Background: Skin cancer is common in Brazil and is related to sun exposure, among other risk factors. There are no data on the incidence of malignant skin neoplasm in rural workers in western Paraná. Objective: To analyze the incidence and profile of rural workers who were diagnosed with skin cancer at a reference service in Cascavel, western Paraná, in the last five years (2011-2016). Methods: This retrospective cross-sectional study was carried out through a review of the anatomopathological reports of rural workers diagnosed with skin cancer at Cascavel Oncology Center (CEONC), in Cascavel. The following variables were collected: year of diagnosis, age, gender, injury location and histological subtype. Results: A total of 681 cases of malignant epithelial neoplasia were identified, with a higher frequency in the 61-70 age group. Data analysis showed an increase of about 210% in the occurrence of skin cancers in the last 5 years. The cephalic region was the most affected, and the most common histological subtype was nodular basal cell carcinoma. There was no association between gender and location. Study limitations: This is a retrospective study and analysis of a secondary data bank. Conclusion: This study is a regional estimation of the incidence of cutaneous neoplasms and provides evidence of a considerable increase in the number of diagnoses in rural workers from western Paraná, Brazil. Moreover, it is possible to conclude that the sample group studied is at risk of developing skin cancer.
Context: Primary central nervous system angeitis (APSNC) is a vasculitis confined to the central nervous system (CNS). Its incidence rate is 2.4 cases per 1,000,000 person-years. It affects predominantly small and medium sized arteries of the cerebral parenchyma, spinal cord and leptomeninges. The most common manifestations are headache, cognitive impairment, stroke and transient ischemic attack. The fact that it results in multifocal inflammation of the arteries and veins can lead to ischemic or hemorrhagic infarctions in multiple vascular territories, more common in the subcortical white matter. Case report: A woman with a past of epilepsy and headache present to us with acute intraparenchymal hemorrhagic stroke, after extensive investigation, arrived at the presumed diagnosis of APSNC. Conclusion:Tests such as MRI and arteriography have low sensitivity and specificity for APSNC and brain biopsy is still the gold standard method for diagnosis, but in practice it is performed in less than half of the cases in clinical practice, this is due to several factors. Next, it is important to note that the biopsy efficiency is around 53-74% in unselected areas, reaching 80% if the site is selected affected by non-invasive exams. The literature specifies brain biopsy as a procedure with relatively low morbidity and mortality, however, it was not performed in more than a half of cases.
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