Molluscum contagiosum on tattoo

Molusco contagioso é uma dermatovirose causada por poxvírus e caracterizada por erupção benigna e autolimitada de uma ou múltiplas pápulas esféricas e brilhantes. A transmissão habitualmente ocorre por contato direto com indivíduos infectados. Relata-se caso de doente masculino, 22 anos, com história de surgimento de numerosas pápulas umbilicadas localizadas estritamente sobre a região de uma tatuagem. Exame histopatológico de uma das pápulas confirmou a hipótese clínica de molusco contagioso. Os autores descrevem uma manifestação pouco frequente da disseminação desse vírus em tatuagens e apresentam uma revisão da literatura, enfatizando as vias de transmissão e a terapêutica do molusco contagioso.Molluscum contagiosum is a disease caused by a poxvirus characterized by benign self-limited eruption of single or multiple cutaneous spherical and pearly papules. Transmission usually occurs by direct contact with infected hosts. It is reported the case of a 22-year-old Caucasian male who presented characteristic pearly and umbilicated papules strictly located on the region of a tattoo. Histopathologic exam confirmed the diagnosis of molluscum contagiosum. The authors describe an uncommomn manifestation of dissemination of this virus in tattoos and also present a literature review emphasizing the transmission pathways and treatment of Molluscum contagiosum

Response of Fibroblastic Rheumatism to Infliximab

Onset is usually sudden with symmetrical articular involvement of both small and large joints, occurrence of solid skin nodules, and rapid progression. Treatment is generally unrewarding. Here we report a severe and disabling case of FR responding favorably to infliximab therapy. After 32 weeks of continuous treatment, skin lesions dramatically improved and arthropathy partially regressed

Psoriasis in childhood and adolescence

A psoríase é doença inflamatória crônica, imunologicamente mediada, recorrente e de caráter universal. Aproximadamente um terço dos adultos acometidos refere início da doença antes dos 16 anos de idade. Quanto mais precoce, mais grave tende a ser a evolução do quadro. Em crianças, as lesões podem ser fisicamente desfigurantes, causando prejuízos psicológicos e evidente comprometimento da qualidade de vida. As medicações sistêmicas utilizadas na psoríase, bem como a fototerapia, têm indicação limitada na infância, devido aos efeitos cumulativos das drogas, à baixa aceitação e ao risco de teratogenicidade. Nesta seção, discutiremos as principais manifestações clínicas da psoríase na infância e na adolescência, bem como os diagnósticos diferenciais, opções terapêuticas e prognóstico.Psoriasis is a chronic, immunologically mediated, recurrent and universal inflammatory disorder. Approximately one third of adults refer onset before 16 years of age. The sooner the onset, the worse is the prognosis. In children, lesions may be physically disfiguring, leading to psychological impairment and evident loss of quality of life. Systemic therapy used in psoriasis, as well as phototherapy, has limited use in children due to accumulative effects of drugs, low acceptance, and risk of teratogenicity. In this section, we discuss the main clinical aspects of psoriasis in childhood and adolescence, differential diagnosis, therapeutic options, and prognosis

Primary Cicatricial Alopecias: A Review of Histopathologic Findings in 38 Patients from a Clinical University Hospital in Sao Paulo, Brazil

BACKGROUND: Scarring alopecias are classified into primary and secondary types according to the initial site of inflammation. In primary scarring alopecias, the hair follicle is the main target of destruction; the term secondary cicatricial alopecia implies that follicular destruction is not the primary pathologic event. AIMS: To review the histopathologic diagnoses of cases of cicatricial alopecia in order to classify them according to the North American Hair Research Society. PATIENTS AND METHODS: Patients with biopsy specimens diagnosed as cicatricial alopecia seen from 2000 to 2005 at the Dermatologic Department of Hospital das Clinicas, São Paulo University Medical School had hematoxylin and eosin, Periodic acid-Schiff and Weigert stained slides reevaluated and sub-typed into different primary cicatricial alopecias. RESULTS: Thirty-eight cases of primary cicatricial alopecias were reclassified as: chronic cutaneous lupus (17), lichen planus pilaris (4), pseudopelade of Brocq (12), folliculitis decalvans (3), dissecting folliculitis (1), and non-specific scarring alopecia (1). In our cases, the methods employed allowed an accurate diagnosis in 12 of 13 cases (92.3%) previously classified as non-specific cicatricial alopecias. CONCLUSIONS: Even in the late, pauci or non-inflammatory phases, an approach with systematic evaluation of a constellation of criteria in routine hematoxylin and eosin stain, Periodic acid-Schiff and Weigert stain allowed for a more accurate diagnosis of cicatricial alopecias

Living near the port area is associated with physical inactivity and sedentary behavior

CONTEXT AND OBJECTIVE: The impact of the port of Santos, Brazil, on the population's health is unknown. We aimed to evaluate the association between living near the port area and physical inactivity and sedentary behavior. DESIGN AND SETTING: Cross-sectional study developed at a university laboratory and a diagnostic clinic. METHODS: 553 healthy adults were selected and their level of physical activity in daily life was assessed using accelerometers. Multiple linear and logistic regressions were performed using physical inactivity and sedentary behavior as the outcomes and living near the port area as the main risk factor, with adjustments for the main confounders. RESULTS: Among all the participants, 15% were resident near the port area. They took 699 steps/day and presented, weekly, 2.4% more sedentary physical activity, 2.0% less time in standing position and 0.9% more time lying down than residents of other regions. Additionally, living near the port area increased the risk of physical inactivity by 2.50 times and the risk of higher amounts of sedentary behavior (>= 10 hours/day) by 1.32 times. CONCLUSION: Living near the port of Santos is associated with physical inactivity and higher sedentary behavior among adults, regardless of confounders. The reasons for this association should be investigated in longitudinal studies.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ Fed Sao Paulo, Lab Epidemiol & Human Movement Epidemiol & Movime, Santos, SP, BrazilUniv Fed Sao Paulo Unifesp, Dept Human Movement Sci, Ave Ana Costa 95, BR-11060001 Santos, SP, BrazilAngiocorpore Inst Cardiovasc Med, Dept Cardiovasc Med, Santos, SP, BrazilInst Coracao InCor, Sao Paulo, SP, BrazilHarvard TH Chan Sch Publ Hlth, Cardiovasc Hlth Program, Boston, MA USADepartment of Human Movement Sciences, Universidade Federal de São Paulo (Unifesp), Santos (SP), BrazilDepartment of Human Movement Sciences, Universidade Federal de São Paulo (Unifesp), Ave Ana Costa 95, BR-11060001, Santos (SP), BrazilFAPESP: 2011/07282-6Web of Scienc

Intensity and physiological responses to the 6-minute walk test in middle-aged and older adults: a comparison with cardiopulmonary exercise testing

The 6-minute walk test (6MWT) is a simple field test that is widely used in clinical settings to assess functional exercise capacity. However, studies with healthy subjects are scarce. We hypothesized that the 6MWT might be useful to assess exercise capacity in healthy subjects. the purpose of this study was to evaluate 6MWT intensity in middle-aged and older adults, as well as to develop a simple equation to predict oxygen uptake (V) over dotO(2)) from the 6-min walk distance (6MWD). Eighty-six participants, 40 men and 46 women, 40-74 years of age and with a mean body mass index of 28 +/- 6 kg/m(2), performed the 6MWT according to American Thoracic Society guidelines. Physiological responses were evaluated during the 6MWT using a K4b2 Cosmed telemetry gas analyzer. On a different occasion, the subjects performed ramp protocol cardiopulmonary exercise testing (CPET) on a treadmill. Peak (V) over dotO(2) in the 6MWT corresponded to 78 +/- 13% of the peak (V) over dotO(2) during CPET, and the maximum heart rate corresponded to 80 +/- 23% of that obtained in CPET. Peak (V) over dotO(2) in CPET was adequately predicted by the 6MWD by a linear regression equation: (V) over dotO(2) mL.min(-1).kg(-1) = -2.863 + (0.0563 x 6MWD(m)) (R-2 = 0.76). the 6MWT represents a moderate-to-high intensity activity in middle-aged and older adults and proved to be useful for predicting cardiorespiratory fitness in the present study. Our results suggest that the 6MWT may also be useful in asymptomatic individuals, and its use in walk-based conditioning programs should be encouraged.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, Lab Epidemiol & Movimento Humano EPIMOV, Dept Ciencias Movimento Humano, Santos, SP, BrazilInst Med Cardiovasc Angiocorpore, Santos, SP, BrazilUniversidade Federal de São Paulo, Lab Epidemiol & Movimento Humano EPIMOV, Dept Ciencias Movimento Humano, Santos, SP, BrazilFAPESP: 2007/08673-3Web of Scienc

Evaluation of dose-response relationship between smoking load and cardiopulmonary fitness in adult smokers: A cross-sectional study

Objective: To evaluate the dose-response relationship between smoking load and cardiopulmonary fitness, as measured with cardiopulmonary exercise testing (CPET), in adult smokers free of respiratory diseases. Methods: After a complete clinical evaluation and spirometry, 95 adult smokers (35 men and 60 women) underwent CPET on a treadmill. Results: The physiological responses during CPET showed lower cardiorespiratory fitness levels, regardless of smoking load, with a peak V-o2(') lower than 100% of the expected value and a lower maximum heart rate. We observed a significant moderate negative correlation between smoking load and peak V-o2('). The smoking load also presented a significant negative correlation with maximum heart rate(r=-0.36p < 0.05), lactate threshold(r=-0.45p < 0.05), and peak ventilation(r=-0.43p<0.05). However, a dose-response relationship between smoking load quartiles and cardiopulmonary fitness was not found comparing quartiles of smoking loads after adjustment for age, sex and cardiovascular risk. Conclusion: There appears to be no dose-response relationship between SL and cardiopulmonary fitness in adult smokers with preserved pulmonary function, after adjusting the analysis for age and cardiovascular risk. Our results suggest that smoking cessation might be useful as the primary strategy to prevent cardiopulmonary fitness decline in smokers, regardless of smoking load. Thus, even a very low dose of tobacco use must be avoided in preventive strategies focusing on becoming people more physically active and fit. (C) 2016 Sociedade Portuguese de Pneumologia. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ Fed Sao Paulo, Lab Epidemiol & Human Movement EPIMOV, Santos, BrazilAngiocorpore Inst Cardiovasc Med, Santos, BrazilUniv Fed Sao Paulo, Lab Epidemiol & Human Movement EPIMOV, Santos, BrazilFAPESP: 2011/07282-6Web of Scienc

Use of cardiopulmonary exercise testing to assess early ventilatory changes related to occupational particulate matter

Spirometry has been used as the main strategy for assessing ventilatory changes related to occupational exposure to particulate matter (OEPM). However, in some cases, as one of its limitations, it may not be sensitive enough to show abnormalities before extensive damage, as seen in restrictive lung diseases. Therefore, we hypothesized that cardiopulmonary exercise testing (CPET) may be better than spirometry to detect early ventilatory impairment caused by OEPM. We selected 135 male workers with at least one year of exposure. After collection of self-reported socioeconomic status, educational level, and cardiovascular risk data, participants underwent spirometry, CPET, body composition assessment (bioelectrical impedance), and triaxial accelerometry (for level of physical activity in daily life). CPET was performed using a ramp protocol on a treadmill. Metabolic, cardiovascular, ventilatory, and submaximal relationships were measured. We compared 52 exposed to 83 non-exposed workers. Multiple linear regressions were developed using spirometry and CPET variables as outcomes and OEPM as the main predictor, and adjusted by the main covariates. Our results showed that OEPM was associated with significant reductions in peak minute ventilation, peak tidal volume, and breathing reserve index. Exposed participants presented shallower slope of Delta VT/Delta lnE (breathing pattern), i.e., increased tachypneic breathing pattern. The OEPM explained 7.4% of the Delta VT/Delta lnE variability. We found no significant influence of spirometric indices after multiple linear regressions. We conclude that CPET might be a more sensitive feature of assessing early pulmonary impairment related to OEPM. Our cross-sectional results suggested that CPET is a promising tool for the screening of asymptomatic male workers.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ Fed Sao Paulo, Dept Ciencias Movimento Humano, Lab Epidemiol & Movimento Humano, Santos, SP, BrazilInst Med Cardiovasc Angiocorpore, Santos, SP, BrazilUniv Fed Sao Paulo, Dept Ciencias Movimento Humano, Lab Epidemiol & Movimento Humano, Santos, SP, BrazilFAPESP: 2011/07282-6Web of Scienc