José Maria de Castro Abreu Junior

Hanseníase em menores de 15 anos: a importância do exame de contato

OBJETIVO: Describir dos casos de enfermedad de Hansen en menores de 15 anos, siendo uno de paciente con 18 meses de edad y otro de 13 anos, diagnosticados por modos de deteccion distintos, subrayando la importancia de examinar a los contactos. DESCRIPCION DEL CASO: Uno de los casos tuvo diagnostico temprano mediante examen de contactos intradomiciliares, mientras que el otro fue diagnosticado por demanda espontanea despues de cuatro anos de surgimiento de las lesiones y, a pesar de ser contacto de un ex-paciente, no fue examinado en la epoca. COMENTARIOS: En paises endemicos, la alta deteccion de enfermedad de Hansen en menores de 15 anos revela la persistencia en la transmision del bacilo y las dificultades de los programas de salud para el control de la enfermedad. El mayor tiempo para diagnostico ocasiona secuelas y deformidades y, de ese modo, la busqueda por los contactos constituye importante metodo para el diagnostico temprano de la enfermedad en la infancia, cuando las senales clinicas no siempre son faciles de identificarse y hay gran diversidad de formas clinicas en que la enfermedad puede presentarse.ABSTRACT Objective : To describe two cases of leprosy in children un-der 15 years old, being one patient aged with 18 months and other 13 years, diagnosed by different modes of detection, emphasizing the importance of examining the contacts. Case description : One of the cases was diagnosed early by examining household contacts, while the other was diag-nosed by spontaneous demand, after four years of the onset of lesions, although he had been a former patient contact who was not examined at the time. Comments : In endemic countries, the high detection of leprosy in children under 15 years old reveals the persistence of the bacillus transmission and the difficulties encountered by public health programs to control the disease. Delay in leprosy diagnosis leads to sequels and deformities and, thus, the search for contacts is important as an effective method for early diagnosis of the disease in childhood, where clinical signs are not always easy to be identified due to the great variety of clinical forms in which the disease may occur.

Leprosy in children under 15 years: the importance of early diagnosis

OBJETIVO: Describir dos casos de enfermedad de Hansen en menores de 15 anos, siendo uno de paciente con 18 meses de edad y otro de 13 anos, diagnosticados por modos de deteccion distintos, subrayando la importancia de examinar a los contactos. DESCRIPCION DEL CASO: Uno de los casos tuvo diagnostico temprano mediante examen de contactos intradomiciliares, mientras que el otro fue diagnosticado por demanda espontanea despues de cuatro anos de surgimiento de las lesiones y, a pesar de ser contacto de un ex-paciente, no fue examinado en la epoca. COMENTARIOS: En paises endemicos, la alta deteccion de enfermedad de Hansen en menores de 15 anos revela la persistencia en la transmision del bacilo y las dificultades de los programas de salud para el control de la enfermedad. El mayor tiempo para diagnostico ocasiona secuelas y deformidades y, de ese modo, la busqueda por los contactos constituye importante metodo para el diagnostico temprano de la enfermedad en la infancia, cuando las senales clinicas no siempre son faciles de identificarse y hay gran diversidad de formas clinicas en que la enfermedad puede presentarse.ABSTRACT Objective : To describe two cases of leprosy in children un-der 15 years old, being one patient aged with 18 months and other 13 years, diagnosed by different modes of detection, emphasizing the importance of examining the contacts. Case description : One of the cases was diagnosed early by examining household contacts, while the other was diag-nosed by spontaneous demand, after four years of the onset of lesions, although he had been a former patient contact who was not examined at the time. Comments : In endemic countries, the high detection of leprosy in children under 15 years old reveals the persistence of the bacillus transmission and the difficulties encountered by public health programs to control the disease. Delay in leprosy diagnosis leads to sequels and deformities and, thus, the search for contacts is important as an effective method for early diagnosis of the disease in childhood, where clinical signs are not always easy to be identified due to the great variety of clinical forms in which the disease may occur.

Kaposi’s sarcoma in persons living with HIV/AIDS: a case series in a tertiary referral hospital

BACKGROUND Kaposis sarcoma (KS) is a rare neoplasm with indolent progression. Since 1981, the Kaposis sarcoma epidemic has increased as co-infection with HIV. OBJECTIVES The study aimed to identify the clinical and demographic characteristics and therapeutic approaches in HIV/AIDS patients in a regional referral hospital. METHODS We analyzed the medical records of 51 patients with histopathological diagnosis of Kaposis sarcoma hospitalized at Hospital Universitário João de Barros Barreto (HUJBB) from 2004 to 2015. RESULTS The study sample consisted of individuals 15 to 44 years of age (80.4%), male (80.4%), single (86.3%), and residing in Greater Metropolitan Belém, Pará State, Brazil. The primary skin lesions identified at diagnosis were violaceous macules (45%) and violaceous papules (25%). Visceral involvement was seen in 62.7%, mainly affecting the stomach (75%). The most frequent treatment regimen was 2 NRTI + NNRTI, and 60.8% were referred to chemotherapy. STUDY LIMITATIONS We assumed that more patients had been admitted to hospital without histopathological confirmation or with pathology reports from other services, so that the current study probably underestimated the number of KS cases. CONCLUSION Although the cutaneous manifestations in most of these patients were non-exuberant skin lesions like macules and papules, many already showed visceral involvement. Meticulous screening of these patients is thus mandatory, even if the skin lesions are subtle and localized.Background Kaposi’s sarcoma (KS) is a rare neoplasm with indolent progression. Since 1981, the Kaposi’s sarcoma epidemic has increased as co-infection with HIV. Objectives The study aimed to identify the clinical and demographic characteristics and therapeutic approaches in HIV/AIDS patients in a regional referral hospital. Methods We analyzed the medical records of 51 patients with histopathological diagnosis of Kaposi’s sarcoma hospitalized at Hospital Universitário João de Barros Barreto (HUJBB) from 2004 to 2015. Results The study sample consisted of individuals 15 to 44 years of age (80.4%), male (80.4%), single (86.3%), and residing in Greater Metropolitan Belém, Pará State, Brazil. The primary skin lesions identified at diagnosis were violaceous macules (45%) and violaceous papules (25%). Visceral involvement was seen in 62.7%, mainly affecting the stomach (75%). The most frequent treatment regimen was 2 NRTI + NNRTI, and 60.8% were referred to chemotherapy. Study limitations We assumed that more patients had been admitted to hospital without histopathological confirmation or with pathology reports from other services, so that the current study probably underestimated the number of KS cases. Conclusion Although the cutaneous manifestations in most of these patients were non-exuberant skin lesions like macules and papules, many already showed visceral involvement. Meticulous screening of these patients is thus mandatory, even if the skin lesions are subtle and localized.

O Sanatório de Belém: a epopeia - ou via sacra? - de sua construção

The present paper intends to approach the origin of the Sanatorium of Belem, framing it in the context of the current care model when it was created in 1938, and also intends to evaluate the circumstances and the long period to its construction and opening in 1959 until its first year of operation.

A fundação da Sociedade Médico-Cirúrgica do Pará

El articulo reconstituye los principales eventos sucedidos entre la fundacion, instalacion y los primeros meses de funcionamiento de la Sociedad Medico Quirurgica de Para, la mas antigua asociacion medica en funcionamiento del Estado de Para, Brasil. Varios hechos desconocidos de la historiografia oficial son destacados

Las primeras sociedades médicas del Estado de Pará, Brasil

This article discusses the founding process of the first medical societies of the State of Pará, Brazil: Sociedade MédicoFarmacêutica and Sociedade de Medicina e Cirurgia. It also analyzes the social context that led to their closure.

As primeiras sociedades médicas do Estado do Pará, Brasil

This article discusses the founding process of the first medical societies of the State of Pará, Brazil: Sociedade MédicoFarmacêutica and Sociedade de Medicina e Cirurgia. It also analyzes the social context that led to their closure.

The first medical societies of Pará State, Brazil

This article discusses the founding process of the first medical societies of the State of Pará, Brazil: Sociedade MédicoFarmacêutica and Sociedade de Medicina e Cirurgia. It also analyzes the social context that led to their closure.

Enfermedad de Hansen en menores de 15 años: la importancia del examen de contacto

OBJETIVO: Describir dos casos de enfermedad de Hansen en menores de 15 anos, siendo uno de paciente con 18 meses de edad y otro de 13 anos, diagnosticados por modos de deteccion distintos, subrayando la importancia de examinar a los contactos. DESCRIPCION DEL CASO: Uno de los casos tuvo diagnostico temprano mediante examen de contactos intradomiciliares, mientras que el otro fue diagnosticado por demanda espontanea despues de cuatro anos de surgimiento de las lesiones y, a pesar de ser contacto de un ex-paciente, no fue examinado en la epoca. COMENTARIOS: En paises endemicos, la alta deteccion de enfermedad de Hansen en menores de 15 anos revela la persistencia en la transmision del bacilo y las dificultades de los programas de salud para el control de la enfermedad. El mayor tiempo para diagnostico ocasiona secuelas y deformidades y, de ese modo, la busqueda por los contactos constituye importante metodo para el diagnostico temprano de la enfermedad en la infancia, cuando las senales clinicas no siempre son faciles de identificarse y hay gran diversidad de formas clinicas en que la enfermedad puede presentarse.ABSTRACT Objective : To describe two cases of leprosy in children un-der 15 years old, being one patient aged with 18 months and other 13 years, diagnosed by different modes of detection, emphasizing the importance of examining the contacts. Case description : One of the cases was diagnosed early by examining household contacts, while the other was diag-nosed by spontaneous demand, after four years of the onset of lesions, although he had been a former patient contact who was not examined at the time. Comments : In endemic countries, the high detection of leprosy in children under 15 years old reveals the persistence of the bacillus transmission and the difficulties encountered by public health programs to control the disease. Delay in leprosy diagnosis leads to sequels and deformities and, thus, the search for contacts is important as an effective method for early diagnosis of the disease in childhood, where clinical signs are not always easy to be identified due to the great variety of clinical forms in which the disease may occur.