Oxidative stress and acute-phase response in patients with pressure sores.

OBJECTIVE: We investigated the relation between oxidative stress and the occurrence of the acute-phase response with serum ascorbic acid and alpha-tocopherol levels in patients with pressure sores. METHODS: The following groups of patients were studied: 1) those who had patients with pressure sores, 2) those who had pneumonia, and 3) those who did not develop pressure sores or any type of infection (control). Concentrations of total proteins, albumin, creatinine, iron, ferritin, transferrin, C-reactive protein, alpha1-acid glycoprotein, total iron-binding capacity, ascorbic acid, alpha-tocopherol, and malondialdehyde were measured during the first days of hospitalization. RESULTS: Albumin concentrations were significantly lower (P < 0.05) and C-reactive protein concentrations were significantly higher (P < 0.05) in patients with pressure sores compared with controls. Concentrations of ascorbic acid and alpha-tocopherol were significantly decreased (P < 0.05) in patients who had pressure sores or infection, whereas malondialdehyde concentrations were significantly increased (P < 0.05) compared with control patients. Five of 11 patients (55.56%) with pressure sores and 10 of 12 patients (83.33%) with pneumonia presented serum ascorbic acid concentrations below the reference value (34 to 91 micromol/L). Concentrations of ascorbic acid and alpha-tocopherol versus malondialdehyde were significantly correlated in the three patient groups (r = -0.44, P < 0.05; r = -0.55, P < 0.01, respectively). CONCLUSION: Patients with pressure sores and acute infection present a systemic inflammatory response accompanied by an increase in lipid peroxidation that is associated with decreased serum ascorbic acid and alpha-tocopherol levels, suggesting that these patients may be at risk for important nutritional deficiencies.

Características evolutivas do Cysticercus cellulosae no encéfalo e no coração humanos / Developmental characteristics of Cysticercus cellulosae in the human brain and heart

O presente estudo teve como objetivos avaliar a prevalência de cisticercose, classificar as etapas evolutivas dos cisticercos encontrados nos encéfalos e coraçöes humanos, diferenciá-las de acordo com os aspectos macro e microscópicos dos processos patológicos gerais e comparar os processos encontrados nos encéfalos e coraçöes. Foram revisados protocolos de autópsias realizadas no Hospital Escola da Faculdade de Medicina do Triângulo Mineiro, Uberaba, MG, Brasil, no período de 1970 a 2000. Verificou-se a prevalência da cisticercose em 71 casos, sendo 18 (25,4 por cento) de cisticercose cardíaca e 53 (74,6 por cento) de encefálica. Foram analisados 19 cisticercos, sendo 9 de encéfalos e 10 de coraçöes. Os cisticercos foram classificados, de acordo com sua fase evolutiva, em etapas: vesicular, vesicular coloidal, granular nodular e nodular calcificada, com similaridade entre os diagnósticos macro e microscópico. Entre os processos patológicos destacaram-se a beta-fibrilose e a fibroelastose endocárdica. Adicionalmente, demonstrou-se que a classificaçäo pode ser aplicada tanto na cisticercose encefálica como na cardíaca

[Developmental characteristics of Cysticercus cellulosae in the human brain and heart]. / Características evolutivas do Cysticercus cellulosae no encéfalo e no coração humanos.

The present study aimed to evaluate the prevalence of cysticercosis, to classify the developmental phases of cysticerci found in human brains and hearts, and differentiate these according to the macro and microscopic aspects of the general pathological processes, and to compare the process found in the brains and hearts. Protocols from autopsies performed at the Hospital of the School of Medicine of the Triângulo Mineiro, Uberaba, MG, Brazil, in the period from 1970 to 2000 were reviewed. The prevalence of cysticercosis was verified in 71 cases, of which 53 (74.6%) were encephalic cysticercosis and 18 (25.3%) cardiac cysticercosis. Nineteen cysticerci were analyzed, from 9 brains and 10 hearts. The cysticerci were classified according to their developmental stage: vesicular, colloidal vesicular, granular nodular and calcified nodular, with similarities between the macroscopic and microscopic diagnoses. Among the pathological processes found beta-fibrilosis and endocardial fibroelastosis are underscored. In addition, it was demonstrated that this classification may be applied both to encephalic and cardiac cysticercosis.