Sarcoidosis

Sarcoidosis is a multisystemic disorder of unknown cause characterized by the formation of immune granulomas in involved organs. It is an ubiquitous disease with incidence (varying according to age, sex, race and geographic origin) estimated at around 16.5/100,000 in men and 19/100,000 in women. The lung and the lymphatic system are predominantly affected but virtually every organ may be involved. Other severe manifestations result from cardiac, neurological, ocular, kidney or laryngeal localizations. In most cases, sarcoidosis is revealed by persistent dry cough, eye or skin manifestations, peripheral lymph nodes, fatigue, weight loss, fever or night sweats, and erythema nodosum. Abnormal metabolism of vitamin D3 within granulomatous lesions and hypercalcemia are possible. Chest radiography is abnormal in about 90% of cases and shows lymphadenopathy and/or pulmonary infiltrates (without or with fibrosis), defining sarcoidosis stages from I to IV. The etiology remains unknown but the prevailing hypothesis is that various unidentified, likely poorly degradable antigens of either infectious or environmental origin could trigger an exaggerated immune reaction in genetically susceptible hosts. Diagnosis relies on compatible clinical and radiographic manifestations, evidence of non-caseating granulomas obtained by biopsy through tracheobronchial endoscopy or at other sites, and exclusion of all other granulomatous diseases. The evolution and severity of sarcoidosis are highly variable. Mortality is estimated at between 0.5–5%. In most benign cases (spontaneous resolution within 24–36 months), no treatment is required but a regular follow-up until recovery is necessary. In more serious cases, a medical treatment has to be prescribed either initially or at some point during follow-up according to clinical manifestations and their evolution. Systemic corticosteroids are the mainstay of treatment of sarcoidosis. The minimal duration of treatment is 12 months. Some patients experience repeated relapses and may require long-term low-dose corticosteroid therapy during years. Other treatments (immunosuppressive drugs and aminoquinolins) may be useful in case of unsatisfactory response to corticosteroids, poor tolerance and as sparing agents when high doses of corticosteroids are needed for a long time. In some strictly selected cases refractory to standard therapy, specific antiTNF-α agents may offer precious improvement. Some patients benefit from topical corticosteroids

Ex vivo sentinel lymph node investigation in colorectal cancer

Introduction: In Brazil, about 26,000 cases of colorectal cancer are diagnosed per year. Pa- tients considered at the early stage of disease (without lymph node) evolve with tumor relapse or recurrence in up to a quarter of cases, probably due to understaging. Objective: Research on ex vivo sentinel lymph node in patients with colorectal adenocarcinoma. Materials and methods: We studied 37 patients who underwent curative surgical resection. The marker used to identify lymph nodes was patent blue dye injected into the peritu- moral submucosa of the open surgical specimen immediately after its removal from the abdominal cavity. Results: Ex vivo identification of sentinel lymph node with marker occurred in 13 (35.1%) patients. The sensitivity was 40% and 60% false negative. The detailed histological examina- tion of sentinel lymph nodes with multilevel section and immunohistochemistry showed metastasis in one (4.3%) individual, considered ultra-staging. Conclusion: The ex vivo identification of sentinel lymph node had questionable benefits, and worse results when include patients with rectal cancer. Restaging of one patient was possible after multilevel section and immunohistochemistry of the sentinel lymph node, but more research is needed to evaluate the role of micrometastases in patients with colorectal cancer. Resumo: Introdução: No Brasil, a cada ano são diagnosticados cerca de 26.000 casos de câncer colorre- tal. Pacientes com estadiamento considerado inicial, sem linfonodo metastático, evoluem com recorrência ou recidiva do tumor em até um quarto dos casos, por provável subesta- diamento. Objetivo: pesquisar sobre linfonodo-sentinela ex vivo em pacientes com adeno- carcinoma colorretal. Objetivo: Foram estudados 37 pacientes, submetidos à cirurgia oncológica com ressecção caráter curativo. O marcador de linfonodos utilizado foi o corante azul patente, injetado na submucosa peritumoral da peça cirúrgica aberta imediatamente depois de sua retirada da cavidade abdominal. Pacientes e métodos: A identificação ex vivo de linfonodo-sentinela com o marcador ocorreu em 13 (35,1%) pacientes. A sensibilidade do método foi de 40% e o falso negativo de 60%. O exame histológico pormenorizado dos linfonodos-sentinela com multissecção e imu- noistoquímica diagnosticou metástase em um (4,3%) indivíduo, sendo considerado ultra--estadiamento. Resultados: A identificação de linfonodo-sentinela ex vivo apresenta benefícios questioná- veis, e piores resultados quando são incluídos pacientes com câncer de reto. Foi possível reestadiamento de um paciente depois da realização de multissecção e imunoistoquímica de linfonodos-sentinela, mas mais trabalhos são necessários para estabelecer a importân- cia das micrometástases em pacientes com câncer colorretal. Keywords: Sentinel lymph node, Ex vivo, Colorectal cancer, Metastases, Palavras-chave: Linfonodo-sentinela, Ex vivo, Câncer colorretal, Metástase

CONSTRUINDO INTERAÇÕES VOLTADAS AO MEIO AMBIENTE A PARTIR DE UM PORTAL VIRTUAL EDUCATIVO

A complexa problemática ambiental da atualidade exige uma aproximação cada vez maior entre Universidade e comunidade, sendo o projeto ou programa de extensão importante meio nesta relação. Assim, ambientes não formais de educação, informativos e interativos são considerados alternativas interessantes de aquisição de conhecimentos fora dos ambientes escolares. Diante disso, este trabalho tem como objetivo utilizar o potencial educativo do ambiente virtual para difundir conhecimentos, promover uma reflexão crítica dos problemas ambientais, bem como, fornecer subsídios e assessoramento para instituições e empresas. Neste sentido, o presente projeto de extensão foi desenvolvido junto a comunidade do município de Fernandes Pinheiro. A metodologia adotada para desenvolver o trabalho foram as oficinas educativas. A oficina foi realizada nas dependências da prefeitura e contou com o envolvimento e participação de membros da Secretaria de Educação, Secretaria de ação Social e pessoas das comunidades da cidade e interior do município. Com base nos dados obtidos percebeu-se que o trabalho realizado despertou nos participantes o gosto pelas causas ambientais. Os resultados alcançados foram muito relevantes, pois os participantes passaram a incentivarem a coleta do óleo de frituras em suas comunidades e justificam esta ação com base nos subsídios teóricos e práticos que tiveram nas oficinas, demonstrando adquirirem conscientização ambiental

Agave sisalana extract induces cell death in Aedes aegypti hemocytes increasing nitric oxide production

AbstractObjectiveTo investigate the effects of Agave sisalana (A. sisalana) extract on Aedes aegypti (Ae. aegypti) primary cell culture.MethodsCells of Ae. aegypti were exposed to different concentrations of A. sisalana crude extract (0.18–6.00 mg/mL) for 24 h. Then, the cells were labeled with propidium iodide and subjected to fluorescence microscopy to verify cell viability. In addition, nitric oxide production was measured.ResultsResults showed that cells exposed to 6 mg/mL of the crude extract presented a greater percentage of death when compared to control (73.8% ± 9.6% vs. 34.6% ± 9.6%). Furthermore, there was an increase in the nitric oxide production in cells exposed to 6 mg/mL of A. sisalana crude extract [(0.81 ± 0.08) μmol/L] compared to control group [(0.41 ± 0.18) μmol/L].ConclusionsThe results show that A. sisalana is cytotoxic to Ae. aegypti and may be used as raw material for new eco-friendly and inexpensive insecticides, since sisal industry discards the liquid waste for the extraction of plant fiber

Research highlights from the 2018 ERS International Congress: interstitial lung diseases

This article reviews a selection of the scientific presentations on interstitial lung disease (ILD)/diffuse parenchymal lung disease (DPLD) that were made at the 2018 European Respiratory Society (ERS) International Congress in Paris. A number of advances in the epidemiology, pathogenesis, diagnosis and treatment of these disorders were presented and discussed by clinicians and researchers. The research topics span over all four groups of ERS Assembly 12: Interstitial Lung Diseases (Group 12.01: Idiopathic interstitial pneumonias; Group 12.02: ILD/DPLD of known origin; Group 12.03: Sarcoidosis and other granulomatous ILD/DPLD; Group 12.04: Rare ILD/DPLD)

Research highlights from the 2018 ERS International Congress: interstitial lung diseases

This article reviews a selection of the scientific presentations on interstitial lung disease (ILD)/diffuse parenchymal lung disease (DPLD) that were made at the 2018 European Respiratory Society (ERS) International Congress in Paris. A number of advances in the epidemiology, pathogenesis, diagnosis and treatment of these disorders were presented and discussed by clinicians and researchers. The research topics span over all four groups of ERS Assembly 12: Interstitial Lung Diseases (Group 12.01: Idiopathic interstitial pneumonias; Group 12.02: ILD/DPLD of known origin; Group 12.03: Sarcoidosis and other granulomatous ILD/DPLD; Group 12.04: Rare ILD/DPLD)

What else in times of COVID-19? The role of minimally invasive autopsy for the differential diagnosis of acute respiratory failure in a case of kala-azar

Visceral leishmaniasis (VL) is a chronic vector-borne zoonotic disease caused by trypanosomatids, considered endemic in 98 countries, mainly associated with poverty. About 50,000–90,000 cases of VL occur annually worldwide, and Brazil has the second largest number of cases in the world. The clinical picture of VL is fever, hepatosplenomegaly, and pancytopenia, progressing to death in 90% of cases due to secondary infections and multi-organ failure, if left untreated. We describe the case of a 25-year-old female who lived in the metropolitan area of Sao Paulo, who had recently taken touristic trips to several rural areas in Southeastern Brazil and was diagnosed post-mortem. During the hospitalization in a hospital reference for the treatment of COVID-19, the patient developed acute respiratory failure, with chest radiographic changes, and died due to refractory shock. The ultrasound-guided minimally invasive autopsy diagnosed VL (macrophages containing amastigote forms of Leishmania in the spleen, liver and bone marrow), as well as pneumonia and bloodstream infection by gram-negative bacilli

ERS International Congress 2021: highlights from the Interstitial Lung Diseases Assembly

This article provides an overview of scientific highlights in the field of interstitial lung disease (ILD), presented at the virtual European Respiratory Society Congress 2021. A broad range of topics was discussed this year, ranging from translational and genetic aspects to novel innovations with the potential to improve the patient pathway. Early Career Members summarise a selection of interesting findings from different congress sessions, together with the leadership of Assembly 12 - Interstitial Lung Disease. © The authors 2022