Existe a necessidade de um diagnóstico preciso sobre a causa dos aumentos de volume na área umbilical de suínos por ocasião do abate, para que sejam adotados critérios adequados durante a inspeção das carcaças. Foi realizada uma avaliação deste tipo e alterações foram observadas e retiradas da carcaça, para abertura e categorização. Através da descrição das características anatomopatológicas externas e internas, e classificadas as diferentes formas de aumento de volume na região umbilical. Foram diagnosticados 515 aumentos de volume entre 96.599 suínos abatidos (0,53%), destes 235 foram avaliados e categorizadas 19 condições patológicas, com diversos tipos de associações. Os diagnósticos obtidos foram: hérnias umbilicais, flaps, cistos, fibrose e abscessos. Hérnias, associadas ou não, representaram o diagnóstico mais frequente, 155 casos. A seguir foram os "flaps", cistos, fibrose e abscessos, respectivamente. No exame histopatológico do saco herniário, foi observada proliferação de tecido conjuntivo denso, adjacente à área de tecido conjuntivo frouxo, revestida por mesotélio. Ainda, áreas de necrose, mineralização e hemorragia focalmente extensa. A composição dos flaps foi basicamente tecido conjuntivo frouxo com acentuada quantidade de formações vasculares, revestido por mesotélio. Os cistos apresentaram proliferação de tecido conjuntivo frouxo com acentuada quantidade de formações vasculares e dilatações císticas com material amorfo eosinofílico no interior, revestido por mesotélio e proliferação de tecido conjuntivo denso perifericamente com área focal de infiltrado de linfócitos. Em relação ao destino das 235 carcaças, 135 (57,44%) foram liberadas para mercado interno, 91 (38,72%) submetidas ao tratamento térmico e 9 (3,82%) enviadas à graxaria. Durante a análise dos casos de aumento de volume na área umbilical pela inspeção federal, não foram adotados os critério de condenação considerando a caracterização precisa das lesões, proposta no presente trabalho. A adoção dos mesmos poderia contribuir para a redução de perdas, sem comprometer critérios que visam a garantir a segurança alimentar. / It is important to reach a precise diagnosis of causes of increase in the volume in the umbilical area of pigs at slaughter, to enable decisions on the use of adequate criteria of carcass inspection. A study to evaluate this problem was carried out observing and removing lesions from the carcass to dissection and characterization. Through description of internal and external anatomopathologic characteristics, different forms of increase in the volume in the umbilical area were classified. Between 96,599 carcasses, 515 increases in the volume were diagnosed (0,53%), among them 235 were assessed and categorized and 19 pathological conditions with different associations were found. The main diagnosis were: umbilical hernias, flaps, cysts, fibrosis and abscesses. Hernias, in isolation or in association, were the most frequent diagnosis, 155. The following were the "flaps", cysts, abscesses and fibrosis, respectively. Using histopathological examination of the hernial sac, it was found proliferation of dense conjunctive tissue, adjacent to an area of loose conjunctive tissue, covered by mesothelium. Additionally, areas of necrosis, mineralization and focally extensive hemorrhage. The composition of flaps was basically loose conjunctive tissue with decreased amount of vascular formations, covered by mesothelium. Cysts showed proliferation of loose connective tissue with accentuated amount of vascular formations and with amorphous eosinophilic material inside, covered by mesothelium and proliferation of dense connective tissue with focal areas of inflammatory infiltrate composed by lymphocytes in the periphery. With respect to the destiny of the 235 carcasses, 135 (57,44%) were released for consumption in the internal market, 91 (38,72%) submitted to heat treatment and 9 (3,82%) sent to meat-and-bone-meal production. During the analysis of cases of increase in the volume in the umbilical area by the Federal Inspection, criteria proposed in the present work were not fully adopted. Its use could contribute to reduce unnecessary losses, without compromising a criterion which would maintain guarantees of food safety.

O estudo trata de infecções fúngicas por Histoplasma, Cryptococcus gattii e Paracoccidioides e por Actinomyces e Nocardia que simularam neoplasia a partir de achados radiológicos. O objetivo deste trabalho é demonstrar, através de casos do banco de dados do Laboratório de Micologia da Irmandade Santa Casa de Misericórdia de Porto Alegre, a importância de um diagnóstico diferencial destas infecções com doenças neoplásicas. Identificamos os aspectos epidemiológicos e clínico-laboratoriais desses pacientes e revisamos criticamente a literatura. A casuística foi constituída por 83 casos, extraídos de uma população de 1.368 pacientes, de 1981 a 2012. As características clínicas e radiológicas de neoplasia foram observadas principalmente na histoplasmose, pela formação de histoplasmoma, na criptococose por C. gattii pela capacidade de formar criptococoma; na actinomicose e na nocardiose pela produção de massas. O que reforça o fato de que a síndrome clínica não é patognomônica da doença neoplásica e que as doenças infecciosas, especialmente granulomatosas devem ser consideradas no diagnóstico diferencial. / The study comes to infections by Histoplasma, Cryptococcus gattii, Paracoccidioides, and also Actinomyces and Nocardia simulating neoplasia from radiological findings. The objective of this study is to demonstrated, through case database of Mycology Laboratory of Irmandade Santa Casa de Misericordia de Porto Alegre, the importance of a differential diagnosis of these infections with neoplastic disease. We identified the epidemiological, clinical and laboratorial datas of these cases and review the literature critically. The casuistic consisted of 83 cases, drawn from a population of 1,368 patients, from 1981-2012. The clinical and radiological features of malignancy were observed mainly in histoplasmosis by manifestation as histoplasmoma, in cryptoccosis by C.gattii to the ability to form crytococcoma; actinomycosis and nocardiosis by the production of masses. This fact emphasizes that the clinical syndrome is not pathognomonic of neoplastic diseases and that infectious diseases, especially granulomatous, should be considered in the differential diagnosis.

A brucelose é uma doença altamente contagiosa, responsável por grandes prejuízos econômicos e de saúde pública. É causada por bactérias do gênero Brucella, cujas espécies e seus biovares costumam ser caracterizados pelo isolamento e identificação de características fenotípicas da colônia. Dificuldades como, o perigo na manipulação dos microrganismos, processos laboriosos de tipificação, demora na obtenção de resultados e a instabilidade de características fenotípicas ou isolamento de linhagens atípicas dificultam a tipificação e encorajaram a busca de técnicas mais sensíveis e específicas, como a PCR, que resolveria as dificuldades e facilitaria a investigação epidemiológica dos casos humanos e animais. Diversas análises e o sequenciamento de determinados genes e do genoma completo de algumas espécies, demonstraram a existência de polimorfismos únicos no DNA das brucelas, que podem ser utilizados na sua identificação. Baseado nas dificuldades de identificação e na descoberta de polimorfismos únicos no DNA bacteriano das espécies, nosso objetivo foi desenvolver primers específicos para identificação de seis espécies do gênero B. abortus, B. melitensis, B. suis, B. canis, B. ovis e B. neotomae, e padronizar PCRs que permitissem identificá-las com maior sensibilidade e rapidez. Tentamos caracterizar marcadores moleculares para o desenho de primers espécie-específicos, através da amplificação randômica e clonagem dos fragmentos específicos, sem resultados satisfatórios. Apenas um primer para B. abortus foi conseguido quando foram analisados os polimorfismos já descritos na literatura. Assim, realizou-se o alinhamento múltiplo das sequências dos cromossomos I e II das espécies de Brucella, que permitiu a identificação de vários eventos polimórficos específicos para cada espécie, dos quais foram escolhidas regiões potenciais para o desenho de sete primers (dois para B. canis, B. melitensis e B. ovis, e outro para B. canis/B. suis) que tiveram sua especificidade analítica verificada com o programa Primer BLAST e testada nas 18 cepas de referência de Brucella, compreendendo a B. abortus, B. melitensis, B. suis e seus biovares, além da <iB. canis, B. ovis e B. neotomae, e em 231 isolados de campo, incluindo B. abortus, B. canis e B. suis. Os testes de especificidade dos primers resultaram na amplificação do fragmento esperado de quase todas as cepas de referência e de campo, exceto para o primer de B. canis e o de B. canis/B. suis. Estes resultados sugerem que os marcadores desenhados são promissores na diferenciação das espécies. / Brucellosis is responsible for great economic losses and serious impact on public health. This infectious disease is caused by bacteria of the genus Brucella, whose species and their respective biovars are often characterized by isolation and identification of differences in phenotypic tests. The complex and laborious process of Brucella typing, comprising the danger in handling of microorganisms, delay in obtaining results and instability of phenotypic characteristics or isolation of atypical strains, stimulated the search for more sensitive and specific techniques such as PCR. This technique would facilitate the epidemiological investigation of human and animal cases. Several analyses even as sequencing of certain genes and the complete genome of some species, demonstrated the existence of polymorphisms in the DNA of Brucella, which can be used to identify them. Due to typing difficulties and discovery of single polymorphisms in DNA bacterial species, our goals were to develop specific primers for identification of six species of the genus B. abortus, B. melitensis, B. suis, B. canis, B. ovis and B. neotomae and standardize PCRs to identify them with greater sensitivity and speed. We tried to characterize species-specific molecular markers using random amplification and cloning of specific fragments to design primers, without satisfactory results. Only one primer based on polymorphisms already described in the literature was successful for B. abortus specie differentiation. Thus, we performed the multiple alignment of the complete sequences of chromosomes I and II of Brucella species. This approach allowed the identification of several specie-specific polymorphic events, from which potential regions were chosen for the design of seven primers (two for B. canis, B. melitensis and B. ovis, and one for B. canis / B. suis). The analytical specificity of all primers was verified with the Primer BLAST software. Tests with specific primers were performed on 18 reference strains of Brucella, including all the six species of the genus Brucella and 231 field strains of B. abortus, B. canis and B. suis. The PCRs showed the expected fragment amplification in almost all reference and field strains, except for the B. canis and the B. canis / B. suis primers. Ours results suggest that these PCRs are able for Brucella species differentiation.

Orientador: Irene Gyongyver Heidemarie Lorand Metze / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T03:04:45Z (GMT). No. of bitstreams: 1 Reis-Alves_SuiellenCarvalho_D.pdf: 1989355 bytes, checksum: c49ffc9bdc49263faef580e3f36d751a (MD5) Previous issue date: 2014 / Resumo: A imunofenotipagem é reconhecida como uma importante ferramenta para o diagnóstico das síndromes mielodisplásicas (SMD). O sistema de pontuação por citometria de fluxo descrito recentemente (FCSS) é útil para o diagnóstico diferencial, bem como para o prognóstico de SMD. Avaliamos se a inclusão de valores quantitativos de expressões anormais em células CD34+ e monócitos nesta pontuação poderia melhorar o seu valor diagnóstico. O FCSS modificado (FCSS -R) abrange 9 alterações granulocíticas, 8 monocíticas e 6 de células CD34+. A análise imunofenotípica foi realizada em células de medula óssea (MO) de 56 pacientes com SMD (76% com blastos na medula óssea <5%), 33 casos de citopenias reacionais e 41 doadores de medula óssea saudáveis de transplante alogênico (controles normais). As duas pontuações foram aplicadas em todos os casos. Embora tenhamos encontrado o desvio à esquerda assíncrono na maturação dos granulócitos, a diminuição das hematogônias e o aumento de monócitos CD16+, bem como casos isolados de co-expressões anormais no amadurecimento de precursores mielomonocíticos em citopenias reacionais, alterações qualitativas e quantitativas nos sub tipos de células mielóides CD34+ foram mais específicas de SMD. Ambas as pontuações permitiram discriminar SMD de citopenias reacionais, mas, de acordo com a área sob a curva ROC, o FCSS -R foi mais sensível (53% para FCSS e 94% para FCSS -R). Ambas as pontuações apresentaram especificidade de 100%. A inclusão de valores quantitativos de expressões anormais nas células CD34+ e monócitos em FCSS melhorou a sensibilidade de FCSS-R para o diagnóstico diferencial entre SMD e citopenias periféricas reacionias / Abstract: Immunophenotyping has been recognized as an important tool for diagnosis of myelodysplastic syndromes (MDS). The recently described flow cytometry scoring system (FCSS) is useful for the differential diagnosis as well as prognosis of MDS. We examined if the inclusion of quantitative values of abnormal expressions in CD34+ cells and monocytes in this score could improve its diagnostic value. The modified FCSS (FCSS-R) covers 9 granulocytic, 8 monocytic and 6 CD34+ cell abnormalities. Immunophenotypic analyzes were performed on bone marrow (BM) cells of 56 patients with MDS (76% with bone marrow blasts <5%), 33 cases of reactive cytopenias and 41 healthy bone marrow donors for allogeneic BM transplantation (normal controls). The two scores were applied in all cases. Although asynchronous shift to the left in the maturing granulocytes, decrease in hematogones and increase in CD16+ monocytes as well as isolated cases of abnormal co-expressions in maturing myelomonocytic precursors could be found in reactive PB cytopenias, the most important differences with MDS were seen in the subsets of myeloid CD34+ cells. Both scores allowed to discriminate MDS from reactive cytopenias, but, according to the area under the ROC curve FCSS-R was more sensitive (53% for FCSS and 94% for FCSS-R). Both scores had a specificity of 100%. The inclusion of quantitative values of abnormal expressions in CD34+ cells and monocytes in FCSS improved the sensibility of FCSS for the differential diagnosis between MDS and reactive peripheral cytopenias / Doutorado / Clinica Medica / Doutora em Clínica Médica

Ménière’s disease is the third most common inner ear disorder. The individual course of Ménière’s disease in different patients makes it difficult to diagnose on the basis of symptomatology alone. The impact of Ménière’s disease on quality of life has highlighted the importance of an additional tool to support the diagnosis of Ménière’s disease. Apart from the patient’s history, audiological data provide the most relevant information for confirming the diagnosis. The aim of this study was to analyse and describe the clinical and audiological features of a cohort of subjects diagnosed with Ménière’s disease, in order to develop understanding of the pathophysiology of the disease and to facilitate the diagnostic process. The research is based on a retrospective study of the medical records of 135 subjects with Ménière’s disease which were selected according to a non-probability sample. Descriptive statistics were used to organize, analyse and interpret the data. Sixty one percent of subjects presented with definite Ménière’s disease, 14 % with probable Ménière’s disease and 25 % with possible Ménière’s disease. The results showed a higher incidence of Ménière’s disease in females especially in the vestibular type. Three percent of subjects indicated a family history of Ménière’s disease. Bilateral Ménière’s disease presented in 39 % of subjects. The results confirmed that vertigo was the most debilitating symptom in Ménière’s disease. Correlating the clinical features of subjects with audiometric and vestibular tests highlighted the clinical value of an audiological test battery including the following tests: Pure tone audiometry, Speech discrimination, Oto-acoustic emissions, Electronystagmography and Electrocochleography. This confirms the role of the audiologist in the diagnostic and rehabilitation process in patients with Ménière’s disease. / Dissertation (Communication Pathology)--University of Pretoria, 2007. / Speech-Language Pathology and Audiology / unrestricted

Background: Malaria is one of the mosquito-transmitted diseases that is killing millions of people every year, with the highest prevalence in Africa. In Tanzania, more than 90 percent of the inhabitants are at risk of being infected with malaria. The malaria parasite Plasmodium falciparum does not obtain specific symptoms and differential diagnoses can make it difficult to diagnose malaria. If malaria gets developed into a severe stage, it can affect organs and eventually cause death. Nurses have the role to educate inhabitants on how to prevent malaria. Purpose: The aim of this study was to describe nurses ́ experiences when caring for patients infected with malaria in Tanzania. Method: Study with a qualitative approach. A content analysis with a manifest structure was carried out, based on individual semi-structured in-depth interviews with nurses. Result: Nurses found it difficult to differentiate malaria from other diseases, like typhoid or meningitis. Nurses focused mostly on patients’ physical by working with medical treatment and education about malaria prevention. Conclusion: This study highlighted the importance for nurses of being educated about malaria and knowing how to assess its condition as it can be a mortal disease.

The histologic distinction of follicular patterned lesions of thyroid, that is follicular adenoma, follicular carcinoma, and the follicular variant of papillary thyroid carcinoma can be extremely difficult. The differential diagnostic criteria regarding nuclear features of papillary thyroid carcinoma are subjective, resulting in high interobserver variability. Although papillary thyroid carcinoma metastasizes mainly via lymphatic vessels, whereas follicular carcinoma spreads mostly hematogenously, there are no data regarding utility of objective quantitative criteria such as lymphatic and general blood vessel density for the differential diagnosis of these lesions. In this study, 35 follicular patterned lesions of thyroid (14 follicular adenomas, 10 follicular carcinomas, and 11 of the follicular variant of papillary thyroid carcinomas) were evaluated immunohistochemically. An assessment of intra- and peritumoral lymphatic vessel density was performed using novel lymphatic endothelium-specific marker D2-40, and the intra- and peritumoral general vessel density was determined by the panendothelial marker CD31. There were no significant differences in the intra- and/or peritumoral general vessel densities, and peritumoral lymphatic vessel densities among follicular adenoma, follicular carcinoma and the follicular variant of papillary thyroid carcinoma. In contrast, the intratumoral lymphatic vessel density was significantly higher in the follicular variant of papillary thyroid carcinoma than in either follicular adenoma or follicular carcinoma (34.63, 15.04, and 0.11 respectively; P<0.0001). The results of the study show that intratumoral lymphatic vessel density may serve as a useful tool in the differential diagnosis of follicular patterned lesions of thyroid. © 2005 USCAP, Inc All rights reserved.

The intent of this thesis is to explore and develop the quantification of AOS features, particularly the deficits of prosodic elements, lexical stress and duration. This study investigated whether PVI can be used as a sensitive tool for the differential diagnosis of AOS. Specifically, we sought to determine whether analysis of vowel length of stressed and unstressed syllables is helpful in differentiating between individuals with AOS and aphasia versus aphasia alone. Significant differences support the hypothesis that PVI, analyzed from vowel length, is uniquely affected in AOS. This yields reason for further research in prosodic deficits in differential diagnosis, as well as application of this theory for a speech-language pathologist.

No description available.

No description available.