SUMMARY Lipodystrophies are characterized by complete or selective loss of adipose tissue and can be acquired or inherited. Familial partial lipodystrophy (FPLD) is a hereditary lipodystrophy commonly caused by mutations in the LMNA gene. Herein, we report two cases of FPLD associated with podocytopathies. Patient 1 was diagnosed with FPLD associated with the heterozygous p.Arg482Trp variant in LMNA and had normal glucose tolerance and hyperinsulinemia. During follow-up, she developed nephrotic-range proteinuria. Renal biopsy was consistent with minimal change disease. Patient 2 was diagnosed with FPLD associated with a de novo heterozygous p.Arg349Trp variant in LMNA. Microalbuminuria progressed to macroalbuminuria within 6 years and to nephrotic range proteinuria in the last year. He remained without diabetes and with hyperinsulinemia. Renal biopsy revealed focal segmental glomerulosclerosis not otherwise specified. This report provides further evidence of variable features of lipodystrophy associated with LMNA variants and the importance of long-term follow-up with evaluation of kidney dysfunction. inherited (FPLD gene Herein podocytopathies pArg482Trp pArgTrp p Arg482Trp Arg Trp hyperinsulinemia followup, followup follow up, up nephroticrange disease pArg349Trp Arg349Trp year specified longterm long term dysfunction pArg ArgTrp

ABSTRACT Purpose: The surgical glue is widely used in closing cutaneous surgical wounds. Corticosteroids are indicated for their anti-inflammatory and immunomodulatory properties. The present work evaluated the pharmacological effects of triamcinolone (AT) incorporated into surgical glue (C) on the initial phase of the wound healing process in Wistar rats. Methods: Through in-vivo studies, the effects of the healing process, C or C+AT in the same rat were evaluated for seven and 14 days post-surgery. Results: The C+AT association did not change the physicochemical properties of the polymer. This association in wound healing confirmed the anti-inflammatory and immunomodulatory effects of the corticosteroid, with less neovascularization and fibrosis, in addition to the remodeling of the extracellular matrix carried out by the balance of myofibroblasts and less dense collagen fibers, culminating in tissue regeneration and possible reduction of side effects. Conclusion: This association is a powerful and innovative pharmacological tool, promising in translational medicine. Purpose wounds antiinflammatory anti inflammatory AT (AT (C rats Methods invivo vivo studies CAT 1 postsurgery. postsurgery post surgery. surgery post-surgery Results polymer corticosteroid fibrosis fibers Conclusion tool medicine

CONTEXTO: A incidência de linfocele em pacientes submetidos a transplante renal varia entre 0,6 e 18% e vários são os fatores relacionados à sua etiologia. A rejeição celular do aloenxerto renal tem sido descrita como um possível fator etiológico das linfoceles. OBJETIVO: Verificar a possível associação entre a ocorrência de linfocele e a rejeição celular aguda em transplante renais. TIPO DE ESTUDO: Estudo retrospectivo. AMOSTRA: 170 pacientes transplantados no período de março de 1992 a janeiro de 1997. LOCAL: Centro de referência hospitalar. RESULTADOS: Dos 19 pacientes que evoluíram com linfocele, 16 apresentaram pelo menos um episódio de rejeição celular aguda (84%), todos tratados com metilpredinisolona. A relação entre linfocele e rejeição foi estatisticamente significativa (p=0.04). O tratamento da linfocele foi realizado através de marsupialização peritoneal em 3 (15,3%) pacientes, drenagem percutânea em 7 (36.8%), marsupialização laparoscópica em 2 (10,5%) e tratamento conservador em 7 (36.8%). A evolução foi favorável em 15 (78.9%), 1 (5,3%) foi a óbito por causa não relacionada à linfocele e 3 (15,8%) perderam o enxerto devido a fatores imunológicos. O período médio de acompanhamento desssa casuística foi de 24,5 meses. CONCLUSÃO: A maior freqüência de rejeição celular aguda encontrada no presente estudo, em pacientes com linfocele, sugere uma possível relação causal entre essas duas entidades.

CONTEXT: The incidence of lymphocele after renal transplantation varies between 0.6 and 18% of cases, and many factors have been associated to its etiology. Cellular rejection of the kidney allograft has been described as a possible causal factor of lymphocele. OBJECTIVE: To analyze the possible relationship between lymphocele and acute cellular rejection. DESIGN: A retrospective study. SETTING: A referral hospital center. SAMPLE: 170 patients submitted to kidney transplantation from March 1992 to January 1997. A standard technique for renal transplantation was used. RESULTS: Of the 19 patients that developed lymphocele, 16 presented at least one episode of acute cell rejection (84%), and were treated with methylprednisolone. The relation between lymphocele and rejection was statistically significant (p = 0.04). Treatment of lymphocele consisted of peritoneal marsupialization in 3 patients (15.3%), percutaneous drainage in 7 (36.8%), laparascopic marsupialization in 2 (10.5%), and conservative treatment in 7 patients (36.8%). Evolution was favorable in 15 patients (78.9%), 1 patient (5.3%) died due to a cause unrelated to lymphocele, and 3 (15.8%) lost the graft due to immunological factors. The average follow-up period was 24.5 months. CONCLUSION: The high incidence of acute cell rejection in patients with lymphocele suggests a possible causal relationship between both conditions.