RESUMO O câncer de pulmão é o primeiro em incidência e mortalidade, sendo responsável mundialmente por cerca de 1,8 milhão de mortes. No Brasil, 31.270 casos novos foram diagnosticados em 2018, sendo 18.740 em homens e 12.350 em mulheres. Um dos principais desafios do câncer de pulmão é o diagnóstico precoce, na maioria das vezes a doença é detectada em fases tardias, o que implica em mau prognóstico. Os biomarcadores tumorais são extremamente relevantes no diagnóstico precoce, compreensão da carcinogênese, determinação do prognóstico e escolha terapêutica. O presente trabalho revisa biomarcadores de câncer de pulmão de células não pequenas descritos na literatura e suas aplicações diagnósticas, prognósticas e terapêuticas, intervenção e controle terapêutico para terapia individualizada. Embora ainda exista um vasto universo a ser explorado, estudos revelam um futuro promissor para o tratamento do câncer de pulmão com terapias cada vez mais personalizadas e assertivas que aumentam as chances de sobrevida livre de progressão.

ABSTRACT Lung cancer is the first in terms of incidence and mortality, being responsible worldwide for about 1.8 million deaths. In Brazil 31,270 new cases were diagnosed in 2018, 18,740 in men and 12,350 in women. One of the main challenges about lung cancer is performing an early diagnosis, in most cases the disease is detected in the late stages, which implies in poor prognoses. Tumor biomarkers are hugely relevant in early diagnosis, understanding of carcinogenesis, prognostic determination and therapeutic choice. The present paper reviews non-small cell lung cancer biomarkers described in the literature and their diagnostic, prognostic and therapeutic applications, intervention and therapeutic control for individualized therapy. Although there is still a vast universe to be explored, studies reveal a promising future for lung cancer treatment with increasingly personalized and assertive therapies that increase the chances of progression-free survival.

ABSTRACT Male patient, 68 years old, immunocompromised, presented himself with fever and malaise for 15 days. At his hospitalization, peripheral blood and Schilley catheter blood cultures were collected, in addition to computed tomography that showed the presence of a peri-pancreatic collection. The material was drained and the samples were sent to the laboratory. Blood culture was positive for pink coconuts identified by mass spectrometry as Roseomonas spp. with the diagnosis of Bloodstream Infection being closed.

ABSTRACT Introduction In Brazil, 8,000 new cases of childhood cancer are estimated each year, whose causes are still little known, although some have genetically determined factors. Approximately 70% of human cancers have alterations in the TP53 gene, which encodes the protein responsible for inhibiting the disordered growth of cells exposed to injuries. However, the frequency of alterations in the expression of TP53 in childhood cancers in Brazil remains poorly known. Objective To evaluate the expression of TP53 gene in patients with childhood cancer in northeastern of Santa Catarina, Brazil. Materials and Methods: Retrospectively, 282 patients diagnosed with cancer between 2005 and 2015 in Joinville were included. TP53 expression was evaluated by immunohistochemistry using a score based on the intensity and percentage of stained cells. Results The p53 protein was positive in 25.2% of cases, with no difference between sexes. Considering the five main groups of tumors in the sample, the expression was positive in 31.8%, 27.3%, 20%, 17.2% and 5.9% of lymphomas, nephroblastomas, neuroblastomas, tumors of the Central Nervous System and leukemias, respectively. Conclusion The prevalence of TP53 expression was evaluated in different childhood cancers in the northeastern of Santa Catarina. Positivity was higher among lymphomas and lower in leukemias, but with no significant difference among the five most frequent tumors. Further studies that allow correlation with aggressiveness and disease evolution are required.

RESUMO Introdução Com o número crescente de casos relacionados a Diabetes Mellitus (DM), é indispensável o controle glicêmico através de métodos laboratoriais ou testes rápidos. Objetivo Analisar a correlação de três metodologias de determinação de glicose (Glicosímetro, análise laboratorial e com o equipamento com inteligência artificial de point of care). Método Foram coletadas amostras de sangue da polpa digital e sangue venoso da fossa antecubital de 20 voluntários de diferentes idades e sexo. Dosagens de glicose sanguínea foram determinadas pelas 3 metodologias acima citadas. Resultado A análise de correlação de Spearman realizada entre todos os tipos de testes mostra que há uma correlação positiva forte e estatisticamente significante, indicando a compatibilidade de resultados independentemente do método aplicado. Conclusão As metodologias apresentam correlação, no entanto, os valores médios obtidos pela inteligência artificial mostraram-se 40% mais elevada que pode impactar na interpretação clínica dos resultados.

ABSTRACT Introduction With the increasing number of cases related to Diabetes Mellitus (DM), glycemic control through laboratory methods or rapid tests is essential. Objective To analyze the correlation of three glucose determination methodologies (Glucometer, laboratory analysis and with point of care artificial intelligence equipment). Method Blood samples from the digital pulp and venous blood from the antecubital fossa were collected from 20 volunteers of different ages and sex. Blood glucose measurements were determined by the 3 methodologies mentioned above. Result Spearmans correlation analysis carried out between all types of tests shows that there is a strong and statistically significant positive correlation, indicating the compatibility of results regardless of the method applied. Conclusion The methodologies are correlated, however, the average values?? obtained by artificial intelligence were 40% higher, which can impact the clinical interpretation of results.

RESUMO Introdução O carcinoma hepatocelular (CHC) é a neoplasia maligna primária mais comum no fígado. O CHC se desenvolve gradualmente a partir de múltiplos estágios que controlam a proliferação e a apoptose. Na hepatocarcinogênese, múltiplas vias de sinalização já foram descritas, como a via Hedgehog (Hh). No entanto, poucos estudos investigaram a expressão de proteínas Hh como um potencial fator prognóstico no CHC humano. Este estudo teve como objetivo investigar a expressão da proteína Shh no CHC e correlacionar com características prognósticas clínicas e morfológicas do tumor. Métodos A expressão imuno-histoquímica da proteína Shh em tumor e parênquima cirrótico foi realizada em 36 amostras de CHC de pacientes submetidos a transplante hepático no Hospital das Clínicas - UFMG. Correlação entre a expressão e etiologia do tumor Shh, número de nódulos, tamanho dos nódulos, níveis de proteína alfa-feto (AFP), pontuação MELD, diferenciação tumoral e invasão vascular foram realizadas. Resultados Em nosso estudo, a marcação da proteína Shh aumentou gradualmente do parênquima normal para o cirrótico e neoplásico. Grau de diferenciação tumoral e invasão vascular foram correlacionados com alta expressão da proteína Shh (p = 0,014 ep = 0,003, respectivamente). As demais variáveis não apresentaram correlação estatisticamente significativa com a marcação de Shh. Conclusão A via Hedgehog tem importância na hepatocarcinogênese. O estudo imuno-histoquímico da via de sinalização Hh pode ter um papel promissor como fator prognóstico para CHC, principalmente devido à correlação positiva entre a expressão de Shh e o grau de diferenciação tumoral e invasão vascular.

ABSTRACT Introduction Hepatocellular carcinoma (HCC) is the most common primary malignant neoplasm in the liver. HCC develops gradually from multiple stages that control proliferation and apoptosis. In hepatocarcinogenesis, multiple signaling pathways were already described, such as the Hedgehog pathway (Hh). However, few studies have investigated the expression of Hh proteins as a potential prognostic factor in human HCC. This study aimed to investigate the expression of the Shh protein in HCC and to correlate with clinical and morphological prognostic characteristics of the tumor. Methods Immunohistochemical expression of Shh protein in tumor and cirrhotic parenchyma was performed in 36 HCC samples from patients who underwent liver transplantation at Clinical Hospital - UFMG. Correlation between the Shh tumor expression and etiology, number of nodules, size of the nodules, levels of alpha-fetus-protein (AFP), MELD score, tumor differentiation, and vascular invasion were performed. Results In our study, Shh protein labeling gradually increased from the normal to the cirrhotic and neoplastic parenchyma. Degree of tumor differentiation and vascular invasion were correlated with high Shh protein expression (p = 0.014 and p = 0.003, respectively). The other variables did not show a statistically significant correlation with Shh labeling. Conclusion Hedgehog pathway has importance in hepatocarcinogenesis. The immunohistochemical study of the Hh signaling pathway may have a promising role as a prognostic factor for HCC, especially due to the positive correlation between the Shh expression and the degree of tumor differentiation and invasion vascular.

ABSTRACT Introduction Pseudomonas aeruginosa infections are common worldwide, affecting mainly hospitalized patients and causing healthcare-associated infections (HAIs), with a high frequency of antibiotic resistance and complicated outcomes. Objective To investigate the P. aeruginosa frequency in HAIs in a medium/high-complexity hospital in Alagoas (Brazil) and the antibiotic susceptibility profiles of the strains. Methods A retrospective cross-sectional study was conducted from January 2013 to December 2014, when P. aeruginosa related-HAIs were evaluated after automated identification (Vitek®2) and documental analysis. Results Seventy-eight samples were positive for P. aeruginosa, with 37 (47.4%) isolates from patients of the general Intensive Care Unit (ICU) and 13 (16.7%) from the surgical unit. Tracheal secretion (25.6%), wound secretions (20.5%) and sputum (18.0%) were the main positive biological samples. Among 68 strains tested, 73.53% showed resistance to aztreonam, while cefepime, ceftriaxone and cefotaxime were not effective for any isolates (all resistant). High resistance to carbapenems imipenem (61.76%) and meropenem (55.88%) was observed, as well as 46 isolates resistant to piperacillin/tazobactam (67.64%); 47 (60.2%) from the general ICU and neonatal ICU were resistant to all antibiotics tested (MDR profile), except for colistin. Conclusion Our results indicated antibiotic-resistant P. aeruginosa highly present in ICU and the therapy with aminoglycosides and colistin as important choices in cases with failure against P. aeruginosa isolates. A constant screening of multidrug-resistant P. aeruginosa is necessary for the control in the hospital environment, evaluating the antibiotic susceptibility to guide the therapeutic choice.

RESUMO A doença linfoproliferativa pós-transplante (DLPT) é formada por um grupo heterogêneo de proliferações hematolinfóides resultantes da proliferação mono ou policlonal das células linfoides. O quadro clínico é variado e dependente dos sítios envolvidos, sendo o trato gastrintestinal e o sistema nervoso central os mais comuns, e sintomas constitucionais são frequentes. O envolvimento isolado do enxerto é raro. Relatamos aqui um caso de DLPT policlonal isolada do enxerto em um receptor de transplante renal com doador vivo HLA idêntico, ocorrido sete anos após o transplante. Digno de nota, o paciente não apresentou sintomas constitucionais e sua única manifestação clínica foi disfunção do enxerto, expressa através da elevação da creatinina e discreta proteinuria, sendo o diagnóstico realizado através de biópsia renal, que evidenciou infiltrado intersticial linfoide denso. Tratava-se de DLPT policlonal não relacionada ao vírus Epstein-Bar (EBV) e foi tratado com sucesso com quimioterapia, redução da imunossupressão e sirolimo.

ABSTRACT Post-transplantation lymphoproliferative disease (PTLD) comprises a heterogeneous group of hematolymphoid proliferations resulting from a monoclonal or polyclonal proliferation of lymphoid cells. The clinical presentation varies according to the affected sites. The gastrointestinal tract and the central nervous system are the most common, and constitutional symptoms are frequent. Isolated allograft involvement is rare. We report a case of polyclonal PTLD isolated in the kidney allograft in a patient who received an HLA-identical living donor seven years before. Noteworthy, this patient did not present constitutional symptoms, and his only clinical manifestation was graft dysfunction, expressed by an increase in serum creatinine and mild proteinuria. The diagnosis was performed through renal biopsy, which showed dense lymphoid interstitial infiltrate. The PTLD was polyclonal, unrelated to Epstein-Bar virus (EBV), and it was successfully treated with chemotherapy, reduced immunosuppression, and sirolimus.

RESUMO Introdução A contagem diferencial de eritroblastos em amostras de sangue por analisadores de hematologia ainda apresenta limitações. Os avanços tecnológicos nos equipamentos de hemograma têm proposto a contagem totalmente automatizada dessas células, porém, não sem sua validação. Objetivo Validar a contagem automatizada de eritroblastos no sangue periférico no analisador hematológico Mindray BC6000 e verificar a existência de correlação dos estágios de maturação dos eritroblastos com os gráficos do equipamento. Material e Métodos Estudo prospectivo com amostras de sangue periférico do Laboratório de Patologia Clínica Dr. Paulo C. Azevedo, independente de idade e sexo, para validação da contagem de eritroblastos no analisador hematológico Mindray BC6000 em comparação ao método manual (padrão ouro), no período de junho de 2019 a dezembro de 2020. Resultados Foram analisadas 17 amostras de sangue periférico de recém-nascidos (17/09 - 52,3%) e de pacientes maiores de 2 anos (17/08 - 47,7%) que apresentavam mais de 18% de eritroblastos após análise morfológica da amostra. A análise estatística das contagens de eritroblastos pelas duas metodologias mostrou que o contador hematológico Mindray BC6000 tem boa reprodutibilidade, precisão e linearidade. Não houve correlação entre os estágios de maturação dos eritroblastos e os gráficos do equipamento. Conclusão A validação proposta mostrou que o contador hematológico Mindray BC6000 apresenta bom desempenho analítico para contagem de eritroblastos em sangue periférico. Porém, não há correlação entre os estágios de maturação dos eritroblastos com os gráficos gerados pelo equipamento.

ABSTRACT Introduction Differential counting of erythroblasts in blood samples by hematology analyzers still has limitations. Technological advances in blood count equipment have proposed the fully automated counting of these cells, however, not without its validation. Objective Validate the automated count of erythroblasts in peripheral blood in the Mindray BC6000 hematology analyzer and verify the existence of correlation of the maturation stages of erythroblasts with the equipment's graphics. Material and Methods Prospective study with peripheral blood samples from the Clinical Pathology Laboratory Dr Paulo C. Azevedo, regardless of age and gender, to validate the erythroblast count in the Mindray BC6000 hematology analyzer compared to the manual method (gold standard), in the period of June 2019 to December 2020. Results Seventeen peripheral blood samples were analyzed from newborns (09/17 - 52.3%) and from patients older than 2 years (08/17 - 47.7%) who had more than 18% of erythroblasts after morphological analysis of the sample. Statistical analysis of erythroblast counts by the two methodologies showed that the Mindray BC6000 hematological counter has good reproducibility, precision and linearity. There was no correlation between the maturation stages of erythroblasts and the equipment graphics. Conclusion The proposed validation showed that the Mindray BC6000 hematological counter has good analytical performance for counting erythroblasts in peripheral blood. However, there is no correlation between the maturation stages of erythroblasts with the graphics generated by the equipment.

ABSTRACT Background Neurosyphilis is difficult to be diagnosed. CSF VDRL is the gold standard, but its sensitivity is low. Cerebrospinal fluid (CSF) PCR for the detection of Treponema pallidum DNA has been evaluated; however, its diagnostic value is still poorly understood. Methods Here we performed a systematic review including articles that assessed the diagnostic sensitivity of CSF PCR in patients with syphilis and neurosyphilis. The CSF PCR sensitivity and specificity of different PCR assays was assessed in patients with neurosyphilis with or without HIV coinfection and in patients with syphilis with no central nervous system (CNS) manifestations. Results Eighteen studies evaluating 703 patients were included. The PCR sensitivity for neurosyphilis was 73.9% among HIV negative and 37.5% among HIV infected patients, having varied from 62.2% to 100% with different PCR assays. The sensitivity of CSF VDRL CSF was 68% in the same population. The specificity of CSF PCR was 93%. CSFPCR was positive in16.4% of the patients with primary and secondary syphilisand 28.9% of patients with latent syphilis. None of the syphilis cases without neurological manifestations were positive with CSF VDRL. Conclusion CSF PCR seems to be at least as sensitive as CSF VDRL, with good specificity. In addition, CSF PCR may potentially reveal early neuroinvasion in patients withsyphilis with no CNS symptoms. Future studies are still needed to assess the potential clinical value of detecting T. pallidum DNA in CSF in syphilis cases prior to the development of CNS symptoms.

RESUMO A doença de Chagas (DC) é uma doença tropical crônica causada pelo Trypanosoma cruzi, atingindo cerca de 8 milhões de pessoas na América Latina. A via das lectinas (VL) do sistema complemento é uma das primeiras linhas de defesa na resposta imunológica contra a infecção pelo T. cruzi, e pode continuar sendo ativada na infecção crônicadevido ao escape do parasito à sua ação. Embora alguns componentes dessa via tenham sido investigados na DC, não existem relatos sobre sua ativação em soro de pacientes. Neste contexto, nosso objetivo foi avaliar a ativação da VL no soro de pacientes com DC crônica e controles pela detecção do componente C4 empregando a técnica de ELISA. Para isso, amostras de soro de 80 pacientes com DC crônica (formas clínicas: indeterminada n=17; sintomática n=63; cardíaca n=45; cardiodigestiva n=13; digestiva n=5) atendidos no Ambulatório de Atenção ao Paciente Chagásico (HC/UFPR) e 80 controles saudáveis (doadores do Banco de Sangue do HC) foram avaliados quanto a ativação da VL. Os resultados demonstraram que a ativação da VL pela lectina ligante de manose (MBL) encontra-se reduzida, enquanto que a ativação pelas ficolinas está aumentada em pacientes com DC quando comparados aos controles. Os mesmos resultados foram observados quando os pacientes foram categorizados quanto às formas clínicas indeterminada e sintomática. Concluímos que a detecção do componente C4 por ELISA é uma metodologia eficiente para avaliar a ativação da VL em soro de pacientes com DC crônica possibilitando diferenciar o perfil de ativação entre pacientes e controles.

ABSTRACT Chagas disease (CD) is a chronic tropical disease caused by Trypanosoma cruzi , affecting about 8 million people in Latin America. The lectin pathway (LP) of the complement system is one of the first lines of host defense in the response against T. cruzi , and can continue to be activated in chronic infection due to the escape of the parasite to its action. Although some components of this pathway have been investigated in CD, there are no reports on its activation in patient serum. In this context, our objective was to evaluate the activation of LP in chronic chagasic patients and controls by the detection of the C4 component, using the direct ELISA assay. For this purpose, serum of 80 patient with chronic CD (clinical forms: asymptomatic n=17; symptomatic n=63; cardiac n=45; cardio digestive n=13; digestive n=5) followed at the Ambulatory of Attention to Chagasic Patients (HC/UFPR) and 80 healthy controls (donors of the Blood Bank of HC) were evaluated regarding the evaluation of the LP. The results showed that LP activation by mannose-binding lectin (MBL) was found reduced while activation by ficolins was increased in patients with CD when compared to controls. The same results were observed when the patients were categorized according to the indeterminate and symptomatic clinical forms. We conclude that the detection of the C4 component by ELISA is an efficient methodology to assess LP activation in serum from patients with chronic CD, enabling to differentiate the activation profile between patients and controls..

RESUMO O coriocarcinoma é um tumor altamente maligno raro. Relatamos um caso de mulher de 35 anos, com história de irregularidade menstrual de quatro meses e gonadotrofina coriônica humana persistentemente positiva que apresentava ultrassonografia transvaginal normal e a tomografia computadorizada de tórax com três nódulos e a abdominal evidenciava um nodular sólido hipervascularizado lesão no rim esquerdo. Uma biópsia guiada por ultrassom do rim esquerdo foi realizada com diagnóstico patológico de coriocarcinoma renal. Após a quimioterapia, a gonadotrofina coriônica humana foi negativa e a paciente retornou aos ciclos menstruais normais.

ABSTRACT Choriocarcinoma is a rare highly malignant tumor. We report a case of 35-year-old woman, with a history of four months menstrual irregularity and human chorionic gonadotropin persistently positive that presented transvaginal ultrasound normal and the computed tomography scan of the chest showed three nodules and abdominal scan evinced a hypervascularized solid nodular lesion on left kidney. An ultrasound-guided biopsy of left kidney was performed with a pathologic diagnosis of renal choriocarcinoma. After chemotherapy the human chorionic gonadotropin was negative and the patient returned to normal menstrual cicles.

RESUMO A sialolitíase é a formação de cálculos no interior do ducto de uma glândula salivar que acomete com maior prevalência a glândula submandibular. O defeito ósseo de Stafne é um defeito mandibular raro de etiologia desconhecida, que comumente apresenta tecido glandular no interior. O objetivo desse trabalho é relatar o primeiro caso clínico de sialolitíase da glândula submandibular com defeito ósseo de Stafne associado.Apesar da maioria dos desfeitos ósseos de Stafne estarem associado à glândula salivar, não há estudos que comprovem a associação entre as duas lesões, sendo necessários mais estudos para elucidar a relação entre as lesões.

ABSTRACT Sialolithiasis is the formation of calcific concretions within duct of a salivary gland that affects the submandibular gland with greater prevalence. Stafne bone cavity is a rare mandibular defect of unknown etiology, which commonly presents glandular tissue inside. The aim of this work is to report the first clinical case of sialolithiasis of the submandibular gland with associated Stafne bone defect. Although most of Stafne bone cavity are associated with the salivary gland, there are no studies that prove the association between the two injuries, and further studies are needed to elucidate the relationship between the injuries.

RESUMO Objetivo A investigação do perfil inflamatório sistêmico de pacientes acometidos por câncer de próstata (CaP) ou hiperplasia prostática (HPB) pode contribuir para caracterizar o perfil patológico, bem como possibilitar a identificação de marcadores e promover alternativas de tratamentos adequados e menos invasivos. Métodos Esta pesquisa comparou os níveis séricos de 10 mediadores inflamatórios clássicos em pacientes com 50 anos ou mais afetados por CaP ou HPB. Para tanto, foram considerados os aspectos clínicos, bioquímicos, metabólicos, antropométricos e inflamatórios de cada paciente. Resultados A partir da análise estatística, foi encontrada umacorrelação positiva fraca (r = 0,16) entre IL-2 com os valores de PSA total sé o. Além disso, os valores medianos de IL-2 no soro foram três vezes maiores em pacientes com CaP em comparação com pacientes com HPB. Conclusão Pela interpretação da literatura atual, hipotetizamos que a atividade de macrófagos do tipo M1 infiltrados e células citotóxicas ativadas no meio da neoplasia pode explicar esse aumento de IL-2 como parte de uma resposta antineoplásica endógena.

ABSTRACT Objective Investigation onthe systemic inflammatory profile ofpatients affected by prostate cancer (PCa) or prostatic hyperplasia (BPH) may contribute to characterize the pathological profile as well as enable identification of markers and promote alternatives for appropriate, less invasive treatments. Methods This research compared serum levels of 10 classic inflammatory mediators among patients aged 50 years or older affected by PCa or BPH. For this, clinical, biochemical, metabolic, anthropometric and inflammatory aspects of each patient was considered. Results From the statistical analysis, a weakpositive correlation (r = 0.16) between IL-2 with serum total PSA values was found. In addition, median serum IL-2 values were three times higher in patients with PCa compared to BPH patients. Conclusion By interpretation of current literature, we hypothesize that the activity of infiltratedtype M1 macrophages and activated cytotoxic cells in the neoplasm milieu might explain this increase of IL-2 as part of anendogenous anti-neoplastic response.

RESUMO Introdução A triagem das bolsas de plasma é uma etapa importante do controle de qualidade nos hemocentros. A turbidez causada pelo aumento de triglicerídeos é detectada por inspeção visual, mas não há consenso acerca do limite no qual o plasma deve ser considerado inadequado para doação. Objetivo Comparar a dosagem de triglicerídeos e a turbidez visual na tomada de decisão para o descarte do plasma. Material e métodos As bolsas de plasma (n=205) foram classificadas pela inspeção visual como límpidas, moderadamente turvas ou turvas e as concentrações de triglicerídeos foram determinadas no soro e plasma com metodologia enzimática-colorimétrica por automação. Resultados Nossos resultados mostraram uma correlação positiva entre soro e plasma (r=0,94) mas observamos que a concentração de triglicerídeos foi mais alta no soro do que no plasma (p<0,03). A maioria das bolsas foi classificada como moderadamente turva ou turva (75%). A inspeção visual e a concentração de triglicerídeos apresentaram uma correlação moderada para o soro (rb=0,57) e plasma (rb=0,52). Entretanto, no grupo moderadamente turvo, houve uma divergência significativa entre as concentrações de triglicerídeos no soro/plasma e a inspeção visual. Discussão Nossos achados corroboram com a literatura, reforçando a subjetividade da inspeção visual. Nós recomendamos a realização de estudos futuros para determinar o limite dos níveis de triglicerídeos para o descarte de plasma em conjunto com a combinação de métodos automatizados para aumentar a acurácia da classificação visual. Conclusão As ações voltadas para a melhoria da qualidade são críticas para a padronização da triagem e evitar o descarte desnecessário de plasma.

ABSTRACT Introduction Blood donor screening is an important stage of quality control in blood banks. Turbidity caused by increased levels of triglycerides is detected by visual inspection, but there is no consensus on its threshold at which plasma should be considered inappropriate for donation. Objective Compare triglycerides dosage and visual turbidity in decision making for the disposal of plasma. Material and methods Plasma bags (n=205) were classified by visual inspection as clear, moderately turbid or turbid and triglyceride concentration were determined in serum and plasma with enzimatic-colorimetric methodology by automation. Results Our results show a positive correlation between serum and plasma triglycerides levels (r=0,94) but we observed a higher concentration in serum when compared to plasma samples (p<0,03). Most of the plasma were classified as moderately turbid or turbid (75%). Visual inspection and triglycerides levels were moderately correlated in serum (rb=0,57) and plasma (rb=0,52). However, moderately turbid samples showed discordance between serum or plasma triglyceride levels and the visual inspection. Discussion Our findings corroborate with the literature data, supporting the subjectivity of the visual inspection. We recommend further studies to determine which triglyceride threshold should be used for the disposal of plasma bags combined with automated methods to enhance visual classification accuracy. Conclusion Quality improvement actions are critical for standardization of the screening in order to avoid unnecessary disposal of the plasma bags.

RESUMO Paciente do sexo feminino, 29 anos de idade, com diagnóstico de lúpus eritematoso sistêmico em uso atual de prednisona e azatioprina, se apresenta com abaulamentos em antebraços, região lombar e coxa esquerda há 15 dias. A ultrassonografia e a ressonância magnética evidenciaram presença de coleções nesses locais cuja punção do material revelou presença de bacilos álcool ácido resistentes e a hemocultura, em meio específico, foi positiva para Mycobacterium tuberculosis. O teste molecular e imunocromatográfico também foram positivos para M. tuberculosis, com diagnóstico final de Piomiosite Tuberculosa.

ABSTRACT Female patient, 29 years old, with systemic lupus erythematosus in current use of prednisone and azathioprine, presents with bulging in the forearms, lumbar region and left thigh for 15 days. Ultrasonography and magnetic resonance imaging showed the presence of serous collections in these locations. The material was punctured and the samples were sent to the laboratory. The microbiological examination revealed the presence of acid-resistant bacilli and blood culture in a specific medium was positive for Mycobacterium tuberculosis. Molecular and immunochromatographic tests were positive for M. tuberculosis, and the diagnosis of Tuberculous Piomyositis was closed.