Prediction and reasons for COVID-19 second dose vaccine hesitation: a cross-sectional study in a municipality of Brazil

ABSTRACT BACKGROUND: Hesitation and refusal to take a second dose of the vaccine for coronavirus disease 19 (COVID-19) are prevalent. OBJECTIVES: We aimed to identify predictive factors for hesitation or refusal and describe groups with higher rates of vaccine hesitancy. DESIGN AND SETTING: A cross-sectional study in Assis City, Brazil. METHODS: The study included adults who passed the due date for taking the COVID-19 second dose vaccine. Participants were recruited in December 2021 using a mobile-based text message. Sociodemographic and clinical data and reasons for hesitance were collected. The outcome was the attitude towards completing the recommended second dose of the vaccine. Bivariate and multivariate Poisson analyses were performed to determine the adjusted predictors. RESULTS: Participants between 30-44 years of age had a 2.41 times higher prevalence of hesitation than those aged 18-29 years. In addition, people who had adverse events or previously had COVID-19 had 4.7 and 5.4 times higher prevalences of hesitation, respectively (P value < 0.05). CONCLUSION: We found a significant group of adults aged between 30-44 years who refused the second dose of the COVID-19 vaccine. Furthermore, those who reported adverse effects after the first dose and those who had COVID-19 previously were a significant group for refusal.

Prediction and reasons for COVID-19 second dose vaccine hesitation: a cross-sectional study in a municipality of Brazil.

BACKGROUND: Hesitation and refusal to take a second dose of the vaccine for coronavirus disease 19 (COVID-19) are prevalent. OBJECTIVES: We aimed to identify predictive factors for hesitation or refusal and describe groups with higher rates of vaccine hesitancy. DESIGN AND SETTING: A cross-sectional study in Assis City, Brazil. METHODS: The study included adults who passed the due date for taking the COVID-19 second dose vaccine. Participants were recruited in December 2021 using a mobile-based text message. Sociodemographic and clinical data and reasons for hesitance were collected. The outcome was the attitude towards completing the recommended second dose of the vaccine. Bivariate and multivariate Poisson analyses were performed to determine the adjusted predictors. RESULTS: Participants between 30-44 years of age had a 2.41 times higher prevalence of hesitation than those aged 18-29 years. In addition, people who had adverse events or previously had COVID-19 had 4.7 and 5.4 times higher prevalences of hesitation, respectively (P value < 0.05). CONCLUSION: We found a significant group of adults aged between 30-44 years who refused the second dose of the COVID-19 vaccine. Furthermore, those who reported adverse effects after the first dose and those who had COVID-19 previously were a significant group for refusal.

QUANTIFICATION OF NEURAL ELEMENTS IN POSTERIOR CRUCIATE LIGAMENT: COMPARISON BETWEEN HEALTHY KNEES AND WITH PRIMARY OSTEOARTHROSIS.

OBJECTIVE: To quantify the neural elements in the posterior cruciate ligament (PCL) in healthy knees and with primary osteoarthrosis (OA). METHODS: In two groups with OA, one of cadavers and another of individuals, the area of neural elements identified in histological sections of PCL with anti-S100 immunohistochemistry was quantified. RESULTS: The overall mean area of the neural elements was 0.96% ± 0.67%, with the value in the cadaver group of 1.02% ± 0.67% and in the OA group of 0.80% ± 0.64%, with a significant statistically difference (p = 0.001). No correlation was observed between neural element quantification and the age of the individuals (p > 0.05). There was no difference in the quantification of neural elements between the sexes in the cadaver group (p = 0.766), but in the OA group there was a statistically significant reduction in males (p = 0.003). Also, in the osteoarthrosis group there was no difference in the quantification of neural elements in the knees with varus or valgus alignment (p = 0.847). CONCLUSION: There was a decrease in neural element quantification in PCL of individuals affected by OA in relation to non-arthritic individuals, with this quantification not related to age or with the axis of the lower limb. However, this quantification is not related to age or the axis of the lower limb. Level of Evidence III, Case control study.

OBJETIVO: Quantificar os elementos neurais no ligamento cruzado posterior (LCP) em joelhos hígidos e com osteoartrose primária (OA). MÉTODOS: Em um grupo de cadáveres e outro de indivíduos com ao, foi realizada a quantificação da área dos elementos neurais identificados em cortes histológicos do LCP com imunohistoquímica anti-S100. RESULTADOS: A média geral da área dos elementos neurais foi 0,96% ± 0,67%, com o valor no grupo cadáver de 1,02% ± 0,67% e no grupo OA de 0,80% ± 0,64%, havendo uma diferença estatisticamente significante (p = 0,001). Não se observou correlação entre a quantificação dos elementos neurais e a idade dos indivíduos (p > 0,05). Não se observou diferença na quantificação dos elementos neurais entre os sexos no grupo cadáver (p = 0,766), mas no grupo OA se observou redução estatisticamente significante no sexo masculino (p = 0,003). No grupo OA não houve diferença na quantificação dos elementos neurais nos joelhos com alinhamento varo ou valgo (p = 0,847). CONCLUSÃO: Foi demonstrada uma redução na quantificação dos elementos neurais no LCP de indivíduos acometidos por OA em relação aos indivíduos não artrósicos, com essa quantificação não tendo relação com idade nem com o eixo do membro inferior. Nível de evidência III, Estudo de caso controle.

Quantification of neural elements in posterior cruciate ligament: comparison between healthy knees and with primary osteoarthrosis / Quantificação dos elementos neurais no ligamento cruzado posterior: comparação entre joelhos hígidos e com osteoartrose primária

ABSTRACT Objective: To quantify the neural elements in the posterior cruciate ligament (PCL) in healthy knees and with primary osteoarthrosis (OA). Methods: In two groups with OA, one of cadavers and another of individuals, the area of neural elements identified in histological sections of PCL with anti-S100 immunohistochemistry was quantified. Results: The overall mean area of the neural elements was 0.96% ± 0.67%, with the value in the cadaver group of 1.02% ± 0.67% and in the OA group of 0.80% ± 0.64%, with a significant statistically difference (p = 0.001). No correlation was observed between neural element quantification and the age of the individuals (p > 0.05). There was no difference in the quantification of neural elements between the sexes in the cadaver group (p = 0.766), but in the OA group there was a statistically significant reduction in males (p = 0.003). Also, in the osteoarthrosis group there was no difference in the quantification of neural elements in the knees with varus or valgus alignment (p = 0.847). Conclusion: There was a decrease in neural element quantification in PCL of individuals affected by OA in relation to non-arthritic individuals, with this quantification not related to age or with the axis of the lower limb. However, this quantification is not related to age or the axis of the lower limb. Level of Evidence III, Case control study.

RESUMO Objetivo: Quantificar os elementos neurais no ligamento cruzado posterior (LCP) em joelhos hígidos e com osteoartrose primária (OA). Métodos: Em um grupo de cadáveres e outro de indivíduos com ao, foi realizada a quantificação da área dos elementos neurais identificados em cortes histológicos do LCP com imunohistoquímica anti-S100. Resultados: A média geral da área dos elementos neurais foi 0,96% ± 0,67%, com o valor no grupo cadáver de 1,02% ± 0,67% e no grupo OA de 0,80% ± 0,64%, havendo uma diferença estatisticamente significante (p = 0,001). Não se observou correlação entre a quantificação dos elementos neurais e a idade dos indivíduos (p > 0,05). Não se observou diferença na quantificação dos elementos neurais entre os sexos no grupo cadáver (p = 0,766), mas no grupo OA se observou redução estatisticamente significante no sexo masculino (p = 0,003). No grupo OA não houve diferença na quantificação dos elementos neurais nos joelhos com alinhamento varo ou valgo (p = 0,847). Conclusão: Foi demonstrada uma redução na quantificação dos elementos neurais no LCP de indivíduos acometidos por OA em relação aos indivíduos não artrósicos, com essa quantificação não tendo relação com idade nem com o eixo do membro inferior. Nível de evidência III, Estudo de caso controle.

Nesidioblastosis Associated with Pancreatic Heterotopia as a Differential Diagnosis of Hypoglycemia: A Literature Review and Case Report.

BACKGROUND Nesidioblastosis is a rare disease that is part of the differential diagnosis of pancreatogenic hyperinsulinemic hypoglycemia (PHH) in patients whose imaging studies do not localize insulinoma. Pancreatic heterotopia is a rare congenital abnormality characterized by pancreatic tissue anatomically separated from the main gland and found in 0.5% of abdominal surgeries. The purpose of this article is to provide a systematic review of the literature on nesidioblastosis in pancreatic ectopic tissue and to describe a case of the co-occurrence of these 2 rare conditions. CASE REPORT A 32-year-old man presented with adrenergic and neuroglycopenic symptoms, with laboratory-confirmed hyperinsulinemic hypoglycemia. There was no evidence of tumors on abdominal CT scan and MRI. Celiac trunk sampling with a calcium stimulation test was done, which showed an insulin gradient in the gastroduodenal artery. However, the intraoperative ultrasound showed a small nodule located at the pancreatic tail, leading to distal pancreatectomy. The histologic examination showed nesidioblastosis associated with pancreatic heterotopia. The patient remained asymptomatic after distal pancreatectomy. CONCLUSIONS Nesidioblastosis accounts for 0.5%-5% of all cases of PHH, with a histology showing hypertrophy and hyperplasia of pancreatic islets. Pancreatic heterotopia is a rare congenital anomaly resulting from failure of pancreatic cell migration, and is found as an incidentaloma in imaging or surgeries. Although it is a rare disease, nesidioblastosis should be considered in the investigation of hypoglycemia, even in the rare presentation of nesidioblastosis in patients with pancreatic heterotopy.

Study on collagen parameters in vulvar cancer and preneoplastic lesions by Second Harmonic Generation microscopy.

The extracellular matrix plays an important role in cellular balance, and collagen fibers are its most important component. Over the last few years, second harmonic generation (SHG) microscopy has been used for the analysis of collagen fibers in several types of gynaecological cancers, such as breast and ovarian cancer. The value of collagen parameters obtained with this technique to gain insights on the physiopathology and on the prognostic evaluation of cancer has been advocated. Herein, we have characterized the collagen fibers in squamous cell carcinoma (VSCC) and preneoplastic lesions using the SHG microscopy. Collagen parameters, quantity, organization, and uniformity, of VSCC, adjacent skin of VSCC or preneoplastic lesions were compared with values obtained in normal tissue of healthy control. There was an evident decrease in the values of collagen fiber parameters in the VSCC. Increased quantity and uniformity of tumor associated collagen fibers were associated with the presence of lymph node metastases, which suggest a prognostic value of such parameters in the evaluation of vulvar cancer.

Congenital Zika Syndrome: The Main Cause of Death and Correspondence Between Brain CT and Postmortem Histological Section Findings From the Same Individuals.

In the present case series, the cause of death of infants diagnosed with congenital Zika syndrome (CZS) was lung disease (pneumonia and sepsis with massive pulmonary aspiration), probably secondary to dysphagia and reflux. The main findings in infants with a confirmed diagnosis of CZS who died were as follows: (1) calcification and hypoplasia of the lentiform nuclei, hypoplasia of the caudate nuclei, and calcification at the cortical-subcortical junction was noted in all cases (100%) and calcification of the caudate nuclei was noted in 66.7% of cases; (2) calcification in the brainstem and along the lateral wall of the lateral ventricles was noted in only the case with arthrogryposis (33.3%); and (3) lesions in the posterior fossa (hypoplasia of the brainstem and cerebellum) were noted in two cases (66.7%), including the case with arthrogryposis. The findings concerning calcifications and brain malformations obtained from non-contrast computed tomography (CT) demonstrated good agreement with findings obtained from the postmortem pathological analysis; however, CT failed to detect discontinuity of the pia mater with heterotopia, invasion of the cerebral tissue into the subarachnoid space, and discontinuity of the ependyma in the lateral ventricles with gliosis; this last feature was only imaged in the most severe case of extreme microcephaly with a simplified gyral pattern. Only histopathology showed grouped calcifications associated with scattered calcifications suggestive of the neuron morphology.

Follow-up brain imaging of 37 children with congenital Zika syndrome: case series study.

Objective To compare initial brain computed tomography (CT) scans with follow-up CT scans at one year in children with congenital Zika syndrome, focusing on cerebral calcifications.Design Case series study.Setting Barão de Lucena Hospital, Pernambuco state, Brazil.Participants 37 children with probable or confirmed congenital Zika syndrome during the microcephaly outbreak in 2015 who underwent brain CT shortly after birth and at one year follow-up.Main outcome measure Differences in cerebral calcification patterns between initial and follow-up scans.Results 37 children were evaluated. All presented cerebral calcifications on the initial scan, predominantly at cortical-white matter junction. At follow-up the calcifications had diminished in number, size, or density, or a combination in 34 of the children (92%, 95% confidence interval 79% to 97%), were no longer visible in one child, and remained unchanged in two children. No child showed an increase in calcifications. The calcifications at the cortical-white matter junction which were no longer visible at follow-up occurred predominately in the parietal and occipital lobes. These imaging changes were not associated with any clear clinical improvements.Conclusion The detection of cerebral calcifications should not be considered a major criterion for late diagnosis of congenital Zika syndrome, nor should the absence of calcifications be used to exclude the diagnosis.

Fat deposition in the left ventricle: descriptive and observacional study in autopsy.

BACKGROUND: The human heart contains varying amounts of fat deposits. Cardiac physiological fat occurs predominantly in the right ventricle (RV). The discovery and characterization of adipose tissue along the left ventricle (LV) has been rarely reported. This study aimed to determine the occurrence of fatty deposits in epicardial, pericoronay and myocardial compartments in the LV, and to trace the epidemiological profile and clinical associations with this finding. METHODS: Epidemiological and morphological data and heart samples were collected from corpses submitted to necropsy. Cardiac samples were fixed, embedded in paraffin and subjected to hematoxylin-eosin for microscopic study. RESULTS: The research was based on 40 samples of cardiac tissue, 21 male cadavers and 19 female ones with mean age of 68.2 years. 52.2% of the subjects had a history of smoking, 20% of them had alcohol consumption and 43.59% showed cardiac cause as a cause of death (acute myocardial infarction - AMI - was the most frequent immediate cause of death). 82.5% of the subjects showed atherosclerotic disease in the ascending aorta (ADAA). The fat deposition in the left ventricule (FDLV) was observed in 95% of cases. Epicardial fat (EF) and pericoronary adipose tissue (PAT) are the most frequent topographies in fat accumulation in the left heart chamber and the EF deposition is associated with myocardial adiposity (MA) (Fisher test [FT] 0.019; odds ratio [OR] 0.097 [95% CI 0.033 to 0.284]; p < 0.05). FDLV was associated with alcoholism (FT 0.04, OR 0.161 [95% CI 0.072 to 0.36]; p < 0.05); smoking (FT 0.508; OR 0581 [95% CI 0.431 to 0.73]; p < 0.05), presence of Frank's sign (FT 0.502; OR 0.567 [95% CI 0.414 to 0.775]; p < 0.05); ADAA (0.774 OR [95% CI 0.6405 to 0.936]; p < 0.05); AMI (OR 0.730 [95% CI 0.600 to 0.888]; p < 0.05) and macroscopic finding of cardiac hypertrophy (OR 0.700 [95% CI 0.525 to 0.933]; p < 0.05). FDLV is related with the thickness of the abdominal fat cushion. CONCLUSIONS: FDLV is common and associated with cardiovascular disease risk factors. Cardiac adiposity cannot be considered a random autopsy finding, requiring diagnostic research and more studies to investigate the clinical implications.

[Assessment of Service to verify the cause of death implementation in Pernambuco State, Brazil, 2012: multiple case study]. / Avaliação da implantação dos Serviços de Verificação de Óbito em Pernambuco, 2012: estudo de casos múltiplos.

OBJECTIVE: to evaluate the implementation of Death Verification Services in Pernambuco State, Brazil, in 2012. METHODS: this was an implementation analysis evaluation study; we constructed a logical framework and judgement matrix were prepared; primary data (direct observation and interviews) and secondary data were used; assessment of the level of Death Verification Services implementation was based on outcome-related structure and process indicators which were compared with the logical framework. RESULTS: the Recife and Caruaru Death Verification Services were considered to have achieved Advanced Partial Implementation, consistent with the outcome indicators measured, reaching 89.0% and 82.0% of the expected values, respectively; the Information Collection and Nosological/Aetiological Diagnosis components were considered to Fully Implemented at the Recife and Caruaru Death Verification Services; whilst the Education and Research component was only considered to be Fully Implemented at the Recife Death Verification Services. CONCLUSION: level of implementation was similar at both services; the higher level of the Education and Research component at the Recife Death Verification Services reveals the importance of technical and academic cooperation.

Avaliação da implantação dos Serviços de Verificação de Óbito em Pernambuco, 2012: estudo de casos múltiplos / Assessment of Service to verify the cause of death implementation in Pernambuco State, Brazil, 2012: multiple case study / Evaluación de la implantación de Servicios de Verificación de Muerte en Pernambuco, 2012: estudio de múltiples casos

OBJETIVO: avaliar a implantação dos Serviços de Verificação de Óbito (SVO) no estado de Pernambuco, Brasil, em 2012. MÉTODOS: pesquisa avaliativa de análise de implantação; elaborou-se modelo lógico e matriz de julgamento; utilizaram-se dados primários (observação direta e entrevistas) e secundários; a avaliação do grau de implantação foi baseada em indicadores de estrutura e processo, relacionados aos resultados e confrontados com o modelo lógico. RESULTADOS: os SVO de Recife e Caruaru alcançaram 89,0% e 82,0% dos valores esperados, respectivamente, e foram considerados como 'Parcialmente Implantado Avançado', de forma coerente com os indicadores de resultado aferidos; os componentes Coleta de Informação e Diagnóstico Nosológico/Etiológico obtiveram grau 'Implantado' nos SVO/Recife e SVO/Caruaru; o componente Ensino e Pesquisa obteve o grau 'Implantado' somente no SVO/Recife. CONCLUSÃO: houve semelhança no grau de implantação nos dois serviços; o maior grau de implantação do componente Ensino e Pesquisa no SVO/Recife revela a importância da cooperação técnico-acadêmica.

OBJECTIVE: to evaluate the implementation of Death Verification Services in Pernambuco State, Brazil, in 2012. METHODS: this was an implementation analysis evaluation study; we constructed a logical framework and judgement matrix were prepared; primary data (direct observation and interviews) and secondary data were used; assessment of the level of Death Verification Services implementation was based on outcome-related structure and process indicators which were compared with the logical framework. RESULTS: the Recife and Caruaru Death Verification Services were considered to have achieved Advanced Partial Implementation, consistent with the outcome indicators measured, reaching 89.0% and 82.0% of the expected values, respectively; the Information Collection and Nosological/Aetiological Diagnosis components were considered to Fully Implemented at the Recife and Caruaru Death Verification Services; whilst the Education and Research component was only considered to be Fully Implemented at the Recife Death Verification Services. CONCLUSION: level of implementation was similar at both services; the higher level of the Education and Research component at the Recife Death Verification Services reveals the importance of technical and academic cooperation.

OBJETIVO: evaluar la implantación de Servicios de Verificación de Muerte (SVM) en Pernambuco, Brasil, 2012. MÉTODOS: investigación evaluativa sobre análisis de implantación. Fue desarrollado el modelo lógico y matriz de juicio; se obtuvieron datos primarios (observación directa y entrevista) y secundarios; la evaluación del grado de implantación fue basado en los indicadores de estructura y proceso, relacionados con los resultados, comparándolos con el modelo lógico. RESULTADOS: los SVM Recife y Caruaru alcanzaron el 89,0% y 82,0% de los valores previstos, respectivamente, y se consideraron parcialmente implantados avanzados, coherentemente con los indicadores de resultados medidos; los componentes Recolección de Información, Diagnóstico Nosológico/Etiológico y Enseñanza e Investigación llegaron al grado implantado en SVM/Recife y en SVM/Caruaru solo losd os primeros, el componente Enseñanza e Investigación resultó no implantado. CONCLUSIÓN: hay una similitud en el grado de implantación de los dos servicios; el mayor grado de implantación del componente Enseñanza e Investigación en SVO/Recife revela la importancia de la cooperación técnica y académica.

A comparative study of the areas of osteochondral defects produced in femoral condyles of rabbits treated with sugar cane biopolymer gel.

PURPOSE: To assess the histological response of damaged osteochondral tissue in the femoral condyles of rabbits after repairing the wounds with sugar cane biopolymer gel - compared to the control group. METHODS: The study investigated 16 New Zealand rabbits, at 90, 120 and 180 days after surgery. In all the animals, a lesion of 3.2 mm in diameter and 4 mm deep was induced in each right and left femoral condyle. Each animal has provided both knees, divided into medial and lateral condyle, resulting in 64 samples. 32 knees were divided into two groups: Right knee, medial and lateral condyles, filled with biopolymer; Left knee, medial and lateral condyles, unfilled. The anatomical specimens were removed, and subjected to histological techniques and morphometric and statistical analysis. RESULTS: In all the periods of the group under study an inflammatory reaction mediated by giant cells and mononuclear cells was found, while in the control group there was early healing produced by fibroblasts and few mononuclear cells with statistical significance between groups. CONCLUSION: The biopolymer gel caused an inflammatory reaction mediated by giant cells and mononuclear cells while the control group there was cicatrization mediated by fibroblasts.

A comparative study of the areas of osteochondral defects produced in femoral condyles of rabbits treated with sugar cane biopolymer gel

PURPOSE: To assess the histological response of damaged osteochondral tissue in the femoral condyles of rabbits after repairing the wounds with sugar cane biopolymer gel - compared to the control group. METHODS: The study investigated 16 New Zealand rabbits, at 90, 120 and 180 days after surgery. In all the animals, a lesion of 3.2 mm in diameter and 4 mm deep was induced in each right and left femoral condyle. Each animal has provided both knees, divided into medial and lateral condyle, resulting in 64 samples. 32 knees were divided into two groups: Right knee, medial and lateral condyles, filled with biopolymer; Left knee, medial and lateral condyles, unfilled. The anatomical specimens were removed, and subjected to histological techniques and morphometric and statistical analysis. RESULTS: In all the periods of the group under study an inflammatory reaction mediated by giant cells and mononuclear cells was found, while in the control group there was early healing produced by fibroblasts and few mononuclear cells with statistical significance between groups. CONCLUSION: The biopolymer gel caused an inflammatory reaction mediated by giant cells and mononuclear cells while the control group there was cicatrization mediated by fibroblasts.

Effectiveness of histology and cytology on musculoskeletal tumor diagnosis.

OBJECTIVE: To compare cytology and histology on the diagnosis of musculoskeletal neoplasms. METHOD: Fifty eight cases available to evaluation were analyzed both by cytology and histology. The results of the biopsies studied by histology and cytology were compared to the results obtained on the surgical specimen or immunohistochemistry. We determined the percentage of correct results, sensitivity, specificity, positive and negative predictive values and accuracy of each method. RESULTS: Twelve per cent of biopsies were inconclusive by cytology. The percentage of correct diagnosis was 70.7% and 81% (p=.179), the ability to differentiate benign lesions from malignant ones was 84.5% and 93.1% (p=0.18) respectively, for cytology and histology. Cytology showed sensitivity of 87.8%, specificity of 76.5%, positive predictive value of 90%, negative predictive value of 72% and accuracy 84.5%. Histology showed sensitivity of 90.2%, specificity of 100%, positive predictive value of 100%, negative predictive value of 81% and accuracy of 93.1%. The Youden index for cytology was 64.3% and for histology it was 90.2%. CONCLUSION: Despite promising, cytology obtained by thin needle aspiration is less accurate and reliable than the histological evaluation on musculoskeletal tumors diagnosis.

Neoplasm seeding in biopsy tract of the musculoskeletal system. A systematic review.

To identify, through a systematic literature review, the characteristics of neoplasm seeding in biopsy performed on the musculoskeletal system. We performed a search on PubMed, MEDLINE, LILACS and SciELO from August to October 2010. We included articles that addressed the neoplasm seeding in biopsy performed on the musculoskeletal system. The search was limited to English, Spanish and Portuguese as publication languages, but it was not limited by year of publication. We retrieved 2858 articles, but only seven were selected based on inclusion and exclusion criteria. Other four papers were found in the references of selected articles, totalizing 11 articles that were used to perform this systematic review. Issues may be raised in the literature: age and gender don't seem to influence the occurrence of neoplasm seeding; without resection of the biopsy tract, the possibility of local recurrence is very real; the influence of the type of tumor in the occurrence of neoplasm seeding is uncertain; it is impossible to conclude whether the closed biopsy technique has a lower chance of neoplasm seeding; it is likely that adjuvant chemotherapy has a protective effect against neoplasm seeding; an unfavorable prognosis is expected according to neoplasm seeding results.

Effectiveness of histology and cytology on musculoskeletal tumor diagnosis

OBJECTIVE: To compare cytology and histology on the diagnosis of musculoskeletal neoplasms. METHOD: Fifty eight cases available to evaluation were analyzed both by cytology and histology. The results of the biopsies studied by histology and cytology were compared to the results obtained on the surgical specimen or immunohistochemistry. We determined the percentage of correct results, sensitivity, specificity, positive and negative predictive values and accuracy of each method. RESULTS: Twelve per cent of biopsies were inconclusive by cytology. The percentage of correct diagnosis was 70.7% and 81% (p=.179), the ability to differentiate benign lesions from malignant ones was 84.5% and 93.1% (p=0.18) respectively, for cytology and histology. Cytology showed sensitivity of 87.8%, specificity of 76.5%, positive predictive value of 90%, negative predictive value of 72% and accuracy 84.5%. Histology showed sensitivity of 90.2%, specificity of 100%, positive predictive value of 100%, negative predictive value of 81% and accuracy of 93.1%. The Youden index for cytology was 64.3% and for histology it was 90.2%. CONCLUSION: Despite promising, cytology obtained by thin needle aspiration is less accurate and reliable than the histological evaluation on musculoskeletal tumors diagnosis. Level of Evidence II, Diagnostic Studies. .

Contaminação tumoral em trajeto de biópsia de tumores ósseos malignos primários / Tumor contamination in the biopsy path of primary malignant bone tumors

OBJETIVO: Estudar os fatores possivelmente associados à contaminação tumoral do trajeto de biópsia de tumores ósseos malignos primários. MÉTODO: Foram estudados, retrospectivamente, 35 pacientes submetidos a tratamento cirúrgico com diagnóstico de osteossarcoma, tumor de Ewing e condrossarcoma. A amostra foi analisada para caracterização quanto à técnica de biópsia empregada, tipo histológico do tumor, realização de quimioterapia neoadjuvante, ocorrência de recidiva local e contaminação tumoral no trajeto da biópsia. RESULTADOS: Nos 35 pacientes avaliados ocorreram quatro contaminações (11,43%). Um caso era de osteossarcoma, dois casos de tumor de Ewing e um caso de condrossarcoma, não se observando associação entre o tipo de tumor e a presença de contaminação tumoral no trajeto da biópsia (p = 0,65). Também não se observou associação entre a presença de contaminação tumoral e a técnica de biópsia (p = 0,06). Por outro lado, observou-se associação entre a presença de contaminação tumoral e a ocorrência de recidiva local (p = 0,01) e entre a presença de contaminação e a não realização de quimioterapia neoadjuvante (p = 0,02). CONCLUSÃO: A contaminação tumoral no trajeto de biópsia de tumores ósseos malignos primários esteve associada à ocorrência de recidiva local. Por outro lado, não mostrou ser influenciada pelo tipo de biópsia realizada e pelo tipo histológico de tumor estudado. A quimioterapia neoadjuvante mostrou um efeito protetor contra esta complicação. A despeito desses achados, a contaminação tumoral é uma complicação que deve sempre ser considerada, sendo recomendada a remoção do trajeto da biópsia na cirurgia de ressecção do tumor.

OBJECTIVE: To study factors possibly associated with tumor contamination in the biopsy path of primary malignant bone tumors. METHOD: Thirty-five patients who underwent surgical treatment with diagnoses of osteosarcoma, Ewing's tumor and chondrosarcoma were studied retrospectively. The sample was analyzed to characterize the biopsy technique used, histological type of the tumor, neoadjuvant chemotherapy used, local recurrences and tumor contamination in the biopsy path. RESULTS: Among the 35 patients studied, four cases of contamination occurred (11.43%): one from osteosarcoma, two from Ewing's tumor and one from chondrosarcoma. There was no association between the type of tumor and presence of tumor contamination in the biopsy path (p = 0.65). There was also no association between the presence of tumor contamination and the biopsy technique (p = 0.06). On the other hand, there were associations between the presence of tumor contamination and local recurrence (p = 0.01) and between tumor contamination and absence of neoadjuvant chemotherapy (p = 0.02). CONCLUSION: Tumor contamination in the biopsy path of primary malignant bone tumors was associated with local recurrence. On the other hand, the histological type of the tumor and the type of biopsy did not have an influence on tumor contamination. Neoadjuvant chemotherapy had a protective effect against this complication. Despite these findings, tumor contamination is a complication that should always be taken into consideration, and removal of the biopsy path is recommended in tumor resection surgery.

[Left and right ventricular hypertrophy at autopsy of hypertensive individuals]. / Hipertrofia cardíaca esquerda e direita em necropsias de hipertensos.

OBJECTIVE: To measure the right and left ventricular thickness in deceased individuals with a history of hypertension submitted to clinical autopsies. METHODS: We selected 90 cases from the Death Verification Service of the city of Recife, state of Pernambuco, Brazil, of both sexes, with a history of essential arterial hypertension related to heart wall thickness, in addition to correlation with autopsy findings and other clinical reports. RESULTS: There was a significant association between the presence of left ventricular hypertrophy (LVH) and right ventricular hypertrophy (RVH) and between severe hypertensive cardiomyopathy and RVH. There was a predominance of RVH and LVH in men aged 60-79 years and a higher prevalence in the Brazilian mulatto and Black ethnic groups and in those with adequate nutritional status or overweight and obese individuals. CONCLUSION: It was observed that the presence of RVH was related to LVH, suggesting that there are similar pathogenic factors involved in the development of bilateral hypertrophy. The RVH seems to be associated with more severe heart disease and may, based on other studies, be considered as a new prognostic factor in the evaluation of hypertensive patients.

Hipertrofia cardíaca esquerda e direita em necropsias de hipertensos / Left and right ventricular hypertrophy at autopsy of hypertensive individuals

OBJETIVO: Medir a espessura ventricular direita e esquerda em falecidos com história de hipertensão arterial, submetidos a necropsias clínicas. MÉTODOS: Foram selecionados 90 casos do Serviço de Verificação de Óbitos de Recife -PE, de ambos os sexos, com história de hipertensão arterial essencial, com relação à espessura das paredes cardíacas, além da correlação com outros achados de necropsia e informes clínicos. RESULTADOS: Observouse associação significativa entre a presença de hipertrofia ventricular esquerda (HVE) e direita (HVD), e de cardiopatia hipertensiva grave e HVD. Houve predomínio da HVD e HVE em homens, na faixa etária dos 60-79 anos, com maior prevalência nas etnias parda e negra, e naqueles com estado nutricional adequado ou com sobrepeso e em obesos. CONCLUSÃO: Observou-se que a presença de HVD relaciona-se com HVE, sugerindo que há fatores patogênicos semelhantes envolvidos no desenvolvimento da hipertrofia bilateral. A HVD parece associar-se à doença cardíaca mais grave, podendo, a partir de outros estudos, ser considerada novo fator prognóstico na avaliação dos pacientes hipertensos.

OBJECTIVE: To measure the right and left ventricular thickness in deceased individuals with a history of hypertension submitted to clinical autopsies. METHODS: We selected 90 cases from the Death Verification Service of the city of Recife, state of Pernambuco, Brazil, of both sexes, with a history of essential arterial hypertension related to heart wall thickness, in addition to correlation with autopsy findings and other clinical reports. RESULTS: There was a significant association between the presence of left ventricular hypertrophy (LVH) and right ventricular hypertrophy (RVH) and between severe hypertensive cardiomyopathy and RVH. There was a predominance of RVH and LVH in men aged 60-79 years and a higher prevalence in the Brazilian mulatto and Black ethnic groups and in those with adequate nutritional status or overweight and obese individuals. CONCLUSION: It was observed that the presence of RVH was related to LVH, suggesting that there are similar pathogenic factors involved in the development of bilateral hypertrophy. The RVH seems to be associated with more severe heart disease and may, based on other studies, be considered as a new prognostic factor in the evaluation of hypertensive patients.