Spontaneous rupture of an umbilical hernia in a cirrhotic patient with ascites A case report and review of the literature.

The authors, report a case of spontaneous rupture of an umbilical hernia in a cirrhotic patient with ascites and perform a literature review. Their results and the published data suggest that it is preferable to perform elective surgery after stabilization of the ascites and the patient's general condition in order to prevent complications and mortality. KEY WORDS: Ascites, Hernioplasty, Spontaneous hernia rupture.

Simultaneous medullary carcinoma and differentiated thyroid cancer. Case report.

BACKGROUND: Medullary thyroid cancer (MTC) is an uncommon and aggressive tumour representing only 5-10% of all thyroid malignancies. MTC arises from parafollicular thyroid cells (C-cells) producing calcitonin hormone. Differentiated thyroid cancer (DTC) is the most frequent thyroid tumour (papillary or follicular), representing 80% of all thyroid cancer. DTC derives from follicular thyroid cells, that come from the central thyroid sketch. The association between medullary and papillary thyroid cancer is rare. Several cases have been reported of mixed carcinomas. CASE REPORT: We report two cases of associated medullary and papillary carcinomas in two different foci in patients with respectively Graves' disease and multinodular goiter. A young woman affected by Grave's disease and multinodular goiter under pharmacological treatment with antithyroidal drugs underwent total thyroidectomy. The histopathological examination revealed the presence of a medullary carcinoma of the middle third of right lobe (1.1 cm) with an adjacent papillary microcarcinoma (0.5 cm). A 72-years-old woman, affected by euthyroid multinodular goiter, underwent total thyroidectomy. The pathological findings were two microcarcinomas, medullary (0.44 cm) in the left lobe and papillary (0.22 cm) in the right lobe. CONCLUSION: We can speculate that this coexistence is inferred, not having shown a specific cause that justifies the association between the two types of tumour and the high prevalence of papillary carcinoma.

Incidência de perdas dentárias e diabetes tipo 2: avaliação da ANAD e do Envelhecer Sorrindo / Incidence of teeth loss and type 2 diabetes: assessment of ANAD and Aging Smiling

Perdas dentais, causadas pelos mais diversos fatores, produzem impacto direto sobre a saúde bucal, com conseqüente repercussão na qualidade de vida das pessoas. Este trabalho procurou dimensionar a incidência de ausências dentais em pacientes diabéticos do município de São Paulo, que participaram da 8ª Campanha Nacional de Diabetes da Associação Nacional de Assistência ao Diabético (ANAD) em 2005. O objetivo foi buscar informações que possibilitem vislumbrar caminhos para prevenir perdas de elementos dentais em tais pacientes. Foi possível traçar e analisar a cronologia das perdas, assim como os desequilíbrios funcionais resultantes das mesmas. Foram avaliados, por meio de questionários, 99 pacientes de ambos os sexos, com idades entre 29 e 89 anos. Os questionários foram aplicados por integrantes do projeto "Envelhecer Sorrindo" da Faculdade de Odontologia da USP. Os resultados foram analisados segundo os testes estatísticos de correlação de Spearman, teste de Mann-Whitney e intervalo de confiança para a média. Após as análises foi possível concluir que a trituração era a função mais prejudicada, uma vez que os elementos dentais posteriores foram mais ausentes do que os anteriores, especialmente no sexo feminino. Além disso, o maxilar apresentou maior número de elementos dentários ausentes do lado direito, enquanto na mandíbula houve perdas bilaterais equivalentes. É consenso que a nutrição e a dieta são essenciais para o controle da taxa glicêmica em pacientes diabéticos. Por isso a redução do número de dentes, como observado nesse estudo, pode prejudicar o controle do diabetes, permitindo que se instalem os mecanismos decorrentes dessa descompensação.

Dental losses due to different factors influence directly oral health as well as quality of people's life. This paper meant to evaluate the incidence of teeth's absences in diabetic patients in São Paulo city, who participated of the 8th National Campaign of Diabetes for the National Diabetic Association (ANAD) in 2005. Besides that it was also meant to make a profile of dental losses' chronology with its consequent functional unbalance. It was evaluated 99 patients aged between 29 and 89 years old, both genders, by means of questionnaires administered by "Envelhecer Sorrindo" staff of dental School of Universidade de São Paulo. The results were submitted to Spearman's correlation tests as well as to Mann-Whitney's test besides trust interval for the average. It was concluded that grinding up was the most impaired function, since posterior teeth were mostly absent specially in female. Besides that, maxillary teeth were more absent in the right side even though in mandible it was not observed such characteristics. It is known that nutrition as well as diet is essential to control glycaemia in diabetic patients. So, decreasing masticatory efficiency can make it worse the diabetes control.