Metastatic Biphasic Primitive Tumor in the Mandible of a Child.

Pediatric mandibular tumors present an aggressive biological behavior and difficult diagnosis. A wide range of odontogenic and nonodontogenic tumors comprise the spectrum of these lesions. We report a case of a 1-year-old male child patient showing facial asymmetry symptomatic of an expansive lesion extending throughout the body and ramus of the left hemimandible with a diameter of 8 cm. The histopathological report suggested a high-grade mucoepidermoid carcinoma (MEC), recommending further immunohistochemical investigation of the ectomesenchymal or neuroectodermal origin of the tumor cells. The patient evolved with extensive bilateral pleural effusion followed by metastasis in the middle third of the right humerus, and died 2 months after the first biopsy procedure by acute renal failure with tubular necrosis, before a final inconclusive immunohistochemical report was reached. The lack of resources for less-favored regions of Brazil impairs rapid biomolecular examinations such as immunohistochemical resulting in delay of appropriate therapeutic procedures.

Risk factors and prophylaxis for venous thromboembolism in hospitals in the city of Manaus, Brazil.

OBJECTIVE: To identify and classify risk factors for venous thromboembolism (VTE) in hospitalized patients, as well as to evaluate medical practices regarding prophylaxis for the disease. METHODS: An observational cross-sectional study, carried out between January and March of 2006, involving inpatients at three hospitals in the city of Manaus, Brazil. Risk stratification for VTE was based on the criteria established by the Brazilian Society of Angiology and Vascular Surgery and by the International Union of Angiology. Clinical, surgical and medication-related risk factors were analyzed. The statistical analysis of the data obtained was conducted, adopting an alpha error of 5% and 95% CI. Qualitative data were analyzed using the chi-square test, whereas quantitative data were analyzed using Student's t-test. RESULTS: Of the 1,036 patients included (total number of admissions, 1,051), 515 (49.7%) were male, and 521 (50.3%) were female. A total of 23 risk factors for VTE were identified (total number of occurrences, 2,319). The stratified risk for VTE was 50.6%, 16.6% and 30.8% among the admissions of high-, moderate- and low-risk cases, respectively. In 73.3% of the admissions, nonpharmacological prophylaxis was not employed at any point during the study period. In 74% of those classified as high- or moderate-risk cases, no prophylactic medications were administered. CONCLUSIONS: This study showed that, in the population studied, risk factors were common and that prophylactic measures were not employed in patients prone to developing VTE and its complications.

Fatores de risco e profilaxia para tromboembolismo venoso em hospitais da cidade de Manaus / Risk factors and prophylaxis for venous thromboembolism in hospitals in the city of Manaus, Brazil

OBJETIVO: Identificar e classificar os fatores de risco para tromboembolismo venoso (TEV) em pacientes internados, avaliando as condutas médicas adotadas para a profilaxia da doença. MÉTODOS: Estudo observacional, de corte transversal no período de janeiro a março de 2006, envolvendo uma população de pacientes internados em três hospitais na cidade de Manaus (AM). A estratificação do risco para TEV foi feita com base nos critérios da Sociedade Brasileira de Angiologia e Cirurgia Vascular e da International Union of Angiology. Foram avaliados variáveis sobre os fatores de risco clínicos, cirúrgicos e medicamentosos, assim como os métodos profiláticos para TEV. Os dados foram analisados estatisticamente, adotando-se um alfa de 5 por cento e IC95 por cento. Os dados qualitativos foram analisados pelo teste do qui-quadrado e os dados quantitativos pelo teste t de Student. RESULTADOS: Foram estudados 1.036 pacientes num total de 1.051 internações, sendo 515 (49,7 por cento) homens e 521 (50,3 por cento) mulheres. Um total de 23 de fatores de risco para TEV foram identificados (número total de eventos, 2.319). O risco estratificado para TEV foi de 50,6 por cento, 18,6 por cento e 30,8 por cento das internações para risco alto, moderado e baixo, respectivamente. Em 73,3 por cento das internações, não foram adotadas medidas profiláticas não-medicamentosas durante o período do estudo, e em 74 por cento das internações que apresentavam risco moderado ou alto, não foram adotadas quaisquer medidas terapêuticas medicamentosas. CONCLUSÕES: Este estudo evidenciou que, na população estudada, os fatores de risco foram frequentes e que medidas profiláticas não foram utilizadas para pacientes com riscos potenciais de desenvolverem TEV e suas complicações.

OBJECTIVE: To identify and classify risk factors for venous thromboembolism (VTE) in hospitalized patients, as well as to evaluate medical practices regarding prophylaxis for the disease. METHODS: An observational cross-sectional study, carried out between January and March of 2006, involving inpatients at three hospitals in the city of Manaus, Brazil. Risk stratification for VTE was based on the criteria established by the Brazilian Society of Angiology and Vascular Surgery and by the International Union of Angiology. Clinical, surgical and medication-related risk factors were analyzed. The statistical analysis of the data obtained was conducted, adopting an alpha error of 5 percent and 95 percent CI. Qualitative data were analyzed using the chi-square test, whereas quantitative data were analyzed using Student's t-test. RESULTS: Of the 1,036 patients included (total number of admissions, 1,051), 515 (49.7 percent) were male, and 521 (50.3 percent) were female. A total of 23 risk factors for VTE were identified (total number of occurrences, 2,319). The stratified risk for VTE was 50.6 percent, 16.6 percent and 30.8 percent among the admissions of high-, moderate- and low-risk cases, respectively. In 73.3 percent of the admissions, nonpharmacological prophylaxis was not employed at any point during the study period. In 74 percent of those classified as high- or moderate-risk cases, no prophylactic medications were administered. CONCLUSIONS: This study showed that, in the population studied, risk factors were common and that prophylactic measures were not employed in patients prone to developing VTE and its complications.