Biomedical subjects

Edenilson Eduardo Calore

Publications and source records attributed to Edenilson Eduardo Calore.

9 recordsLinked to original sources

PubMed2006

P-glycoprotein expression in non-Hodgkin's lymphomas of human immunodeficiency virus infected patients.

Multidrug resistance (MDR) is a challenge in cancer treatment. One of the most studied mechanisms is P-glycoprotein (P-gp), which acts as a drug efflux pump, with decreased intracellular accumulation of drugs. It still needs to be clarified whether P-gp expression has a significant impact on non-Hodgkin's lymphoma treatment response, but a poor outcome has been reported in patients with positive P-gp expression. AIDS-related lymphomas have aggressive behavior, and although a complete response could be achieved, relapse is not uncommon. In an attempt to determine a possible relationship between MDR and poor outcome in this population, histologic samples obtained from 45 non-Hodgkin's lymphoma HIV-infected patients without previous cytotoxic therapy were submitted to immunohistochemical analysis using monoclonal antibody C494 specific for the MDR-1 isoform of P-gp. Samples from 27 patients (60%) were positive. Response to treatment (P=0.02) and overall survival (P=0.001) were significantly lower in patients with positive P-gp expression. In patients having achieved complete remission, the median disease-free survival (DFS) was not reached; the mean DFS was 57.2 months with DFS rates of 72.9% in three years. Our results show that P-gp is expressed before treatment of non-Hodgkin's lymphoma of HIV patients, and is related to poor response to treatment and overall survival.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed2006

Bone marrow biopsy in the diagnoses of infectious and non-infectious causes in patients with advanced HIV infection.

AIMS: Fever and peripheral blood abnormalities in patients with advanced acquired immunodeficiency syndrome are usually due to disseminated opportunistic infections. The objective of this study was to evaluate the diagnostic yield of histopathological and microbiological investigations of bone marrow samples from HIV-infected patients with fever and/or cytopenias. METHODS AND RESULTS: The diagnostic utility of bone marrow aspiration, biopsy and culture was retrospectively examined in 82 patients with HIV/AIDS (median CD4 count 51 microL(-1), range 1-430 microL(-1)) with peripheral cytopenias and/or fever attended at a large tertiary care hospital in Brazil during a one-year period. The diagnostic yield of bone marrow biopsy was 34.1% (28 cases) in contrast to only 8.5% (eight cases) attained by the bone marrow smear. Opportunistic pathogens were isolated from bone marrow cultures in 26.8% of patients. CONCLUSIONS: Bone marrow biopsy has value in diagnosis of opportunistic infections, malignancies or other conditions in one-third of adult patients with advanced AIDS and fever or cytopenias and should be considered in this patient group.

AIDS-Related Opportunistic Infections↗

PubMed2006

Non-Hodgkin's lymphoma among patients infected with human immunodeficiency virus: the experience of a single center in Brazil.

The relative risk of non-Hodgkin's lymphoma (NHL) among patients infected with human immunodeficiency virus (HIV) is elevated compared with the general population. We describe a retrospective study of 78 HIV-infected patients with NHL treated between 1999 and 2006 at the Infectology Institute, a reference center for HIV treatment in São Paulo, Brazil. All patients were treated with standard CHOP therapy (cyclophosphamide, doxorubicin, vincristine, and prednisone). An evaluation of treatment response was available for 48 (61.5%) of the patients who completed initial treatment. Twenty-three patients (47.9%) achieved a complete response (CR), 3 (6.3%) achieved a partial response, and 22 (45.8%) failed to respond to treatment. Of the 30 patients (38.5%) who were not available for response evaluation, 23 died of sepsis during treatment, 5 abandoned treatment, and 2 are still under treatment. After a median follow-up of 3 years, the overall survival rate for all patients is 20.5%. A univariate analysis showed a significant CR rate in patients with respect to the following factors: no acquired immunodeficiency syndrome (AIDS) diagnosis prior to the lymphoma, disease stage of I to II, and an International Prognostic Index (IPI) of low or low-intermediate risk. A multivariate analysis indicated that only a previous AIDS diagnosis and the IPI were significantly related to the CR rate. A median disease-free survival (DFS) time for the patients who achieved a CR was not reached, with a mean survival time of 73 months and a 3-year DFS rate of 77.5%. Our results provide additional information regarding HIV-related lymphoma in Brazil.

Adolescent↗

PubMed2004

[Human papillomavirus oncogenicity and grade of anal intraepithelial neoplasia in HIV positive patients].

OBJECTIVE: We decided to evaluate if grade of anal intraepithelial neoplasia (AIN) was associated to the HPV type in HIV positive patients, since this group of patients has immunodeficiency over long periods. We identified HPV types by PCR (polimerase chain reaction) and histological examination to determine the AIN grade in 39 HIV positive males with anal condylomata acuminata. RESULTS: We observed high grade AIN (HAIN) in 9 (23.1 percent) and low grade AIN (LAIN) in 30 patients (76.9 percent). The most frequent HPV types were 6 and 11 (64 percent) and oncogenic types 16, 18 and 31 appeared in 20.5 percent of patients. We could not identify viral type in four patients (10.2 percent) despite tests revealing presence of viral deoxiribonucleic acid. Comparing AIN grades with viral types we observed that non-oncogenic types can also be associated with HAIN lesions. CONCLUSION: These results allowed us to conclude that both oncogenic and non-oncogenic HPV types can be associated with HAIN lesions in HIV positive patients.

Adolescent↗

PubMed2004

Bone marrow pathology in AIDS.

Bone marrow morphology is frequently abnormal in patients with AIDS. In this study, we reviewed 97 bone marrow biopsies of AIDS patients performed between 1998 and 2000 in the Emílio Ribas Institute of Infectology, which is the reference department for HIV. Specific diagnoses were performed in 33 cases. Fungi were observed in eight cases. Five of them were Histoplasma capsulatum, two were Cryptococcus neoformans, and one probably Candida albicans. Acid-fast bacilli were observed in 12 bone marrow biopsies, three of which were diagnosed to have no mycobacteriosis clinically. Foci of necrosis with clusters of macrophages without any well-formed granuloma were observed in nine cases and well-formed granuloma in three cases. Lymphomatous infiltration was observed in four cases of non-Hodgkin's lymphoma and in two Hodgkin's diseases (mixed cellularity). Extensive necrosis of bone marrow was observed in one case of Burkitt's lymphoma. In conclusion, bone marrow biopsy should be performed to elucidate the etiology of cytopenias, secondary infections, and fever of undetermined origin in AIDS patients.

AIDS-Related Opportunistic Infections↗

PubMed2003

Dejerine-Sottas disease: a case report.

CONTEXT: Hereditary peripheral neuropathies (hereditary motor-sensory neuropathies or hereditary demyelinating neuropathies) are abnormalities of Schwann cells and their myelin sheaths, with peripheral nerve dysfunction. They include Charcot-Marie-Tooth disease, Dejerine-Sottas disease, congenital hypomyelinating neuropathy and hereditary neuropathy with liability to pressure palsy. OBJECTIVE: The objective of the present work was to describe a case of Dejerine-Sottas disease. CASE REPORT: A 9-year-old boy presented progressive slight motor deficit in the lower limbs, particularly in the feet, and generalized hyporeflexia. Electromyography disclosed significant reduction in motor and sensory nerve conduction velocities. Sural nerve biopsy showed axons surrounded by a thin myelin sheath and concentrically arranged cytoplasmic processes of Schwann cells forming onion-bulbs. No axon damage was observed.

Biopsy↗

PubMed2003

Herpes simplex type 2 pneumonia.

Extensive reviews of pulmonary infections in AIDS have reported few herpetic infections. Generally these infections are due to Herpes simplex type 1. Pneumonia due to herpes type 2 is extremely rare. We describe a 40 year-old HIV positive woman who complained of fever, cough and dyspnea for seven years. She had signs of heart failure and the appearance of her genital vesicles was highly suggestive of genital herpes. Echocardiography showed marked pulmonary hypertension, right ventricular hypertrophy and tricuspid insufficiency. After a few days of hospitalization she was treated with Aciclovir and later with Ganciclovir. An open pulmonary biopsy revealed an interstitial inflammation, localized in the alveolar walls. Some pulmonary arteries had widened walls and focal hyaline degeneration. Immunohistochemistry indicated that the nuclei had herpes simplex virus type 2 in many endothelial cells (including vessels with widened walls), macrophages in the alveolar septa and pneumocytes. There was clinical improvement after treatment for herpes. We concluded that as a consequence of herpes infection, endothelial involvement and interstitial inflammation supervene, with thickening of vascular walls and partial obliteration of the vessel lumen. A direct consequence of these changes in pulmonary vasculature was pulmonary hypertension followed by heart failure.

AIDS-Related Opportunistic Infections↗

PubMed2003

Postoperative follow-up of anal condylomata acuminata in HIV-positive patients.

PURPOSE: The purpose of this study was to analyze the postoperative follow-up of HIV-positive patients with anal condylomata acuminata, associating recurrence to the AIDS status. METHODS: Ninety-seven male, homosexual patients with anal condylomata were submitted to surgical treatment from August 1992 to December 1997. Specimens were obtained for histologic investigation of Ki-67 cell proliferation marker and for polymerase chain reaction to define the human papillomavirus type. The patients were advised to return weekly during the first month, and monthly up to the sixth month, to evaluate recurrence. Patients with high-grade anal intraepithelial neoplasia remain in follow-up. RESULTS: Histology revealed low-grade anal intraepithelial neoplasia in 81.44 percent of patients and high-grade lesions in 18.56 percent. The results showed that high-grade lesions were not more frequent in late-stage AIDS patients. Ki-67 expression, a cell proliferation marker, was greater in high-grade than in low-grade anal intraepithelial neoplasia, but had no association with AIDS status. Nononcogenic human papillomavirus 6 and 11 were the commonest types. Comparing papillomavirus types and anal intraepithelial grade, we noticed that both oncogenic and nononcogenic types were responsible for high-grade lesions. All patients healed and 51 (52.6 percent) had recurrence up to the sixth month. AIDS status and papillomavirus type were not associated with recurrence. However, high-grade anal intraepithelial neoplasia patients had more recurrence than those with low-grade lesions. Topical treatment failed in 20 patients (41.6 percent), and these were submitted to new surgical treatment. All of them were in the late stage of AIDS. Three who had high-grade lesions in the first operation had low-grade lesions in specimens from the second surgery. The same histologic pattern was observed in 17 patients who had low-grade lesions in warts removed in the first operation. Other patients with high-grade lesions had no recurrence or evolution to invasive carcinoma from five to ten years of follow-up. CONCLUSION: High-grade anal intraepithelial neoplasia and late-stage AIDS are risk factors for recurrence of anal condylomata.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Effects of long-term administration of Senna occidentalis seeds in the large bowel of rats.

Plants of the genus Senna that contain anthranoides derivatives are frequently used as cathartics. Radiological studies have demonstrated that patients with chronic constipation who have used stimulant laxative have colonic redundancy and dilatation more frequently than patients who have not. The objective of the present work was to study morphological and histochemical changes of the lower gut after administration of Senna occidentalis seeds for a long period to rats, as observed in skeletal muscle fibers. Fragments of the lower gut of young and adult rats treated with S. occidentalis seeds (2% for 171 days and 3% for 61 days in the diet) were submitted to histological and histochemical analysis and to densitometry. The most important finding was decreased oxidative enzyme activity in smooth muscle cells and in myenteric neurons of the large bowel. As oxidative metabolism is essential for ATP and energy production, these results suggest that the functional intestinal disturbance caused by the chronic use of Senna occidentalis as a laxative can be due to a metabolic effect involving energy production, which would decrease colonic motility and cause functional colonic dilatation, but without any irreversible anatomic change.

Animals↗