1310, ene.-mar. 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1251720

ABSTRACT

Introducción: Los síndromes mielodisplásicos constituyen un grupo heterogéneo de desórdenes hematológicos clonales adquiridos, que afectan la célula madre. Se caracterizan morfológicamente por: hematopoyesis ineficaz, citopenias periféricas progresivas, displasia en uno o más linajes celulares y tendencia evolutiva a leucemia aguda. Los avances recientes en la comprensión de los mecanismos genéticos y moleculares de los síndromes mielodisplásicos, han revelado la asociación entre alteraciones inmunológicas y las mutaciones recurrentes. Las células de la respuesta inmune innata y adaptativa, así como diversos mediadores solubles liberados por ellas, pueden establecer una respuesta antitumoral protectora o, por el contrario, inducir eventos de inflamación crónica que favorezcan la promoción y progresión de esta enfermedad. Objetivos: Resumir los conocimientos actuales de la relación sistema inmune-síndromes mielodisplásicos, enfatizando en las células inmunes del microambiente de la médula ósea y su importancia en la clínica de la enfermedad. Métodos: Se realizó investigación bibliográfica-documental acerca del tema. Se consultaron las bases de datos Scielo y Pubmed. Conclusiones: La comprensión de la función dual que ejerce el sistema inmune en los síndromes mielodisplásicos, constituye un desafío y son necesarios estudios clínicos rigurosos para poder establecer el valor de la manipulación del sistema inmune como una forma posible de tratamiento de esta enfermedad(AU)


Introduction: Myelodysplastic syndromes (MDS) constitute a heterogeneous group of acquired clonal hematological disorders that affect the stem cell. These are characterized morphologically and clinically by: ineffective hematopoiesis, progressive peripheral cytopenia, dysplasia in one or more cell lineages, in most of cases and evolutionary tendency to acute leukemia. Recent advances in understanding the genetic and molecular mechanisms of MDS have revealed the association between immunological alterations and recurrent mutations. Cells of the innate and adaptive immune response, as well as various soluble mediators released by them, can establish a protective antitumor response or, on the contrary, induce events of chronic inflammation that favor the promotion and progression of this disease. Objective: To summarize the current knowledge of the immune system-MDS relationship, emphasizing the immune cells of the bone marrow microenvironment and their importance in the clinic of the disease. Methods: A bibliographic-documentary research was carried out on the subject. The Scielo and Pubmed databases were consulted. Conclusions: Understanding the dual role of the immune system in MDS constitutes a challenge and rigorous clinical studies are necessary to establish the value of manipulating the immune system as a possible form of treatment of this disease(AU)


Subject(s)
Humans , Stem Cells , Myelodysplastic Syndromes/complications , Leukemia , Adaptive Immunity , Hematopoiesis/genetics , Immune System/physiopathology , Inflammation/diagnosis
4.
Rev. argent. cir ; 112(3): 343-347, jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1279750

ABSTRACT

RESUMEN La migración de malla en el posoperatorio alejado de la eventroplastìa y su consecuente infección es una complicación poco frecuente y peligrosa. La malla migrada genera reacción inflamatoria de tipo cuerpo extraño. Puede causar obstrucción intestinal, perforación intestinal o dolor abdominal cróni co. Solo se informan 4 casos en la literatura mundial de migración y uno con compromiso intestinal. Presentamos el caso de un tumor inflamatorio adherido a la pared abdominal, con contenido de poli propileno. El objetivo de esta carta científica es presentar una complicación poco habitual, destacando los aspectos más importantes de su manejo, definiendo algunas recomendaciones y remarcando la importancia del abordaje multidisciplinario.


ABSTRACT Mesh migration with subsequent infection years after incisional hernia repair is an uncommon and dangerous complication. Mesh migration produces an inflammatory foreign body reaction and can cause bowel obstruction, bowel perforation or chronic abdominal pain. Only four cases have been reported in the international literature, one of them with bowel involvement. We report a case of an inflammatory tumor containing polypropylene traces adhered to the abdominal wall. The aim of this scientific letter is to report a rare complication, emphasizing the most relevant aspects about its ma nagement, recommendations, and the relevance of a multidisciplinary approach.


Subject(s)
Humans , Female , Adult , Surgical Mesh/adverse effects , Abdominal Wall/surgery , Inflammation/diagnosis , Tomography, X-Ray Computed/methods , Abdominal Pain/complications , Laparoscopy , Intestinal Obstruction/complications
6.
Rev. argent. cir ; 112(2): 171-177, 2020. ilus, tab
Article in English, Spanish | LILACS | ID: biblio-1125798

ABSTRACT

Antecedentes: la colecistectomía laparoscópica es uno de los procedimientos quirúrgicos más frecuentemente realizados. Las diferencias en la anatomía y en el grado de inflamación vesicular suelen causar dificultades técnicas intraoperatorias. Objetivo: determinar el valor de la proteína C reactiva (PCR) y la velocidad de sedimentación globular (VSG) como predictores de colecistectomía dificultosa y evaluar su aplicación en la planificación prequirúrgica de un programa de residencia universitario. Material y métodos: se confeccionó un estudio retrospectivo, analítico, en un hospital universitario de tercer nivel. Se incluyeron 104 pacientes adultos operados de colecistectomía laparoscópica por litiasis vesicular sintomática entre enero y julio de 2019. Se categorizó a los pacientes en un grupo de colecistectomías dificultosas y otro de colecistectomías no dificultosas. Resultados: se obtuvieron diferencias estadísticamente significativas al comparar los valores de VSG y PCR de ambos grupos (p < 0,001). La sensibilidad de la VSG fue del 100%, la especificidad del 45%, el VPP del 40% y el VPN de 100%. La sensibilidad de la PCR fue del 87,5%, la especificidad del 86,3%, el VPP del 70% y el VPN de 95%. Ambos parámetros se vieron elevados en 14 de 16 colecistectomías dificultosas y en 2 de 44 colecistectomías no dificultosas. La sensibilidad para ambos parámetros elevados fue del 87,5%, la especificidad del 95%, el VPP del 87,5% y el VPN de 95%. Conclusión: la VSG y la PCR han demostrado ser un método fiable en la predicción de colecistectomías dificultosas por litiasis vesicular sintomática. Esto podría ser aplicado en la programación de cirugías dentro de un programa de residencia universitario.


Background: laparoscopic cholecystectomy is one of the most common procedures performed in general surgery. The anatomical differences of the gallbladder and the presence of factors related to inflammation can cause technical issues during surgery. Objective: the aim of the present study was to determine the value of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) as predictors of difficult cholecystectomy and to evaluate their application during presurgical planning within a university residency program. Material and methods: we conducted a retrospective and analytical study in a tertiary university hospital. A total of 104 adult patients undergoing laparoscopic cholecystectomy due to symptomatic cholelithiasis between January and July 2019 were included. The patients were categorized into two groups: difficult cholecystectomy and non-difficult cholecystectomy. Results: there were statistically significant differences in ESR and CRP values between both groups (p < 0.001). Sensitivity of ESR was 100%, specificity was 45%, with a PPV of 40% and NPV of 100%. Sensitivity of CRP was 87.5%, specificity was 86.3%, with a PPV of 70% and NPV of 95%. Both parameters were elevated in 14 of 16 difficult cholecystectomies and in 2 of 44 non-difficult cholecystectomies. Sensitivity of CRP was 87.5%, specificity was 86.3%, with a PPV of 70% and NPV of 95%. Conclusion: measuring ESR and CRP has proved to be a reliable method to predict difficult cholecystectomies due to symptomatic cholelithiasis. This could be applied for surgical planning within a university residency program.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , C-Reactive Protein/analysis , Cholecystectomy, Laparoscopic/methods , General Surgery/methods , Blood Sedimentation , Body Mass Index , Retrospective Studies , Hospitals, University , Inflammation/diagnosis , Internship and Residency
7.
Rev. chil. pediatr ; 90(3): 328-335, jun. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1013841

ABSTRACT

INTRODUCCIÓN: El tumor miofibroblástico inflamatorio (TMI) es una neoplasia benigna infrecuente, de comportamiento clínico impredecible. OBJETIVOS: describir 3 casos de TMI diagnosticados entre marzo 2014 y enero 2018 en Hospital Clinico San Borja Arriaran, y realizar una revisión actualizada de la literatura. CASO 1: Adolescente de género masculino de 14 años de edad, hospitalizado por dolor abdominal, diagnosticado de invaginación yeyunoyeyunal secundaria a un tumor de pared intestinal. La histología fue compatible con un tumor miofibroblástico inflamatorio. CASO 2: Adolescente de género femenino, edad 12 años, hospitalizada por neumonía y dolor lumbar en estudio asociado a pérdida de peso. Se diagnosticó una masa retroperitoneal que comprometía el músculo psoas derecho, músculos paravertebrales, vértebras, riñón derecho y diafragma ipsilateral. Se efectuó biopsia por punción cuyo resultado fue compatible con un tumor miofibroblástico inflamatorio. CASO 3: Preadolescente de género femenino de 11 años de edad, hospitalizada para estudio de infección del tracto urinario a repetición. Se identificó un tumor vesical y la biopsia mostró ser compatible con tumor miofibroblástico inflamatorio. CONCLUSIÓN: Debido al comportamiento variable del tumor miofibroblástico inflamatorio, el manejo de este dependerá de la localización, la expresión del anaplasic like lymphoma (ALK), el comportamiento del tumor y la posibilidad de resección.


INTRODUCTION: The inflammatory myofibroblastic tumor is an infrequent benign neoplasm with unpredictable cli nical behavior. OBJECTIVES: to describe three clinical cases at the San Borja Arriarán Clinical Hospital between March 2014 and January 2018 and to carry out an updated review of the literature. CASE 1: 14-year-old male adolescent, hospitalized due to abdominal pain, diagnosed with jejunojejunal intus susception secondary to an intestinal wall tumor. The histology was compatible with an inflamma tory myofibroblastic tumor. CASE 2: 12-year-old female adolescent, hospitalized due to pneumonia and low-back pain under study associated with weight loss. A retroperitoneal mass was diagnosed involving the right psoas muscle, paravertebral muscles, vertebrae, right kidney, and ipsilateral dia phragm. A puncture biopsy was performed and the result was compatible with an inflammatory myofibroblastic tumor. CASE 3: 11-year-old female pre-adolescent, hospitalized to study recurrent urinary tract infection. A bladder tumor was identified, and the biopsy showed compatibility with inflammatory myofibroblastic tumor. CONCLUSION: Due to the variable behavior of the inflammatory myofibroblastic tumor, its management will depend on the location, expression of the anaplastic lymphoma kinase (ALK), tumor behavior, and the resection possibility.


Subject(s)
Humans , Male , Female , Child , Adolescent , Retroperitoneal Neoplasms/diagnosis , Urinary Bladder Neoplasms/diagnosis , Intestinal Neoplasms/diagnosis , Retroperitoneal Neoplasms/pathology , Urinary Bladder Neoplasms/pathology , Myofibroblasts/pathology , Inflammation/diagnosis , Inflammation/pathology , Intestinal Neoplasms/pathology
8.
Braz. j. med. biol. res ; 52(8): e8309, 2019. tab, graf
Article in English | LILACS | ID: biblio-1011605

ABSTRACT

This study aimed to detect the expression of the long non-coding RNA (lncRNA) antisense non-coding RNA in the INK4 locus (ANRIL) and evaluate its correlation with disease risk, stenosis degree, inflammation, as well as overall survival (OS) in coronary artery disease (CAD) patients. A total of 230 patients who underwent diagnostic coronary angiography were consecutively recruited and assigned to CAD group (n=125) or control group (n=105) according to presence or absence of CAD. Gensini score was calculated to assess the severity of coronary artery damage. Plasma samples were collected and the expression ANRIL was detected in all participants. High-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and cytokines including tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6, IL-8, IL-10, and IL-17 in CAD patients were measured and OS was calculated. The relative expression of ANRIL was higher in CAD patients compared to controls (P<0.001). Receiver operating characteristic disclosed that ANRIL could distinguish CAD patients from controls with an area under the curve of 0.789 (95%CI: 0.731-0.847). Spearman's rank correlation test revealed that expression of ANRIL was positively correlated with Gensini score (P=0.001), levels of hs-CRP (P=0.001), ESR (P=0.038), TNF-α (P=0.004), and IL-6 (P<0.001), while negatively correlated with IL-10 level (P=0.008) in CAD patients. Kaplan-Meier curve revealed that high expression of ANRIL was associated with shorter OS (P=0.013). In conclusion, circulating ANRIL presented a good diagnostic value for CAD, and its high expression was associated with increased stenosis degree, raised inflammation, and poor OS in CAD patients.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Coronary Artery Disease/diagnosis , RNA, Long Noncoding/genetics , Prognosis , Blood Sedimentation , Coronary Artery Disease/complications , Coronary Artery Disease/genetics , Coronary Artery Disease/blood , C-Reactive Protein/analysis , Survival Analysis , Cytokines/blood , Risk Assessment , Coronary Stenosis/complications , Inflammation/diagnosis
9.
Arch. argent. pediatr ; 116(5): 679-683, oct. 2018. ilus, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-973673

ABSTRACT

La osteomielitis crónica multifocal recurrente fue recientemente clasificada dentro de las enfermedades autoinflamatorias, caracterizadas por episodios de inflamación sistèmica, que incluyen indicadores serológicos de inflamación, en ausencia de autoanticuerpos o agentes patógenos. La característica clínica es la aparición insidiosa de dolor, tumefacción y sensibilidad localizada sobre el hueso afectado, principalmente, en la metáfisis y epífisis de los huesos largos, clavícula y también vértebras. Son episodios autolimitados y recurrentes. Se presenta a un paciente de 2 años y 2 meses con afectación ósea tipo osteolítica en dos focos aislados con un año de diferencia entre ambos episodios. La biopsia ósea fue compatible con osteomielitis crónica y se descartó patología de origen infeccioso, neoplásico y enfermedad proliferativa. Presentó buena respuesta al tratamiento con antiinflamatorios. El conocimiento de esta entidad como diagnóstico diferencial evita el tratamiento antibiótico prolongado, estudios complementarios y biopsias óseas, considerando los criterios diagnósticos y recurrencia de los episodios.


Chronic recurrent multifocal osteomyelitis has recently been classified as an autoinflammatory disorder characterized by episodes of systemic inflammation including serological signs of inflammation occurring in the absence of autoantibodies or pathogen agents. The insidious onset of pain with swelling and tenderness localized over the affected bones are the main manifestations. The metaphysis and epiphyses of the long bones, clavicle and vertebrae are affected. We report a male patient aged 2 years and 2 months with osteomyelitis with lytic destruction in two different single sites with a year difference between the episodes. Histological examination of the bone showed inflammation and chronic osteomyelitis, excluding the existence of infectious osteomyelitis, neoplasm and myeloproliferative disease. Clinical symptoms improved under treatment with nonsteroidal anti-inflammatory drugs. Considering chronic recurrent multifocal osteomyelitis may shorten time to diagnosis in order to avoid potentially unnecessary prolonged courses of intravenous antibiotics, complementary studies and multiple biopsies.


Subject(s)
Humans , Male , Child, Preschool , Osteomyelitis/diagnosis , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Inflammation/diagnosis , Osteomyelitis/pathology , Osteomyelitis/drug therapy , Time Factors , Treatment Outcome , Diagnosis, Differential , Inflammation/pathology , Inflammation/drug therapy
10.
Rev. chil. pediatr ; 89(3): 346-351, jun. 2018. tab
Article in Spanish | LILACS | ID: biblio-959532

ABSTRACT

INTRODUCCIÓN: La presencia de un estado de inflamación de bajo grado en niños obesos, se debería, entre otros factores, a que el tejido adiposo de los obesos produce moléculas proinflamatorias que contribuyen al desarrollo de aterosclerosis. OBJETIVO: Determinar en una población de niños obesos los niveles séricos de ligando CD-40 soluble (sCD40L), proteína quimioatractante de monocitos 1 (MCP-1), interleuquina 6 (IL-6), Factor de Necrosis tumoral a (TNF-a) y Proteína C Reactiva ultrasensible (PCR-us), comparados con un grupo control y analizar la correlación de estas moléculas con las variables antropométricas y metabólicas. PACIENTES Y MÉTODO: Estudio transversal de 37 niños obesos de 8 a 12 años y 20 niños con peso normal. A todos los pacientes se les realizó una historia clínica consignando edad, peso, talla, IMC, circunferencia de cintura, estadios de Tanner y antecedentes familiares. Se determinaron los niveles séricos de sCD40L, MCP-1, IL-6, TNF-a y PCR-us mediante ELISA, PCR-us por quimioluminiscencia, glucemia, insulina plasmática, perfil lipídico y se calculó el índice HOMA. Los datos se expresaron como la mediana y rango intercuartil y se utilizó el coeficiente de Spearman para investigar las correlaciones entre variables. RESULTADOS: Los niños obesos presentaron valores significativamente mayores de sCD40L, MCP-1, IL-6, TNF-a, PCR-us que los niños controles. El índice de masa corporal y la circunferencia de cintura se correlacionaron positivamente con sCD40L y MCP-1. CONCLUSIÓN: Los niveles elevados de las moléculas estudiadas sugieren la presencia de inflamación de bajo grado asociada a obesidad en esta población.


INTRODUCTION: Obesity is a chronic disease that affects adults as well as children and is associated with insulin resistance, type 2 diabetes and cardiovascular disease. One of the reasons for the presence of low-grade inflammation in these patients could be that adipose tissue of the obese produces proin flammatory molecules that favor the development of atherosclerosis. OBJECTIVE: To determine serum levels of soluble CD40 ligand (sCD40L), monocyte chemoattractant protein 1 (MCP-1), interleukin 6 (IL-6), Tumor Necrosis Factor alpha (TNF-Α) and high sensitivity CRP (hsCRP), in an obese chil dren population compared to a control group, also to analyze the correlation of these molecules with the anthropometric and metabolic variables. PATIENTS AND METHOD: A cross-sectional, observational study was carried out on 37 obese children, aged 8 to 12 years, and 20 children with normal weight. Serum levels of sCD40L, MCP-1, IL-6, TNF-Α and hsCRP were determined. Data were expressed as the median and interquartil range and Spearman coefficient was used to investigate correlations between variables. RESULTS: Compared to the control group, obese children presented significantly higher values of sCD40L, MCP-1, IL-6, TNF-Α, and hsCRP than control group. Body mass index and waist circumference correlated positively with sCD40L and MCP-1. CONCLUSION: Elevated levels of the studied molecules studied suggest the presence of low-grade inflammation associated with obesity in this population.


Subject(s)
Humans , Male , Female , Child , Pediatric Obesity/physiopathology , Inflammation/etiology , Biomarkers/blood , Case-Control Studies , Cross-Sectional Studies , Pediatric Obesity/blood , Inflammation/diagnosis , Inflammation/blood
11.
Acta cir. bras ; 32(7): 576-586, July 2017. tab, graf
Article in English | LILACS | ID: biblio-886217

ABSTRACT

Abstract Purpose: To evaluate the inflammatory responses induced by laparoscopic hysterectomies with multiport and singleport approaches. Methods: This was a pilot prospective randomized study that included 42 women candidates for hysterectomy at School of Medicine, Hospital das Clínicas, USP. The patients were randomized to two groups: MP-TLH (total laparoscopic hysterectomy with 3 abdominal incisions), and SP-TLH (total laparoscopic hysterectomy with a single umbilical incision).We evaluated the inflammatory response (via CRP, IL-6, IL-10, TNFα, VEGF and leukogram assessments), surgical time, postoperative pain, blood loss and surgical complications in both groups. Results: Both techniques were similar regarding C-reactive protein (p=.666), IL-6 (p=.833), IL-10 (p=.420), TNF-α(p=.098), VEGF (p=.092) and the leukogram (p=.712) measures. The operative time was significantly longer in the SP-TLH group than in the MP-TLH group (p=.001). The pain evaluation was similar in both groups (p=.170). Hemoglobin variation and the aspirated blood volume were similar in both groups (p=.493 and p=.347). There were no major complications. Conclusions: Multiport and singleport laparoscopic approaches are both safe methods for hysterectomy. Although SP-TLH resulted in a significantly longer operative time than MP-TLH, no differences were observed between the groups in inflammatory responses, blood loss and postoperative pain.


Subject(s)
Humans , Female , Adult , Middle Aged , Biomarkers/blood , Hysterectomy/methods , Inflammation/etiology , Pain, Postoperative , Prospective Studies , Treatment Outcome , Laparoscopy/adverse effects , Laparoscopy/methods , Operative Time , Hysterectomy/adverse effects , Inflammation/diagnosis , Length of Stay
12.
Ann. hepatol ; 16(1): 77-85, Jan.-Feb. 2017. graf
Article in English | LILACS | ID: biblio-838089

ABSTRACT

Abstract: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. We have previously shown that hepatic reticuloendothelial system (RES) iron deposition is associated with an advanced degree of nonalcoholic steatohepatitis (NASH) in humans. In this study, we aimed to determine differentially expressed genes related to iron overload, inflammation and oxidative stress pathways, with the goal of identifying factors associated with NASH progression. Seventy five patients with NAFLD were evaluated for their biochemical parameters and their liver tissue analyzed for NASH histological characteristics. Gene expression analysis of pathways related to iron homeostasis, inflammation and oxidative stress was performed using real-time PCR. Gene expression was compared between subjects based on disease status and presence of hepatic iron staining. We observed increased gene expression of hepcidin (HAMP) (2.3 fold, p = 0.027), transmembrane serine proteinase 6 (TMPRSS6) (8.4 fold, p = 0.003), signal transducer and activator of transcription 3 (STAT3) (5.5 fold, p = 0.004), proinflammatory cytokines; IL-1β (2.7 fold, p = 0.046) and TNF-α (3.8 fold, p = 0.001) in patients with NASH. TMPRSS6, a negative regulator of HAMP, is overexpressed in patients with NASH and HIF1α (hypoxia inducible factor-1) is downregulated. NAFLD patients with hepatic iron deposition exhibited higher hepcidin expression (3.1 fold, p = 0.04) but lower expression of cytokines. In conclusion, we observed elevated hepatic HAMP expression in patients with NASH and in NAFLD patients who had hepatic iron deposition, while proinflammatory cytokines displayed elevated expression only in patients with NASH, suggesting a regulatory role for hepcidin in NAFL to NASH transition and in mitigating inflammatory responses.


Subject(s)
Humans , Male , Female , Middle Aged , Oxidative Stress/genetics , Iron Overload/genetics , Non-alcoholic Fatty Liver Disease/genetics , Inflammation/genetics , Iron/analysis , Liver/chemistry , Serine Endopeptidases/genetics , Gene Expression Regulation , Tumor Necrosis Factor-alpha/genetics , Tumor Necrosis Factor-alpha/blood , Inflammation Mediators/blood , Iron Overload/diagnosis , Iron Overload/blood , STAT3 Transcription Factor/genetics , Interleukin-1beta/genetics , Interleukin-1beta/blood , Real-Time Polymerase Chain Reaction , Hepcidins/genetics , Non-alcoholic Fatty Liver Disease/diagnosis , Non-alcoholic Fatty Liver Disease/blood , Inflammation/diagnosis , Inflammation/blood , Liver/pathology , Membrane Proteins/genetics
13.
An. bras. dermatol ; 92(1): 72-80, Jan.-Feb. 2017. tab, graf
Article in English | LILACS | ID: biblio-838007

ABSTRACT

ABSTRACT Autoinflammatory disorders are immune-mediated diseases with increased production of inflammatory cytokines and absence of detectable autoantibodies. They course with recurrent episodes of systemic inflammation and fever is the most common symptom. Cutaneous manifestations are prevalent and important to diagnosis and early treatment of the syndromes. The purpose of this review is to emphasize to dermatologists the skin symptoms present in these syndromes in order to provide their early diagnosis.


Subject(s)
Humans , Skin Diseases/etiology , Autoimmune Diseases/complications , Autoimmune Diseases/diagnosis , Inflammation/complications , Inflammation/diagnosis , Skin Diseases/immunology , Inflammation/immunology
14.
Pesqui. bras. odontopediatria clín. integr ; 17(1): e2577, 13/01/2017. tab
Article in English | LILACS, BBO | ID: biblio-914209

ABSTRACT

Objective: To evaluate the metabolic control and compare the clinical effects between non-surgical and surgical therapies on periodontal treatment of residual pockets of type 2 diabetic patients. Material and Methods: 352 periodontal sites in 16 type 2 diabetic subjects with residual pockets of similar depths were randomly selected, whose contralateral quadrants were divided into G1 and G2 undergoing surgical and nonsurgical therapy, respectively, and evaluated 3 and 6 months after the first intervention. The data were analyzed by Statistical Package of Social Science (SPSS) version 20.0, using descriptive and inferential statistical methods. Fisher's exact test was used to verify differences between means obtained in the clinical parameters between G1 and G2. The significance level adopted was 5%. Results: The mean Hb1Ac values of patients were significantly reduced and the mean PD and CIL values were reduced in G1 with no significant difference when compared to G2. Conclusion: Periodontal treatment was effective in metabolic control of type 2 diabetic patients and that both therapies, surgical and non-surgical, behaved similarly when compared.


Subject(s)
Diabetes Mellitus, Type 2/diagnosis , Inflammation/diagnosis , Periodontal Diseases/diagnosis , Brazil , Double-Blind Method , Randomized Controlled Trial , Statistics, Nonparametric
15.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 26(4): 234-239, out.-dez.2016.
Article in Portuguese | LILACS | ID: biblio-831553

ABSTRACT

A presente revisão descreve os principais achados anatomopatológicos que caracterizam a cardiopatia chagásica crônica, discute a teoria autoimune e parassimpaticopriva que dominaram a explicação patogenética nas ultimas décadas e propõe novos caminhos a partir de achados mais recentes. Esses achados se relacionam com a presença de outros microrganismos que talvez tenham sejam levados até o miocárdio por estarem em simbiose com o T. cruzi, como micoplasmas, clamídias e arqueias. As arqueias têm como característica aumentar a inflamação por apresentarem antígenos aos linfócitos T CD8+. A inflamação exacerbada pode levar à vasodilatação da microcirculação e à falha na distribuição de sangue no miocárdio, ocasionando áreas de isquemia em regiões distais de dupla irrigação. Isto explicaria as regiões de afilamento e dilatação aneurismática ventricular, bem como a fibrose e infiltração gordurosa do sistema de condução (feixe de His, nó sinoatrial e atrioventricular). Esses microrganismos no interior da fibra cardíaca podem induzir uma resposta imunológica com fibrose ao redor dos cardiomiócitos, os quais se tornam extremamente hipertróficos por não entrarem em apoptose. A simbiose entre esses microrganismos pode levar à produção de micropartículas infecciosas que circulam e fazem parte da patogenia da descompensação cardíaca. Assim, a ação terapêutica na doença de Chagas deveria incluir a eliminação simultânea desses diferentes microrganismos e não somente do T. cruzi


This review describes the main anatomopathological findings that characterize chronic Chagasic cardiomyopathy, discusses the autoimmune and parasympathetic dysautonomia theories that have dominated the pathogenic explanation in recent decades, and proposes new routes based on the most recent findings. These findings relate to the presence of other microorganisms, such as micoplasmas, chlamydias and archaea, that are perhaps carried to the myocardium as they are in symbiosis with T. cruzi. A characteristic of archaea is that they increase inflammation by presenting T CD8+ lymphocyte antigens. Exacerbated inflammation may lead to vasodilation of the microcirculation and failure of blood distribution in the myocardium, leading to areas of ischemia in distal regions of double irrigation. This would explain the regions of thinning and dilation of the ventricular aneurysm, as well as the fibrosis and fatty infiltration of the conduction system (His bundle, sinoatrial node and atrioventricular node). These microorganisms in the interior of the heart fiber may lead to an immunological response with fibrosis around the cardiomyocytes, which become extremely hypertrophic, as they do not enter apoptosis. The symbiosis between these microorganisms can lead to the production of infectious microparticles that circulate and form part of the pathogenesis of decompensated heart failure. The therapeutic conduct in Chagas disease should therefore include the simultaneous elimination of these different microorganisms, and not only of T. cruzi


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Arrhythmias, Cardiac/complications , Chagas Disease/pathology , Heart Failure/etiology , Trypanosoma cruzi/parasitology , Infections/diagnosis , Inflammation/diagnosis
16.
Article in English | WPRIM | ID: wpr-149380

ABSTRACT

Heart failure with preserved ejection fraction (HFPEF) is a global health problem of considerable socioeconomic burden. It is projected to worsen with the aging population worldwide. The lack of effective therapies underscores our incomplete understanding of this complex heterogeneous syndrome. A novel paradigm has recently emerged, in which central roles are ascribed to systemic inflammation and generalized endothelial dysfunction in the pathophysiology of HFPEF. In this review, we discuss the role of the endothelium in cardiovascular homeostasis and how deranged endothelial-related signaling pathways contribute to the development of HFPEF. We also review the novel therapies in various stages of research and development that target different components of this signaling pathway.


Subject(s)
Animals , Endothelium, Vascular/physiopathology , Heart Failure/diagnosis , Humans , Inflammation/diagnosis , Inflammation Mediators/metabolism , Prognosis , Risk Factors , Signal Transduction , Stroke Volume , Ventricular Function, Left
17.
São Paulo; s.n; 2016. 67 p.
Thesis in Portuguese | LILACS | ID: biblio-871071

ABSTRACT

Introdução - Evidências recentes de estudos clínicos e epidemiológicos sugerem uma relação inversa entre o consumo de alimentos lácteos e inflamação, demonstrando a relevância do tema para Saúde Pública diante de sua possível atuação na redução do risco cardiovascular. Objetivo - Avaliar a associação entre consumo de alimentos lácteos e marcadores inflamatórios em uma amostra representativa de adultos residentes no município de São Paulo. Métodos - Trata-se de um estudo com delineamento transversal, de base populacional, que utilizará dados bioquímicos (coleta de sangue) e de consumo alimentar (Recordatório Alimentar de 24 horas e Questionário de Frequência Alimentar) provenientes de 269 indiviÍduos de ambos os sexos e idade entre 19 e 59 anos participantes do ISA Capital - 2008/2009. Resultados - Após ajustes de idade e sexo, o consumo total de lácteos demonstrou correlação inversa com as concentrações séricas de homocisteína e interleucina-8. O tercil de maior consumo de iogurte esteve significativamente associado com menores níveis de interleucina-8, fator de necrose tumoral-, homocisteína, triglicérides e VLDL-colesterol e maiores da leptina quando comparado ao tercil de menor consumo (p<0,005). Os queijos com menor teor de gordura apresentaram seu consumo inversamente associado às concentrações de interleucina-8, proteína quimiotática de monócitos-1 e triglicérides e positivamente com HDL-colesterol e leptina, apesar de também correlacionados ao fator de necrose tumoral- e adiponectina (p<0,005). Os grupos do leite e queijos em geral também estiveram associados com alguns marcadores inflamatórios.


Introduction - Recent evidence from clinical and epidemiological studies suggest an inverse relationship between dairy consumption and inflammation, which demonstrates the relevance of the subject to Public Health considering its possible role on reducing cardiovascular risk. Objective - To investigate the association between dairy products consumption and circulating levels of inflammatory biomarkers among a representative sample of Brazilian adults from São Paulo City. Methods - The data come from a cross-sectional population-based study, Health Survey for São Paulo (HS-SP). All individuals aged 20 to 59 included in this research gave out completed food consumption information (24-hour dietary recall and Food Frequency Questionnaire) and blood sampling analysis totalizing a 269 subjects sample. Results - After age and gender adjustments, total dairy consumption exhibited an inverse relation with both homocysteine and interleunkin-8. A higher consumption of yogurt was significantly associated with lower levels of interleukin-8, tumor necrosis factor-, homocysteine, triglycerides and VLDL-cholesterol and higher of leptin (p for trend 0.005).


Subject(s)
Humans , Male , Female , Adult , Dairy Products , Eating , Inflammation/diagnosis , Inflammation/blood , Cardiovascular Diseases , Cross-Sectional Studies , Diet Surveys , Public Health
18.
J. bras. pneumol ; 41(4): 343-350, July-Aug. 2015. tab, ilus
Article in English | LILACS | ID: lil-759331

ABSTRACT

AbstractObjective: To describe the clinical characteristics, lung function, radiological findings, and the inflammatory cell profile in induced sputum in children and adolescents with severe therapy-resistant asthma (STRA) treated at a referral center in southern Brazil.Methods: We retrospectively analyzed children and adolescents (3-18 years of age) with uncontrolled STRA treated with high-dose inhaled corticosteroids and long-acting β2 agonists. We prospectively collected data on disease control, lung function, skin test reactivity to allergens, the inflammatory cell profile in induced sputum, chest CT findings, and esophageal pH monitoring results.Results: We analyzed 21 patients (mean age, 9.2 ± 2.98 years). Of those, 18 (86%) were atopic. Most had uncontrolled asthma and near-normal baseline lung function. In 4 and 7, induced sputum was found to be eosinophilic and neutrophilic, respectively; the inflammatory cell profile in induced sputum having changed in 67% of those in whom induced sputum analysis was repeated. Of the 8 patients receiving treatment with omalizumab (an anti-IgE antibody), 7 (87.5%) showed significant improvement in quality of life, as well as significant reductions in the numbers of exacerbations and hospitalizations.Conclusions: Children with STRA present with near-normal lung function and a variable airway inflammatory pattern during clinical follow-up, showing a significant clinical response to omalizumab. In children, STRA differs from that seen in adults, further studies being required in order to gain a better understanding of the disease mechanisms.


ResumoObjetivo: Descrever as principais características clínicas, a função pulmonar, as características radiológicas e o perfil inflamatório do escarro induzido de crianças e adolescentes com asma grave resistente a terapia (AGRT) tratados em um centro de referência do sul do Brasil.Métodos: Foram analisadas retrospectivamente crianças e adolescentes de 3-18 anos com diagnóstico de AGRT não controlada acompanhados durante pelo menos 6 meses e tratados com doses elevadas de corticoide inalatório associado a um β2-agonista de longa duração. Foram coletados prospectivamente dados relativos ao controle da doença, função pulmonar, teste cutâneo para alérgenos, perfil inflamatório do escarro induzido, TC de tórax e pHmetria esofágica.Resultados: Foram analisados 21 pacientes (média de idade: 9,2 ± 2,98 anos). Dos 21, 18 (86%) eram atópicos. A maioria apresentava asma não controlada e função pulmonar basal próxima do normal. Em 4 e 7 pacientes, o escarro induzido revelou-se eosinofílico e neutrofílico, respectivamente, e 67% dos pacientes que repetiram o exame apresentaram mudança no perfil inflamatório. Dos 8 pacientes que receberam omalizumabe (um anticorpo anti-IgE), 7 (87,5%) apresentaram melhora importante da qualidade de vida, com redução importante das exacerbações e hospitalizações.Conclusões: Crianças com AGRT apresentam função pulmonar próxima do normal e padrão inflamatório das vias aéreas variável durante o seguimento clínico, com importante resposta clínica ao omalizumabe. A AGRT em crianças difere da AGRT em adultos, e são necessários mais estudos para esclarecer os mecanismos da doença.


Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Asthma , Anti-Asthmatic Agents/therapeutic use , Hypersensitivity/diagnosis , Asthma/drug therapy , Asthma/physiopathology , Asthma , Brazil , Drug Resistance , Esophageal pH Monitoring , Hypersensitivity/drug therapy , Inflammation/diagnosis , Omalizumab/therapeutic use , Quality of Life , Respiratory Function Tests , Retrospective Studies , Severity of Illness Index , Skin Tests , Sputum/cytology , Treatment Failure
19.
Säo Paulo med. j ; 133(1): 20-27, Jan-Fev/2015. tab, graf
Article in English | LILACS | ID: lil-733012

ABSTRACT

CONTEXT AND OBJECTIVE: Inadequate Pap smears do not provide satisfactory cell samples for evaluation, thus making it more difficult to detect cervical cytological abnormalities. The objective of this study was to determine the cytological and histological follow-up results from women with inadequate smear reports in primary healthcare centers in Santiago, Chile 2010-2011. DESIGN AND SETTING: Prospective cohort study at primary healthcare clinics in Santiago, Chile. METHODS: The population was taken from the “Cito-Expert" database of 2010. The data were then organized according to the cytological and histological follow-up results of 2,547 women with inadequate cervical cytological reports over the 12-month period. The samples were assigned to groups based on the cause of inadequacy (smears with endocervical cells alone; insufficient, hemorrhagic, inflammatory or poorly fixed samples; insufficient and hemorrhagic samples; or insufficient and inflammatory specimens). The data were analyzed using the “conditional probability tree diagram" and descriptive statistics. RESULT: Half of the women (n = 1,285) met the requirements of the Ministry of Health for repeating these inadequate smears, and 1,104 of these women had normal cytological results (85.9%). The detection rate for cervical lesions according to group ranged ...


CONTEXTO E OBJETIVO: Esfregaços inadequados de Papanicolaou não fornecem amostra satisfatória de células para avaliação, ficando assim mais difícil detectar anomalias citológicas cervicais. O objetivo deste estudo foi determinar os resultados de seguimento citológico e histológico de mulheres com relatórios de esfregaços inadequados nas unidades básicas de saúde em Santiago, Chile, 2010-2011. DESENHO E LOCAL: Estudo prospectivo de coorte em unidades básicas de saúde em Santiago, Chile. MÉTODOS: A população foi selecionada do banco de dados Cito-Expert em 2010. Na sequência, os dados foram organizados pelos resultados de seguimento citológico e histológico de 2.547 mulheres com relatórios inadequados de citologia cervical pelo período de 12 meses. As amostras foram atri-buídas a grupos com base na causa de inadequação (esfregaços com células endocervicais; amostras insuficientes, inflamatórias, ou com má fixação, amostras insuficientes e hemorrágicas, ou espéci-mes insuficientes e inflamatórios). Os dados foram analisados com base no “conditional probability tree diagram" e estatísticas descritivas. RESULTADOS: Metade das mulheres (n = 1.285) preencheram os requisitos ...


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Young Adult , Epithelial Cells/cytology , Epithelial Cells/pathology , Outcome and Process Assessment, Health Care/organization & administration , Papanicolaou Test/methods , Vaginal Smears/methods , Chile , Follow-Up Studies , Inflammation/diagnosis , Lost to Follow-Up , Practice Guidelines as Topic , Prospective Studies , Papanicolaou Test/standards , Papanicolaou Test/statistics & numerical data , Specimen Handling , Squamous Intraepithelial Lesions of the Cervix/diagnosis , Vaginal Smears/standards , Vaginal Smears/statistics & numerical data
20.
Salvador; s.n; 2015. 84 p. ilus, tab.
Thesis in Portuguese | LILACS | ID: biblio-1000959

ABSTRACT

Introdução: A leishmaniose cutânea (LC) é a forma clínica mais frequente da leishmaniose humana, considerada um importante problema de saúde no Brasil. A infecção por Leishmania braziliensis induz um amplo espectro de lesões que pode se manifestar como uma única lesão cutânea localizada, geralmente em partes descobertas do corpo. Tem início com uma pápula, caracterizando a leishmaniose cutânea recente (LCR) e, na maioria dos casos, tende a desenvolver uma úlcera, representando a leishmaniose cutânea clássica (LCC). Pacientes com LCR apresentam um elevado número de parasitas na lesão e, frequentemente, não respondem positivamente à terapia padrão, desenvolvendo a lesão mesmo após o tratamento. Objetivo: Descrever de modo comparativo os aspectos histopatológicos na Leishmaniose Cutânea Recente e Leishmaniose Cutânea Clássica. Métodos: Secções histológicas obtidas de biópsias de pele de 15 pacientes com LCR e 28 com LCC, foram coradas em HE e mensuradas as áreas de inflamação e necrose nas diferentes fases da doença. Realizamos imunohistoquímica para marcação de células CD3+, CD4+, CD8+, CD20+, CD68+ e CD138+...


Introduction: Cutaneous leishmaniasis (CL) is the most common clinical form of human leishmaniasis induced by L. braziliensis. It is considered a major health problem in Brazil. Leishmania braziliensis infection induces a large spectrum of lesions that can manifest as one localized skin lesion, usually undressed body parts. It starts with a papule in early cutaneous leishmaniasis (ECL) clinical manifestation and, in most cases, tends to develop an ulcer, in the late cutaneous leishmaniasis (LCL). ECL patients have a high number of parasites in the lesion, and often do not respond to standard therapy, developing the lesion even after treatment. Aim: To describe comparative the histopathological aspects of early cutaneous leishmaniasis compared to late ulcerated cutaneous leishmaniasis. Methods: Histological sections of skin biopsies from 15 ECL patients and 28 LCL, were stained with HE and measured areas of inflammation and necrosis in the different stages of the disease. We performed immunohistochemical for CD3+, CD4+, CD8+, CD20+, CD68+ and CD138+...


Subject(s)
Humans , Inflammation/complications , Inflammation/diagnosis , Inflammation/parasitology , Inflammation/pathology , Inflammation/prevention & control , Leishmaniasis, Cutaneous/parasitology , Leishmaniasis, Cutaneous/prevention & control , Leishmaniasis, Cutaneous/transmission , Macrophages/parasitology , Macrophages/pathology
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