André Cartell

Clinical outcomes of eradication of Helicobacter pylori in nonulcer dyspepsia in a population with a high prevalence of infection : results of a 12-month randomized, double blind, placebo-controlled study

Ninety-one Helicobacter pylori-positive patients with nonulcer dyspepsia were randomized to receive either lansoprazole, amoxicillin, and clarithromycin or lansoprazole and placebo. A validated questionnaire assessed dyspeptic symptoms at baseline and at 3, 6, and 12 months. Endoscopies and biopsies were performed at baseline and at 3 and 12 months. There was an overall trend, although not statistically significant, for a benefit of H. pylori eradication. Of the patients in the antibiotics group, 16 of 46 (35%) had symptomatic improvement, versus 9 of 43 (21%) in the control group (P = 0.164). In a secondary analysis, it was found that of the patients without endoscopic gastric erosions, 15 of 34 (44%) in the antibiotics group and 5 of 33 (15%) of controls had symptomatic improvement (P = 0.015). Helicobacter pylori eradication did not prove to be clinically beneficial, although a tendency to symptomatic benefit was detected. Further studies are necessary to confirm the implications of endoscopic gastric erosions in these patients.

Could matrix metalloproteinase‐9 be a link between Demodex folliculorum and rosacea?

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Epidermodysplasia verruciformis-like disorder in a teenager with HIV and HCV infections

ichthyosiform state only resembling ichthyosis vulgaris. We presume this ichthyosis vulgaris-like state is related to the underlying metabolic disease, and to our knowledge, a similar condition has not been previously described associated to MMA. Additional data from a 2-year follow-up is that our patient’s dermatosis does not seem to depend on dietary treatment or episodes of metabolic decompensation, in contrast to those patients previously reported.

Metastatic renal cell carcinoma involving the rectum.

AbstractBackground and aims. Metastatic spread of a distant tumor to the rectum is extremely rare. To our knowledge, there have been no published reports of hematogenic metastasis from a renal cell carcinoma to the rectum. Patients and methods. A patient with a renal cell carcinoma was initially treated by a radical right nephrectomy. Results. Nine months after the surgery he started to have multiple episodes of hematochezia. Colonoscopy showed a nodular lesion located in the distal rectum, and biopsy revealed an undifferentiated carcinoma. The patient then underwent abdominoperineal resection of the rectum, and histological examination showed metastatic renal clear cell carcinoma. Conclusion. This case represents an exceedingly rare condition, which has never been reported before.

Distribution of clinical‐pathological types of cutaneous melanomas and mortality rate in the region of Passo Fundo, RS, Brazil

Objective  To describe the characteristics of all cases of primary cutaneous melanoma during the period 1995–2001, registered at pathology departments in the region of Passo Fundo.

Systemic mastocytosis in childhood: report of 3 cases

OBJECTIVE Mastocytosis comprises a group of diseases characterized by accumulation of mast cells on the skin, with the possibility of affecting other systems. Symptoms can be exclusively cutaneous, associated with symptoms of the organs involved or even systemic, due to the release of chemical mediators. Three cases of systemic mastocytosis are described, each case presenting different manifestations of the disorder. DESCRIPTION The first report is about a patient with urticaria pigmentosa that presented persistent lesions until puberty when systemic manifestations initiated with lymphoreticular involvement, splenomegaly and bone marrow infiltration. In the second case, the child had bullous mastocytosis associated with gastrointestinal symptoms, whose investigation showed mast cell infiltration in the intestinal wall. The third patient presented an early and extensive cutaneous manifestation of mastocytosis, with a dramatic evolution to shock and posterior death. DISCUSSION Clinical aspects, treatment and prognosis of such forms of the disease are discussed.

p53 protein expression in skin with different levels of photoaging.

In non‐melanoma skin cancer, keratinocytes show marked p53 protein expression. Considering photoaging as a background for skin cancer, p53 protein expression by immunohistochemistry was evaluated in normal skin with different levels of photoaging. The difference in p53 expression between mild and severe levels of photoaging was not statistically significant (P=0.169).

Immunohistochemical expression of matrix metalloproteinase-2 and -9 in melanocytic nevi is altered by ultraviolet B

Background: Ultraviolet B (UVB) radiation can cause morphological and biological alterations similar to those of melanoma in situ in irradiated melanocytic nevi. matrix metalloproteinase (MMP‐2) and ‐9 appear to be involved with tumour invasion, the formation of metastases and neoangiogenesis in melanomas. The effects of UVB on the immunohistochemical expression of gelatinases in different cell types in melanocytic nevi have not been completely studied.

Dermabrasion in acquired melanocytic nevi: a histopathological and immunohistochemical study.

Introduction:When subjected to trauma, acquired melanocytic nevi may present atypical histological features similar to alterations that occur after exposure to ultraviolet radiation. These persist for up to 3 weeks. To date, no study has evaluated the alterations that occur after dermabrasion in acquired melanocytic nevi. Objective:To evaluate the histopathological and immunohistochemical alterations those occur in acquired melanocytic nevi, 4 weeks after dermabrasion. Materials and Methods:This study evaluated 50 acquired melanocytic nevi, in which half of each lesion was submitted to dermabrasion, leaving the other half intact, and compared the histopathological and immunohistochemical findings from the 2 sides 4 weeks after the procedure. Results:Five acquired melanocytic nevi were from male and 45 from female patients. The age of the patients varied from 15 to 69 years. On the dermabraded side, there was a greater frequency of atypical melanocytes (P = 0.015), increase in relation to nucleus/cytoplasm of the melanocytes (P = 0.034); inflammatory infiltrate (P = 0.007); and neovascularization (P = 0.004). In the immunohistochemical evaluation, there was a significantly higher percentage of immunoreactive melanocytes on this side for the HMB-45 only in the junctional component (P = 0.001) and for Ki-67, at a low rate, in the dermis (P = 0.03). Conclusions:Four weeks after the dermabrasion, atypical features, such as melanocytic atypia and pagetoid spread remained. Although these alterations may simulate melanoma in situ, the association with features of histopathological tissue repair (inflammatory infiltrate and neovascularization), together with immunohistochemical findings that are uncharacteristic of malignancy, favors a diagnosis of a benign lesion. These atypical alterations persist longer than those found after ultraviolet radiation.

Fatores associados à rosácea em amostras populacionais do Sul do Brasil: análise de estudos casos-controles

BACKGROUND: Rosacea is a dermatosis that has many factors associated with its onset. Most studies on this condition come from the United States and European countries, with little information produced and published about the disease in the Southern hemisphere, particularly in Brazil. OBJECTIVES: To describe the main clinical and histopathological factors associated with rosacea in population samples from southern Brazil. METHODS: Two case-control studies performed sequentially, with univariate and bivariate analysis, using p<0.05 for statistical significance (Chi-square test and Mantel-Haenzel, for stratifications) RESULTS: Rosacea is most frequent among women and in the age range of 40-50 years. Almost all cases have phototypes II and III. The inflammatory forms of rosacea are more often diagnosed than the vascular form and there is an association with serological positivity to Helicobacter pylori and with histopathological presence of Demodex folliculorum (p<0.05). Emotional and climatic changes, exposure to the sun and intake of alcoholic beverages were the main factors described as provoking or worsening the disease. CONCLUSIONS: We have obtained an overview of rosacea in a sample of the southern population of Brazil. While some data are similar to those already described internationally, other aspects, such as economic issues and the factors described as provoking or worsening the disease, are provided in greater detail.