RESUMO
Hypertrophic pseudo tumoral herpetic lesion is an uncommon presentation in immunocompromized hosts that can be refractory to established therapies. We describe bipolar anal and tonsilar herpetic tumoral lesions related to acyclovir-resistant HSV-2 in a human immunodeficiency virus-infected patient. Treatment with valacyclovir, cidofovir, and thalidomide failed and surgical excision was required.
Assuntos
Aciclovir/farmacologia , Antivirais/farmacologia , Doenças do Ânus , Infecções por HIV/complicações , Herpes Simples , Herpesvirus Humano 2 , Doenças Faríngeas , Aciclovir/uso terapêutico , Animais , Terapia Antirretroviral de Alta Atividade , Antivirais/uso terapêutico , Doenças do Ânus/complicações , Doenças do Ânus/tratamento farmacológico , Doenças do Ânus/cirurgia , Doenças do Ânus/virologia , Chlorocebus aethiops , Farmacorresistência Viral , Herpes Simples/complicações , Herpes Simples/tratamento farmacológico , Herpes Simples/patologia , Herpes Simples/virologia , Herpesvirus Humano 2/efeitos dos fármacos , Herpesvirus Humano 2/genética , Herpesvirus Humano 2/isolamento & purificação , Humanos , Hipertrofia , Masculino , Pessoa de Meia-Idade , Tonsila Palatina/patologia , Tonsila Palatina/virologia , Doenças Faríngeas/complicações , Doenças Faríngeas/tratamento farmacológico , Doenças Faríngeas/patologia , Doenças Faríngeas/virologia , Células VeroRESUMO
OBJECTIVE: To assess the reporting of surgical interventions, care providers, and number of centers in randomized clinical trials. METHODS: Systematic review was performed to assess reports of randomized controlled trials assessing surgical procedure published in 2004. A standardized abstraction form was used to extract data. RESULTS: A total of 158 articles were included. Details on the intervention intended, such as the surgical procedure, were reported in 138 (87.3%) articles, anesthetic management in 56 (35.4%), preoperative care in 34 (15.2%), and postoperative care in 78 (49.4%). How the experimental surgical intervention was carried out was reported in 64 articles (40.5%). Most trials were conducted in single centers (n = 109, 69.0%). The setting was reported in only 11 articles, and the volume of interventions performed was only reported in 5. Selection criteria were reported for care providers in 64 articles (40.5%). The number of care providers performing the intervention was reported in 51 articles (32.2%). The quality of reporting was low as assessed by CLEAR NPT (a 10-items checklist specifically developed to assess the reporting quality of RCTs assessing nonpharmacologic treatment). CONCLUSIONS: Inadequate reporting on the management of the surgical procedure, care providers, and surgery center may introduce bias in RCTs of surgical interventions, making their results questionable. We recommend extending the CONSORT Statement to surgical interventions.
Assuntos
Ensaios Clínicos Controlados Aleatórios como Assunto/tendências , Procedimentos Cirúrgicos Operatórios/normas , Humanos , Controle de Qualidade , Procedimentos Cirúrgicos Operatórios/tendênciasRESUMO
Perineuriomas are infrequent tumors that may be intraneural or extraneural in soft tissue with no apparent relation with a nerve. Some cases of soft tissue perineurioma may have a retiform pattern, but this pattern has not been described to date in intraneural perineurioma. We report a case of a unique perineurioma arising in a nerve of the neck that had a distinctive reticular pattern and was intraneural. The patient was a 21-year-old woman who had a lump on the left side of the neck abutting the vena jugularis. The tumor had features of both reticular perineurioma and intraneural perineurioma with pseudo-onion bulb pattern. The tumor cells were positive for epithelial membrane antigen. The patient is free of tumor 6 months after operation.