Hypertrophic Lichen Planus in a 38-year-old Filipino male: A case report

@#Hypertrophic lichen planus (HLP) is a papulosquamous eruption presenting with extremely pruritic hyperkeratotic flat-topped papules, plaques, and nodules. This is a case of 38-year-old male who presented with a 2-month history of generalized erythematous-to-hyperpigmented papules, patches, and plaques topped with white-to-gray oyster shell-like scales on a background of hyperpigmented macules and patches. There was no involvement of the conjunctival, otic, oral, and genital mucosae, and palmar and plantar aspects of the hands and feet. Dermoscopy showed reticular pearly white structures corresponding to the Wickham striae, comedo-like openings, blue-gray dots, brownish-black dots, and scales. Histopathologic examination revealed marked compact hyperkeratosis, wedge-shaped hypergranulosis, irregular saw-toothed epidermal acanthosis, scattered dyskeratotic keratinocytes, and superficial perivascular lichenoid infiltrate of lymphocytes, histiocytes, and melanophages. The patient was managed as a case of HLP. He was started on methotrexate 10 mg per week, bath psoralen photochemotherapy (PUVA) three times a week, betamethasone valerate 1mg/g cream twice a day for 2 weeks alternating with tacrolimus 0.1% ointment twice a day for another 2 weeks, 10% lactic acid, emollients, and sunscreen. After 6 months of treatment, there was almost 80% improvement of lesions and relief of pruritus.

Knowledge, attitudes, and practices on teledermatology among dermatologists in the Philippines

Background@#Teledermatology has been widely used during the coronavirus disease 2019 (COVID-19) pandemic to overcome barriers in access to care. The objective of this study was to assess the current knowledge, attitudes, and practices regarding teledermatology among dermatologists in the Philippines.@*Materials and Methods@#This was a cross-sectional and analytical study conducted from January 2022 to April 2022, among Filipino dermatologists using a self-administered online questionnaire. Descriptive statistics was used to summarize the demographics of the participants. The two-sample t-test, Chi-square test, and multiple logistic regression model were used to analyze the data.@*Results@#Out of 113 respondents, 108 (95.5%) had adequate knowledge and a positive attitude toward teledermatology. The majority (110/113, 97.35%) practiced teledermatology. The most commonly used platform was instant messaging applications(78/100, 70.91%), and the most common factor that influenced their practice was patient demands or needs(74/110, 67.27%). Those who did not practice teledermatology cited technological difficulties as the main reason.@*Conclusion@#Teledermatology was widely used by Filipino dermatologists to provide remote care during the COVID-19 pandemic. However, to fully utilize its potential and limit potential issues associated with its use even after the pandemic, continuous training and education among dermatologists and a more enabling technological environment may be needed.

Psychological distress among transgender people in Brazil: frequency, intensity and social causation - an ICD-11 field study

Objective: To describe self-reported experiences of gender incongruence related to discomfort and body changes to be more congruent to the desired gender, and to examine whether experiences of psychological distress related to gender identity were more strongly related to the experience of gender incongruence per se or to experiences of social rejection. Methods: This field study used a structured interview design in a purposive sample of transgender adults (aged >18 years or older) receiving health-care services in two main reference centers in Brazil. Results: A high proportion of participants (90.3%, n=93) reported experiencing psychological distress related to their gender identity and report having experienced social rejection related to their gender identity during the interview index period and that rejection by friends was the only significant predictor for psychological distress. Conclusions: Gender incongruence variables were not significant predictors of distress. This result supports the recent changes proposed by the Word Health Organization in ICD-11 to move transgender conditions from the Mental and Behavioral Disorders chapter to a new chapter on Sexual Disorders and Conditions Related to Sexual Health.

Triiodothyronine (T3) upregulates the expression of proto-oncogene TGFA independent of MAPK/ERK pathway activation in the human breast adenocarcinoma cell line, MCF7

ABSTRACT Objective: To verify the physiological action of triiodothyronine T3 on the expression of transforming growth factor α (TGFA) mRNA in MCF7 cells by inhibition of RNA Polymerase II and the MAPK/ERK pathway Materials and methods: The cell line was treated with T3 at a physiological dose (10−9M) for 10 minutes, 1 and 4 hour (h) in the presence or absence of the inhibitors, α-amanitin (RNA polymerase II inhibitor) and PD98059 (MAPK/ERK pathway inhibitor). TGFA mRNA expression was analyzed by RT-PCR. For data analysis, we used ANOVA, complemented with the Tukey test and Student t-test, with a minimum significance of 5%. Results: T3 increases the expression of TGFA mRNA in MCF7 cells in 4 h of treatment. Inhibition of RNA polymerase II modulates the effect of T3 treatment on the expression of TGFA in MCF7 cells. Activation of the MAPK/ERK pathway is not required for T3 to affect the expression of TGFA mRNA. Conclusion: Treatment with a physiological concentration of T3 after RNA polymerase II inhibition altered the expression of TGFA. Inhibition of the MAPK/ERK pathway after T3 treatment does not interfere with the TGFA gene expression in a breast adenocarcinoma cell line.

Resveratrol attenuates metabolic, sperm, and testicular changes in adult Wistar rats fed a diet rich in lipids and simple carbohydrates / 亚洲男科学杂志(英文版)

High-fat diets affect male reproduction and sexual function. Therefore, we evaluated the effects of prolonged resveratrol administration on the metabolic, sperm, and testicular parameters of rats fed a cafeteria diet. Male Wistar rats were divided at weaning into control (C, n = 20) and cafeteria (CAF, n = 16) groups. At 3 months, half of them were given daily supplementations of resveratrol (C-R, n = 10; CAF-R, n = 8) at a dosage of 30 mg kg-1 body mass for 2 months. Animals were killed at 5 months of age, and blood, spermatozoa, and testes were collected for further analysis. Data were analyzed by one-way ANOVA, and P < 0.05 was considered statistically significant. The CAF diet promoted hyperglycemia (P < 0.0001), and treatment with resveratrol reversed this condition (P < 0.0001). The CAF diet reduced sperm viability and motility, while resveratrol improved these parameters (P < 0.05). Regarding testicular morphology, the height of the seminiferous epithelium was reduced in the CAF group compared with that of the C group (P = 0.0007). Spermatogenic cell proliferation was also reduced in the CAF group compared with that of the C group. However, the CAF-R showed an increase in cell proliferation rate compared with that of the untreated CAF group (P = 0.0024). Although it did not modify body mass, the consumption of a CAF diet promoted hyperglycemia, adverse testicular morphology remodeling, and abnormal sperm, which were attenuated by treatment with resveratrol, thus suggesting a protective effect of this antioxidant on spermatogenesis.

The efficacy of single dose intravenous dexamethasone vs placebo combined with caudal block on postoperative analgesia in children undergoing outpatient urologic surgery: A prospective, double-blind, randomized study

BACKGROUND@#Pain in the pediatric age is more difficult to assess and treat. Inadequate pain management may produce anxiety and trauma in children and affect not only the surgical outcome but the child‘s overall quality of life and recovery. Advances in various perioperative techniques to provide optimal analgesia continually grow especially in the outpatient setting where there are a significant number of pediatric patients. Caudal block is easy to perform and can be used in combination with general anesthesia. It provides excellent analgesia but is often short-lived. Dexamethasone is a potent synthetic glucocorticoid with anti-inflammatory and anti-emetic properties. The exact mechanism for its analgesic action is said to be related to its strong anti-inflammatory action.@*OBJECTIVES@#The study aims to determine and compare the anxiety of children with acute lymphoblastic leukemia (ALL) and their well siblings based on Child drawing: Hospital manual and to identify factors associated with the level of anxiety.@*METHODOLOGY@#This is a prospective, double-blind, randomized study that included sixty-four patients, aged 3 - 12 years old, ASA I and II, scheduled for outpatient urologic surgery under combined general and regional caudal anesthesia. Patients were randomized into two groups: Group D received 0.5mg/kg (maximum of 16mg) single dose intravenous dexamethasone in 5mL volume and Group P received the same volume of saline after the start of surgery when successful caudal block was determined. Postoperative pain scores using the Wong-Baker Faces Pain Rating Scale and vital signs were monitored at the PACU at hourly intervals until discharge. The time to first rescue analgesic and the total analgesic consumption given at home for forty-eight hours were recorded.@*RESULTS@#Group D showed significantly longer block duration and time to rescue analgesic and lesser analgesic consumption.@*CONCLUSION@#A single dose intravenous dexamethasone combined with caudal block effectively prolongs duration of caudal block and time to first rescue analgesic and lessens analgesic consumption in children undergoing outpatient urologic surgery.

Rapid sequence induction (RSI) in trauma patients:Insights from healthcare providers / 世界急诊医学杂志（英文）

BACKGROUND@# We aimed to describe the current practice of emergency physicians and anaesthesiologists in the selection of drugs for rapid-sequence induction (RSI) among trauma patients.@*METHODS@# A prospective survey audit was conducted based on a self-administered questionnaire among two intubating specialties. The preferred type and dose of hypnotics, opioids, and muscle relaxants used for RSI in trauma patients were sought in the questionnaire. Data were compared for the use of induction agent, opioid use and muscle relaxant among stable and unstable trauma patients by the intubating specialties.@*RESULTS@#A total of 102 participants were included; 47 were anaesthetists and 55 were emergency physicians. Propofol (74.5%) and Etomidate (50.0%) were the most frequently used induction agents. Significantly higher proportion of anesthesiologist used Propofol whereas, Etomidate was commonly used by emergency physicians in stable patients (P=0.001). Emergency physicians preferred Etomidate (63.6%) and Ketamine (20.0%) in unstable patients. The two groups were comparable for opioid use for stable patients. In unstable patients, use of opioid differed significantly by intubating specialties. The relation between rocuronium and suxamethonium use did change among the anaesthetists. Emergency physicians used more suxamethonium (55.6% vs. 27.7%, P=0.01) in stable as well as unstable (43.4 % vs. 27.7%, P=0.08) patients.@*CONCLUSION@# There is variability in the use of drugs for RSI in trauma patients amongst emergency physicians and anaesthesiologists. There is a need to develop an RSI protocol using standardized types and dose of these agents to deliver an effective airway management for trauma patients.

Gender incongruence: a comparative study using ICD-10 and DSM-5 diagnostic criteria

Objective: To compare the presence of criteria listed in the DSM-5 and ICD-10 diagnostic manuals in a Brazilian sample of transgender persons seeking health services specifically for physical transition. Methods: This multicenter cross-sectional study included a sample of 103 subjects who sought services for gender identity disorder in two main reference centers in Brazil. The method involved a structured interview encompassing the diagnostic criteria in the two manuals. Results: The results revealed that despite theoretical disagreement about the criteria, the manuals overlap regarding diagnosis confirmation; the DSM-5 was more inclusive (97.1%) than the ICD-10 (93.2%) in this population. Conclusions: Although there is no consensus on diagnostic criteria on transgenderism in the diversity of social and cultural contexts, more comprehensive diagnostic criteria are evolving due to society's increasing inclusivity.

The prostate after castration and hormone replacement in a rat model: structural and ultrastructural analysis

ABSTRACT Purpose: To evaluate if late hormonal replacement is able to recover the prostatic tissue modified by androgenic deprivation. Materials and Methods: 24 rats were assigned into a Sham group; an androgen deficient group, submitted to bilateral orchiectomy (Orch); and a group submitted to bilateral orchiectomy followed by testosterone replacement therapy (Orch+T). After 60 days from surgery blood was collected for determination of testosterone levels and the ventral prostate was collected for quantitative and qualitative microscopic analysis. The acinar epithelium height, the number of mast cells per field, and the densities of collagen fibers and acinar lumen were analyzed by stereological methods under light microscopy. The muscle fibers and types of collagen fibers were qualitatively assessed by scanning electron microscopy and polarization microscopy. Results: Hormone depletion (in group Orch) and return to normal levels (in group Orch+T) were effective as verified by serum testosterone analysis. The androgen deprivation promoted several alterations in the prostate: the acinar epithelium height diminished from 16.58±0.47 to 11.48±0.29μm; the number of mast cells per field presented increased from 0.45±0.07 to 2.83±0.25; collagen fibers density increased from 5.83±0.92 to 24.70±1.56%; and acinar lumen density decreased from 36.78±2.14 to 16.47±1.31%. Smooth muscle was also increased in Orch animals, and type I collagen fibers became more predominant in these animals. With the exception of the densities of collagen fibers and acinar lumen, in animals receiving testosterone replacement therapy all parameters became statistically similar to Sham. Collagen fibers density became lower and acinar lumen density became higher in Orch+T animals, when compared to Sham. This is the first study to demonstrate a relation between mast cells and testosterone levels in the prostate. This cells have been implicated in prostatic cancer and benign hyperplasia, although its specific role is not understood. Conclusion: Testosterone deprivation promotes major changes in the prostate of rats. The hormonal replacement therapy was effective in reversing these alterations.

Metabolic and Testicular Effects of the Long-Term Administration of Different High-Fat Diets in Adult Rats

To evaluate the effects of different high-fat diets on body mass, carbohydrate metabolism and testicular morphology in rats seven months old.

Human pancreatic islet transplantation: an update and description of the establishment of a pancreatic islet isolation laboratory

Type 1 diabetes mellitus (T1DM) is associated with chronic complications that lead to high morbidity and mortality rates in young adults of productive age. Intensive insulin therapy has been able to reduce the likelihood of the development of chronic diabetes complications. However, this treatment is still associated with an increased incidence of hypoglycemia. In patients with “brittle T1DM”, who have severe hypoglycemia without adrenergic symptoms (hypoglycemia unawareness), islet transplantation may be a therapeutic option to restore both insulin secretion and hypoglycemic perception. The Edmonton group demonstrated that most patients who received islet infusions from more than one donor and were treated with steroid-free immunosuppressive drugs displayed a considerable decline in the initial insulin independence rates at eight years following the transplantation, but showed permanent C-peptide secretion, which facilitated glycemic control and protected patients against hypoglycemic episodes. Recently, data published by the Collaborative Islet Transplant Registry (CITR) has revealed that approximately 50% of the patients who undergo islet transplantation are insulin independent after a 3-year follow-up. Therefore, islet transplantation is able to successfully decrease plasma glucose and HbA1c levels, the occurrence of severe hypoglycemia, and improve patient quality of life. The goal of this paper was to review the human islet isolation and transplantation processes, and to describe the establishment of a human islet isolation laboratory at the Endocrine Division of the Hospital de Clínicas de Porto Alegre – Rio Grande do Sul, Brazil.

The effectiveness of finasteride and dutasteride used for 3 years in women with androgenetic alopecia.

Background: The effectiveness of finasteride and dutasteride in women with androgenetic alopecia has been the subject of debate. Aim: To evaluate the effectiveness of finasteride and dutasteride on hair loss in women with androgenetic alopecia over a period of 3 years. Methods: From a database containing systematically retrieved data on 3500 women treated for androgenetic alopecia between 2002 and 2012 with finasteride 1.25 mg or dutasteride 0.15 mg, a random sample stratified for age and type of medication was taken to yield 30 women in two age categories: below and above 50 years, and for both medications. Hair thickness of the three thinnest hairs was measured from standardized microscopic images at three sites of the scalp at the start of the treatment and after 3 years of continuous medication intake. The macroscopic images were evaluated independently by three European dermatologists/hair experts. The diagnostic task was to identify the image displaying superior density of the hair. Results: Both age categories showed a statistically significant increase in hair thickness from baseline over the 3‑year period for finasteride and dutasteride (signed rank test, P = 0.02). Hair thickness increase was observed in 49 (81.7%) women in the finasteride group and in 50 (83.3%) women in the dutasteride group. On average, the number of post‑treatment images rated as displaying superior density was 124 (68.9%) in the finasteride group, and 118 (65.6%) in the dutasteride group. Dutasteride performed statistically significantly better than finasteride in the age category below 50 years at the central and vertex sites of the scalp. Conclusions: Finasteride 1.25 mg and dutasteride 0.15 mg given daily for 3 years effectively increased hair thickness and arrested further deterioration in women with androgenetic alopecia.

Genetics of diabetic nephropathy / Bases genéticas da nefropatia diabética

The increasing prevalence of diabetes mellitus has led to a growing number of chronic complications including diabetic nephropathy (DN). In addition to its high prevalence, DN is associated with high morbidity and mortality especially due to cardiovascular diseases. It is well established that genetic factors play a role in the pathogenesis of DN and genetically susceptible individuals can develop it after being exposed to environmental factors. DN is probably a complex, polygenic disease. Two main strategies have been used to identify genes associated to DN: analysis of candidate genes, and more recently genome-wide scan. Great efforts have been made to identify these main genes, but results are still inconsistent with different genes associated to a small effect in specific populations. The identification of the main genes would allow the detection of those individuals at high risk for DN and better understanding of its pathophysiology as well.

A crescente elevação na prevalência do diabetes melito (DM) acarretou em um aumento de suas complicações crônicas, entre elas a nefropatia diabética (ND). Além da elevada prevalência, a ND está associada à importante morbidade e mortalidade, principalmente por doenças cardiovasculares. É notória a contribuição genética na patogênese da ND, em que, na presença de fatores ambientais propícios, aqueles indivíduos geneticamente predispostos desenvolverão a doença. Trata-se de uma doença com provável transmissão genética do tipo poligênica e complexa. Duas estratégias principais têm sido utilizadas na busca dos genes associados à ND: a avaliação de genes candidatos e, mais recentemente, a utilização de genoma wide scan. Grande empenho tem sido realizado para identificar os principais genes associados à ND, mas os resultados ainda são heterogêneos com diferentes genes apresentando um efeito pequeno em populações específicas. A identificação dos principais genes permitiria prever os indivíduos de maior risco para o desenvolvimento da ND, além de possibilitar um melhor entendimento fisiopatológico da doença.

Incidência e principais fatores associados à falha de extubação em recém-nascidos com peso de nascimento < 1.250 gramas / Incidence and main risk factors associated with extubation failure in newborns with birth weight < 1.250 grams

OBJETIVOS: Determinar a incidência de falha de extubação em recém-nascidos prematuros com peso de nascimento < 1.250 g extubados para pressão positiva contínua nas vias aéreas nasais e identificar os principais fatores de risco que possam estar associados à necessidade de reintubação nessa população. MÉTODOS: Análise retrospectiva dos prontuários de pacientes internados e ventilados mecanicamente durante o período de julho de 2002 a junho de 2004. Falha na extubação foi definida como necessidade de reintubação nos primeiros 7 dias após a primeira tentativa de extubação. RESULTADOS: Entre 52 pacientes estudados, 13 faleceram antes da primeira tentativa de extubação. Do restante, apenas nove falharam na extubação (23,1 por cento). Comparando esses recém-nascidos com aqueles extubados com sucesso, houve diferença estatisticamente significativa em relação a peso de nascimento, idade gestacional e escore de Apgar no 5º minuto. Após a regressão logística, apenas a idade gestacional se manteve significativa. Alguns resultados secundários também foram significativamente diferentes: incidência de hemorragia intracraniana graus III e/ou IV, persistência do canal arterial e óbito. CONCLUSÕES: Nosso estudo demonstrou uma incidência de falha na extubação semelhante à da literatura. O principal fator de risco para falha nessa população foi a prematuridade (≤ 28 semanas). Nesses prematuros extremos, a implementação de estratégias para extubação precoce, o uso de metilxantinas, a prevenção da abertura do canal arterial e o uso de outros métodos de assistência ventilatória pós-extubação podem contribuir para a melhora desses resultados.

OBJECTIVES: To determine the incidence of extubation failure in preterm newborns with birth weight < 1,250 g extubated to nasal continuous positive airway pressure and to identify the main risk factors associated with the need for reintubation in this population. METHODS: A retrospective review of eligible infants admitted and mechanically ventilated between July 2002 and June 2004 was performed. Extubation failure was defined as the need for reintubation within 7 days after the first extubation attempt. RESULTS: Of the 52 patients included in the study, 13 died before the first extubation attempt. Of the remaining 39 patients, only nine failed extubation (23.1 percent) Comparing the two groups (failure vs. successful), there was a statistically significant difference regarding birth weight, gestational age and 5-minute Apgar score. After logistic regression, only gestational age was significant. Other secondary outcomes showed significant difference between the groups: intracranial hemorrhage grade III and/or IV, patent ductus arteriosus and death. CONCLUSIONS: The incidence of extubation failure in our population was similar to the rate reported in the literature. The main risk factor for extubation failure was prematurity (≤ 28 weeks). In this population of extreme preterm infants, implementation of strategies for early extubation, use of methylxanthines, prevention of patent ductus arteriosus, and use of different modes of assisted ventilation after extubation may improve the outcomes.

Avaliação da eficácia clínica de uma nova modalidade de fototerapia utilizando diodos emissores de luz / Efficacy of new microprocessed phototherapy system with five high intensity light emitting diodes (Super LED)

OBJETIVO: Avaliar a eficácia terapêutica de um sistema de fototerapia microprocessada que utiliza diodos emissores de luz (Super LED) de alta intensidade no tratamento da hiperbilirrubinemia em recém-nascidos prematuros. MÉTODOS: Ensaio clínico, randomizado e controlado, utilizando a fototerapia Super LED no grupo experimental e duas fototerapias halógenas no grupo controle. A randomização foi realizada em blocos e estratificada por peso de nascimento. A duração da fototerapia e a queda nos níveis séricos de bilirrubina total nas primeiras 24 horas de tratamento foram os principais desfechos analisados. RESULTADOS: Foram estudados 88 recém-nascidos, 44 no grupo da fototerapia Super LED e 44 no grupo da fototerapia halógena. As características demográficas da população foram semelhantes nos dois grupos. O nível sérico médio inicial de bilirrubina no grupo do Super LED (10,1±2,4 mg por cento) foi semelhante ao do grupo que recebeu fototerapia halógena (10,9±2,0 mg por cento). A queda percentual na concentração sérica de bilirrubina total nas primeiras 24 horas de tratamento foi significativamente maior (27,9 versus 10,7 por cento, p < 0,01), e a duração do tratamento foi significativamente menor (36,8 versus 63,8 h, p < 0,01) no grupo do Super LED do que no grupo que recebeu fototerapia halógena. Após 24 horas de tratamento, um número significativamente maior de recém-nascidos recebendo fototerapia Super LED atingiu níveis de bilirrubina que permitiram a suspensão da fototerapia (23 versus 10, p < 0,01). CONCLUSÕES: Os resultados demonstram que a eficácia da fototerapia Super LED é significativamente maior do que a da fototerapia halógena no tratamento da hiperbilirrubinemia de recém-nascidos prematuros.

OBJECTIVES: To evaluate the efficacy of a microprocessed phototherapy (PT) system with five high intensity light emitting diodes (Super LED) for the treatment of neonatal hyperbilirubinemia of premature infants. METHODS: Randomized clinical trial using Super LED phototherapy in the study group and twin halogen spotlight phototherapy in the control group. A stratified blocked randomization, based on birth weight, was performed. The duration of phototherapy and the rate of decrease of total serum bilirubin (TSB) concentration in the first 24 hours of treatment were the main outcome measures. RESULTS: We studied 88 infants, 44 in the Super LED group and 44 in the halogen spotlight PT group. The demographic characteristics of the patients in both groups were similar. Infants in the Super LED group had a similar mean initial serum bilirubin level (10.1±2.4 mg percent) to those receiving halogen spotlight treatment (10.9±2.0 mg percent). After 24 hours of treatment, the decrease in total serum bilirubin levels was significantly greater in the Super LED group (27.9 vs. 10.7 percent, p< 0.01) and duration of phototherapy was significantly shorter in this group (36.8 h vs. 63.8 h, p < 0.01). After 24 hours of treatment, a significantly greater number of patients receiving Super LED phototherapy had reached serum bilirubin concentrations low enough to allow withdrawal of treatment (23 vs. 10, p < 0.01). CONCLUSIONS: Our results demonstrate that the efficacy of Super LED phototherapy for treating hyperbilirubinemia in premature infants was significantly better than halogen phototherapy.

Aspectos do diagnóstico na Síndrome de Sjögren / Diagnostic aspects in Sjögren's Syndrome

Introduçäo: A Síndrome de Sjögren é uma doença auto-imune que envolve principalmente as glândulas salivares e lacrimais e que pode cursar apenas com xerostomia e diminuiçäo do lacrimejamento ou mesmo com outras manifestaçöes sistêmicas. Vários estudos tentaram estabelecer critérios diagnósticos, já que näo existe um exame de certeza. Objetivo: Nosso estudo tem como objetivo a avaliaçäo dos métodos utilizados para o diagnóstico da doença. Forma de estudo: Clínico prospectivo. Material e Método: Foram avaliadas 15 pacientes com suspeita de Síndrome de Sjögren no Ambulatório de Estomatologia do Depto. de Otorrinolaringologia da Santa Casa de Säo Paulo. Resultados: Das 15 pacientes avaliadas, o diagnóstico foi confirmado apenas em 6 casos. Conclusöes: Existe grande dificuldade em se estabelecer o diagnóstico desta doença e, por este motivo, técnicas de exame pouco invasivas devem ser desenvolvidas com a participaçäo do otorrinolaringologista

Proposta de um método prático de sialometria / A proposal for a practical method of sialometry

Introduçäo: A xerostomia é uma queixa subjetiva que pode ou näo estar relacionada à diminuiçäo da salivaçäo. Deve, porém, ser sempre investigada, pois está freqüentemente associada a doenças sistêmicas, incluindo a síndrome de Sjögren. Apesar de näo haver padräo universal que caracterize a hipossalivaçäo, consideramos a sialometria importante para avaliaçäo do tratamento, através da realizaçäo de exames seriados em um mesmo paciente. Analisando as técnicas de sialometria já descritas, optamos por adaptar e padronizar o método de Bolwig e Rafaelsen (1972) por considerá-lo o mais prático e fidedigno e visando à partir de entäo a sua utilizaçäo em larga escala. Objetivo: Avaliar os resultados de método submúltiplo de sialometria. Material e método: Foram avaliados 10 sujeitos, 5 sem sintomatologia de xerostomia que formam considerados compatíveis e 5 com xerostomia. Foram submetidos ao método de sialometria com algodäo pré e pós estimulados. Os resultados foram comprovados. Resultados: Todos os pacientes apresentaram melhora da saliva mensurável pelo método pós-estimulado. Conclusöes: O método utilizado se mostrou de fácil realizaçäo e fidedigno

Estudo da prevalência de papilomavírus humanos em lesöes do trato genital masculino / Prevalence study of human papillomavirus infection in male genital lesions

Os papilomavírus humanos säo os principais agentes causadores de cånceres genitais. Epidemias de HPV têm se tornado cada vez mais freqüentes no mundo inteiro, sendo a infecçäo pelo HPV hoje estimada como a mais comum das doenças sexualmente transmissíveis. O estudo teve como objetivo pesquisar a presença de HPV em biópsias de leöes do trato genital masculino, compatíveis com infecçäo por esse vírus, pelo método de hibridizaçäo in situ. Foram examinadas 75 biópsias de lesöes classificadas à peniscopia em condilomas, lesöes papulares e lesöes acetobrancas. A prevalência de infecçäo foi de 78,7 por cento, 59-75, com predominåncia dos tipos 6 e 11, de baixo risco, detectados em 59,3 por cento dos casos positivos e a presença de HPV de alto risco em 37,2 por cento das amostras