A Bernard o que é de Bernard: resgatando o significado de “vida livre”

A recent critique on “homeostasis”, as elaborated by Walter Cannon (1871-1945), identifies contradictions intrinsic to the conditional association made by Claude Bernard (1813-1878) between “constancy of the internal environment” and “free life”. On the one hand, the critique reiterates the importance of the “internal environment” - the liquid where tissue cells live, extending to the evolution of the body’s fluid compartments. However, it also shows that the conditional association made by Bernard has neither empirical nor logical support. Therefore, assuming that “constancy of the internal environment” is the condition for “free life” is invalid. Apart from its intrinsic contradiction, other works have criticized the conditional on the assumption that Bernard, followed by Cannon, was referring to a rigid regulation of biological (life) variables in general. The objective of the present work is to show that this criticism is also invalid because, in our view, Bernard does not make this type of generalization when referring to “free life”. We conclude that avoiding ambiguities is necessary to appreciate Bernard’s theoretical contribution to physiology effectively.Uma avaliação crítica recente da “homeostase”, elaborada por Walter Cannon (1871-1945), identifica contradições intrínsecas à associação condicional, feita por Claude Bernard (1813-1878), entre “constância do meio interno” e “vida livre”. Por um lado, a avaliação reitera a importância do “meio interno” - líquido onde vivem as células dos tecidos, estendendo-a à evolução dos compartimentos líquidos corporais. Entretanto, ela também mostra que a associação condicional não tem suporte empírico nem lógico. Portanto, é inválido assumir que “constância do meio interno” seja condição para “vida livre”. À parte de sua contradição intrínseca, outros trabalhos têm criticado o condicional presumindo que Bernard seguido por Cannon estava se referindo a uma rigidez regulatória das variáveis biológicas (da vida) em geral.  O objetivo do presente trabalho é mostrar que essa crítica é também inválida, pois a nosso ver Bernard não faz esse tipo de generalização ao se referir a “vida livre”. Concluímos que evitar ambiguidades torna-se necessário para uma efetiva apreciação da contribuição teórica de Bernard para a fisiologia

Inhibition of salty taste and sodium appetite by estrogens in spontaneously hypertensive rats

Estrogen has a well-known effect of reducing salt intake in rats. This mini review focuses on recent findings regarding the interaction of estradiol with brain angiotensin II to control increased sodium palatability that occurs as a result of sodium appetite in spontaneously hypertensive rats

Anatomopathological analysis of sentinel and nonsentinel lymph nodes in breast cancer: Hematoxylin-eosin versus immunohistochemistry

The authors compare the detection of metastases in sentinel lymph nodes (SLNs) and nonsentinel lymph nodes (NSLNs) using hematoxvlin-eosin (HE) staining versus immunohistochemistry (IHC). Thirty-six patients with breast carcinoma undergo exeresis of the primary tumor and of 50 SLNs and 491 NSLNs. Sentinel lymph nodes are sectioned into transverse slices of 2- to 3-mm thickness, and a cytologic smear and a frozen section were obtained from each slice. The slices are completely cut into serial sections at 100-mu m intervals. Two consecutive 4-mu m-thick sections are then obtained from each level and were prepared for HE staining and IHC. Nonsentinel lymph nodes are evaluated similarly to SLNs. The authors obtain 4076 SLN sections and 32 012 NSLN sections, fora total of 36 088 sections. A comparison of HE staining versus IHC based on the total number of sections shows a sensitivity of 93.8%, a negative predictive value of 98.9%, and an accuracy of 99.1 %. The values obtained by HE staining are similar to those obtained by IHC

Oklahoma Neuigkeiten

Weekly German newspaper from Perry, Oklahoma that includes local, state, and national news along with advertising

Tratamento Clínico e Seguimento das Hiperplasias de Endométrio Clinical Treatment and Follow-up of Endometrial Hyperplasia

Objetivos: avaliar a eficácia do acetato de medroxiprogesterona e do acetato de megestrol nas hiperplasias de endométrio. Métodos: foram incluídas, retrospectivamente 47 pacientes com sangramento uterino anormal, submetidas a curetagem uterina diagnóstica e/ou biópsia de endométrio, cujo achado histopatológico foi de hiperplasia de endométrio. Nas pacientes com hiperplasia sem atipia foi iniciado a terapêutica com acetato de medroxiprogesterona por via oral, na dose de 10 mg/dia durante 10-12 dias por mês. Nas com atipia, era utilizado o acetato de megestrol por via oral, dose de 160 mg/dia, uso contínuo. O período de tratamento variou de 3 a 18 meses. Biópsia de endométrio e/ou curetagem uterina de controle foram realizadas entre três e seis meses do início do tratamento e periodicamente para avaliar a resposta terapêutica. Resultados: foram analisadas 42 pacientes com hiperplasia endometrial sem atipia e cinco com atipia. A média de idade das pacientes foi de 49,5 ± 10,6 anos, sendo 70,2% com idade superior a 45 anos. O acetato de medroxiprogesterona foi eficaz em fazer regredir as hiperplasias sem atipias em 83,2% (35/42) e o acetato de megestrol em 80% (4/5) das hiperplasias com atipia. Em 16,8% (7 casos) das hiperplasias sem atipia e em 20% (1 caso) das com atipia, ocorreu persistência das lesões, apesar do tratamento. Em nenhum caso ocorreu progressão para câncer de endométrio, durante o período de seguimento que foi de 3 meses a 9 anos. No acompanhamento dessas pacientes, verificamos que 18 (38,3%) apresentaram amenorréia, em 12 (25,5%) ocorreu regularização do ciclo menstrual e 17 (36,2%) permaneceram com sangramento uterino anormal, sendo submetidas a histerectomia total abdominal. O exame anatomopatológico mostrou a persistência da lesão hiperplásica em oito casos, leiomioma em quatro, adenomiose em três, mio-hipertrofia uterina difusa em um caso e útero normal em outro, tendo havido regressão das lesões hiperplásicas nesses últimos nove casos. Conclusões: o tratamento das hiperplasias de endométrio com acetato de medroxiprogesterona e/ou acetato de megestrol, representa uma alternativa satisfatória para mulheres que desejam preservar o útero ou que tenham risco cirúrgico elevado. Entretanto, é necessário monitorização cuidadosa do endométrio, o que deve ser realizado pela avaliação dos sintomas, ultra-sonografia transvaginal e biópsia periódica.<br>Purpose: to evaluate the efficacy of medroxyprogesterone acetate and megestrol acetate in endometrial hyperplasia. Patients and Methods: forty-seven patients with abnormal uterine bleeding were retrospectively evaluated. These patients were submitted to diagnostic uterine curettage and/or endometrial biopsy, with histopathological finding of endometrial hyperplasia. Patients with hyperplasia without atypia received 10 mg/day oral medroxyprogesterone acetate during 10 to 12 days a month. Those with hyperplasia with atypia received 160 mg/day oral megestrol acetate continuously. The length of treatment ranged from 3 to 18 months. Control endometrial biopsy and/or uterine curettage were performed 3 and 6 months from the beginning of treatment, and then periodically to evaluate whether or not regression of hyperplasia occurred. Results: forty-two patients with endometrial hyperplasia without atypia and 5 with hyperplasia with atypia were included. The mean age of the patients was 49.5 ± 10.6 years (22 to 72 years), 70.2% aged over 45 years. Medroxy-progesterone acetate was effective in promoting regression of 83.2% (35/42) of hyperplasia without atypia, and megestrol acetate in 80% (4/5) of hyperplasia with atypia. Despite treatment, lesions persisted in 16.8% (7 cases) of hyperplasia with atypia and in 20% (1 case) of hyperplasia without atypia. No progression to endometrial cancer was seen during the follow-up period of 3 months to 9 years. During follow-up, we found that 18 patients (38.3%) showed amenorrhea, 12 (25.5%) menstrual cycle regulation, and 17 (36.2%) persistent abnormal uterine bleeding and underwent total abdominal hysterectomy. Histological examination of the uterus showed 8 patients with persistence of hyperplastic lesion, 4 with leiomyoma, 3 with adenomyosis, 1 with diffuse uterine myohypertrophy, and 1 with normal uterus, despite regression of the hyperplastic lesions in 9 of the 17 patients. Conclusions: the treatment of endometrial hyperplasia with medroxyprogesterone acetate and megestrol acetate can be a safe alternative for women who refuse to have their uterus removed or those at high risk for surgery. However, a careful monitoring of the endometrium is needed. This can be achieved with periodical endometrial biopsy, transvaginal ultrasonography, and evaluation of the symptoms