Clinical, histological and electron microscopic aspects of vocal fold granulomas

SummaryGranulomas are bilateral and pediculated lesions of the vocal apophysis. Etiologies: intubation, reflux, trauma, vocal abuse, idiopathic origin. Aim: To analyze the clinical and morphological aspects of post intubation granulomas. Methods: retrospective study of patients submitted to microsurgery for post intubation laryngeal granulomas seen at our Medical School starting in 2002. We analyzed: age, gender, indication and time of intubation, symptoms, videolaryngoscopic diagnosis and biopsy findings. Light microscopy was performed on all specimens, and electron microscopy on three of them. Results: ten patients (7 females and 3 males), between the ages of 2 and 72 years, intubation time between 4h and 21 days. Hoarseness was a frequent symptom, starting in the first week following extubation. Histology shows mild epithelial hyperplasia, severe inflammation and vessel proliferation in the corion. Under SEM, the epithelium presented mild superficial desquamation. Under TEM, intracellular junctions showed widening with structural changes in the desmosomes. In the corion there were vessel proliferations, inflammation and fibroblasts with structural alterations. Conclusions: post intubation granulomas appear in any age and hoarseness is a frequent symptom. Morphological alterations occur in the corion as vessel proliferations, inflammation, and intracytoplasmatic alterations in fibroblasts suggesting cellular dysfunction and damage

Microglial cells are involved in the susceptibility of NADPH oxidase knockout mice to 6-hydroxy-dopamine-induced neurodegeneration

We explored the impact of Nox-2 in modulating inflammatory-mediated microglial responses in the 6-hydroxydopamine (6-OHDA)-induced Parkinson’s disease (PD) model. Nox1 and Nox2 gene expression were found to increase in striatum, whereas a marked increase of Nox2 expression was observed in substantia nigra (SN) of wild-type (wt) mice after PD induction. Gp91phox-/- 6-OHDA-lesioned mice exhibited a significant reduction in the apomorphine-induced rotational behavior, when compared to wt mice. Immunolabeling assays indicated that striatal 6-OHDA injections reduced the number of dopaminergic (DA) neurons in the SN of wt mice. In gp91phox-/- 6-OHDA-lesioned mice the DA degeneration was negligible, suggesting an involvement of Nox in 6-OHDA-mediated SN degeneration. Gp91phox-/- 6-OHDA-lesioned mice treated with minocycline, a tetracycline derivative that exerts multiple anti-inflammatory effects, including microglial inhibition, exhibited increased apomorphine-induced rotational behavior and degeneration of DA neurons after 6-OHDA injections. The same treatment also increased TNF-α release and potentiated NF-κB activation in the SN of gp91phox-/--lesioned mice. Our results demonstrate for the first time that inhibition of microglial cells increases the susceptibility of gp91phox-/- 6-OHDA lesioned mice to develop PD. Blockade of microglia leads to NF-κB activation and TNF-α release into the SN of gp91phox-/- 6-OHDA lesioned mice, a likely mechanism whereby gp91phox-/- 6-OHDA lesioned mice may be more susceptible to develop PD after microglial cell inhibition. Nox2 adds an essential level of regulation to signaling pathways underlying the inflammatory response after PD inductionFAPESPCNPqApplied Neuroscience Nucleus (NAPNA, University of São Paulo

Kommentar: Fejde eller fred - Kommentar til antologien "Feider og fred i nordisk middelalder"

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Objective Our aim was to assess renal function using as laboratory measurements serum creatinine and cystatin C concentrations before and after administration of low-osmolarity (nonionic) iodinated contrast medium in patients with cancer undergoing computed tomography (CT). Methods This prospective study included 400 oncologic outpatients. Serum creatinine and cystatin C concentrations were measured before and 72 h after contrast administration. Glomerular filtration rates (GFRs) were estimated using serum creatinine-based [Modification of Diet in Renal Disease (MDRD) and Cockroft-Gault and cystatin C based (Larsson) equations. Exploratory data analysis was performed. The nonparametric Wilcoxon test was used to compare pre and post contrast of test results and estimated clearance. The confidence interval used in the analysis was 95%. Results Compared with the pre-contrast values, the mean serum creatinine concentration was significantly higher and average GFRs estimated using MDRD and Cockcroft-Gault equations were significantly lower after the administration of contrast (p < 0.001). It was also observed a significant increase after contrast in the concentration of Cystatin C (p = 0.015). In addition, a decrease in GFR estimated using the average Larsson (p = 0.021) was observed between time points. However, none of the patients presented clinically significant nephropathy. Conclusions Assessment using serum creatinine and cystatin C concentrations showed changes in renal function among patients with cancer undergoing contrast-enhanced CT examination in this study. No significant renal damage related to the use of low-osmolarity iodinated contrast medium of the type and dosage employed in this study was observed. This contrast medium is thus safe for use in patients with cancer.105Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)AC Camargo Cancer CenterFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Phytoseiidae (Acari: Mesostigmata) from the Atlantic Forest in Rio de Janeiro, Brazil, with complementary description of Amblyseius impeltatus Denmark & Muma

Phytoseiid mites (Acari: Phytoseiidae) have been largely used for the biological control of arthropod pests. However, information on the phytoseiid fauna associated with plants of the Rio de Janeiro State, Brazil is still scanty. Surveys were carried out in two areas of Atlantic Forest in Rio de Janeiro State – Jaguanum island and Paraty. We report 11 species of seven genera from all three subfamilies. A complementary re-description is provided for Amblyseius impeltatus Denmark &amp; Muma, 1973 and measurements are provided for ten other species

Extravasation of iodinated contrast medium in cancer patients undergoing computed tomography

Abstract Objective: The aim of this study was to evaluate the incidence of extravasation of iodinated contrast medium (ICM) at the site of intravenous injection in oncology patients submitted to computed tomography (CT). Materials and Methods: This was a retrospective, descriptive, single-center study that evaluated all patients who underwent CT with ICM administration and presented ICM extravasation, at a cancer center, between January 2010 and December 2015. Results: During the study period, we evaluated a total of 99,076 ICM injections and identified 199 cases of extravasation, the incidence rate therefore being 0.20%. Among the patients who presented extravasation, the mean age was 59.22 years and 60% were female. The extravasation was classified as mild in 94.10% of the patients and as moderate in 5.90%. There were no cases of severe extravasation in the sample. Conclusion: The incidence of ICM extravasation in cancer patients submitted to CT in the present study was similar to that reported for the general population, according to other studies in the literature. The vast majority of cases of extravasation were considered mild, and no severe cases were observed in the study sample

Avaliação do programa de coleta seletiva de resíduos sólidos de Pelotas - RS

In Brazil, the urban disorderly growing associated with the consumerist life style turned into a challenge to the public managers aiming for social, economic and environmental sustainability for their solid waste. In this context, the city of Pelotas is looking for alternatives to improve the efficiency of its integrated solid waste management, in which the selective collection is presented as an important instrument for recycling and the correct destination to the solid waste. This study had as objective to identify fragilities and potentials present in the selective collection program in the city, aiming the proposition of technical tools and options, when possible. The applied methodology was: studies on the literature related to the subject and other cities models added to interviews to the technicians en engineer and engineer responsible for the program and official documents. The most important fragilities identified were in relation to the lack of educational programs for the population, which results in the inappropriate waste segregation,  absence of devices for packaging the recyclable waste that is going to be collected as well, inappropriate vehicles for the collecting activities, and others. However, in relation to the present positive aspects, were identified the " Programa Adote uma Escola" (Adopt a school), the a environmental and sanitary educational center, the support from the prefecture to the cooperatives of waste pickers. Afterward, technical propositions were made according to the identified fragilities.No Brasil, o crescimento urbano desordenado associado ao estilo de vida consumista da sociedade moderna tornou um desafio para os gestores públicos que visam a sustentabilidade econômica, ambiental e social do gerenciamento de seus resíduos sólidos. Nesse contexto, o município de Pelotas tem buscado alternativas a fim de melhorar a eficiência de sua gestão integrada de resíduos sólidos, na qual a coleta seletiva se apresenta como um importante instrumento para a reciclagem e a destinação correta. Esse estudo teve como objetivo identificar fragilidades e potencialidades presentes no programa de coleta seletiva do município, visando a proposição de ferramentas técnicas quando possível. A metodologia aplicada foi: estudos da literatura e modelos de coleta seletiva, somados a entrevistas com os técnicos e o engenheiro responsáveis pelo programa no município e documentos oficiais. As principais fragilidades identificadas foram em relação à educação ambiental e sensibilização da população, resultando na segregação inadequada, ausência de dispositivos para o acondicionamento dos resíduos a serem coletados, veículos coletores inadequados para a função entre outras. Em relação aos aspectos positivos, foram identificados o Programa Adote uma Escola, o Núcleo de Educação Ambiental em Saneamento, subsídios da prefeitura às cooperativas de catadores, etc. Posteriormente, proposições técnicas foram realizadas referentes às fragilidades encontradas

Morphological findings in the tracheal epithelium of dogs exposed to the inhalation of poorly conditioned gases under use of an endotracheal tube or laryngeal mask airway Alterações morfológicas no epitélio traqueal de cães expostos à inalação de gases pouco condicionados, sob ventilação com tubo traqueal ou máscara laríngea

PURPOSE: To study morphological findings in the tracheal epithelium of dogs exposed to the inhalation of poorly conditioned gases under use of an endotracheal tube (ET) or laryngeal mask airway (LMA). METHODS: Twelve dogs randomly were allocated to two groups: ET group (n-6) and LMA group (n-6), anaesthetized and mechanically ventilated, without CO2 reabsorption. Haemodynamic and ventilatory parameters, tympanic temperature, temperature, relative and absolute humidity of the ambient and inhaled gases were analyzed during three hours. The animals were submitted to euthanasia and biopsies were carried out along the tracheal segment to morphological study. Three healthy dogs were used to morphological control. RESULTS: Inhaled gas temperature was maintained between 24ºC and 26ºC, relative humidity between 10% and 12%, and absolute humidity between 2 - 3 mg H2O.L-1 with no significant differences between groups. In both groups, histological analysis showed epithelial inflammation and congestion in the corion and scanning electron microscopy showed ciliary grouping and disorganization. Transmission electron microscopy showed higher alterations in ET group than LMA group as widening of cell junctions, ciliary disorientation, cytoplasmic vacuolization, nuclear abnormalities, picnosis and chromatin condensation. CONCLUSION: LMA determined less pronounced changes in the tracheal epithelium in dogs exposed to the inhalation of poorly conditioned gases.<br>OBJETIVO: Avaliar as alterações morfológicas no epitélio traqueal de cães expostos à inalação de gases pouco condicionados, sob ventilação com tubo traqueal (TT) ou máscara laríngea (ML). MÉTODOS: Doze cães adultos foram divididos aleatoriamente em dois grupos: grupo TT (n-6) e grupo ML (n-6), submetidos à anestesia venosa e ventilação mecânica, em sistema sem reabsorção de CO2. Foram registrados parâmetros hemodinâmicos e ventilatórios, temperatura timpânica, temperatura, umidade relativa e absoluta do ar ambiente e dos gases inalados durante 3 horas. Ao término do experimento, os animais foram submetidos a eutanásia e realizadas biópsias ao longo do segmento traqueal para estudo morfológico. Três cães saudáveis foram utilizados para controle morfológico. RESULTADOS: A temperatura dos gases inalados manteve-se entre 24ºC e 26ºC, a umidade relativa entre 10% e 12%, e umidade absoluta entre 2 -3 mg H2O.L-1 sem diferença significativa entre os grupos. Em ambos os grupos a análise histológica evidenciou processo inflamatório epitelial e congestão no córion, e a microscopia eletrônica de varredura mostrou agrupamento e desorganização ciliar. A microscopia eletrônica de transmissão detectou maiores alterações no grupo TT do que no ML, como alargamento das junções intercelulares, desorientação ciliar, vacuolização citoplasmática, alterações nucleares como pcinose e condensação da cromatina. CONCLUSÃO: A máscara laríngea determinou alterações menos pronunciadas no epitélio traqueal de cães expostos à inalação de gases pouco condicionados