Comparison of histological and molecular diagnosis of Helicobacter pylori in benign lesions and gastric adenocarcinoma

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Inv dup (15): Is the electroclinical phenotype helpful for this challenging clinical diagnosis?

Objective: To study the electroclinical phenotype in 5 patients with large Supernumerary marker chromosome referred as inv dup (15), in an attempt to analyze the electroclinical spectrum in order to determine if the binomial epilepsy-EEG is stereotyped enough to corroborate this challenging diagnosis.Methods: Five patients with large inv dup (15) were submitted to EEG and/or V-EEG, with a minimum duration of 2 h. Two certified neurophysiologists analyzed all EEG tracings simultaneously, blinded to clinical and molecular data. Epilepsy was characterized by detailed history and a standard questionnaire according to International League Against Epilepsy guidelines and corroborated by V-EEG findings.Results: Epilepsy started during infancy in 4 patients, in 3 with spasms. Spasms were easily controlled in one but not in others. Epilepsy evolved with generalized seizures in two patients and, generalized and focal in one. Currently, 3 patients present refractory epilepsy and two are seizure-free. In one patient, only one isolated episode suggestive of a secondary generalized tonic-clonic event occurred at the age of 12 years without recurrence. Regarding the EEG, patients had distinct features, except for two patients with very high amplitude fast activity, resembling recruiting rhythm. Despite good seizure outcome in 3 patients, EEGs remained remarkably abnormal with frequent epileptiform discharges over poorly organized background.Conclusions: Our data showed a heterogeneous electroclinical phenotype with generalized and partial epilepsy, presenting distinct degrees of severity and refractoriness.Significance: Our findings suggest that it is not possible to delineate an electroclinical phenotype in this neurogenetic syndrome. Therefore, inv dup (15) remains as a diagnostic challenge and epilepsy and EEG features are valuable only when inserted in the proper clinical context. (c) 2006 International Federation of Clinical Neurophysiology. Published by Elsevier B.V.. All rights reserved.

Clinical evaluation of the association of noncarious cervical lesions, parafunctional habits, and TMD diagnosis

Objective: To verify a potential association between the presence of noncarious cervical lesions, parafunctional habits, and temporomandibular disorder (TMD) diagnosis. Method and Materials: Sample-size calculation provided a value of 130 participants with a confidence level of 95% and an error margin of 5%. A population of 132 volunteers (30 men: mean age, 23.7 +/- 3.05 years; 102 women: mean age, 24.9 +/- 5.86 years) underwent an oral examination and was interviewed by a trained dentist. The following parameters were registered: personal details, TMD diagnosis, parafunctional habits, and noncarious cervical lesion presence. The population was then divided into a noncarious cervical lesion group and a control group and subjected to the t test, chi-square test, Fisher exact test, and Spearman correlation (alpha = .05). Results: Noncarious cervical lesions were present in 39% of the population, with the largest concentrations found in the maxillary premolars (32%). The data showed a significant association between noncarious cervical lesion presence, tooth clenching (P = .03), and nail biting (P = .02), as well as a relation with TMD diagnosis (Fonseca Index [P = .01] and Research Diagnostic Criteria for TMD (RDC/TMD) [P = .004] ). In the noncarious cervical lesion group, direct rank correlation was found between maxillary premolars and clenching (P = .03), mandibular canines and nail biting (P = .05), and mandibular incisors and parafunctional habits without dental contacts (P = .02). Conclusion: Parafunctional habits and TMD presence should be taken into account in the diagnosis and treatment plan of noncarious cervical lesions.

Potentially malignant epithelial oral lesions: Discrepancies between clinical and histological diagnosis

OBJECTIVE: To evaluate the discrepancy index between the clinical and histological diagnosis and the prevalence of epithelial dysplasia and carcinoma in 45 patients with potentially malignant epithelial oral lesions (PMEL). PATIENTS AND METHODS: We submitted 45 patients with PMEL to clinical examination and obtained a biopsy from each. The results of histological diagnosis were compared to the clinical diagnosis. RESULTS: Clinical diagnosis showed that the most common PMEL was leukoplakia followed by lichen planus and by actinic cheilitis associated with leukoplakia. The most common site was the buccal mucosa. Histological diagnosis revealed that 46.7% of the PMEL were lichen planus. The discrepancy index between clinical and histological diagnosis was 24.4%. The higher discrepancy index occurred among leukoplakias. The prevalence of epithelial dysplasia and carcinoma was 17.8%. CONCLUSIONS: We conclude that all PMEL should be submitted to a microscopic analysis because the discrepancy between clinical and histological diagnosis was present in a quarter of these lesions. Otherwise, the epithelial dysplasia and carcinoma were more frequent in the leukoplakias.

The natural history of carpal tunnel syndrome: A study of 20 hands evaluated 4 to 9 years after initial diagnosis

Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy. In the last decade several papers have been published on epidemiology, clinical aspects, diagnosis, and treatment, but little is known about its natural history. The objective of this work was to study the natural history of CTS syndrome. From 358 patients with clinical and conduction study diagnosis of CTS, 12 cases were identified that had refused surgical treatment, had not used anti-inflammatory medications, and had not undergone orthopaedic procedures, such as immobilization or anaesthetic infiltration. These 12 patients have 20 compromised hands which have been followed up for between 4 and 9 years. In all cases sensory and motor conduction studies were performed on the median nerve, at the beginning and end of follow-up period. Electrical improvement was marked in 5 hands and slight in 3; there was no significant change in 10, and deterioration in 2. As 8 hands (7 patients) showed improved clinical symptoms and conduction studies over several years, this brings the universally accepted procedure of surgical treatment into doubt.

Diagnosis of a compacted area for mining through the mechanical resistance to the penetration using geostatistical methods in the Amazon Forest

The mining process promotes land modification and complete landscape alteration. Those alterations in the surface are shown more obviously in the aesthetical aspect as the visual elements of form, texture, climbs, complexity and color which composes the landscape. As a consequence, mining has impacts on the topography, in the soil, in the vegetation and in the area's drainage, with a direct influence on the enterprise. A quite common problem in the recovery of degraded areas in mineral exploration is the compaction of the soil due to the intense traffic of machines and earth movement. The most common problem of the compaction of a degraded surface is an increase of the mechanical resistance to the penetration of plant roots, a reduction of the aeration, an alteration of the flow of water and heat, also in the availability of water and nutrients. Thus, the present work had the basic objective of diagnosing the compaction of an area degraded by mining in a spacial way, through the mechanical resistance and the penetration, to guide the future subsoiling in the area requiring recovery. Through the studies, it was concluded that the krigagem method in agreement with the space variation allows the division of the area under study into sub areas facilitating a future work to reduce costs and unnecessary interference to the atmosphere. The method was shown to be quite appropriate and it can be used in the diagnosis of compaction in a degraded area by mining, foreseeing the subsoiling requirement.

Bovine abortion associated with Neospora caninum: Diagnosis and epidemiological aspects of a dairy cattle herd in the northeast region of São Paulo state, Brazil

The objective of this study was to report the presence of Neospora caninum-associated abortion in bovines at a farm in the northeast region of São Paulo State. In January 2010, it was sent to the Department of Pathology, UNESP-Jaboticabal, a bovine fetus with an estimated age of seven months, which was natural of a dairy farm with 300 animals and an average daily production of 3,000 liters of milk, nearly 20 liters per cow. The animals were vaccinated against rabies, foot and mouth disease, carbuncle, brucellosis, leptospirosis, bovine herpes virus type I and bovine viral diarrhea virus. The herd consisted of purebred Holstein animals, Jersey, and mostly by crossbred animals 7-8 (gir x holstein). During necropsy, samples of the serosanguineous liquid present at the thoracic cavity and the heart of the fetus were collected for the detection of anti-Neospora caninum antibodies through Indirect Immunofluorescence Assay (IFA). Fragments of brain, cerebellum, tongue, liver, heart and kidneys were collected for the execution of histopathology (HP), immunohistochemistry (IHC) and Polymerase Chain Reaction. In order that IFA could be performed, the owner was requested blood samples without anticoagulants of the mother and other cows in the farm, with or without a history of abortion. At necropsy, it was verified a severe autolysis of the fetus. The serology of the fetus was 1:25, while the serology of the mother was 1:3,200. At HP, it was observed discrete multifocal non-suppurative encephalomyelitis characterized by gliosis and mononuclear inflammatory infiltration associated with cellular debris. DNA amplification of N. caninum was positive in fragments of brain, tongue, cerebellum, heart and kidneys. At IHC, it has been observed immunoreactivity to a cyst located in the tongue. The owner reported that his herd showed endemic episodes of abortion, while 27.69% (18/65) of the 65 animals sampled were seropositive. Although it has not been a significant difference (p>0.05), a higher seropositivity was observed in animals with a history of abortion (10/26) 38.46%, in comparison with animals without previous abortion (8/39) 20.51%. These findings show that the abortion under study was provoked by the protozoan N. caninum, while this is the first report concerning cattle in the northeast region of São Paulo State.

Environmental diagnosis in areas with different use and occupation using the perception of diverse biological activity

In Brazil, the degradation of soil and landscape by urban and agricultural frontiers expansion leads to the need for comprehensive studies and consider the diverse biological activities generated from different interventions in the landscape, becoming an instrument for assessing the impacts and the decision for its environmental management. The objective of this study was to evaluate the influence of different forms of occupation of the landscape, considering ecological elements and their interactions. The work was carried out on the Instituto Agronômico in the county of Jundiai, in the state of Sao Paulo, Brazil. The area under study has been subjected to different use and occupancy for a period of about 40 years. During this period the landscape has been transformed, with the current scenario can be classified as a degraded area mining; grassy area; Araucaria forest and pasture. These areas were evaluated by means of a transect, from which ten sampling sites were selected for the description of diverse biological activities, which included: evaluation and description of ground cover, identifying the presence of fungus and insect species. Furthermore, we evaluated in these points the pH, fertility and porosity of the topsoil (0-0.10 m). The results showed a variation of the elements analyzed and a relationship between the use and occupation of land in the different scenarios of the current landscape. The biological activity was more diverse in the Araucaria forest, reflected by the abundance of litter, higher content of organic matter and soil nutrients, demonstrating the effectiveness of the technique for assessing the level of degradation of the landscape used, which is expeditious and inexpensive.

Clinical diagnosis and histological analysis of vocal nodules and polyps

Recent studies emphasize the importance of the clinical-histology correlation in laryngeal pathologies. Objective: To compare the ENT diagnosis with the pathology diagnosis one of 132 surgical specimens, from 119 patients with vocal nodules and polyps. Method: Retrospective study. We investigated the paraffin blocks corresponding to the lesions of the operated patients. We made new histology cross-sections, totaling 396 new slides, divided into three groups: hematoxylin and eosin, Gomori trichrome and PAS. We analyzed the following histological parameters: epithelium, lamina propria, basement membrane, vascular changes. We compared the laryngological and pathological diagnoses, and we did the statistical analysis, checking the predominant histological aspects in each lesion. Results: There was an agreement between the clinical and pathological diagnoses in 123 (93.18%) of 132 lesions analyzed (42.42% nodules and 50.76% polyps). In the histological parameters we found: epithelial changes such as nodules hyperplasia (82.14%) and polyp atrophy (31.34%). Lamina propria: edema in polyps (71.43%), fibrosis in the nodules (57.14%). Basement membrane: thickened nodules (100%), thin/no change in polyps (100%). There was a predominance of vascular changes in the polyps. Conclusion: We found a high correlation between the ENT diagnosis and the pathology report. Histopathologically, the nodules presented with predominantly epithelial changes, lamina propria and basement membrane fibrosis, while the polyps by changes strictly on the lamina propria and vascular aspects.

Cephalometric analysis for the diagnosis of sleep apnea: a comparative study between reference values and measurements obtained for Brazilian subjects

OBJECTIVE: To verify if the reference values of Sleep Apnea cephalometric analysis of North American individuals are similar to the ones of Brazilian individuals presenting no craniofacial anomalies. The study also aimed to identify craniofacial alterations in Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) patients in relation to individuals without clinical characteristics of the disease through this cephalometric analysis. METHOD: It were used 55 lateral cephalograms consisting of 29 for the control group of adult individuals without clinical characteristics of OSAHS and 26 apneic adults. All radiographs were submitted to Sleep Apnea cephalometric analysis through Radiocef Studio 2.0. The standard values of this analysis were compared, by means of z test, to the ones obtained from the control group and these were compared to values from apneic group through Student's t test. RESULTS: There were no significant differences between values obtained from control group and standard values. On the group of OSAHS patients it was observed a decrease on the dimensions of upper airways and an increase on the soft palate length. CONCLUSIONS: The standard values of Sleep Apnea analysis can be used as reference in Brazilian individuals. Besides, through lateral cephalograms it was possible to identify craniofacial alterations in OSAHS patients.

Diagnostic accuracy of semi-quantitative and quantitative culture techniques for the diagnosis of catheter-related infections in newborns and molecular typing of isolated microorganisms

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Plant iononne diagnosis using sound balances: case study with mango (Mangifera Indica)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Objective CT-Based Quantification of Lung Sequelae in Treated Patients With Paracoccidioidomycosis

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Collaboration of ultrasonography in the diagnosis of thyroid gland carcinoma in a dog - case report

The sonographic evaluation of thyroid glands in veterinary medicine presents challenges due to the complexity of the anatomical region, professional experience and type of ultrasonography equipment. The technique is considered a versatile diagnostic method that is noninvasive and has a low cost indicated in different clinical situations. Thyroid carcinoma is a malignant tumor that is often invasive and frequently metastatic to regional lymph nodes and lungs. The prognostic indicators for survival after surgery include tumor size, histological type, mobility and presence or absence of metastasis. The objective of the present report is to demonstrate the importance of ultrasound as a complementary method in the evaluation of thyroid carcinoma in dogs. At the Dr. Halim Atique Veterinary Hospital, an eight-year-old male Pit Bull was examined due to a history of firm painless swelling, approximately six inches in diameter, in the ventral cervical region, for about two months. The sonogram showed a nodular area, with defined and regular margins, and heterogeneous hypoechoic parenchyma, with areas of cavitation and swelling of the thyroid. Histopathology of the nodule was consistent with carcinoma. After thyreoidectomy and hormone replacemet, the patient is in good clinical condition.

Violence against children and adolescents: the importance of knowledge of the spectrum of bruise colors in its diagnosis

Introduction: One of the violence types more observed against children is the physical abuse, which produces many types of traumatic injuries. Contusions are common trauma signs and may indicate aggression when frequently present in locations where accidental injuries are rare. Contusions in skin undergo color changes with the passage of time, and such change in color is called “spectrum of bruise colors of Legrand du Saulle”. Thus, it is possible to estimate the age of the lesion based on the evaluation of color. Injuries caused by child abuse often reach regions of head, face and neck, because they are exposed and easily accessible. Therefore, the dentist is responsible with regard to the diagnosis and the actions to be undertaken against the cases of child abuse. Objective: To present and discuss the significance of the spectrum of bruise colors as a considerable visible trace in suspicion of violence against children and adolescents, during dentists’ clinical routine. Literature review: The study of the “spectrum of bruise colors of Legrand du Saulle” refers to the estimation of the age of the injury, in respect to the color change. The application of this study is of great value for identify if a lesion occurred from a single incident or from multiple incidents, especially in cases where it occurs in the same region of the body, indicative of repetitive trauma. Conclusion: The spectrum of bruise colors is very important for health professionals, such as dentists, for the identification or suspicion of cases of abuse against children and adolescents. As great part of the lesions originated of abuse involve the areas of head and neck, it is unacceptable that these professionals are unaware of the basic signs to help in early diagnosis, which is the case of the colors of the lesions. However, concerning the chronology of the spectrum of bruise colors, it is not possible to establish rigorous times.