Pituitary metastasis as the first manifestation of lung carcinoma.

Pituitary metastases are rare. Clinical presentation could range from asymptomatic to panhypopituitarism or local symptoms. We present a case report of a 43-year-old male patient with a new onset headache, visual disturbances, and panhypopituitarism. The investigation led to the diagnosis of pituitary metastasis as the first manifestation of underlying lung cancer.

Primary Cutaneous Anaplastic Large Cell Lymphoma With 6p25.3 Rearrangement and Epidermotropism.

ABSTRACT: Primary cutaneous anaplastic large cell lymphoma may harbor a 6p25.3 rearrangement, which has been associated with an epidermotropic small cell component. We report the case of a patient with said lymphoma harboring that rearrangement. It presented as a forehead nodule, histologically composed of an intermediate-to-large cell dermal component alongside a small-to-intermediate cell epidermotropic component. After multiple cutaneous and regional lymph node relapses, disease progression has been documented to a distant lymph node, despite local radiotherapy of the cutaneous lesions, chemotherapy, and anti-CD30 therapy, albeit with an indolent course over 6 years. Cases of pcALCL with nonregional lymph node involvement are unusual. Nevertheless, in this case, progression to a distant lymph node was not associated with an aggressive transformation of the disease.

Hyperleukocytosis in Solid tumors: A Rare Paraneoplastic Syndrome Associated with Poor Prognosis.

Hematological paraneoplastic syndromes are fairly uncommon. While mild leukocytosis in solid tumors is well reported, white blood cell (WBC) count over 50,000 u/L, described as paraneoplastic leukemoid reaction (PLR), is not. Indeed, when found, it is usually associated with a higher burden of disease, tumor activity and worse clinical outcomes. We report the case of a challenging and burdensome diagnosis of a presumptive hematological paraneoplastic syndrome in a patient with a locally advanced lung cancer admitted in the Internal Medicine ward. After the end of chemotherapy, clinical and laboratory benefit was observed; however, the aggressive course of the disease became clear, with progression and downhill course that was unresponsive to treatment.

Fusarium spp.-An Emerging Pathogen in Chronic Diabetic Ulcer: Case Report and Review of the Literature.

The genus Fusarium is ubiquitous in the environment and has been emerging as an opportunistic human pathogen. We report the case of a 65-year-old man with a history of neuroischemic, otherwise unamenable to revascularization, diabetic foot, who was admitted due to an infected deep foot ulcer. Despite conventional antibiotic and wound care treatment, no improvement was initially observed. A reappraisal of the diagnosis, with microbiological and histological analyses, documented infection of the foot ulcer with Fusarium oxysporum. Clinical improvement was noted under prolonged oral voriconazole therapy. The present case broadens the differential diagnosis of diabetic foot infection. Subcutaneous fusariosis should be considered in recalcitrant infected diabetic ulcers, as early diagnosis and management may help prevent amputation and life-threatening disease.

A rare diarrheic parasite in a kidney transplant patient: Cystoisospora belli.

Cystoisospora belli colitis is a rare complication of immunosuppression in solid organ transplant recipients. We describe a case of Cystoisospora belli infection with colitis following renal transplantation.

Prevalência de dor nas costas e fatores associados de escolares de Viamão, RS / Back pain prevalence and associated factors among schoolchildren from Viamão, RS

Introdução: Dores nas costas estão presentes cada vez mais em crianças e adolescentes e existem diversos fatores que contribuem para isso. Objetivos: Verificar a prevalência de dor nas costas e identificar os fatores associados em estudantes de uma escola privada do município de Viamão/RS. Métodos: Participaram do estudo 155 estudantes do 4º ao 6º ano do ensino fundamental, que responderam ao questionário BackPEI. Resultados: A partir de análise multivariável, apurouse que a dor nas costas está associada (p<0,05) com dor nas costas dos pais e o nível de escolaridade dos mesmos. Conclusão: Concluímos que a prevalência de dor nas costas dos estudantes foi de 56,9%, o que sugere a necessidade do desenvolvimento de programas preventivos nessa comunidade escolar.

Introduction: Back pain is increasingly present in children and adolescents and there are several factors to contribute to this. Aim: To verify the prevalence of back pain and to identify the associated risk factors in students from a private school in the city of Viamão/RS. Methods: 155 students from the 4th to 6th grade of elementary school participated, who answered the Back Pain and Body Posture Evaluation (BackPEI) Questionnaire. Results: Based on multivariate analysis, it was found that back pain is associated (p>0.05) with parents' back pain and their schooling level. Conclusion: We concluded that the prevalence of back pain among students was 56.9%, suggesting the need to develop preventive programs in this school community.

Regioselective synthesis, biological evaluation, and molecular docking of dihydropyrimidin-4-ols as acetylcholinesterase inhibitors.

A new series of 3,6-disubstituted 2-(methylthio)-4-(trifluoromethyl)-3,4-dihydropyrimidin-4-ols displaying methyl, phenyl, aryl, and heteroaryl groups at the 6-position; and methyl, ethyl, allyl, and phenyl groups at the 3-position of the dihydropyrimidine ring, were synthesized and evaluated in vitro for acetylcholinesterase inhibitory activity. Seven compounds showed activity with IC50 values in the lower micromolar range. The compound 4-trifluoromethyl-6-(4-fluorophenyl)-3-methyl-2-methylthio-3,4-dihydropyrimidin-4-ol (6e) had the best inhibitory activity (IC50 2.2 ± 0.9 µm) and this inhibition was characterized as competitive. The molecular docking study showed that the acetylcholinesterase enzyme accommodates compound 6e in its catalytic site. The enantiomers of compound 6e, present similar interactions: π-π stacking interactions between the aromatic ring of the ligand's 4-fluorophenyl moiety and the aromatic rings of the electron-rich Trp84; and H-bonds between the hydroxyl group of Tyr121 and the hydroxyl moiety from 6e. The antioxidant effect of the dihydropyrimidin-4-ols was also investigated.

Posturas e estratégias sobre sexualidade a partir do programa saúde na escola: discursos de professores / Posturas y estrategias sobre la sexualidad desdela salud emla escuela: discursos de profesores / Positionings and strategies on sexuality from the school health program: teachers' speeches

Objetivo: analisar as posturas e estratégias de enfrentamento dos professores, acerca da educação sexual e reprodutiva em sala de aula, em uma escola pública de Juazeiro-BA, conveniada ao Programa Saúde na Escola (PSE). Método: qualitativo, exploratório e descritivo, com 11 professores e um gestor escolar, por meio de entrevista semiestruturada, com fechamento amostral por saturação teórica. Utilizou-se a Análise de Discurso, com o suporte teórico da metodologia problematizadora empregada por Paulo Freire.Resultados: como postura revelada, as discussões sobre o tema se mostraram sem constrangimentos aos professores, pois, dentre as estratégias adotadas, alguns recursos como vídeos e debates são utilizados. Porém, a atuação dos educadores não encontra sustentabilidade no PSE, pois os professores desconhecem o programa. Conclusões: o tema deve ser socializado e horizontalizado de maneira a promover a integração do conhecimento em espaços escolares, com oportunidades dialógicas de discussão sobre sexualidade na adolescência, a partir de um trabalho conjunto entre educação e saúde.

Aim: to analyze teachers’ postures and strategies for handling sexual and reproductive education in the classroom, in a public school in Juazeiro-BA, in agreement with the School Health Program (PSE). Method: qualitative, exploratory and descriptive study, carried out with 11 teachers and a school manager, through a semistructured interview, with sample closure by theoretical saturation. Discourse Analysis was used, with the theoretical support of the problem-solving methodology practiced by Paulo Freire. Results: as a revealed attitude, the discussions about the subject were developed without constraints to the teachers, since, among the strategies adopted, some resources like videos and debates are used. However, the performance of educators does not find sustainability in the PSE, since teachers are unfamiliar with the program. Conclusions: the theme should be socialized and balanced in order to promote knowledge integration in school spaces, with dialogic opportunities for discussion on sexuality in adolescence, based on a joint work between education and health.

Objetivo: analizar las actitudes y estrategias de enfrentamiento de los profesores sobre la educación sexual y la reproducción en el aula, de una escuela pública, en Juazeiro-BA, convenida en el Programa de Salud Escolar (PSE). Método: cualitativo, exploratorio y descriptivo, con 11 profesores y la dirección de la escuela, por medio de entrevistas semi-estructuradas, con muestra por saturación teórica. Se utilizó el análisis del discurso, con el apoyo teórico de la metodología de investigación utilizada por Paulo Freire. Resultados: como la postura ha revelado, las discusiones sobre el tema han mostrado profesores no constreñidos pues, entre las estrategias adoptadas se utilizan algunos recursos, tales como, videos y debates. Sin embargo, el papel de los educadores no encuentra sostenibilidad en el PSE, porque los profesores no conocen el programa. Conclusiones: el tema debe ser socializado y divulgado con el objetivo de divulgación y de la integración de los conocimientos en los espacios escolares, con oportunidades dialógicas para la discusión de la sexualidad en la adolescencia, a partir de un trabajo en conjunto entre la educación y la salud.

Rosmarinic acid prevents lipid peroxidation and increase in acetylcholinesterase activity in brain of streptozotocin-induced diabetic rats.

We investigated the efficacy of rosmarinic acid (RA) in preventing lipid peroxidation and increased activity of acetylcholinesterase (AChE) in the brain of streptozotocin-induced diabetic rats. The animals were divided into six groups (n = 8): control, ethanol, RA 10 mg/kg, diabetic, diabetic/ethanol and diabetic/RA 10 mg/kg. After 21 days of treatment with RA, the cerebral structures (striatum, cortex and hippocampus) were removed for experimental assays. The results demonstrated that the treatment with RA (10 mg/kg) significantly reduced the level of lipid peroxidation in hippocampus (28%), cortex (38%) and striatum (47%) of diabetic rats when compared with the control. In addition, it was found that hyperglycaemia caused significant increased in the activity of AChE in hippocampus (58%), cortex (46%) and striatum (30%) in comparison with the control. On the other hand, the treatment with RA reversed this effect to the level of control after 3 weeks. In conclusion, the present findings showed that treatment with RA prevents the lipid peroxidation and consequently the increase in AChE activity in diabetic rats, demonstrating that this compound can modulate cholinergic neurotransmission and prevent damage oxidative in brain in the diabetic state. Thus, we can suggest that RA could be a promising compound in the complementary therapy in diabetes.