Tumores neuroendócrinos pancreáticos: revisão histopatológica / Pancreatic neuroendocrine tumors: histopathological review

Introdução: Os tumores neuroendócrinos pancreáticos são considerados raros. Eles são classificados em funcionantes e não funcionantes. Objetivo: Definir e classificar tumores neuroendócrinos pancreáticos de acordo com sua avaliação histopatológica e imunoistoquímica, associado aos critérios diagnósticos. Método: Trata-se de revisão narrativa sobre publicações encontradas no PubMed, SciELO e Google Acadêmico. Resultados: Esses tumores podem ser bem ou pouco diferenciados e apresentam características microscópicas distintas. As células bem diferenciadas têm formato pequeno, núcleos uniformes redondos ou ovais, citoplasma finamente granular indicando forte capacidade secretória e mantêm a estrutura organoide. A presença de necrose tumoral, atividade mitótica aumentada e índice de Ki-67 elevado indicam alta probabilidade de neoplasia neuroendócrina. Cromogranina A e sinaptofisina favorecem o diagnóstico do bem diferenciado. Já a marcação positiva do BCL 10 em conjunto com a ausência de expressão da cromogranina A e da sinaptofisina mostram a precária diferenciação tumoral. A presença de marcação positiva para as expressões hormonais não define o tumor como funcionante. Conclusão: Houve aumento do diagnóstico de tumores neuroendócrinos pancreáticos com o uso de técnicas de imagem e a conscientização sobre a doença. A análise histopatológica com imunoistoquímica, especialmente quando há sintomas consumptivos, podem indicar o tipo do carcinoma e induzir ao mais adequado tratamento.

Introduction: Pancreatic neuroendocrine tumors are considered rare. They are classified into functioning and non-functioning. Objective: To define and classify pancreatic neuroendocrine tumors according to their histopathological and immunohistochemical evaluation, associated with diagnostic criteria. Method: This is a narrative review of publications found in PubMed, SciELO and Google Scholar. \Results: These tumors can be well or poorly differentiated and have distinct microscopic characteristics. Well-differentiated cells are small in shape, have uniform round or oval nuclei, finely granular cytoplasm indicating strong secretory capacity, and maintain the organoid structure. Presence of tumor necrosis, increased mitotic activity and high Ki-67 index indicate a high probability of neuroendocrine neoplasia. Chromogranin A and synaptophysin favor the diagnosis of well-differentiated. The positive staining of BCL 10 together with the absence of expression of chromogranin A and synaptophysin show poor tumor differentiation. The presence of positive staining for hormone expressions does not define the tumor as functioning. Conclusion: There was an increase in the diagnosis of pancreatic neuroendocrine tumors with the use of imaging techniques and awareness of the disease. Histopathological analysis with immunohistochemistry, especially when there are consuming symptoms, can indicate the type of carcinoma and lead to the most appropriate treatment.

Encontros narrativos: mulheres pesquisadoras em meio à pandemia / Narrative encounters: women researchers amidst the pandemic

RESUMO A pandemia de Covid-19 gerou uma grave ruptura do cotidiano, submetendo as pessoas ao distanciamento e ao isolamento social e exigindo o desempenho de diversos papéis ocupacionais em um só ambiente. Diante disso, 11 mulheres de 2 universidades federais se uniram para fazer ciência e produzir grupos de ajuda e suporte mútuo virtuais para a população de 6 públicos-alvo diferentes. Neste artigo, apresenta-se uma reflexão sobre os caminhos percorridos pelas autoras a partir de aspectos semelhantes e singulares, dificuldades e privilégios identificados que perpassam suas vidas. Recorreu-se à cartografia para desenvolver este texto pela possibilidade de romper a lógica positivista acadêmica e expressar sentimentos e subjetividades. Entendendo tal experiência como irreprodutível pela técnica, construíram-se narrativas a partir da pergunta: "Como a minha história, constituindo-se mulher, afeta a minha participação nesta atividade de pesquisa?". Depois das leituras, elencaram-se oito categorias de análise e inferiu-se que gênero, raça/etnia e classe podem ser privilégios ou obstáculos a depender da sua expressão: masculino/ feminino, branco/negro, alta/baixa. Para as mulheres, a divisão sexual e a dupla jornada de trabalho, assim como a maternidade, ampliam a desvantagem causada pelo gênero.

ABSTRACT The Covid-19 pandemic caused a serious rupture in everyday life, subjecting people to social distancing and isolation, demanding performances of several occupational roles in the same environment. Thus, eleven women from two federal universities came together to do science and produce mutual virtual support groups for the population for six different target-groups. In this article, we present a reflection on the authors' stories from similar and singular aspects, difficulties and privileges identified that permeate our lives. We used cartography to develop this article due to the possibility of breaking the academic positivist logic and expressing feelings and subjectivities. Understanding this experience as irreproducible by its technique, narratives were built from the question: "How does my history as a woman affect my participation in this research activity?". After the readings, eight categories of analysis were listed and it was inferred that gender, race/ethnicity, and class may be privileges or obstacles depending on their expression: male/female, white/ black, high/low. For women, the sexual division of labor, double working hours, and motherhood amplify the disadvantage caused by gender.

Correlating rrs and eis promoter mutations in clinical isolates of Mycobacterium tuberculosis with phenotypic susceptibility levels to the second-line injectables

Objective/background: The in vitro drug-susceptibility testing of Mycobacterium tuberculosis reports isolates as resistant or susceptible on the basis of single critical concentrations. It is evident that drug resistance in M. tuberculosis is quite heterogeneous, and involves low level, moderate level, and high level of drug-resistant phenotypes. Thus, the aim of our study was to correlate rrs [X52917] and eis [AF144099] promoter mutations, found in M. tuberculosis isolates, with corresponding minimum inhibitory concentrations of amikacin, kanamycin, and capreomycin

Methods: Ninety M. tuberculosis clinical isolates were analyzed in this study. The minimum inhibitory concentrations were determined by MGIT 960 for 59 isolates with resistance-associated mutations in the rrs and eis promoter gene regions, and 31 isolates with wild-type sequences, as determined by the GenoType MTBDRsI [version 1] assay

Results: The rrs A1401G mutation was identified in 48 isolates resistant to the second- line injectables. The eis promoter mutations C-14T [n = 3], G-10C [n = 3], G-10A [n = 3], and C-12T [n = 2] were found within 11 isolates with various resistance profiles to the second-line injectables. Thirty-one isolates had wild-type sequences for the rrs and eis promoter gene regions of interest, one of which was amikacin, kanamycin, and capreomycin resistant. The isolates with the rrs A1401G mutation had amikacin, kanamycin, and capreomycin minimum inhibitory concentrations of >40 mg/L, >20 mg/L, and 515 mg/L, respectively. The isolates with eis promoter mutations had amikacin, kanamycm, and capreomycin minimum inhibitory concentrations of 0.25-1.0 mg/L, 0.625-10 mg/ L, and 0.625-2.5 mg/L, respectively

Abordagem odontológica com obturador palatino imediato em um paciente portador de tumor neuroectodérmico melanótico da infância: relato de caso / Dental strategy with immediate palatal obturator in a patient with melanotic neuroectodermal tumor of infancy: case report

O objetivo do presente artigo é relatar a abordagem odontológica com obturador palatino imediato diferenciado em um caso clínico de tumor neuroectodérmico melanótico da infância, ocorrido no Instituto Nacional de Câncer José Alencar Gomes da Silva, realizando uma revisão da literatura e abordando o atendimento multidisciplinar como garantia do cuidado integral ao paciente. Lactente, 4 meses, sexo masculino, tumoração em maxila esquerda, foi encaminhado à seção de Odontologia para confecção de obturador palatino com projeção maxilar. O paciente que é submetido a um tratamento mutilador na tentativa de cura de alguma neoplasia de cabeça e pescoço necessita de conforto, bem-estar e um cuidado integral da equipe multidisciplinar, sendo o cirurgião-dentista parte dessa equipe.

The aim of this paper is to report a dental strategy with a differentiated immediate palatal obturator in a case of melanotic neuroectodermal tumor of infancy, held at the National Cancer Institute José Alencar Gomes da Silva, by performing a literature review and addressing the multidisciplinary treatment as a guarantee of integral care for the patient. Infant, 4 months, male, tumor in the left maxilla, was referred to the Odontology section for a palatal obturator confection with maxillary projection. The patient who is submitted to a mutilating treatment in an attempt to cure any head and neck neoplasm needs comfort, wellness and integral care from the multidisciplinary team, being the dentist part of it.

Avaliação da utilização de ensaio imunocromatográfico para o diagnóstico e estudo de prevalência da hepatite A / Evaluation of an immunochromatographic assay for diagnosis and prevalence study of hepatitis A

O diagnóstico da infecção pelo vírus da hepatite A (HAV) através de testes de alta sensibilidade e especificidade pode levar um diagnóstico mais precoce e mais preciso,melhorando o prognóstico da doença. Deve também ser mencionado que um diagnóstico mais preciso pode tornar estudos epidemiológicos mais confiáveis e servir de base para a produção de programas de controle e erradicação mais efetivos. O objetivo deste estudo foi avaliar a utilização de um teste imunocromatográfico em surtos e estudos epidemiológicos de prevalência, triagem de candidatos para programas de vacinação e detecção de resposta imunológica pós-vacinação. Para este fim, 342 amostras provenientes de quatro grupos diferentes foram analisadas: (I) amostras de doadores de sangue (n= 96), (II) amostras de indivíduos vacinados contra a hepatite A (n= 46), amostras de surtos de hepatite A (III) (n=103) e (IV) amostras de casos esporádicos de hepatite A (n= 97). Estas amostras foram submetidas ao teste rápido SD BIOLINE HAV IgG/IgM e todos os resultados do teste rápido foram comparados com os resultados do ensaio imunoenzimático para HAV (EIA), que é o padrão ouro para detectar anticorpos contra o HAV...

The diagnosis of infection by the hepatitis A virus (HAV) through high sensitivity andspecificity tests can lead an earlier and more accurate diagnosis, improving the prognosis ofthe disease. It should also be mentioned that a more precise diagnosis can become morereliable epidemiological studies and as a basis for the production of more effective controland eradication programs. The aim of this study was to evaluate an immunochromatographictest in outbreaks and epidemiological studies of prevalence, screening candidates forvaccination and post-vaccination surveillance programs. For this purpose, 342 samples frompatients of four different groups were analyzed: (I) samples from blood donors (n=96), (II)samples from individuals vaccinated for hepatitis A (n=46), (III) samples from hepatitis Aoutbreaks (n=103) and (IV) samples from sporadic cases of hepatitis A (n=97). These sampleswere submitted to the rapid test SD BIOLINE HAV IgG/IgM and all results of the rapid testwere compared to the results of HAV enzyme immunoassay (EIA) that is the gold standard todetect antibodies against HAV. The results obtained for the group I showed that, 33.3%(32/96) were positive for anti-HAV IgG using the rapid test and 67.7% (65/96) were positivefor IgG anti-HAV by EIA. At group II, 71.7% (33/46) of the samples were positive for antiHAVIgG by EIA and none of them (0/33) was reactive by rapid test. Groups III and IV weretested for the presence of anti-HAV IgG and anti-HAV IgM antibodies...

How does protein malnutrition or food deprivation interfere with the growth of the epiphyseal plate in animals? / Cómo interfieren la desnutrición protéica o la privación alimentaria en el crecimiento de la placa epifisaria de animales?

The aim of this study was to conduct a literature review of impacts of protein malnutrition and/or early food deprivation on the formation of the growth plate in young animals. A search was performed using the databases PubMed/MEDLINE, LILACS, SciELO and the Cochrane Library, without language restrictions or any limit as to year. Initially, 150 articles were identified, however, after application of the inclusion and exclusion criteria only five remained. In three studies the nutritional stress was due to protein malnutrition, another due to fasting and the fifth was due to food restriction. All the studies had some methodological omissions. The studies included in this review-demonstrated corroboration in the results obtained, regardless of whether the animals had been subjected to protein malnutrition, fasting or food restriction. The findings uncovered were reduction in height of the epiphyseal plate, in the number of proliferative and hypertrophic chondrocytes, in the bone growth rate and in the longitudinal length of the bone in animals subjected to nutritional stress. In this systematic review, it was possible to observe the susceptibility of the epiphyseal plate in the first place, and secondarily, of the long bones to the effects of nutritional stress by means of protein malnutrition or food deprivation applied in young animals.

El objetivo fue realizar una revisión de la literatura sobre el impacto de la desnutrición proteica y/o privación de alimentos en la temprana formación de la placa de crecimiento en animales jóvenes. La búsqueda fue realizada en las bases de datos PubMed/MEDLINE, LILACS, SciELO y Biblioteca Cochrane sin restricción de lengua o límite de año. Fueron identificados inicialmente ciento cincuenta artículos que, posterior a la aplicación de los criterios de inclusión y exclusión, solo quedaron cinco. En tres estudios el estrés nutricional fue causado por la desnutrición proteica, otro al ayuno y el tercero fue por restricción alimentaria. Todos los estudios presentaban algunas omisiones metodológicas. Las investigaciones incluidas en esta revisión demostraron concordancia en sus resultados obtenidos, independientemente que los animales hayan sido sometidos a desnutrición proteica, ayuno o restricción alimentaria. Los datos obtenidos mostraron que los animales sometidos al estrés nutricional presentaron una reducción en la altura de la placa epifisaria, en el número de condrocitos proliferativos e hipertróficos, en la tasa de crecimiento óseo y en la longitud ósea. En esta revisión sistemática fue posible observar que los efectos del estrés nutricional, a través, de desnutrición proteica o de la privación alimentaria aplicada en animales jóvenes presentan, en primer lugar, una susceptibilidad de la placa epifisaria y de los huesos largos de manera secundaria.

Is a composite reference standard [CRS] an alternative to culture in assessment and validation of a single tube nested in-house PCR for TB diagnosis?

Introduction: Delay in diagnosis of paucibacillary extra pulmonary tuberculosis [TB] and of smear negative TB has hampered the efforts taken by Control Programs to curb its spread. Better efforts to control spread of TB require more accurate and rapid diagnostic test

Aims: To facilitate early diagnosis of TB directly from clinical specimens, we have standardized and validated the use of a single tube in-house nested PCR in comparison against culture and composite reference standard [CRS]

Methods: Single tube nested PCR was performed using primers targeting Insertion Sequence [IS] 6110 of Mycobacterium tuberculosis complex. Microbiological techniques includes AFB smear microscopy, and cultivation on solid egg-based medium [Lowenstein-Jensen [LJ]] and on liquid culture medium using BACTEC MGIT 960 system, BD Microbiology Systems

Results: The sensitivity and specificity of PCR against culture was observed to be 89.7% [95% CI: 84.1-93.5] and 73.1% [95% CI: 67.4-78.1] respectively and that against CRS criteria was 80.2% [95% CI: 75.1-84.5] and 97.1% [95% CI: 92.9-98.9] respectively. PCR showed 100% [111/111, 95% CI: 97-100] sensitivity for smear positive specimens. For smear negative specimens sensitivity and specificity of PCR against culture was observed to be 78.4% [69/88, 95% CI: 68.4-86.5] and 77.3% [204/264, 95% CI: 71.7-82.2] respectively and that against CRS was 68.1% [124/182, 95% CI: 60.8-74.8] and 97.1% [165/170, 95% CI: 93.3-99] respectively

Conclusion: CRS criteria were observed to be better than culture for assessing the diagnostic accuracy of PCR test

Impacto da desnutrição e do treinamento aeróbico moderado sobre a estrutura da parede arterial de ratos em processo de envelhecimento / Impact of malnutrition and moderate aerobic training on the structure of arterial wall in aging rats

Foram avaliadas as repercussões tardias da desnutrição multicarencial imposta no período de aleitamento e os possíveis efeitos e/ou alterações tanto do processo de envelhecimento como do treinamento físico aeróbio moderado sobre o diâmetro luminal e a área da túnica média da parede das artérias carótida comum esquerda, aorta horizontal e aorta torácica de ratos em processo de envelhecimento. Vinte e quatro ratos machos, Wistar, foram separados de acordo com a dieta e o treinamento físico em: GNS - nutrido sedentário, GNT - nutrido treinado, GDS - desnutrido sedentário e GDT - desnutrido treinado. Aos 10 meses, o GNT e o GDT foram submetidos ao treinamento, em meio aquático, durante oito semanas. Em seguida, os ratos foram anestesiados, sacrificados e, posteriormente, foram coletados fragmentos arteriais para o processamento histológico. A área da túnica média foi mensurada através da diferença entre as áreas externa e interna da parede arterial e o diâmetro luminal foi mensurado a partir da média de dois diâmetros medidos a partir de quatro pontos marcados na camada interna do vaso. A área da túnica média apresentou redução na aorta horizontal quando comparamos os grupos GNS x GDS (p = 0,015) e um aumento da artéria carótida comum esquerda entre os grupos GNT e GNS (p < 0,001). A aorta torácica apresentou um aumento do diâmetro luminal ao compararmos o GDS com o GDT (p= 0,041). Tanto a desnutrição multicarencial induziu alterações parciais na parede aorta horizontal, como também o treinamento físico foi capaz de promover mudanças na área da túnica média da artéria carótida comum esquerda e no diâmetro luminal da aorta torácica.

We evaluated the late effects of malnutrition multicarencial imposed during lactation and the possible effects and / or changes to both the aging process as of moderate aerobic training on the luminal diameter and the tunica media area of the left common carotid artery, horizontal aorta and thoracic aorta of rats in the aging process. Twenty-four Wistar rats male were separated according to diet and physical training: GNS - Nourished Sedentary Group, GNT - Trained Nourished Group, GDS - Malnourished Sedentary Group and GDT - Malnourished Trained Group. At 10 months, the GNT and GDT were submitted to TAM, in water for 8 weeks. Then the mice were anesthetized and sacrificed and the arterial fragments were collected for histological processing. The area of the tunica media was measured by the difference between external and internal areas of the arterial wall and luminal diameter was measured from the average of two diameters measured from four points marked on the inner layer of the vessel. The area of tunica media decreased in the horizontal aorta when compared the groups GNS x GDS (p = 0.015) and increased in left common carotid artery between the groups GNS and GNT (p = <0.001). The thoracic aorta showed an increase in luminal diameter when comparing the GDS with the GDT (p = 0.041). Both malnutrition multicarencial induced partial changes in the horizontal aorta wall, as well as the physical training was able to promote changes in the tunica media area of the left common carotid artery and luminal diameter of the thoracic aorta.