Relato de caso: pólipo piloso da nasofaringe em adulto / Case report: a hairy polyp of nasopharynx in adult

O pólipo piloso é um tumor congênito que se manifesta, normalmente, nos primeiros anos de vida, como uma massa coberta com pele contendo glândula sebácea e pelo. Foi descrito, primeiramente, por Brown-Kelly em 1918, com predominância no sexo feminino. A manifestação clínica depende da localização e do tamanho do pólipo, mas, geralmente, causa sintomas respiratórios e alimentares. Há predileção pelo lado esquerdo do organismo, ainda não explicada (1). Não há predisposição genética ou identificação em parentes, e normalmente apresenta-se como um defeito isolado, sem relatos de malignização. O diagnóstico pode ser suspeitado através do estudo de imagem. O tratamento envolve a exérese completa da massa, não havendo necessidade de nenhuma outra complementação (2). Relatamos o caso de uma paciente de 21 anos cujo diagnóstico foi confirmado com anatomopatológico da peça cirúrgica(AU)

The hairy polyp is a congenital tumor that usually manifests in early life as a mass covered with skin containing sebaceous gland and hair. It was first described by Brown-Kelly in 1918, predominantly in females. The clinical manifestation depends on the polyp's location and size, but it usually causes respiratory and feeding symptoms. It is more likely to appear on the left side of the body, a predilection not yet explained. (1) There is no genetic predisposition or identification in relatives, and it usually presents as an isolated defect without malignant reports. The diagnosis may be suspected by imaging. Treatment involves complete excision of the mass, with no need for any other action. (2) We report the case of a 21-year-old patient whose diagnosis was confirmed by pathology of the surgical specimen(AU)

Biochemical and inflammatory aspects in patients with severe sepsis and septic shock: The predictive role of IL-18 in mortality.

BACKGROUND: Sepsis is a major health care problem, with a significant mortality rate in intensive care units. We evaluated biochemical and inflammatory markers in patients with severe sepsis and septic shock and its association of with mortality rates. METHODS: Critically ill patients with diagnoses of sepsis - severe sepsis group (n=23) and septic shock group (n=25), and a control group (n=17) were recruited within 24h of entry into the ICU. Serum levels of inflammatory mediators were measured (IL-1ß, IL-6, IL-8, IL-10, TNF-α, IL-18 and nitric oxide). We have also collected clinical parameters and laboratorial tests to estimate severity and organ dysfunction (APACHE II, SOFA, lactate). These results were compared between survivors and no survivors. RESULTS: IL-18 was directly related to mortality independently of other inflammatory mediators, especially IL-1ß, although the inflammatory pathway is closely linked to inflammasome activation and both have simultaneous release in the infectious process. Mortality was directly proportional to IL-18 plasma levels, which did not occur with other inflammatory mediators. CONCLUSIONS: IL-18 is an important predictor of mortality in humans with both severe sepsis and septic shock, independent of IL-1ß.