RESUMOIntrodução: O tumor de pele não melanoma é o de maior prevalência e incidência no Brasil, englobando o carcinoma espinocelular (CEC) e o basocelular (CBC). O principal fator de risco para o desenvolvimento desses tumores é a exposição crônica aos raios solares, justificando a faixa etária e as localizações anatômicas mais acometidas. O tratamento objetiva extirpar a lesão com deformidade mínima. A excisão cirúrgica com margens seguras é a principal opção terapêutica; outras dependem do número de lesões, localização, tipo histológico, estado geral e comorbidades clínicas. Objetivos: Descrever o perfil epidemiológico dos pacientes com tumores cutâneos malignos; identificar a prevalência dos não melanoma; e avaliar a margem cirúrgica. Métodos: Estudo observacional, longitudinal e retrospectivo de pacientes submetidos à ressecção de lesões suspeitas em serviço secundário. Resultados: Foram identificadas 140 lesões em 67 pacientes, sendo 59% do sexo masculino e 71,6% maiores de 60 anos. O segmento mais acometido foi cabeça/pescoço (72,1%); 69,1% eram CBC, 29,2% CEC e 1,6% melanoma; 80,4% informavam margens livres, 7,3% indicavam comprometimento; esses pacientes apresentavam média de 75,2 anos e 8,7 lesões concomitantes. A associação foi significante entre gênero feminino e presença de lesões <5 mm. Conclusões: O predomínio de lesões em indivíduos do sexo masculino acima de 60 anos é compatível com o padrão já descrito na literatura. As margens livres, obtidas em grande parte do presente estudo, indicam eficácia terapêutica da excisão cirúrgica simples. As margens macroscópicas adotadas na marcação pré-operatória favorecem a eficácia, reservando a cirurgia de Möhs para recidivas ou comprometimento de margem. Palavras-chave: neoplasias cutâneas; procedimentos cirúrgicos operatórios; carcinoma de células escamosas; carcinoma basocelular. ABSTRACT Introduction: Non-melanoma skin tumor is the one with highest prevalence and incidence in Brazil, comprising squamous cell carcinoma (SCC) and basal cell carcinoma (CBC). The main risk factor for the development of these tumors is chronic exposure to sunlight, justifying the most affected age group and anatomical locations. Treatment aims to excise the lesion with minimal deformity. Surgical excision with safe margins is the main therapeutic option; others depend on the number of lesions, location, histological type, general health and medical comorbidity. Objectives: To describe the epidemiological profile of patients with skin tumors; to identify the prevalence of non-melanoma; and to evaluate surgical margin. Methods: Observational, longitudinal and retrospective study of patients undergoing resection of suspicious lesions in secondary service. Results: We identified 140 lesions in 67 patients, 59% were male and 71.6% over 60 years of age. The most affected regions were head and neck (72.1%); 69.1% were CBC, 29.2% CBC, and 1.6% melanoma; 80.4% informed free margins, 7.3% indicated affected margins; the mean age of these patients was 75.2 years and the mean number of co...
RESUMO Introdução:No Brasil, um a cada nove pacientes hospitalizados é vítima de acidente de trânsito. O impacto desses números implicam repercussões econômicas, sociais e administrativas. Objetivos: Levantar dados epidemiológicos sobre as vítimas de eventos traumáticos com motocicletas encaminhadas para um hospital terciário (Conjunto Hospitalar de Sorocaba), descrever as lesões encontradas e discutir o impacto na qualidade de vida dessas vítimas. Método: estudo prospectivo que incluiu vítimas de trauma envolvidas em acidentes com motocicletas, no período de abril a setembro de 2013, referenciadas a um hospital de nível terciário. Para a coleta de dados, foi elaborada ficha padronizada com escores de trauma, seu mecanismo e descrição das lesões. Resultados: Um total de 143 pacientes foram analisados: 83,2% homens e 16,8% mulheres, com o predomínio do grupo etário entre 20-29 anos (49,6%). O uso de capacete foi relatado em 98,5% dos casos. O gênero masculino representou cerca de 86% na categoria de condutor da motocicleta. Os principais mecanismos de trauma foram colisões (72,7%), seguidas de queda da motocicleta (15,4%). Quanto às lesões, as mais encontradas foram as escoriações (72,9%) e os ferimentos corto-contusos (13,8%). Os segmentos anatômicos mais acometidos foram os membros superiores e inferiores, representando 83% dos casos. Pacientes foram avaliados quanto ao Revised Trauma Score (RTS); as vítimas com RTS=12 somaram 97,9%, o que sugere gravidade relativamente leve da maioria dos pacientes. Conclusões: Os achados do presente estudo, quanto ao padrão majoritário das vítimas de acidentes envolvendo motocicletas, são compatíveis com a literatura. O predomínio da população economicamente ativa do país em eventos tão onerosos e incapacitantes como os acidentes com motocicletas implica na necessidade de novas estratégias na gestão do trânsito e da saúde pública. Palavras-chave: acidentes de trânsito; ferimentos e lesões; violência. ABSTRACT Introduction:In Brazil, at least one in nine hospitalized patients was a traffic accident victim. The impact of these numbers implies economic, social and administrative repercussions. Objectives: To raise epidemiological data on victims of traumatic events with motorcycles forwarded to a tertiary level hospital (Conjunto Hospitalar de Sorocaba) to describe the injuries and discuss the impact on quality of life of these victims. Method: Prospective study that included trauma victims from accidents with motorcycles, between April and September, 2013, referenced to a tertiary level hospital. For data collection, standardized form was drawn up with trauma scores, mechanism of trauma and description of injuries. Results: A total of 143 patients were analyzed: 83.2% men and 16.8% women, with the predominance of the age group between 20-29 years (49.6%). The use of helmets was reported in 98.5% of cases. The male gender accounted for about 86% in the category of the motorcycle driver. The main mechanisms of trauma were collisions (72.7%), followed by drop of motorcycle (15.4%)...
Porokeratosis (PK) consists of abnormal keratinization of the epidermis of uncertain etiology and was first described by Mibelli in 1893. Multiple clinical variants of porokeratosis are recognized. The following is a case of a young male who presented more than one form of PK simultaneously. The hallmark of PK is the cornoid lamella, which can be identified in histopathology, and sometimes, as in our case, dermoscopy examination is the clue for diagnosis. This condition is often misdiagnosed and, therefore, not appropriately treated. Several treatment options are available and each clinical form may respond better to a specific therapy. However, consistency in treatment guidelines is still lacking.
Aneurysms and thromboses of the portal vein are rare pathologies of the portal system that commonly follow an asymptomatic course. The vast majority of cases are diagnosed as incidental findings during imaging studies. Symptoms of aneurysms are the result of mass effects, while thrombosis symptoms are a function of the liver's ability to form a collateral circulation network in the thrombosis. The scant experience with such cases poses a dilemma for patient management and so the vast majority of authors choose an expectant approach with rigorous patient surveillance and only intervene in symptomatic patients. We report one case of an aneurysm of the portal vein and one case of portal vein thrombosis and discuss management and observation of these patients.
Psoriasis consists of a chronic inflammatory disease with systemic character and may be associated with several comorbidities. Although its etiopathogenesis has not yet been fully elucidated, it is known that it is an immune-mediated pathology, especially by T cells. Like other inflammatory and autoimmune disorders, psoriasis is also related to changes in the cutaneous microbiome. Vitamin D deficiency is one of the conditions associated with pathologies whose microbiome is altered, although the causal relationship between these events is not precisely determined. Thus, the objective of this study was to estimate the prevalence of vitamin D deficiency in patients with psoriasis who attended the Dermatology Clinic of ABC Medical School (FMABC) and compare it to the prevalence of vitamin D deficiency among patients with non-inflammatory pathologies. 88 patients with psoriasis and 91 patients with non-inflammatory diseases (Control Group) were evaluated and had their serum vitamin D measured. It was observed that the Psoriasis Group had lower serum vitamin D levels compared to the Control Group (p<0.001) and It was observed that the chance of a person with psoriasis present low vitamin D levels is about seven times higher.
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