PURPOSE:To investigate whether there are differences between the phagocytic function of the remaining lower spleen pole after subtotal splenectomy and autogenous splenic implants. METHODS:Thirty-six male Wistar rats, weighting 364 ± 60g were used. They were subjected to subtotal splenectomy preserving the lower spleen pole and to autogenous splenic implant in the greater omentum. Its viability was assessed microscopically. Phagocytic function was assessed by splenic uptake of the radioisotope-labeled colloid and by macrophages counting. RESULTS:The viability of the autogenous splenic implant and of the lower spleen pole was found in 33 animals, with no difference between them. The weight of the implants was higher than the lower pole of animals from groups G1, G7, G30, G60 and G120. The implants phagocytic function by radioisotope uptake was higher than the lower pole in G7 and G120 groups and it did not differ from the other groups. The number of macrophages was higher in G1, G60, G90 and G120 and did not differ from the other groups. CONCLUSION:Until the 16th week, the phagocytic function was more pronounced in autogenous splenic implants when compared with the lower spleen pole, but it became similar thereafter.

Although lung injuries were significantly more frequent in children who had received total parenteral nutrition, it was impossible to conclude that the lipid infusion had a direct relationship with these injuries, because prematurity and duration of hospital stay were significant co-factors.

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Suggested citation: Ramos-Silva V, Castello JS, da Motta LL, Pereira FE, Oliveira NS, Lamounier JA. Pulmonary lesions and total parenteral nutrition in children admitted to a pediatric intensive care unit. J Pediatr (Rio J). 2005;81:155-61. AbstractObjective: To describe lung injuries in autopsied pediatric patients (neonates through 15 years old) subjected or not to total parenteral nutrition, in an intensive care unit. Methods:Sections from six paraffin-embedded lung fragments, from 114 children were studied by routine staining. Demographic, clinical and therapeutic data were retrieved from the records. Statistical analysis was performed using Statistical Package for the Social Sciences.Results: The 114 patients were divided in two groups: 50 who were treated with total parenteral nutrition with lipid emulsion and 64 who did not receive total parenteral nutrition. The two groups did not differ in gender (p = 0.654), age (p = 0.682) or body weight (p = 0.175), but duration of hospital stay (p = 0.000), prematurity (p = 0.008) and treatment with blood products (p=0.009) were all higher in the group treated with total parenteral nutrition. All patients received mechanical ventilation during hospitalization. Chi-square comparisons showed that diffuse alveolar injury (p=0.022), pulmonary fibrosis (p = 0.019), pneumocyte hyperplasia (p = 0.004), microthromboembolism (p = 0.047) and thrombophlebitis (0.033) all exhibited a significant relationship with total parenteral nutrition. However, a multivariate analysis by logistic regression, taking into account prematurity and duration of hospital stay, demonstrated that total parenteral nutrition was an independent factor only with respect of pulmonary fibrosis. Conclusion:Although lung injuries were significantly more frequent in children who had received total parenteral nutrition, it was impossible to conclude that the lipid infusion had a direct relationship with these injuries, because prematurity and duration of hospital stay were significant co-factors.

This is a case report about the only confirmed death in the State of Espírito Santo due to acute Chagas-related myocarditis in a 2-year-old child living in the rural area of Guarapari. He presented with fever, abdominal pain, headache, and vomiting, resulting in death 21 days after the presentation of symptoms. Amastigote forms were observed in the myocardial fibers in histological examination. The boy's mother had reported finding "kissing bugs" in the child's hand. This case highlights the need to include Chagas disease in the differential diagnosis in health care to provide early treatment and avoid death in affected individuals.

Background: Reports on pulmonary lipid deposition after parenteral nutrition (PN) in children were based on small samples. Here we report the prevalence of pulmonary lipid deposition in 114 consecutive autopsied children from a pediatric intensive care unit, including neonates, lactants, preschool, school children and adolescents that used or not PN before death. The objective of this study is to evaluate whether there is an association between the intrapulmonary deposition of fat and the use of lipid infusion in total parenteral nutrition in children.

PURPOSE:To determine whether tension in the spermatic cord of rats causes lesions in the testis, epididymis or vas deferens. METHODS:Forty Wistar rats were randomly allocated into four groups. A traction force of 1.6 Newton (N) in group I and 1 N in group II was applied to the right spermatic cord. Group III was the sham, and group IV served as the control. RESULTS:Testicular lesions occurred on the right side in 66.7% of the rats and on the left side in 46.1% of the rats. The testes showed a decreased number of Sertoli cells, necrosis and a decreased number of germ cells in the seminiferous tubules. Anatomopathological changes in the vas deferens were not identified. There was no decrease in the thickness of the muscle wall of the vas deferens. In the right epididymis, 71.8% of the animals showed a reduction and 5% showed an absence of intraluminal sperm. In the left epididymis, 37.5% of the rats showed a reduction. The volume and the final testicular weight of the right side in group IV was different from those in the other groups. CONCLUSIONS:Anatomopathological lesions were found in the testis and epididymis.