Tinnitus and its association with psychiatric disorders: systematic review.

OBJECTIVES: To systematically review the literature on the occurrence of psychiatric diagnoses in a tinnitus-affected population, and correlate the presence of psychiatric disorders with tinnitus-related annoyance and severity. METHOD: A systematic review of the literature published between January 2000 and December 2012 was performed using PubMed, ISI Web of Science and SciELO databases. Original articles in English and Portuguese that focused on the diagnosis of mental disorders associated with tinnitus, especially anxiety and depression, were identified. RESULTS: A total of 153 articles were found and 16 were selected. Fifteen articles showed a high prevalence of psychiatric disorders in tinnitus-affected patients, and nine showed a high correlation between the presence of a psychiatric disorder and tinnitus-related annoyance and severity. CONCLUSION: The prevalence of psychiatric disorders, especially anxiety and depression, is high in tinnitus patients, and the presence of these disorders correlates with tinnitus-related annoyance and severity.

Synthesis and characterization of hematite pigment obtained from a steel waste industry.

Pigments that meet environmental and technology requirements are the focus of the research in the ceramic sector. This study focuses on the synthesis of ceramic pigment by encapsulation of hematite in crystalline and amorphous silica matrix. Iron oxide from a metal sheet rolling process was used as chromophore. A different content of hematite and silica was homogenized by conventional and high energy milling. The powders obtained after calcinations between 1050 and 1200 °C for 2h were characterized by X-ray diffraction and SEM analysis. The pigments were applied to ceramic enamel and porcelain body. The effect of pigment was measured by comparing L*a*b* values of the heated samples. Results showed that the color developed is influenced by variables such as oxide content employed, conditions of milling and processing temperature. The results showed that the use of pigment developed does not interfere in microstructural characteristics of pigmented material. The best hue was obtained from samples with 15 wt% of chromophore, heated at 1200 °C in amorphous silica matrix.

Influence of drying methods over in vitro antitumoral effects of exopolysaccharides produced by Agaricus blazei LPB 03 on submerged fermentation.

Agaricus blazei is a mushroom that belongs to the Brazilian biodiversity and is considered as an important producer of bioactive compounds beneficial to human health. Studies have demonstrated that these compounds present immuno-modulatory, antioxidant and antitumor properties. In order to compare the most used method for fungal polysaccharide drying, lyophilization with other industrial-scale methods, the aim of this work was to submit A. blazei LPB 03 polysaccharide extracts to vaucum, spray and freeze drying, and evaluate the maintenance of its antitumoral effects in vitro. Exopolysaccharides produced by A. blazei LPB 03 on submerged fermentation were extracted with ethanol and submitted to drying processes. The efficiency represents the water content that was removed during the drying process. The resultant dried products showed water content around 3% and water activity less than 0.380, preventing therefore the growth of microorganisms and reactions of chemical degradation. Exopolysaccharide extracts dried by vacuum and spray dryer did not showed any significant cytotoxic effect on cell viability of Wistar mice macrophages. Content of total sugars and protein decrease after drying, nevertheless, 20 mg/ml of exopolysaccharides dried by spray dryer reached 33% of inhibition rate over Ehrlich tumor cells in vitro.

Experimental hepatitis A virus (HAV) infection in Callithrix jacchus: early detection of HAV antigen and viral fate.

Common marmosets (Callithrixjacchus) were orally inoculated with a Brazilian strain (HAF-203) of hepatitis A virus (HAy). Three monkeys were euthanized at postinoculation hours 6, 12 and 24 to investigate the early events of HAV infection. Following others three inoculated and one control marmosets remained throughout the 46 day to evaluation of viral excretion. Different samples were collected to detect sequential presence of HAV RNA by nested reverse transcription-polymerase chain reaction (RT-PCR) in liver, saliva, bile and stools at 6 hours to 461h days postinoculation. Liver tissues were examined by immunofluorescence assay in a confocal laser-scanning microscope for the presence of HAV antigen. HAV RNA was detected in saliva during the course of the study, in bile from 24 hours to 46 days. in stools from 7 to 46 days and liver at 12 hours postinfection. In immunofluorescence of liver stained preparations, viral antigen was present at six hours after inoculation throughout the remainder of the 46-day study. The animals developed histological and biochemical acute hepatitis after second week postinoculation. Spleen, duodenum, and mesenteric lymph nodes specimens were negative for HAV antigens. This study supports the possibility that in Callithrixjacchus orally inoculated with hepatitis A virus the saliva route may be additional way of viral elimination. The viral replication in the liver was responsible for biliary HAV presence and latter HAV detection in fecal samples.

Influence of the pineal gland on the physiology, morphometry and morphology of pancreatic islets in rats.

To investigate the influence of the pineal gland through melatonin secretion on the physiological and morphological parameters of pancreatic islets, we studied the plasma biochemistry and morphological and morphometric characteristics of the endocrine pancreas of male Wistar rats. The animals were distributed into five groups of ten rats each: NC - normal control group; NS -- sham-operated group; Px (25) -- pinealectomised group, studied 15--25 days after surgery; Px (70) -- pinealectomised group, studied 60-70 days after surgery; ALX - alloxan monohydrate-treated group. Data are analyzed statistically by ANOVA and by the Kruskal-Wallis test. Although there was no significant difference in plasma glucose or insulin levels between the Px (25), Px (70) and NC groups, Px (25) animals showed a tendency to increased glucose and reduced insulin levels. The ALX group showed a clear elevation of plasma glucose and a reduction of plasma insulin compared to the other groups. Morphometric analysis showed a larger pancreatic islet area and a lower pancreatic islet density in the pancreas of Px (70) animals and an increase in degenerative pathological processes in the pancreatic islets of the Px (25) and ALX groups. The present results suggest that melatonin, in addition to acting on tissue sensitivity to insulin (as reported in other studies), affects the secretory action of beta cells, as demonstrated by the morphological and morphometric changes observed in pinealectomised animals.

Cytological aspects of melanotic variant of medullary thyroid carcinoma.

We had the opportunity to examine a case of fine-needle aspiration (FNA) of a melanotic variant of medullary thyroid carcinoma (MTC) in a 20-yr-old man. The patient presented a single node, hardened and mobile upon deglutition, in the right lobe of the thyroid, for 9 mo, without symptoms of glandular dysfunction. Calcitonin (138 pg/ml), urinary calcium (177 mg/dl), and the carcinoembryonic antigen (341 ng/ml) were increased. The nodular aspirate, drawn by FNA, was represented by pleomorphic cells, with frequent intranuclear cytoplasmic inclusions, sometimes bi- or multinucleated, with abundant, finely granular cytoplasm, sometimes containing a brown pigment resembling melanin. An immunohistochemical study using monoclonal antibodies (Dako Corp., Carpinteria, CA) showed that the neoplastic cells were intensely and diffusely positive for calcitonin and chromogranin, and focally positive for HMB45. In view of these findings, the case was characterized as a melanotic variant of medullary carcinoma, a rare type of neoplasia, but having a prognosis similar to the classical variant of MTC.

Parasitic thyroid nodule in a patient with Hashimoto's chronic thyroiditis.

A case of parasitic thyroid nodule is presented. The patient was a non symptomatic 53-year-old white woman, on irregular course of L-thyroxine to treat hypothyroidism due to Hashimoto's thyroiditis. Without a history of thyroid trauma or surgery, she presented a 1.6 x 0.7 x 0.5cm right pre-laryngeal lymph node-like mass which, on ultrasonography, appeared distinct from the gland. TSH, thyroid peroxidase antibody and thyroglobulin antibody serum levels were elevated and T4-free level was normal. Thyroid and total body 99mTc isonitrile scintiscan showed a topic thyroid without radionuclide uptake in the nodule. Fine-needle aspiration of the nodule showed epithelial cells with nuclear atypia and oncocytic changes plus intense lymphoid infiltration and germinative center formation, simulating lymph node metastasis of papillary thyroid carcinoma. Conventional biopsy revealed a parasitic thyroid nodule with Hashimoto's chronic thyroiditis. Parasitic thyroid nodule must always be remembered so that unnecessary surgical assessment and undesirable sequels may be avoided.

C cells in normal thyroid aspirates.

OBJECTIVE: To quantify C cells in normal thyroid aspirates. STUDY DESIGN: Smears of 18 glands from patients with no thyroid disease, 8 women and 10 men aged on average 52.8 years, were analyzed. Five samples were aspirated from the upper, middle and lower thirds of each lateral lobe and from the isthmus. Smears were stained with anticalcitonin monoclonal antibody. RESULTS: C cells were detected in all specimens, ranging in number from 3 to 19 per gland, with 53.4% of the cells in the right lobe, 42.8% in the left lobe and 3.7% in the isthmus. The aspirates from the right lobe had 0-13 cells in the upper third, 0-9 in the middle third and 0-3 in the lower third. In the left lobe aspirates there were 0-7 cells in the upper third, 0-6 in the middle third and 0-2 in the lower third. One to two C cells were observed in the isthmus in only four cases. CONCLUSION: It is possible to determine the presence of C cells in normal thyroids and confirm studies conducted on histologic material; the cells were more frequently detected in the middle and upper third and mainly on the right side. They were rare in the isthmus. The search for C cells in thyroid aspirates is of great importance because it permits one to confirm rapidly, precisely and minimally invasively cases suspected of C cell hyperplasia, a preneoplastic condition that precedes the development of medullary carcinoma. In addition, the method shows numerical changes in these cells in such conditions as Hashimoto's thyroiditis and colloid goiter, in which the present results could serve as a control.

Congenital hyperthyroidism: autopsy report.

We report the autopsy of a stillborn fetus with congenital hyperthyroidism born to a mother with untreated Graves' disease, whose cause of death was congestive heart failure. The major findings concerned the skull, thyroid, heart, and placenta. The cranial sutures were closed, with overlapping skull bones. The thyroid was increased in volume and had intense blood congestion. Histological examination showed hyperactive follicles. The heart was enlarged and softened, with dilated cavities and hemorrhagic suffusions in the epicardium. The placenta had infarctions that involved at least 20% of its surface, and the vessels of the umbilical cord were fully exposed due to a decrease in Wharton's jelly. Hyperthyroidism was confirmed by the maternal clinical data, the fetal findings of exophthalmia, craniosynostosis, and goiter with signs of follicular hyperactivity. Craniosynostosis is caused by the anabolic action of thyroid hormones in bone formation during the initial stages of development. The delayed initiation of treatment in the present case contributed to the severity of fetal hyperthyroidism and consequent fetal death.

[Progressive multifocal leukoencephalopathy as initial manifestation of acquired immunodeficiency]. / Leucoencefalopatia multifocal progressiva como manifestação inicial da síndrome da imunodeficiência adquirida.

This is a report of a man with acquired immunodeficiency syndrome (AIDS) who presented acutely ill with severe progressive multifocal leukoencephalopathy (PML) as the first manifestation of AIDS. PML was diagnosed in the brain after gross and microscopical examination as well as by immunohistochemistry with an antibody against JC virus.

[Immunohistochemical identification of biochemical defect of dyshormonogenetic goiter]. / Defeito bioquímico de bócio disormonogenético identificado através de estudo imuno-histoquímico.

This is a report of two cases of congenital goiter in which it was possible to indicate, through immunohistochemistry method, the disorder in the hormonal synthesis. One of these cases was of a sixteen-year-old woman, with goiter since childhood who used thyroid hormone replacement for ten years. Pathology showed coloid goiter with follicular adenoma. Immunohistochemistry showed strong mainly apical follicular cell thyroglobulin. Thyroglobulin was not found in the coloid. This finding is compatible with a malfunction of thyroglobulin exocitosis. The reaction for thyroid peroxidase was adequate for the age. The other case was a 13 year-old-boy with goiter and thyroid hormone replacement since the age of 1 year. He presented slight mental and growth retardation. Pathology showed coloid goiter with follicular adenoma. Immunohistochemistry study showed a very weak and diffuse reaction for thyroid peroxidase while the reaction for thyroglobulin was adequate. These findings indicate quantitative defect of thyroid peroxidase.

[Hanseniasis virchowiana in Chagas cardiopathy: an autopsy report]. / Hanseníase virchowiana em cardiopata chagásico: relato de necropsia.

This is a case report of lepromatous infection diagnosed at necropsy, with cardiac alterations directly caused by mycobacteria, in a 34-year-old black male with the cardiac form of Chagas' disease. The possible role of inflammatory mediators on cardiac dysfunction, and the possibility that immune depression may be due to factors associated with heart failure, as congestive splenomegaly and splenic infarctions, are emphasized.

[Heterotopic adipose tissue in the uterine cervix]. / Tecido adiposo heterotópico na cérvix uterina]

Lipomatous lesions of the uterus are uncommon and the few cases reported only describe those lesions associated with neoplasia of the soft tissue such as leiomyomas, or pure, characterizing lipomas, and there are no reports on the diffuse or neoplastic form. A 34-year-old woman, para 1, abortion 1, presented with discrete leukorrhea without other complaints. On speculum examination, polypoid papillary ectopia was observed macroscopically which may have been caused by epithelial hyperplasia due to papillomavirus infection or the use of anovulatory drugs. Histologic examination revealed diffuse infiltration of the endocervical stroma by mature adipocytes, characterizing choristoma. The patient did not receive any treatment and was found to be well 2 years after a biopsy. The presence of mature heterotopic non-neoplastic adipose tissue in the uterine cervix has not been previously reported. The histogenesis of the lesion has not been defined; however, the hypothesis has been raised that smooth muscle cells of the cervical stroma are directly transformed into adipocytes, as demonstrated by immuno-histochemical analysis.

[Cryptococcus infection limited to the prostate in an AIDS patient with disseminated mycobacteriosis. A necropsy report]. / Infecção por Cryptococcus limitada à próstata em paciente aidético com micobacteriose disseminada. Relato de necropsia.

This is a case report of asymptomatic and restrained cryptococcal prostatic infection in a 32-year-old black male with the acquired immunodeficiency syndrome, whose death was caused by systemic mycobacteriosis probably pertaining to MAI complex. The importance of autopsy studies to evaluate the real prevalence of fungus infections in AIDS patients, specially in cases of persistent silent focuses, is emphasized.

Neurological examination in obsessive-compulsive disorder.

Recent studies suggest the occurrence of a neurological dysfunction in Obsessive-Compulsive Disorder (OCD). The purpose of the present study was to verify the clinical value of a neurological evaluation in patients with the disease. We submitted 15 patients with OCD (five of whom were under clomipramine) and 15 controls in a detailed neurological examination, including assessment of the neurological soft-signs. Eleven patients (73.3 percent) and four controls (26.7 percent) presented abnormalities on examination. The main findings among the patients were: palmomental reflex (six cases); mirror movements (five cases); agraphestesia and dysdiadochokinesia (three cases). Three out of the four patients who had a normal examination were on clomipramine. Palmomental reflex was the main finding among the controls. These results, although preliminary, stress the interest and usefulness of performing a detailed neurological examination in OCD.

[Metastasis of kidney carcinoma to thyroid gland seventeen years after resection of primary tumor]. / Metástase de carcinoma de rim para tireóide dezessete anos após a ressecção do tumor primário.

Renal cell carcinoma is an unpredictable tumor that can recur many years after the original diagnosis. Metastasis of this tumor to the thyroid is an uncommon occurrence that can cause clinical and pathologic problems in diagnosis. The authors report case that present clinically as a palpable thyroid nodule 17 years after the primary renal cell carcinoma had been resected. This lesion appeared a solitary "cold" nodule on iodine 131 scan and was misdiagnosed as primary thyroid neoplasm. The diagnosis was facilitated by the use of immunohistochemical study.

[Paracoccidioidomycosis in a patient with human immunodeficiency virus infection. A necropsy case]. / Paracoccidioidomicose em paciente com a infecção pelo vírus da imunodeficiência humana. Relato de necrópsia.

This is a case report of the association of Paracoccidioidomycosis and Acquired Immunodeficiency Syndrome (AIDS) occurring in a 43-year old male. This is, to the best of our knowledge, the first detailed pathological account of that association. Also discussed are the low rates of that association, its natural history and treatment results. It is emphasised the importance of the associations of AIDS and tropical infectious diseases in this country.

[Multiple neoplasms after a well succeeded treatment of Hodgkin's disease]. / Neoplasias múltiplas após tratamento bem sucedido de doença de Hodgkin.

The authors refer to a 21-year-old Caucasian (white) woman, who in 1977 presented fever and cervical and axillary adenopathy, whose biopsy showed nodular sclerosis Hodgkin's Disease, stage IIIB. The patient received six chemotherapy cycles associated with immunotherapy and supplemented with radiation therapy with good response. RESULTS--In 1985, after routine gynaecological examination and a hysterectomy, cervical intraepithelial neoplasia grade 3 (CIN 3) and atypic leiomyoma of the uterine body were diagnosed. Five years later, biopsies diagnosed invasive duct carcinoma in the right breast and homolateral axillary and cervical nodes. The patient was submitted to chemo and radiation therapy and died nine months later. CONCLUSION--The possibility of later occurrence of a second or multiple new malignancies in patients successfully treated for Hodgkin's Disease points out the need for a more complete long-term follow-up, including periodic mammography.