RESUMO
The overwhelming postsplenectomy infection syndrome (OPSI) is a fulminant sepsis that is mainly caused by Streptococcus pneumoniae and is characterized by a particular high mortality. Patients whose spleen was removed due to a hematological disease are at special risk. Even after the recommended immunization against Streptococcus pneumoniae 20-30 % of these patients do not develop an adequate level of antibody response. Therefore, this particular group of patients must be trained how to behave in case of fever and need to obtain immediate specific sepsis therapy with antibiotic prophylaxis.
Assuntos
Infecções Pneumocócicas/terapia , Complicações Pós-Operatórias/terapia , Esplenectomia/efeitos adversos , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Síndrome de Resposta Inflamatória Sistêmica/terapia , Antibacterianos/uso terapêutico , Antibioticoprofilaxia , Anticorpos Antibacterianos/imunologia , Contagem de Células Sanguíneas , Análise Química do Sangue , Transtornos da Coagulação Sanguínea/etiologia , Transtornos da Coagulação Sanguínea/terapia , Transfusão de Sangue , Diagnóstico Diferencial , Evolução Fatal , Coração Auxiliar , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos , Infecções Pneumocócicas/etiologia , Complicações Pós-Operatórias/diagnóstico , Risco , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Tomografia Computadorizada por Raios XAssuntos
Neoplasias do Apêndice/diagnóstico , Neoplasias do Apêndice/cirurgia , Carcinoma in Situ/diagnóstico , Carcinoma in Situ/cirurgia , Cistadenoma Mucinoso/diagnóstico , Cistadenoma Mucinoso/cirurgia , Doenças Raras , Apendicectomia , Neoplasias do Apêndice/patologia , Apêndice/patologia , Carcinoma in Situ/patologia , Cistadenoma Mucinoso/patologia , Diagnóstico Diferencial , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada MultidetectoresRESUMO
Cytogenetic analyses were performed on 340 follicular thyroid adenomas and goiters after short-term culture. Clonal chromosomal changes were found in 67 cases. Trisomy 7 as the sole abnormality or along with other trisomies was the most frequent type of aberration (19 cases). Other recurrent numerical changes were loss of chromosome 22 (4 cases) and the second X or the Y chromosome (5 cases). Translocations involving 19q13 (12 cases) were frequent structural chromosomal changes. Dicentric chromosomes or telomeric associations were frequent in goiters (12 cases). After a histopathologic classification of all cases, we have correlated the cytogenetic findings with the histology of the tumors. Only 8.4% of the goiters showed clonal abnormalities, whereas 44.9% of the adenomas revealed clonal abnormalities. Furthermore, simple clonal changes were predominantly found in goiters and complex changes in adenomas. The most impressive correlation was found in the group of lesions with trisomy 7. Although all but one lesion with one or two additional trisomies were goiters, those having three or more additional trisomies were all adenomas or adenomatous goiters.
Assuntos
Adenoma/genética , Adenoma/patologia , Doenças da Glândula Tireoide/genética , Doenças da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/patologia , Células Cultivadas , Aberrações Cromossômicas , Cromossomos Humanos Par 19 , Cromossomos Humanos Par 7 , Células Clonais , Humanos , Translocação Genética , TrissomiaRESUMO
Cytogenetic studies of thyroid hyperplasias and adenomas have shown that besides cases with an apparently normal karyotype different groups of cytogenetic abnormalities exist. Herein we describe the cytogenetic analyses of two benign thyroid tumors with deletions of the short arm of chromosome 2. A similar case has been described previously. Besides the previously well-established subgroups, alterations of chromosome 2 may thus characterize a new cytogenetic subgroup of benign thyroid tumors.
