Investigation of nerve fibers in the skin by biopsy: technical aspects, indications, and contribution to diagnosis of small-fiber neuropathy

ABSTRACT Skin biopsy with investigation of small-diameter nerve fibers in human epidermis and dermis has been proven to be a useful method for confirming small-fiber neuropathy. In medical practice, small-fiber neuropathy is increasingly recognized as a leading cause of neuropathic pain. It is a prevalent complaint in medical offices, brought by patients often as a "painful burning sensation". The prevalence of neuropathic pain is high in small-fiber neuropathies of different etiologies, especially in the elderly; 7% of population in this age group present peripheral neuropathy. Pain and paresthesia are symptoms which might cause disability and impair quality of life of patients. The early detection of small-fiber neuropathy can contribute to reducing unhealthy lifestyles, associated to higher incidence of the disease.

Brazilian guidelines for diagnosis, treatment and follow-up of primary cutaneous melanoma - Part II

Abstract The last Brazilian guidelines on melanoma were published in 2002. Development in diagnosis and treatment made updating necessary. The coordinators elaborated ten clinical questions, based on PICO system. A Medline search, according to specific MeSH terms for each of the 10 questions was performed and articles selected were classified from A to D according to level of scientific evidence. Based on the results, recommendations were defined and classified according to scientific strength. The present Guidelines were divided in two parts for editorial and publication reasons. In this second part, the following clinical questions were answered: 1) which patients with primary cutaneous melanoma benefit from sentinel lymph node biopsy? 2) Follow-up with body mapping is indicated for which patients? 3) Is preventive excision of acral nevi beneficious to patients? 4) Is preventive excision of giant congenital nevi beneficious to patients? 5) How should stages 0 and I primary cutaneous melanoma patients be followed?.

Guidelines of the Brazilian Dermatology Society for diagnosis, treatment and follow up of primary cutaneous melanoma - Part I

Abstract: The last Brazilian guidelines on melanoma were published in 2002. Development in diagnosis and treatment made updating necessary. The coordinators elaborated ten clinical questions, based on PICO system. A Medline search, according to specific MeSH terms for each of the 10 questions was performed and articles selected were classified from A to D according to level of scientific evidence. Based on the results, recommendations were defined and classified according to scientific strength. The present Guidelines were divided in two parts for editorial and publication reasons. In the first part, the following clinical questions were answered: 1) The use of dermoscopy for diagnosis of primary cutaneous melanoma brings benefits for patients when compared with clinical examination? 2) Does dermoscopy favor diagnosis of nail apparatus melanoma? 3) Is there a prognostic difference when incisional or excisional biopsies are used? 4) Does revision by a pathologist trained in melanoma contribute to diagnosis and treatment of primary cutaneous melanoma? What margins should be used to treat lentigo maligna melanoma and melanoma in situ?.

Estudo da açäo do extrato de Ginkgo biloba e amido hidroxietílico hipertônico na atenuaçäo de alteraçöes decorrentes de isquemia e reperfusäo de órgäos esplâncnicos em ratos / Study of action of Ginkgo biloba extract and hypertonic hydroxyethyl starch on attenuating of ischemia and reperfusion changes of splanchnic organs in rats

A oclusäo e reperfusäo das artérias esplâncnicas ocasiona choque circulatório, causado principalmente pelo aumento de permeabilidade vascular e pela agressäo celular provocada por radicais livres derivados do oxigênio. Este estudo tem por finalidade verificar a açäo do extrato de Ginkgo biloba (Egb-761) e do amido hidroxietílico (AHH) na prevençäo do choque circulatório produzido pela isquemia e reperfusäo de órgäos esplâncnicos. O Egb-761 tem propriedades antioxidantes relatadas na literatura. O AHH, tem sido utilizado como recurso terapêutico do choque hipovolêmico. Ratos anestesiados receberam infusäo contínua de Egb-761 ou AHH, sendo submetidos à isquemia (oclusäo do tronco celíaco, artéria mesentérica superior e artéria mesentérica inferior por 30 minutos) e reperfusäo (por 90 minutos) dos órgäos esplâncnicos. Foram feitas: análise histopatológica ileal, dosagem de malondialdeído ileal e determinaçäo contínua da pressäo arterial média (PAM). A PAM ao final do período de reperfusäo foi significativamente mais elevada nos animais tratados com Egb-761 e AHH, que no grupo controle (F=18,29; p<0,001). Näo houve diferença entre os grupos tratados e controle quanto à dosagem de MDA (H=4,61; p>0,10) e quanto às alteraçöes histológicas (H=6,003; p>0,10). Em conclusäo, houve melhora nas condiçöes hemodinâmicas, com atenuaçäo do choque nos ratos que receberam Egb-761 ou AHH. Novos estudos seräo necessários para se avaliar melhor as alteraçöes histológicas e para esclarecer a formaçäo de produtos finais da peroxidaçäo lipídica.