Clinical and epidemiological prevalence of glomerulopathies elderly in the city of Uberaba - MG.

INTRODUCTION: Currently, the elderly population of Brazil is suffering significant increase. Aging is a physiological process that causes changes in various organs, including the kidney. A kidney biopsy is of paramount importance to clarify the morphological changes of these entities. OBJECTIVES: The aim of this work was to conduct a clinical epidemiological analysis of elderly patients and evaluate the prevalence of major glomerulopathies that affect. METHODS: This is a retrospective and descriptive, with a review of 104 reports of renal biopsies of elderly aged over 60 years, performed in the Nefropatologia Federal University of Triângulo Mineiro (UFTM), between periods January 1996 and December 2010. Patients were grouped according to clinical syndrome. RESULTS: We reviewed 104 biopsies of elderly patients. Of these, 52.94% were male. The Hypertension was found in 50.54% of patients. The clinical syndrome was the predominant nephrotic syndrome (42.17%). Most disease was glomerular origin. The glomerulopathy was the most prevalent (34.07%). DISCUSSION/CONCLUSION: Through this review, we noted that the nephrotic syndrome was the main clinical syndrome and Podocytophaties glomerulopathies were more prevalent in the group of elderly patients undergoing renal biopsy. The analysis of renal biopsies of elderly patients is of paramount importance, since knowledge of the clinical manifestations of major glomerulopathies that affect this group, to assist in establishing the diagnosis and therapeutic management.

Prevalência clínica e epidemiológica de glomerulopatias em idosos na cidade de Uberaba - MG / Clinical and epidemiological prevalence of glomerulopathies elderly in the city of Uberaba - MG

Resumo Introdução: Atualmente, a população idosa do Brasil está sofrendo aumento significativo. O envelhecimento é um processo fisiológico que causa alterações nos diversos órgãos, inclusive no rim. A biópsia renal é de suma importância para esclarecimento das alterações morfológicas dessas entidades. Objetivos: Os objetivos deste trabalho foram realizar a análise clínica e epidemiológica dos pacientes idosos e avaliar a prevalência das principais glomerulopatias que os acometem. Métodos: Trata-se de um estudo retrospectivo e descritivo, com revisão de 104 laudos de biópsias renais de idosos, com idade igual ou superior a 60 anos, realizados no Serviço de Nefropatologia da Universidade Federal do Triângulo Mineiro (UFTM), entre o período de janeiro de 1996 e dezembro de 2010. Os pacientes foram agrupados segundo síndrome clínica. Resultados: Foram revistas 104 biópsias de pacientes idosos. Destes, 52,94% pertenciam ao gênero masculino. A Hipertensão Arterial foi encontrada em 50,54% dos pacientes. A síndrome clínica predominante foi a Síndrome Nefrótica (42,17%). A maioria das doenças foi de origem glomerular. As podocitopatias foram as glomerulopatias mais prevalentes (34,07%). Discussão/Conclusão: Por meio dessa revisão, observamos que a síndrome nefrótica foi a principal síndrome clínica e as podocitopatias foram as glomerulopatias com mais prevalência no grupo de pacientes idosos submetidos à biópsia renal. A análise das biópsias renais dos pacientes idosos é de fundamental importância, uma vez que o conhecimento das manifestações clínicas das principais glomerulopatias que acometem esse grupo auxiliam a elucidação diagnóstica e no estabelecimento da conduta terapêutica. .

Abstract Introduction: Currently, the elderly population of Brazil is suffering significant increase. Aging is a physiological process that causes changes in various organs, including the kidney. A kidney biopsy is of paramount importance to clarify the morphological changes of these entities. Objectives: The aim of this work was to conduct a clinical epidemiological analysis of elderly patients and evaluate the prevalence of major glomerulopathies that affect. Methods: This is a retrospective and descriptive, with a review of 104 reports of renal biopsies of elderly aged over 60 years, performed in the Nefropatologia Federal University of Triângulo Mineiro (UFTM), between periods January 1996 and December 2010. Patients were grouped according to clinical syndrome. Results: We reviewed 104 biopsies of elderly patients. Of these, 52.94% were male. The Hypertension was found in 50.54% of patients. The clinical syndrome was the predominant nephrotic syndrome (42.17%). Most disease was glomerular origin. The glomerulopathy was the most prevalent (34.07%). Discussion/Conclusion: Through this review, we noted that the nephrotic syndrome was the main clinical syndrome and Podocytophaties glomerulopathies were more prevalent in the group of elderly patients undergoing renal biopsy. The analysis of renal biopsies of elderly patients is of paramount importance, since knowledge of the clinical manifestations of major glomerulopathies that affect this group, to assist in establishing the diagnosis and therapeutic management. .

A retrospective study on cervical intraepithelial lesions of low-grade and undetermined significance: evolution, associated factors and cytohistological correlation.

CONTEXT AND OBJECTIVES: Cervical cancer is an important cause of morbidity and mortality throughout the world. There is some controversy about the factors that may be associated with infection by the human papillomavirus (HPV) that may favor or protect against evolution from a low-grade intraepithelial lesion to a high-grade intraepithelial lesion or invasive neoplasia. The objective here was to evaluate the evolution of low-grade intraepithelial lesions and squamous or glandular lesions of undetermined significance, the associated factors and cytohistological correlations. DESIGN AND SETTING: Retrospective study conducted in a public tertiary-level university hospital. METHODS: Information was obtained by reviewing patient records and/or colposcopy reports. A statistical analysis was performed using logistic regression, calculating the odds ratio and applying chi-square tests. RESULTS: Of the 3390 patients, 409 evolved to high-grade intraepithelial lesions, of which 354 had an initial diagnosis of HPV infection, 27 of squamous atypia of undetermined significance, 22 of low-grade intraepithelial lesions with or without cytological diagnosis of infection by associated HPV and six of glandular cell atypia of undetermined significance. CONCLUSIONS: Lactobacillus sp and bacterial vaginosis on the smears, smoking and immunodepression were factors associated with evolution. A single partner, use of hormonal contraceptives, lower parity, age and a cytological diagnosis of cytolytic vaginosis, T. vaginalis, Candida sp or cocci were factors associated with protection. With regard to cytohistological correlation, there was a 74.08% agreement among patients with high-grade lesions and a biopsy obtained during the same period.

Correlation of cytokines and inducible nitric oxide synthase expression with prognostic factors in ovarian cancer.

The study related the immunohistochemical staining of cytokines (IL2, IL5, IL6, IL8, IL10, and TNF-alpha), and iNOS staining with clinical and pathological parameters of patients with primary ovarian malignancy. We prospectively evaluated 40 patients who underwent surgical treatment in accordance with pre-established criteria and later confirmed diagnosis of ovarian cancer. Immunohistochemistry study for cytokines (IL2, IL5, IL6, IL8, IL10, TNF-alpha) and iNOS was performed. The evaluation of prognostic factors was performed using the Fisher's exact test. The significance level was less than 0.05. Histological grade 1 was significantly correlated with strong intensity for TNF-α (p=0.0028). In addition, early stages showed strong expression intensity of TNF-α, but this was at the limit of significance (p=0.0525). Strong staining immunohistochemical IL5 was related to disease-free survival less than or equal to 24 months, suggesting that a factor of poor prognosis, but there was no statistical significance (p=0.1771). There was no statistical significance in relation at other cytokines studied. Therefore, immunohistochemical staining in strong intensity for TNF-α was related to histological grade 1 and early stages of ovarian cancer in our sample of patients.

A retrospective study on cervical intraepithelial lesions of low-grade and undetermined significance: evolution, associated factors and cytohistological correlation / Estudo retrospectivo sobre lesões intraepiteliais cervicais de baixo grau e de significado indeterminado: evolução, fatores associados e correlação citohistológica

CONTEXT AND OBJECTIVES: Cervical cancer is an important cause of morbidity and mortality throughout the world. There is some controversy about the factors that may be associated with infection by the human papillomavirus (HPV) that may favor or protect against evolution from a low-grade intraepithelial lesion to a high-grade intraepithelial lesion or invasive neoplasia. The objective here was to evaluate the evolution of low-grade intraepithelial lesions and squamous or glandular lesions of undetermined significance, the associated factors and cytohistological correlations. DESIGN AND SETTING: Retrospective study conducted in a public tertiary-level university hospital. METHODS: Information was obtained by reviewing patient records and/or colposcopy reports. A statistical analysis was performed using logistic regression, calculating the odds ratio and applying chi-square tests. RESULTS: Of the 3390 patients, 409 evolved to high-grade intraepithelial lesions, of which 354 had an initial diagnosis of HPV infection, 27 of squamous atypia of undetermined significance, 22 of low-grade intraepithelial lesions with or without cytological diagnosis of infection by associated HPV and six of glandular cell atypia of undetermined significance. CONCLUSIONS: Lactobacillus sp and bacterial vaginosis on the smears, smoking and immunodepression were factors associated with evolution. A single partner, use of hormonal contraceptives, lower parity, age and a cytological diagnosis of cytolytic vaginosis, T. vaginalis, Candida sp or cocci were factors associated with protection. With regard to cytohistological correlation, there was a 74.08% agreement among patients with high-grade lesions and a biopsy obtained during the same period. .

CONTEXTO E OBJETIVOS: O câncer do colo uterino é importante causa de morbidade e mortalidade no mundo. Existem controvérsias sobre fatores que podem estar associados à infecção por papilomavírus humano (HPV) e favorecer ou proteger contra a evolução de lesão intraepitelial de baixo grau até lesão intraepitelial de alto grau ou neoplasia invasiva. O objetivo aqui foi de avaliar a evolução de lesões intraepiteliais de baixo grau e de significado indeterminado, escamosas ou glandulares, os fatores associados e as correlações citohistológicas. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo realizado em hospital universitário público terciário. MÉTODOS: As informações foram obtidas por meio de revisão de prontuários e/ou fichas de colposcopia. A análise estatística foi realizada por meio de regressão logística, calculando-se o odds ratio e aplicando-se o teste qui-quadrado. RESULTADOS: Das 3.390 pacientes, 409 evoluíram para lesão intraepitelial de alto grau, das quais 354 tinham diagnóstico inicial de infecção por HPV, 27 de atipias escamosas de significado indeterminado, 22 de lesão intraepitelial de baixo grau com ou sem diagnóstico citológico de infecção por HPV associado e 6 de atipias em células glandulares de significado indeterminado. CONCLUSÕES: Lactobacillus sp e vaginose bacteriana nos esfregaços, tabagismo e imunodepressão foram fatores associados com a evolução. Único parceiro, uso de contraceptivo hormonal, baixa paridade, idade e diagnóstico citológico de vaginose citolítica, T. vaginalis, Candida sp ou cocos foram fatores associados a proteção. Com relação à correlação citohistológica, encontramos concordância de 74,08% ...

An overview of molecular mechanism of nephrotic syndrome.

Podocytopathies (minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS)) together with membranous nephropathy are the main causes of nephrotic syndrome. Some changes on the expression of nephrin, podocin, TGF-ß, and slit diaphragm components as well as transcription factors and transmembrane proteins have been demonstrated in podocytopathies. Considering the pathogenesis of proteinuria, some elucidations have been directed towards the involvement of epithelial-mesenchymal transition. Moreover, the usefulness of some markers such as TGF-ß1, nephrin, synaptopodin, dystroglycans, and malondialdehyde have been determined in the differentiation between MCD and FSGS. Experimental models and human samples indicated an essential role of autoantibodies in membranous glomerulonephritis, kidney damage, and proteinuria events. Megalin and phospholipase-A2-receptor have been described as antigens responsible for the formation of the subepithelial immune complexes and renal disease occurrence. In addition, the complement system seems to play a key role in basal membrane damage and in the development of proteinuria in membranous nephropathy. This paper focuses on the common molecular changes involved in the development of nephrotic proteinuria.

Research on Trypanosoma cruzi and Analysis of Inflammatory Infiltrate in Esophagus and Colon from Chronic Chagasic Patients with and without Mega.

To compare parasitism and inflammatory process in esophagus and colon from chronic chagasic patients, immunohistochemistry was carried out to research for T. cruzi and to evaluate the inflammatory infiltrate in the muscular and myenteric plexus in 39 esophagi (20 with and 19 without megaesophagus) and 50 colons (25 with and 25 without megacolon). The frequency of T. cruzi in megaesophagus was 20%, and in megacolon it was 4%. No amastigotes were found in organs without mega; considering the total of esophagi (with and without mega), the frequency of T. cruzi would be 10% and 2% in the colon. Myositis and ganglionitis were more frequent and intense in organs with mega compared to those without mega, and in esophagus compared to colon. Qualitatively, inflammatory infiltration in esophagus and colon, with or without mega, was similar, consisting predominantly of T lymphocytes (CD3+), scarce macrophages (CD68+), and rare B lymphocytes (CD20+).