Francisco Parente

Iloprost infusion through elastomeric pump in the treatment of Raynaud’s phenomenon and digital ulcers:

Introduction: Systemic sclerosis is a systemic autoimmune disease characterized by microangiopathy and fibroblast dysfunction resulting in fibrosis of the skin and internal organs. Raynaud’s phenomenon and digital ulcers are the main clinical features of vascular involvement. Treatment with iloprost is recommended to reduce the frequency and severity of Raynaud’s phenomenon attacks and to heal active digital ulcer. Classical forms of treatment require admission to a ward or day-hospital unit to ensure safety during infusion, causing disruption of the patient’s normal daily life and resulting in significant costs with hospitalization. Nowadays, new portable devices, of which the elastomeric pump is an example, are becoming available in order to avoid hospitalization. Case reports: We describe five cases of patients with systemic sclerosis or mixed connective tissue disease and severe Raynaud’s phenomenon/critical ischaemia or active digital ulcers that were successfully treated with iloprost infusion through elastomeric pump without experiencing any side effects. We present our unit’s protocol for ambulatory infusion. Discussion/conclusion: Our case reports and a brief review of literature prove that iloprost infusion through elastomeric pump is safe, easy and well tolerated and might even improve patient compliance with treatment. Meanwhile, it may also decrease the economic burden of hospitalization with these patients.

ADENOPATIA SUPRACLAVICULAR COMO FORMA DE APRESENTAÇÃO DE CANCRO DA PRÓSTATA METASTIZADO

portuguesA neoplasia da prostata na sua forma avancada tem geralmente metastizacao ossea ou para gânglios pelvicos. O envolvimento de gânglios supraclaviculares e raro (0,4-1% de todos os casos)1 e a sua apresentacao como adenopatia supraclavicular e ainda mais rara, com apenas alguns casos descritos na literatura2-7. Neste contexto, apresentamos o caso de um homem de 62 anos, saudavel, com tumefacao de novo na fossa supraclavicular esquerda, sem sintomas associados. Apos a investigacao estabeleceu-se o diagnostico de adenocarcinoma da prostata em fase avancada, com metastizacao disseminada. Alertamos para uma forma rara de apresentacao de adenocarcinoma da prostata e discutimos a abordagem diagnostica em casos de adenopatias isoladas. EnglishProstate cancer in its advanced form usually metastasizes to the bone or pelvic ganglia. The involvement of the supraclavicular lymph nodes is rare (0.4% to 1% of all cases)1. Its presentation as a supraclavicular lymphadenopathy is even more unusual with only a few cases described in the literature2-7. In this context, we describe the case of a 62 year old man presenting with a left supraclavicular mass without any other signs or associated symptoms. After all the workup, we established the diagnosis of widely metastasized prostate adenocarcinoma. We bring forward this case as an example of a rare form of presentation of prostate cancer and we use it as a base for discussing an approach to isolated peripheral lymphadenopathy.

Fascioliasis—a rare cause of hepatic nodules

Fascioliasis is a zoonotic disease that can sometimes affect humans. It presents with non-specific signs and symptoms which makes it difficult to establish an early definitive diagnosis. This can be particularly true in non-endemic countries where a high degree of suspicion is needed to make the diagnosis. Another confounding factor is that many of the initial complains and findings are very similar to those of malignancy. We report a case of an otherwise healthy 47 year-old male presenting with abdominal pain, night-time sweating, anorexia, weight loss and loose stools that had several hepatic nodules visible in the abdominal CT scan. Although the initial hypothesis was hepatic malignancy or liver metastasis of unknown primary neoplasm, the workup performed led us to the correct diagnosis. He was treated successfully for hepatic fascioliasis, with a full recovery.

O átomo de Bohr no Ensino Médio

Ha cem anos o fisico dinamarques Niels Bohr publicava um dos mais importantes trabalhos da fisica do seculo 20, no qual pela primeira vez um modelo do atomo compativel com os fatos experimentais e com hipotese de quantizacao de energia de Max Planck era apresentado. Para muitos estudantes, o modelo de Bohr ainda e a porta de entrada para o mundo fascinante da estrutura interna da materia. No presente trabalho discutimos um modo relativamente simples de introduzir o modelo de Bohr no Ensino Medio.

Os 100 anos do átomo de Bohr

A hundred years ago the Danish physicist Niels Bohr published one of the most important papers of the 20th century physics. In that paper, Bohr introduced a model for a one-electron atom built on experimental facts and Plancks hypothesis of the quantization of energy. Although Bohrs model was replaced by the new quantum mechanics due to Heisenberg, Schrodinger, and other important physicists of that period, even today it is the usual entrance door to the fascinating world of the internal structure of the matter. We revise the main features of Bohrs model and discuss its pedagogical relevance.