Síndrome Compartimental Aguda: série de sete casos no Hospital Nossa Senhora da Conceição - Tubarão / Acute Compartment Syndrome: Report of seven cases in a Hospital in South Brazil

Objetivo: relatar de maneira retrospectiva sete casos de pacientes com síndrome compartimental aguda em traumas ortopédicos no Hospital Nossa Senhora da Conceição de Tubarão ? Santa Catarina. Métodos: realizado um estudo descritivo, relato de série de casos, em sete indivíduos com diagnóstico de síndrome compartimental aguda. Critérios de inclusão: pacientes com diagnóstico de síndrome compartimental aguda confirmada em prontuários. Critérios de exclusão: síndrome não relatada no prontuário, prontuários perdidos. Resultados: foram atendidos sete pacientes com diagnóstico de síndrome compartimental no período compreendido entre julho de 2004 a março de 2007. A idade variou de 12 a 46 anos. Seis pacientes eram do sexo masculino e um feminino. Cinco pacientes eram de etnia branca e dois negra. O mecanismo de lesão foi: três acidentes de motocicleta, três atropelamentos, e uma lesão por esmagamento. O local de lesão foi variável. O tempo decorrido entre a lesão, o diagnóstico e o tratamento da síndrome compartimental foi em média nas primeiras 24 horas. A fasciotomia foi realizada em cinco pacientes. A estabilização da fratura foi realizada em três pacientes no momento da fasciotomia e um paciente com fratura de punho foi estabilizado cirurgicamente após cinco dias de evolução. A evolução clínica foi variável para cada caso. O tempo de seguimento foi em média de dois anos. Conclusão: a síndrome compartimental é uma doença grave, sendo importante o diagnóstico e tratamento precoce para possibilitar um melhor prognóstico e um menor índice de complicações para estes casos.

Objective: to report, in a retrospective manner, seven cases of acute compartment syndrome, in orthopedic trauma patients of the Nossa Senhora da Conceição Hospital, Tubarão ? Santa Catarina ? South Brazil. Methods: a descriptive case series report, of seven patients with acute compartment syndrome diagnosis, was realized. Inclusion criteria: patient with acute compartment syndrome confirmed in medical records. Exclusion criteria: syndrome not mentioned in medical records and lost records. Results: seven patients were attended to with the diagnosis of acute compartment syndrome from July of 2004 though march of 2007. The age varied from 12 to 46 years. Six patients were of the masculine sex and one was of the feminine. Five patients were Caucasian and two were Black. The injury mechanisms were: motorcycle accident in three of the cases, traffic accidents involving pedestrians also in three of the cases, and one injury by crushing. The location of the lesion varied. The average time between the accident, diagnosis, and treatment was around the first 24 hours. Fasciotomy was realized in five patients. The stabilizing of the fracture was realized at the time of the fasciotomy in three of the patients, one, with a wrist fracture, was stabilized surgically after five days of evolution. The clinical evolution varied for each case. The follow-up time was 2 years in average. Conclusion: the compartment syndrome is a severe disease, therefore, early diagnosis and treatment, allowing a better prognosis and a lower complication incidence, for these cases is important.

Epidemiologia dos carcinomas basocelulares em Tubarão, Santa Catarina (SC), Brasil, entre 1999 e 2008 / Epidemiology of basal cell carcinomas in Tubarão, Santa Catarina (SC), Brazil between 1999 and 2008

FUNDAMENTOS: O câncer da pele é frequente no Brasil, com incidência crescente. Na Região Sul de Santa Catarina não existem dados da incidência de carcinoma basocelular. OBJETIVO: Estabelecer dados do carcinoma basocelular em Tubarão (SC) entre 1999 e 2008. MÉTODOS: Estudo transversal com revisão dos laudos anatomopatológicos de carcinoma basocelular dos laboratórios de Tubarão (SC), com coleta das variáveis de interesse: ano do diagnóstico, idade, gênero, cidade de origem, local da lesão, subtipo histológico, diâmetro da lesão, comprometimento de margem e ocorrência de recidiva. RESULTADOS: Identificaram-se 3.253 laudos de carcinoma basocelular, com maior frequência na faixa etária entre 61 e 80 anos. Calculou-se o coeficiente de incidência para carcinoma basocelular de 164,5 em 1999 e 295,2 em 2008 para cada 100 mil habitantes, acarretando aumento de 80 por cento. A região cefálica foi a mais acometida e o subtipo histológico mais comum foi o nodular. Houve associação entre gênero masculino e a localização em tronco e orelha, e entre gênero feminino e ocorrência de carcinoma basocelular no nariz. O subtipo esclerodermiforme foi o mais agressivo em relação ao comprometimento de margens. CONCLUSÃO: Do total de casos de carcinoma basocelular, houve prevalência de margens comprometidas após ressecção em 27 por cento das lesões. Após análise multivariada, as lesões de 2cm ou mais apresentaram probabilidade 5,5 vezes maior de comprometimento de margens, ao passo que a localização em face indicou probabilidade 1,8 vez maior (p<0,0001).

BACKGROUND: Skin cancer is the most frequent type of neoplasm in Brazil. There are no data on the incidence of basal cell carcinoma in the Southern region of Santa Catarina. OBJECTIVE: To establish epidemiological data on basal cell carcinoma in Tubarão, Santa Catarina, between 1999 and 2008. METHODS: A crosssectional study was conducted in which anatomopathological reports of basal cell carcinoma from the laboratories of Tubarão, Santa Catarina, were analyzed. We considered the following variables: year of diagnosis, age, gender, city of origin, tumor site, histological subtype, lesion diameter, margin involvement, and relapse. RESULTS: Reports of 3,253 subjects most frequently between the ages of 61 and 80 years diagnosed with basal cell carcinoma were obtained. The incidence of basal cell carcinoma was 164.5 cases per 100,000 inhabitants in 1999 and 295.2 per 100,000 in 2008, showing an increase of 80 percent. Most lesions occurred in the cephalic region and nodular was the most common histological subtype. There was an association between males and basal cell carcinoma of the torso and ear, and between females and basal cell carcinoma of the nose. The sclerodermiform subtype was the most aggressive in relation to margin involvement. CONCLUSION: There was a prevalence of involved margins following resection in 27 percent of lesions. Based on multivariate analysis, lesions ? 2 cm in diameter were 5.5 times more likely to present margin involvement, and basal cell carcinoma of the face was 1.8 times more likely to occur (p <0.0001).

Epidemiology of basal cell carcinomas in Tubarão, Santa Catarina (SC), Brazil between 1999 and 2008.

BACKGROUND: Skin cancer is the most frequent type of neoplasm in Brazil. There are no data on the incidence of basal cell carcinoma in the Southern region of Santa Catarina. OBJECTIVE: To establish epidemiological data on basal cell carcinoma in Tubarão, Santa Catarina, between 1999 and 2008. METHODS: A cross-sectional study was conducted in which anatomopathological reports of basal cell carcinoma from the laboratories of Tubarão, Santa Catarina, were analyzed. We considered the following variables: year of diagnosis, age, gender, city of origin, tumor site, histological subtype, lesion diameter, margin involvement, and relapse. RESULTS: Reports of 3,253 subjects most frequently between the ages of 61 and 80 years diagnosed with basal cell carcinoma were obtained. The incidence of basal cell carcinoma was 164.5 cases per 100,000 inhabitants in 1999 and 295.2 per 100,000 in 2008, showing an increase of 80%. Most lesions occurred in the cephalic region and nodular was the most common histological subtype. There was an association between males and basal cell carcinoma of the torso and ear, and between females and basal cell carcinoma of the nose. The sclerodermiform subtype was the most aggressive in relation to margin involvement. CONCLUSION: There was a prevalence of involved margins following resection in 27% of lesions. Based on multivariate analysis, lesions of 2 cm in diameter were 5.5 times more likely to present margin involvement, and basal cell carcinoma of the face was 1.8 times more likely to occur (p <0.0001).