Skin lesions simulating blue toe syndrome caused by prolonged contact with a millipede

Venomous animals are those that, by means of a hunting and defense mechanism, are able to inject their prey with a toxic substance produced in their bodies, directly from specialized glands (e.g., tooth, sting, spur) through which the poison passes. Millipedes are poisonous animals; they can be harmful to humans, and their effects usually manifest as erythematous, purpuric, and cyanotic lesions; local pain; and paresthesia. Here, we report a case of skin contact with a millipede for 6h resulting in skin lesions similar to blue toe syndrome.

Indicators of inflammation and cellular damage in chronic asymptomatic or oligosymptomatic alcoholics: correlation with alteration of bilirubin and hepatic and pancreatic enzymes

Biochemical and hematimetric indicators of inflammation and cell damage were correlated with bilirubin and hepatic and pancreatic enzymes in 30 chronic male alcoholics admitted into psychiatric hospital for detoxification and treatment of alcoholism. Aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, alkaline phosphatase, and total bilirubin were altered, respectively, in 90%, 63%, 87%, 23% and 23% of the cases. None of the indicators of inflammation (lactic dehydrogenase, altered in 16% of the cases; alpha-1 globulin, 24%; alpha-2 globulin, 88%; leucocyte counts, 28%) was correlated with alterations of bilirubin or liver enzymes. Lactic dehydrogenase was poorly sensitive for detection of hepatocytic or muscular damage. Alterations of alpha-globulins seemed to have been due more to alcohol metabolism-induced increase of lipoproteins than to inflammation. Among indicators of cell damage, serum iron, increased in 40% of the cases, seemed to be related to liver damage while creatine phosphokinase, increased in 84% of the cases, related to muscle damage. Hyperamylasemia was found in 20% of the cases and significantly correlated with levels of bilirubin, alkaline phosphatase and gamma-glutamyltransferase. It was indicated that injuries of liver, pancreas, salivary glands, and muscle occurred in asymptomatic or oligosymptomatic chronic alcoholics.

Pouchitis: extracolonic manifestation of ulcerative colitis?

Pouchitis is the most frequent complication of ileal pouch-anal anastomosis for treatment of ulcerative colitis. There are several possible explanations. Among them, we focus on the one that considers pouchitis as an extracolonic manifestation of ulcerative colitis. The aim of this study was to investigate the association between pouchitis and extra-intestinal manifestations (EIM), which are frequent in these patients. Sixty patients underwent restorative proctocolectomy with an ileal J pouch (IPAA) from September 1984 to December 1998. Pouchitis was defined by clinical, endoscopic, and histologic criteria. The following extra-intestinal manifestations were studied: articular, cutaneous, hepatobiliary, ocular, genitourinary, and growth failure. Thirteen patients, of which 10 were female (76.9%), developed one or more episodes of pouchitis. Twelve patients of this group (92.3%) presented some kind of extra-intestinal manifestation, 4 pre-operatively (exclusively), 2 post-operatively (exclusively), and 6 both pre- and post-operatively (1.7 per patient). Twenty patients (42.7%) of the 47 without pouchitis did not present extra-intestinal manifestations; 10/35 (28.5%) of females had pouchitis, compared to 3/35 (12.0%) of men. Pouchitis was more frequent among females, though not statistically significant. EIM increases the risk of pouchitis. Pouchitis is related to EIM in 92.3 % of cases, corroborating the hypothesis that it could be an extracolonic manifestation of ulcerative colitis.

The importance of the ligation of the inferior thyroid artery in parathyroid function after subtotal thyroidectomy

We prospectively studied the effects of the ligation of the inferior thyroid artery (ITA) on postoperative hypoparathyroidism in 48 patients who underwent functional subtotal thyroidectomy. Patients were randomized into two groups: A, with bilateral ligation of the ITA and B, without ligation of the ITA. Parathyroid function was checked preoperatively and after surgery by clinical examination and measurement of total calcium, intact PTH, urinary calcium, and AMPc. RESULTS: A significant incidence of postoperative hypocalcemia occurred: 17% in group A and 13% in B on the 4th postoperative day. Six months later, the incidence was 5% in Group A and 0% in Group B. These differences were not statistically significant between the two groups, and neither were any of the other clinical and laboratory observations. CONCLUSION: The ligation of the ITA was not an important causal factor for the occurrence of postoperative hypocalcemia after subtotal thyroidectomy.

Pelvic lymphoscintigraphy: contribution to the preoperative staging of rectal cancer

PURPOSE: Preservation of the anal sphincter in surgery for cancer of the distal rectum in an attempt to avoid colostomy has been a main concern of colorectal surgeons. Various proposed procedures contradict oncological principles, especially with respect to pelvic lymphadenectomy. Therefore, prior knowledge of pelvic lymph node involvement is an important factor in choosing the operative technique, i.e., radical or conservative resection. Introduction of ultrasound, computerized tomography, and magnetic resonance have made preoperative study of the area possible. Nevertheless, these resources offer information of an anatomical nature only. Lymphoscintigraphy enables the morphological and functional evaluation of the pelvic area and contributes toward complementing the data obtained with the other imaging techniques. The objective of this prospective study is twofold: to standardize the lymphoscintigraphy technique and to use it to differentiate patients with rectal cancer from those with other coloproctologic diseases. CASUISTIC AND METHODS: Sixty patients with various coloproctologic diseases were studied prospectively. Ages ranged from 21 to 96 years (average, 51 and median, 55 years). Twenty-six patients were male and 34 were female. Thirty patients had carcinoma of the distal rectum as diagnosed by proctologic and anatomic-pathologic examinations, 20 patients had hemorrhoids, 5 had chagasic megacolon, 2 had diverticular disease, 2 had neoplasm of the right colon, and 1 had ulcerative colitis as diagnosed by proctologic exam and/or enema. The lymphoscintigraphy method consisted of injecting 0.25 mL of a dextran solution marked with radioactive technetium-99m into the right and left sides of the perianal region and obtaining images with a gamma camera. The results were analyzed statistically with a confidence level of 95% (P < .05) using the following statistical techniques: arithmetic and medium average, Fisher exact test, chi-square test corrected for continuity according to Yates, and distribution tables for the number of patients. RESULTS: In rectal cancer, the tracer progresses unilaterally or is absent; in other patients, the progress of the tracer is bilateral and symmetrical, although its progress may be slow. Statistical tests showed with high significance that the agreement index between the clinical diagnosis and the result of the lymphoscintigraphic exam was 93%. CONCLUSIONS: Lymphoscintigraphy is a standardized, painless, and harmless test that can be performed in all cases; it differentiates patients with rectal cancer from those with other coloproctological diseases.

Salivary gland tumors in a Brazilian population: a retrospective study of 124 cases

Salivary gland tumors constitute a highly heterogeneous histopathologic group. There are few epidemiological studies of large series of benign and malignant salivary gland tumors in Brazil. MATERIAL AND METHODS: Hospital records of 124 patients with salivary gland tumors diagnosed from January 1993 to December 1999 were reviewed. The patients were analyzed according to gender, age, size, location, and histopathology of the tumor. RESULTS AND CONCLUSIONS: Patients with benign and malignant tumors presented with a mean age of 47.7 and 48.8 years, respectively. The frequency of benign tumors was 80% (n = 99) and malignant tumors 20% (n = 25). Tumors were localized in the parotid gland 71% (n = 88), in the submandibular gland 24% (n = 30), and in the minor salivary glands 5% (n = 6). The most common benign tumors were pleomorphic adenoma in 84% (n = 84) and Warthin's tumor in 13% (n = 13). Among malignant tumors, mucoepidermoid carcinoma was the most common in 52% (n = 13), adenoid cystic carcinoma occurred in 20% (n = 5), and carcinoma ex pleomorphic adenoma was detected in 12% (n = 3).

C-cells in colloid goiter

PURPOSE: The aim of this investigation was to quantitatively evaluate C-cells in colloid goiters, analyzing 36 thyroids that were obtained through thyroidectomy from 24 patients with goiter and 12 normal glands from adult patients without thyroid disease, which were used as the control group. MATERIAL AND METHODS: On average, 6 different thyroid areas were sampled and labeled by immunohistochemistry with a monoclonal anticalcitonin antibody, utilizing the avidin-biotin-peroxidase complex. C-cells were counted in fields measuring 1 square centimeter, and the mean number of cells per field was then calculated. Data were statistically analyzed using the Mann-Whitney test. RESULTS: In the colloid goiter group, the number of C-cells ranged from 0 to 23 per field, while in normal controls they ranged from 20 to 148 per field. CONCLUSIONS: These results demonstrate a significant decrease of C-cell number in the colloid goiter group compared with control group, indicating that the hyperplastic process is restricted to follicular cells, to the detriment of C-cells, which probably cease to receive trophic stimuli.

Induction of experimental mammary carcinogenesis in rats with 7,12-dimethylbenz(a)anthracene

PURPOSE: To test an experimental model of chemical mammary carcinogenesis induction in rats. METHODS: Twenty young virgin Sprague-Dawley female rats, aged 47 days, received 20 mg of 7,12-dimethylbenz(a)anthracene (DMBA) intragastrically by gavage. Afterwards, at 8 and 13 weeks, their mammary glands were examined. At the end of the experiment, the animals were sacrificed, and the mammary tumors were measured and weighed. Tumor fragments were analyzed using light microscopy. RESULTS: Eight weeks after DMBA injection, 16 rats presented at least 1 breast tumor (80%). After 13 weeks, all of them (100%) developed breast carcinomas that were confirmed by histopathological analysis. CONCLUSION: This experimental animal model of chemical mammary induced carcinogenesis is feasible and can be used in further experiments on the role of tumorigenic biomodulator substances.

Anorectal leiomyomas: report of two cases with different anatomical patterns and literature review

Gastrointestinal mesenchymal tumors comprise a rare group of gastrointestinal tract wall tumors that have long been a source of confusion and controversy, especially in terms of pathological classification, preoperative diagnosis, management strategies, and prognosis. This report describes the clinical manifestations and management of 2 rectal leiomyomas and reviews the pertinent literature. Case 1: A 44-year-old woman was admitted reporting a nodule in the right para-anal region for the previous 2 years. At proctological examination, a 4-cm diameter fibrous mass situated in the para-anal region that produced an arch under the smooth muscle on the right rectal wall just above the anorectal ring was noted. Computed tomography and magnetic resonance imaging of the abdomen and pelvis showed the lesion and detected no other abnormalities. Surgical treatment consisted of wide local resection of the tumor through a para-anal incision, with no attempts to perform lymphadenectomy. Case 2: A 40-year-old male patient was admitted reporting constant anal pain for 4 months. He presented a 3-cm submucosal nodule at the anterior rectal wall just above the dentate line. After 2 inconclusive preoperative biopsies, transanal resection of the tumor was performed. Histological analysis of the specimen showed a benign leiomyoma. A review of the literature is presented, emphasizing some clinical and therapeutic aspects of this unusual rectal tumor.

Prevalência da C.trachomatis entre homens que fazem sexo com homens (HSH) que frequentam um centro clínico comunitário alternativo em Barcelona

RESUMO - Enquadramento: A infeção por Chlamydia trachomatis (CT) é considerada um grave problema de Saúde Pública. É causa de infeções sintomáticas tanto no homem como na mulher, bem como, de infeções assintomáticas que podem ter consequências muito graves a longo prazo. A presença de CT sem tratamento aumenta o risco de transmissão do vírus da imunodeficiência humana. Existem vários estudos publicados de prevalência da CT por todo o mundo, no entanto, estudos de prevalência da CT em populações assintomáticas, envolvendo homens que fazem sexo com homens (HSH) são raros na Europa. Assim, o presente estudo, ao estimar a prevalência e ao descrever as caraterísticas epidemiológicas e de conduta dos HSH, pretende contribuir para o plano de ação contra as IST´s e VIH na Catalunha, através de estratégias concretas para deteção e prevenção da CT. Métodos: Trata-se de um estudo observacional, transversal de prevalência da CT em HSH utentes de um serviço comunitário em Barcelona, com recurso a técnicas de diagnóstico de biologia molecular e a um questionário. Durante Março e Junho de 2015, foram recrutados 200 voluntários de um serviço comunitário em Barcelona que foram testados para CT e NG em três locais anatómicos através de uma PCR em tempo real utilizando o ensaio Anyplex™ CT/NG Real-time Detection. Resultados: O presente estudo permitiu uma caraterização da situação atual quanto á prevalência e aos fatores de risco associados á infeção por CT em HSH. A prevalência nesta população específica foi de 12,6% e os fatores risco associados foram o facto de serem VIH e praticarem sexo anal insertivo/recetivo com parceiro estável. Conclusões: Os resultados obtidos reforçam a necessidade do desenvolvimento de estratégias adequadas de controlo e prevenção da CT nesta população de risco, tais como: rastreios frequentes e tratamento dos casos positivos para quebrar a cadeia de transmissão, promoção da saúde, educação e notificação dos parceiros sexuais. Também demonstram a importância destes rastreios nos três locais anatómicos: uretra, reto e faringe.

IDENTIFICAÇÃO BOTÂNICA DE ÁRVORES DE FLORESTA TROPICAL ÚMIDA DA AMAZÔNIA POR MEIO DE COMPUTADOR

Na execução de inventários florestais a identificação das espécies é problemática por causa das dificuldades na obtenção de flores, frutos, sementes e folhas. As chaves analíticas usadas na identificação botânica baseiam-se nas diferenças entre as estruturas reprodutivas das plantas. Por isso, a identificação de árvores usa métodos onde a classificação é feita a partir de caracteres vegetativos. Mostra-se que a partir de um banco de dados dendrológicos é possível proceder a identificação botânica de espécies por meio de um computador. Utilizou-se o programa GUESS e um menu de caracteres botânicos selecionados, que permitem distinguir espécies diferentes. Para cada espécie coletou-se dados de 10 a 20 árvores, na Reserva Ducke e nas Estações de Silvicultura Tropical e Manejo Florestal, do INPA, 26 e 90 km ao norte de Manaus, respectivamente, cujo material botânico foi identificado no Herbário do INPA. O Banco de Dados conta com 226 espécies distribuídas em 34 famílias. O programa permite identificar espécies arbóreas, o qual pode ser usado por botânicos, engenheiros florestais, e outros usuários. A identificação é rápida e confiável, mas não deve ser excluída a consulta a herbários para dirimir dúvidas taxonômicas, dada a grande heterogeneidade florística da floresta tropical.

Caracterização química parcial das sementes de Lecythis pisonis camb. (Sapucaia)

Estudou-se a composição química de amêndoas do fruto da sapucaia (Lecythis pisonis Camb), provenientes da Estação Experimental de Santa Rita do Passa Quatro (SP), do Instituto Florestal de São Paulo. As análises químicas foram realizadas segundo as "Normas Analíticas do Instituto Adolfo Lutz (1985). Os resultados obtidos mostraram altos teores lipídicos (63,5 g/100g), protéicos (19,9 g/l00g), vitamina C (17,1 mg/100g) e valor calórico de 684 Kcal/100g. A fração oleosa apresentou um perfil de ácido graxos e índice de iodo (113,5), equivalente ao do óleo de milho comestível, destacando-se o ácido linoléico (48,6 % p/p) considerado como ácido graxo essencial e participante nos processos de inibição de germinação de sementes. O perfil de ácidos graxos do óleo das amêndoas de sapucaia, os teores de lipídios e de proteína foram semelhantes aos das amêndoas de castanhas-do-Pará (Bertholletia excelsa), espécie da mesma família da sapucaia, cultivada na Amazônia. Para a determinação dos nutrientes, as amostras foram tratadas por via úmida (H2SO4 e H2O2), através da radiação de microondas por sistema aberto de digestão e quantificadas por Espectrometria de Emissão Atômica com Plasma de Argônio Induzido (ICP-AES). A espécie revelou teores elevados para Na (49,8 mg/g); K (46,4 mg/g); B (64,5 mg/g); Mn (91,0 ųg/g); Fe (14,2 ųg/g) e Al (4,91 ųg/g). Entretanto, o nível de Pb encontrado (0,96 ųg/g), está acima do limite máximo permitido pela legislação brasileira (0,5 ųg/g), evidenciando uma possível toxicidade da amostra e contaminação antrópica do local amostrado.

Two new Bucephalidae (Trematoda) from Fishes of the Brazilian Amazon

Two new species of Bucephalidae (Trematoda) are described from fishes of the Brazilian Amazon. Glandulorhynchus turgidus gen. et sp. n. from Hydrolycus sp. differs from all others in the family by having conspicuous glands near the anterior extremity and an expanded uterus used for storing eggs. Prosorhynchus piranhus sp. n. from Serrasalmus rhombeus is characterized as having a small rhynchus and pharynx, and a large cirrus sac.

Descrição de duas novas espécies de Sciaenidae (Perciformes) de água doce da Bacia Amazônica

São descritas duas novas espécies de Sciaenidae da região Amazônica, pertencentes aos gêneros Pachyurus e Plagioscion. Pachyurus junki sp. n. difere das demais espécies congenéricas descritas por apresentar a seguinte combinação de caracteres: extremidade posterior da nadadeira pélvica distante do ânus; largura interorbital contida menos do que 6,0 vezes no comprimento da cabeça; segundo espinho da nadadeira anal contido mais do que 2,1 vezes no comprimento da cabeça; 29 a 33 raios na nadadeira dorsal; 11 a 16 séries de escamas acima da linha lateral; 11 a 16 séries de escamas abaixo da linha lateral e 58 a 68 escamas perfuradas na linha lateral. Plagioscion montei sp. n. difere das demais espécies do gênero por apresentar: ânus distante da nadadeira anal, estando a distância ânus-anal contida de 2,4 a 3,5 vezes no comprimento da cabeça; nadadeira peitoral relativamente longa, quando adpressa sua extremidade posterior chega próximo ou ultrapassa a linha vertical que passa pela origem do ânus; largura interorbital relativamente ampla, contida entre 3,5 e 5,0 vezes no comprimento da cabeça e segundo espinho da nadadeira anal forte e curto, contido de 2,5 a 4,4 vezes no comprimento da cabeça.

Caracterização de sintomas de carências nutricionais em mudas de pupunheira cultivadas em solução nutritiva

Os conhecimentos de nutrição mineral da pupunheira (Bactris gasipaes Kunth, Palmae) são relativamente escassos e incipientes, faltando dados consistentes sobre sua demanda nutricional desde a fase de viveiro até a fase de produção. Com o objetivo de caracterizar os sintomas de carências de macro e micronutrientes, e identificar os níveis analíticos associados às carências minerais em mudas de pupunheira, foi conduzido um ensaio em casa de vegetação, pertencente ao Instituto Nacional de Pesquisas da Amazônia, Manaus, AM. Plantas de pupunheira foram cultivadas em solução nutritiva, tendo como substrato areia lavada. Os tratamentos foram: completo e omissão individual de nitrogênio, fósforo, potássio, cálcio, magnésio, enxofre, ferro, boro, cobre, manganês, zinco e molibdênio. O delineamento experimental foi inteiramente casualizado com treze tratamentos e quatro repetições. As deficiências dos nutrientes nas mudas de pupunheiras se traduziram por sintomas típicos e facilmente identificáveis, e os níveis analíticos de adequação e deficiência obtidos nas folhas foram: N (g kg-1) 30.7 - 10.1; P (g kg-1) 3.4 - 1.0; K (g kg-1) 27.8 - 4.7; Ca (g kg-1) 12.7 - 2.6; Mg (g kg-1) 3.5 - 0.9; Fe (mg kg-1) 175 - 191; Zn (mg kg-1) 33 - 41.