Background: The colorectal neoplasm is the fourth most common malignancy among males and the third among females. In the Western world is estimated that 5% of the population will develop it, making this disease a major public health problem. Aim: To analyze the prevalence of the polymorphism -765G / C region of the COX-2 gene in colorectal cancer patients compared to a control group, analyzing the possible association between this polymorphism and susceptibility to colorectal cancer. Method: This is a case-control study with 85 participants. Were selected 25 with colorectal cancer (case group) and 60 participants without colorectal neoplasia (control group). The molecular genetic analysis was perform to identify the polymorphism -765G / C COX2 gene with standard literature technique. In addition, patient’s clinical and pathological data were analyzed. Results: There was a light increase in prevalence between men in the case group, although this difference was not statistically significant. The results showed a high prevalence of GC and CC genotype in individuals with colorectal cancer, demonstrating an association between the presence of the polymorphism in the COX2 gene and susceptibility to colorectal cancer in this pattern (p=0.02). Similarly, there was also difference in allele frequencies in the groups. When patients with cancer were separated by tumor location, there was a higher prevalence of polymorphism in the left colon (p=0.02). Conclusion: The polymorphism in the COX2 gene is associated with increased susceptibility to colorectal cancer, specially rectosigmoid tumors.
The Unilateral Nevoid Telangiectasia consists of a rare vascular dermatitis whose etiology remains undefined, making it difficult to treat. Due to the scarcity of data in the literature its diagnosis and its treatment represent a challenge. There is a predominance of this pathology in females in the proportion of 2:1. The main hypothesis for its etiopathogeny is hyperestrogenism. This justifies the performance of pregnancy tests, dosage of liver enzymes or serologies for hepatotrophic viruses to investigate situations that raise estrogen. The diagnosis is exclusively clinical. The therapeutic modality instituted is laser therapy. Both the Nd: YAG 1064nm long pulse laser and pulsed dye laser are effective for the treatment of vascular lesions.
Background: The Epiploic Appendagitis is an uncommon pathology arising from the torsion or spontaneous venous thrombosis of the veins responsible for the drainage of the apoptotic appendages. Aim: The purpose of this research is to report the characteristics of this disease. Method: The review includes articles published in papers indexed in the Scielo and PubMed databases over the last eight years (2008-2016). The following headings were crossing: Epiploic Appendagitis, differential diagnosis of Appendagitis and diagnostic methods of Appendagitis, and their respective literal translations in English, were selected 26 articles, used for database. Results: Although there is discordance in the literature, the male sex is more frequently affected by this pathology. The characteristic manifestation is acute non-migratory abdominal pain, most often located in the lower left quadrant of the abdomen. The diagnosis is made from images from the Computed Tomography. The treatment occurs outpatient and provides for administration of analgesic and anti-inflammatory. Conclusion: A correct initial approach avoids invasive and unnecessary procedures
This pathology is a rare and serious form of acne vulgaris. Its treatment is a challenge because it does not respond satisfactorily to traditional acne therapies. Its diagnosis must be early so that the appropriate therapy is instituted quickly, avoiding sequelae. The case reported is a young male patient with acneic lesions associated with systemic manifestations and laboratory abnormalities. Treatment with prednisone and oral antibiotic therapy is instituted. After weaning from corticosteroid therapy, oral isotretinoin was introduced in a stepwise dose. The patient progresses with improvement of active lesions and cicatricial lesions on the back. The Acne Fulminans is destructive, begins with acute pain, with abrupt development of acneic lesions, hemorrhagic nodules and ulcerations with necrotic background, associated with systemic manifestations. The diagnosis is clinical. Therapy should be aggressive, involving oral corticosteroids with isotretinoin. Dapsone is also used as an antiinflammatory agent.
Objective: To draw a physiological and behavioral profile from patients treated at Policlínica established in the city of Londrina in order to identify the developments caused by the use of Anticholinesterasics and also to evaluate the main characteristics of those patients.Method: Cohort retrospective, through the collection and analysis of data obtained from medical records from 39 patients who fulfilled all the necessary criteria. Results:The average age of patients was 76,6 years, the majority being female (73,3%) and illiterate (63,2%). The majority did not present comorbidities such as stroke (89,5%) and traumatic Brain Injury (TBI) (97,4%), although 60,5% have some cardiovascular disease associated. The Basic Activity of Daily living (ADLs) from 81, 6% of the patients did not change between the current one and the one found at the diagnosis time. The Mini Mental State Examination (MMSE) had its value unchanged in 21,1% of the patients and had its high value at 1 point in 10,5%, 2 points in 21,1% and in 3 or more points in 13,2% of the cases. There was a decrease of the MMSE value in 1 point in 7,9% of the patients, 2 points in 10,5% and 3 or more points in 6%. Among the medicine used, Donepezil was the most prevalent one (73,6%), followed by Galantamine (15,8%) and by Rivastigmine (10,5%). Besides, the Memantine was associated to Donepezil in 2 cases and to Galantamine in 1 case. Conclusion:The results showed a correlation between Basics ADLs and TBI variables; educational level and MMSE variation and family history of AD and cardiovascular disease. The other risk and protective factors studied were not determinant for the outcome of the disease probably due to its multifactorial characteristic.
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Introduction: Breast cancer is the leading cause of death from cancer in women. Among the most common morphologies stands out associated with the HER-2 receptor whose over expression indicates more aggressive disease. Objective: To report the changes to the treatment regimen used throughout the course of the disease in a patient with carcinoma patients with over expression of HER-2. Case report: A female patient diagnosed since 2010 with infiltrating ductal carcinoma grade (CDI) 3 with micrometastases in lymph node and over expression of HER 2. In 2013, showed metastasis in right axillary region. She was, then, submitted to a lymphadenectomy, radiation therapy, followed by administration of Anastrozole. She was later diagnosed liver metastasis and fossa above right clavicle, starting chemotherapy with trastuzumab (Herceptin) and docetaxel Pertuzumab (PerjetaTM), obtaining initial response. However, in January 2015, liver injury progressed and after three cycles of chemotherapy with T-DM1 she had a partial regression. The patient still maintained the stable condition for another year during the current treatment until clinical worsening due to progression of liver metastases, and death due to complications of hepatic failure in the first half of 2016. Discussion: The patient therapy one of the targets against the HER-2 receptor was Herceptin, given in combination with Pertuzumab and Docetaxel. However, the short duration of event-free survival imposed changes in therapy from Capecitabine and Laparinibe. On the progression of liver injury was replaced the previous scheme by DM1 Trastuzumab, an antibody-drug conjugate. This conjugate showed a positive response in the outcome. Conclusion: case report highlights the importance of discussion of new systemic therapies for the increase in overall survival of patients with breast carcinoma with overexpression of HER-2.
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