MARISA DOLHNIKOFF
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Patologia, Faculdade de Medicina - Docente
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
9 resultados
Resultados de Busca
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- Mechanical evaluation of the resistance and elastance of post-burn scars after topical treatment with tretinoin(2011) DEMATTE, Maria Fernanda; GEMPERLI, Rolf; SALLES, Alessandra Grassi; DOLHNIKOFF, Marisa; LANCAS, Tatiana; SALDIVA, Paulo Hilario Nascimento; FERREIRA, Marcus CastroOBJECTIVE: After burn injuries, scarred skin lacks elasticity, especially in hypertrophic scars. Topical treatment with tretinoin can improve the appearance and quality of the skin (i.e., texture, distensibility, color, and hydration). The objective of this prospective study was to examine the effects of treatment with 0.05% tretinoin for one year on the biomechanical behavior and histological changes undergone by facial skin with post-burn scarring. Setting: Tertiary, Institutional. METHOD: Fifteen female patients who had suffered partial thickness burns with more than two years of evolution were selected. Skin biopsies were obtained initially and after one year of treatment. The resistance and elastance of these skin biopsies were measured using a mechanical oscillation analysis system. The density of collagen fibers, elastic fibers, and versican were determined using immunohistochemical analysis. RESULTS: Tretinoin treatment significantly lowered skin resistance and elastance, which is a result that indicates higher distensibility of the skin. However, tretinoin treatment did not significantly affect the density of collagen fibers, elastic fibers, or versican. CONCLUSION: Topical tretinoin treatment alters the mechanical behavior of post-burn scarred skin by improving its distensibility and thus leads to improved quality of life for patients.
- Medical students with performance difficulties need wide support: Initial results of an academic tutoring program(2021) BELLODI, Patricia Lacerda; DOIHNIKOFF, MarisaBACKGROUND: Even students with previous academic success may face challenges that affect their academic performance. Many medical schools offer programs to students at the risk of academic failure, to ensure that they succeed in the course. OBJECTIVE AND METHODS: In this report we describe a pioneering academic tutoring program developed at a Brazilian medical school and discuss the initial results of the program based on the feedback from tutors and data regarding the progression of students in the medical course. RESULTS: In 2018, 33 students enrolled into the program. Students' performance difficulties were mainly associated with mental health problems and socioeconomic vulnerability. Of the 33 students, 27 (81.8%) were assisted by the Mental Health Support Service and 16 (48.5%) were assisted by the Social Assistance Service. In addition to the planning academic activity class load, tutors were able to assist students in solving socioeconomic issues, carrying out personal support interventions with the promotion of self-esteem, and presenting suggestions for behavioral changes in their routine. For most students (72%), the action plan proposed by the tutors was successful. Eight of the 14 (57%) students in the fourth year progressed to the final two years of in-hospital practical training (internship). CONCLUSIONS: The Academic Tutoring Program showed positive results for most of the students. Close monitoring and tutor intervention allowed students with poor academic performance to overcome the low performance cycle. These important tasks demand time and energy from tutors, and institutional recognition of these professionals is essential for the successful maintenance of the program.
- Lung cancer biopsy: Can diagnosis be changed after immunohistochemistry when the H&E-Based morphology corresponds to a specific tumor subtype?(2018) BERNARDI, Fabiola Del Carlo; BERNARDI, Marcela Del Carlo; TAKAGAKI, Teresa; SIQUEIRA, Sheila Aparecida Coelho; DOLHNIKOFF, MarisaOBJECTIVES: Advancements in non-small cell lung cancer treatment based on targeted therapies have made the differentiation between adenocarcinoma and squamous cell carcinoma increasingly important. Pathologists are challenged to make the correct diagnosis in small specimens. We studied the accuracy of an immunohistochemical panel in subclassifying non-small cell lung cancer in routine small biopsies and compared the results with the diagnosis from resected lung specimens, autopsy samples or biopsied/resected metastases. METHODS: In total, 340 lung cancer biopsies were investigated for the expression of CK5, TTF1, p63 and surfactant. RESULTS: We characterized 166 adenocarcinomas and 124 squamous cell carcinomas. Overall, 85% of cases displayed binary staining (TTF1 positive/p63 negative, and vice versa). The diagnoses of ten cases with a morphology that indicated a specific tumor subtype were changed after immunohistochemistry (IHC). A second specimen was available for 71 patients, and the first diagnosis at biopsy was confirmed in 95% of these cases. Most non-small cell lung cancer cases present a binary immunohistochemical profile in small biopsies, contributing to good diagnostic accuracy with routine markers. In a small proportion of cases, the diagnosis can be changed after IHC even when the morphological aspects indicate one specific tumor subtype. CONCLUSIONS: We recommend that routine small biopsies of lung cancer without classic morphology should be subjected to a minimum immunohistochemical panel to differentiate adenocarcinoma from squamous cell carcinoma.
- Postmortem Chest Computed Tomography in Fatal COVID-19: A Valuable Diagnostic Tool for Minimally Invasive Autopsy(2021) SILVA, Paulo Savoia Dias da; SAWAMURA, Marcio Valente Yamada; MONTEIRO, Renata Aparecida de Almeida; DUARTE-NETO, Amaro Nunes; MARTIN, Maria da Graca Morais; DOLHNIKOFF, Marisa; MAUAD, Thais; SALDIVA, Paulo Hilario Nascimento; LEITE, Claudia Costa; SILVA, Luiz Fernando Ferraz da; CARDOSO, Ellison Fernando
- Extended minimally invasive autopsy: Technical imp-rovements for the investigation of cardiopulmonary events in COVID-19(2021) THEODORO-FILHO, Jair; MONTEIRO, Renata Aparecida de Almeida; DUARTE-NETO, Amaro Nunes; MAUAD, Thais; SILVA, Luiz Fernando Ferraz da; SALDIVA, Paulo Hilario Nascimento; DOLHNIKOFF, MarisaOBJECTIVES: Ultrasound-guided minimally invasive autopsies (MIA-US) are an alternative to conventional autopsies and have been used in our institution to investigate the pathophysiology of COVID-19 since the beginning of the pandemic. Owing to the limitations of post-mortem biopsies for evaluating cardiopulmonary events involving large vessels, we continuously improved the technique during this period. Objectives: To demonstrate the usefulness of an extended MIA-US technique (EMIA-US) for the study of thoracic involvement in COVID-19. METHOD: US-guided percutaneous tissue sampling was combined with a small thoracic incision (p5 cm), allowing for the sampling of larger tissue samples or even the entire organ (lungs and heart). RESULTS: EMIA-US was performed for eight patients who died of COVID-19 in 2021. We demonstrate cardiopulmonary events, mainly thromboembolism and myocardial infarction, that could be evaluated using EMIA-US. CONCLUSIONS: Minimally invasive image-guided post-mortem tissue sampling isa flexible and practical method to conduct post-mortem studies of human diseases, mainly in areas that do not have autopsy facilities or, alternatively, when autopsy is not possible owing to financial constraints, cultural and religious values, or for safety reasons, such as in the case of highly contagious infectious diseases. We present evidence that EMIA-US is feasible and can be used as an alternative to increase the accuracy of MIA-US in detecting cardiopulmonary events involving large vessels, which may not be assessed through post-mortem biopsies.
- Ultrasound-guided minimally invasive autopsies: A protocol for the study of pulmonary and systemic involvement of COVID-19(2020) MONTEIRO, Renata Aparecida de Almeida; DUARTE-NETO, Amaro Nunes; SILVA, Luiz Fernando Ferraz da; OLIVEIRA, Ellen Pierre de; THEODORO FILHO, Jair; SANTOS, Glaucia Aparecida Bento dos; OLIVEIRA, Ilka Regina Souza de; MAUAD, Thais; SALDIVA, Paulo Hilario do Nascimento; DOLHNIKOFF, Marisa
- Pulmonary arterial involvement leading to alveolar hemorrhage in lymphangioleiomyomatosis(2011) BALDI, Bruno Guedes; PIMENTA, Suzana Pinheiro; KAWASSAKI, Alexandre de Melo; BERNARDI, Fabiola Del Carlo; DOLHNIKOFF, Marisa; CARVALHO, Carlos Roberto Ribeiro
- Major discrepancy between clinical diagnosis of death and anatomopathological findings in adolescents with chronic diseases during 18-years(2023) RIBEIRO, Maira P.; DUARTE-NETO, Amaro N.; DOLHNIKOFF, Marisa; LINDOSO, Livia; LOURENCO, Benito; MARQUES, Heloisa H.; PEREIRA, Maria F. B.; CRISTOFANI, Lilian M.; ODONE-FILHO, Vicente; CAMPOS, Lucia M. A.; SALLUM, Adriana M. E.; CARNEIRO-SAMPAIO, Magda; DELGADO, Artur F.; CARVALHO, Werther B.; MAUAD, Thais; SILVA, Clovis A.Objectives: To evaluate the inconsistency between clinical diagnosis of death and autopsy findings in adolescents with chronic diseases.Methods: A cross-sectional study including a sample of adolescents' autopsies who died in a pediatric and adoles-cent tertiary hospital over 18 consecutive years. During this period, there were n = 2912 deaths, and n = 581/ 2912(20%) occurred in adolescents. Of these, n = 85/581(15%) underwent autopsies and were analyzed. Further results were divided into two groups: Goldman classes I or II (high disagreement between main clinical diagnosis of death and anatomopathological findings, n = 26) and Goldman classes III, IV or V (low or no disagreement between these two parameters, n = 59).Results: Median age at death (13.5 [10-19] vs. 13 [10-19] years, p = 0.495) and disease duration (22 [0-164] vs. 20 [0-200] months, p = 0.931), and frequencies for males (58% vs. 44%, p = 0.247) were similar between class I/II vs. class III/IV/V. The frequency of pneumonia (73% vs. 48%, p = 0.029), pulmonary abscess (12% vs. 0%, p = 0.026), as well as isolation of yeast (27% vs. 5%, p = 0.008), and virus (15% vs. 2%, p = 0.029) identified in the autopsy, were significantly higher in adolescents with Goldman class I/II compared to those with Goldman class III/IV/V. In contrast, cerebral edema was significantly lower in adolescents of the first group (4% vs. 25%, p = 0.018).Conclusion: This study showed that 30% of the adolescents with chronic diseases had major discrepancies between clinical diagnosis of death and autopsy findings. Pneumonia, pulmonary abscess, as well as isolation of yeast and virus were more frequently identified at autopsy findings in the groups with major discrepancies.
- Chemical composition modulates the adverse effects of particles on the mucociliary epithelium(2015) CARVALHO-OLIVEIRA, Regiani; PIRES-NETO, Ruy Camargo; BUSTILLOS, Jose Oscar Viega; MACCHIONE, Mariangela; DOLHNIKOFF, Marisa; SALDIVA, Paulo H. Nascimento; GARCIA, Maria Lucia BuenoOBJECTIVE: We compared the adverse effects of two types of real ambient particles; i.e., total suspended particles from an electrostatic precipitator of a steel mill and fine air particles from an urban ambient particulate matter of 2.5 mu m, on mucociliary clearance. METHOD: Mucociliary function was quantified by mucociliary transport, ciliary beating frequency and the amount of acid and neutral mucous in epithelial cells through morphometry of frog palate preparations. The palates were immersed in one of the following solutions: total suspended particles (0.1 mg/mL), particulate matter 2.5 mm 0.1 mg/mL (PM0.1) or 3.0 mg/mL (PM3.0) and amphibian Ringer's solution (control). Particle chemical compositions were determined by X-ray fluorescence and gas chromatography/mass spectrometry. RESULTS: Exposure to total suspended particles and PM3.0 decreased mucociliary transport. Ciliary beating frequency was diminished by total suspended particles at all times during exposure, while particulate matter of 2.5 mm did not elicit changes. Particulate matter of 2.5 mm reduced epithelial mucous and epithelium thickness, while total suspended particles behaved similarly to the control group. Total suspended particles exhibited a predominance of Fe and no organic compounds, while the particulate matter 2.5 mm contained predominant amounts of S, Fe, Si and, to a lesser extent, Cu, Ni, V, Zn and organic compounds. CONCLUSION: Our results showed that different compositions of particles induced different airway epithelial responses, emphasizing that knowledge of their individual characteristics may help to establish policies aimed at controlling air pollution.