Minor Salivary Gland Polymorphous Adenocarcinoma With Local Recurrence After Seven Years: A Case Report.

Polymorphous adenocarcinoma is a rare neoplasm of the minor salivary glands with an indolent behavior. Here, we report and describe the computed tomography (CT) and magnetic resonance imaging (MRI) of polymorphic adenocarcinoma in a 69-year-old patient who presented with local recurrence seven years after the initial treatment. On contrast CT, the primary lesion appeared heterogeneous and invaded the pterygopalatine fossa and the sphenopalatine foramen. The recurrent lesion on MRI showed a hypointense signal on the T1-weighted sequence, a hyperintense signal on the T2-weighted sequence, and heterogeneous enhancement with contrast. The patient underwent a new surgery for lesion resection and is currently under clinical and radiological follow-up. It is recommended to follow patients for at least 15 years after diagnosis, as local recurrences can occur up to 10 years after the initial treatment.

Post-harvest quality and sensory analysis of 'Prata' bananas produced in different cultivation field locations.

Banana 'Prata' has a significant demand in the Brazilian market, and Minas Gerais is one of the largest banana producers in the country. Scientific studies that evaluate the bananas quality produced in different cultivation regions are still incipient. Thus, this study evaluated the physical, biochemical and sensory attributes of banana 'Prata' from south and north of Minas Gerais and Vale do Ribeira (SP). Bananas from south were also cultivated in different production systems, organic and conventional. Data were submitted to multivariate analysis that provided the discrimination of the samples according to the cultivation regions. Bananas from southern presented higher levels of soluble solids and acidity, better taste, higher diameter and overall acceptance, where in the organic bananas were the most preferred by consumers. Fruit from northern stood out in appearance, texture, aroma and color, in addition to greater length. Fruit from Vale do Ribeira had higher levels of total phenolics and antioxidant activity. With these results we can assume that fruit quality is highly related to the specific climatic conditions from each producing region. Bananas from the south of Minas Gerais showed superiority for most of the evaluated traits, reflecting on consumer preference.

Role of routine small intestinal biopsy in adult patient with irritable bowel syndrome-like symptoms.

AIM: The clinical evaluation of patients with chronic diarrhea and/or abdominal pain requires a complex work-up. The aim of the study was to evaluate whether routine duodenal biopsy sampling of macroscopically normal mucosa of patients with irritable bowel syndrome-like symptoms undergoing upper endoscopy assists in diagnosis and management. METHODS: Consecutive adults scheduled for upper endoscopy for evaluation of uninvestigated dyspepsia and abdominal pain and/or chronic diarrhea based upon the history, were enrolled. Gastric biopsies and 3 duodenal biopsies were taken for histological evaluation. RESULTS: A total of 786 sets of biopsies from 262 consecutive patients (200 females and 62 males, mean age 46 years; range: 15-82), were analyzed. Microscopic damage was observed in 212 of 262 patients (81%) with normal mucosa. Mild to moderate and severe duodenitis or villi atrophy was histologically confirmed in 65%, 26% and 8% of 212 patients respectively. The negative predictive value of a normal appearing duodenal mucosa was 19%. Additional tests confirmed celiac disease in 12 patients. Lactose malabsorption was present in 42%, bacterial overgrowth in 14%, and H. pylori infection in 28%. Colonoscopy performed in 92 patients revealed non specific colitis (25%), microscopic colitis (28%), Crohn's disease (1%), and diverticulosis (15%). CONCLUSION: Duodenal biopsies revealed abnormalities in the majority of adults with chronic diarrhea and/or abdominal pain despite macroscopically normal gross findings. These results suggest that duodenal biopsies could be helpful in patients with chronic diarrhea and/or abdominal pain for the following work up.

Chronic maxillary sinusitis associated with dental impression material.

A 62-year-old man was referred for routine treatment of hyperplasia of the mucosa in the anterior lower jaw. An oroantral fistula was detected in the right superior alveolar ridge. The patient had no complaints. Plain radiographs showed a radiopaque foreign body in the posterior region associated with opacification of the maxillary sinus. Computed tomography showed the same hyperdense foreign body located in the posterior lower part of the sinus and an abnormal soft tissue mass in the entire right maxillary sinus. When asked about sinusitis, the patient mentioned occasional episodes of pus taste and intermittent crises of headache lasting for one week. The patient has been edentulous for 20 years. Sinus debridement was performed and the oroantral fistula was closed. The clinical suspicion of the presence of zinc oxide-eugenol paste was confirmed by microscopical and chemical analysis. After 6 months of follow-up, the fistula continued to be closed and sinusitis did not recur. This clinical case of maxillary chronic sinusitis illustrates a different odontogenic origin.

A revascularizaçäo renal com artérias autógenas

Os autores apresentam 10 casos de derivaçäo aorto-renal com artérias autógenas realizados para tratamento de lesöes obstrutivas das artérias renais. Seis pacientes tinham dosplasia fibromuscular, três tinham doença aterosclerótica e um único apresentava arterite. Em sete pacientes foram realizadas reconstruçöes arteriais "in ssitu" e em três o autotransplante renal com cirurgia ex-vivo. Houve um óbito. Todas as reconstruçöes arteriais funcinaram bem e houve alívio da hipertensäo arterial em 8/9 pacientes que sobreviveram a operaçäo