A 31-year-old Bolivian woman, nonsmoker, mother of two children, whose last pregnancy had occurred 8 years before, presented in our hospital with vaginal bleeding and high levels of ␤-human chorionic gonadotropin (␤hCG) 320 mIU/ml (normal value Ͻ3 mIU/ml). She was submitted to a curettage due to suspected miscarriage. At this moment, the endometrial biopsy showed normal glands, without atypical cells. The gynecology team chose to perform seriated ␤hCG measurements and carry out the clinical follow-up. After 2 months, a new bleeding episode occurred, and the ␤hCG level was 700 mIU/ml; a new curettage was performed, which disclosed proliferative endometrium. At this time, radiological assessment was requested to investi

Purpose: Experimental study aimed at evaluating whether pleural neoplastic disease is associated with the degree of pleural fibrosis over time caused by talc pleurodesis. The study describes changes in levels of inflammatory mediators and determines whether the course of time involved in progression of neoplastic pleural disease is the factor that influences safety of talc pleurodesis usage in mice. Materials and Methods: Animals were randomized into two groups: Cancer group (CG) that received intrapleural injection of Lewis cells or Saline group (SG) that received saline injection. After, the animals were subdivided into Early (pleurodesis 3 days after pleural injection) and Late (pleurodesis 7 days after pleural injection) groups. Half of the animals in each group were euthanized 24 hours after pleurodesis (to obtain the inflammatory data); the remaining animals were killed after 8 days (to obtain the scores of pleural fibrosis). Results: CGs had lower fibrosis scores than SGs comparing early phases to late phases. Inflammation scores were lower in CGs, particularly in Late group. In SGs the inflammation was intense in 100% of the animals. In Late CG group pleural adhesions had the lowest scores; we found intense fibrosis only in SGs. VEGF and LDH levels had increased in animals with cancer, particularly in Late group. Systemic distribution of talc occurred only in Late CG. Conclusions: The time for pleural neoplasia to evolve is inversely proportional to the degree of pleural fibrosis. Earlier pleurodesis yielded the best results related to fibrosis, with less systemic inflammation and is safer in mice.

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Resumo 7). CONCLUSÃO: O tempo de evolução da neoplasia pleural é inversamente proporcional ao grau de fibrose pleural em camundongos submetidos a pleurodese com talco. Quanto mais precoce a pleurodese, melhores os resultados relacionados a fibrose, menor inflamação sistêmica, a circulação do talco é menor e consequentemente, maior a segurança da pleurodese.