PERFURAÇÃO DE ALÇA INTESTINAL POR OBJETO ESTRANHO

Relato da abordagem de uma paciente sintomática ao procurar o pronto-atendimento do Hospital da Policia Militar, após deglutir parte de sua órtese dentária. Realizada a anamnese e feito o exame físico, encaminhou-se a paciente para radiografia de abdômen.O exame de  imagem sugeriu corpo estranho em topografia de reto com na junção de sigmoide.Feito o preparo retrógrado, seguiu-se uma retossigmoidoscopia rígida, procedimento no qual que não foi visualizado o objeto. Optou-se então por submeter a paciente a uma colonoscopia para melhor estudo colônico, na busca da localização do corpo estranho, não tem sido encontrado. Nova radiografia de abdômen foi solicitada considerado o risco de ter sido o objeto ter sido eliminado pelo preparo. O exame de imagem mostrou que o corpo estranho permanecia na pelve da paciente. Desta forma, realizou-se um tomografia computadorizada, sendo a imagem mais sugestiva da localização no intestino delgado, na porção íleo terminal. Assim sendo, foi encaminhada a paciente para o bloco cirúrgicopara a realização de uma laparatomia exploradora, tendo sido o objeto encontrado em uma perfurando alça de íleo terminal.PALAVRAS CHAVE: Objeto estranho. Trato gastrointestinal. Exames de imagem. Colonoscopia. Laparatomia exploradora

Paroxysmal nocturnal hemoglobinuria (PNH): higher sensitivity and validity in diagnosis and serial monitoring by flow cytometric analysis of reticulocytes

Flow cytometric analysis of GPI-anchored proteins (GPI-AP) is the gold standard for diagnosis of paroxysmal nocturnal hemoglobinuria (PNH). Due to therapy options and the relevance of GPI-deficient clones for prognosis in aplastic anaemia detection of PNH is gaining importance. However, no generally accepted standard has been established. This study analysed the usefulness of a flow cytometric panel with CD58, CD59 on reticulocytes and erythrocytes, CD24/CD66b and CD16, FLAER on granulocytes and CD14, and CD48 on monocytes. Actual cut-off (mean + 2 SD) for GPI-deficient cells was established in healthy blood donors. We studied 1,296 flow cytometric results of 803 patients. Serial monitoring was analysed during a median follow-up of 1,039 days in 155 patients. Of all, 22% and 48% of 155 follow-up patients. showed significant GPI-AP-deficiency at time of initial analyses. During follow-up in 9%, a new PNH diagnosis, and in 28%, a significant change of size or lineage involvement was demonstrated. Highly significant correlations for GPI-AP deficiency were found within one cell lineage (r2 = 0.61–0.95, p < 0.0001) and between the different cell lineages (r2 = 0.49–0.88, p < 0.0001). Especially for detection of small GPI-deficient populations, reticulocytes and monocytes proved to be sensitive diagnostic tools. Our data showed superiority of reticulocyte analyses compared with erythrocyte analyses due to transfusion and hemolysis independency especially in cases with small GPI-deficient populations. In conclusion, a screening panel of at least two different GPI-AP markers on granulocytes, erythrocytes, and reticulocytes provides a simple and rapid method to detect even small GPI-deficient populations. Among the markers in our panel, CD58 and CD59 on reticulocytes, CD24/66b, and eventually FLAER on granulocytes as well as CD14 on monocytes were most effective for flow cytometric diagnosis of GPI deficiency

Melt processing of polymer biocomposites

A coupled device extruder and injection moulding were used to prepare biocomposites in order to provide a continuous and large-scale production, and overcome the fiber degradation inside the extruder. Two types of biocomposites were prepared, Sisal/poly(buthylene adipate-co-terephthlate) – PBAT and Juta/poly(lactide acid)/poly(buthylene adipate-co-terephthlate) blend. The biocomposites were prepared with fiber as-received and alkaline treated. The mechanical properties of biocomposites were increased by the fibers content; and the alkaline treatment was efficient to promote a good adhesion between fiber and polymer. In the case of the Juta fiber, the alkaline treatment used was too strong and led to fiber degradation. The results presented here show an alternative and continuous process to obtain biocomposites with relevant mechanical properties using fiber roving and avoiding fiber degradation