Intestinal lymphangitis carcinomatosa related to ovarian cancer: Case report and review of the literature.

We present a 57-year-old woman with ovarian cancer that presented to the Emergency Room with a proximal small bowel obstruction. Exploratory laparotomy evidenced a thickened 10 cm extension of the proximal jejunum without bowel peristalsis, with stenotic enteric lumen, with a lesion apparently originating from its submucosal and muscular layers. The patient underwent an exploratory laparotomy with total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, small bowel resection and peritoneal biopsies. Final pathology and immunohistochemistry confirmed the intra-operative suspicion of lymphatic intestinal spread of malignant cells originating from a high grade serous carcinoma of ovarian origin. To the best of our knowledge, this is the first report in the literature of intestinal carcinomatous lymphangitis related to ovarian cancer, and the first report of involvement of the proximal portion of the jejunum.

p14 expression differences in ovarian benign, borderline and malignant epithelial tumors.

BACKGROUND: Abnormalities in tumor suppressors p14, p16 and p53 are reported in several human cancers. In ovarian epithelial carcinogenesis, p16 and p53 show higher immunohistochemical staining frequencies in malignant tumors and are associated with poor prognoses. p14 was only analyzed in carcinomas, with conflicting results. There are no reports on its expression in benign and borderline tumors. This study aims to determine p14, p16 and p53 expression frequencies in ovarian benign, borderline and malignant tumors and their associations with clinical parameters. METHODS: A cross-sectional study utilizing immunohistochemistry was performed on paraffin-embedded ovarian epithelial tumor samples. Clinical data were collected from medical records. Fisher's exact test and the Bonferroni correction were performed for frequency associations. Survival comparisons utilized Kaplan-Meier and log rank testing. Associations were considered significant when p < 0.05. RESULTS: p14 absent expression was associated with malignant tumors (60 % positive) (p = 0.000), while 93 % and 94 % of benign and borderline tumors, respectively, were positive. p16 was positive in 94.6 % of carcinomas, 75 % of borderline and 45.7 % of benign tumors (p = 0.000). p53 negative staining was associated with benign tumors (2.9 % positive) (p = 0.016) but no difference was observed between borderline (16.7 %) and malignant tumors (29.7 %) (p = 0.560). No associations were found between expression rates, disease-free survival times or clinical variables. Carcinoma subtypes showed no difference in expression. CONCLUSIONS: This is the first description of p14 expression in benign and borderline tumors. It remains stable in benign and borderline tumors, while carcinomas show a significant absence of staining. This may indicate that p14 abnormalities occur later in carcinogenesis. p16 and p53 frequencies increase from benign to borderline and malignant tumors, similarly to previous reports, possibly reflecting the accumulation of inactive mutant protein. The small sample size may have prevented statistically significant survival analyses and clinical correlations. Future studies should investigate genetic abnormalities in p14 coding sequences and include all types of ovarian epithelial tumors. Bigger sample sizes may be needed for significant associations.

Queixa ocular X condutas nas farmácias de Pelotas, RS: o que mudou em 12 anos / Eye complaints X clerks' conducts in drugstores of Pelotas, RS: changes in twelve years

Introdução: Investigar a conduta dos balconistas de farmácia frente a um caso simulado de olho vermelho e comparar com os resultados de pesquisa similar ocorrida há 12 anos na mesma cidade, bem como avaliar a associação entre a localização do estabelecimento farmacêutico com indicação de consulta médica. Métodos: Através de estudo transversal, investigaram-se 146 farmácias em Pelotas, RS, por meio de um questionário padronizado e pré-codificado. O entrevistador chegava ao estabelecimento com a suposta queixa: “Ao acordar nesta manhã venho sentindo ardência ocular e lacrimejamento, além de perceber o olho vermelho, o que posso fazer?”. Caso a resposta do balconista fosse diversa da orientação da procura de atendimento médico, era feita a seguinte pergunta: “Você acha que devo procurar um médico?”. As associações foram estudadas através do teste qui-quadrado. Resultados: As principais condutas foram: 89 (60,9%) atendentes indicaram o uso de descongestionantes oculares, 17 (11,6%) o uso de lágrima artificial ou soro fisiológico, 12 (8,2%) o uso de colírio antisséptico, 9 (6,2%) o uso de antibióticos. Além disso, 10 (5,8%) atendentes indicaram a procura do médico. Em comparação com estudo similar realizado em 1997, houve significativo aumento na indicação de lágrimas artificiais e diminuição na indicação de descongestionantes e antibióticos. Ademais, o estudo atual demonstrou que uma maior proporção de indicações de procura médica associou-se a farmácias da área central da cidade. Conclusão: Sugerem-se iniciativas que contemplem a fiscalização mais rigorosa do comércio de medicamentos oftalmológicos, fomento à educação populacional e maior acesso aos cuidados básicos de saúde.

Introduction: To investigate the conduct of drugstore clerks in the face of a simulated case of red eyes, and to compare the results with those of a similar research performed 12 years ago in the same city, as well as to evaluate the association between the location of the drugstore and an indication of a medical visit. Methods: In a cross-sectional study we investigated 146 drugstores in South Brazil through a standardized pre-coded questionnaire. The interviewer reached the store and told the clerk: “When I woke up this morning my eyes were burning and tearing and red; what can I do about it?” If the clerk’s response was other than referral to medical care, we asked the following question:” Do you think I should see a doctor?” Associations were studied using the chi–square test. Results: The main suggested courses of action by the clerks were: 89 (60.9%) indicated the use of ocular decongestants, 17 (11.6%) the use of artificial tears or saline, 12 (8.2%) the use of a topical antiseptic, and 9 (6.2%) the use of antibiotics. In addition, 10 (5.8%) clerks advised seeking medical care. Compared with a similar research conducted in 1997, there was a significant increase in the indication of artificial tears and a decrease in the indication of decongestants and antibiotics. Moreover, the current study showed that a higher proportion of indications of seeking medical care was associated with drugstores in the downtown area. Conclusion: We suggest initiatives that provide for a stricter control of the trade of eye care drugs, promotion of population education, and increased access to basic health care.

Cervicalgia em estudantes universitários do Sul do Brasil: prevalência e fatores associados / Cervical pain in university students in South Brazil: prevalence and associated factors

A dor cervical é uma queixa comum na prática clínica, sendo, atualmente, considerada um problema de saúde pública. A fim de implementar medidas preventivas torna-se fundamental o conhecimento dos fatores de risco associados. O presente estudo objetivou determinar a prevalência do sintoma em uma amostra de estudantes universitários da Universidade Federal de Pelotas, bem como verficar alguns fatores de risco. Foram entregues questionários a 348 alunos. 49,7% dos entrevistados apresentaram cervicalgia nos últimos 12 meses, incidência maior do que a descrita na literatura. A dor esteve significativamente associada ao sexo, tempo de uso diário do computador e sedentarismo. Assim, além de se identificar grupos de risco, aos quais se devem direcionar medidas preventivas, também foi demonstrada a importância de um estilo de vida saudável no curso de um sintoma de grande impacto social.