Frequency of various types of neoplasia in a group of acromegalic patients

OBJECTIVE: To determine the frequency of colon cancer, primary hyperparathyroidism, thyroid tumor, and skin cancer in all acromegalic patients in follow-up at the Clinics Hospital - Botucatu Medical School, from 2005 to 2011. SUBJECTS AND METHODS: These patients were evaluated retrospectively for colon cancer, primary hyperparathyroidism, dermatological, and thyroid tumors. RESULTS: Of 29 patients included at the beginning of the study, two were excluded. Among 19 patients submitted to colonoscopy, one presented colon adenocarcinoma (5%). Thyroid nodules were present in 63% of patients, and papilliferous carcinoma was confirmed in two patients (7,7%). Four patients were confirmed as having primary hyperparathyroidism (15%). The most common dermatologic lesions were thickened skin (100%), acrochordons (64%), epidermal cysts (50%), and pseudo-acanthosis nigricans (50%). Only one patient presented basal cell carcinoma. CONCLUSION: Although a small number of acromegalic patients was studied, our findings confirm the high frequency of thyroid neoplasias and primary hyperparathyroidism in this group of patients.

Translation, cultural adaptation to Brazil and validation of the venous leg ulcer quality of life questionnaire (VLU-QoL-Br)

Objetivo:traduzir o instrumento Venous legulcer quality of life questionnaire (VLU-QoL), adaptá-lo culturalmente para o português do Brasil e validá-lo com pacientes do Hospital das Clínicas da Faculdade de Medicina de Botucatu (FMB) da Universidade Estadual Paulista (Unesp). Métodos:o questionário foi traduzido por um tradutor profissional e por dois dermatologistas especialistas na área de úlceras venosas (UV), sendo reformulado em reunião com os três tradutores. O constructo (VLU-QoL-Br) foi submetido a pré-entrevista com 10 portadores de UV para a adaptação da linguagem. Posteriormente, foi aplicado em pacientes do HC-Unesp, e como teste-reteste para verificação de sua reprodutibilidade. Resultados:foram avaliados 82 pacientes, sendo 56 (68%) do sexo feminino. A idade média foi de 67,3 anos. O questionário foi traduzido, adaptado e aplicado aos pacientes. O constructo apresentou alta consistência interna (alfa= 0,94) e adequada correlação item-total. Quando avaliados os 32 retestes, observou-se correlação intraclasse para concordância de 0,78 (p < 0,01), indicando boa reprodutibilidade do constructo. A análise fatorial confirmatória corroborou as dimensões do questionário original: atividades, psicológico e sintomas. Escores do VLU-QoL-Br se associaram, independentemente, à área total das úlceras e a menor escolaridade dos sujeitos (p < 0,01). Conclusão:a tradução, a adaptação e a validação do questionário VLU-Qol-Br demonstrou boa performance psicométrica, permitindo seu uso clínico no Brasil. É importante avaliar seu desempenho em outras regiões e em diferentes amostras de indivíduos.

Prevalence of antibodies against Toxoplasma gondii and Neospora caninum in dogs

Toxoplasmosis and neosporosis are parasitic diseases of global importance. The present study had the objective to determine the influence of age, sex and breed in the prevalence of antibodies against both diseases in dogs from Brotas city, São Paulo State, Brazil. Blood samples of 342 dogs were collected, and the age, sex and breed of each animal were recorded. The serological diagnosis for toxoplasmosis and neosporosis were performed using the immunofluorescent antibody test (IFAT). The Fischer's test was used to calculate the association probability of the variables, with a = 5%. For toxoplasmosis the prevalence of antibodies was 26.9% (CI 95% 22.4-31.8%), and for neosporosis 4.97% (CI 95% 3.1-7.8%). The statistical analysis revealed a higher risk of infection for T. gondii in dogs with more than five years.

Avaliação sorológica de Parainfluenzavirus Tipo 1, Salmonella spp., Mycoplasma spp. e Toxoplasma gondii em aves silvestres

Newcastle disease, salmonellosis and mycoplamosis are the most important infectious diseases in poultry. Toxoplamosis is a common disease in urban environment. The present study investigated serologic evidence of these diseases in captive and wildlife birds, with rapid plate agglutination test, haemagglutination inhibition test, and modified agglutination test. In a total of 117 blood serum samples, 20 showed the presence of Toxoplasma gondii, Mycoplasma gallisepticum, and Salmonella spp. antibodies. Amazona aestiva was the specie with the highest number of positive individuals (13/20). We also verified the first detection of T. gondii antibodies in birds of prey from Mivalgo chimachima and Rupornis magnirostris species.

Prozone effects in microscopic agglutination tests for leptospirosis in the sera of mice infected with the pathogenic Leptospira interrogans serovar Canicola

Mice experimentally infected with a pathogenic strain of Leptospira interrogans serovar Canicola produced false negative results (prozone effect) in a microscopic agglutination test (MAT). This prozone effect occurred in several serum samples collected at different post-infection times, but it was more prominent in samples collected from seven-42 days post-infection and for 1:50 and 1:100 sample dilutions. This phenomenon was correlated with increased antibody titres in the early post-infection phase. While prozone effects are often observed in serological agglutination assays for the diagnosis of animal brucellosis and human syphilis, they are not widely reported in leptospirosis MATs.

Effects caused by the spinal administration of ketamine S (+) 5% with no preservatives, using a single puncture, and located on the spinal cord and meninges in rabbits

PURPOSE: To evaluate the effect of ketamine S (+) 5% with no preservatives and administered as a subarachnoid single puncture on the spinal cord and meninges of rabbits.METHODS: Twenty young adult female rabbits, each weighing 3500-5000 g and having a spine length between 34 and 38 cm, were divided by lot into two groups (G): 0.9% saline in G1 and ketamine S (+) 5% in G2, by volume of 5 μg per cm column (0.18 mL). After intravenous anaesthesia with ketamine and xylazine, the subarachnoid space was punctured at S1-S2 under ultrasound guidance, and a random solution was injected. The animals remained in captivity for 21 days under medical observation and were sacrificed by decapitation. The lumbosacral spinal cord portion was removed for immunohistochemistry to assess the glial fibrillary acidic protein (GFAP), and histology was assessed using hematoxylin and eosin (HE) stain.RESULTS:No histological lesions were found in the nervous tissue (roots and cord) or meninges in either group.CONCLUSION: The ketamine S (+) 5% unpreserved triggered no neurological or histological lesions in the spinal cord or meninges of rabbits.

Produção in vitro de embriões de bovinos da raça Nelore oriundos de ovócitos de ovários com e sem corpo lúteo

Comparou-se a produção de embriões a partir de ovócitos oriundos de ovários com e sem corpo lúteo de vacas da raça Nelore, em relação à qualidade e quantidade de ovócitos obtidos, embriões produzidos, taxa de prenhez e proporção dos sexos. Foram realizadas aspirações foliculares dos dois ovários de 219 vacas em 250 seções, igualmente distribuídas em cinco grupos, sendo G1=fêmeas gestantes; G2=não gestantes, com CL e submetidas a tratamento hormonal com progestágeno+BE+PGF2∝; G3=não gestantes, sem CL e com o mesmo tratamento de G2; G4=não gestantes, com presença de CL e sem tratamento; G5=não gestantes, sem presença de CL e sem tratamento. Os resultados foram avaliados pela análise de variância (ANOVA) e aplicado o Teste de Tukey para comparação entre médias, a 5% de significância, pelo programa SISVAR. Já para comparação de proporção de sexos dentro e entre os grupos, foi utilizado o teste de comparação múltipla de proporções. O G4 produziu maior média de ovócitos totais aspirados que G2 e G3. Comparando-se os três grupos que apresentavam CL (G1, G2, G4), o G4 foi superior a G1 e G2 em ovócitos totais, no ovário com e sem CL. Em ovócitos viáveis, G2 foi superior a G1 no ovário com CL. Os ovócitos obtidos de ovários com CL é que resultaram em melhores índices de produção de embriões. As vacas gestantes produziram melhor nos ovários sem CL, com mais ovócitos viáveis (p<0,05) e iguais em embriões (p>0,05), em relação ao ovário com CL. As taxas de prenhez e proporção dos sexos foram semelhantes entre os grupos (p>0,05). A concentração de progesterona (P4) foi diferente entre os grupos, mas não influenciou as variáveis analisadas. A utilização do tratamento hormonal não melhorou os resultados de nenhuma variável. Portanto, o melhor critério de escolha de doadoras Nelore para programas de Produção in vitro (PIV) de embriões é o conhecimento individual de cada animal ao longo das seções de aspiração folicular.

Respostas fisiológicas de genótipos de Eucalyptus grandis x E. urophylla à disponibilidade hídrica e adubação potássica

Conduziu-se este trabalho, com o objetivo de estudar as respostas fisiológicas de cinco genótipos de eucalipto à disponibilidade hídrica e adubação potássica. As mudas foram plantadas em vasos preenchidos com sete litros de um Neossolo Quartzarênico, com baixo teor natural de potássio (0,2 mmol c.dm-3 K), e submetidas a dois regimes de irrigação (RI1 - diário e RI2 - irrigação suspensa até o aparecimento de sintomas iniciais de murcha), sem (K0) e com suprimento de potássio (K1 - 200 mg.dm-3 K2O), em casa de vegetação. Avaliou-se a taxa fotossintética (A), condutância estomática (gs), transpiração (E), índice de conteúdo de clorofila (ICC), conteúdo relativo de água (CRA), eficiência fotoquímica (Fv/Fm), eficiência intrínseca (EUAintr) e instantânea no uso da água (EUAinst) e potencial hídrico foliar (Ψf). O experimento foi estabelecido no delineamento de blocos ao acaso, em esquema fatorial 5 x 2 x 2 (5 genótipos, 2 regimes de irrigação e 2 níveis de adubação potássica), com cinco repetições. À exceção da eficiência fotoquímica, as demais características apresentaram alterações significativas no regime RI2, com redução nos valores de A, gs e E e aumento em ICC e EUAinst. O suprimento de potássio nas plantas do RI2 proporcionou maiores valores de A, gs, E e CRA. Dos genótipos avaliados, o G1 é o mais resistente e o G2 o mais sensível à deficiência hídrica. Conclui-se que a adubação potássica pode amenizar os efeitos negativos da deficiência hídrica nos estádios iniciais de crescimento de eucalipto.

Efeito da desmama precoce na eficiência reprodutiva de vacas Guzerá

The early weaning method is an alternative to increase the body weight of calves, since it is based on the total or temporary interruption of suckling by animals, in an attempt to faster develop the rumen of those receiving milk ad libitum. Thus, this study was conducted in Selvíria, Mato Grosso do Sul State, Brazil, in order to evaluate the weight gain of calves subjected to two weaning methods (conventional, i.e., calves were kept with cows, and controlled, where calves had access to suckling for one hour per day), as well as body condition and pregnancy rate of Guzerá primiparous and multiparous cows. Once a month, the animals were weighed, in order to measure their weight gain. At the birth and definite weaning of calves, the cows had their body condition evaluated, as well as their pregnancy rate, at the end of weaning. It was found that the controlled weaning method showed no significant difference, however, it becomes feasible in the beef cattle chain, since it can reduce the delivering intervals, due to the improved body condition of cows, especially in times of drought, when there is low food availability. An increase in the weight of calves at weaning was also observed for primiparous cows.

Factors that influence healing of chronic venous leg ulcers: a retrospective cohort

BACKGROUND: Venous ulcers have a significant impact on patient quality of life, and constitute a worldwide public health problem. Treatment is complex, with high failure rates.OBJECTIVES: To identify clinical and therapeutic factors that influence healing of venous ulcers.METHODS: Retrospective cohort study of patients with venous ulcers. Ulcer area was measured at the first visit (T0) and after 6 months (T6) and 1 year (T12). A reduction in ulcer area of 50% or more at T6 and T12 was the outcome of interest, weighted by clinical, demographic and treatment aspects.RESULTS: Ninety-four patients were included (137 ulcers). A reduction in ulcer area of 50% or more was seen in 40.1% of patients (95% CI 31.9 to 48.4%) at T6 and 49.6% (95% CI 41.2 to 58.1%) at T12. Complete healing occurred in 16.8% (95% CI 10.5 to 23.1%) at T6 and 27% (95% CI 19.5 to 39.5%) at T12. The lowest ulcer area reductions at T6 were associated with longstanding ulcer (RR=0.95; 95% CI 0.91 to 0.98), poor adherence to compression therapy (RR=4.04; 95% CI 1.31 to 12.41), and infection episodes (RR=0.42; 95% CI 0.23 to 0.76). At T12, lower reductions were associated with longstanding ulcer (RR=0.95; 95% CI 0.92 to 0.98), longer topical antibiotic use (RR=0.93; 95% CI 0.87 to 0.99), and systemic antibiotic use (RR=0.63; 95% CI 0.40 to 0.99).CONCLUSIONS: Longstanding ulcer, infection, poor adherence to compression therapy, and longer topical and systemic antibiotic use were independently correlated with worse healing rates.

Skin diseases reported by workers from UNESP campus at Rubiao Jr, Botucatu-SP (Brazil)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Retinoids for prevention and treatment of actinic keratosis

Actinic keratosis is a common cause of dermatological consultations and it presents a strong association with squamous cell carcinoma. Many substances are used for treatment and prevention, such as retinoids. Nevertheless, many studies on retinoids emphasize their application in treating and preventing non melanoma skin cancers. In this article, we reviewed studies about systemic and topical retinoids used with immunocompetent patients and organ transplant recipients with actinic keratosis, as primary or secondary outcomes. The majority of these papers pointed to a reduction in actinic keratosis count after treatment with retinoids. However, studies need to be better-defined in order to address the lack of a standardized dose, the absence of control groups, the low number of patients and short follow-up periods. Blind, randomized and controlled clinical trials with adequate sample sizes, specifically focused on actinic keratosis, are needed to clarify the real benefit of topical and/or oral retinoids. Comparison of efficacy and safety between oral and topical retinoids in the prevention and treatment of non-melanoma skin cancers and actinic keratosis is an essential pre requisite to establish new strategies to control these conditions.

Oral acetylsalicylic acid and prevalence of actinic keratosis

Objective: To investigate the influence of a regular oral use of acetylsalicylic acid in the prevalence of actinic keratosis.Methods: A case-control study with dermatologic outpatients above 50 years of age assessed between 2009 and 2011. Cases were defined as those who had been under regular use of oral acetylsalicylic acid for more than six consecutive months. The assessment focused on: age, sex, skin-type, tobacco smoking, use of medication, occurrence of individual or family skin cancer, and sunscreen and sun exposure habits. Actinic keratoses were counted in the medial region of the face and upper limbs. Counts were adjusted by co-variables based on a generalized linear model.Results: A total of 74 cases and 216 controls were assessed. The median time of acetylsalicylic acid use was 36 months. Cases differed from controls as to the highest age, highest prevalence of use of angiotensin-converting enzyme inhibitors and fewer keratosis on the face and on the upper limbs (p < 0.05). The multivariate model showed that the use of acetylsalicylic acid was associated to lower counts of face actinic keratosis and upper-limb erythematous actinic keratosis (p < 0.05), regardless of other risk factors.Conclusion: The regular use of oral acetylsalicylic acid for more than six months was associated to a lower prevalence of actinic keratosis, especially facial and erythematous ones.

Time needed to schedule dermatological consultations in Brazil

BACKGROUND: It is not clear what the population's demand for dermatologists is, nor how many professionals are needed in order to provide adequate care in this area of expertise. Knowledge of the flow of patients at dermatological clinics throughout the country allows for the formation of expansion and distribution policies regarding professionals, and provides backing for the decision to increase medical residency places. OBJECTIVES: To evaluate the time it takes to schedule a private dermatological consultation in Brazil, and other factors concerning consultations. METHODS: Survey with a random sample of 14% of Brazilian dermatologists, simulating the scheduling of emergency clinical and cosmetic consultations, and botulinum toxin procedures. Also, details relating to cost and professionals, were studied. Data were adjusted for each region of the country. RESULTS: A total of 873 dermatologists were evaluated. Full SBD members represented 85%, and 66% were women. The median time to schedule a consultation ranged from 6 (out-of-pocket payment) to 7 (medical insurance) consecutive working days. Times varied depending on the region. A multivariate analysis showed that out-of-pocket consultations and procedures were scheduled sooner than with medical insurance, regardless of whether they were clinical or cosmetic. CONCLUSION: The characteristics of dermatologists are varied throughout regions of the country. Private consultations and procedures are scheduled sooner than with insurance companies.

Keratosis pilaris and prevalence of acne vulgaris: a cross-sectional study

BACKGROUND: Acne vulgaris has an important genetic predisposition, as well as keratosis pilaris. Clinical observations suggest that patients with keratosis pilaris have less frequent or less severe acne breakouts; however, we found no studies on this regard OBJECTIVE: To determine if the presence of keratosis pilaris is associated with lower prevalence and severity of acne. METHODS: A cross-sectional study was conducted with dermatology outpatients aged between 14 and 35 years. We evaluated history and clinical grade of acne, demographic variables, history of atopy, smoking, and use of hormonal contraceptives. Two groups were defined by the presence or absence of moderate to severe keratosis pilaris on the arms and were compared by bivariate analysis and by conditional multiple logistic regression. RESULTS: We included 158 patients (66% women), with a median age of 23 +/- 11 years. Twenty-six percent of them had keratosis pilaris, which was associated with a history of atopy (odds ratio [OR]=2.80 [1.36 to 5.75]; p<0.01). Acne was present in 66% of subjects, and was related to family history of acne (OR=5.75 [2.47 to 13.37]; p<0.01). In bivariate and multivariate analysis, the group with keratosis pilaris had a less frequent history of acne (OR=0.32 [0.14 to 0.70]; p<0.01). CONCLUSION: The presence of moderate to severe keratosis pilaris on the arms was associated with lower prevalence of acne vulgaris and lower severity of facial lesions in adolescents and young adults.