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Nass F.R.,Federal University of Parana | Kotze L.M.,Catholic University of Parana | Nisihara R.M.,Federal University of Parana | de Messias-Reaso I.T.,Federal University of Parana | da Rosa Utiyama S.R.,Federal University of Parana
Arquivos de Gastroenterologia

Context - Autoimmune diseases are 3 to 10 times more frequently in patients with celiac disease and their relatives than in the general population. Objective - To investigate a broad spectrum of autoantibodies in celiac disease relatives from Southern Brazil, in a serological follow-up of 6-10 years, aiming to associate with other autoimmune diseases, degree of parentage, demographic and clinical data. Methods - Serum samples of 233 relatives were analyzed in two different phases: n = 186 in phase I (1997-2000) and n = 138 (being 91 = follow-up group and 47 = newly tested) in phase II (2006-2007). As controls, 100 unrelated individuals were evaluated. Autoantibodies to smooth muscle, mitochondrial, liver-kidney microssome, parietal cell and thyroid microssome were tested by indirect immunofluorescence. Results - A significant increase of autoantibodies, in both phases, was observed in the relatives when compared to the non-relatives (P = 0.0064), specifically to anti-thyroid microssome and anti-parietal cell. In both phases, the female/male proportion of autoantibodies was of 4:1 to 3:1 (P≤0.041). The frequency of autoantibodies amongst 1st and 2nd degree relatives was 11.8% and 9.68% in phase I and 4% and 6.67% in phase II. Conclusion - Celiac disease relatives presented other autoantibodies and serological screening is a useful instrument for identifying autoimmune diseases along the years. Source

Tanaka O.M.,Catholic University of Parana | Maruo H.,University of Campinas
Dental Press Journal of Orthodontics

Introduction: Nicotine is harmful to angiogenesis, osteogenesis and synthesis of collagen. Objective: The aim of this study was to investigate the effect of nicotine on bone remodeling during orthodontic movement in rats. Methods:Eighty male Wistar rats were randomly divided into three groups: Group C (control), group CM (with orthodontic movement) and group NM (nicotine with orthodontic movement) groups. The animals comprising groups C and CM received 0.9% saline solution while group NM received nicotine solution (2 mg/kg). A nickel-titanium closed-coil spring was used to induce tooth movement. The animals were euthanized and tissue specimens were processed histologically. We quantified blood vessels, Howship's lacunae and osteoclast-like cells present in the tension and compression areas of periodontal ligaments. The extent of bone formation was evaluated under polarized light to determine the percentage of immature/mature collagen. Results:We observed lower blood vessel densities in the NM group in comparison to the CM group, three (p < 0.001) and seven (p < 0.05) days after force application. Osteoclast-like cells and Howship's lacunae in the NM group presented lower levels of expression in comparison to the CM group, with significant differences on day 7 (p < 0.05 for both variables) and day 14 (p < 0.05 for osteoclast-like cells and p < 0.01 for Howship's lacunae). The percentage of immature collagen increased in the NM group in comparison to the CM group with a statistically significant difference on day 3 (p < 0.05), day 7 (p < 0.001), day 14 (p < 0.001) and day 21 (p < 0.001). Conclusions:Nicotine affects bone remodeling during orthodontic movement, reducing angiogenesis, osteoclast-like cells and Howship's lacunae, thereby delaying the collagen maturation process in developed bone matrix. © 2014 Dental Press Journal of Orthodontics. Source

De Noronha L.,Catholic University of Parana | Cecilio W.A.C.,Rua Petit Carneiro | Da Silva T.F.A.,Rua Petit Carneiro | Maggio E.M.,Federal University of Parana | Serapiao M.J.,Federal University of Parana
Pediatric and Developmental Pathology

We describe a rare occurrence of congenital peribronchial myofibroblastic tumor of the lung presenting in early fetal life. A female patient in the 24th week of gestation who presented with polyhydramnios was admitted for examination. Ultrasound examination revealed a mass compromising the lungs. Because the intrauterine fetal death was revealed by the ultrasound, delivery was induced. Necropsy revealed a pulmonary lesion compromising the left lower pulmonary lobe together with hepatomegaly. Microscopic analysis of the lung showed a lesion with a storiform arrangement of spindle cells with focal peribronchial distribution. Hepatic architecture was diffusely altered by fibrotic tissue. Immunohistochemical analysis on the pulmonary lesion showed high vimentin positivity in the fusocellular components, pointing to the mesenchymal nature of the lesion. Significant differentiation of smooth muscle tissue, as indicated by high HHF35 positivity, was also observed. Electron microscopy on the pulmonary lesion revealed elongated cells with some cytoplasmatic processes, a finding that is also compatible with mesenchymal differentiation. © 2010 Society for Pediatric Pathology. Source

Riella M.C.,Catholic University of Parana | Roy-Chaudhury P.,University of Cincinnati
Nature Reviews Nephrology

Despite all the progress achieved since Scribner first introduced the arteriovenous (AV) shunt in 1960 and Cimino and Brescia introduced the native AV fistula in 1962, we have continued to face a conundrum in vascular access for dialysis, in that dialysis vascular access is at the same time both the 'lifeline' and the 'Achilles' heel' of haemodialysis. Indeed, findings from a multitude of published articles in this area, unfortunately mainly observational studies, reflect both our frustration and our limited knowledge in this area. Despite improved understanding of the pathophysiology of stenosis and thrombosis of the vascular access, we have unfortunately not been very successful in translating these advances into either improved therapies or a superior process of care. As a result, we continue to face an epidemic of arteriovenous fistula (AVF) maturation failure, a proliferation of relatively ineffective interventions such as angioplasty and stent placement, an extremely high incidence of catheter use, and more doubts rather than guidance with regard to the role (or lack thereof) of surveillance. An important reason for these problems is the lack of focused translational research and robust randomized prospective studies in this area. In this Review, we will address some of these critical issues, with a special emphasis on identifying the best process of care pathways that could reduce morbidity and mortality. We also discuss the potential use of novel therapies to reduce dialysis vascular access dysfunction. © 2013 Macmillan Publishers Limited. All rights reserved. Source

Ghanem V.C.,Sadalla Amin Ghanem Eye Hospital | Ghanem V.C.,University of Sao Paulo | Ghanem R.C.,Sadalla Amin Ghanem Eye Hospital | Ghanem R.C.,University of Sao Paulo | De Oliveira R.,Catholic University of Parana

PURPOSE: To evaluate the postoperative pain after corneal collagen cross-linking (CXL). METHODS: This prospective study included 178 consecutive eyes of 135 patients with progressive keratoconus who underwent CXL at Sadalla Amin Ghanem Eye Hospital, Joinville, Brazil. Pain was assessed postoperatively using the need for analgesia with 30 mg of codeine (Tylex) and by the patients' subjective evaluation on the Wong-Baker FACES Pain Rating Scale at the end of each day until postoperative day (PO) 5. Correlation of postoperative pain with maximum keratometric reading and central corneal thickness, which were assessed preoperatively, was investigated. RESULTS: Mean patient age was 23.38 ± 5.86 years. Mean (±SD) patient-scored pain decreased significantly (P < 0.05) from 2.78 (±1.68) on the day of surgery (immediate postoperative period, iPO) to 0.12 (±0.46) on PO5. The mean number of codeine pills was 0.94, 0.72, and 0.28 at iPO, PO1, and PO2, respectively, showing a significant decrease at each time point. Statistical analysis showed significant (P < 0.05) correlation between age and pain at PO3 and PO4 (the younger the patients the greater the pain) and between age and the number of codeine pills on iPO. There was no significant correlation between mean overall pain and preoperative apical keratometry (P = 0.546) and pachymetry (P = 0.072) readings. CONCLUSIONS: CXL postoperative pain can be intense, especially in the first 3 days, even with an aggressive pain control regimen; however, pain and the need for analgesia decreased significantly on each consecutive day. Pain was significantly correlated with the patient's age. Copyright © 2012 by Lippincott Williams & Wilkins. Source

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