Melanoma ungueal e vitiligo: relato de caso / Ungueal melanoma and vitiligo: case report

O melanoma ungueal é uma forma de apresentação rara do melanoma. É frequente o diagnóstico tardio. Geralmente afeta polegar ou hálux e a maioria dos pacientes é de meia idade ou idosos de pele escura. A associação entre melanoma e vitiligo é tem sido descrita há mais de 50 anos e os pacientes acometidos tem apresentado maior sobrevida sugerindo resposta imune ao melanoma. O objetivo deste relato é descrever um caso de melanoma ungueal com surgimento de linfonodo inguinal e vitiligo associado diagnosticado tardiamente com posterior evolução para doença sistêmica...

Subungual melanoma is a rare clinical entity of melanoma. It usually involves an unsuspecting lesion in the thumb or big toe, thus late diagnosis. Majority of patients are middle-aged or older, usually of dark skin ethnicity. The association between melanoma and vitiligo has been described for over 50 years, showing increased survival rates in affected patients suggesting immune response to melanoma. The objective of this report is to describe a clinical case of nail melanoma, presenting as enlargened unilateral inguinal lymph node associated with rapid and progressive vitiligo. However, investigations proved late diagnosis,with subsequent progression of the disease...

Gastric contractility in experimental gastroschisis.

BACKGROUND/PURPOSE: The mechanism of fetal gastric dilation in gastroschisis is controversial. This study was designed to characterize changes in the contractile profile of strips of stomach from rats following experimental gastroschisis. METHODS: Pregnant Wistar rats were operated on day 18.5. Fetuses were divided into three groups: gastroschisis (G), sham (S), and control (C). On day 21.5, gastric fundus and antrum strips were obtained and suspended to a force transducer connected to a digital data acquisition system. They were submitted to increasing concentrations of carbachol (CCh) and weighed at the end of each procedure. Frequency and amplitude of each contraction were evaluated. RESULTS: Under basal conditions, spontaneous oscillatory contractions of antrum and fundus strips of G, S, and C were similar (P>0.05; ANOVA). However, cumulative concentrations of CCh (0.01-100 µM) produced different effects in all groups and were characterized by a significant increase in amplitude and frequency of spontaneous contractions in antral smooth muscle and a sustained increase in tonus in fundic strips. Upon analysis, no significant difference in frequency or amplitude was noted in antral tissues comparing C to G and to S (P>0.05). No significant contractility difference was noted in fundic smooth muscle (comparing all groups, P>0.05), with the CCh-induced curve following a typical sigmoidal format, dependent on increasing concentrations (P<0.001). CONCLUSIONS: Gastric contractile responses to CCh are preserved in experimental gastroschisis. These results do not support the theory that gastric dilation occurs secondary to intestinal inflammation alone.

Hyponatremia, acute kidney injury, and mortality in HIV-related toxoplasmic encephalitis

BACKGROUND: There are no reports on hyponatremia and acute kidney injury (AKI) involved in the course of HIV-related toxoplasmic encephalitis (TE). The main objective of this study was to describe the occurrence of hyponatremia and its relationship with AKI and mortality in HIV-related toxoplasmic encephalitis (TE). METHODS: This was a retrospective cohort study on patients with HIV-related TE. AKI was considered only when the RIFLE (risk, injury, failure, loss, end-stage) criterion was met, after the patient was admitted. RESULTS: A total of 92 patients were included, with a mean age of 36 ± 9 years. Hyponatremia at admission was observed in 43 patients (46.7%), with AKI developing in 25 (27.1%) patients during their hospitalization. Sulfadiazine was the treatment of choice in 81% of the cases. Death occurred in 13 cases (14.1%). Low serum sodium level correlated directly with AKI and mortality. Male gender (OR 7.89, 95% CI 1.22-50.90, p = 0.03) and hyponatremia at admission (OR 4.73, 95% CI 1.22-18.30, p = 0.02) were predictors for AKI. Independent risk factors for death were AKI (OR 8.3, 95% CI 1.4-48.2, p < 0.0001) and hyponatremia (or 9.9, 95% ci 1.2-96.3, p < 0.0001). CONCLUSION: AKI and hyponatremia are frequent in TE. Hyponatremia on admission is highly associated with AKI and mortality.

Hyponatremia, acute kidney injury, and mortality in HIV-related toxoplasmic encephalitis.

BACKGROUND: There are no reports on hyponatremia and acute kidney injury (AKI) involved in the course of HIV-related toxoplasmic encephalitis (TE). The main objective of this study was to describe the occurrence of hyponatremia and its relationship with AKI and mortality in HIV-related toxoplasmic encephalitis (TE). METHODS: This was a retrospective cohort study on patients with HIV-related TE. AKI was considered only when the RIFLE (risk, injury, failure, loss, end-stage) criterion was met, after the patient was admitted. RESULTS: A total of 92 patients were included, with a mean age of 36±9 years. Hyponatremia at admission was observed in 43 patients (46.7%), with AKI developing in 25 (27.1%) patients during their hospitalization. Sulfadiazine was the treatment of choice in 81% of the cases. Death occurred in 13 cases (14.1%). Low serum sodium level correlated directly with AKI and mortality. Male gender (OR 7.89, 95% CI 1.22-50.90, p = 0.03) and hyponatremia at admission (OR 4.73, 95% CI 1.22-18.30, p = 0.02) were predictors for AKI. Independent risk factors for death were AKI (OR 8.3, 95% CI 1.4-48.2, p < 0.0001) and hyponatremia (OR 9.9, 95% CI 1.2-96.3, p < 0.0001). CONCLUSION: AKI and hyponatremia are frequent in TE. Hyponatremia on admission is highly associated with AKI and mortality.

The essential oil of Eucalyptus tereticornis and its constituents, α- and ß-pinene, show accelerative properties on rat gastrointestinal transit.

The essential oil of Eucalyptus tereticornis (EOET) has pharmacological activities but their effects on the gastrointestinal tract are yet unknown. It possesses α- and ß-pinene as minor constituents, isomers largely used as food or drink additives. In this work, we studied their actions on gut motility. After feeding with a liquid test meal, conscious rats received perorally EOET, α-, or ß-pinene, and the fractional dye retention was determined. EOET and its constituents decreased the gastric retention. In anesthetized rats, pinenes increased gastric tonus, while enhancing the meal progression in the small intestine of conscious rats. Both α- and ß-pinene contracted gastric strips IN VITRO but relaxed the duodenum. Conversely, EOET relaxed both the gastric and duodenal strips. In conclusion, EOET accelerates the gastric emptying of liquid, and part of its action is attributed to the contrasting effects induced by α- and ß-pinene on the gut.