Sydney Correia Leão

IL-10 and ET-1 as biomarkers of rheumatic valve disease

Objective To evaluate the immunological profile and gene expression of endothelin-1 (ET-1) in mitral valves of patients with rheumatic fever originated from a reference service in cardiovascular surgery. Methods This was a quantitative, observational and cross-sectional study. Thirty-five subjects (divided into four groups) participated in the study, 25 patients with chronic rheumatic heart disease and ten control subjects. The mean age of the sample studied was 34.5 years. Seventeen of them (48.58%) were male and 18 (51.42%) were female. Inflammatory cytokines (TNF-α, IL-4 and IL-10) were measured and ten mitral valves of patients who underwent first valve replacement were collected for determination of gene expression of endothelin-1 by real time PCR. Results Among the groups studied (patients vs. controls), there was a statistically significant difference in IL-10 levels (P=0.002), and no differences in other cytokines. Expression of endothelin-1 was observed in 70% of samples. Quantitatively, average of ET-1 expression was 62.85±25.63%. Conclusion Inflammatory cytokine IL-10 participates in the maintenance of chronicity of rheumatic fever in patients who underwent valve replacement and those who are undergoing medical treatment. The expression of endothelin-1 in heart valve lesions in patients undergoing mitral valve replacement confirms its association with inflammatory activity in rheumatic fever.

Solid-pseudopapillary tumor of pancreas in a young woman: a case report and literature review.

Solid-pseudopapillary tumor of pancreas is a rare neoplasm which occurs pre-dominantely in young females. This tumor generally is asymptomatic or minimally symptomatic and some imaging tests are useful for its diagnosis. We report a 17 years-old woman with dyspeptic symptoms submitted to an abdominal ultrasound (US), that revealed a hypoechogenic mass between the liver, right kidney and pancreas. Computer tomography (CT) scan showed a hypodense and heterogeneous mass on pancreas head. The patient underwent elective resection of the mass and the histopathology was consistent with a solid-pseudopapillary tumor of pancreas. Immunohistochemical positivity for NSE (neuron-specific enolase), progesterone receptor, alfa-1-antitrypsin, vimentin, AE1/AE3, and negativity for synaptophysin and chromogranin A confirmed the diagnosis. After four years of clinical follow-up, the patient remains in a good general condition without signs of tumor recurrence.El tumor solido pseudopapilar de pancreas es una neoplasia poco frecuente, que ocurre predominantemente en mujeres jovenes. Este tumor generalmente es asintomatico o minimamente sintomatico y las imagenes son utiles para su diagnostico. Presentamos una mujer de 17 anos de edad con dispepsia que fue sometida a una ecografia abdominal que revelo una masa tumoral hipoecogenica entre el higado, el rinon derecho y el pancreas. La tomografia computarizada mostro una masa hipodensa y heterogenea en la cabeza del pancreas. La paciente fue sometida a reseccion electiva de la masa y la histopatologia fue consistente con el tumor solido pseudopapilar de pancreas. La inmunohistoquimica fue positiva para NSE (enolasa neuronal especifica), receptor de progesterona, alfa-1-antitripsina, vimentina, AE1/ AE3, y negativa para sinaptofisina y cromogranina A, lo que confirmo el diagnostico. Despues de cuatro anos seguimiento clinico, la paciente permanece en buen estado general sin signos de recurrencia del tumor.

Gene expression of endothelin receptors in replaced rheumatic mitral stenotic valves.

OBJECTIVES Rheumatic fever is a highly prevalent disease in Brazil, and it poses a major public health problem. It is the leading cause of acquired heart disease in childhood and adolescence. The aim of this study was to evaluate the gene expression of ET-3 and its receptors, in replaced rheumatic mitral valves. METHODS We studied the gene expression of endothelin-3 (ET-3) and its receptors, endothelin receptor A and endothelin receptor B (ETr-A and ETr-B), in the rheumatic mitral valves of 17 patients who underwent valve replacement surgery. The samples also underwent a histological analysis. RESULTS Our data showed that almost all patients, regardless of individual characteristics such as gender or age, expressed the endothelin receptor genes, but did not express the genes for ET-3. In quantitative analysis, the ETr-A/GAPDH mean ratio was 33.04 ± 18.09%; while the ETr-B/GAPDH mean ratio was 114.58 ± 42.30%. Regarding histopathological individual features, the frequency of fibrosis is 100%, 88.23% of mononuclear infiltrate, 52.94% of neovascularization, 58.82% of calcification and absence of ossification. CONCLUSION The presence of receptors ETr-A and ETr-B in rheumatic mitral valves suggests its interaction with the system of circulating endothelins, particularly ETr-B (known for acting in the removal of excess endothelin) detected in a greater proportion, which could explain the lack of expression of endothelin in rheumatic mitral valve, process to be elucidated.

Mixed subtype of congenital mesoblastic nephroma with poor evolution: a case report and literature review

A male child born at 27 weeks, weighting 1305 g and presenting with a right-sided abdominal tumor. Computed tomography scan demonstrated the presence of a solid mass compressing the right kidney. Puncture biopsy revealed congenital mesoblastic nephroma. The patient underwent total right nephroureterectomy, and died on the second day after surgery.

The Relationship between Different Types of Streptococci and Pharyngotonsillitis: A Systematic Review

Introduction: Streptococci were initially viewed by Louis Pasteur in 1879. Brown, in 1919, created the first systematized classification of streptococci in α, β and γ. Rebecca Lancefield contributed for knowledge of streptococcal polysaccharides discovering groups and M cell wall protein. Streptococci are gram positive, catalase and oxidase negative. Streptococci related to pathogenesis of acute sore throat are Streptococcus β-hemolytic of the groups A, B, C, F and G. Objective: Our objective was to make a review of the different types of streptococcus that can cause infection in the oropharynx. Review: Streptococcus pyogenes is belonging to the Lancefield grouping. Skin and mucous membranes of humans are the only known reservoir in the nature of streptococcus group A. Streptococcus of Group B (SGB) was originally isolated by Nocard in 1887. The primary habitat of these bacteria is the human colon, although it may colonize the oropharynx and especially, the vagina. For this reason, in mid-1960, the SGB has become a major cause of perinatal bacterial infection, including bacteremia and urinary tract infection in pregnant women. Group C is involved in purulent pharyngitis outbreaks. According to Fox et al, Streptococcus anginosus is the most common isolate β-hemolytic group C in the oropharynx. Streptococcus Group C (SGC) is reported as “pyogenes-like” because it shares important virulence factors such as hemolysins, extracellular enzymes and M proteins as well as the SGA. Conclusion: We conclude that it’s important to have knowledge about the different types of streptococci to better treat patients with sore throats and problems associated with this condition.

A Decade of Lipid Profiles: A Gender Focus

Introduction and Objectives: The lipid profile is an important predictor of the risk of coronary heart disease (CHD). Higher rates of total cholesterol (TC) and cholesterol of low-density lipoprotein (LDL-C) increase the chances of developing this disease. However, it is known that women due to hormonal factors would have fewer cardiovascular events. The main objective of this article is to assess the association among different parameters of the lipid profile between the different sexes in the population of a city in Brazil. Methods: This is a descriptive, longitudinal and retrospective study based on secondary data collected in the period from 2003 to 2013 in a medical laboratory in Aracaju, Brazil. The lipid profile was determined using the following markers: total cholesterol (TC); high-density lipoprotein cholesterol (HDL-C); low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG). Statistical analysis was performed using measures of central tendency and variance. The inferential analysis was performed by student’s t test and the p-value was 0.05. Results: The sample consists of 63,396 people, 24,425 male and 38,971 female, with mean age of 42.02±17.38 years. The mean value of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglyceride was respectively, 193.39±43.62 mg/dl, 48.80±11.24 mg/dl, 118.35±36.75 mg/dl and 131.28±82.21 mg/dl. Between the genres, it was observed statistical significant differences between all parameters of lipid profile (p<0.0001). Conclusion: We concluded that women have higher rates of total cholesterol and low-density lipoprotein cholesterol; while men have lower rates of high-density lipoprotein cholesterol and higher of triglyceride, which predisposes males to the development of metabolic syndrome.

Polymorphic Genetic Markers in Patients with Chronic Periodontitis

1Department of Pathology, Federal University of São Paulo, São Paulo, SP, Brazil 2Department of Morphology, Federal University of Sergipe, São Cristóvão, SE, Brazil 3Department of Biology, Federal University of Sergipe, São Cristóvão, SE, Brazil 4Department of Odontology, Federal University of Sergipe, Aracaju, SE, Brazil *Corresponding author Sydney Correia Leão, MD Medical Pathology Assistant Department of Pathology Federal University of São Paulo São Paulo, SP, Brazil E-mail: sydneyleao@hotmail.com