RESUMO
Acne fulminans is a severe and rare form of inflammatory acne. Lesion severity and subsequent scarring has a negative impact on the patient's quality of life. We conducted a narrative review of the literature on acne fulminans based on a search for relevant English- and Spanish-language articles published in Medline. We included case reports and case series. The main aim was to describe the clinical and demographic characteristics of patients with acne fulminans. A secondary aim was to determine whether quality of life was affected by the site or extent of lesions. We reviewed 91 articles describing 212 cases of acne fulminans. The mean age of the patients (91.94% male) was 16.6 years. A personal and family history of acne vulgaris was reported for 97.63% and 54.90% of patients, respectively. A trigger was identified in 44.79% of cases. The main cause was pharmacologic (96.63%) and the main drug isotretinoin (65.28%). The sites most often affected were the face (89.31%), the posterior trunk (77.86%), and the anterior trunk (74.81%). The predominant disease subtype was acne fulminans with systemic symptoms (59.12%), which were mostly general (97.06%). Systemic corticosteroids were the most widely used treatment (81.03%). The impact of the disease on quality of life was reported for two patients. In conclusion, acne fulminans mainly affects the face and trunk of male adolescents with a history of acne vulgaris. The main subtype was acne fulminans with systemic symptoms, and most patients were treated with systemic corticosteroids. The effect of acne fulminans on quality of life is under-reported.
RESUMO
Acne fulminans is a severe and rare form of inflammatory acne. Lesion severity and subsequent scarring has a negative impact on the patient's quality of life. We conducted a narrative review of the literature on acne fulminans based on a search for relevant English- and Spanish-language articles published in Medline. We included case reports and case series. The main aim was to describe the clinical and demographic characteristics of patients with acne fulminans. A secondary aim was to determine whether quality of life was affected by the site or extent of lesions. We reviewed 91 articles describing 212 cases of acne fulminans. The mean age of the patients (91.94% male) was 16.6 years. A personal and family history of acne vulgaris was reported for 97.63% and 54.90% of patients, respectively. A trigger was identified in 44.79% of cases. The main cause was pharmacologic (96.63%) and the main drug isotretinoin (65.28%). The sites most often affected were the face (89.31%), the posterior trunk (77.86%), and the anterior trunk (74.81%). The predominant disease subtype was acne fulminans with systemic symptoms (59.12%), which were mostly general (97.06%). Systemic corticosteroids were the most widely used treatment (81.03%). The impact of the disease on quality of life was reported for 2 patients. In conclusion, acne fulminans mainly affects the face and trunk of male adolescents with a history of acne vulgaris. The main subtype was acne fulminans with systemic symptoms, and most patients were treated with systemic corticosteroids. The effect of acne fulminans on quality of life is underreported.
Assuntos
Acne Vulgar , Qualidade de Vida , Adolescente , Humanos , Masculino , Feminino , Acne Vulgar/tratamento farmacológico , Acne Vulgar/epidemiologia , Isotretinoína/uso terapêutico , Corticosteroides/uso terapêuticoRESUMO
Previous observations have noted that in some species of higher termites the soldier caste lacks pigmented particles in its gut and, instead, is fed worker saliva that imparts a whitish coloration to the abdomen. In order to investigate the occurrence of this trait more thoroughly, we surveyed a broad diversity of termite specimens and taxonomic descriptions from the Old World subfamilies Apicotermitinae, Cubitermitinae, Foraminitermitinae, Macrotermitinae, and Termitinae. We identified 38 genera that have this "white-gutted" soldier (WGS) trait. No termite soldiers from the New World were found to possess a WGS caste. Externally, the WGS is characterized by a uniformly pale abdomen, hyaline gut, and proportionally smaller body-to-head volume ratio compared with their "dark-gutted" soldier (DGS) counterparts found in most termitid genera. The WGS is a fully formed soldier that, unlike soldiers in other higher termite taxa, has a small, narrow, and decompartmentalized digestive tube that lacks particulate food contents. The presumed saliva-nourished WGS have various forms of simplified gut morphologies that have evolved at least six times within the higher termites.
RESUMO
BACKGROUND: Desmoid tumor is a rare benign mesenchymal neoplasm in children primarily originated in the muscle connective tissue, fascial sheaths, and musculoaponeurotic structures. It is often misdiagnosed as fibroids, reactive processes or low-grade fibrosarcomas. It is characterized by slow growth, locally aggressive nature, high recurrence rate without metastasize capacity. MATERIAL AND METHODS: 7 year old girl with right paramandibular tumor, a year of evolution. It was characterized by slow and painless growth, trismus and mandibular latero-deviation to the left during mouth opening. Imaging tests showed soft parts tumor in masseteric region with a periosteal reaction in the mandibular body. The biopsy reported a desmoid tumor. RESULTS: Risdon approach was performed for tumor resection and external cortical Split mandibular body, without preserving the marginal branch of CP VII. The pathology reports of aggressive fibromatosis without bone involvement. It currently presents marginal paralysis and free-disease. CONCLUSIONS: Desmoid tumors of head and neck are difficult to treat because of the proximity or involvement in vital structures, infiltrative nature and tendency to local recurrence. Primary surgery with negative surgical margins is the treatment of choice. However, in many cases this involves disfiguring surgery. Therefore, in these cases and in those surgical margins affections, the use of chemotherapy/non-cytotoxic drugs can be an alternative. Because they are low incidence tumors prospective multicenter studies are needed to clarify the role of adjuvant treatment in this tumor.
Assuntos
Fibromatose Agressiva , Neoplasias de Cabeça e Pescoço , Criança , Feminino , Fibromatose Agressiva/diagnóstico , Fibromatose Agressiva/cirurgia , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/cirurgia , HumanosRESUMO
The breast surgery has undergone changes in recent years, encouraging new initiatives for the anaesthetic management of these patients in order to achieve maximum quality and rapid recovery. The fundamental tool that has allowed a significant improvement in the progress of regional anaesthesia for breast disease has been ultrasound, boosting the description and introduction into clinical practice of interfascial chest wall blocks, although the reference standard is still the paravertebral block. It is very likely that these blocks will change the protocols in the coming years. A review is presented of the anatomy of the breast region, description of nerve blocks and techniques, as well as their indications, all according to published articles and the opinion of the authors based on their experience.
Assuntos
Bloqueio Nervoso , Mama/cirurgia , Neoplasias da Mama/cirurgia , Humanos , Mastectomia , Ultrassonografia MamáriaAssuntos
Cimentos Ósseos/uso terapêutico , Sedação Consciente , Pressão Positiva Contínua nas Vias Aéreas/instrumentação , Osteólise/terapia , Doenças da Coluna Vertebral/terapia , Vértebras Torácicas , Corticosteroides/efeitos adversos , Corticosteroides/uso terapêutico , Idoso , Anestésicos Intravenosos/administração & dosagem , Anestésicos Intravenosos/uso terapêutico , Humanos , Hipnóticos e Sedativos/administração & dosagem , Hipnóticos e Sedativos/uso terapêutico , Injeções Intralesionais , Masculino , Midazolam/administração & dosagem , Midazolam/uso terapêutico , Osteólise/etiologia , Osteoporose/induzido quimicamente , Osteoporose/complicações , Pré-Medicação , Propofol/administração & dosagem , Propofol/uso terapêutico , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doenças da Coluna Vertebral/induzido quimicamente , Vértebras Torácicas/patologiaRESUMO
Following the discovery and biochemical characterization of natural somatostatin its action profile has been thoroughly investigated. Although the name somatostatin was coined in virtue of its growth hormone release-inhibiting properties, a number of central and peripheral endocrine and paracrine actions have been ascribed to this peptide. Its inhibitory effect on a series of pituitary and gastrointestinal hormones has characterized somatostatin as a classical brain-gut hormone. Circulating and tissue levels of somatostatin and its possible physiological role are analyzed and clinical implications are drawn.
Assuntos
Hipófise/metabolismo , Somatostatina/fisiologia , Animais , Encéfalo/fisiologia , Humanos , Somatostatina/sangue , Somatostatina/líquido cefalorraquidianoRESUMO
The efficacy and safety of famotidine (40 mg at night), a new potent H2-receptor antagonist, has been studied in 119 patients by four investigators in four Spanish hospitals in a randomized double-blind comparative study with cimetidine (800 mg at night). Antacid tablets were allowed as additional treatment, if needed for pain relief. There were no significant differences between the groups in baseline characteristics, including duodenal ulcer size. Efficacy parameters included daytime and nocturnal symptom relief and duodenal ulcer healing, documented by endoscopy, and defined as complete reepithelization of the ulcer crater. Endoscopy was performed at baseline and after 4 and 6 weeks of treatment. One hundred and five patients fulfilled the evaluation criteria (51 patients in the famotidine group and 54 in the cimetidine group). After 4 weeks, in 91.6% of the patients receiving famotidine and 82.3% of the patients receiving cimetidine ulcers were healed. After 6 weeks, healing rates were 96% (famotidine) and 85.1% (cimetidine) (p = 0.056). Pain relief was rapid in both treatment groups, with a tendency to better response during the day in the famotidine group. The intake of antacids, as well as the clinical and laboratory safety profile were similar for both groups.