Valentino Magno

Mate (chimarrão) é consumido em alta temperatura por população sob risco para o carcinoma epidermóide de esôfago

ABSTRACT – “Mate”, a popular hot infusion of a herb ( Ilex paraguayensis) drunk in large volumes, is a known risk factor for squamous cellcarcinoma of the esophagus and there is a suspicion that high temperature of boiled water used for the infusion may contribute for carcinogenesis. Methods - We measured the temperature of “mate” infusion drank by a sample of the population at risk for this carcinoma in Taquara, so uthernBrazil. We interviewed inhabitants for drinking habits and the temperature of the infusion was measured with high precision thermometers.Temperature of the infusion was asked to consumers and their estimate compared to our measurements. We considered 60 o C or higher as “hot”. Results - In 36 residencies, 107 individuals were drinking “mate”. Most individuals drunk it daily (97,2%), and the medium daily volume was1,265 ml (SD ± 1,132 mL) ranging from 250 to 6,000 mL. The measured temperature was 60 o C or higher in 72% of residencies with mediumof 63.4 o C (51-78 o

Efficacy, safety, and acceptability of thermocoagulation for treatment of cervical intraepithelial neoplasia in a hospital setting in Brazil

To analyze the acceptability, safety, and effectiveness of thermocoagulation for the treatment of histologically proven cervical intraepithelial neoplasia grade 2–3 (CIN2–3) lesions.

Pyoderma gangrenosum postlaparoscopy: a rare complication.

Pyoderma gangrenosum (PG) is a rare, chronic, often destructive, inflammatory skin disease in which a painful nodule or pustule breaks down to form a progressively enlarging ulcer. There are only 4 reported cases of postlaparoscopic PG and the purpose of this case report is to describe a patient found to have the disease after elective laparoscopy. Although rare, the occurrence of PG after surgery, even where incisions are small such as in laparoscopic surgery, is a diagnosis that cannot be neglected, especially due to the high morbidity, which increases if the diagnosis is not made and the patient is subjected to debridement.

Maternal ophthalmic artery Doppler ultrasonography in preeclampsia and pregnancy outcomes

OBJECTIVE To examine the association of ophthalmic artery (OA) Doppler measure - the ratio of velocity peaks (PR) - to adverse pregnancy outcomes in preeclampsia. STUDY DESIGN AND MAIN OUTCOMES Prospective cohort study of 56 women with preeclampsia that underwent Doppler measurements of OA flow, medial to optic nerve. PR results were classified as normal (PR < 0.78), abnormal (PR 0.78-0.98), or highly abnormal (PR ≥ 0.99). Attending clinicians were blinded to OA Doppler results. The primary endpoints were (1) a composite of adverse maternal outcomes-central nervous system injury (eclampsia or posterior reversible encephalopathy syndrome), HELLP syndrome, hypertensive crisis, maternal admission to the intensive care unit, and maternal death-and (2) a composite of adverse perinatal outcomes-birth weight <10th percentile for gestational age, neonatal acidemia, 5-min Apgar score <7, admission of infants weighing >2500 g to the neonatal intensive care, preterm birth <32 weeks, fetal or neonatal death. RESULTS Adverse maternal outcomes became more frequent as the PR values increased (p=.005). The occurrence of hypertensive crisis after hospital admission (secondary endpoint) was also positively associated with PR values (p=.001). Adverse perinatal outcomes were not associated with PR values (p=.551), but women in the highly abnormal PR group (PR ≥ 0.99) had the earliest deliveries (p=.001) and the smallest newborns (p=.004). All women in the highly abnormal PR group (n=16) had an adverse outcome. CONCLUSIONS Maternal OA Doppler PR ≥ 0.99 in preeclampsia may identify women at increased risk of adverse maternal outcomes and pregnancies at the greatest risk of preterm birth.

Tumor de células de Leydig do ovário associado a virilização em paciente na pós-menopausa

Tumores de celulas de Leydig sao neoplasias de celulas esteroides e correspondem a menos de 0,5% dos tumores ovarianos. Ocorrem mais comumente na pos-menopausa e se apresentam com virilizacao em metade dos casos. Relatamos o caso de uma mulher de 53 anos com historia de virilizacao. A investigacao com ressonância magnetica demonstrou altos niveis sericos de testosterona e um nodulo de 2 cm no ovario direito. A paciente foi submetida a ooforectomia bilateral, e a analise patologica confirmou o diagnostico de tumor de celulas de Leydig do ovario direito. Um dia apos a cirurgia, o nivel serico de testosterona se normalizou. Em quatro meses, a paciente apresentou nivel serico normal de testosterona e regressao parcial da alopecia. Em mulheres pos-menopausicas com quadro de virilizacao progressiva, deve-se suspeitar de neoplasias ovarianas produtoras de androgenos. Palavras-chave: tumor de celulas de Leydig; virilizacao

Adenocarcinoma de endométrio : epidemiologia, tratamento e sobrevida de pacientes atendidas no Hospital de Clínicas de Porto Alegre

Introducao: Neste estudo, descreve-se o perfil clinico das pacientes e as caracteristicas histopatologicas dos carcinomas de endometrio tratados no setor de Oncologia Genital do Hospital de Clinicas de Porto Alegre (HCPA), assim como as formas de tratamento, fatores prognosticos e sobrevida. Metodos: Estudo de coorte historica incluindo todas as pacientes submetidas a tratamento cirurgico primario entre 1996 a 2012. Apos revisao de prontuarios medicos, foram analisadas as variaveis idade, status hormonal, tipo histologico e grau tumoral, invasao miometrial, estadiamento cirurgico, cirurgia realizada, tratamento complementar e sobrevida. Resultados: Cento e sessenta e quatro pacientes foram incluidas no estudo, com idade media de 64,2 anos (31-95 anos), sendo quase 90% delas pos-menopausicas. O tempo de seguimento variou de 4 dias a 14,6 anos. O tipo histologico endometrioide foi o mais encontrado (78% dos casos). A histerectomia com salpingo-ooforectomia bilateral com linfadenectomia pelvica foi a cirurgia mais realizada (77,5%). Tratamento complementar foi realizado em 57,9% das pacientes, sendo a radioterapia o tratamento de escolha em 87,4% deles. Ocorreram 36 obitos (22%) durante o seguimento, com uma sobrevida media global de 125 meses. Em analise bivariada, idade ≥ 65 anos, tipo histologico nao endometrioide, tumores pouco diferenciados (G3), invasao miometrial ≥ 50% e metastase linfonodal relacionaram-se significativamente a um menor tempo de sobrevida. Em analise multivariada, a histologia nao endometrioide estadio III e IV, e a presenca de comprometimento linfonodal foram significativamente associados ao obito. Conclusao: Os resultados encontrados sao compativeis com a literatura existente e vem em acrescimo a escassa estatistica nacional.

Prevalencia y repercusión en las recidivas de la invasión linfovascular en el cáncer cervicouterino incipiente: prevalencia de la invasión linfovascular en el cáncer cervicouterino

Objetivo. El propósito de este estudio era determinar la prevalencia de la invasión linfovascular (ILV) en el cuello uterino y su repercusión en la supervivencia en mujeres con muestras de cáncer cervical incipiente sometidas a histerectomía radical. Materiales y métodos. Se revisó la invasión linfovascular en 107 casos de cáncer cervicouterino en estadios IB1 y IIA y se comparó con el examen anatomopatológico original. Además, se calculó adecuadamente la repercusión en las recidivas en cada paciente y se comparó con la presencia de ILV. Resultados. Se detectó invasión linfovascular en el cuello uterino en el 17,8% (19/107) de los casos (IC del 95% = 11,37‐ 25,87) en el examen anatomopatológico original, y cuando las muestras se revisaron específicamente en busca de esta alteración en el presente estudio, el 74,8% (80/107) de los casos (IC del 95% = 65,9‐82,31) eran positivos. Se hizo un seguimiento de las pacientes durante una media de 4,87 ± 2,66 años, y la recidiva tumoral no fue diferente entre las pacientes con (27,5%; 22/80) y sin (7,4% 2/27) ILV (p = 0,058), aunque se demostró una fuerte tendencia. Conclusiones. La prevalencia de la ILV se infravalora en los exámenes anatomopatológicos habituales, y su tasa aumenta considerablemente con una revisión meticulosa. Hay que seguir investigando la relación entre su presencia y un pronóstico peor.

Contents Vol. 67, 2009

M.A. Belfort, Provo, Utah J. Bornstein, Nahariya H.L. Brown, Durham, N.C. C. Chapron, Paris J. de Haan, Maastricht G.A. Dekker, Adelaide J.A. Deprest, Leuven K. Hecher, Hamburg S. Kahhale, São Paulo H. Kliman, New Haven, Conn. T.F. Kruger, Tygerberg J.A. Kuller, Raleigh, N.C. M.J. Kupferminc, Tel Aviv H. Minkoff , Brooklyn, N.Y. J. Moodley, Congella J.M. Mwenda, Nairobi H. Odendaal, Tygerberg J.T. Repke, Hershey, Pa. Founded 1895 as ‘Monatsschrift für Geburtshilfe und Gynäkologie’, continued 1946–1969 as ‘Gynaecologia’ and 1970–1977 as ‘Gynecologic Investigation’