Physical and mental health impacts during COVID-19 quarantine in adolescents with preexisting chronic immunocompromised conditions

Abstract Objective: To evaluate physical and mental health indicators in adolescents with preexisting chronic immunocompromised conditions during coronavirus disease 2019 (COVID-19) quarantine. Methods: A cross-sectional study included 355 adolescents with chronic conditions and 111 healthy adolescents. An online self-rated survey was used to investigate socio-demographic features, healthcare routine, and the quarantine impact on physical and mental health. The validated self-reported version of the Strengths and Difficulties Questionnaire (SDQ) was also applied. Results: The median of age [14 (10-18) vs. 15 (10-18) years, p = 0.733] and frequencies of female (61% vs. 60%, p = 0.970) were similar between adolescents with preexisting chronic conditions and healthy adolescents during quarantine of COVID-19 pandemic. The frequencies of abnormal total difficulties score of SDQ were similar in patients and controls (30% vs. 31%, p = 0.775). Logistic regression analysis showed that being female (OR = 1.965; 95% CI = 1.091-3.541, p = 0.024), fear of underlying disease activity/complication (OR = 1.009; 95%CI = 1.001-1.018, p = 0.030) were associated with severe psychosocial dysfunction in adolescents with chronic conditions, whereas school homework (OR = 0.449; 95% CI = 0.206-0.981, p = 0.045) and physical activity (OR = 0.990; 95% CI = 0.981-0.999, p = 0.030) were protective factors. Further analysis of patients with chronic immunocompromised conditions and previous diagnosis of mental disorders (9%) compared with patients without diagnosis showed higher median of total difficulties score (p = 0.001), emotional (p = 0.005), conduct (p = 0.007), peer problems (p = 0.001) and hyperactivity (p = 0.034) in the former group. Conclusion: Adolescents with preexisting chronic immunocompromised conditions during COVID-19 quarantine were not at higher risk of adverse health indicators. Being female, fear of underlying disease activity/complication, and household members working outside of the home were relevant issues for adolescents with preexisting chronic conditions. This study reinforces the need to establish mental health strategies for teens with chronic conditions, particularly during the pandemic.

Poor Sleep quality and health-related quality of life impact in adolescents with and without chronic immunosuppressive conditions during COVID-19 quarantine

OBJECTIVE: To assess the possible factors that influence sleep quality in adolescents with and without chronic immunosuppressive conditions quarantined during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional study included 305 adolescents with chronic immunocompromised conditions and 82 healthy adolescents. Online surveys were completed, which included questions on socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and the following validated questionnaires: the Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), and Pediatric Outcome Data Collection Instrument (PODCI). RESULTS: The median current age [14 (10-18) vs. 15 (10-18) years, p=0.847] and frequency of female sex (62% vs. 58%, p=0.571) were similar in adolescents with chronic conditions compared with healthy adolescents. The frequency of poor sleep quality was similar in both groups (38% vs. 48%, p=0.118). Logistic regression analysis, including both healthy adolescents and adolescents with chronic conditions (n=387), demonstrated that self-reported increase in screen time (odds ratio [OR] 3.0; 95% confidence interval [CI] 1.3-6.8; p=0.008) and intrafamilial violence report (OR 2.1; 95% CI 1.2-3.5; p=0.008) were independently associated with poor sleep quality in these adolescents. However, the PODCI global function score was associated with a lower OR for poor sleep quality (OR 0.97; 95% CI 0.94-0.99; p=0.001). Further logistic regression, including only adolescents with chronic conditions (n=305), demonstrated that self-reported increase in screen time (OR 3.1; 95% CI 1.4-6.8; p=0.006) and intrafamilial violence report (OR 2.0; 95% CI 1.2-3.4; p=0.011) remained independently associated with poor quality of sleep, whereas a lower PODCI global function score was associated with a lower OR for sleep quality (OR 0.96; 95% CI 0.94-0.98; p<0.001). CONCLUSION: Self-reported increases in screen time and intrafamilial violence report impacted sleep quality in both healthy adolescents and those with chronic conditions. Decreased health-related quality of life was observed in adolescents with poor sleep quality.

Carcinoma basocelular na face de adolescente não sindrômico: de raridade para uma nova realidade? / Basal Cell Carcinoma in the Face of Non-Syndromic Adolescents: From Rarity to a New Reality?

O aumento na incidência do carcinoma basocelular (CBC) atinge todas as faixas etárias, incluindo jovens abaixo dos 20 anos. Por ser pouco lembrado nesse grupo de pacientes, o atraso no diagnóstico e o tratamento tardio da neoplasia podem ser mais comuns. Assim como para outras faixas etárias, a exposição excessiva à radiação ultravioleta é o principal fator de risco associado, porém fatores genéticos também podem estar envolvidos nos casos não sindrômicos. Descreve-se um caso de CBC na face de um adolescente, tratado com cirurgia micrográfica de Mohs

The increase in the incidence of basal cell carcinoma (BCC) affects all age groups, including young patients under twenty years old. Because it is poorly remembered in this group of patients, late diagnosis and treatment of this neoplasia may be more common. Like other age groups, excessive exposure to ultraviolet radiation is the main associated risk factor; however, genetic factors may also be involved in non-syndromic cases. We report a case of BCC on the face of an adolescent treated with Mohs micrographic surgery

Tratamento de necrobiose lipoídica no antebraço esquerdo com associação entre luz intensa pulsada e laser Erbium-YAG 2940nm / Treatment of Necrobiosis Lipoidica in the left forearm with association of Intense Pulsed Light and Erbium-Yag Laser 2940nm

A necrobiose lipoídica (NL) é uma dermatose granulomatosa, que acomete principalmente diabéticos devido à degeneração do colágeno. Embora existam diferentes tratamentos, todos apresentam pouca resposta. Dentre as opções, a luz intensa pulsada (LIP) e o laser Erbium-YAG permitem aumentar a produção e remodelamento do colágeno tratando a atrofia, além de diminuir o eritema pela coagulação de vasos sanguíneos. Relata-se caso de mulher, 24 anos, com diabetes mellitus tipo I, submetida a tratamento de NL no antebraço esquerdo em sete sessões com a associação entre LIP e laser Erbium-YAG 2940nm. Observou-se melhora da atrofia central e do eritema.

Necrobiosis Lipoidica (NL) is a granulomatous dermatosis, mainly affecting people with diabetes due to collagen degeneration. Although there are different treatments, all have little response. Among the options, the Intense Pulsed Light (IPL) and the Laser Erbium-YAG enhance the production and remodeling of the collagen treating the atrophy, besides reducing the erythema by the coagulation of blood vessels. We report a case of a 24-year-old woman with type I Diabetes Mellitus who underwent NL treatment on her left forearm in seven sessions with the association of IPL and 2940 nm Erbium-YAG laser. We observed improvement in central atrophy and erythema

Associação de luz intensa pulsada e laser Erbium: Yag 2940nm para tratamento de lentigo na face / Association of intense pulsed light and Erbium: Yag 2940 nm laser for treatment of lentigo on the face

O lentigo solar está presente em 90% da população com mais de 50 anos de idade, apresentando-se como manchas hipercrômicas em regiões fotoexpostas, que aumentam com o envelhecimento e são mais frequentes em peles claras. Há diversas modalidades terapêuticas com melhores resultados quando associadas. Descrevemos o caso de um homem de 62 anos, fototipo II de Fitzpatrick, com queixa de máculas acastanhadas em dorso nasal há oito anos. Foi submetido à biópsia de pele, e o estudo histológico confirmou ser lentigo solar. O paciente foi tratado com seis sessões de luz intensa pulsada associada a laser de Erbium: YAG 2940nm, com bom resultado clínico

Solar lentigo is present in 90% of the population over 50 years of age andcharacterizes as hyperchromic spots in photoexposed regions. It increases with aging and is more frequent in light skin. There are several therapeutic modalities, which achieve better results whenassociated. We describe the case of a 62-year-old man with Fitzpatrick skinphototype II, complaining of brownish macules in nasal dorsum for eight years. The patient underwent a skin biopsy, and the histological study confirmed solar lentigo. The patient was treated with six sessions of Intense Pulsed Light associated with Erbium-Yag2940 nm Laser with a good clinical result

O papel do uso de tecnologias combinadas na abordagem de uma paciente com microstomia / The role of the use of combined technologies in the approach to a patient with microstomia

A microstomia ocorre em 70% dos pacientes com esclerose sistêmica e há poucas opções terapêuticas. Descrevemos caso de mulher de 39 anos com diagnóstico de esclerose sistêmica em 2010, em uso de micofenolato de mofetil e rituximabe, apresentando microstomia. Foram realizadas duas sessões de luz intensa pulsada e sete sessões de laser fracionado ablativo Erbium:YAG de 2940nm, com resposta clínica importante. A formação e reorganização de fibras colágenas e elásticas foram responsáveis pela melhora da microstomia. Há poucos estudos com o uso de tecnologias para a abordagem da microstomia. Este é o primeiro com Er:YAG 2940nm para esta finalidade

Facial surgeries are often challenging for surgeons due to their complex anatomy, aesthetic and functional importance. Interventions in the cosmetic subunit that comprises the eyebrows can be particularly difficult. This case report aims to demonstrate the use of island flap in this region. We performed the excision of melanocytic nevus, with a good outcome and absence of postoperative complications. This technique is commonly used for facial reconstruction; however, the literature describes only a few cases using this method for eyebrow reconstruction.

Antitumor activity and toxicity of volatile oil from the leaves of Annona leptopetala

Abstract Annona leptopetala (R.E.Fr.) H. Rainer, Annonaceae, is used in folk medicine like antitumor and anti-inflammatory. The aim of this study was to determine chemical composition, toxicity and antitumor activity of A. leptopetala leaves volatile oil. Fresh leaves were hydrodistilled and then the volatile oil chemical composition was assessed by gas chromatography and mass spectrometry. Toxicity was assessed using haemolysis, micronucleus and acute toxicity protocols. Antitumor effects were determined in vitro and in vivo, using sulforhodamine B assay and sarcoma 180 murine tumor model, respectively. Spathulenol was the major component identified (12.56%). The volatile oil showed in vitro antitumor activity mainly in leukemia cell line (K-562), with Total growth inhibit (TGI) (concentration producing TGI) of 0.64 µg/ml. In other hand, the volatile oil <250 µg/ml did not inhibit HaCat non-tumor cell line growth. The concentration that produced 50% haemolysis was 372.8 µg/ml. The 50% lethal dose in mice was approximately 447.2 mg/kg intraperitoneally. Sarcoma 180 tumor growth inhibition rates were 59.29% and 58.77% at 100 and 150 mg/kg intraperitoneally, respectively. The volatile oil presented moderate gastrointestinal toxicity and no genotoxicity was observed at 350 mg/kg. Thus, the volatile oil shows antitumor activity with moderate toxicity.

Cutaneous angiosarcoma: report of three different and typical cases admitted in a unique dermatology clinic

Abstract: Angiosarcoma is a rare and aggressive tumor with high rates of metastasis and relapse. It shows a particular predilection for the skin and superficial soft tissues. We report three distinct and typical cases of angiosarcoma that were diagnosed in a single dermatology clinic over the course of less than a year: i) Angiosarcoma in lower limb affected by chronic lymphedema, featuring Stewart-Treves syndrome; ii) a case of the most common type of angiosarcoma loated in the scalp and face of elderly man and; iii) a skin Angiosarcoma in previously irradiated breast. All lesions presented characteristic histopathological findings: irregular vascular proliferation that dissects the collagen bundles with atypical endothelial nuclei projection toward the lumen.

Toxicity and antitumor efficacy of Croton polyandrus oil against Ehrlich ascites carcinoma cells

ABSTRACT The essential oil from Croton polyandrus Spreng., Euphorbiaceae, leaves was tested for the toxicity and antitumor activity. The concentration producing 50% hemolysis was 141 µg/ml on mice erythrocytes. In the acute toxicological study, the estimated LD50 was 447.18 mg/kg. The essential oil did not induce increase in number of micronucleated erythrocytes, suggesting low genotoxicity. Essential oil (100 or 150 mg/kg) showed significant antitumor activity in Ehrlich ascitic carcinoma model. We observed that essential oil induces cell-cycle arrest at the G0/G1 phase, and increases the sub-G1 peak, which represents a marker of cell death by apoptosis. Survival also increased for the treated animals. The toxicological analyses revealed reduction in body weight, increased aspartate aminotransferase and alanine aminotransferase activity, hematological changes, and a thymus index reduction. These data suggest gastrointestinal and liver toxicity, anemia, leukopenia/lymphocytopenia, and immunosuppressive effects. Histopathological analysis revealed the weak hepatotoxicity of essential oil. In summary, essential oil of C. polyandrus displays in vivo antitumor activity and moderate toxicity.

Bacillary angiomatosis with bone invasion

Abstract Bacillary angiomatosis is an infection determined by Bartonella henselae and B. quintana, rare and prevalent in patients with acquired immunodeficiency syndrome. We describe a case of a patient with AIDS and TCD4+ cells equal to 9/mm3, showing reddish-violet papular and nodular lesions, disseminated over the skin, most on the back of the right hand and third finger, with osteolysis of the distal phalanx observed by radiography. The findings of vascular proliferation with presence of bacilli, on the histopathological examination of the skin and bone lesions, led to the diagnosis of bacillary angiomatosis. Corroborating the literature, in the present case the infection affected a young man (29 years old) with advanced immunosuppression and clinical and histological lesions compatible with the diagnosis.

Histiocytoid Sweet's syndrome presenting with annular erythematous plaques

Abstract Histiocytoid Sweet's Syndrome is a rare inflammatory disease described in 2005 as a variant of the classical Sweet's Syndrome (SS). Histopathologically, the dermal inflammatory infiltrate is composed mainly of mononuclear cells that have a histiocytic appearance and represent immature myeloid cells. We describe a case of Histiocytoid Sweet's Syndrome in an 18-year-old man. Although this patient had clinical manifestations compatible with SS, the cutaneous lesions consisted of erythematous annular plaques, which are not typical for this entity and have not been described in histiocytic form so far. The histiocytic subtype was confirmed by histopathological analysis that showed positivity for myeloperoxidase in multiple cells with histiocytic appearance.

Disseminated cutaneous sporotrichosis associated with ocular lesion in an immunocompetent patient

Abstract: A 59-year-old female patient, previously healthy, immunocompetent, presented left bulbar conjunctiva lesions and nodular-ulcerated lesions on the arms and cervical region, besides left cervical and retroauricular lymphadenopathy. She had previous contact with domestic cats that excoriated her face. The diagnosis was conclusive of disseminated sporotrichosis through clinical and epidemiological history and cultures of skin and ocular secretions. It evolved with good response to oral antifungal therapy.

Effect of the activity of the Brazilian polyherbal formulation: Eucalyptus globulus Labill, Peltodon radicans Pohl and Schinus terebinthifolius Radd in inflammatory models

The Brazilian polyherbal formulation (BPF) is composed by dyes of Eucalyptus globulus Labill, Peltodon radicans Pohl and Schinus terebinthifolius Raddi in alcohol at 13.3° GL. The formulation is popularly used in Paraíba state, Brazil since 1889 and it is used as an antiseptic and anti-inflammatory medicine. The aim of this study was to evaluate the anti-inflammatory property of the polyherbal formulation. For this purpose it was used the12-O-tetradecanoylphorbol 13-acetate (TPA) and capsaicin-induced mouse ear edema and the carrageenan-induced rat paw edema. The BPF at dose of 26 mL/Kg inhibited both 12-O-tetradecanoylphorbol 13-acetate (TPA) and capsaicin-induced ear edema by 49 percent (p < 0.05) and 24 percent (p < 0.01) respectively. Preliminary results on carrageenan-induced rat paw edema demonstrated that oral administration also inhibited the paw edema by approximately 29 percent. The results demonstrate that the Brazilian polyherbal formulation has anti-inflammatory activity and the better dose was the one used by the population.

O medicamento fitoterápico brasileiro - BPF é composto de corantes das plantas Eucalyptus globulus Labill, Peltodon radicans Pohl e Schinus terebinthifolius Raddi em alcool a 13,3° GL. Este medicamento é popularmente usado no estado da Paraíba, Brasil desde 1889 como anti-séptico e antiinflamatório. O objetivo deste estudo foi avaliar a propriedade antiinflamatória deste medicamento fitoterápico. Para tal, foram utilizadas as técnicas de edema de orelha em camundongos induzido por 12-O-tetradecanoilforbol 13-acetato (TPA) ou capsaicina e o edema de pata de rato induzido por carragenina. O BPF na dose de 26 mL/kg inibiu tanto edema de orelha induzido por TPA como por capsaicina a 49 por cento (p < 0.05) e 24 por cento (p < 0.01) respectivamente. Estudos preliminares utilizando a técnica de edema de pata induzido por carragenina demonstraram que a administração oral também inibiu o edema de pata em aproximadamente 29 por cento. Os resultados demonstraram que o medicamento fitoterápico brasileiro (BPF) apresentou propriedades antiinflamatórias e a melhor dose foi aquela que é usada pela população.

Natural products inhibitors of the enzyme acetylcholinesterase / Produtos naturais inibidores da enzima acetilcolinesterase

Alzheimer's disease (AD) is a progressive, neurodegenerative pathology that primarily affects the elderly population, and is estimated to account for 50-60 percent of dementia cases in persons over 65 years of age. The main symptoms associated with AD involve cognitive dysfunction, primarily memory loss. Other features associated with the later stages of AD include language deficits, depression, behavioural problems including agitation, mood disturbances and psychosis. One of the most promising approaches for treating this disease is to enhance the acetylcholine level in the brain using acetylcholinesterase (AChE) inhibitors. The present work reviews the literature on plants and plant-derived compounds inhibitors of enzyme acetylcholinesterase. The review refers to 309 plant extracts and 260 compounds isolated from plants, which are classified in appropriate chemical groups and model tested, and cites their activity. For this purpose 175 references were consulted.

A Doença de Alzheimer (DA) é uma patologia neurodegenerativa, progressiva, que afeta principalmente a população idosa, responsável por 50-60 por cento dos casos de demência em pessoas com mais de 65 anos de idade. Os principais sintomas associado a DA envolve deficiência orgânica cognitiva, principalmente perda de memória. Outras características associadas com os estágios avançados de DA inclui déficit na linguagem, depressão, problemas de comportamento, inclusive agitação, alterações de humor e psicose.Um dos mais promissores caminhos para tratar esta doença é aumentar o nível de acetilcolina no cérebro usando inibidores da acetilcolinesterase (AChE). Este trabalho teve como objetivo revisar a literatura das plantas e substâncias encontradas nas plantas, inibidores da enzima acetilcolinesterase. Foram levantadas 309 plantas e 260 substâncias isoladas de plantas que foram classificados em grupos químicos adequados, os modelo testados, e suas atividades. Foram consultados 175 referências.

Polidrâmnio agudo idiopático recorrente: relato de um caso / Recurrent idiopatic acute polydramnio: a case report

Neste trabalho os autores ressaltam a raridade do ocorrência de Polidrâmnio Agudo Idiopático Recorrente - PAIR, sendo que a incidência de polidrâmnio na populaçäo geral é de 0,4 a 1,5 por cento e destes 34 por cento säo idiopáticos, havendo apenas quatro casos de PAIR descritos na literatura. Para ilustrar tal fato, é relatado o caso de uma paciente de 28 anos de idade sem qualquer patologia, com duas gestaçöes diagnosticadas como polidrâmnio idiopático sem presença de malformaçöes fetais, acompanhada pelo serviço de ginecologia e Obstetrícia da Faculdade de Medicina da FUABC. Na segunda cesárea, foi encontrado uma tumoraçäo em tuba direita, cujo anatomo-patológico fora Endometriose, uma associaçäo inédita na literatura. É conhecida a relaçäo entre o polidrâmnio e as anomalias congênitas fetais, presentes em 1/5 dos casos, especialmente as do SNC e do tubo digestivo alto. Säo feitas mençöes de possíveis etiologias ainda näo confirmadas como: teoria imunológica dos receptores hormonais placentários e presença de antígenos de compatibilidade leucocítica, destacando-se os métodos de diagnóstico e tratamento mais recente

Tumores benignos cervicais na infância / Cervical benign tumors in childhood

Os autores comentam os tumores cervicais benignos mais freqüêntes na infância, salientando o diagnóstico e as principais formas de tratamento