Browsing by Author "Araújo, Stanley de Almeida"
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Item Combined use of Paracoccidioides brasiliensis recombinant rPb27 and rPb40 antigens in an enzyme-linked immunosorbent assay for immunodiagnosis of paracoccidioidomycosis.(2011) Fernandes, V. C.; Coitinho, Juliana Barbosa; Veloso, Juliana Márcia Ribeiro; Araújo, Stanley de Almeida; Pedroso, Enio Roberto Pietra; Goes, Alfredo Miranda deParacoccidioidomycosis (PCM) is one of themost important endemicmycoses in LatinAmerica; it's usually diagnosed by observation and/or isolation of the etiologic agent, Paracoccidioides brasiliensis, as well as by a variety of immunological methods, such as complement fixation and immunodiffusion. Although these approaches are useful, historically their sensitivity and specificity have often been compromised by the use of complex mixtures of undefined antigens. The use of combinations of purified,well-characterized antigens appears preferable andmay yield good results. In the present study combinations of the previously described 27-kDa recombinant antigen(rPb27) and a recombinant 40-kDa-molecular-mass antigen(rPb40) fromthis fungus, that was identified by Goes et al. (2005) through the AST strategy as a homolog of Neurospora crassa calcineurin B, were used in an indirect enzyme linked immunosorbent assay (ELISA) for diagnosis and follow-up of patients with PCM. The complete coding cDNA of rPb40 and rPb27 were cloned into a pET-21a and a pET-DEST 42 plasmid, respectively, expressed in E. coli with a his-tag and purified by affinity chromatography. Among 109 PCM serum samples analyzed, a homogeneous IgG response to these proteinswas observed. 62 serumsamples frompatientswith other diseases, 18 frompatientswith othermycosis and 23 fromhealthy individualswere also studied. Detection of anti-rPb27 and anti-rPb40 antibodies in sera of patientswith PCMby ELISA using a combination of the two purified proteins showed a sensitivity of 96% with a specificity of 100% in relation to control normal human sera andto sera frompatientswith other systemicmycosis and 93.5%to sera from patients with diverse infections. The use of this two proteins combination provided an excellent immunodiagnosis assaywith great values of sensitivity and specificity, even in relation to sera frompatients with othermycosis,making possible the standadization of a new methodology to diagnose this important mycosis, with a good confiability and reprodutibility.Item Cutaneous disseminated paracoccidioidomycosis.(2012) Araújo, Stanley de Almeida; Espindola, Bernardo Magalhães; Pedroso, Enio Roberto PietraItem Hanseníase multibacilar em paciente transplantado renal : relato de caso.(2015) Dutra, Flávia Albuquerque de Rezende; Araújo, Marcelo Grossi; Farah, Kátia de Paula; Maciel, Mônica Maria Moreira Delgado; Lucas Junior, Fernando da Mercês; Araújo, Stanley de Almeida; Guedes, Antônio Carlos MartinsO Brasil é um país onde a hanseníase ainda é um problema de saúde pública, apresentando mais de 30.000 novos casos por ano nos últimos anos. Apesar do crescente número de transplante de órgãos sólidos realizados no país, sobretudo o transplante renal, não são frequentes os relatos dessa micobacteriose em pacientes imunossuprimidos pelas medicações pós-transplante. Os autores relatam um caso de hanseníase multibacilar manifestada 12 anos depois do transplante renal, acompanhado desde o diagnóstico, durante a poliquimioterapia, tratamento e seguimento do eritema nodoso hansênico.Item Mesangial C4d deposition may predict progression of kidney disease in pediatric patients with IgA nephropathy.(2017) Fabiano, Rafaela Cabral Gonçalves; Araújo, Stanley de Almeida; Bambirra, Eduardo Alves; Oliveira, Eduardo Araújo; Silva, Ana Cristina Simões e; Pinheiro, Sérgio Veloso BrantBackground Data on the risk factors for chronic kidney disease in children with immunoglobulin A nephropathy (IgAN) are scarce. This study was aimed at investigating whether glomerular C4d immunostaining is a prognostic marker in pediatric IgAN. Methods In this retrospective cohort study, 47 patients with IgAN biopsied from 1982 to 2010 were evaluated. Immunohistochemistry for C4d was performed in all cases. For analysis, patients were grouped according to positivity or not for C4d in the mesangial area. Primary outcome was a decline in baseline estimated glomerular filtration rate (eGFR) by 50% or more. Results Median follow-up was 8.3 years. Median renal survival was 13.7 years and the probability of a 50% decline in eGFR was 13% over 10 years. Nine children exhibited the primary outcome and 4 developed end-stage renal disease (ESRD). Compared with C4d-negative patients (n = 10), C4d-positive patients (n = 37) presented higher baseline proteinuria (1.66 ± 0.68 vs 0.47 ± 0.19 g/day/1.73 m2, p < 0.001), a progressive decline in eGFR (−10.04 ± 19.38 vs 1.70 ± 18.51 ml/min/1.73 m2/year; p = 0.045), and more frequently achieved the primary outcome (50.0 vs 10.8%, p = 0.013), and ESRD (30.0 vs 2.7%, p = 0.026). No difference was observed in Oxford classification variables. Baseline proteinuria, endocapillary hypercellularity and mesangial C4d deposition were associated with primary outcome in univariate analysis. Proteinuria and mesangial C4d deposition at baseline independently predicted the decline in eGFR. Renal survival was significantly reduced in C4d-positive patients (8.6 vs 15.1 years in C4d-negative patients, p < 0.001). Conclusions In this exclusively pediatric cohort, positivity for C4d in the mesangial area was an independent predictor of renal function deterioration in IgAN.Item Paracoccidioidomycosis case series with and without central nervous system involvement.(2012) Pedroso, Vinicius Sousa Pietra; Lyon, Ana Cláudia; Araújo, Stanley de Almeida; Veloso, Juliana Márcia Ribeiro; Pedroso, Enio Roberto Pietra; Teixeira, Antônio LúcioIntroduction: Paracoccidioidomycosis (PCM) is the most important systemic mycosis in South America. Central nervous system involvement is potentially fatal and can occur in 12.5% of cases. This paper aims to contribute to the literature describing eight cases of neuroparacoccidioidomycosis (NPMC) and compare their characteristics with patients without neurological involvement, to identify unique characteristics of NPCM. Methods: A cohort of 213 PCM cases was evaluated at the Infectious Diseases Clinic of the University Hospital, Federal University of Minas Gerais, Brazil, from October 1976 to August 2008. Epidemiological, clinical, laboratory, therapeutic and follow-up data were registered. Results: Eight patients presented NPCM. The observed NPCM prevalence was 3.8%. One patient presented the subacute form of PCM and the other seven presented the chronic form of the disease. The parenchymatous form of NPCM occurred in all patients. 60% of the patients who proceeded from the north/ northeast region of Minas Gerais State developed NPCM. The neurological involvement of a mother and her son was observed. NPCM patients exhibited demographical and clinical profiles similar to what is described in the literature. When NPCM cases were compared to PCM patients, there were differences in relation to origin and positive PCM family history. Conclusions: The results corroborate the clinical view that the neurological findings are extremely important in the evaluation of PCM patients. Despite the limitations of this study, the differences in relation to patient’s origins and family history point to the need of further studies to determine the susceptibility factors involved in the neurological compromise.Item Pheochromocytoma-induced shock : a case report.(2012) Araújo, Stanley de Almeida; Carmo, Paula Alves Santos do; Paulino Junior, Eduardo; Borges, Isabela Nascimento; Rocha, Luiz Otávio SavassiBecause of its rarity, together with the variability and nonspecificity of its signs and symptoms, pheochromocytoma, a tumor arising from chromaffin cells, creates an unlucky paradox: it is often missed but only rarely found. Besides the association with arterial hypertension, often in the form of paroxysmal attacks, pheochromocytoma may also be associated, in up to 40% of cases, with orthostatic hypotension which, when present, provides a clue to the diagnosis of the tumor. Far more rare (about 2% of cases) is the clinical presentation in the form of shock, a possibility that, among other attributes, justifies the epithet “the great mimic” applied to the neoplasia. The authors report the case of a 51-year-old hypertensive woman whose death was erroneously attributed to septic shock. Autopsy disclosed an unsuspected left adrenal bulky pheochromocytoma with areas of hemorrhage and extensive central necrosis, pronounced pulmonary edema, left ventricular mural thrombus, and histological evidence of acute myocardial injury.Item Polyomavirus infection in renal allograft.(2013) Araújo, Stanley de Almeida; Sampaio, Kinulpe Honorato; Fernandes Júnior, Ladislau JoséItem The Oxford Classification predictors of chronic kidney disease in pediatric patients with IgA nephropathy.(2017) Fabiano, Rafaela Cabral Gonçalves; Araújo, Stanley de Almeida; Bambirra, Eduardo Alves; Oliveira, Eduardo Araújo; Silva, Ana Cristina Simões e; Pinheiro, Sérgio Veloso BrantObjective: The Oxford Classification for Immunoglobulin A nephropathy (IgAN) identifies pathological variables that may predict the decline of renal function. This study aimed to evaluate the Oxford Classification variables as predictors of renal dysfunction in a cohort of Brazilian children and adolescents with IgAN. Methods: A total of 54 patients with IgAN biopsied from 1982 to 2010 were assessed. Biopsies were re-evaluated and classified according to the Oxford Classification. Multivariate analysis of laboratory and pathological data was performed. The primary outcomes were decline of baseline estimated glomerular filtration rate (eGFR) greater than or equal to 50%. Results: Mean follow-up was 7.6 ± 5.0 years. Mean renal survival was 13.5 ± 0.8 years and probability of decline ≥50% in baseline eGFR was 8% at five years of follow-up and 15% at ten years. Ten children (18.5%) had a decline of baseline eGFR ≥ 50% and five (9.3%) evolved to end-stage renal disease. Kaplan---Meier analysis showed that baseline proteinuria, proteinuria during follow-up, endocapillary proliferation, and tubular atrophy/interstitial fibrosis were associated with the primary outcome. Multivariate Cox analysis showed that only baseline proteinuria (HR, 1.73; 95% CI, 1.20---2.50, p = 0.003) and endocapillary hypercellularity (HR, 37.18; 95% CI, 3.85---358.94, p = 0.002) were independent predictors of renal dysfunction. No other pathological variable was associated with eGFR decline in the multivariate analysis.Item The role of immunohistochemistry in the detection of vascular invasion in specimens of endoscopic submucosal dissection.(2013) Aldeman, Nayze Lucena Sangreman; Palhares, Daniel Moore Freitas; Araújo, Stanley de Almeida; Pedrosa, Moisés Salgado; Castro, Luísa Lima; Arantes, Vitor Nunes; Cabral, Mônica Maria Demas ÁlvaresIntroduction: Endoscopic submucosal dissection (ESD) of early neoplasias of the gastrointestinal tract (GIT) has been increasingly applied as an alternative to invasive surgical procedures, with the aim to preserve the patient’s organ and quality of life, although it does not allow the histopathological analysis of lymph nodes. Previous studies demonstrated that the presence of neoplastic emboli in lymphatic (lymphatic vascular invasion [LVI]) or blood vessels (blood vascular invasion [BVI]) is considered a positive predictive factor for the occurrence of lymph node metastasis. The assessment of vascular invasion carried out only by routine hematoxylin and eosin staining (HE) may yield both falsepositive and false-negative results. D2-40 is a specific monoclonal antibody to the lymphatic endothelium. Thus, it is useful for identifying LVI and distinguishing if tumor embolization is found in blood or lymphatic vessels. Objective: To determine the role of immunohistochemistry (IHC) in the assessment of ESD specimens by comparing the detection of LVI and BVI by HE and IHC with D2-40 and CD34 immunolabeling. Method: We conducted the IHC study using D2-40 and CD34 markers (pan-endothelial) in 30 cases of ESD with histological diagnosis of carcinoma in order to assess the presence of LVI and BVI. Results: The detection of LVI was more prevalent than BVI. Three out of six cases with LVI were false-positive by HE and six were false-negative by IHC. Regarding BVI, five cases were identified and one was false-negative by IHC. Conclusion: Our results indicated that the histopathological analysis of ESD specimens by exclusively routine HE staining does not allow proper evaluation of BVI or LVI.Item The role of lymph node revealing solution on the improvement of lymph node harvest in colorectal cancer specimens.(2016) Profeta da Luz, Magda Maria; Lacerda Filho, A.; Cabral, Mônica Maria Demas Álvares; Fonseca, Leonardo Maciel da; Araújo, Stanley de Almeida; Sanches, Soraya Rodrigues de Almeida; Silva, R. Gomes daAim The correct analysis of lymph node status is one of the most important parameters for the accurate pathological diagnosis of colorectal cancer. Our aim was to evaluate the number of lymph nodes among the specimens obtained from colorectal resections due to colorectal cancer, before and after the routine use of a lymph node revealing solution (LNRS). Method Data from 780 surgical specimens from patients of both genders with colorectal cancer were studied. The cases were divided chronologically into two groups: the conventional group included 497 specimens treated with conventional methods, i.e. without the use of the LNRS (January 2000 to July 2007), and the LNRS group included 283 specimens examined through the routine use of this solution (August 2007 to July 2012). Results Most patients were female (57.4%) with a median age of 62 years. The median lymph node number was 18, and 75.9% of the cases (592) had 12 or more nodes dissected. Lymph node metastases were noted in 334 cases (42.8%). A median of 24 lymph nodes was dissected in the LNRS group compared to 15 in the conventional group (P < 0.001). The LNRS group had 9.2% of cases with fewer than 12 lymph nodes dissected compared with 32.6% in the conventional group (P < 0.001). Conclusions The use of the LNRS increases the number of lymph nodes obtained from colorectal cancer surgical specimens and can help to reduce the number of cases with < 12 lymph nodes.