Drug eruptions in the elderly.

Because the older group of the population is becoming more numerous, we see a high prevalence in drug adverse reactions among the elderly. Polypharmacy, which is the use of five or more medications, is one reason why this group has a greater risk of adverse drug reactions. Cutaneous adverse reactions to drugs are not always life threatening, but they can be an important factor for a poor quality of life among older patients. The potential benefits of appropriately prescribed medications are unquestionable, but the possibility of an adverse reaction must be recognized and prevented in older people so they can have a better quality of life.

Human papillomavirus detection and typification in cutaneous and mucosal lesions of HIV-seropositive patients.

High-risk human papillomavirus (HPV) in a lesion is related to an increased chance of neoplasic transformation, especially when with immunosuppression, as in HIV infection. We investigated HPV frequency in cutaneous and mucosal lesions of HIV-seropositive male patients. The frequency of malignancy, its association with the HPV type detected and some clinical variables were also assessed. A total of 38 lesions from 27 patients were studied in a period of 18 months. The biopsied fragment was submitted to HPV detection and typification, through polymerase chain reaction with generic (MY09/11) and specific (types 6, 11, 16 and 18) primers. HPV frequency was 63.2%, with detection of HPV types 6, 11 or 16 in 18 lesions and with multi-infection in three. There was low detection of high-risk HPV (type 16, 18.4%) and no HPV type 18. Of the lesions, 36.8% were already premalignant or malignant, and the frequency of moderate or severe dysplasia was higher in the study patients than that described in the HIV-seronegative population. High-risk HPV (type 16) was detected in four benign lesions and low-risk HPV (type 6) in three premalignant genital lesions. There was no significant association between the clinical variables and an increase in the prevalence of premalignant or malignant lesions.

Hair, nail, and pigment changes in major systemic disease.

In this article, the nail, hair, and pigment changes caused by systemic diseases will be reviewed. Among the subjects discussed are abnormalities of shape, attachments, surface, and color of the nails; hair alterations such as telogen and anagen effluvium, scarring alopecia, hypertrichosis, and hirsutism; and pigment changes due to connective tissue disorders, sarcoidosis, and metabolic and endocrinologic diseases, among others.

Considerações sobre o diagnóstico diferencial entre hanseníase multibacilar e tuberculose: relato de três casos / Differencial diagnosis between lepromatous leprosy and tuberculosis: three case reports

Introdução: A hanseníase e a tuberculose são doenças endêmicas, ambas causadas por micobactérias que, na maioria das vezes, apresentam-se com quadros clínicos distintos. No entanto, o diagnóstico diferencial entre as duas micobacterioses pode ser difícil, principalmente nos casos iniciais de hanseníase virchowiana. Apresentação dos casos: são apresentados três casos de hanseníase virchowiana que foram inicialmente diagnosticados como tuberculose em uma unidade de referência para tratamento dessas doenças. Discussão: o quadro clínico inicial de hanseníase virchowiana apresentado nos três casos dificultou o diagnóstico de hanseníase, principalmente devido a não inclusão desta doença entre os diagnósticos diferenciais, comprometendo a busca ativa de sinais e sintomas mais específicos. Conclusão: São perdidas oportunidades de diagnóstico precoce de hanseníase quando a doença se apresenta com manifestações gerais mais exuberantes do que o quadro cutâneoneurológico. O diagnóstico precoce dos casos de hanseníase multibacilar é particularmente importante para o controle dos focos e conseqüente diminuição do número de casos novos da doença

Mayaro virus infection alters glucose metabolism in cultured cells through activation of the enzyme 6-phosphofructo 1-kinase.

Although it is well established that cellular transformation with tumor virus leads to changes on glucose metabolism, the effects of cell infection by non-transforming virus are far to be completely elucidated. In this study, we report the first evidence that cultured Vero cells infected with the alphavirus Mayaro show several alterations on glucose metabolism. Infected cells presented a two fold increase on glucose consumption, accompanied by an increment in lactate production. This increase in glycolytic flux was also demonstrated by a significant increase on the activity of 6-phosphofructo 1-kinase, one of the regulatory enzymes of glycolysis. Analysis of the kinetic parameters revealed that the regulation of 6-phosphofructo 1-kinase is altered in infected cells, presenting an increase in Vmax along with a decrease in Km for fructose-6-phosphate. Another fact contributing to an increase in enzyme activity was the decrease in ATP levels observed in infected cells. Additionally, the levels of fructose 2,6-bisphosphate, a potent activator of this enzyme, was significantly reduced in infected cells. These observations suggest that the increase in PFK activity may be a compensatory cellular response to the viral-induced metabolic alterations that could lead to an impairment of the glycolytic flux and energy production.