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  1. Article ; Online: The need for integrated research autopsies in the era of precision oral medicine.

    Fernandes Matuck, Bruno / Ferraz da Silva, Luiz Fernando / Warner, Blake M / Byrd, Kevin Matthew

    Journal of the American Dental Association (1939)

    2023  Volume 154, Issue 3, Page(s) 194–205

    Abstract: Background: Autopsy has benefited the practice of medicine for centuries; however, its use to advance the practice of oral health care is relatively limited. In the era of precision oral medicine, the research autopsy is poised to play an important role ...

    Abstract Background: Autopsy has benefited the practice of medicine for centuries; however, its use to advance the practice of oral health care is relatively limited. In the era of precision oral medicine, the research autopsy is poised to play an important role in understanding oral-systemic health, including infectious disease, autoimmunity, craniofacial genetics, and cancer.
    Types of studies reviewed: The authors reviewed relevant articles that used medical and dental research autopsies to summarize the advantages of minimally invasive autopsies of dental, oral, and craniofacial tissues and to outline practices for supporting research autopsies of the oral and craniofacial complex.
    Results: The authors provide a historical summary of research autopsy in dentistry and provide a perspective on the value of autopsies for high-resolution multiomic studies to benefit precision oral medicine. As the promise of high-resolution multiomics is being realized, there is a need to integrate the oral and craniofacial complex into the practice of autopsy in medicine. Furthermore, the collaboration of autopsy centers with researchers will accelerate the understanding of dental, oral, and craniofacial tissues as part of the whole body.
    Conclusions: Autopsies must integrate oral and craniofacial tissues as part of biobanking procedures. As new technologies allow for high-resolution, multimodal phenotyping of human samples, using optimized sampling procedures will allow for unprecedented understanding of common and rare dental, oral, and craniofacial diseases in the future.
    Practical implications: The COVID-19 pandemic highlighted the oral cavity as a site for viral infection and transmission potential; this was only discovered via clinical autopsies. The realization of the integrated autopsy's value in full body health initiatives will benefit patients across the globe.
    MeSH term(s) Humans ; Autopsy ; Biological Specimen Banks ; Pandemics ; COVID-19 ; Oral Health
    Language English
    Publishing date 2023-01-27
    Publishing country England
    Document type Journal Article ; Review ; Research Support, N.I.H., Intramural
    ZDB-ID 220622-5
    ISSN 1943-4723 ; 0002-8177 ; 1048-6364
    ISSN (online) 1943-4723
    ISSN 0002-8177 ; 1048-6364
    DOI 10.1016/j.adaj.2022.11.017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Postmortem chest computed tomography in COVID-19: A minimally invasive autopsy method.

    Savoia, Paulo / Valente Yamada Sawamura, Marcio / de Almeida Monteiro, Renata Aparecida / Nunes Duarte-Neto, Amaro / Morais Martin, Maria da Graça / Dolhnikoff, Marisa / Mauad, Thais / Nascimento Saldiva, Paulo Hilário / da Costa Leite, Claudia / Ferraz da Silva, Luiz Fernando / Cardoso, Ellison Fernando

    European journal of radiology open

    2024  Volume 12, Page(s) 100546

    Abstract: Objectives: Performing autopsies in a pandemic scenario is challenging, as the need to understand pathophysiology must be balanced with the contamination risk. A minimally invasive autopsy might be a solution. We present a model that combines radiology ... ...

    Abstract Objectives: Performing autopsies in a pandemic scenario is challenging, as the need to understand pathophysiology must be balanced with the contamination risk. A minimally invasive autopsy might be a solution. We present a model that combines radiology and pathology to evaluate postmortem CT lung findings and their correlation with histopathology.
    Methods: Twenty-nine patients with fatal COVID-19 underwent postmortem chest CT, and multiple lung tissue samples were collected. The chest CT scans were analyzed and quantified according to lung involvement in five categories: normal, ground-glass opacities, crazy-paving, small consolidations, and large or lobar consolidations. The lung tissue samples were examined and quantified in three categories: normal lung, exudative diffuse alveolar damage (DAD), and fibroproliferative DAD. A linear index was used to estimate the global severity of involvement by CT and histopathological analysis.
    Results: There was a positive correlation between patient mean CT and histopathological severity score indexes - Pearson correlation coefficient (R) = 0.66 (p = 0.0078). When analyzing the mean lung involvement percentage of each finding, positive correlations were found between the normal lung percentage between postmortem CT and histopathology (R=0.65, p = 0.0082), as well as between ground-glass opacities in postmortem CT and normal lungs in histopathology (R=0.65, p = 0.0086), but negative correlations were observed between ground-glass opacities extension and exudative diffuse alveolar damage in histological slides (R=-0.68, p = 0.005). Additionally, it was found is a trend toward a decrease in the percentage of normal lung tissue on the histological slides as the percentage of consolidations in postmortem CT scans increased (R =-0.51, p = 0.055). The analysis of the other correlations between the percentage of each finding did not show any significant correlation or correlation trends (p ≥ 0.10).
    Conclusions: A minimally invasive autopsy is valid. As the severity of involvement is increased in CT, more advanced disease is seen on histopathology. However, we cannot state that one specific radiological category represents a specific pathological correspondent. Ground-glass opacities, in the postmortem stage, must be interpreted with caution, as expiratory lungs may overestimate disease.
    Language English
    Publishing date 2024-01-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2810314-2
    ISSN 2352-0477
    ISSN 2352-0477
    DOI 10.1016/j.ejro.2024.100546
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  3. Article ; Online: LPS Response Is Impaired by Urban Fine Particulate Matter.

    de Souza Xavier Costa, Natália / Ribeiro Júnior, Gabriel / Dos Santos Alemany, Adair Aparecida / Belotti, Luciano / Frota Cavalcante, Marcela / Ribeiro, Susan / Matera Veras, Mariana / Kallás, Esper Georges / Saldiva, Paulo Hilário Nascimento / Dolhnikoff, Marisa / Ferraz da Silva, Luiz Fernando

    International journal of molecular sciences

    2022  Volume 23, Issue 7

    Abstract: Fine particulate matter ( ... ...

    Abstract Fine particulate matter (PM
    MeSH term(s) Acute Lung Injury/pathology ; Animals ; Bronchoalveolar Lavage Fluid ; Cytokines/pharmacology ; Interleukin-17/pharmacology ; Interleukin-4/pharmacology ; Interleukin-6/pharmacology ; Lipopolysaccharides/toxicity ; Lung/pathology ; Male ; Mice ; Mice, Inbred BALB C ; Particulate Matter/toxicity
    Chemical Substances Cytokines ; Interleukin-17 ; Interleukin-6 ; Lipopolysaccharides ; Particulate Matter ; Interleukin-4 (207137-56-2)
    Language English
    Publishing date 2022-04-01
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms23073913
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  4. Article ; Online: Ultrasound assessment of pulmonary fibroproliferative changes in severe COVID-19: a quantitative correlation study with histopathological findings.

    de Almeida Monteiro, Renata Aparecida / Duarte-Neto, Amaro Nunes / Ferraz da Silva, Luiz Fernando / de Oliveira, Ellen Pierre / do Nascimento, Ellen Caroline Toledo / Mauad, Thais / Saldiva, Paulo Hilário do Nascimento / Dolhnikoff, Marisa

    Intensive care medicine

    2021  Volume 47, Issue 2, Page(s) 199–207

    Abstract: Purpose: This study was designed to evaluate the usefulness of lung ultrasound (LUS) imaging to characterize the progression and severity of lung damage in cases of COVID-19.: Methods: We employed a set of combined ultrasound parameters and ... ...

    Abstract Purpose: This study was designed to evaluate the usefulness of lung ultrasound (LUS) imaging to characterize the progression and severity of lung damage in cases of COVID-19.
    Methods: We employed a set of combined ultrasound parameters and histopathological images obtained simultaneously in 28 patients (15 women, 0.6-83 years) with fatal COVID-19 submitted to minimally invasive autopsies, with different times of disease evolution from initial symptoms to death (3-37 days, median 18 days). For each patient, we analysed eight post-mortem LUS parameters and the proportion of three histological patterns (normal lung, exudative diffuse alveolar damage [DAD] and fibroproliferative DAD) in eight different lung regions. The relationship between histopathological and post-mortem ultrasonographic findings was assessed using various statistical approaches.
    Results: Statistically significant positive correlations were observed between fibroproliferative DAD and peripheral consolidation (coefficient 0.43, p = 0.02) and pulmonary consolidation (coefficient 0.51, p = 0.005). A model combining age, time of evolution, sex and ultrasound score predicted reasonably well (r = 0.66) the proportion of pulmonary parenchyma with fibroproliferative DAD.
    Conclusion: The present study adds information to previous studies related to the use of LUS as a tool to assess the severity of acute pulmonary damage. We provide a histological background that supports the concept that LUS can be used to characterize the progression and severity of lung damage in severe COVID-19.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; COVID-19/diagnostic imaging ; COVID-19/pathology ; Child ; Child, Preschool ; Correlation of Data ; Female ; Humans ; Infant ; Lung/diagnostic imaging ; Lung/pathology ; Male ; Middle Aged ; Ultrasonography ; Young Adult
    Language English
    Publishing date 2021-01-03
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-020-06328-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Understanding yellow fever-associated myocardial injury: an autopsy study.

    Giugni, Fernando Rabioglio / Aiello, Vera Demarchi / Faria, Caroline Silverio / Pour, Shahab Zaki / Cunha, Marielton Dos Passos / Giugni, Melina Valdo / Pinesi, Henrique Trombini / Ledesma, Felipe Lourenço / Morais, Carolina Esteves / Ho, Yeh-Li / Sztajnbok, Jaques / de Morais Fernezlian, Sandra / Ferraz da Silva, Luiz Fernando / Mauad, Thais / Ferreira Alves, Venâncio Avancini / Hilário do Nascimento Saldiva, Paulo / Antonangelo, Leila / Dolhnikoff, Marisa / Duarte-Neto, Amaro Nunes

    EBioMedicine

    2023  Volume 96, Page(s) 104810

    Abstract: Background: Yellow fever (YF) is a viral hemorrhagic fever, endemic in parts of South America and Africa. There is scarce evidence about the pathogenesis of the myocardial injury. The objective of this study is to evaluate the cardiac pathology in fatal ...

    Abstract Background: Yellow fever (YF) is a viral hemorrhagic fever, endemic in parts of South America and Africa. There is scarce evidence about the pathogenesis of the myocardial injury. The objective of this study is to evaluate the cardiac pathology in fatal cases of YF.
    Methods: This retrospective autopsy study included cases from the São Paulo (Brazil) epidemic of 2017-2019. We reviewed medical records and performed cardiac tissue histopathological evaluation, electron microscopy, immunohistochemical assays, RT-qPCR for YF virus (YFV)-RNA, and proteomics analysis on inflammatory and endothelial biomarkers.
    Findings: Seventy-three confirmed YF cases with a median age of 48 (34-60) years were included. We observed myocardial fibrosis in 68 (93.2%) patients; cardiomyocyte hypertrophy in 68 (93.2%); endothelial alterations in 67 (91.8%); fiber necrosis in 50 (68.5%); viral myocarditis in 9 (12.3%); and secondary myocarditis in 5 (6.8%). Four out of five patients with 17DD vaccine-associated viscerotropic disease presented with myocarditis. The cardiac conduction system showed edema, hemorrhages and endothelial fibrinoid necrosis. Immunohistochemistry detected CD68-positive inflammatory interstitial cells and YFV antigens in endothelial and inflammatory cells. YFV-RNA was detected positive in 95.7% of the cardiac samples. The proteomics analysis demonstrated that YF patients had higher levels of multiple inflammatory and endothelial biomarkers in comparison to cardiovascular controls, and higher levels of interferon gamma-induced protein 10 (IP-10) in comparison to sepsis (p = 0.01) and cardiovascular controls (p < 0.001) in Dunn test.
    Interpretation: Myocardial injury is frequent in severe YF, due to multifactorial mechanisms, including direct YFV-mediated damage, endothelial cell injury, and inflammatory response, with a possible prominent role for IP-10.
    Funding: This study was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo, Bill and Melinda Gates Foundation, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
    MeSH term(s) Humans ; Middle Aged ; Yellow Fever/epidemiology ; Myocarditis/etiology ; Chemokine CXCL10 ; Retrospective Studies ; Brazil/epidemiology ; Heart Injuries ; RNA ; Autopsy ; Biomarkers ; Necrosis
    Chemical Substances Chemokine CXCL10 ; RNA (63231-63-0) ; Biomarkers
    Language English
    Publishing date 2023-09-25
    Publishing country Netherlands
    Document type Review ; Journal Article
    ZDB-ID 2851331-9
    ISSN 2352-3964
    ISSN (online) 2352-3964
    DOI 10.1016/j.ebiom.2023.104810
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  6. Article ; Online: COVID-19 induces more pronounced extracellular matrix deposition than other causes of ARDS.

    de Souza Xavier Costa, Natália / Ribeiro Júnior, Gabriel / do Nascimento, Ellen Caroline Toledo / de Brito, Jôse Mara / Antonangelo, Leila / Faria, Caroline Silvério / Monteiro, Jhonatas Sirino / Setubal, João Carlos / Pinho, João Renato Rebello / Pereira, Roberta Verciano / Seelaender, Marilia / de Castro, Gabriela Salim / Lima, Joanna D C C / de Almeida Monteiro, Renata Aparecida / Duarte-Neto, Amaro Nunes / Saldiva, Paulo Hilário Nascimento / Ferraz da Silva, Luiz Fernando / Dolhnikoff, Marisa / Mauad, Thais

    Respiratory research

    2023  Volume 24, Issue 1, Page(s) 281

    Abstract: Background: Lung fibrosis is a major concern in severe COVID-19 patients undergoing mechanical ventilation (MV). Lung fibrosis frequency in post-COVID syndrome is highly variable and even if the risk is proportionally small, many patients could be ... ...

    Abstract Background: Lung fibrosis is a major concern in severe COVID-19 patients undergoing mechanical ventilation (MV). Lung fibrosis frequency in post-COVID syndrome is highly variable and even if the risk is proportionally small, many patients could be affected. However, there is still no data on lung extracellular matrix (ECM) composition in severe COVID-19 and whether it is different from other aetiologies of ARDS.
    Methods: We have quantified different ECM elements and TGF-β expression in lung tissue of 28 fatal COVID-19 cases and compared to 27 patients that died of other causes of ARDS, divided according to MV duration (up to six days or seven days or more). In COVID-19 cases, ECM elements were correlated with lung transcriptomics and cytokines profile.
    Results: We observed that COVID-19 cases presented significant increased deposition of collagen, fibronectin, versican, and TGF-β, and decreased decorin density when compared to non-COVID-19 cases of similar MV duration. TGF-β was precociously increased in COVID-19 patients with MV duration up to six days. Lung collagen was higher in women with COVID-19, with a transition of upregulated genes related to fibrillogenesis to collagen production and ECM disassembly along the MV course.
    Conclusions: Fatal COVID-19 is associated with an early TGF-β expression lung environment after the MV onset, followed by a disordered ECM assembly. This uncontrolled process resulted in a prominent collagen deposition when compared to other causes of ARDS. Our data provides pathological substrates to better understand the high prevalence of pulmonary abnormalities in patients surviving COVID-19.
    MeSH term(s) Humans ; Female ; Pulmonary Fibrosis/metabolism ; COVID-19/metabolism ; Extracellular Matrix/metabolism ; Collagen/metabolism ; Lung/metabolism ; Transforming Growth Factor beta/pharmacology ; Respiratory Distress Syndrome/metabolism
    Chemical Substances Collagen (9007-34-5) ; Transforming Growth Factor beta
    Language English
    Publishing date 2023-11-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041675-1
    ISSN 1465-993X ; 1465-993X
    ISSN (online) 1465-993X
    ISSN 1465-993X
    DOI 10.1186/s12931-023-02555-7
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  7. Article ; Online: Air pollution impairs recovery and tissue remodeling in a murine model of acute lung injury.

    de Souza Xavier Costa, Natália / Ribeiro Júnior, Gabriel / Dos Santos Alemany, Adair Aparecida / Belotti, Luciano / Schalch, Alexandre Santos / Cavalcante, Marcela Frota / Ribeiro, Susan / Veras, Mariana Matera / Kallás, Esper Georges / Saldiva, Paulo Hilário Nascimento / Dolhnikoff, Marisa / Ferraz da Silva, Luiz Fernando

    Scientific reports

    2020  Volume 10, Issue 1, Page(s) 15314

    Abstract: Evidence regarding the impact of air pollution on acute respiratory distress syndrome (ARDS) is limited, and most studies focus on ARDS onset. Our study aimed to evaluate whether exposure to fine particulate matter interferes with lung recovery and ... ...

    Abstract Evidence regarding the impact of air pollution on acute respiratory distress syndrome (ARDS) is limited, and most studies focus on ARDS onset. Our study aimed to evaluate whether exposure to fine particulate matter interferes with lung recovery and remodeling in a murine model of acute lung injury. Forty-eight mice received nebulized LPS or the vehicle (controls). Blood, BALF, lungs and spleen were collected after 5 weeks of exposure to either PM
    MeSH term(s) Acute Lung Injury/metabolism ; Acute Lung Injury/pathology ; Air Pollution/adverse effects ; Animals ; Bronchoalveolar Lavage Fluid ; Cytokines/metabolism ; Disease Models, Animal ; Inflammation/metabolism ; Inflammation/pathology ; Interleukin-1beta/metabolism ; Interleukin-6/metabolism ; Lung/metabolism ; Lung/pathology ; Male ; Mice ; Mice, Inbred BALB C ; Particulate Matter/adverse effects ; Respiratory Distress Syndrome/metabolism ; Respiratory Distress Syndrome/pathology
    Chemical Substances Cytokines ; Interleukin-1beta ; Interleukin-6 ; Particulate Matter
    Language English
    Publishing date 2020-09-17
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-020-72130-3
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  8. Article ; Online: An autopsy study of the spectrum of severe COVID-19 in children: From SARS to different phenotypes of MIS-C.

    Duarte-Neto, Amaro Nunes / Caldini, Elia Garcia / Gomes-Gouvêa, Michele Soares / Kanamura, Cristina Takami / de Almeida Monteiro, Renata Aparecida / Ferranti, Juliana Ferreira / Ventura, Andrea Maria Cordeiro / Regalio, Fabiane Aliotti / Fiorenzano, Daniela Matos / Gibelli, Maria Augusta Bento Cicaroni / Carvalho, Werther Brunow de / Leal, Gabriela Nunes / Pinho, João Renato Rebello / Delgado, Artur Figueiredo / Carneiro-Sampaio, Magda / Mauad, Thais / Ferraz da Silva, Luiz Fernando / Saldiva, Paulo Hilario Nascimento / Dolhnikoff, Marisa

    EClinicalMedicine

    2021  Volume 35, Page(s) 100850

    Abstract: Background: COVID-19 in children is usually mild or asymptomatic, but severe and fatal paediatric cases have been described. The pathology of COVID-19 in children is not known; the proposed pathogenesis for severe cases includes immune-mediated ... ...

    Abstract Background: COVID-19 in children is usually mild or asymptomatic, but severe and fatal paediatric cases have been described. The pathology of COVID-19 in children is not known; the proposed pathogenesis for severe cases includes immune-mediated mechanisms or the direct effect of SARS-CoV-2 on tissues. We describe the autopsy findings in five cases of paediatric COVID-19 and provide mechanistic insight into the mechanisms involved in the pathogenesis of the disease.
    Methods: Children and adolescents who died with COVID-19 between March 18 and August 15, 2020 were autopsied with a minimally invasive method. Tissue samples from all vital organs were analysed by histology, electron microscopy (EM), reverse-transcription polymerase chain reaction (RT-PCR) and immunohistochemistry (IHC).
    Findings: Five patients were included, one male and four female, aged 7 months to 15 years. Two patients had severe diseases before SARS-CoV-2 infection: adrenal carcinoma and Edwards syndrome. Three patients were previously healthy and had multisystem inflammatory syndrome in children (MIS-C) with distinct clinical presentations: myocarditis, colitis, and acute encephalopathy with status epilepticus. Autopsy findings varied amongst patients and included mild to severe COVID-19 pneumonia, pulmonary microthrombosis, cerebral oedema with reactive gliosis, myocarditis, intestinal inflammation, and haemophagocytosis. SARS-CoV-2 was detected in all patients in lungs, heart and kidneys by at least one method (RT-PCR, IHC or EM), and in endothelial cells from heart and brain in two patients with MIS-C (IHC). In addition, we show for the first time the presence of SARS-CoV-2 in the brain tissue of a child with MIS-C with acute encephalopathy, and in the intestinal tissue of a child with acute colitis. Interpretation: SARS-CoV-2 can infect several cell and tissue types in paediatric patients, and the target organ for the clinical manifestation varies amongst individuals. Two major patterns of severe COVID-19 were observed: a primarily pulmonary disease, with severe acute respiratory disease and diffuse alveolar damage, or a multisystem inflammatory syndrome with the involvement of several organs. The presence of SARS-CoV-2 in several organs, associated with cellular ultrastructural changes, reinforces the hypothesis that a direct effect of SARS-CoV-2 on tissues is involved in the pathogenesis of MIS-C.
    Funding: Fundação de Amparo à Pesquisa do Estado de São Paulo, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Bill and Melinda Gates Foundation.
    Language English
    Publishing date 2021-04-26
    Publishing country England
    Document type Journal Article
    ISSN 2589-5370
    ISSN (online) 2589-5370
    DOI 10.1016/j.eclinm.2021.100850
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  9. Article ; Online: Ultrasound-Guided Minimally Invasive Tissue Sampling: A Minimally Invasive Autopsy Strategy During the COVID-19 Pandemic in Brazil, 2020.

    Duarte-Neto, Amaro Nunes / Ferraz da Silva, Luiz Fernando / Monteiro, Renata Aparecida de Almeida / Theodoro Filho, Jair / Leite, Thabata Larissa Luciano Ferreira / de Moura, Catia Sales / Gomes-Gouvêa, Michele Soares / Pinho, João Renato Rebellho / Kanamura, Cristina Takami / de Oliveria, Ellen Pierre / Bispo, Kely Cristina Soares / Arruda, Cássia / Dos Santos, Aline Brito / Aquino, Flavia Cristina Gonçalves / Caldini, Elia Garcia / Mauad, Thais / Saldiva, Paulo Hilário Nascimento / Dolhnikoff, Marisa

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2021  Volume 73, Issue Suppl_5, Page(s) S442–S453

    Abstract: Background: Minimally invasive autopsies, also known as minimally invasive tissue sampling (MITS), have proven to be an alternative to complete diagnostic autopsies (CDAs) in places or situations where this procedure cannot be performed. During the ... ...

    Abstract Background: Minimally invasive autopsies, also known as minimally invasive tissue sampling (MITS), have proven to be an alternative to complete diagnostic autopsies (CDAs) in places or situations where this procedure cannot be performed. During the coronavirus disease 2019 (COVID-19) pandemic, CDAs were suspended by March 2020 in Brazil to reduce biohazard. To contribute to the understanding of COVID-19 pathology, we have conducted ultrasound (US)-guided MITS as a strategy.
    Methods: This case series study includes 80 autopsies performed in patients with COVID-19 confirmed by laboratorial tests. Different organs were sampled using a standardized MITS protocol. Tissues were submitted to histopathological analysis as well as immunohistochemical and molecular analysis and electron microscopy in selected cases.
    Results: US-guided MITS proved to be a safe and highly accurate procedure; none of the personnel were infected, and accuracy ranged from 69.1% for kidney, up to 90.1% for lungs, and reaching 98.7% and 97.5% for liver and heart, respectively. US-guided MITS provided a systemic view of the disease, describing the most common pathological findings and identifying viral and other infectious agents using ancillary techniques, and also allowed COVID-19 diagnosis confirmation in 5% of the cases that were negative in premortem and postmortem nasopharyngeal/oropharyngeal swab real-time reverse-transcription polymerase chain reaction.
    Conclusions: Our data showed that US-guided MITS has the capacity similar to CDA not only to identify but also to characterize emergent diseases.
    MeSH term(s) Autopsy ; Brazil/epidemiology ; COVID-19 ; COVID-19 Testing ; Humans ; Pandemics ; SARS-CoV-2 ; Ultrasonography, Interventional
    Language English
    Publishing date 2021-12-15
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciab885
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  10. Article ; Online: Effects of hepatocyte growth factor injection and reinjection on healing in the rabbit vocal fold.

    Dias Garcia, Roberta Ismael / Tsuji, Domingos Hiroshi / Imamura, Rui / Mauad, Thais / Ferraz da Silva, Luiz Fernando

    Journal of voice : official journal of the Voice Foundation

    2012  Volume 26, Issue 5, Page(s) 667.e7–12

    Abstract: Objectives/hypothesis: Hepatocyte growth factor (HGF) is a multifunctional polypeptide that plays various roles in embryogenesis and tissue regeneration and exhibits marked antifibrotic activity. The present study sought to assess the effects of HGF ... ...

    Abstract Objectives/hypothesis: Hepatocyte growth factor (HGF) is a multifunctional polypeptide that plays various roles in embryogenesis and tissue regeneration and exhibits marked antifibrotic activity. The present study sought to assess the effects of HGF injection and reinjection coinciding with its peak of activity on collagen density, vessel density, inflammatory reaction in the lamina propria, and mean epithelial thickness in the injured rabbit vocal fold.
    Study design: Prospective, controlled, experimental animal study.
    Methods: Fourteen rabbits were subdivided into two groups and underwent injury of the vocal folds. Immediately after injury, animals in group 1 received HGF injections into the right vocal fold (RVF), whereas those in group 2 received bilateral HGF injections and a single reinjection into the RVF 10 days after the first, to coincide with the peak of HGF activity. The left vocal folds (LVFs) served as controls in both groups. Histological assessment of laryngeal specimens was performed at 30 and 40 days, respectively.
    Results: In both groups, collagen density was lower in the right (treated) vocal folds than in the left (control) folds (P=0.018). Vessel density was higher in the RVFs in group 2 (P=0.018). Differences were found in mean epithelial thickness and inflammatory reaction in the lamina propria but did not reach statistical significance.
    Conclusions: In the scarred rabbit vocal fold, HGF injection is associated with decreased collagen density in the lamina propria, whereas reinjection after 10 days produces decreased collagen density and higher vessel density.
    MeSH term(s) Animals ; Collagen/metabolism ; Disease Models, Animal ; Drug Administration Schedule ; Female ; Fibrosis ; Hepatocyte Growth Factor/administration & dosage ; Injections ; Laryngoscopy ; Neovascularization, Physiologic/drug effects ; Rabbits ; Time Factors ; Vocal Cords/blood supply ; Vocal Cords/drug effects ; Vocal Cords/injuries ; Vocal Cords/metabolism ; Vocal Cords/pathology ; Wound Healing/drug effects ; Wounds and Injuries/drug therapy ; Wounds and Injuries/metabolism ; Wounds and Injuries/pathology ; Wounds and Injuries/physiopathology
    Chemical Substances HGF protein, human ; Hepatocyte Growth Factor (67256-21-7) ; Collagen (9007-34-5)
    Language English
    Publishing date 2012-09
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 17459-2
    ISSN 1873-4588 ; 1557-8658 ; 0892-1997
    ISSN (online) 1873-4588 ; 1557-8658
    ISSN 0892-1997
    DOI 10.1016/j.jvoice.2011.08.007
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