Prurido do traje de banho: relato de seis casos no Sul do Brasil

O prurido do traje de banho ou seabather s eruption é uma dermatite intensamente pruriginosa que ocorre pelo contato com larvas plânulas do cnidário cifozoário Linuche unguiculata, especialmente sob os trajes de banhistas. As larvas disparam seus nematocistos a partir de cnidócitos ou células urticantes de defesa na pele da vítima, causando uma típica erupção pápulo-eritemato-pruriginosa. Os primeiros cinco casos descritos no Brasil foram publicados em 2001, no litoral Sudeste (Ubatuba, SP), obtendo-se associação com larvas de Linuche unguiculata, uma vez que a ocorrência e o ciclo de vida do cnidário já haviam sido estudados no Canal de São Sebastião, SP. Os autores relatam os seis casos na região Sul do Brasil (Estado de Santa Catarina), enfatizando os aspectos clínicos e a pesquisa para identificação do agente na água do mar local.

Epidemiologia do transtorno obsessivo-compulsivo: uma revisão

Os inquéritos populacionais são importantes, pois amostras clínicas tendem a apresentar vieses de seleção. Aspectos sociodemográficos e relacionados à própria condição mórbida podem interferir na procura por tratamento. Pela natureza egodistônica do transtorno obsessivo-compulsivo, seus portadores tendem a ocultar o problema, podendo não procurar ou demorar a procurar tratamento. Porém, a maior parte do conhecimento atual sobre o transtorno obsessivo-compulsivo advém de amostras clínicas, que não representam a totalidade dos casos. Foi feita uma revisão convencional da literatura através do Medline, PsicoInfo e Lilacs de inquéritos populacionais sobre o transtorno obsessivo-compulsivo, cobrindo o período de 1980 a 2004, utilizando-se como palavras-chave epidemiologia, transtorno obsessivo-compulsivo, inquéritos populacionais e prevalência. Estudos realizados em diferentes países indicam para o transtorno obsessivo-compulsivo uma prevalência atual em torno de 1,0% e ao longo da vida de 2,0 a 2,5%. Diferentemente de amostras clínicas, em quase todas as amostras populacionais há predomínio de mulheres e portadores que têm apenas obsessões. A freqüente comorbidade com outros transtornos mentais, particularmente depressão e outros transtornos ansiosos, repete-se em casos da população geral, que apresentam ainda uma associação com abuso de substâncias. Muitos portadores não estão em tratamento, particularmente os casos puros. Indicadores de incapacitação funcional demonstram um considerável impacto negativo do transtorno obsessivo-compulsivo. É preciso melhorar o conhecimento da população e dos profissionais de saúde sobre os sintomas do transtorno obsessivo-compulsivo para aumentar a procura de atendimento, assim como a correta identificação e abordagem terapêutica deste grave problema de saúde.

Emprego da imunofluorescência direta no estudo das alterações de mucosa de palato, compatíveis com candidíase atrófica crônica, em indivíduos portadores de próteses dentárias totais muco-suportadas.

Histopathology by hematoxilin-eosin (HE) and periodic acid Schiff (PAS), concomitant direct immunofluorescence (DI) against total human immunoglobulins and against Candida albicans, was effectuated in 25 persons dentures wearers. In 5 persons without chronic athrofic candidiasis (CAC) clinical signals in the palate the HE showed wise inflammatory elements in the connective tissue and the PAS marked the continuous basal layer, the intra-cellular grains of granular layer and the uniform parakeratin on epithelial surface. In 20 others, with palatal signals of CAC, in the HE was frequent the features encountered in Candida infected and PAS revealed, beside descontinuous lamina basal and epithelial surface covered by tide and discontinuous parakeratin, the presence of round bodies few largers that presents in the granular layer, casually isolated in the medial portion of ret pegs and connective papillae. In the first 5 persons the DI against total human immunoglobulins not showed signals of the humoral immunologic phenomena, the same was valid to others 20 patients with CAC clinical aspects. However the DI with conjugate against C. albicans in the 20 cases with CAC signals revealed suitable aspects of the structures assumed by Candida in tissues. Cultures of samples obtained of the persons with CAC signals was positive in 100% to Candida, 70% presumptively albicans, against 80% of positiviness to generus Candida, 67% presumptively albicans, in the persons without CAC signals.

ESTUDO CLINICO DO TETANO. REVISAO - 1994

The author did a review entitled clinical aspects of tetanus emphasizing the etiology, epidemiology, pathogenesis, diagnostic, clinical aspects, differential diagnosis, laboratorial tests, treatment, complications and prophylaxis.

SINDROME DE DUBOWITZ

A presentation of two cases of Dubowitz syndrome in monozigous twin girls. The syndrome is a rare congenital disorder, the main clinical aspects of which include retarded intrauterine and post-natal growth, microcephaly, peculiar face and an eczemic rash, resulting from photosensitivity of the regions exposed to sunlight.

Epidemiologia e quadro clínico do botulismo epizoótico dos bovinos no Estado de São Paulo

In order to investigate epidemiological and clinical aspects of beef cattle mortalities caused by botulism, a syndrome popularly known as doença da vaca caída, studies were carried out in 32 naturally affected 4 to 9 year old cows, 27 belonging to the Nellore breed and 5 to crossbred Nellore, all from 27 farms located in municipalities near Botucatu, State of São Paulo. The epidemiological and clinical features were based, respectively, on the farm and herd managements, and on the general physical examination of the cows. Mouse bioassay and complement microfixation tests were performed to detect the presence of botulinum toxins in liver samples. The results showed that the disease occurs in beef cattle of range breeding systems, reared under inadequate mineral nutrition and deficient health management. Pregnant and milking cows represented the group at risk, and the incidence was higher during the rainy season (December to March), with morbidity and mortality rates of 3,2 ± 3,6%. Clinical examination revealed cows with no alterations of vital signs, behavior, visual and auditory acuities and skin sensation; but revealed ruminal hypomotility, anorexia, dehydration, flaccid para or tetraparesis with permanent recumbency, and a paretic or paralytic tongue. The diagnosis of botulism, involving type C and D toxins, was consistent with the epidemiological and clinical findings.

The natural history of carpal tunnel syndrome: A study of 20 hands evaluated 4 to 9 years after initial diagnosis

Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy. In the last decade several papers have been published on epidemiology, clinical aspects, diagnosis, and treatment, but little is known about its natural history. The objective of this work was to study the natural history of CTS syndrome. From 358 patients with clinical and conduction study diagnosis of CTS, 12 cases were identified that had refused surgical treatment, had not used anti-inflammatory medications, and had not undergone orthopaedic procedures, such as immobilization or anaesthetic infiltration. These 12 patients have 20 compromised hands which have been followed up for between 4 and 9 years. In all cases sensory and motor conduction studies were performed on the median nerve, at the beginning and end of follow-up period. Electrical improvement was marked in 5 hands and slight in 3; there was no significant change in 10, and deterioration in 2. As 8 hands (7 patients) showed improved clinical symptoms and conduction studies over several years, this brings the universally accepted procedure of surgical treatment into doubt.

Animais aquáticos de importância médica no Brasil

The injuries caused by venomous and poisonous aquatic animals may provoke important morbidity in the victim. The cnidarians (jellyfishes, especially cubomedusas and Portuguese-Man-of-War) caused nearly 25% of 236 accidents by marine animals, while sea urchins were responsible for about 50% and catfish, stingrays and scorpionfish nearly 25%). In freshwater, stingrays and catfish cause injuries with a very similar mechanism to the poisoning and the effects of the toxins of marine species. In a series of about 200 injuries observed among freshwater fishermen, nearly 40% were caused by freshwater catfish, 5% freshwater stingrays and 55% by traumatogenic fish, such as piranhas and trairas. The author presents the aquatic animals that cause injuries to humans in Brazil, the clinical aspects of the envenoming and the first measures for the control of the severe pain observed mainly in the accidents caused by cnidarians and venomous fishes.

Doença pulmonar obstrutiva crônica

The chronic obstructive lung disease is reviewed with emphasys on its epidemiology and risk factors. The diagnosis, clinical aspects pulmonary, functional alterations and laboratorial findings are discussed. The treatment is also reviewed, based on the actual consensus, considering the following classes of approaches: bronchodilators, inhaled β-agonists, corticoids, methilxanthines, prolonged domiciliar-orygen therapy.

Pediatras e os distúrbios respiratórios do sono na criança

OBJECTIVES. assessment of opinions and practices of pediatricians concerning sleep-disordered breathing (SDB) in children. Methods. randomly 516 pediatricians were selected in the state of São Paulo, Brazil. A survey mailed to them included questions regarding: their professional profile, knowledge about SDB in childhood, opinions and practices for diagnosis and treatment of these diseases. RESULTS. 112 anonymous completed surveys were returned (21.7%). The teaching of SDB during medical school and pediatric residency training was considered unsatisfactory respectively by 65.2% and 34.8% of the pediatricians. Forty-nine respondents (43.8%) rated their knowledge about SDB in children as regular, 39 (34.8%) as good and 17 (15.2%) as unsatisfactory. The most important sleep-related questions were: mouth breathing, breathing pauses, sleep amount, excessive daytime sleepiness and nocturnal wheezing. Clinical aspects regarded as the most significant for suspecting obstructive sleep apnea syndrome (OSAS) were: breathing pauses, adenoid hypertrophy, mouth breathing, craniofacial anomaly and snoring. The most frequent practices for evaluation of OSAS in children were: cavum radiography with referral to an otorhinolarnygologist (25%) and nocturnal pulse oximetry (14.2%). Only 11.6% of pediatricians recommended overnight polysomnography and 4.5%, nap polysomnography. The most effective practices for SDB were considered to be: adenoidectomy and adenotonsillectomy, parents counseling, weight loss and sleep hygiene. CONCLUSIONS. there is a gap between research on SDB in childhood and pediatric practice. © 2006 Associação Médica Brasileira.

Persistência do forame de Huschke: Um estudo tomográfico

OBJECTIVE: To evaluate the persistency of foramen of Huschke by means of computed tomography study of the ear region and approaching important clinical aspects related to the presence of this anatomical anomaly. MATERIALS AND METHODS: Two examiners have analyzed the whole tympanic portion of temporal bone in 150 bilateral computed tomography studies of the ear region, searching for foramen of Huschke presence or absence. RESULTS: The mentioned anatomical anomaly was found in 17 cases (11.3%), 13 patients (76.5%) being female and four (23.5%) male. This higher female incidence is statistically confirmed. CONCLUSION: Ear and/or temporomandibular joint specialists should turn their attention to the persistency of foramen of Huschke.

Toxoplasmose canina: Aspectos clínicos e patológicos

Inquiries about toxoplasmosis are essential because its zoonotic potential and pathogenicity in pets and production animals. The dog can be involved in the mechanical transmission of the infection by Toxoplasma gondii and in spite of not being the definitive host, it has an epidemiological role in this disease. The high rate of dogs naturally infected by T. gondii and the great possibility of adquiring this protozoan, justify the importance of attempting against for the occurrence of this illness. The aim of this article was to demonstrated through literature revision, some clinical aspects, epidemic and pathological of the toxoplasmosis in the canine species.

Effects of mandibular fixed implant-supported prostheses on masticatory and swallowing functions in completely edentulous elderly individuals

Purpose: To evaluate the effect of oral rehabilitation with immediately loaded fixed implant-supported mandibular prostheses on chewing and swallowing in elderly individuals. Materials and Methods: Fifteen completely edentulous patients aged more than 60 years (10 women and rive men), wearing removable dentures in both arches, had a mandibular denture replaced by an implant-supported prosthesis. All individuals were evaluated before surgery and again 3, 6, and 18 months later with regard to mastication and swallowing conditions. Examinations entailed an interview, evaluation of tactile sensitivity of the face, and observation of food intake, masticatory type, formations of bolus, and pain during mastication. The swallowing evaluation comprised observation of clinical signs related to the oral and pharyngeal stages of swallowing, as well as the presence of oral residue. The findings of different evaluations before and 3, 6, and 18 months after the surgical-prosthetic procedure were statistically compared by analysis of variance for repeated measurements at a significance level of 5%. Results: The questionnaire revealed a reduction in complaints of masticatory and swallowing disturbances, a decreased need for liquid ingestion, and reduced choking and coughing. Clinical evaluations showed improved oral function and bolus propulsion for both solid and paste-consistency foods; pain during mastication was also resolved. Conclusion: Treatment with mandibular implant-supported dentures had positive effects on the clinical aspects of mastication and swallowing in elderly individuals.

Doença pulmonar obstrutiva crônica

The present review summarizes the clinical aspects, diagnostics criteria and treatment of Chronic Obstructive Pulmonary Disease (COPD). Besides, will be reviewed the systemic manifestations associated with COPD and its clinical relevance in the patient's follow up. © Copyright Moreira Jr. Editora.

Incidence of the mandibular accessory foramina in Brazilian population

In adults, the mandibular accessory foramina are variables and are located on the medial surface of the mandible in positions above or below of the mandibular foramen. The aim of this study was to evaluate the incidence of the mandibular accessory foramina in Brazilians human mandibles and discuss the clinical aspects related to the presence of these foramina. Were evaluated 222 mandibles, adults, irrespective of gender. Was observed that 27.93% and 43.24% of the mandibles presented at least one mandibular accessory foramina located on the medial surface in position below and above, respectively, of the mandibular foramen. Unilaterally, the mandibular accessory foramina were observed below and above of the mandibular foramen in 22.07% and 25.22%, of the mandibles, respectively, and 5.85% and 18.02% bilaterally, respectively. This study demonstrated that the incidence of mandibular accessory foramen in the Brazilian population is significant and should be considered in the planning and execution of procedures in several areas of dental clinical practice in order to avoid complications.