The relationship between overall plasma antioxidant activity and senile cataract was examined in 148 subjects aged 37-90 years. Antioxidant activity of plasma from 52 control and 96 patients with senile cataract was determined by a method which measures the capacity of plasma to inhibit auto-oxidation of bovine brain homogenate. In contrast to previous studies which demonstrated a relationship between decreased levels of antioxidant components in blood and the occurrence of lens opacities, the present study does not show any significant difference between subjects with and without senile cataract.
Primary renal lymphomas are very rare. However, the kidney may be a site of metastasis, usually from a disseminated aggressive lymphoma. A 58-year-old woman was brought to the medical facility due to acute mental confusion, severe hypotension, septic shock, and signs of disseminated intravascular coagulation. Laboratory tests showed severe leukopenia, renal failure, altered liver function, and elevated serum lactate dehydrogenase levels. Protein electrophoresis revealed hypergammaglobulinemia with a monoclonal peak of IgG lambda. The clinical outcome was fulminant and the patient died less than 24 hours after admission. Autopsy revealed an indolent B-cell lymphoma with extensive plasmacytic differentiation infiltrating the right renal sinus and involving the submandibular and sublingual glands, cervical and peri-aortic lymph nodes, multiple microscopic foci in pituitary and adrenal glands, lung, breast, liver, thyroid, and bone marrow. Numerous IgG4-positive plasma cells were detected by immunohistochemistry although other histological features of IgG4-related disease were missing. There was also extensive hemorrhagic necrosis of the adrenal glands and purulent cystitis, which was probably responsible for the septic shock. The authors concluded that the kidney was most likely the primary site of the indolent lymphoma, as that was the site with the largest tumor mass. Infiltration of other organs was considered as dissemination of the disease. The differential diagnosis with mucosa-associated lymphoid tissue and lymphoplasmacytic lymphoma is discussed.
Brandão de Assis, por aceitarem me orientar e repensaram comigo o controle de infecção nas Instituições de Longa Permanência para Idosos. Aos membros da banca de qualificação, que contribuíram com excelentes sugestões e críticas à dissertação. Às minhas calouras (agora colegas) Solange, Fernanda, Giovanna, Tauany e Victoria que me auxiliaram nas entrevistas desse trabalho. Aos médicos e enfermeiros que dispuseram de seu tempo para contribuir com este Inquérito. Às amigas Adriana, Aline, Ana Beatriz, Claudia, Talita e Sigrid, pelas dicas e conselhos durante essa trajetória. Aos meus pais Cleofa e Edison e à minha irmã Cássia, pelo apoio incondicional em cada etapa de minha formação e por me fazerem compreender o valor dessas conquistas. Ao Roberto e ao Beco, pelo amor, apoio e paciência, mas principalmente por me lembrarem sempre que devo acreditar em mim. Ao meu tio João, por mais uma vez me inspirar e me incentivar a estudar esse tema apaixonante. Ao Dr. Ricardo, que me atraiu para o incrível mundo da infectologia e que será sempre meu grande exemplo. E aos Pietros, Yolandas, Sandovals, Romeus, Paulos e tantos outros pacientes que me fazem lembrar todos os dias que fiz a escolha certa.
Epígrafe"Por vezes sentimos que aquilo que fazemos não é senão uma gota de água no mar. Mas o mar seria menor se lhe faltasse uma gota".
Madre Teresa de CalcutaEsta tese está de acordo com as seguintes normas, em vigor no momento desta publicação: Referências: adaptado de International Committee of Medical Journals Editors (Vancouver).
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