[Postinfectious Lucio phenomenon in diffuse leprosy. Report of 2 cases]. / Postinfektiöses Lucio-Phänomen bei diffuser Lepra. Bericht über zwei Fälle.

In the clinical classification of leprosy the diffuse nonnodular form belongs to the lepromatous subtype. In these patients only a diffuse cutaneous infiltration without nodules or plaques is seen. Although the cutaneous features can be difficult to identify, the reactional state in these cases may lead to a serious necrotizing vasculitis, known as Lucio's phenomenon. We describe two cases of Lucio's phenomenon triggered by erysipelas. The diagnosis of leprosy was established only after the immunologic reaction had occurred. Both patients were treated with steroids and thalidomide. In the second case, the bacterial infection led to sepsis and death. In at-risk patients with a necrotizing vasculitis, leprosy should be considered in the differential diagnosis.

[Populational study of investigation of perinatal and infant deaths: methodology, validity of diagnosis and under-registration]. / Estudo populacional de investigação de óbitos perinatais e infantis: metodologia, validade do diagnóstico e sub-registro.

OBJECTIVE: The main objectives of the present study were to evaluate the percentage of under-registration of infant mortality in 1993 and compare it with the ones found 1982; to analyze the agreement between the official death certificates and the ones made by the referees. METHODS: The infant mortality of all children born in Pelotas, in 1993, was monitored through daily visits to hospitals, as it was done in 1982; monthly, cemeteries and public registration offices were visited to detect any deaths outside the hospitals. Besides the official death certificates, two independent referees established the underlying cause of death based on information from pediatricians, case-notes, autopsies and through a home visit to the parents of the children. RESULTS: The percentage of under-registration fell substantially from 24%, in 1982, to 5.4%, in 1993. The agreement between the official death certificates and the ones made by the referees showed satisfactory Kappas, unless for ill defined diseases such as sudden infant death, where the agreement was null. CONCLUSIONS: The authors conclude that there was a significant fell of the under-registration for infant death in Pelotas, and the ill defined causes such as sudden infant death have been hidden by the diagnosis of pneumonia.

Endoscopic removal of Ascaris lumbricoides from the common bile duct.

The management of biliary obstruction caused by Ascaris lumbricoides has usually been surgical. This report describes the endoscopic removal of a roundworm located in the common bile duct.

Aspectos clinicos do esofago de Barrett. / Clinical aspects of Barrett esophagus

Em 1430 procedimentos endoscopicos to trato digestivo alto, foram encontrados 14 casos de esofago de Barrett. Os sintomas apresentados sao analisados, verificando-se a prevalencia de quadro clinico do tipo "esofagite de refluxo". A patogenese e discutida com alusoes a origem do epitelio sua configuracao histologica, diagnostico e potencial de malignidade

Blastomicose sul-americana palpebral. / Palpebral South-american blastomycosis

Os autores relatam um caso de blastomicose sulamericana, cuja lesao palpebral foi a primeira manifestacao clinica. Sao descritos os achados clinicos e os exames complementares e brevemente comentados oa aspectos de raridade e os achados anatomopatologicos

Blastomicose sul-americana com comprometimento genital. / South-American blastomycosis with genital involvement

Relata-se um caso de blastomicose sul-americana sistemica com comprometimento genital. Descreve-se a sintomatologia do paciente, exame clinico,exames complementares, evolucao e dificuldades diagnosticas encontradas, ressaltando-se a rara ocorrencia em epididimo, deferente, escroto e testiculo