Unique Cytomegalovirus Tongue Ulcer in an Older Adult Patient with Prolonged Systemic Steroid Treatment

Introduction: Cytomegalovirus (CMV) is a member of the Herpesviridae family that infects humans. It infects approximately 90% of adults. It is an opportunistic pathogen, common among immunosuppressed patients and can affect multiple organs. To date, there has been only one reported case of a CMV-related tongue ulcer that occurred during steroid treatment. Case Presentation: We report a case of CMV tongue ulcer in an elder, immunodeficient patient under prolonged steroid treatment. Management and Prognosis: A 67-year-old man under chronic steroidal treatment due to severe chronic obstructive pulmonary disease (COPD), with chronic ischemic heart disease (CIHD) and poorly treated diabetes mellitus (DM) was hospitalized in Soroka university medical center. He suffered from an ulcerative wound about 10 mm in its greater diameter with raised margins on the left lateral tongue. Daktarin Oral Gel treatment showed no improvement. On histopathological examination, a diagnosis of CMV-related tongue ulcer was given. Conclusion: To the best of our knowledge, this is the most detailed case report of CMV tongue ulcer due to prolonged steroid treatment. An early diagnosis of CMV infection in patients with oral lesions is crucial because CMV infection can increase immunosuppression, and is associated with opportunistic infections.

Hemodynamic and thermoregulatory effects of xylazine-ketamine mixture persist even after the anesthetic stage in rats / Efeitos hemodinâmicos e termorregulatórios da mistura cetamina-xilasina persistem mesmo após o período anestésico em ratos

The xylazine-ketamine mixture (KX) is an anesthetic approach commonly administered to assess cardiovascular function in rodents. This study aimed to examine if the cardiovascular and thermoregulatory effects of KX could persist after the anesthetic state ceased in rats. Male Wistar rats were anesthetized with K (50mg/kg) X (10mg/kg) through the intra-peritoneal route. Hemodynamic and thermoregulatory repercussions were evaluated in animals in awake state, during an anesthetic depth and after complete recovery of anesthetized state. KX was efficient to significantly induce deep anesthesia in all rats after 10min. A complete recovery of anesthetized state was observed only after 210min. Compared with preanesthetic state and control animals that received no drug, KX induced a significant reduction of systolic and diastolic blood pressure at 10min. Hypotension was more prominent at 150min. The heart rate was also significantly reduced after 10 min of KX and the highest magnitude of bradycardia was observed at 30min. In addition, rectal temperature was markedly decreased at 30min of KX and the higher reduction occurred at 150min. The hemodynamic and thermoregulatory effects of KX were maintained even after complete anesthetic recovery.

Objetivou-se com este estudo avaliar a persistência dos efeitos cardiovasculares e termorregulatórios da associação cetamina e xilasina (CX) mesmo após o período anestésico em ratos. Ratos Wistar machos foram anestesiados com cetamina 50mg/kg e xilasina 10mg/kg, por via intra-peritoneal. As repercussões hemodinâmica e termorregulatória foram avaliadas com os animais acordados, durante o período anestésico e após recuperação completa da anestesia. A CX foi eficiente em induzir significante regime anestésico em todos os ratos após 10min. A recuperação completa do estado de anestesia foi observada somente após 210min. Comparado com o estado pré-anestésico e com animais controles, que não receberam anestesia, a CX induziu significativa redução das pressões sistólica e diastólica aos 10min. A hipotensão foi mais evidente aos 150min após CX. A frequência cardíaca também foi significativamente reduzida com 10min de CX e a bradicardia foi mais acentuada aos 30min. A temperatura retal foi reduzida aos 30min, sendo mais acentuada após 150min de anestesia. Os efeitos hemodinâmicos e termorregulatórios da CX persistem mesmo após completa recuperação anestésica.

Increased expression of tissue factor and protease-activated receptor-1 does not correlate with thrombosis in human lung adenocarcinoma

A correlation between cancer and hypercoagulability has been described for more than a century. Patients with cancer are at increased risk for thrombotic complications and the clotting initiator protein, tissue factor (TF), is possibly involved in this process. Moreover, TF may promote angiogenesis and tumor growth. In addition to TF, thrombin seems to play a relevant role in tumor biology, mainly through activation of protease-activated receptor-1 (PAR-1). In the present study, we prospectively studied 39 lung adenocarcinoma patients in relation to the tumor expression levels of TF and PAR-1 and their correlation with thrombosis outcome and survival. Immunohistochemical analysis showed TF positivity in 22 patients (56 percent), most of them in advanced stages (III and IV). Expression of PAR-1 was found in 15 patients (39 percent), most of them also in advanced stages (III and IV). Remarkably, no correlation was observed between the expression of TF or PAR-1 and risk for thrombosis development. On the other hand, patients who were positive for TF or PAR-1 tended to have decreased long-term survival. We conclude that immunolocalization of either TF or PAR-1 in lung adenocarcinoma may predict a poor prognosis although lacking correlation with thrombosis outcome.

Clinicopathological trends in colorectal carcinoma in a Black South African population.

The clinico pathological characteristics of colorectal carcinoma in 127 Black South African patients were studied. The main presenting symptoms were altered bowel habits in 70% of the patients, weight loss in 64.3% and abdominal pain in 47.1%. Anaemia was present in 75.7%. There was a 31% incidence of mucinous carcinoma with a particular predilection for the younger age groups. Mucinous tumors were found more commonly in Duke stage C and D than in earlier stages. Tumors arising from a pre-existing adenoma constituted to 5.5% of the lot of patients with cancer colon.

Influência dos hormônios testiculares sobre a regeneraçâo óssea em fraturas da tíbia de ratos / Influence of testicular hormones over bone regeneration in rats tibial fractures

Foram estudados 32 ratos machos Wistar, com aproximadamente 120 dias, pesando em média 280 gramas. Os animais foram divididos em dois grupos (grupo controle e grupo submetido a orquiectomia) de 16 ratos cada um, e cada rato foi mantido em gaiola individual, durante toda a experiência. O trabalho foi desenvolvido em 3 etapas distintas 1ª etapa: Os animais do grupo controle, foram mantidos em condiçöes normais de um biotério, sem restriçöes. Os animais do grupo submetido a orquiectomia, foram anestesiados com éter etilico por inalaçäo, e posteriormente submetidos a orquiectomia bilateral através de uma incisäo longitudinal mediana na bolsa escrotal 2ª etapa: Os animais petencentes à ambos os grupos foram anestesiados com éter etílico por inalaçäo e submetidos a fratura na porçäo média da diáfise tibial. Os animais pertencentes ao grupo orquiectomizados foram submetidos à 2ª etapa trinta dias após a primeira cirúrgia (orquiectomia). 3ª etapa: Metade dos animais de ambos os grupos, após o 8§ dia e a outra metade após o 12§ da fratura, foram sacrificados e a tibia fraturada foi retirada. Após a remoçäo estas foram fixadas em formol a 10% durante 48 horas, em seguida foram colocadas no descalcificados (E.D.T.A. 10%), onde permaneceram 45 dias. Após a descalcificaçäo as peças foram incluidas em parafina, cortadas numa espessura de 7 micrômetros e os cortes corados pela Hematoxilina Eosina. Observando as lâminas, montadas pelos métodos histológicos convencionais, verificamos que: 1§ o calo ósseo consequente à fratura dos animais orquiectomizados, era constituído de fibrocartilagem, e dos animais näo orquiectomizados, era constituído por cartilagem calcificada apresentando regiöes osteogênicas; 2§ o periósteo e o endosteo parecem participar ativamente no processo de regeneraçäo do tecido ósseo; 3§ o processo de ossificaçäo foi mais intenso e mais acentuado em animais näo orquiectomizados. 4§ Portanto, houve diferença acentuada no processo de fraturar entre os animais dos dois grupos; em decorrencia disto talvez possamos sugerir que, os hormonios testiculares agem diretamento sobre o tecido ósseo em relaçäo a síntese da matriz orgânica