Hemodialysis patients: inflammatory status and lean body mass

AIMS: To investigate the relationship of the inflammatory status with the lean body mass in hemodialysis patients. METHODS: A cross-sectional observational study included patients on hemodialysis for at least three months. The body composition analysis was performed by segmental multi-frequency bioimpedance (InBody 520®). The nutritional status associated with inflammation was evaluated using the instrument that computes the Malnutrition-Inflammation Score. RESULTS: The sample included 59 subjects, 30 were female. The mean age was 58.7 ± 14.4 years, the median time on dialysis was 24 (9-49) months, the mean estimated dry weight was 67.0 ± 14.7 kg and mean lean body mass was 29.7 ± 5.5 kg. The median serum level of ultrasensitive C-reactive protein was 8.6 (3.9 to 18.0) mg / L and above the normal limit (equal or less than 5.0 mg / L), suggesting the presence of inflammation. The malnutrition-inflammation score had a median of 4 (2-6). There was a significant correlation between the score malnutrition-inflammation and age (rs = 0.350, p less than 0.01) and with time on dialysis: (rs = 0.320, p less than 0.05). Inflammation assessed by the level of ultrasensitive C-reactive protein was significantly associated with lean body mass (rs = - 0.283, p less than 0.05). CONCLUSIONS: The increased time on dialysis and increased age were associated with poorer nutritional status. In this population, apparently the lower lean body mass the higher level of ultrasensitive C-reactive protein, suggesting a possible association between inflammation and lean body mass in these patients

Pindborg tumor in the distal femur

ABSTRACT To describe a case of possible diagnosis of Pindborg tumor on the distal femur. A 32-years-old female patient, a native of Bolivia, resident in Brazil, arrived to this service for tumor research in the right femur. After biopsies and resection of the lesion, the case was referred to analysis and consultancy in the United States. In a report of review by the Pathology Laboratory, it was characterized the histological appearance and immunohistochemical profile were characteristic of Pindborg tumor. Currently, the patient is being followed-up at the Orthopedics and Traumatology Department of this institution, and presents a good evolution. This study presents the case of a patient with a rare tumor that was investigated for an extensive period and through many tests. Pindborg tumor was suggested as a diagnostic hypothesis due to the characteristics and behavior of the neoplastic lesion. Although this lesion is more commonly observed in odontology, the neoplasia was compatible with the diagnosis. Therefore, despite the fact that this tumor has benign characteristics, long-term monitoring is necessary, given the high rate of tumor recurrence

Caso de hemianopsia reversível no pós-parto decorrente de síndrome da encefalopatia reversível posterior (PRES) em gestante com eclâmpsia tardia

Resumo Objetivos: Descrever um caso de Síndrome da Encefalopatia Reversível Posterior em gestante diagnosticada com eclâmpsia tardia, bem como seu manejo clínico. Descrição do caso: Paciente feminina, 34 anos, em sua terceira gestação, iniciou com aumento dos níveis tensionais durante o trabalho de parto e, após onze dias de puerpério, apresentou quadro de diminuição da acuidade visual à direita, seguida de crise convulsiva e subsequente perda parcial da visão do olho direito. Após a realização de exames de imagem e descartada a possibilidade de acidente vascular encefálico, a paciente foi diagnosticada com Síndrome da Encefalopatia Reversível Posterior (PRES). Instituído o manejo clínico das crises convulsivas e hipertensivas, houve remissão completa dos sintomas e reversão do quadro clínico inicial. Conclusões: Uma vez adequadamente diagnosticada e tratada, a Síndrome da Encefalopatia Reversível Posterior pode apresentar evolução satisfatória, especialmente quando associada a um fator desencadeado agudamente, como a eclâmpsia

Increased levels of the soluble receptor of Interleukin-6 in patients with preeclampsia compared to normotensive pregnant women

AIMS: To compare Interleukin-6 soluble receptor (IL-6sR) plasmatic levels between normotensive pregnant controls and preeclamptic women. METHODS: Maternal blood samples were collected before delivery from 21 patients with preeclampsia and 39 normotensive pregnant controls. Samples were stored at -80°C until laboratory assay. IL-6sR was measured by ELISA enzyme immunoassay. To compare groups Student's t test was used. Results with P less than 0.05 were considered significant. RESULTS: Data from preeclampsia and normotensive pregnant controls were respectively: maternal age 22.3±4.8 vs 26.0±3.7 years (P=0.06); gestational age 32.7±5.8 vs 40.1±0.8 weeks (P=0.01); systolic blood pressure 143.0±2.2 vs 118.8±3.1 mmHg (P=0.01); diastolic blood pressure 112.5±4.0 vs 77.2±10.2 mmHg (P=0.01); uric acid 5.87±1.10 vs 4.57±0.12 mg/dL (P=0.02); creatinine 0.82±0.12 vs 0.73±0.09 mg/dL (P=0.01); birth weight 2130.7±839.3 vs 3555.0±261.0 g (P=0.01); placental weight 621.3±167.0 vs 796.3±154.2 g (P=0,05). Proteinuria over creatininuria ratio in the preeclampsia group was 2.40±1.31. The concentration of IL-6sR (ng/dL) was 28.7±10.8 in preeclampsia vs 16.5±6.4 in normotensive pregnant controls (P=0.01). CONCLUSIONS: These results show an increased plasma levels of IL-6sRin patients with preeclampsia compared to normotensive pregnant women. More studies are necessary to clarify the pathophysiology of this entity, including the analysis of other cytokines linked to this receptor, due to the fact that they can be the key for the systemic inflammatory response that occurs in these patients and therefore for their treatment