Navegando por Palavras-chave "biópsia"
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- ItemAcesso aberto (Open Access)Do standardization and quantification of histopathological criteria improve the diagnosis of inflammatory bowel disease?(Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, 2014-06-01) Baldin, Rosimeri Kuhl Svoboda; Telles, José Ederaldo Queiroz; Bonardi, Renato Araújo; Amarante, Heda Maria Barska Dos Santos; Baldin Júnior, Antônio; Universidade Federal do Paraná Hospital de Clínicas Medical Pathology Department; Universidade Federal de São Paulo (UNIFESP); UFPR Hospital de Clínicas Medical Pathology Department; UFPR Department of Surgery; UFPR Internal Medicine Department; UFPR Hospital de ClínicasIntroduction:Inflammatory bowel disease comprises two major categories: Crohn's disease and ulcerative rectocolitis, both with different clinical and histological aspects, causing sometimes significant morbidity.Objectives:Choose and apply standardized and quantified histopathological diagnosis method, and compare the results and quality index with the original diagnosis.Materials and methods:43 histological colonoscopic biopsies of 37 patients were re-evaluated by standardized system.Results and discussion:The original diagnoses were more inconclusive (23.3%) than those standardized (2.3%). The agreement with gold standard (clinical, colonoscopical, and radiological diagnosis) was higher on standardized diagnoses (95.3%) than in original (74.4%), especially in relation to Crohn's disease, which percentages were 92.3% and 46.1%, respectively. The quality index was calculated in conclusive diagnosis of each method. For ulcerative rectocolitis, both methods showed sensitivity and negative predictive value of 100%; otherwise the original diagnosis demonstrated specificity of 85.7%, positive predictive value of 96.3% and accuracy of 97.0%, and the standardized diagnosis 92.3%, 96.7% and 97.6%, respectively. For Crohn's disease, there is specificity and positive predictive value of 100% in both methods; the original diagnosis showed sensitivity of 85.7%, negative predictive value of 96.3% and accuracy of 97%, while for the standardized diagnoses 92.3%, 96.7%, and 97.6%, respectively.Conclusion:The standardized diagnosis presented a higher percentage of correct and conclusive diagnoses than those presented in the original diagnosis, especially for Crohn's disease, as well as equal or slightly higher values in some quality index.
- ItemSomente MetadadadosPapel da biópsia pulmonar cirúrgica no transplantado renal com doença respiratória(Universidade Federal de São Paulo (UNIFESP), 2014-11-26) Tomotani, Daniere Yurie Vieira [UNIFESP]; Machado, Flavia Ribeiro Machado [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The purpose of this study was to assess the role of surgical lung biopsy in determining the specific causative diagnosis in renal transplant patients with pulmonary disease of unknown cause and the complications related to this procedure. We conducted a single-center, retrospective study at Hospital do Rim e Hipertensão. From April 2010 to April in 2014, we included kidney transplant over 18 years-old admitted to the intensive care unit after elective surgical lung biopsy and those who underwent the procedure during admission to the intensive care unit because of acute respiratory failure. Were included 87 patients, 54 (62.1%) were admitted to the ICU after elective surgical biopsy. We obtained a specific histopathological diagnosis in 74 (85.1%) patients, 59 (67.8%) were infection. Fungi were the most common agents (37.9%), but tuberculosis was the most prevalent opportunistic infection (21.8%). Complications occurred in 28.7% of procedures, with persistent air leak being the most frequent (10.3%). A change in therapy was instituted in 46 patients (52.9%). The mortality rate was 25.3%. In the logistic regression analysis, risk factors associated with mortality were age (OR: 1.10 [95% CI: 1.03 to 1.18], p = 0.003), Simplified Acute Physiologic Score score 3 (SAPS 3) (OR: 1.10 [95% CI: 1.07 to 1.29], p <0.001) and the presence of complications directly related to the procedure (OR: 4.98 [95% CI: 1.22 to 20.32] p <0.025). In conclusion, surgical lung biopsy is a procedure that leads to a specific diagnosis in the majority of renal transplant recipients with pulmonary disease. However, it is not a harmless procedures as complications are frequent. Age, severity of disease and the postoperative complications were associated with a higher mortality.
- ItemAcesso aberto (Open Access)Paralisia periódica: estudo anátomo-patológico do músculo esquelético de 14 pacientes(Academia Brasileira de Neurologia - ABNEURO, 1994-03-01) Tengan, Célia Harumi [UNIFESP]; Oliveira, Acary Souza Bulle [UNIFESP]; Morita, Maria Da Penha Ananias [UNIFESP]; Kiyomoto, Beatriz Hitomi [UNIFESP]; Schmidt, Beny [UNIFESP]; Gabbai, Alberto Alain [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Periodic paralysis is a rare disease, characterized by transient weakness associated with abnormal levels of serum potassium. Muscle biopsy may show a wide range of abnormalities, vacuoles being more specifically linked to the disease. We analysed 17 muscle biopsies from 14 patients with periodic paralysis (14 hypokalemic, 2 hyperkalemic). All of them showed at least one histological abnormality. Fourteen specimens showed vacuoles that were peripheral, single, frequent and preferentially found in type I fibers. Frequency or severity of attacks did not correlate with the presence of vacuoles but those were more easily found in patients with long term disease. Ten biopsies showed tubular aggregates, specially on the patients with frequent crises or long term disease. A second biopsy was done in three patients and in two we observed a worsening of the histopathologic picture. One patient manifested interictal weakness with evident myopathic changes on the muscle biopsy. Nonspecific changes were found in variable degrees in 15 biopsies. Our study shows that vacuoles and tubular aggregates are frequent changes in periodic paralysis and therefore helpful for the diagnosis. Important myopathic findings in the muscle biopsy suggest a permanent myopathy which probably develops after severe crises or long term disease.