Signo de Leser-Trélat asociado a adenocarcinoma gástrico: Caso clínico / Leser-Trélat sign associated with gastric cancer: Report of one case

We report a 66-year-old male presenting with malaise, heartburn and pruritic seborrheic keratoses in both feet of sudden onset, suggesting a Leser-Trélat sign. An upper gastrointestinal endoscopy disclosed a gastric cancer. The patient was subjected to a total gastrectomy and duringfollow up, the skin lesions had disappeared.

Cuidados y competencias de enfermería en la valoración, tratamiento y seguimiento de un paciente diabético con lesiones del pie / Care and nursing skills in the assessment, treatment and monitoring of diabetic patients with foot injuries

El presente artículo tiene la finalidad de compartir una experiencia asistencial, en la cuál se efectuó un tratamiento conservador en el pie de un paciente diabético, y que fue sugerido por el equipo de enfermería. En primer lugar se hace una introducción sobre los problemas en colaboración o potenciales de la diabetes, y los tratamientos mas frecuentes; luego se presenta el caso, los cuidados y seguimiento durante la internación y posteriores al alta, hasta lograr la derivación del paciente para realizar un injerto en el talón.

Hipofosfatemia revertida al extirpar hemangioendotelioma compuesto del dedo mayor del pie / Reversion of hypophosphatemia after the excision of a composite hemangioendothelioma in the great toe

We report a 43 years old male admitted to the hospital for progressive lumbar pain, lasting 20 years, that caused severe disability. On admission the patient had a serum phosphate of 2 mg/dl, an urine phosphate excretion over 300 mg/dl and serum alkaline phosphatases over 750 U/L. Serum intact parathormone was normal and tubular maximum phosphorus/glomerular filtration was 0.7 mg/dl. Bone scintigraphy showed an increased radionuclide uptake in condro-costal joints. Bone densitometry showed femoral osteoporosis. A violet colored mass was detected in a great toe. It was removed and the pathological diagnosis was a composite hemangioendothelioma. After tumor excision, serum phosphate levels returned to normal values and symptoms disappeared within 15 days.

Peripheral gangrene in nonfatal pediatric cerebral malaria: a report of two cases.

Two Thai girls aged 10 and 13 years from the same rural area were admitted to Paholpolpayuhasena Hospital, Kanchanaburi, Thailand during the rainy season of 1989 with cerebral malaria. After several days of conventional treatment, both developed gangrene involving the feet and toes, but the lesions healed and no other complications were seen. In the absence of convincing clinical and laboratory evidence of vasculitis or coagulopathy, it seems likely that host factors (dehydration, sluggish peripheral circulation, platelet activation, subclinical intravascular coagulation) combined with strain-specific parasite factors (tissue sequestration of mature forms, rosette formation) may predispose to peripheral microvascular occlusion sufficient to produce infarction of tissue in susceptible children. However, despite the apparently ominous appearance of such lesions in a comatose child, the prognosis seems good.

Carcinoma epidermóide em úlcera angiodérmica: relato de nove casos / Epidermoid carcinoma in angiodermic ulcer: report of 9 cases

Säo relatados nove casos de carcinoma epidermóide em úlcera angiodérmica, diagnosticados no período de 1978-1989 no Hospital Universitário Clementino Fraga Filho (UFRJ). O grupo consistiu de cinco pacientes masculinos e quatro femininos na faixa etária de 48 a 87 anos, nos quais o tempo de evolouçäo da úlcera variou de dois a 40 anos. A biópsia demonstrou seis carcinomas bem diferenciados e três pouco diferenciados: a amputaçäo foi realizada em sete casos e a ressecçäo local com enxertia em um caso. Concluiu-se que a condiçäo é relativamente rara e que a biópsia é imperativa em úlceras crônicas

Tetanus in patient with lepromatous leprosy (I).

Tetanus in lepromatous leprosy is rare and reported occasionally as case reports only. We present a case of lepromatous leprosy who succumbed to death due to rapidly progressing tetanus. The mechanism of protection from tetanus in leprosy is discussed.

Squamous cell carcinoma in trophic ulcer cases.

Two cases having trophic ulcer over the heel, for long time, later developed squamous cell carcinoma are reported, because of its paucity in literature. Various factors blamed for carcinomatous change are enumerated.

Squamous cell carcinoma developing in trophic ulcer in leprosy--a case report.

Development of malignancy in the trophic ulcer in leprosy is not previously believed rare. In India, less than a dozen cases are reported uptil now. We present a case of squamous cell carcinoma in trophic ulcer in leprosy patient because of its paucity in literature. Aetiopathogenesis of malignancy is discussed briefly.

Anaerobic flora in trophic ulcers in leprosy patients.

Material from 108 trophic ulcers from leprosy cases were studied bacteriologically. 4 cases showed growth of pure anaerobes and 69 showed mixed growth of aerobic and anaerobic bacteria. The predominant anaerobes were Fusobacteria (41), anaerobic cocci (30) and Bacteroides (25). Clostridia were isolated only in 10 cases. Metronidazole, chloramphenicol, penicillin and ampicillin were found effective against anaerobes in in-vitro studies.

Aspectos da assistência de enfermagem na hanseníase: prevençäo da úlcera plantar / Aspects of nursing care in hanseniasis: prevention of plantar ulcer

Foram estudados 206 pacientes hansenianos com anestesia plantar internados em hospital, a fim de verificar as variáveis que influenciam na ocorrência da úlcera plantar. A coleta de dados foi realizada mediante entrevista com preenchimento de formulário específico. Os resultados submetidos a tratamento estatístico, demonstraram que o sexo, a idade, a escolaridade, a ocupaçäo e o tempo de anestesia plantar näo interferem na ocorrência da úlcera plantar. Acreditando-se no real valor preventivo das técnicas simples, fez-se um levantamento do conhecimento e da prática dessas técnicas nos pacientes com ou sem úlcera plantar. Verificou-se que os pacientes hansenianos com pé anestésico sem úlcera plantar, conhecem e praticam mais as técnicas simples de prevençäo do que aqueles que têm úlcera plantar