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Distribuição dos valores do antígeno prostático específico em pacientes com hiperplasia prostática benigna e câncer prostático e em indivíduos sadios

2026-05-31T11:55:05Z

Título: Distribuição dos valores do antígeno prostático específico em pacientes com hiperplasia prostática benigna e câncer prostático e em indivíduos sadios Autor(es): Figueiredo, Maria de Fátima Abstract: Benign prostatic hyperplasia (BPH) and prostatic adenocarcinomas (PC) are among the most common pathologies of Brazilian adult men. The preliminary diagnostic criteria most used forthese pathologies include digital rectal examination (DRE), and measurement of serum prostate specific antigen (PSA). The aim of the present studies was to evaluate the distribution of total serum PSA leveis (PSA-st), in patients with confirmed diagnosis for prostate pathologies, and the influence of DRE on the PSA-st leveis in healthy adult men; as also the normal leveis of PSA-st in healthy adult males. Of the 147 patients studied, 85 (58.6%) had HPB, and 62 (41.4%) were diagnosed with PC. In the patients with HPB, the PSA-st values varied from 0.01 to 83.00 ng/mL; with a mean value of 9.43 ± 10.30 ng/mL, and a median value of 7.70 ng/mL. Sixteen of these patients (18.8%) revealed PSA-st leveis below 4.00 ng/mL; while in 22 (25,9%) the values were higher than 10.00 ng/mL; indicating that 44.7% of the patients diagnosed for HPB had PSA-st leveis outside the range considered suggestive of this pathology. The PSA-st leveis of 62 patients with prostatic câncer were generally higher than those for HPB; with the values ranging from 0.01 and 500 ng/mL, and median and mean values, respectively, of 13.40 and 38.90 ± 85.11 ng/mL. Twenty two (32.3%) of the cases of PC had PSA-st values below 10 ng/mL; while four (6.2%) revealed leveis between 129 and 500 ng/mL. The median values of the patients with HPB and PC were highly significantly different (p < 0.001). In both the pathologies, the PSA-st leveis increased with higher age; but the median values among the age groups were not statistically significant, either in individuais with HPB or in PC patients (p >0.05). DRE carried out in 48 healthy males, induced only modest, and non-significant, elevations in PSA-st leveis in a minority. A normal adult male population of 469 individuais revealed mean and median PSA-st values of 2.40 ± 4.30 ng/mL and 1.20 ng/mL; respectively; with the values increasing in higher age groups. The median values among the age groups were significantly different (p < 0.001). Our observations on the PSA-st values of patients with confirmed diagnosis suggest that the PSA-st values show a quantitative relation, in general, with each of the pathologies; without revealing distributions of values that enable a definite characterization of either HPB or PC. Tipo: Dissertação

Evolução e desfecho da leucemia mieloide crônica em mulheres grávidas: uma análise retrospectiva em um serviço de referência em hematologia

2026-05-26T18:08:52Z

Título: Evolução e desfecho da leucemia mieloide crônica em mulheres grávidas: uma análise retrospectiva em um serviço de referência em hematologia Autor(es): Pereira, Bárbara Rebeca Alves Abstract: Chronic Myeloid Leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of the Philadelphia chromosome and the formation of the BCR-ABL1 fusion gene, which is responsible for constitutive tyrosine kinase activity and uncontrolled cellular proliferation. The introduction of tyrosine kinase inhibitors (TKIs) has transformed the prognosis of the disease, enabling deep and sustained hematologic, cytogenetic, and molecular responses.However, pregnancy during treatment requires temporary discontinuation of therapy, which may compromise the maintenance of response and disease control. The aim of this study was to evaluate the clinical course and outcomes of CML in women who became pregnant while receiving TKIs, followed at a hematology referral center in the state of Ceará, Brazil.This is an observational, descriptive, and retrospective study that included patients over 18 years of age with a clinical, cytogenetic, and/or molecular diagnosis of CML, receiving TKIs, who had a confirmed pregnancy between January 2002 and December 2024. Sociodemographic variables, prognostic scores, hematologic, cytogenetic, and molecular response profiles, therapeutic management during pregnancy, time to TKI reintroduction, and disease evolution after delivery were analyzed. Statistical analyses were performed using R software, with p < 0.05 considered significant.A total of 26 pregnancies were identified in 19 women with CML, among approximately 243 patients followed at the center. The mean age at diagnosis was 27 years, with a predominance of low-risk patients according to the prognostic scores evaluated. At the time of conception, 38% of pregnancies occurred in patients with major or deep molecular response, while 62% had not yet achieved an adequate molecular response.During pregnancy, there was a significant increase in the frequency of molecular response loss compared to the pre-pregnancy period (p < 0.05). TKI discontinuation was statistically associated with this loss (p < 0.05), particularly among patients who did not have a deep molecular response prior to conception.After TKI reintroduction in the postpartum period, a significant recovery of molecular response was observed (p < 0.05). Most patients regained at least a major molecular response, and some achieved deep molecular response again. A statistically significant association was observed between pre-pregnancy deep molecular response and a higher likelihood of response recovery after delivery, with a greater proportion of recovery in the previously responsive group (p < 0.05).There were two cases of disease progression and two deaths after pregnancy. Overall survival and event-free survival, estimated by Kaplan–Meier analysis, remained high throughout follow-up. Cases of therapeutic failure or need for permanent TKI switch were infrequent.Pregnancy outcomes were favorable, with a predominance of term births and no significant increase in severe complications. These findings indicate that, under appropriate monitoring, temporary discontinuation of therapy may lead to reversible molecular instability, reinforcing the importance of achieving a deep molecular response prior to conception for better hematologic outcomes. Tipo: Dissertação

Leishmania braziliensis resistente ao antimoniato de meglumina imunomodula a resposta de macrófagos murinos M1 e M2 in vitro

2026-04-29T14:25:14Z

Título: Leishmania braziliensis resistente ao antimoniato de meglumina imunomodula a resposta de macrófagos murinos M1 e M2 in vitro Autor(es): Eugenio, Ana Lívia Rodrigues Abstract: Leishmania braziliensis is the main etiological agent of cutaneous leishmaniasis (CL), a disease with a high incidence in Brazil, representing a significant public health challenge. Meglumine antimoniate is the standard drug for treating the disease; however, the emergence of resistant strains has hampered its effectiveness. Macrophages act as host cells for Leishmania and play a fundamental role in the immune response against these parasites. The activation of macrophages to the M1 inflammatory profile is crucial for parasite elimination, but there is still little knowledge about how resistant strains of L. braziliensis modulate the plasticity of these cells. Therefore, the objective was to eva-luate the immunomodulation of murine macrophages in in vitro infection by L. brazi-liensis strains resistant (LbR) and susceptible (LbS) to meglumine antimoniate. To this end, murine J774 macrophages were polarized to M1 (with 1μg/ml of LPS) or M2 (with 1μg/ml of IL-4) and then infected with LbR or LbS strains. After 24 and 48h, the fol-lowing were analyzed: parasite load, cytokine production (TNF-α, IL-12, IL-6, IL-4 and IL-10), nitric oxide (NO), urea and arginase activity. The results demonstrated that M1 macrophages infected with LbR presented a significantly higher parasite load compared to those infected with LbS, in both periods evaluated. Regarding inflammatory media-tors, infection with LbR resulted in lower levels of TNF-α, IL-12, and NO in the group of M1 macrophages infected with the LbR strain, compared to M1 macrophages in-fected with the LbS strain. Conversely, in M2 macrophages, infection with LbR induced a significant production of IL-10, IL-4, and IL-6, while LbS did not provoke a relevant response in the production of these cytokines. Arginase and urea modulate the immune response by influencing macrophage polarization and the efficiency of the immune re-sponse to the parasite. These data suggest that the LbR strain has the ability to decrease the production of inflammatory cytokines and NO in M1 macrophages, as well as in-duce the production of regulatory cytokines in M2. This results in a less inflammatory intracellular environment, favoring the survival of the parasite and, consequently, its persistence, which hinders the treatment and cure of the disease. These findings high-light the need for further studies that can deepen the understanding of the resistance mechanisms of these protozoa to traditional therapies, which may contribute to the de-velopment of new, more effective therapeutic strategies. Tipo: Dissertação

Estudo analítico da associação da doença de Hodkin com o vírus de Epstein-Barr em uma região tropical: Comparação com dados oriundos de pesquisas em regiões com distintos níveis de desenvolvimento social e econômico

2026-03-24T12:16:44Z

Título: Estudo analítico da associação da doença de Hodkin com o vírus de Epstein-Barr em uma região tropical: Comparação com dados oriundos de pesquisas em regiões com distintos níveis de desenvolvimento social e econômico Autor(es): Leite, Lindomagno Pessoa Abstract: Many studies have shown that Hodgkin’s disease (HD) is associated with Epstein-Barr virus (EBV) in a substantial number of cases, and that in these cases EBV DNA is localized exclusively in Reed-Stemberg (RS) cells. In the present study, we carried out an analytic analysis in a sample with 50 HD cases from Ceara, Northeast Brazil. The sample was divided in two main groups: group aged less than 18 years old (infant-juvenile) and group aged more than 18 years old (adult). Chi-square (X2) test was performed to analyses the possible relation of EBV in each age group with the histopathologic subtypes of HD. The possible correlation between economic development and positiveness for EBV was also evaluated. For this purpose, data from 15 different geographic and economic areas were analysed using the Spearman coefficient. The development was evaluated according to the Human Development Rate. The results suggest a strong association between EBV and HD in Ceara State. It is more evident in the infant-juvenile group and in the subtype mixed cellularity. Besides, it shows an inverse relationship between regional development and positiviness into HD sample. Tipo: Dissertação