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Dohi's Reticulated Acropigmentation: a Case Report Dohi网状顶色素沉着1例
Pub Date : 2018-01-06 DOI: 10.3823/2544
Adriana Kamilly Leitão Pitman Machado, Danielle Oliveira de Sousa, Miguel Saraty de Oliveira, Débora Bacellar Cruz Nunes, Michelle Fonseca Goiabeira, B. P. Casagrande, W. Loureiro, Samira Oliveira Silveira, C. Mainardi, F. Carneiro
Background: Dohi's Reticulated Acropigmentation is a rare autosomal dominant genodermatosis with high penetrance, characterized by small, irregular, hypo and hyperpigmented macules on the dorsal surface of the distal extremities. Case: The authors report a case of Dohi’s Reticulated Acropigmentation in a 61 years old female patient. The patient complained of spots on hands, feet and posteriorly face involvement since she was 7 years old. Conclusion: Dohi's Reticulated Acropigmentation is a rare clinical condition, which usually appear in childhood and commonly interrupt their onset before adolescence. The diagnosis is based on clinical data, physical examination and histopathological findings. The treatment is unsatisfactory and still no therapy is proposed.
背景:Dohi网状色素沉着是一种罕见的高外显率常染色体显性遗传病,其特征是远端肢体背表面出现小的、不规则的、低色素和高色素的斑点。病例:作者报告了一例61岁女性患者的Dohi网状色素沉着症。患者自诉自7岁起手、脚及后脸有斑点累及。结论:Dohi网状色素沉着症是一种罕见的临床疾病,通常出现在儿童期,通常在青春期前中断发病。诊断是基于临床资料,体格检查和组织病理学结果。治疗效果不理想,仍未提出任何治疗方法。
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引用次数: 0
Transverse myelitis associated with Zika virus infection: a Case Report 与寨卡病毒感染相关的横脊髓炎:1例报告
Pub Date : 2018-01-02 DOI: 10.3823/2543
B. P. Casagrande, Danielle Oliveira de Sousa, Adriana Kamilly Leitão Pitman Machado, C. Mainardi, Carolina Barros Kahwage
Title: Transverse myelitis associated with Zika virus infection: a Case Report.: The zika virus belongs to the family flaviviridae, and is transmitted by the arthropod Aedes aegypt. Its major importance is related to the several debilitating neurological manifestations associated with it, such as transverse myelitis. Case: The authors report a case of transverse myelitis in a patient with a previous diagnosis of Zika virus infection. After the image exams and serology, the diagnosis was confirmed and treatment with prednisone was performed with an unsatisfactory clinical outcome. Conclusion: Brazil is the country of greatest concern worldwide due to the thousands of Zika cases with associated neurological complications, causing sequels and physical disabilities. However, cases worldwide have increased substantially.
标题:与寨卡病毒感染相关的横贯脊髓炎:一例报告。寨卡病毒属于黄病毒科,由节肢动物埃及伊蚊传播。其主要重要性与与之相关的几种衰弱的神经系统表现有关,如横贯脊髓炎。病例:作者报告了一例既往诊断为寨卡病毒感染的患者发生横贯脊髓炎。经影像学检查和血清学检查,确诊并使用强的松治疗,临床结果不理想。结论:巴西是世界上最令人担忧的国家,因为有数千例寨卡病例伴有相关的神经系统并发症,导致后遗症和身体残疾。然而,世界范围内的病例已大幅增加。
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引用次数: 1
Effectiveness in the performance of organ transplants in the State of Paraná, Brazil 巴西帕拉纳州器官移植的有效性
Pub Date : 2018-01-01 DOI: 10.3823/2542
Iriana Oliveira, C. M. D. Souza, M. Galdino, Paloma de Souza Cavalcante Pissinati, L. G. D. Silva, M. Vannuchi, M. Haddad
Objective: To analyze the effectiveness of organ transplants in the state of Parana, Brazil. Methods: A cross-sectional quantitative study was conducted with data from 2,036 solid organ transplants performed in the state between 2011 and 2015. Three indicators were calculated, per capita transplants, meeting the demands of the population and the demand for transplants, which demonstrated the effectiveness and the disparities in the process. The association between the variables was verified by Pearson's Chi-Square test and Fisher's exact test. Results: Most transplants were performed in philanthropic hospitals, male, funded by public funding, and there was an annual increase in the number of transplants per capita and in the productivity of kidney, liver and heart transplantation teams. Although renal transplantation is the most performed in absolute numbers, it served a maximum of 2.2% of its demand. Conclusion: It is necessary to devise strategies to meet the demand for organ transplants, above all, to consolidate the process of donating organs in the state under study.
目的:分析巴西巴拉那州器官移植的有效性。方法:对2011年至2015年在该州进行的2036例实体器官移植的数据进行横断面定量研究。计算了人均移植量、满足人口需求和移植需求三个指标,显示了移植的有效性和过程中的差距。通过Pearson卡方检验和Fisher精确检验验证了变量之间的相关性。结果:大多数移植手术在慈善医院进行,男性,由公共资金资助,人均移植数量和肾、肝、心移植团队的生产力每年都在增加。虽然肾移植在绝对数量上是最多的,但它最多只能满足其需求的2.2%。结论:有必要制定满足器官移植需求的策略,首先要巩固所研究国家的器官捐献进程。
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引用次数: 0
Successful Treatment For Chronic Eosinophilic Leukemia (CEL) With Imatinib Mesylate 甲磺酸伊马替尼成功治疗慢性嗜酸性粒细胞白血病
Pub Date : 2017-12-31 DOI: 10.3823/2539
Rayane da Silva Souza, N. A. C. Tavares, Martina Bragante Fernandes Pimenta, Marcelle Bragante Fernandes Pimenta, Matheus Cartaxo Eloy Fialho, Ary Santos, A. Paz, F. Pimenta
We report a case of a patient with Chronic Eosinophilic Leukemia (CEL) with mutation in alfa PDGFR gene exhibiting a satisfactory response to treatment with imatinib mesylate. A 25-year-old man presented in a hematology service with a persistent cough and hemogram alterations. His blood count showed a hemoglobin level of 12.5 g/dL and a white blood cell count of 94,030/mm3, eosinophils were 68% of all cells. Bone marrow aspiration and biopsy showed hypercellularity with marked eosinophilia (77%) and erythroid differentiation series was hypocellular with normoblast maturation. The immunohistochemically of the bone biopsy was positive for myeloperoxidase and negative for CD34/CD99, consistent with CEL. Fluorescence in situ hybridization (FISH) for the beta-fraction of platelet-derived growth factor (PDGFRβ) and Philadelphia chromosome (Ph 1) were negative and the alfa PDGFR (Platelet-Derived Growth Factor) was positive and showed heterozygosis in c.2531T>C on 18 Exon and homozygous in C.2562+1G>A at the region of the splicing site at the 18 intron. Treatment was initiated and maintained by administering 400mg/day imatinib mesylate. Laboratory findings returned to normal ranges, with clinical improvement and a hematological response observed after the second month of therapy. Currently, the patient’s blood count shows the white blood cell count (5,400 total leukocytes), eosinophils (8.6/mm3), hemoglobin (15.5 g/dl), hematocrit (45.4%) and platelets (298,000/mm3) within normal ranges. The mutation search was negative in in peripheral blood one year after the initial treatment. Our work corroborates other studies on the efficacy of imatinib mesylate in the treatment of patients with CSF PDGFR alpha positive. We emphasize the importance of molecular studies, considering its relevance for the correct staging of the disease. Since CEL is a rare disease, it is important to define its etiology and anticipate its treatment, thus minimizing the damage induced by the disease.
我们报告了一例慢性嗜酸性粒细胞白血病(CEL)患者,其alfa PDGFR基因突变,对甲磺酸伊马替尼治疗表现出满意的反应。一名25岁男子因持续咳嗽和血象改变在血液科就诊。他的血液计数显示血红蛋白水平为12.5 g/dL,白细胞计数为94030/mm3,嗜酸性粒细胞占所有细胞的68%。骨髓抽吸和活检显示细胞高,嗜酸性粒细胞增多(77%),红系分化系列细胞低,成骨细胞成熟正常。骨髓过氧化物酶阳性,CD34/CD99阴性,与CEL一致。血小板衍生生长因子(PDGFRβ)的β级分和费城染色体(Ph 1)的荧光原位杂交(FISH)为阴性,而血小板衍生生长因数(alfa PDGFR)为阳性,在18内含子剪接位点的c.2531T>c中显示杂合,在c.2562+1G>A中显示纯合。通过给药400mg/天甲磺酸伊马替尼开始并维持治疗。实验室检查结果恢复到正常范围,治疗第二个月后观察到临床改善和血液学反应。目前,患者的血液计数显示白细胞计数(5400个总白细胞)、嗜酸性粒细胞(8.6/mm3)、血红蛋白(15.5 g/dl)、红细胞压积(45.4%)和血小板(298000/mm3)在正常范围内。在初次治疗一年后,外周血中的突变搜索为阴性。我们的工作证实了其他关于甲磺酸伊马替尼治疗CSF PDGFRα阳性患者疗效的研究。考虑到分子研究与疾病正确分期的相关性,我们强调了分子研究的重要性。由于CEL是一种罕见疾病,因此重要的是确定其病因并预测其治疗,从而最大限度地减少该疾病引起的损害。
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引用次数: 0
What Are The Benefits In The Association Of SGLT2 Inhibitors And Other Drugs SGLT2抑制剂和其他药物联合使用的益处是什么
Pub Date : 2017-11-22 DOI: 10.3823/2540
Deici Aparecida Gomes Rodrigues, I. Alves, Isabelly de Oliveira Pinheiro, Élida Camilla Nunes Valões, Erich Pires Lisboa
The SGLT2 inhibitors are a class of drugs that blocks the sodium-glucose co-transport, which is responsible for 90% of the nephron glucose. Objective: To show the benefits of the SGLT2 inhibitors in monotherapy and in association with other drugs. Results: The association of SGLT2 inhibitors and other drugs has shown several additional benefits after their interaction, including weight loss, reduction of body fat, reduction of triglycerides level, decrease of glycated hemoglobin, decrease in postprandial glucose level, reduction of arterial pressure, decrease of hypoglycemia risk and improvement of glucose metabolism. Therefore, this is a promising interaction for type 2 diabetes.
SGLT2抑制剂是一类阻断钠-葡萄糖共转运的药物,钠-葡萄糖共转运负责90%的肾单位葡萄糖。目的:显示SGLT2抑制剂在单药治疗和与其他药物联合治疗中的益处。结果:SGLT2抑制剂与其他药物相互作用后显示出一些额外的益处,包括体重减轻、体脂减少、甘油三酯水平降低、糖化血红蛋白水平降低、餐后血糖水平降低、动脉压降低、低血糖风险降低和葡萄糖代谢改善。因此,这是一种很有前景的治疗2型糖尿病的相互作用。
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引用次数: 0
Are There Scientific Evidences that the Stem Cell Use Is Benefic to Patient with Dilated Cardiomyopathy 有科学证据表明干细胞的使用对扩张型心肌病患者有益吗
Pub Date : 2017-11-22 DOI: 10.3823/2541
Isabelly de Oliveira Pinheiro, I. Alves, Élida Camilla Nunes Valões, Deici Aparecida Gomes Rodrigues, Ângelo Roncalli Ramalho Sampaio
The dilated cardiomyopathy (DCM) is one of the most important causes of cardiac insufficiency, leading to morbidity and mortality augment, due to therapeutic restriction. Objective: To search scientific evidences about the treatment of dilated cardiomyopathy with stem cells use. Results: The stem cells use in this pathology has shown benefits through human and animals experiments, verified through images and laboratorial exams. Conclusion: Even with positive results, this treatment requires deeper studies that can show consistent vantages of this therapy in humans.
扩张型心肌病(DCM)是心功能不全的重要原因之一,由于治疗的限制,导致发病率和死亡率增加。目的:探讨应用干细胞治疗扩张型心肌病的科学依据。结果:通过人类和动物实验,通过图像和实验室检查证实,干细胞在这种病理学中的应用显示出益处。结论:即使有积极的结果,这种治疗还需要更深入的研究,才能显示这种治疗在人类身上的一致优势。
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引用次数: 0
Unilateral Duplication Of Parotid Duct. A Rare Anatomical Variation 腮腺导管单侧复制。一种罕见的解剖学变异
Pub Date : 2017-11-16 DOI: 10.3823/2537
Humberto Ferreira Arquez
Background: The paired parotid glands are the largest of the major salivary glands and produces mainly serous secretions. The secretion of this gland reaches the oral cavity through single parotid duct (Stensen’s duct). The parotid duct begins at the anterior border of the gland, crosses the masseter muscle, and then pierces the buccinator muscle to reach the mucosa lining the mouth at the level of the cheek. The purpose of this study is determine the morphologic features of the parotid duct and describe an anatomical variation until now unreported. Methods and Findings: A total of 17 cadavers were used for this study in the Morphology Laboratory at the University of Pamplona. In a cadaver were findings: The main parotid duct originated two conducts: Left superior parotid duct and Left inferior parotid duct, is observed the criss-cross of the ducts, and then perforated the buccinator muscle and entered the oral cavity at a double parotid papilla containing a double opening, separated from each other in 0,98 mm. In the remaining  33 parotid regions (97.06%) the parotid duct is conformed to the classical descriptions given in anatomical textbooks. Conclusions: The parotid duct anatomy is important for duct endoscopy, lithotripsy, sialography and trans-ductal facial nerve stimulation in the early stage of facial palsy in some cases. The anatomical variations also has clinical importance for parotid gland surgery and facial cosmetic surgery. To keep in mind the parotid duct variation will reduce iatrogenic injury risks and improve diagnosis of parotid duct injury.
背景:成对的腮腺是主要唾液腺中最大的,主要产生浆液性分泌物。该腺的分泌物通过单个腮腺管(斯坦森管)到达口腔。腮腺导管从腺体的前边界开始,穿过咬肌,然后刺穿颊肌,到达脸颊水平的口腔粘膜。本研究的目的是确定腮腺导管的形态学特征,并描述一种迄今尚未报道的解剖变异。方法和发现:本研究共使用了潘普洛纳大学形态学实验室的17具尸体。在一具尸体中发现:腮腺主管起源于两个导管:左腮腺上管和左腮腺下管,观察到导管的纵横交错,然后穿过颊肌,在含有双开口的双腮腺乳头处进入口腔,彼此间隔0.98mm。在剩下的33个腮腺区(97.06%)中,腮腺导管符合解剖学教科书中的经典描述。结论:在某些病例的面瘫早期,腮腺导管解剖对导管内镜、碎石、唾液酸造影和经导管面神经刺激具有重要意义。解剖变异对腮腺手术和面部美容手术也具有临床意义。要记住腮腺导管的变异将降低医源性损伤的风险,并提高腮腺导管损伤的诊断水平。
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引用次数: 1
Anatomical Variation Of The Submandibular Gland Duct. A Unreported Anomaly 下颌下腺管的解剖学变异。未报告的异常
Pub Date : 2017-11-16 DOI: 10.3823/2538
Humberto Ferreira Arquez
Background: The submandibular gland is the second largest major salivary gland and weighs 7–16 gr. The gland is located in both sides of the face, at the same level of the body of the jaw, in the submandibular triangle, The submandibular duct or Wharton’s duct exits anteriorly, coursing deep to the lingual nerve and medial to the sublingual gland, the main excretory duct of the submandibular gland, whose diameter is of 2 to 3mm and approximately 4–5 cm long. It empties lateral to the lingual frenulum through a papilla in the floor of the mouth behind the lower incisor tooth. The purpose of this study is determine the morphologic features and describe an unusual anatomical variation of the path of the submandibular duct. Methods and Findings: A total of 17 cadavers were used for this study in the Morphology Laboratory at the University of Pamplona. In a cadaver were findings: The excretory duct of the left submandibular gland had an external location that ascends and crosses vertically off the body of the mandible, in its termination it is divided in four ducts that had separate openings into the oral cavity upon a small papillas independent, opposites to the first and second lower molar Crown. Conclusions: Awareness of potential variations of the excretory ducts of the salivary glands can aid in the accurate diagnosis and treatment of patients with salivary conditions as well as help surgeons avoid further complications or duct lacerations during surgical procedures.
背景:下颌下腺是第二大唾液腺,重7-16克。该腺位于面部两侧,与下颌身体处于同一水平,处于下颌下三角。下颌下管或沃顿管位于前方,深入舌神经和舌下腺内侧,下颌下腺的主要排泄管,直径为2至3毫米,长约4至5厘米。它通过下门牙后面口腔底部的乳头排空舌系带的外侧。本研究的目的是确定下颌下管路径的形态学特征,并描述一种不寻常的解剖变异。方法和发现:本研究共使用了潘普洛纳大学形态学实验室的17具尸体。在一具尸体中发现:左侧下颌下腺的排泄管有一个外部位置,它向上垂直穿过下颌骨,在其末端,它被分成四个管道,在一个独立的小乳头上有单独的开口进入口腔,与第一和第二下臼齿冠相对。结论:了解唾液腺排泄管的潜在变异有助于准确诊断和治疗唾液疾病患者,并帮助外科医生避免手术过程中出现进一步的并发症或管道撕裂。
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引用次数: 2
Nervous Communications In The Upper Limb. A Cadaveric Study 上肢的神经交流。尸体研究
Pub Date : 2017-11-16 DOI: 10.3823/2536
Humberto Ferreira Arquez
Background: Anatomical variations of the terminal branches of the brachial plexus in terms of communication between nerves at the level of upper limb have been reported, these communications were median and musculocutaneous nerve, median and ulnar nerve, radial and ulnar nerve (at level humeral), but communications between the radial and ulnar nerve at level of the forearm are very rare. Methods and Findings: 34 upper extremities of 15 male and 2 females embalmed adults cadavers in the laboratory of Morphology of the University of Pamplona. The upper limbs were studied serially during the years 2013-2016. Of the 34 upper limbs studied in the Laboratory of Mor­phology of the University of Pamplona, in a 75 year-old male cadaver anatomical variations were found, dissected carefully and morphological details were photographed, these variations consisted of nervous communications between median and musculocutaneous nerve in the arm, median and ulnar nerve in the forearm, radial and ulnar nerve in the forearm. Conclusions: Knowledge of these communications is of clinical significance. Surgical, therapeutic and diagnostically invasive procedures require extreme caution to prevent lesions of the anastomotic branches.
背景:臂丛末端分支在上肢水平神经之间的交通方面的解剖变化已经被报道过,这些交通是正中和肌肉皮神经,正中和尺神经,桡和尺神经(肱骨水平),但前臂水平的桡和尺神经之间的交通是非常罕见的。方法与发现:对西班牙潘普洛纳大学形态学实验室保存的15具男性尸体和2具女性尸体的34具上肢进行了防腐处理。2013-2016年对上肢进行了连续研究。在潘普洛纳大学形态学实验室研究的34个上肢中,在一具75岁男性尸体上发现了解剖变异,仔细解剖并拍摄了形态学细节,这些变异包括上肢正中神经与肌皮神经之间的神经通讯,前臂正中神经与尺神经之间的神经通讯,前臂桡神经与尺神经之间的神经通讯。结论:了解这些沟通具有临床意义。手术,治疗和诊断侵入性的程序需要非常谨慎,以防止病变的吻合分支。
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引用次数: 0
The Behavior Associated to Death from External Causes in Elderly People in Brazil 巴西老年人与外部原因死亡相关的行为
Pub Date : 2017-11-16 DOI: 10.3823/2535
Eliana Barreto Fixina, E. Maia, Dario de Queiroz Ribeiro
METHODS: This is an ecological study that aimed to understand the behaviour of deaths from external causes in the population older than 60 years old in all Brazilian states. The data was collected using the Brazilian Mortality Information System and the population data from the Brazilian Institute of Geography and Statistics and from the SUS Informatics Department organized in historic series from 1995 to 2010. RESULTS AND CONCLUSIONS: It is not possible to deny that deaths from external causes in elder citizens is not in an increasing and statistically significant tendency in most Brazilian states. This brings preoccupation about the issue, since discussions on the subjects are limited in the country, which makes this study good for future references in the field.
方法:这是一项生态学研究,旨在了解巴西所有州60岁以上人群因外部原因死亡的行为。这些数据是使用巴西死亡率信息系统以及巴西地理和统计研究所和SUS信息学部1995年至2010年历史系列的人口数据收集的。结果和结论:不能否认,在巴西大多数州,老年人的外部原因死亡没有增加和统计上显著的趋势。这引起了人们对这个问题的关注,因为在国内对这些主题的讨论是有限的,这使得这项研究有利于未来在该领域的参考。
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引用次数: 0
期刊
International archives of medicine
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