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Biomedical subjects

M I Duarte

Publications and source records attributed to M I Duarte.

At least 37 records · Page 2Linked to original sources
PubMed1985

Ultrastructure of the lung in falciparum malaria.

We describe a case of fatal falciparum malaria, with severe pulmonary insufficiency in the absence of fluid overload or cardiac failure. At autopsy the most striking change was a marked pulmonary interstitial edema. The endothelial cell was the most altered structure, showing marked cytoplasmic swelling which narrowed the capillary lumen. Monocytes were also found occupying the capillary lumen. The edematous interstitium also showed macrophages with endocytes and malarial pigment. There was no disseminated intravascular coagulation or other terminal complications. The patient's respiratory insufficiency seems not to have derived from the complications usually associated with the fatal malaria but from malaria-induced alveolar septal changes.

Endothelium↗
PubMed1984

Histopathological and ultrastructural aspects of interstitial pneumonitis of experimental visceral leishmaniasis.

Golden hamsters inoculated with Leishmania donovani developed interstitial pneumonitis. Three developmental phases were characterized: exudative, cellular and fibrotic. From the sequence of events, a relationship between the types of cellular proliferation and the appearance of fibrosis could be established. The participation of septal interstitial cells with lipid inclusions (ICLI) in the process and their possible role in the development of fibrosis was demonstrated.

Animals↗
PubMed1983

Interstitial nephritis in human kala-azar.

Little is known about renal alterations in kala-azar. The renal histopathology of 21 patients admitted to hospital in São Paulo, Brazil, during the period 1960 through 1981 who either died or had a renal biopsy (two cases) is presented. All the specimens showed oedema and diffuse interstitial inflammatory infiltrate of lymphocytes and plasma cells with more compact foci of cells in some areas. In general, glomeruli did not show any important alterations. These aspects were interpreted as acute interstitial nephritis aetiologically related to later phase kala-azar. This interstitial alteration does not usually seem to determine any clinical manifestations. However, it seems that moderate and severe cortical intersitial damage contribute to the onset of renal insufficiency when severe clinical complications occur. The precise mechanisms of this lesion need further investigation since the aetiological agents have not been seen causing the damage locally.

Adolescent↗
PubMed1978

Relationship between glomerular mesangial cell proliferation and amyloid deposition as seen by ultrastructural and morphometric analysis in experimental kala-azar of the hamster.

Light and electron microscopic studies combined with a morphometric analysis of the hamster glomerulus in experimental kala-azar showed progressive hyperplasia of mesangial cells beginning on the 10th day and reaching a peak on the 20th day after infection. Afterward, the number of mesangial cells declined and a progressive rise of amyloid deposits over the mesangial matrix was observed. This system for amyloid production is unique if we consider that probably one cell, the mesangial cell, is involved in glomerular amyloid deposition. Our data support a slight modification in the sequence of events of the biphasic theory of amyloid formation. We observed that the number of mesangial cells declines when amyloid deposition increases and that mesangial cell morphology in this stage is not that of an actively secreting cell. It is therefore hypothesized that amyloid precursor material is secreted into the matrix during the proliferative phase. In the second phase, amyloid deposits occur in the extracellular media close to functionally impaired mesangial cells.

Amyloid↗
PubMedDate not supplied

Interstitial pneumonitis in human visceral leishmaniasis.

The involvement of the lung in 13 cases of human visceral leishmaniasis was studied. Interstitial pneumonitis with mononuclear cells was found in 76.8% of the cases; 53.8% also had foci of septal fibrosis. Leishmania were seen within macrophages in 3 cases only. However, all 10 interstitial pneumonitis cases showed PAP-positive material using specific L. donovani (MHOM/BR/72/LD 46) antiserum. 3 cases with no interstitial pneumonitis were PAP-negative. A short discussion about clinical aspects and the course of the disease is presented.

Autopsy↗
PubMedDate not supplied

Paracoccidioidomycosis in a renal transplant recipient.

Paracoccidioidomycosis is a fungal infection rarely described in immunodeficient patients. We report a severe case of pulmonary paracoccidioidomycosis in a renal transplant recipient and demonstrate deficiencies of in vitro lymphocytic transformation assays, skin hypersensitivity tests, as well as low levels of antibodies to Paracoccidioides brasiliensis.

Adult↗
PubMedDate not supplied

Aerosolised pentamidine for Pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome.

The goal of this study was to evaluate inhaled pentamidine for the treatment of patients with mild and moderate Pneumocystis carinii pneumonitis. Eight adults with AIDS and pneumocystis pneumonia (4 with a first episode and 4 with a repeat pneumocystosis) received daily inhalations of aerosol pentamidine isethionate for 21 days. Six patients were treated with doses of 300 mg of pentamidine and the remaining 2 received 600 mg every day. In the 300 mg treatment group, 2 individuals showed discrete and transient neutropenia. However, both subjects that received 600 mg of aerosol pentamidine daily developed leukopenia. One of them had major toxicity (overall severe intolerance of 12.5%) that required drug discontinuation and did not allow any analysis of the treatment efficacy. Of the 7 evaluable patients, 6 (88%) completed the treatment successfully. One subject of the 300 mg regimen experienced an early recurrence. In conclusion, inhaled pentamidine is an effective treatment for mild and moderate cases of P. carinii pneumonia. It is less toxic than standard anti-pneumocystis therapy and is suitable for outpatient use.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Respiratory complications in Brazilian patients infected with human immunodeficiency virus.

PURPOSE: To determine how often and by what means an indentifiable pulmonary pathogen can be recognized in human immunodeficiency virus (HIV) infected patients with respiratory disorders in Brazil, which are the most frequently observed microorganisms and what impact specific therapy has on these agents. PATIENTS AND METHODS: Thirty-five HIV seropositive subjects with respiratory complaints were studied. All patients had a complete history, physical examination and blood counts. The pulmonary assessment included chest radiograms; sputum examination for bacterial and fungal pathogens; bronchoscopy with bronchoalveolar lavage and transbronchial biopsy. Patients with treatable complications received standard antimicrobial therapy. RESULTS: One or more microorganisms were found in 24 subjects and another 3 individuals showed nonspecific interstitial pneumonitis. The sputum examination identified the pulmonary pathogens in 7 cases. The bronchoalveolar lavage and the histopathologic examination were diagnostic in 14% and 83%, respectively, of the 28 individuals that were submitted to bronchoscopy. The most frequently identified microorganism was P. carinii (55%), followed by M. tuberculosis (41%) and cytomegalovirus (8%). The clinical, laboratory and radiographic findings failed to distinguish the specific pulmonary pathogens. Twenty-three individuals with P. carinii pneumonitis and/or tuberculosis received specific therapy; among the evaluable patients the therapeutic response rates were 79% for PCP and 100% for TB. CONCLUSIONS: We have determined that tuberculosis, P. carinii and cytomegalovirus pneumonitis are the most common respiratory opportunistic diseases in Brazilian patients infected with HIV. The histologic evaluation was crucial in order to identify the pulmonary pathogens. Tuberculosis in AIDS individuals displayed clinical and radiographic findings atypical for reactivation disease. However, most of the features observed in HIV infected patients had been previously described in infection of the normal host. Furthermore, the AIDS subjects showed a good therapeutic response to anti-tuberculous drugs.

Adult↗