Some technical contributions to the treatment of buried penis.

Buried penis is a rare condition in which the preputial skin and the fat in the hypogastric area cause the body of the organ to be involved in such a way as to convey the impression that the patient has a micro penis. We present a few technical contributions to the surgical treatment of buried penis, suggesting modifications that may be of help in the treatment of those patients.

Sinonasal melanoma: a systematic review of the prognostic factors.

The objective was to evaluate the available published data on sinonasal melanoma and analyse its clinical features, treatment modalities, and prognostic factors. An electronic search was undertaken in March 2018 in multiple databases. Eligibility criteria included publications with sufficient clinical, histological, and immunohistochemical information to confirm the diagnosis. Seventy-three publications (439 cases) were included. The lesion was more prevalent in females than in males. There was a higher prevalence in the seventh and eighth decades of life. The lesions mainly presented as epistaxis and commonly involved the nasal cavity. Age (>67.6 years; P=0.0012), primary location (middle turbinate; P=0.0112), disease stage (advanced disease stage; P=0.0026), treatment (radiotherapy; P=0.0111), recurrence (recurrence presented; P=0.0137), and distant metastasis (distant metastasis presented; P=0.0011) were independently associated with a lower survival rate. Recurrence was significantly correlated with age (>67.6 years; P=0.0021), sex (males tended to present a higher recurrence rate than females; P=0.0051), disease stage (stages III and IV presented a higher recurrence rate than stages I and II; P=0.0331), and histological type (amelanotic lesions presented a higher index of recurrence than melanotic lesions; P=0.0095). In conclusion, sinonasal melanoma is a neoplasm with a poor prognosis, presenting a 30.69% possibility of survival after 5 years.

Evaluation of a fibrate, specific stimulant of PPARα, as a therapeutic alternative to the treatment of clinical ovine pregnancy toxaemia.

Ovine pregnancy toxaemia is a metabolic disorder affecting sheep in their last 6 weeks of pregnancy as a result of their inability to maintain adequate energy homoeostasis. Different alternative treatments are available with variable results. The aim of this research was to evaluate a peroxisome proliferator-activated receptor alpha (PPARα) stimulant as an alternative to treat clinical pregnancy toxaemia. Thirty-three adult sheep, with known gestation date and carrying a single foetus, were fasted from day 130 of gestation until animals showed clinical disease. From that moment onwards, sheep were treated during 6 days with three different therapeutic alternatives: 10 mg/kg of 2-methyl-2-phenoxy-propionic acid; 10 mg/kg of 2-methyl-2-phenoxy-propionic acid + 100 mL of propylene glycol oral; or 100 mL of propylene glycol oral. Glycaemia and serum ß-hydroxybutyrate (BHOB) were determined daily. Liver biopsies were taken at day 130 of gestation, at the beginning and end of treatments and at 5 days postpartum, evaluating the extent and degree of the steatosis lesion. Even though in sheep treated with 2-methyl-2-phenoxy-propionic acid, serum concentrations of glucose and BHOB recovered more slowly, we conclude that 2-methyl-2-phenoxy-propionic acid alone or combined with propylene glycol can be used as an alternative to effectively treat fatty liver, and therefore pregnancy toxaemia.

O papel terapêutico do Programa Farmácia Viva e das plantas medicinais / The therapeutic role of the Program Farmacia Viva and the medicinal plants in the center-south of Piauí

RESUMOEste trabalho realizou um levantamento sobre o uso de plantas medicinais na cidade de Picos-PI, identificou as plantas cultivadas no horto pertencente ao Laboratório Fitoterápico de Picos (LAFIPI), e analisou o uso de fitoterápicos dispensados pelo Programa Farmácia Viva no triênio 2008-2010. Do total dos 750 entrevistados, 37,6% foram homens e 62,4 % mulheres, dentre os quais a maioria não concluiu o segundo grau (69,2%) e 77,2% possuíam renda mensal de até dois salários mínimos. Com relação ao consumo de plantas medicinais, 76,3% afirmaram utilizá-las para tratar doenças, principalmente por considerá-las mais saudáveis (84,8%). A indicação do uso foi orientada, sobretudo, por familiares (82,2%), embora a maioria adquira as plantas em feiras livres (32,8%). Das 127 plantas relatadas, as mais citadas foram erva-cidreira, boldo e hortelã, sendo as folhas a parte mais utilizada (42,3%), predominantemente por infusão (39,4%). As aplicações mais lembradas foram para tratar dores em geral (17%), distúrbios respiratórios (16,5%) e digestivos (16%). As espécies mais cultivadas no horto são chambá (Justicia pectoralis), alecrim pimenta (Lippia sidoides), malva santa (Plectranthus barbatus) e erva cidreira (Lippia alba). O lambedor de chambá foi o fitoterápico mais procurado pela população entre 2008 e 2010. Esse estudo descreveu, pela primeira vez, o uso tradicional de plantas medicinais no município de Picos e demonstrou, também de forma inédita, a relevância de investimentos do Programa Farmácia Viva no município de Picos e sua inclusão no Programa Saúde da Família como forma de disponibilizar à população de baixa renda fitoterápicos produzidos localmente a custos reduzidos.

ABSTRACTThis study performed a research about the use of medicinal plants in Picos city, identifying the plants grown in the garden belonging to the Laboratory of Phytotherapics in Picos (LAFIPI) and analying the use of phytotherapics distributed by the Farmácia Viva Project between 2008-2010. From the total of 750 interviewed participants, 37.6% were men and 62.4 % women. Most of them do not have secondary education (69.2%) and 77.2% had an income of up until two minimum wages. Regarding consumption of medicinal plants, 76.3 % used them to treat diseases, mainly because they considered them to be healthier (84.8%). The indication of use of the plants was mainly suggested by relatives (82.2%), even though the majority of the participants acquires plants in open markets (32.8%). From the 127 plants mentioned, the most cited ones were balm, boldo and mint, and leaves were the most utilized parts (42.3%), predominantly by infusion (39.4%). The most common reasons for the usewere to treat pain in general (17%), and respiratory (16.5%) and digestive disorders (16%). The most cultivated species in the garden were chambá (Justicia pectoralis), alecrim pimenta (Lippia sidoides), malva santa (Plectranthus barbatus) and erva cidreira (Lippia alba). The "chambá licker" was the most herbal medicine searched by the population between 2008 and 2010. This investigation described, for the first time, the traditional use of medicinal plants in Picos and demonstrated,alsounprecedentedly, the relevance of investments in the Farmácia Viva Project in Picos city and its inclusion in the Family Health Program as a strategyin order to provide locally producedphytotherapics for low-income population at low costs.

Scatter fraction with simulations.

In this work, the authors revisit the measurements of Trout and Kelley, and Simpkin and Dixon, by means of Monte Carlo simulations. Starting with a simple cylindrical homogeneous phantom, the authors introduce a more realistic phantom and the effect of the bucky in the simulations. The results indicate that optimised shielding methodologies should not neglect the attenuation and scattering by the patient plus bucky.

Reassessment of structural shielding design in mammography installations.

In this article, it is argued that current shielding methodologies can lead to an over-shielding of low-energy X-ray imaging facilities. Measurements of scattered air kerma rates in a mammography installation, including the effect of an anthropomorphic phantom of the patient, are presented. Detailed Monte Carlo calculations that support the measured results are also shown. Calculations for a mobile mammography installation, including the 'patient transmission factor', are presented and results are discussed.

Clinicopathological analysis of head and neck chondrosarcoma: three case reports and literature review.

Chondrosarcoma (CHS) is a malignant neoplasm characterized by the formation of cartilaginous matrix by neoplastic cells, with a high propensity for local recurrences. Head and neck CHS is rare, accounting for less than 12% of all cases of CHS, usually affecting the maxilla. The majority of affected patients are in the fourth decade of life, with a slight predilection for male patients. A painless swelling is commonly the most frequent complaint. Surgery with wide en-bloc resection is the preferred treatment for CHS; radiotherapy and chemotherapy are usually palliative options. Owing to its rarity, there are few clinical series evaluating the biological behaviour of head and neck CHS. The aim of this study is to analyse the clinicopathological characteristics of head and neck CHS by reporting 3 new cases of this neoplasia affecting the jaw bones and reviewing the clinical series previously published in the English literature.

Clear-PEM: a dedicated PET camera for improved breast cancer detection.

Positron emission mammography (PEM) can offer a non-invasive method for the diagnosis of breast cancer. Metabolic images from PEM using 18F-fluoro-deoxy-glucose, contain unique information not available from conventional morphologic imaging techniques like X-ray radiography. In this work, the concept of Clear-PEM, the system presently developed in the frame of the Crystal Clear Collaboration at CERN, is described. Clear-PEM will be a dedicated scanner, offering better perspectives in terms of position resolution and detection sensitivity.

[Cerebrovascular disease: its relationship with cardiovascular and renal pathology in 134 clinical autopsies]. / Enfermedad cerebrovascular: su relación con cardiovasculopatías y nefropatías en 134 necropsias clínicas.

OBJECTIVE: To establish the relationship between cardiopathy and chronic nephropathy, and cerebral vascular pathology in clinical necropsies performed in adult patients. MATERIAL AND METHODS: The protocols of 861 clinical autopsies done during the lapse 1990-2000 were reviewed, of these, 134 cases with diagnosis of cerebrovascular disease (CVD) were selected. Analyzed features included: neuropathological study of CVD, renal and cardiovascular pathology, and cause of death. RESULTS: CVD represented 15.5% of all autopsies done during the study period. Ischemic CVD constituted 56.7% of the cases, whereas cases of hemorrhagic CVD accounted for 43.3% of the total. Causes included arterial hypertension (33%), atherosclerosis (19%), emboli and vascular malformations (13% each, respectively), coagulopathies (8%), angeiitis (4%), tumors (1%), and unknown origin (11%). Ischemic CVD was caused by atherosclerosis in 34.2% of the cases, lacunar infarcts in 32.8%, of embolic cause in 14.4% of the cases, angeiitis in 1.3%, and of unknown origin in 17.1% of the cases. Hemorrhagic CVD presented as intraparenchymal hematoma in 50% of the cases, as sub-arachnoid hemorrhage in 28%, as disseminated petechial hemorrhages in 19%, and intraventricular in 3% of the cases. Ischemic CVD was associated with hypertensive cardiopathy in 86.5% of the cases, and with nephrosclerosis in 51.3%, whereas hemorrhagic CVD was seen associated with the same pathological entities in 86.2% and 29.3% of the cases, respectively. Cerebral herniation was the cause of death in 2.6% of the patients with ischemic CVD, and in 74.1% of the patients with hemorrhagic CVD. CONCLUSIONS: CVD was associated with a high frequency of intercurrent pathological processes, namely hypertensive cardiopathy, atherosclerosis, nephroscleroisis, and other chronic nephropathies, that eventually interact, and constitute well known predisposing and/or concomitant factors to the cerebrovascular event

[Non neoplastic space occupying lesions mimicking central nervous system tumors]. / Lesiones ocupantes de espacio no neoplasicas que simulan tumores del sistema nervioso central.

OBJECTIVE: To establish the frequency and nature of space occupying lesions of the central nervous system (CNS) that mimic neoplastic growths. PATIENTS AND METHODS: We reviewed the clinical records, imaging and neuropathological studies of patients operated in different hospitals of Maracaibo, Venezuela during the period January 1 1996 July 31 2002. These patients had a pre operative diagnosis of CNS tumor, and their definitive diagnosis was non neoplastic disease. RESULTS: The 33 cases of expansive, non neoplastic growths represented 8% of 408 CNS lesions diagnosed during the study period. Approximately two thirds of the cases (63,36%) consisted of either inflammatory or vascular lesions, whereas the rest of the cases grouped miscellaneous conditions. CONCLUSIONS: Even though it is not frequent that non neoplastic lesions of the CNS mimic expansive growths of neoplastic nature, on occasions the clinical and neuroimaging features of both groups of entities are remarkably similar.

Autosomal dominant congenital macroglossia: further delineation of the syndrome.

We describe seven patients from two Mexican families with congenital macroglossia. Comparative analysis of these cases and the patients previously described in literature, allows to confirm the notion that this isolated primary macroglossia is a distinct dominant condition.

Serum uric acid levels in Chagas' disease

A uricemia foi estudada em uma amostra de 192 indivíduos de uma regiäo altamente endêmica para a doença de Chagas (Bambuí, Estado de Minas Gerais, Brasil). A amostra continha 50 indivíduos sorologicamente negativos (controles) e os positivos foram classificados na base da presença de alteraçöes eletrocardiográficas (63), esvaziamento esofagiano alterado (16), ou ausência de sinais ou sintomas da doença (76). Somente os indivíduos com a forma digestiva da doença de Chagas crônico mostraram hiperuricemia, quando comparados com controles adequados. Dados familiares sugerem que a hiperuricemia é um efeito da patologia digestiva em vez de causa, uma vez que os irmäos näo afetados dos pacientes com megaesôfago näo apresentaram níveis elevados de ácido úrico sérico

Serum uric acid levels in Chagas' disease.

Uricemia was studied in a sample of 192 individuals from a highly endemic site for Chagas' disease (Bambuí, State of Minas Gerais, Brazil). The sample had 50 serologically negative individuals (controls) and the positive ones were classified on the basis of the presence of electrocardiographic alterations (63), altered esophageal emptying (16), or without any sign on symptom of the disease (76). Only the individuals with the digestive form of chronic Chagas' disease showed hyperuricemia, when compared with the appropriate controls. Family data suggest that hyperuricemia is an effect of the digestive pathology, rather than a cause, since the non-infected sibs of the megaesophagous patients did not show elevated levels of serum uric acid. Possible mechanisms responsible for these findings are postulated.