Estudo morfométrico do miocárdio em adultos com subnutriçäo protéico-energética / Myocardial morphometric study in protein-energy malnourished adults

Objetivo - Comparar o tamanho das células musculares e a presença de lipofuscina no coração de adultos necropsiados, subnutridos e controles. Método - De uma casuística inicial de 315 necropsias de adultos, foram excluídos casos com sinais de retenção hídrica, cardiopatias, hepatopatias, hipertensão e nefropatias. Subnutrição foi caracterizada pelo índice de massa corporal (IMC) <17kh/m2. Fragmentos de miocárdio foram processados para morfometria computadorizada, determinando-se a espessura dos miocardiócitos e a presença de lipofuscina. Resultados - Subnutridos (n=8) e controles (n=4) foram estatisticamente diferentes, respectivamente, quanto ao IMC (14,86+1,13 vs 22,02+0,9 kg/m2), relação peso cardíaco/peso corporal (0,68+0,09 vs 0,54+0,07 por cento), espessura de miocardiócitos (10,91+0,77 vs 12,90+54,4 por cento). Conclusão - Comparados aos controles, adultos subnutridos têm menores espessuras de miocardiócitos e presença de lipofuscina, fenômenos que refletir um distúrbio metabólico com repercussões clínicas danosas em pacientes terminais.

Prevalência de infartos renais em necropsias de chagásicos crônicos / Prevalence of renal infarction in necropsies of chronic chagasic patients

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.