We describe the fifth case of mucoepidermoid carcinoma. The patient had penile ulcer with bilateral inguinal and pelvic lymphadenopathy and underwent total penectomy. After antibiotic therapy, the patient began outpatient chemotherapy, but the treatment was discontinued due to his intolerance. The patient died due to infectious complications of the inguinal lymphatic fistula 7 months after the histological diagnosis. Notably, the periurethral area was involved in the anatomopathological evaluation of the excised penis. The penile mucoepidermoid carcinoma was aggressive and the perimeatal region was involved. This case helps demystify the origins and prognosis of this rare case. More reports documenting patient characteristics and their evolution with penile mucoepidermoid carcinoma are needed. IntroductionSquamous cell carcinoma (SCC) accounts for 95% of the histological types of penile cancer, 1 but other rarer types, such as mucoepidermoid carcinoma (MC), may also affect the penis. The origin of SCC of the penis is usually the scamous epithelial surface, while the MC of the penis does not have a known source. Glans cancer frequently arises from the periurethral glands of Littré, bulbar Cowper, and sweat glands. 2-4The prognosis of penile cancer in its early stages is good. The survival and the risk of metastasis of SCC of the penis are different according to histologic variants. The histological subtypes verrucous, papillary, and verrucoid are low risk, and the usual SCC is intermediate risk and the sarcomatoid or basaloid variants are high risk.5 Although non-SCC types are not classified in risk, their behaviour and prognosis can be ascertained. Basal cell carcinomas are highly curable and have a low potential for metastasis; they are prone to local recurrence, but metastases are rare and the melanomas are aggressive but can be cured if treated early. 6 The adenosquamous carcinoma is locally aggressive, with high histologic grade differentiation at diagnosis and a high rate of lymphovascular invasion.7 It well-known that, generally, metastatic tumours to the penis have a poor prognosis.6 MC of the penis is extremely rare and has a pattern of behavior has not yet been established.We used 4 databases for our analysis (PubMed, Portal de Periódicos da Capes, Lilacs, and SciELO) on February 17, 2014. We searched without filtres and with the intersection of the following MESH terms: "Penile neoplasms" versus "Mucoepidermoid Tumour" or "Carcinoma, Mucoepidermoid" and "Penis" versus "Mucoepidermoid Tumor" or "Carcinoma, Mucoepidermoid." In doing so, we identified 4 cases of primary penile MC (Table 1). This is the fifth case, which adds to the literature and helps delineate the behaviour and origin of this disease. Case reportOur patient, a 47-year-old had a wound on the penis after circumcision. He sought medical attention 45 days after lesion onset; it was a single lesion, showing ulcerative and infiltrative aspect, about 7 cm, occupying the entire glans and about four-fifths of the distal penile shaft (Fig...

ABSTRACT.-Moura L.R., Orpinelli S.R.T., Sousa J.H., Faleiro M.B.R., Conceição E. Goiânia, Doxorubicin (DOX) is a chemotherapic drug used in the treatment of malignancies, but has the cardiotoxicity as collateral effect. The objective of this study was to evaluate the action of pequi shell etanolic extract (Caryocar brasiliense) (PSEE) through morphological evaluation (macroscopic, microscopic and ultramicroscopic), and to evaluate the expression of metalloproteinases (MMP2 and MMP9) and its tissue inhibitors (TIMP1 and TIMP2) in the myocardium of rats with chronic cardiotoxicity by DOX and treated or not with PSEE. The experiment lasted three months and 30 Wistar rats were divided into six groups of five animals. G1 and G2 received 300mg/kg and 600mg/kg of PSEE, respectively, as pretreatment, by gavage for seven days and continued treatment for 21 days of application of DOX. In G1, G2, G3, G4 and GC, cardiotoxicity was induced with weekly applications of 2mg/kg DOX, intraperitoneally, totaling four applications (8 mg/kg), and in the Sham group (GS) 1ml of saline solution was applied. G3 animals received daily 300mg/ kg of PSEE, and G4, 600mg/kg, by gavage, for 21 days of application of DOX. The GC and GS received 1ml of water daily by gavage also. After the completion of the application, the animals were kept for two months, with three months of experiment. Macroscopic evaluation was performed after 90 days, at which time samples were taken for analysis in electron microscopy, histopathology and immunohistochemistry. At necropsy, ascites was observed in animals that received DOX. There was a low mortality rate (3.33%), being one mouse that developed false road pneumonia. There was no change in weights and measures of the rat hearts. At doses of 300 and 600mg/kg, the PSEE attenuates myocyte vacuolar degeneration. At a dose of 600mg/kg, PSEE reduces amount Anitschkow cells. There was no significant result on the immunostaining of MMP, but considering their inhibitors (TIMP) there was a greater immunostaining of TIMP2 in GC, the group that received only DOX. It was concluded that PSEE is effective in minimizing effects of chronic cardiotoxicity induced by DOX in the myocardium of rats, whereas at doses of 300 and 600mg/ 1 Recebido em 13 de abril de 2016.Aceito para publicação em 12 de setembro de 2016.

Hypersensitivity pneumonitis is a diffuse interstitial and granulomatous lung disease caused by the inhalation of any one of a number of antigens. The objective of this study was to illustrate the spectrum of abnormalities in high-resolution computed tomography and histopathological findings related to hypersensitivity pneumonitis. We retrospectively evaluated patients who had been diagnosed with hypersensitivity pneumonitis (on the basis of clinical-radiological or clinical-radiological-pathological correlations) and had undergone lung biopsy. Hypersensitivity pneumonitis is clinically divided into acute, subacute, and chronic forms; high-resolution computed tomography findings correlate with the time of exposure; and the two occasionally overlap. In the subacute form, centrilobular micronodules, ground-glass opacities, and air trapping are characteristic high-resolution computed tomography findings, whereas histopathology shows lymphocytic inflammatory infiltrates, bronchiolitis, variable degrees of organizing pneumonia, and giant cells. In the chronic form, high-resolution computed tomography shows traction bronchiectasis, honeycombing, and lung fibrosis, the last also being seen in the biopsy sample. A definitive diagnosis of hypersensitivity pneumonitis can be made only through a multidisciplinary approach, by correlating clinical findings, exposure history, high-resolution computed tomography findings, and lung biopsy findings.

Análise dos hábitos alimentares e da prática de atividade física em discentes de medicina Analysis of alimentary habits and physical exercise on medicine students

Objetivo: Identificar a prevalência bacteriana em mão, estetoscópio e celulares de profissionais e acadêmicos de saúde em enfermarias de um hospital filantrópico em Anápolis, Goiás, avaliando-se o perfil de sensibilidade das bactérias isoladas a beta-lactâmicos e verificar a ocorrência de práticas de higienização para estetoscópios e ou celulares. Métodos: estudo observacional, transversal e descritivo. Os pesquisados foram submetidos à aplicação de questionário e à coleta de amostra biológica. As amostras foram testadas para a pesquisa de bactérias do gênero Staphylococcus spp e para bacilos gram-negativos com destaque para enterobactérias produtoras de beta-lactamase de espectro estendido (ESBL) e Staphylococcus aureus resistente à oxacilina (ORSA). Resultados: foram avaliadas 60 amostras de mãos, 59 celulares e 19 estetoscópios, observando-se contaminação de 86,7% amostras de mãos, 89,8% de celulares e 94,7% de estetoscópios. A maior prevalência de ORSA foi observada em amostras de estetoscópios (25%). Não foi documentado isolamento de ESBL. A não adesão à prática de higienização de estetoscópios e celulares foi verificada em 26,3% e 27,1% dos participantes, respectivamente. Observou-se que as mãos de estudantes de medicina, terapeutas e outros profissionais exibiram maior taxa de contaminação. Conclusões: foram verificadas altas taxas de contaminação em fômites e mãos de acadêmicos e profissionais de saúde em enfermarias. A importância conferida em relação à higienização das mãos é maior comparada aos fômites pesquisados.

BackgroundThe number of malignancies increased alarmingly. Surgery constitutes one of the most efficient therapeutic modalities for the treatment of solid tumors. The neoplastic implant in surgical wound is a complication whose percentage of occurrence reported in the literature is variable, but sets with high morbidity and therapeutic difficulties. Protecting the wound is one of the recommended principles of oncologic surgery.AimTo evaluate the influence of wound protection in the development of tumor implantation.MethodsSarcoma 180 tumor cells were used, with intraperitoneal inoculation in Swiss mice. After the establishment of neoplastic ascites, animals were randomized into two groups of 10, each group consisting of five males and five females. In both groups, laparotomy and manipulation of intra-abdominal organs was performed. In a group laparotomy was performed using the protection of the abdominal wound and the other group without it. On the 9th postoperative day macroscopic evaluation of the operative scar was performed, which was later removed for microscopic evaluation.ResultsThere was microscopic infiltration of tumor cells in the wound of all animals. However, the group that held the protection, infiltration was less intense when compared to the group without it. The infiltration was also more severe in females than in males of the same group.ConclusionTumor infiltration into the wound was more intense in the group in which the protection of the surgical site was not performed, and in females when compared to males of the same group.

Cutaneous melanoma has an aggressive clinical presentation, showing rapid rate of growth and metastatic dissemination due to the permanence of cancer stem cells. The present study was to evaluate the expression of the self-renewal regulatory factor and the clinical significance of the transcription factor OCT4 in melanoma. Melanoma tissues were stained by immunohistochemistry and the correlation between the expression of this marker was determined through clinical-pathological variables and survival outcomes. Positive expression of nuclear and cytoplasmic OCT4 was observed in 49% and 41.2% of cases, respectively. The positive expression of nuclear OCT4 in melanoma was significantly associated with prognostic factors, such as Breslow depth, Clark's level, ulceration and metastasis. Survival of patients was 56% compared to positive nuclear OCT4 expression and 94.2% when compared to the low expression of the gene. Nuclear OCT4 positive genotype indicated aggressive tumor behavior with a worse clinical outcome, which indicates OCT4 as a useful biomarker in the prognosis of melanoma. Melanoma Res 31: 439

Neurocysticercosis (NCC) is classified as a neglected tropical disease, which affects mainly Latin America and Africa in spite of some reports in North America and Europe. NCC represents the cause of up to 30% of the reported cases of epilepsy in endemic countries. The NCC injuries present direct relation to the development stage, location, and number of parasites as well as to the host immune response. This study aimed the characterization of the inflammatory response and tissue injuries by means of the analyses of the periventricular and parenchymatous demyelination through the experimental intraventricular NCC infection. Therefore, BALB/c mice were submitted to experimental NCC inoculation with Taenia crassiceps cysticerci. Their brains were removed at 7, 30, 60, and 90 days after the inoculation (DAI), and analyzed after staining with hematoxylin and eosin (HE), Luxol Fast Blue, and Nissl. It was possible to observe ventriculomegaly, inflammatory infiltration composed by polymorphonuclear and mononuclear cells, and foamy macrophages. The presence of inflammatory cells was associated with neurodegeneration detected by the areas with demyelination observed initially in the periventricular area and lately in the parenchyma. In conclusion, the presence of cysticerci and the consequent inflammation were able to promote initial periventricular demyelination followed by parenchymatous demyelination as the infection progressed.