Objective To evaluate the difference in transepidermal water loss in patients diagnosed with hyperhidrosis and healthy subjects, in an air-conditioned environment.Methods Twenty patients diagnosed with hyperhidrosis and 20 healthy subjects were subjected to quantitative assessment using a closed-chamber device, in six previously established sites.Results The measurements showed different transepidermal water loss values for healthy subjects and patients with hyperhidrosis, especially in the hands and feet. In the Control Group, the median for the hands was 46.4g/m2/hour (p25: 36.0; p75: 57.6), while in the Hyperhidrosis Group, the median was 123.5g/m2/hour (p25: 54.3; p75: 161.2) – p<0.001. For the feet, the Control Group had a median of 41.5g/m2/hour (p25: 31.3; p75: 63.5) and the Hyperhidrosis Group, 61.2g/m2/hour (p25: 32.3; p75: 117) – p<0.02. Measurements of the axillas also showed differences. In the Control Group, the median was 14.8g/m2/hour (p25: 11.8; p75: 19.0) and, in the Hyperhidrosis Group, 83.5g/m2/hour (p25: 29.5; p75: 161.7) – p<0.001.Conclusion Measuring transepidermal water loss is sufficient for diagnosis and follow-up of patients with hyperhidrosis.

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Objective: to assess safety, efficacy and quality of life in patients with benign pleural effusions undergong pleural drainage with Wayne pleural catheter (DW) in an outpatient setting. Method: this is a prospective study, in which 47 patients were evaluated between July 2017 and October 2018. Patients with non-malignant pleural effusions underwent pleural drainage with clinical evolution compatible with outpatient care were included. Patients who underwent drainage due to other conditions and patients were excluded. Results: after catheter placement, the mean length of hospital stay was 3.14 (± 3.85) days, and 21 patients (44.68%) were discharged within 24 hours. The mean time with the catheter was 12.63 (± 7.37) days. The analysis of the pleural fluid was transudate in 87.3% of cases and exudate in 12.3%. The causes of pleural effusion were heart failure (72.3%), renal failure (19.1%), liver failure (6.3%) and pneumonia (8.5%). The quality of life, analyzed according to the parameters of the questionnaire SF 36, showed low average values when compared to other studies. Analyzing each descriptor, the average was greater only in the limitation related to physical aspects. In the other descriptors, the results were similar, but smaller. Conclusion: the outpatient use of pleural catheters of the Wayne type (pigtail) proved to be feasible, safe and with a low associated infection rate. This is a viable option for selected patients.

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INTRODUCTION: Pulmonary nodules are common findings on imaging studies, such as pre-operative exams for elective surgeries. Part of these nodules show up as early-stage lung cancer or even metastatic pulmonary disease. We report a case of a 79 year old patient who was thought to have metastatic pulmonary disease of unknown primary site. After surgical lung biopsy, she had the diagnosis of a rare condition: pulmonary meningioma. CASE PRESENTATION:A healthy 79 year old female patient without pulmonary symptoms was up to perform colecystectomy due to gallstone, found in a routine ultrasound, in Sancta Maggiore Hospital, a specialized center for elderly patients in Sao Paulo, Brazil. She had hypertension, hyperlipidemia, hypothyroidism and a myocardial infarction 7 years ago, treated with angioplasty and coronary stent, with no background of cancer, smoking, alcoholism, allergies or previous surgeries. During a preoperative examination, chest X-ray and CT scan revealed several pulmonary nodules, suggesting pulmonary carcinomatosis. She had a normal neurological investigation. The patient underwent lung biopsy by non-anatomical segmentectomy (wedge res section) of the posterior basal segment of the right lower lobe. The macroscopic appearance was carcinomatosis, because of the several solid micronodules spread throughout the lung. Freezing biopsy was positive for cancer, but without lung cancer pattern.The final pathological pattern showed proliferation of spindle cell with clear limits, but with perivascular infiltration. Absence of necrosis and mitosis. Immunohistochemical analysis has shown diffuse expression of EMA (epithelial membrane antigen) and progesterone receptor, and pulmonary meningioma was the definitive diagnosis. In subsequent imaging exams, there was no evidence of metastatic disease, except for the lungs. DISCUSSION:The pulmonary metastatic form of meningioma is a rare condition. It is considered benign, but malignant behavior has been reported sometimes. Primary lung meningioma are even rarer and described only in about 40 cases, first in 1981. Most of these cases were asymptomatic, without any neurological signs. We also noted that the pulmonary meningioma is rare in the elderly. The most affected group is aged around 60 years old. There are few reports of this condition in patients older than 75 years. The oncology group decided not to prescribe chemotherapy because of the low rating of cell replication. The patient is being followed up by the multidisciplinary group.CONCLUSIONS: Pulmonary meningioma is a rare disease, especiallywhen it is primary. The appearance of this condition in elderly people has very few reports, which makes this case unique. Reference #1: Wang M, Zhan R, Zhang C, Zhou Y. Multiple pulmonary metastases in recurrent intracranial meningioma: Case report and literature review. J Int Med Res. 2016 Mar 4. pii: 0300060515618053.Reference #2: Kim YY, Hong YK, Kie JH, Ryu SJ.Primary pulmonary meningioma: an unusual cause of a nodule with strong and homogeneous enhancement.

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