ENTOMODERMATOSCOPIA - UM NOVO MÉTODO DE DIAGNÓSTICO EM DERMATOLOGIA GERAL

Among the new applications of dermoscopy, five main fields can be distinguished: dermoscopy of skin infections and infestations (entomodermoscopy), inflammatory skin diseases (inflammoscopy), hair disorders (trichoscopy), nailfold cappilaries (capillaroscopy), and dermoscopy for treatment decisions or treatment monitoring. The term entomodermoscopy, from the words dermoscopy and entomology, has been introduced to describe the use of dermoscopy in the diagnosis of infectious skin disorders. Herein, we report several cases concerning its applicability in the diagnosis of molluscum contagiosum, scabies, lice infestations, viral warts and early cutaneous leishmaniasis.Entre as diversas aplicações da dermatoscopia, distinguem-se cinco campos: dermatoscopia nas infeções e infestações (entomodermatoscopia), nas doenças inflamatórias da pele (inflamoscopia), na patologia do cabelo (tricoscopia), na avaliação da prega ungueal (capilaroscopia), e a sua aplicação na monitorização da resposta à terapêutica não cirúrgica no cancro cutâneo. O termo entomodermatoscopia deriva das palavras dermatoscopia e entomologia, tendo sido introduzido para descrever a aplicação da primeira no diagnóstico das patologias infeciosas da pele. Assim, descrevemos casos clínicos que demonstram a sua utilidade reconhecida no diagnóstico de molusco contagioso, escabiose, pediculose, verrugas virais e leishmaniose cutânea

Apresentação Dermatoscópica e Microscópica Confocal de Melanoma Raro do Mamilo

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Reflectance confocal microscopy for the diagnosis of skin infections and infestations

Reflectance confocal microscopy (RCM) is a noninvasive real-time imaging technique that has been widely used for the diagnosis of skin cancer. More recently, it has been reported as a useful tool for the diagnosis and management of several inflammatory and infectious skin disorders. This article provides an overview of the current available applications of RCM use in cutaneous infections and infestations. PubMed was used to search the following terms in various combinations: reflectance confocal microscopy, skin, hair, nail, infection, parasitosis, mycosis, virus, bacteria. All papers were accordingly reviewed. In most cutaneous infections or infestations, the main alterations are found in the epidermis and upper dermis, where the accuracy of confocal microscopy is nearly similar to that of histopathology. The high resolution of this technique allows the visualization of most skin parasites, fungi, and a few bacteria. Although viruses cannot be identified because of their small size, viral cytopathic effects can be observed on keratinocytes. In addition, RCM can be used to monitor the response to treatment, thereby reducing unnecessary treatments

New World Leishmaniasis: The Role of Confocal Microscopy in Diagnosis and Follow-up - Tropical Dermatology

Cutaneous leishmaniasis may mimic other infections in overlapping endemic areas and timely treatment prevents dissemination of the parasite. The required histopathological and microbiological examinations are not always available, and can only give a deferred confirmation of the diagnosis. In contrast, reflectance confocal microscopy (RCM) allows real-time visualization till the level of papillary dermis. A 59-year-old Brazilian male presented with ulcerated plaques and tumors on the extremities. The clinical differential diagnosis included leishmaniasis and other infections with lymphocutaneous pattern of dissemination. RCM showed the characteristic picture of «eggs in a bird’s nest» which has been described in cutaneous leishmaniasis. The diagnosis of leishmaniasis was later confirmed by skin biopsy, in which Leishmania guyanensis was identified by parasitological examination. After treatment with liposomal amphotericin B, reassessment with RCM corroborated the clinical cure, showing an «empty nest» picture. In conclusion, RCM noninvasively provides useful information for diagnosis and follow-up of cutaneous leishmaniasis

RECIDIVA NA DOENÇA DE HANSEN - ESTUDO RETROSPECTIVO E DESCRITIVO DE 5 ANOS

Introduction: Relapse of Hansen's disease refers to the appearance of new signs and symptoms in patients with a previous diagnosis and who completed the treatment regimen proposed by WHO.Objectives: To determine and characterize relapse cases of Hansen's disease within five years (2008-2012), in Hansen's disease consultation from Hospital Curry Cabral.Material and Methods: We conducted a retrospective and descriptive review of clinical records, identifying cases in a total of 89 patients seen in consultation in that period. The minimum follow-up time was 6 months. In all cases, clinical suspicion of relapse was confirmed by bacteriological and histopathological examination.Results: We identified 4 cases of relapse, which corresponded to 4.5% of patients observed, all with a previous diagnosis of borderline lepromatous clinical form, according to the Ridley-Jopling classification. Therapy has been established for multibacillar forms according to WHO scheme in all cases. Relapses occurred in a follow-up period between 7 and 16 months after treatment discontinuation.Discussion: The frequency of relapse in this population was higher than that observed in most studies. There was poor adherence to therapy in all cases, admitted as the cause of relapse, after excluded other factors. We emphasize the importance of regular monitoring of patients undergoing treatment, to ensure adherence and effectiveness of therapy.Introdução: A recidiva na doença de Hansen refere-se ao aparecimento de novos sinais e sintomas em doentes com diagnóstico prévio e que completaram o esquema de tratamento proposto pela OMS.Objectivos: Determinar e caracterizar os casos de recidiva da doença de Hansen num período de 5 anos (2008-2012), na consulta de doença de Hansen do Hospital Curry Cabral.Material e Métodos: Realizou-se um estudo retrospectivo e descritivo, através da consulta dos processos clínicos, com identificação dos casos num total de 89 doentes observados na consulta no referido período. O tempo mínimo de seguimento foi de 6 meses. Em todos os casos, a suspeita clínica de recidiva foi confirmada por baciloscopias e exame histopatológico.Resultados: Foram identificados 4 casos de recidiva, o que correspondeu a 4,5% do total dos doentes observados, todos com diagnóstico prévio da forma clínica borderline lepromatosa, de acordo com a classificação de Ridley-Jopling. Foi instituída terapêutica para as formas multibacilares de acordo com esquema OMS em todos os casos. As recidivas ocorreram num período de seguimento entre 7 e 16 meses após interrupção do tratamento.Discussão: A frequência da recidiva da doença na população de doentes foi superior à observada na maioria dos estudos. Verificou-se incumprimento da terapêutica em todos os doentes, admitida como causa de recidiva, excluídos outros factores. Destacamos a importância do acompanhamento regular dos doentes em tratamento, permitindo assegurar a adesão à terapêutica e a sua eficácia

Dermatoscopia na Idade Pediátrica – Parte I: Tumores Cutâneos

Melanocytic lesions and other skin tumors represent one of the most frequent reasons for pediatric dermatology consultation. Although often benign, some of them may simulate melanoma, which can be a source of anxiety for parents and clinicians. Dermoscopy is a non-invasive and painless technique that increases the diagnostic accuracy for skin tumours, while avoiding unnecessary skin biopsies. In part I of this article, we highlight the importance of dermoscopy for the diagnosis of skin tumors in pediatric patients.As lesões melanocíticas e outros tumores cutâneos constituem um dos principais motivos de consulta de dermatolo- gia pediátrica. Apesar de serem frequentemente benignos, alguns podem simular o melanoma, sendo um motivo de ansiedade para os pais e clínicos. A dermatoscopia é uma técnica não-invasiva e indolor, que auxilia o diagnóstico de tumores cutâneos, poupando os doentes a biópsias desnecessárias. Na parte I deste artigo, destacamos a importância da dermatoscopia para diagnóstico de patologia cutânea tumoral na idade pediátrica

Dermatoscopia na Idade Pediátrica – Parte II: Dermatoses Infeciosas e Inflamatórias

Dermoscopy is a noninvasive technique that increases diagnostic accuracy of several skin lesions. Being painless, dermoscopy is particularly useful in children, sparing them from unnecessary biopsies and treatments. In part II of this article, we highlight the importance of dermoscopy for the diagnosis and follow-up of infectious and inflammatory skin disorders in pediatric patients.A dermatoscopia é uma técnica não-invasiva, que permite aumentar a acuidade diagnóstica de diversas lesões cutâneas. Sendo um procedimento indolor, a dermatoscopia é particularmente útil nas crianças, poupando-as de biópsias e terapêuticas desnecessárias. Na parte II deste artigo, destacamos a importância da dermatoscopia para diagnóstico e acompanhamento de dermatoses infeciosas e inflamatórias na idade pediátrica

The Dysplastic Nevus

O nevo melanocítico displásico é uma entidade controversa. Os autores realizaram uma revisão da literatura com o objectivo de tentar esclarecer o que é um nevo displásico, quais os critérios actuais para o seu diagnóstico, qual a sua relação com o risco de melanoma e como abordar o doente com história de nevos displásicos.Dysplastic nevus is a controversial identity. The authors make a review of the literature with the aim to characterize what is a dysplastic nevus, the diagnostic criteria, what the relation with melanoma risk is and how to manage a patient with dysplastic nevus

Craft beers fermented by potential probiotic yeast or lacticaseibacilli strains promote antidepressant-like behavior in swiss webster mice

This study aimed to produce a probiotic-containing functional wheat beer (PWB) by an axenic culture system with potential probiotic Saccharomyces cerevisiae var boulardii 17 and probiotic-containing functional sour beer (PSB) by a semi-separated co-cultivation system with potential probiotic Lacticaseibacillus paracasei DTA 81 and Saccharomyces cerevisiae S-04. Additionally, results obtained from in vivo behavioral tests with Swiss Webster mice treated with PWB or PSB were provided, which is scarce in the current literature. Although the use of S. boulardii to produce beers is not a novelty, this study demonstrated that S. boulardii 17 performance on sugar wort stills not completely elucidated; therefore, further studies should be considered before using the strain in industrial-scale production. Co-culture systems with lacticaseibacilli strain and S. cerevisiae have been reported in the literature for PSB production. However, lacticaseibacilli survivability in beer can be improved by semi-separated co-cultivation systems, highlighting the importance of growing lacticaseibacilli in the wort before yeast pitching. Besides, kettle hopping must be chosen as the method for hop addition to produce PSB. The dry-hopping method may prevent iso-alpha formation in the wort; however, a tendency to sediment can drag cells at the tank bottom and negatively affect L. paracasei DTA 81 viability. Despite stress factors from the matrices and the stressful conditions encountered during GI transit, potential probiotic S. boulardii 17 and potential probiotic L. paracasei DTA 81 withstood at sufficient doses to promote antidepressant effects in the mice group treated with PWB or PSB, respectively.The Foundation for Science and Technology (FCT, Portugal) provided financial support by national funds FCT/MCTES to CIMO (UIDB/00690/2020) and the Brazilian National Council for Scientific and Technological Development (CNPq).info:eu-repo/semantics/publishedVersio

Conceptualization, Definition and Assessment of Internal Logistics through Different Approaches Using Artificial Intelligence

The aim of this chapter is to develop a new concept of internal logistics, its components parts and how to evaluate it. To quantify the level of performance of the internal logistics of a company is an important issue to gain competitiveness. There are few papers now at days that analyze how to quantify this issue. In recent years, it has been developed numerous applications of Fuzzy logic and Neural Networks to solve diverse problems of Engineering. Fuzzy logic is a mathematical tool that emulates the method used for humans for managing and processing information and Neural Networks are computing systems inspired by the biological neural networks that constitute human brains. Such systems “learn” to perform tasks by considering examples, generally without being programmed with task-specific rules. This chapter offers a new definition of internal logistics and shows the procedure to evaluate its level in a company. This procedure for assessing the internal logistics was developed through an Excel tab, a fuzzy inference system and a neural network. To validate this procedure, it was applied to 93 companies in the Industrial Pole of Manaus. Results obtained by different approaches are very similar, demonstrating the validity of the procedure developed