Identifying the similarities and differences between single nucleotide polymorphism array (SNPa) analysis and karyotyping in acute myeloid leukemia and myelodysplastic syndromes

Objective: To standardize the single nucleotide polymorphism array (SNPa) method in acute myeloid leukemia/myelodysplastic syndromes, and to identify the similarities and differ- ences between the results of this method and karyotyping. Methods: Twenty-two patients diagnosed with acute myeloid leukemia and three with myelodysplastic syndromes were studied. The G-banding karyotyping and single nucleotide polymorphism array analysis (CytoScan(r) HD) were performed using cells from bone marrow, DNA extracted from mononuclear cells from bone marrow and buccal cells (BC). Results: The mean age of the patients studied was 54 years old, and the median age was 55 years (range: 28-93). Twelve (48%) were male and 13 (52%) female. Ten patients showed abnormal karyotypes (40.0%), 11 normal (44.0%) and four had no mitosis (16.0%). Regarding the results of bone marrow single nucleotide polymorphism array analysis: 17 were abnor- mal (68.0%) and eight were normal (32.0%). Comparing the two methods, karyotyping identified a total of 17 alterations (8 deletions/losses, 7 trissomies/gains, and 2 translocations) and single nucleotide polymorphism array analysis identified a total of 42 alterations (17 losses, 16 gains and 9 copy-neutral loss of heterozygosity). Conclusion: It is possible to standardize single nucleotide polymorphism array analysis in acute myeloid leukemia/myelodysplastic syndromes and compare the results with the abnormalities detected by karyotyping. Single nucleotide polymorphism array analysis increased the detection rate of abnormalities compared to karyotyping and also identified a new set of abnormalities that deserve further investigation in future studies. .

Videopericardioscopia. Como melhorar a eficácia diagnóstica em derrames pericárdicos / Video-assisted pericardioscopy. How to improve diagnostic efficacy in pericardial effusions

OBJECTIVE: To assess, in a prospective way, the experience with video-assisted pericardioscopy obtained in patients with pericardial effusion of unclear etiology in the preoperative period. METHODS: From January 1998 to June 2000, 20 patients were operated upon with the aid of video-assisted pericardioscopy. On echocardiography, 17 of these patients had significant pericardial effusion, and 3 had moderate pericardial effusion. Video-assisted pericardioscopy was performed through a small incision of the Marfan type. RESULTS: The diagnosis of pericardial effusion was established as follows: idiopathic in 9 (45 percent) patients, neoplastic in 4 (20 percent), resulting from hypothyroidism in 3 (15 percent), tuberculous in 2 (10 percent), due to cholesterol in 1 (5 percent), and chylopericardial in 1 (5 percent). The biopsy was positive in 30 percent of the patients, and the etiology could not be defined in 45 percent of the patients. CONCLUSION: Video-assisted pericardioscopy proved to be a method with low morbidity and a high index of diagnostic positivity. A high percentage of pericardial effusions are caused by viral infections, which are not diagnosed through current methods, being, therefore, classified as idiopathic

Remodelamento do coracao pos-IAM / Heart remodeling following acute myocardial infarction

O remodelamento do coracao e o conjunto de alteracoes observadas no musculo cardiaco durante determinadas situacoes, podendo ocorrer em patologias que envolvam um aumento constante do trabalho cardiaco. O remodelamento pode ser de quatro tipos, hipertrofico concentrico, hipertrofico excentrico, remodelamento concentrico e de geometria normal. No Infarto Agudo do Miocardio, a dilatacao ventricular ocorre como resposta a agressao ao colageno cardiaco. Ha evidencias que hormonios difusiveis sao fundamentais neste processo, especialmente a Angiotensina II e a Prostaglandina E. Estes hormonios agem diretamente sobre o fibroblasto cardiaco, sendo que esta interacao parece ser de grande importancia para a regulacao da fibrose do miocardio. Considerando-se estes efeitos do sistema renina-angiotensina-aldosterona e o acumulo de colageno pos-infarto, o tratamento por inibidores da enzima conversora de angiotensina e bloqueadores do receptor cardiaco para angiotensina parece promissor na regressao da fibrose do miocardio...