Linear verrucous epidermal nevus with oral manifestations: report of two cases

Linear verrucous epidermal nevi (LVEN) are characterized by verrucous papules often coalescing into well-demarcated skin-colored or brown plaques following the lines of Blaschko. We present two new cases of LVEN with oral mucosa involvement and briefly discuss this very rare finding. In both cases, oral biopsies showed hyperkeratosis, acanthosis, and papillomatosis. Although several treatment modalities have been reported for the cutaneous lesions, there is no consensus for the management of oral lesions so far

Does sleep deprivation and morphine influence wound healing?

The contrast between present-day sleep habits and those of the pre-industrial era are quite evident. One study recent has shown that the amount of sleep has decreased 2 h per night over the past 50 years. Such sleep curtailment, ubiquitous in the modern lifestyle, inflicts adverse repercussions upon health and well being. Investigations examining the relationship between stress and the skin have shown that different types of stress affect the healing process. Morphine is an immunosuppressive drug, and when it is used chronically, it can lead to an increased incidence of infections and a delay in the healing process. Therefore, our hypothesis is that the lack of sleep associated with chronic treatment with morphine is detrimental to the healing of the skin in the animal model we have adopted. Thus, it is important that future studies consider the paradigm of sleep curtailment when investigating the mechanisms involved in the process of skin healing in individuals who are dependent on morphine. (C) 2011 Elsevier B.V. All rights reserved.Associacao Fundo de Incentivo a Pesquisa (AFIP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, Dept Psicobiol, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Dermatol, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psicobiol, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Dermatol, BR-04024002 São Paulo, BrazilFAPESP: 98/14303-3Web of Scienc

Avaliação preoperatória de nódulos thireóides: papel da ultrassonografia e da biópsia de aspiraçào por agulha fina, seguida de citologia

PURPOSE:To evaluate the preoperative assessment of thyroid nodules using ultrasound studies and cytology of nodular aspirates. SUBJECTS AND METHODS: 2,468 patients with thyroid nodules were examined from 1999 to 2005. All patients were clinically examined and underwent ultrasonography followed by fine-needle aspiration biopsy (FNAB) and cytology. RESULTS:Nodules larger than 10 mm were classified ultrasonographically in a 4-tier system and received a score according to the criterion of possible malignancy. Cytological examinations were conducted independently by 2 cytologists and classified as benign (score 1), indeterminate (score 2), suspicious (score 3), and malignant (score 6). Combining both scores, an index was generated that would indicate a higher probability of malignancy (benign, doubtful, suspicious, and malignant). Thyroid surgery was performed in 274 patients. Of those, 115 patients had a score of 2 to 5 and only 8 had a histological diagnosis of thyroid cancer (6.9%). For patients with a score of 5 (n = 51), 11.5% had a malignant lesion, and 51% of the 61 patients with a score of 6 had confirmed thyroid cancer. Of the 98 patients with a combined score of 7 to 10, 99% had a histological confirmation of malignancy. CONCLUSIONS: The index score had a sensitivity of 94.1% and specificity of 77.5%. The overall accuracy was 85.8%. Therefore, we concluded that this methodology may improve the preoperative diagnosis of thyroid cancer in nodules larger than 10 mm. Association with other methods such as color Doppler echography, serum TSH concentration, galectin-3 expression analysis, and FDG/PET scan would be useful in avoiding the higher costs of thyroid surgical procedures.OBJETIVO: Avaliar a possibilidade de diagnóstico pré-operativo de nódulos da tireóide (de diâmetro superior a 10mm) usando ultra-sonografia da glândula tireóide e citologia de punção aspirativa por agulha fina guiada pela ultra-sonografia. CASUÍSTICA E MÉTODOS: Nódulos tireóideos (maiores que 10mm) foram classificados ultra-sonograficamente em graus de I a IV e escores numéricos de 1 a 4, de acordo com crescente possibilidade de malignidade. O exame citológico, subseqüentemente, classificou os nódulos como benigno (escore 1) indeterminado (escore 2) suspeito (escore 3) e maligno (escore 6). Somando-se os escores obtidos nas duas metodologias obtém-se um índice considerado benigno (índice combinado 2-4), duvidoso (índice combinado 5) suspeito para malignidade (índice combinado 6) e elevada probabilidade de malignidade (índice combinado 7 a 10). Cirurgia da Tireóide foi realizada em 274 pacientes, dos quais 64 apresentavam índice de 2-4; destes, apenas 2 pacientes (3,1%) apresentaram comprovação histológica de câncer. Em pacientes com índice 5 (n= 51), 11,8% apresentaram câncer de tireóide e, em 61 pacientes com índice 6, (n= 31), 51% tiveram diagnóstico confirmado de malignidade. O índice combinado de 7-10 (n= 98) apresentou 99% de pacientes com câncer de tireóide. CONCLUSÕES: O índice combinado apresentou sensibilidade de 94,1% e especificidade de 77,5%. A precisão desta metodologia foi de 85,8%. Concluímos que o índice combinado pode ser útil no diagnóstico pré-cirúrgico do nódulo tireóideo, mormente se associado com outras metodologias como a ecografia com Doppler colorido, nível elevado de TSH sérico, análise de expressão de galectina-3 e imagens por FDG/PET

Detecção de infecção pelo Mycobacterium leprae em tatus selvagens da espécie Dasypus novemcinctus utilizando o teste rápido ML Flow

Mycobaterium leprae infection was investigated in armadillos from the State of Espírito Santo, Brazil. The ML Flow test was performed on 37 nine-banded armadillos and positive results were found in 11 (29.7%). The ML Flow test may be used to identify possible sources of Mycobaterium leprae among wild armadillos.Tem sido pesquisado infecção pelo Mycobaterium leprae em tatus provenientes do estado do Espírito Santo-Brasil. O teste rápido ML Flow, foi realizado em 37 tatus selvagens, tendo sido positivo em 11 (29,7%). O teste de ML Flow pode ser utilizado para identificar possíveis fontes de Mycobaterium leprae em tatus selvagens.Universidade Federal do Espírito Santo Centro de Ciências da Saúde Departamento de Medicina SocialUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de DermatologiaUNIFESP, EPM, Depto. de DermatologiaSciEL

Epidemiological profile of nonmelanoma skin cancer in renal transplant recipients: experience of a referral center

BACKGROUND: Nonmelanoma skin cancer is the most common form of cancer in humans and also the malignant disease that is increasingly common among kidney transplant recipients. OBJECTIVE: To determine the epidemiological characteristics of renal transplant recipients with nonmelanoma skin cancer seen at a referral transplantation center. METHODS: Cross-sectional descriptive study with renal transplant recipients presenting nonmelanoma skin cancer, treated at a transplantation referral center between 08/01/2004 and 08/31/2009. Analyzed variables were: gender, age, skin phototype, occupational and recreational sun exposure, use of photoprotection, personal and family history of non-melanoma skin cancer, clinical type and location, time between transplantation and the appearance of the first nonmelanoma skin cancer, occurrence of viral warts, timing of transplantation, type of donor, cause of kidney failure, previous transplants, comorbidities, pre-transplant dialysis, type and duration of dialysis. RESULTS: 64 subjects were included. Males - 71.9%; low skin phototypes (up to Fitzpatrick III) - 89%; mean age - 57.0 years - and mean age at transplant - 47.3 years; sun exposure - 67.2% occupational - and 64.1% recreational; photoprotection - 78.2% (although only 34.4% in a regular manner); squamous cell carcinoma - 67.2%; squamous cell carcinoma/basal cell carcinoma ratio - 2:1; personal history of nonmelanoma skin cancer - 25% - and family history - 10.9%; location at photoexposed area - 98.4%; average latency time between transplantation and first nonmelanoma skin cancer appearance - 78.3 months; viral warts (HPV) after transplant - 53.1%; average timing of transplantation - 115.5 months; living donor - 64.1%; triple regimen (antirejection) - 73.2%; comorbidities - 92.2%; pre-transplant dialysis - 98.4%; hemodialysis - 71.7%; average duration of dialysis - 39.1 months; previous transplants - 3.1%; hypertension as cause of renal failure - 46.9%. CONCLUSION: This study allowed the epidemiological characterization of a population of kidney transplant recipients with nonmelanoma skin cancer.Universidade de TaubatéUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Acne-specific quality of life questionnaire (Acne-QoL): translation, cultural adaptation and validation into Brazilian-Portuguese language

BACKGROUND: many studies about the psychosocial impact of acne have been reported in international medical literature describing quality of life as a relevant clinical outcome. It is well known that the patient's perception about the disease may be different from the physician's evaluation. Therefore, it is important to use validated instruments that turn the patient's subjective opinion into objective information. OBJECTIVES: to translate into Brazilian-Portuguese language and to culturally adapt a quality of life questionnaire, the Acne-Specific Quality of Life Questionnaire (Acne-QoL), as well as to evaluate its reliability and validity. METHODS: measurement properties were assessed: 1) validity: comparison between severity and Acne-QoL domain scores, correlations between acne duration and Acne-QoL domain scores, and correlation between Acne-QoL domain scores and SF-36 components; 2) internal consistency: Cronbach's α coefficient; 3) test-retest reproducibility: intraclass correlation coefficient and Wilcoxon test. RESULTS: Eighty subjects with a mean age of 20.5 ± 4.8 years presenting mild (33.8%), moderate (36.2%) and severe (30%) facial acne were enrolled. Acne-QoL domain scores were similar among the different acne severity groups except for role-social domain. Subjects with shorter acne duration presented significant higher scores. Acne-QoL domains showed significant correlations, both between themselves and with SF-36 role-social and mental health components. Internal consistency (0.925-0.952) and test-retest reproducibility were considered acceptable (0.768-0.836). CONCLUSIONS: the Brazilian-Portuguese version of the Acne-QoL is a reliable and valid satisfactory outcome measure to be used in facial acne studies.Universidade Federal de São Paulo (UNIFESP) Department of DermatologyUNIFESP, Department of DermatologySciEL

A inteligência competitiva e a área de informação tecnológica no Instituto de Pesquisas Tecnológicas do Estado de São Paulo S.A.

O artigo apresenta uma avaliação da mudança de paradigma que está sendo implementada na atual gestão do Centro de Informação Tecnológica (Citec), do Instituto de Pesquisas Tecnológicas do Estado de São Paulo (IPT-SP). Busca-se demonstrar a atuação do profissional de informação como agente de mudança e as formas como pode intervir na cultura da organização, dentro da nova estratégia do IPT , de compartilhamento dos riscos e benefícios do desenvolvimento tecnológico entre os setores produtivo, privado e público

Ultrasonographic evaluation of the thyroid, determination of ioduria and iodine concentration in kitchen salt used by schoolchildren in Ribeirão Preto, São Paulo, Brazil

OBJETIVO E MÉTODOS: Estudos prévios apontaram Ribeirão Preto, São Paulo, como área de carência limítrofe de iodo e, posteriormente, de iodação excessiva. Reavaliando seu estado iódico em 2007-2008, foram analisados 300 escolares entre 8 e 10 anos de idade, procedentes de três escolas de diferentes níveis socioeconômicos e realizadas dosagens de iodo urinário e da concentração de iodo no sal doméstico e ultrassonografia tireoidiana. RESULTADOS E CONCLUSÃO: A iodúria foi superior na escola com maior nível socioeconômico, comparada às outras, e a diferença foi significante aos 8 e 10 anos para os meninos (p < 0,0001 e p = 0,0106, respectivamente) e aos 8 e 9 anos para as meninas (p = 0,0024 e p = 0,0154, respectivamente). As concentrações medianas de iodo em amostras de sal doméstico variaram entre 26,6 e 27,8 mg iodo/kg e não foram diferentes nas escolas estudadas. À ultrassonografia, 15,6% das tireoides examinadas apresentaram-se hipoecoicas, sugerindo que elas possam apresentar mudanças em sua arquitetura sem ainda alterar seus volumes.OBJECTIVE AND METHODS: Previous studies have pointed out that Ribeirão Preto, São Paulo, is an area of borderline iodine deficiency, later becoming a region of excessive iodination. In a reevaluation of the iodine status of the city in 2007-2008, 300 schoolchildren aged 8 to 10 years were evaluated, from 3 schools of 3 different socioeconomic levels who were submitted to the determination of iodine concentration in urine samples and in kitchen salt and thyroid ultrasound. RESULTS AND CONCLUSION: Among boys and girls ioduria was higher in the school of highest socioeconomic level compared to the others, with a significant difference in the ages 8 and 10 years for boys with ranges : p < 0,0001 and p = 0,0106, respectively; and in the ages 8 and 9 years for girls with ranges: p = 0,0024 and p = 0,0154, respectively. Median iodine concentrations in samples of kitchen salt ranged from 26.6 to 27.8 mg iodine/kg and did not differ between the schools studied. Ultrasound evaluation revealed that 15,6% of thyroids examined were hypoechoic, suggesting that these glands may present changes in the architecture not reflected yet in their volume

Inhibitory effects of flavonoids on human immunodeficiency virus type-I integrase

One hundred and eighty-three flavonoids were screened for their inhibitory effects on HIV-l integrase (IN) using a multiplate integration assay (MIA). Of the tested flavonoids, 6-hydroxyluteolin, scutellarein, pedalitin, scutellarin, baicalein dimer, hypolaetin, 7-O-benzyl-6-hydroxyluteolin and baicalein showed appreciable inhibition with IC_ values of 0.4, 0.6, 1.3, 1.7, 2.0, 2.1, 3.0 and 3.6 μM, respectively. The potent inhibition was observed with flavonoids having at least one pair of vicinal hydroxyl groups and the activity was highly dependent on the number of vicinal hydroxyl groups. On the other hand, the inhibitory activity tended to be decreased by replacing a hydroxyl group with one of methoxyl, acetoxyl, isopropoxyl, isopentenyl, benzyloxyl, glucuronyl and glycosyl groups. No flavanones, flavanonols and chalcones examined in this experiment showed any significant inhibitory activity. マルチプレートインテグレーション法を用いて183種のフラボノイド類のHIV-1インテグラーゼ阻害効果を検討した。これらのうち6-hydroxyluteolin, scutellarein, pedalitin, scutellarin, baicalein二量体,hypolaetin,7-O-benzyl-6-hydroxyluteolinおよびbaicaleinは強い阻害を示し,それらの50%阻害濃度はそれぞれ0.4, 0.6, 1.3, 1.7, 2.0 ,2.1 ,3.0および3.6μMであった。フラボノイド類による阻害には少なくとも一対の隣接したヒドロキシル基が必要であった。また,隣接したヒドロキシル基の数が増加するに従い,HIV-1インテダラーゼ阻害活性も上昇した。他方,ヒドロキシル基がmethoxyl基, acetoxyl基, isopropoxyl基, isopentenyl基, benzyloxyl基, glucuronyl基 及びglycosyl基に置換されると阻害活性は減少あるいは消失した。試験したフラバノン,フラバノール,カルコン類には顕著な阻害活性は認められなかった

Prevalence and heritability of psoriasis and benign migratory glossitis in one Brazilian population

Background: An oral condition associated to psoriasis is benign migratory glossitis. The review of the literature does not show any publication about heritability in both psoriasis and benign migratory glossitis and prevalence of psoriasis in the Brazilian population. Objective: This research was carried out in order to determine the prevalence of psoriasis and benign migratory glossitis in the Brazilian population from a Brazilian sample, as well as the heritability in these conditions. Methods: Six thousand patients were studied from the records of the outpatient dermatology department. The sample had 129 patients with cutaneous psoriasis, 399 with benign migratory glossitis without psoriasis and a control group with 5,472 patients. After data collection, the statistical analysis was made using Woolf, Chi-square and Falconer tests. Results: The prevalence of psoriasis was 2.15% and the benign migratory glossitis was 7.0%. The prevalence of benign migratory glossitis in the psoriasis group was high (16.3%), and that was statistically significant. Family history in the psoriasis group was 38% for the condition itself and 2,75% for benign migratory glossitis and in the benign migratory glossitis group was 17.54% for the condition itself and 1.5% for psoriasis. The study of heritability was 38.8% for psoriasis and 36.6% for benign migratory glossitis, both with medium heritability. Study limitations: This study was only in the state of Sao Paulo. Conclusion: This is the first publication that quantifies how much of these conditions have a genetic background and how important the environmental factors are in triggering them.Univ Marilia Unimar, Sch Med, Discipline Dermatol, Marilia, SP, BrazilCESD, Res Ctr, Dracena, SP, BrazilUniv Fed Sao Paulo Unifesp, Dept Dermatol, Sao Paulo, SP, BrazilUniv Fed Fluminense, Sch Med, Dept Pathol, Niteroi, RJ, BrazilUniv Fed Sao Carlos UFSCar, Fac Hlth Sci, Dept Genet & Evolut, Sao Carlos, SP, BrazilUniv Fed Sao Paulo Unifesp, Dept Dermatol, Sao Paulo, SP, BrazilWeb of Scienc