25 research outputs found
Cutaneous Metastasis As The First Manifestation Of Occult Malignant Breast Neoplasia
Cutaneous metastases from primary internal malignancies represent 0.7-9% of patients with cancer. We report a 65year-old female patient referred for evaluation of normochromic papules on the trunk and upper limbs that had been present for three months. A skin biopsy revealed diffuse cutaneous infiltration by small round cell tumors. Immunohistochemistry was positive for AE1/ AE3, CK7, estrogen receptor and mammaglobin. The final diagnosis was cutaneous metastasis of occult breast cancer, since the solid primary tumor was not identified. The location of the primary tumor can not be determined in 5-10% of cases. In these cases, 27% are identified before the patient's death, 57% at autopsy, and the remaining 16% can not be located.915110510
Estudo epidemiológico da prevalência de achados sugestivos de papilomavírus humano em pacientes com carcinoma espinocelular de orofaringe e/ou boca em um hospital de referência de Roraima
Introduction: Oropharynx and/or mouth spinocellular carcinoma (CEC-OB) has gained importance due to increased incidence rates and morbidity-mortality. It's associated with multiple factors, whose knowledge is important for early diagnosis and treatment. The emergence of human-papillomavirus (HPV) relationship, responsible for different sociodemographic-behavioral, morphological and symptomatological presentation, as well as better prognosis and therapeutic response is highlighted. Objective: To demonstrate the epidemiological profile of patients treated in Roraima from January/2016-January/2018 with CEC-OB and their findings suggestive of HPV, considering sociodemographic-behavioral factors and associated with the lesion. Methods: Qualitative-quantitative, retrospective and descriptive study. Sampling of 34 patients seen at the High Complexity Unit in Oncology at the General Hospital of Roraima. Analysis of information (gender, age, exposure to smoking and alcoholism, primary tumor location, clinical staging, presence of papilloma, koilocytosis, non-keratinization and P16INK4a expression) of patients medical records included in the proposed criteria after signing the Free and Informed Consent Form and approval by the Research Ethics Committee of the Federal University of Roraima for de number 2.442.554. Statistical analyzes were performed using EpiInfo® 7.1 Windows software (CDC, Atlanta, USA), Microsoft® Office Excel 2013 spreadsheets and Fisher's exact test in the analysis of contingency tables. Results: Of those included, 32% of the patients presented findings suggestive of HPV, with a standard profile, male gender, older than 40 years old, non-smoker, with advanced staging. Conclusion: Although the etiology of CEC-OB for many years has strong association with smoking and alcoholism, HPV has been showing important relation with this neoplasm since its presence was noted.Introdução: O Carcinoma espinocelular de boca e/ou orofaringe (CEC-OB) tem ganhado importância devido aumento nas taxas de incidência e morbimortalidade. Está associado a múltiplos fatores, cujo conhecimento é importante para diagnóstico/tratamento precoce. Destaca-se o surgimento da relação com o Papilomavírus humano (HPV), responsável por diferente apresentação sociodemográfica-comportamental, morfológica e sintomatológica, bem como melhor prognóstico e resposta terapêutica. Objetivo: Demonstrar o perfil epidemiológico de pacientes atendidos em Roraima de janeiro/2016-janeiro/2018 com CEC-OB e achados sugestivos de HPV, considerando fatores ociodemográficos-comportamentais e associados à lesão. Métodos: Estudo qualitativoquantitativo, retrospectivo, descritivo. Amostragem de 34 pacientes atendidos na Unidade de Alta Complexidade em Oncologia no Hospital Geral de Roraima. Análise de informações (gênero, idade, exposição ao tabagismo e etilismo, localização primária do tumor, estadiamento clínico, presença de papiloma, coilocitose, não queratinização e expressão P16INK4a) dos prontuários dos pacientes incluídos pelos critérios propostos após assinatura do Termo de Consentimento Livre e Esclarecido e aprovação pelo Comitê de Ética em Pesquisa da Universidade Federal de Roraima sob número 2.442.554. Para as análises estatísticas utilizou-se o software EpiInfo® 7.1 Windows (CDC, Atlanta, EUA), planilhas do programa Microsoft® Office Excel 2013 e o Teste Exato de Fisher na análise das tabelas de contingência. Resultados: Dos incluídos, 32% dos pacientes apresentaram achados sugestivos de HPV, com um perfil padrão, gênero masculino, maior que 40 anos, etilista e não tabagista, com avançado estadiamento. Conclusão: Ainda que a etiologia do CEC-OB por muitos anos apresente forte associação ao tabagismo e etilismo, o HPV vem mostrando importante relação com essa neoplasia visto que foi notada sua presença
Evaluation of the Quantitative and Qualitative Alterations in the Fatty Acid Contents of the Sebum of Patients with Inflammatory Acne during Treatment with Systemic Lymecycline and/or Oral Fatty Acid Supplementation
Background. Acne is a dermatosis that involves an altered sebum pattern. Objectives. (1) To evaluate if a treatment based on antibiotics (lymecycline) can alter fatty acids contents of the sebum of patients with acne; (2) to evaluate if oral supplementation of fatty acids can interfere with fatty acids contents of the sebum of patients with acne; (3) to evaluate if there is any interaction in fatty acids contents of the sebum of patients with acne when they use both antibiotics and oral supplementation of fatty acids. Methods. Forty-five male volunteers with inflammatory acne vulgaris were treated with 300 mg of lymecycline per day, with 540 mg of γ-linolenic acid, 1,200 mg of linoleic acid, and 510 mg of oleic acid per day, or with both regimens for 90 days. Every 30 days, a sample of sebum from the forehead was collected for fatty acids’ chromatographic analysis. Results. Twelve fatty acids studied exhibited some kind of pattern changes during the study: C12:0, C14:0, C15:0, C16:1, C18:0, C18:1n9c+C18:1n9t, C18:2n6t, C18:3n6, C18:3n3, C20:1, C22:0, and C24:0. Conclusions. The daily administration of lymecycline and/or specific fatty acids may slightly influence some fatty acids levels present in the sebum of patients with inflammatory acne vulgaris
Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.
BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700
Associations between dengue and combinations of weather factors in a city in the Brazilian Amazon
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Previous issue date: 2006Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Entomologia. Laboratório de Transmissores de Hematozoários. Rio de Janeiro, RJ, Brasil / Freitas-Tsouris Consultants. Spata, Attica, Greece.Millersville University of Pennsylvania. Department of Geography. Millersville, Pennsylvania, USA.Universidade Federal de Roraima. Centro de Ciências Biológicas e da Saúde. Núcleo Avançado de Vetores. Convênio Fundação Oswaldo Cruz-Universidade Federal de Roraima. Boa VIsta, RR, Brasil / Freitas-Tsouris Consultants. Spata, Attica, Greece.Universidade Federal de Roraima. Centro de Ciências Biológicas e da Saúde. Núcleo Avançado de Vetores. Convênio Fundação Oswaldo Cruz-Universidade Federal de Roraima. Boa VIsta, RR, Brasil.Universidade Federal de Roraima. Centro de Ciências Biológicas e da Saúde. Núcleo Avançado de Vetores. Convênio Fundação Oswaldo Cruz-Universidade Federal de Roraima. Boa VIsta, RR, Brasil.El dengue se ha convertido en la enfermedad endémica más importante
de Brasil. El estado amazónico de Roraima presenta una de las tasas de incidencia de
dengue más elevadas de ese país. El objetivo del presente estudio fue determinar si
existen relaciones temporales significativas entre el número de casos informados de
dengue y las mediciones climáticas a corto plazo en la ciudad de Boa Vista, capital de
Roraima. De comprobarse esa relación, existiría la posibilidad de predecir el número
de casos de dengue a partir de las condiciones climáticas antecedentes, lo que contribuiría
a desarrollar un sistema de aviso temprano de dengue basado en las mediciones
climáticas en Boa Vista.Dengue has become the most important endemic disease in Brazil. The Amazonian state of Roraima has one of the highest incidence rates of dengue in the country. The objective of this study was to determine whether significant temporal relationships exist between the number of reported dengue cases and short-term climate measures for the city of Boa Vista, the capital of Roraima. If such relationships exist, that suggests that it may be possible to predict dengue case numbers based on antecedent climate, thus helping develop a climate-based dengue early-warning system for Boa Vista
Cutaneous metastasis as the first manifestation of occult malignant breast neoplasia
Cutaneous metastases from primary internal malignancies represent 0.7-9% of patients with cancer. We report a 65year-old female patient referred for evaluation of normochromic papules on the trunk and upper limbs that had been present for three months. A skin biopsy revealed diffuse cutaneous infiltration by small round cell tumors. Immunohistochemistry was positive for AE1/ AE3, CK7, estrogen receptor and mammaglobin. The final diagnosis was cutaneous metastasis of occult breast cancer, since the solid primary tumor was not identified. The location of the primary tumor can not be determined in 5-10% of cases. In these cases, 27% are identified before the patient's death, 57% at autopsy, and the remaining 16% can not be located9151105107sem informaçã