Navegando por Palavras-chave "Schistosomiasis mansoni"
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- ItemAcesso aberto (Open Access)Avaliação hepática e esplênica por ressonância magnética em pacientes portadores de esquistossomose mansônica crônica(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2004-10-01) Bezerra, Alexandre Sérgio de Araújo; D'Ippolito, Giuseppe [UNIFESP]; Caldana, Rogério Pedreschi [UNIFESP]; Cecin, Alexandre Oliveira [UNIFESP]; Szejnfeld, Jacob [UNIFESP]; Universidade Católica de Brasília; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To qualitatively and quantitatively evaluate the morphological changes of the liver and spleen using magnetic resonance imaging (MRI) in patients with chronic infection by Schistosoma mansoni and the reproducibility of MRI findings in the hepatosplenic evaluation of these patients. MATERIALS AND METHODS: We prospectively studied 28 schistosomotic patients submitted to MRI of the upper abdomen. The scans were performed using a high field equipment (1.5 T), a body coil and a power injector for administration of intravenous contrast. The scans were interpreted by two independent examiners who evaluated the presence of morphological changes in the liver and spleen. Interobserver and intraobserver agreement were measured using the kappa and intraclass correlation tests. RESULTS: Qualitative variables presented good interobserver and intraobserver agreement (kappa > 0.65 and r > 0.66, respectively). The best interobserver agreement was for the anteroposterior diameter of the spleen (r = 0.98). The observers identified reduction of the right hepatic lobe, enlargement of the left hepatic lobe and caudate lobes associated with splenomegaly in almost all patients, and also identified fissure widening, heterogeneity of hepatic parenchyma, irregularity of hepatic contours, presence of peripheral hepatic vessels and periportal fibrosis in almost all patients. CONCLUSION: Hepatic morphological changes are characterized by reduction of the right lobe and enlargement of the caudate and left lobes, and morphological changes in the spleen are characterized by the presence of splenomegaly and siderotic nodules. MRI presents high reproducibility for the evaluation of these changes in patients with chronic infection by Schistosoma mansoni.
- ItemAcesso aberto (Open Access)Avaliação ultra-sonográfica de nódulos sideróticos esplênicos em pacientes esquistossomóticos com hipertensão portal(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2008-04-01) Gonzalez, Thais Dias [UNIFESP]; Santos, José Eduardo Mourão [UNIFESP]; Sales, Danilo Moulin [UNIFESP]; Takemoto, Kenji [UNIFESP]; Capobianco, Júlia [UNIFESP]; Brant, Paulo Eugênio [UNIFESP]; Colleoni Neto, Ramiro [UNIFESP]; Ahmed, Munneb; D'Ippolito, Giuseppe [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Harvard Medical School Beth Israel Deaconess Medical Center Department of RadiologyOBJECTIVE: To evaluate ultrasound sensitivity and reproducibility as compared with magnetic resonance imaging as the gold standard in the detection of splenic siderotic nodules in schistosomal patients. MATERIALS AND METHODS: Initially, 21 patients with hepatosplenic schistosomiasis and diagnosed with splenic siderotic nodules by magnetic resonance imaging were ultrasonographically evaluated for determining the method sensitivity. In a second phase, the method reproducibility in the detection and quantification of siderotic nodules (A: 1-5 nodules; B: 6-20 nodules; C: > 20 nodules) was evaluated in 30 patients who were submitted to ultrasonography blindly and independently assessed by two observers. Interobserver agreement was measured by kappa statistics. RESULTS: Ultrasound sensitivity was 95.2% (95% confidence interval [77.3%; 99.2%]). Intermethod agreement in the detection of siderotic nodules was 96.7% (95% confidence interval [82.8%; 99.9%]). For classification of nodules according to their quantification, the kappa test demonstrated a statistically significant interobserver agreement (kappa = 0.67). CONCLUSION: Ultrasonography is highly sensitive and accurate in the assessment of splenic siderotic nodules in schistosomal patients.
- ItemAcesso aberto (Open Access)Correlação interobservador das alterações morfológicas das vias biliares em pacientes com esquistossomose mansoni pela colangiorressonância magnética(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2009-10-01) Sales, Danilo Moulin [UNIFESP]; Santos, José Eduardo Mourão dos [UNIFESP]; Shigueoka, David Carlos [UNIFESP]; Leão, Alberto Ribeiro de Souza [UNIFESP]; Colleoni Neto, Ramiro [UNIFESP]; Borges, Durval Rosa [UNIFESP]; D'Ippolito, Giuseppe [UNIFESP]; Szejnfeld, Jacob [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To describe changes of the biliary tree demonstrated by magnetic resonance cholangiography (MRC) in patients with the hepatosplenic presentation of schistosomiasis mansoni, and evaluating the interobserver agreement in the detection of schistosomal cholangiopathy. MATERIALS AND METHODS: Prospective, cross-sectional study involving 24 patients with hepatosplenic schistosomiasis and 6 healthy patients (control group) submitted to biliary tree evaluation by MRC. The following changes of the biliary tree were considered: distortion, thinning, stenosis, dilation and irregularity. The interobserver agreement in the detection of biliary tree changes was calculated with the McNemar's test and the kappa index of agreement (κ). RESULTS: The interobserver agreement in the detection of distortion and thinning of the biliary tree was almost perfect (κ = 0.867; confidence interval [CI] 95% [0.512-1.0] and κ = 0.865; CI 95% [0.51-1.0], respectively). There was a substantial agreement for stenosis (κ = 0.78; CI 95% [0.424-1.0]), moderate agreement for dilation (κ = 0.595; CI 95% [0.247-0.942]) and mild agreement for thinning (κ = 0.229; CI 95% [0.095-0.552]). CONCLUSION: In a decreasing order of frequency, the changes of the biliary tree were observed: distortion, thinning, stenosis, dilation and irregularity. The interobserver agreement for signs of schistosomal cholangiopathy was almost perfect for distortion and thinning, and substantial for stenosis.
- ItemAcesso aberto (Open Access)Elevação da gama-glutamiltransferase sérica na hepatopatia esquistossomótica não se correlaciona com a carga parasitária e precede alterações ultra-sonográficas(Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2002-03-01) Feldner, Ana Cristina de Castro Amaral [UNIFESP]; Aguiar, Luciane Aparecida Köpke de [UNIFESP]; Souza, Mônica Rodrigues de Araújo [UNIFESP]; Toledo, Carlos Fischer de [UNIFESP]; Borges, Durval Rosa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background - Liver disorders are the major manifestations of schistosomiasis mansoni. Factors that account for increased concentrations of cholestasis-indicating enzymes in the hepatosplenic form of the disease are unknown. Objective - To assess the correlation between increased gamma-glutamyltransferase serum levels and both the parasitic load and ultrasound alterations in patients with schistosomiasis. Patients and methods - Twenty-five patients with the chronic form of schistosomiasis were assessed for the presence or absence of increased enzymatic levels, for the parasitic load (low x medium/high) and for ultrasound parameters. Furthermore, analysis of prothrombin time and a platelet count were performed. Results - Of the 25 patients, 13 showed increased gamma-glutamyltransferase plasma levels. No significant correlation was found between increased gamma-glutamyltransferase levels and the parasitic load, or between increased enzyme levels and ultrasound alterations. Nor did the prothrombin index or the platelet count differ between the two groups (normal gamma-glutamyltransferase levels and increased gamma-glutamyltransferase levels). Conclusion - The parasitic load explains no rise in gamma-glutamyltransferase plasma levels in patients with the chronic form of schistosomiasis, and conventional ultrasound is not a sensitive method to detect the alteration suggested by the increased enzyme level in those patients.
- ItemSomente MetadadadosEndothelial Markers in Schistosomiasis Patients With or Without Portal Hypertension(Springer, 2009-06-01) Toledo, Carlos Fischer de [UNIFESP]; Carvente, Claudia Teresa [UNIFESP]; Shigueoka, David Carlos [UNIFESP]; Borges, Durval Rosa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose To evaluate the serum levels of von Willebrand factor (vWF), vascular endothelial growth factor (VEGF), endothelin-1 (ET-1), and endothelin-3 (ET-3) in patients with the isolated, inactive form of Schistosomiasis mansoni. Patients were classified into two groups: 10 patients without (SM group) and 18 with (PH group) portal hypertension. Results Serum albumin, VEGF, and vWF levels did not differ between the two groups (P > 0.05). the prothrombin time (INR), number of platelets, spleen size, splenic vein diameter, and endothelin levels differentiated the PH group, which showed decreased ET-1 (SM = 22.4 +/- A 2.4 pg/ml and PH = 16.4 +/- A 1.5 pg/ml; P = 0.034) and increased ET-3 (SM = 2.1 +/- A 0.1 ng/ml and PH = 3.2 +/- A 0.1 ng/ml; P = 0.000) levels. Conclusions in patients with schistosomiasis and portal hypertension (presinusoidal type), the levels of VEGF and ET-1 differ from those reported in patients with cirrhosis.
- ItemSomente MetadadadosGlomerular detection of schistosomal antigen by immunoelectron microscopy in human mansonian schistosomiasis(Westminster Publ Inc, 1999-10-01) Brito, Thales de [UNIFESP]; Nussenzveig, Israel; Carneiro, Celia Regina Whitaker [UNIFESP]; Nakhle, Maria Cristina; Carvalho, S.; Silva, Ana Maria G; Sandoval, Marina; Saldanha, L. B.; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)Schistosomal antigens (S. mansoni) were detected in glomeruli of nine patients with nephropathy and nephrotic syndrome by immunoelectron microscopy. the criteria for patients' selection were presence of intestinal schistosomiasis and absence of any surgical or other medical diseases, particularly lupus erythematosus, syphilis, and hepatitis B and C, which could explain the renal disease. When examined by light microscopy, kidney biopsies showed type I membranoproliferative glomerulonephritis in four patients, focal segmental glomerulosclerosis in two, and mesangioproliferative glomerulonephritis, membranous glomerulonephritis, and minimal change disease in one each of the remaining three patients. Immunofluorescence showed mainly immunoglobulin G (IgG), IgM, and different complement components (C3, C1q) deposits, particularly in the mesangial area, in eight patients. All patients had gold-labeled schistosomal antigen deposits in their glomeruli, chiefly in mesangial cells and matrix, along the glomerular membrane, and occasionally in the cytoplasm of epithelial cells. Although membranous glomerulonephritis has been rarely described in association with schistosomiasis and minimal change disease may be occasionally caused by an infectious disease like syphilis, the absence of definite experimental models and epidemiologic data suggests that coincidental pathologies without causal relationship with schistosomiasis cannot be ruled our to explain these findings.
- ItemSomente MetadadadosLigadura elástica ou escleroterapia para tratamento das varizes de esôfago: resultados de um estudo prospectivo, randomizado, duplo cego em pacientes portadores da forma hepatoesplênica da Esquistossomose Mansoni(Universidade Federal de São Paulo (UNIFESP), 1996) Siqueira, Eduardo Sampaio [UNIFESP]; Ferrari, Angelo Paulo [UNIFESP]
- ItemAcesso aberto (Open Access)Varizes gástricas: retrospectiva na esquistossomose mansônica hepato-esplênica(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2003-06-01) Goldenberg, Saul [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Instituto Dante Pazzanese de Cardiologia Laboratório de Cirurgia Experimental; Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia; ACTA CIRÚRGICA BRASILEIRAA retrospective data about gastric varices in patients with schistosomiasis mansoni was done. The purpose was to present effective contributions published by the author about the subject between 1963 and 1973. The primacy was assured by a preliminary note published in 1972 in the journal Revista da Associação Médica Brasileira, indexed in MEDLINE. Other pionner works were published showing several aspects of gastric varices in schistosomiasis mansoni: radiological, splenoportographic, gastroscopic and photos of gastric varices obtained by opening the stomach during surgical treatment of bleeding varices. In spite that the articles were published 30 years ago, there is no excuse to unknown and not to quote the pioneer publications, as was seen in recent article published in a brazilian journal.