Treatment of keloids and hypertrophic scars. Position statement of the Brazilian expert group GREMCIQ.

Keloids (K) and hypertrophic scars (HS) are abnormal responses to wound healing that occur as the result of dermal inflammation. Despite the advances on their treatment, many patients still suffer from the negative effects of excessive scarring; its approach is impaired by the lack of objective data on different treatments and the large genetic variability among patients and the difficulties in producing multicentre studies. Their incidence among the Brazilian population is high, as the result of an admixture of Amerindians, Europeans and Africans ancestral roots. With the aim of producing multicentre studies on K and HS, a panel of senior Brazilian dermatologists focused on their treatment was invited to contribute with the K and HS Treatment Brazilian Guidelines. In the first part of this study, different treatment modalities for keloids and HS are fully reviewed by the panel. The second part of the study presents a consensus recommendation of treatment for different types of lesions. More than a literature review, this article aims to show the pitfalls and pearls of each therapeutic option, as well as a therapeutic approach by the Panel of Experts on keloids and Scars on a highly mixed population, providing simple guidelines.

Sarcoma gástrico em cão: relato de caso / Gastric sarcoma in a dog: case report

Tumores gástricos em animais domésticos são raros, e a literatura pertinente é escassa. Em humanos, esse tumor representa 80% dos tumores mesenquimais do trato digestivo, sendo mais comum no estômago (70%). Indivíduos de meia-idade e idosos, principalmente do gênero masculino, são os mais afetados, e o diagnosticado é feito com base em suas manifestações clínicas associadas à morfologia celular típica e à imuno-histoquímica positiva. O presente trabalho objetiva descrever um sarcoma gástrico em cão, assim como o diagnóstico, o tratamento cirúrgico e o pós-cirúrgico do animal. Foi atendido no Hospital Veterinário da Universidade Metropolitana de Santos (Unimes) um cão macho, SRD, 10 anos, 8,3kg, castrado, com bom estado geral, com queixa de emese há um ano. Na ultrassonografia abdominal foi observada a presença de uma formação arredondada no estômago que media 3,20 x 2,61cm, localizada na região epigástrica em contiguidade com a parede. O cão foi submetido a endoscopia gástrica, em que se observou a presença de uma massa arredondada na região pilórica, confirmada na laparotomia e na gastrotomia. O tumor retirado foi enviado para avaliação anatomopatológica, e os achados foram compatíveis com sarcoma estromal gástrico.(AU)

Gastric tumors in domestic animals are rare and the literature is scarce. In humans this tumor represents 80% of mesenchymal tumors of the digestive tract, most commonly in the stomach (70%). Affected individuals are middle-aged and elderly, especially males, diagnosed from its clinical manifestations in association with typical cell morphology and positive immunohistochemistry. The aim of this report was to describe a gastric sarcoma in a dog, as well as the diagnosis, surgical and post surgical treatment. The experiment was conducted in the Veterinary Hospital of the Metropolitan University of Santos (UNIMES) on a male dog, SRD, 10 years old, 8.3kg, castrated, in a good general condition, with complaint of emesis for year. In the abdominal ultrasound exam we observed the presence of a round formation in the stomach which measured 3.20 x 2.61cm, located in the epigastric region contiguous with the wall. The dog was submitted to gastric endoscopy, in which the presence of a rounded mass in the pyloric region was observed, and laparotomy and gastrostomy were performed. The removed tumor was sent for pathologic evaluation, where the findings were compatible with gastric stromal sarcoma.(AU)

Silicone versus nonsilicone gel dressings: a controlled trial.

BACKGROUND: Silicone gel dressings decrease scar volume and soften hypertrophic tissue, allowing it to be more easily controlled by other methods. Although silicone does not appear to be an essential component of the treatment, nonsilicone dressings have been reported to cause no change in physical parameters during a 2-month treatment period. OBJECTIVE: To compare silicone and nonsilicone gel dressings in the treatment of keloids and hypertrophic scars, including a control group, and to evaluate the effectiveness of these treatments using two new assessment techniques. METHODS: Patients were randomly chosen to receive silicone or nonsilicone gel dressings in a 4.5-month controlled prospective study. Scar size, induration, and symptoms were evaluated before and after the treatment. Scar color was visually measured using a color palette catalog, and a new device was developed to measure intracicatricial pressure. RESULTS: All of the measured parameters were significantly reduced in both silicone- and nonsilicone-treated groups, as compared to the control, with no significant differences between them. CONCLUSION: Silicone and nonsilicone gel dressings are equally effective in the treatment of keloids and hypertrophic scars.

[Prevalence and indirect costs of headache in a Brazilian Company]. / Prevalência e custos indiretos das cefaléias em uma empresa Brasileira.

Employees from a Brazilian oil company research centre (n = 993) were interviewed on the occurrence of headache during a 30 days period. Headache prevalence was 49.8%, with a mean frequency of 4.3 +/- 7.0 attacks per month, lasting 12.2 +/- 21.4 hours each. According to the International Headache Society diagnostic criteria, migraine (5.5%), episodic tension-type headache (26.4%), chronic tension-type headache (1.7%) and headaches not fulfilling the criteria for such disorders (16.2%) were observed. Women suffered comparatively more headache and specifically migraine than men. The pain interfered with work productivity in 10% of the subjects, corresponding to 538.75 hours off. According to an indirect costs estimation for each headache, the company may loose up to US$125.98 per employee annually. Since among headaches migraine has the highest indirect cost, migraine prevention and treatment is particularly important at the working environment. Migraine frequency may be prevented to a large extent, resulting on positive effects in both the quality of life and productivity. The cost-benefit ratio clearly favours therapeutic and preventive programs against chronic headaches.