RESUMO O adenocarcinoma de uretra é uma rara neoplasia maligna, que ocorre predominantemente em mulheres. Nesse grupo, sua incidência é maior a partir dos 50 anos. O conhecimento acerca da doença é limitado pela sua infrequência e baseia-se, sobretudo, em relatos de caso. Apesar de raramente apresentar metástase a distância, as consequências clínicas do tratamento dessa condição podem trazer forte impacto negativo na vida da portadora, em decorrência de cirurgias mutiladoras e da necessidade de uso de sonda vesical permanente. Apresenta-se um relato de caso de uma paciente com adenocarcinoma uretral e sua condução terapêutica.

ABSTRACT The urethral adenocarcinoma is a rare malignant tumor that affects predominantly women. Its incidence is higher after the age of 50 in this group. The knowledge about this disease is limited due to its low frequency and is mainly based on case reports. Although rarely presenting distant metastasis, the clinical consequences of treating this condition may bring an important negative impact on patient's quality of life. This is mainly due to mutilating surgery and the need to use permanent urinary catheter. It is presented a case report of a patient with urethral adenocarcinoma and its therapeutic management.

Ostraceous psoriasis is a rare form of psoriasis, characterized by lesions with firmly adhered thick scales, in various colors, with surfaces resembling oysters shells. The protracted course of clinical presentation allied with peculiar lesions and histopathological examination permit the diagnosis. Lesions are usually resistant to topical medications, requiring systemic treatment. It is important that dermatologists are able to diagnose the unusual forms of psoriasis to avoid iatrogeny. We report the case of a patient with ostraceous psoriasis treated with methotrexate.

Os autores descrevem um caso de paciente de 33 anos de idade com história de crises convulsivas isoladas sem qualquer antecedente, sendo diagnosticadas metástases cerebrais tendo como sítio primário um adenocarcinoma papilífero de pulmão. É enfatizada a investigação diagnóstica para metástase cerebral e avaliação prognóstica do adenocarcinoma papilífero de pulmão, além de realizar breve revisão sobre essas doenças.

The authors describe the case of a 33-year-old patient with history of seizures alone without any previous symptom, being diagnosed with brain metastases from primary papillary adenocarcinoma of the lung. Emphasis is given to the diagnostic investigation for brain metastasis and prognostic evaluation of papillary adenocarcinoma of the lung, and a brief literature review on such diseases is performed.

OBJECTIVE: To identify the scope and the characteristics of fall-related traumas in urgent care centers in Sergipe, Brazil and to verify potential associations among the following variables: gender, age, and where the event occurred. METHOD: This descriptive, cross-sectional study with a quantitative approach was conducted in the urgent care centers of two public referral hospitals in the state of Sergipe, Brazil. The data collection was conducted in November 2010, after approval was obtained from the Human Research Ethics Committee, through a structured interview with a sample of 509 fall victims. RESULTS: Most of the participants were male, between 0 and 19 years old, single, with no impairments or preexisting diseases, nor regular use of medication or alcohol. The victims were brought to the hospital by ambulance and were accompanied. Most events occurred at home, were same-level falls, and most frequently resulted from slipping and tripping during recreational activities with a subsequent fracture, contusion or sprain. Most victims were discharged from the hospital after care delivery. Statistically significant associations were found between place of fall and age and gender. CONCLUSION: There is a high incidence of seeking out care in urgent care centers due to falls, which constitutes a severe public health problem that affects both genders in different age groups. The adoption of preventive measures aimed to reduce such events is urgently required.

OBJETIVOS: conhecer os aspectos clínicos e patológicos dos casos de câncer de mama feminino cadastrados num serviço público de oncologia de Sergipe. MÉTODOS: procurou-se fazer uma associação do estadiamento com as características presentes nos tumores. A coleta de dados foi realizada em 165 prontuários de mulheres cadastradas no período de 2005 a 2008 no ambulatório de oncologia do Hospital Cirurgia, localizado em Aracaju-Sergipe, por meio de formulário de coleta de dados, em 2009. RESULTADOS: identificou-se o carcinoma ductal invasivo como o tipo de neoplasia mamária mais frequente com 80,8% dos casos; 76 (46,1%) neoplasias foram diagnosticadas em estádio avançado (IIB, III e IV) e a mastectomia prevaleceu como tipo de cirurgia utilizado no tratamento independente do estadiamento. Quanto aos receptores hormonais todos apresentaram associação com o grau do estádio e, ainda, notou-se que a positividade do estrogênio e progesterona é fator de proteção para um pior prognóstico. CONCLUSÃO: é notável que os casos de câncer de mama estudados apresentam maior agressividade biológica, cursando com pior prognóstico, considerando o estádio clínico. Fazem-se necessárias ações de detecção precoce voltadas ao câncer de mama na atenção básica de Sergipe para redução da morbi-mortalidade, melhora da sobrevida e qualidade de vida entre as mulheres acometidas por essa neoplasia.

OBJECTIVES: to discover the clinical and pathologic aspects of cases of female breast cancer registered at a public oncology service in Sergipe. METHODS: an attempt was made to associate the stage with the characteristics of the tumors. Data was gathered from 165 medical records taken between 2005 and 2008 at the oncology outpatients clinic of the Hospital Cirurgia, in the city of Aracaju, Sergipe, using a data collection form in 2009. RESULTS: ductal invasive carcinoma was identified as the most frequent kind of neoplasia, accounting for 80.8% of cases. Seventy-six (46.1%) of neoplasias were identified at an advanced stage (IIB, III and IV) and mastectomy was the main kind of surgery used, irrespective of the stage of the cancer. All the hormone receptors were associated with the stage and it was noted that positive estrogen and progesterone levels were associated with a more positive prognosis. CONCLUSIONS: it is worth noting that the cases of breast cancer studied were those that are more biologically aggressive with a less promising prognosis in terms of clinical stage. Action to ensure early detection of breast cancer needs to be taken in the course of basic care in Sergipe in order to reduce morbidity and mortality and to improve the survival rates and quality of life of women afflicted with this kind of neoplasia.

INTRODUÇÃO: A dengue permanece como uma doença de elevada significância para a saúde pública e sua incidência tem aumentado nas últimas décadas. Este estudo objetivou caracterizar a incidência epidemiológica da dengue no período de 2001-2010. MÉTODOS: Trata-se de um estudo epidemiológico da dengue no município de Aracaju, Sergipe, no período de 2001 a 2010, cujos dados foram obtidos do Sistema de Informação de Agravos de Notificações. Foi realizada a análise descritiva do número de casos confirmados de dengue segundo ano, semestre, distrito sanitário, faixa etária e sexo. RESULTADOS: Foram confirmados 16.462 casos, com destaque para o ano de 2008, o qual obteve maior incidência da doença, com 10.485 casos confirmados. O primeiro semestre obteve maior registro dos casos em todos os anos da pesquisa, com predomínio do sexo feminino e da faixa etária de 15-49 anos. Com relação à distribuição territorial, destaque para o segundo distrito do município que apresentou maior número de casos. CONCLUSÕES: Verificou-se que no ano de 2008, na Cidade de Aracaju, SE, houve aumento significativo da proporção de casos de dengue em relação aos demais anos. No entanto, nota-se um declínio vertiginoso nos anos posteriores, possivelmente devido à intensificação de ações de prevenção e combate ao mosquito transmissor do vírus da dengue.

INTRODUCTION: The dengue fever remains to be a disease of serious public health concern, and its incidence has increased in the past decades. This study aimed to characterize the epidemiological incidence of dengue in the period 2001-2010. METHODS: This is an epidemiological study of dengue in the municipality of Aracaju, state of Sergipe, in the period between 2001 and 2010, whose data were obtained from the Information System of Diseases Notifications. A descriptive analysis of the number of confirmed cases of dengue, according to year, semester, sanitary district, age, and sex, was performed. RESULTS: There were 16,462 confirmed cases, especially in 2008, which obtained the highest incidence of the disease, with 10,485 confirmed cases. The first semester obtained the highest registration of cases during the years of research; this was predominated by females between 15 and 49 years old. With regard to the territorial distribution, the second district of the municipality obtained the highest number of cases. CONCLUSIONS: In 2008, in the City of Aracaju, SE, a significant increase in the proportion of dengue cases compared with other years was verified. However, a fast decline in the other years was observed, possibly because of the intensification of preventive actions to combat the mosquito that transmits the dengue virus.

OBJETIVO: Discutir aspectos epidemiológicos, clínicos, anátomo-patológicos e terapêuticos de cistos mesentéricos atendidos em hospitais do Estado de Sergipe. MÉTODOS: Estudo observacional, descritivo e transversal, consistindo de um levantamento de uma série de casos de cistos mesentéricos, nos arquivos do Laboratório de Patologia da Universidade Federal de Sergipe no período de 1995 a 2007. Revisaram-se os prontuários dos pacientes para coleta de dados: gênero, idade, quadro clínico, exames complementares e abordagem terapêutica. RESULTADOS: Foram encontrados 18 casos de cistos mesentéricos. O gênero predominante foi o feminino (72,2%). A média de idade dos pacientes ao diagnóstico foi de 30,48 anos. Os sintomas mais freqüentes foram dor e massa abdominal. A ultra-sonografia de abdome, realizada em todos os pacientes, não foi conclusiva em metade dos casos. Tomografia computadorizada de abdome com contraste foi realizada em seis casos, sendo a tumoração cística bem evidenciada em todos estes. Quanto ao tipo histopatológico foram encontrados oito linfangiomas, oito cistos mesoteliais, um cisto hemorrágico em organização e um cisto mucinoso. O tratamento cirúrgico foi empregado em todos os casos. Hemorragia intracística foi a principal complicação apresentada, ocorrendo em três casos. CONCLUSÃO: Os cistos mesentéricos apresentaram-se clinicamente com sintomas inespecíficos e pouco sintomáticos. Quanto ao diagnóstico, a tomografia computadorizada mostrou ser mais efetiva que a ultrassonografia. Linfangiomas e mesoteliomas foram encontrados em proporções iguais. A ressecção completa do cisto foi o tratamento de eleição e não houve óbitos no pós-operatório.

OBJECTIVE: To evaluate epidemiologic, clinical, pathologic and therapeutic characteristics of the mesenteric cysts in hospitals of Sergipe, Brazil. METHODS: Mesenteric cysts were assessed by a non-interventional cross-sectional study from the archives of the Pathology Laboratory of Federal University of Sergipe between 1995 and 2007. The charts of the patients were reviewed in order to find out: gender, age, clinical findings, complementary exams and therapeutic approach. RESULTS: Eighteen cases of mesenteric cysts were found. Females were more affected (72.2%). Mean of age of the patients was 30.46. More frequent symptoms were pain and abdominal mass. Ultrasonography of abdomen, performed in all patients, was not conclusive in half of the cases. CTscan of abdomen with contrast was performed in six cases, being cystic tumor well identified in all of them. Regarding histopathology, 6 lymphangiomas, 8 mesotheliomas, 1 hemorrhagic cyst in organization and 1 mucinous cyst were found. Surgical treatment was performed in all cases. Intracystic bleeding was the main complication in 3 cases. CONCLUSION: The mesenteric cysts presented clinically with unspecific symptoms. CTscan was more effective than ultrasonography for the diagnosis. Lymphangiomas and mesothelioma had been found in equal ratios. The complete ressection of the cyst was the treatment of election. There were no deaths in postoperative period.

São apresentados sete casos de esquistossomose ectópica (cinco de pele, um de ovário e um de supra-renal) procedentes do Estado de Sergipe, coletados a partir de pesquisa de prontuários e laudos anátomo-patológicos nos arquivos dos Serviços de Dermatologia e de Patologia do Hospital Universitário da Universidade Federal de Sergipe, entre os anos de 1995 e 2005. A média de idade dos pacientes ao diagnóstico foi de 21,1 anos. Nos casos dermatológicos, houve melhora total das lesões após tratamento com oxamniquine. No caso de ovário houve associação com carcinoma embrionário; a paciente foi submetida à cirurgia com quimioterapia adjuvante e praziquantel, evoluindo satisfatoriamente. O caso de supra-renal estava associado a adenoma.

Seven cases of patients with ectopic schistosomiasis from the State of Sergipe, Brazil, are presented (five involving skin, one ovarian and one adrenal). Data were collected from surveying the clinical records and anatomopathological reports in the files of the dermatology and pathology clinics of the University Hospital of the Federal University of Sergipe, from 1995 to 2005. The patients' mean age at diagnosis was 21.1 years. In the dermatological cases, full cures were achieved after treatment with oxamniquine. In the ovarian case, there was an association with embryonic carcinoma: this patient underwent surgery with adjuvant chemotherapy and praziquantel treatment, with satisfactory evolution. The adrenal case was associated with adenoma.

Este trabalho teve como objetivo a avaliação da toxicidade aguda do extrato aquoso de folhas de Erythrina velutina, espécie vegetal muito usada na medicina popular principalmente como tranqüilizante. O protocolo experimental utilizado seguiu o Guia para a Realização de Estudos de Toxicidade Pré-clínica de Fitoterápicos da Agência Nacional de Vigilância Sanitária (Anvisa, 2004). Ratos Wistar adultos foram tratados por via oral com a dose limite de 5 g/kg do extrato e observados por 14 dias consecutivos. Nenhum animal veio a óbito e nenhum sinal de toxicidade foi detectado nas observações comportamentais ou nas autópsias, indicando uma razoável atoxicidade do extrato.

The aim of this work was to evaluate the acute toxicity of the aqueous extract of Erythrina velutina leaves, which is frequently used in folk medicine as a tranquilizer. The experimental design followed the Guide for Preclinical Toxicity Studies of Herbal Medicines from the Agência Nacional de Vigilância Sanitária (Anvisa, 2004). Adult Wistar rats were treated per os with the limit dose of 5g/kg of the extract and then observed for 14 consecutive days. No animals died and no signs of toxicity were detected either during the behavioral observations or at the autopsies, what indicates a reasonable lack of toxicity for the extract.

In chronic hepatitis C (CHC), liver biopsy is the gold standard method for assessing liver histology, however it is invasive and can have complications. Non-invasive markers have been proposed and aspartate aminotransferase (AST)-to-platelet ratio index (APRI) has been shown as an easy and inexpensive marker of liver fibrosis. This study evaluated the diagnostic performance of APRI for significant fibrosis and cirrhosis prediction in CHC patients. This study included treatment-naive CHC patients who had undergone liver biopsy from January 2000 to August 2006. All histological slides were reviewed according to the METAVIR system. APRI was calculated based on laboratory results performed within four months from the biopsy. Twenty-eight (56%) patients had significant fibrosis (F2-F4) and 13 (26%) had cirrhosis (F4). The area under ROC curves of APRI for predicting significant fibrosis and cirrhosis were 0.92 (0.83-1.00) and 0.92 (0.85-1.00), respectively. Using cut-off values recommended by prior studies, significant fibrosis could be identified, in accordance with liver biopsy, in 44% and cirrhosis in 66% of patients. APRI could identify significant fibrosis and cirrhosis at a high degree of accuracy in studied patients.

An accessory soleus muscle was found in the left leg of a male cadaver in the dissecting room. The muscle was situaded posteromedially, between the soleus muscle and the flexor digitorum longus and flexor hallucis longus. The origin of the muscle was in the superior third of the anterior fascia of the soleus muscle and the insertion, was attached with separate tendon, in the anteromedial surface of calcaneus bone

Durante una disección de rutina, se encontró un músculo soleo accesorio, en la pierna izquierda de un cadáver masculino. El músculo se localizaba posteromedialmente en la pierna, entre los músculos flexor largo de los dedos y largo del hálux. Su origen estaba en el tercio superior de la fascia anterior del músculo soleo y su inserción se realizaba, a través de un tendón en la superficie anteromedial del hueso calcáneo

OBJETIVO: Avaliar os efeitos do omeprazol e do pantoprazol sobre a regeneração hepática após hepatectomia parcial. MÉTODOS: Cinqüenta e oito ratos Wistar machos foram divididos em 4 grupos: Grupo SHAM, Grupo HP, Grupo PANTO e Grupo OMEP. Eles foram submetidos a hepatectomia parcial de 67% (Grupos HP, PANTO e OMEP) ou laparotomia (Grupo SHAM). Os fígados foram removidos 32 e 56 horas após a operação. Depois, os animais foram sacrificados. Em todos os grupos, as substâncias (solução salina, omeprazol e pantoprazol) foram aplicadas diariamente a partir do momento em que foram operados até o sacrifício. RESULTADOS: O índice de mitose no Grupo SHAM não foi significativo. Trinta e duas horas após a hepatectomia, a contagem de mitoses foi de 1,2 ± 1,09 para o Grupo HP, 1,2 ± 1,6 para o Grupo OMEP e 2,6 ± 3,2 para o Grupo PANTO. Na análise após 56 horas, os valores foram 1,6 ± 0,89 para o HP, 2 ± 1,8 para o OMEP e 2,6 ± 0,54 para o PANTO. Esses resultados não foram estatisticamente significativos. CONCLUSÃO: O omeprazol e o pantoprazol, agentes inibidores da bomba de prótons (H+, K+-ATPase), não interferem na regeneração hepática 32 e 56 horas após hepatectomia parcial a 67% em ratos.

PURPOSE: To assess the effects of omeprazole and pantoprazole on liver regeneration after partial hepatectomy. METHODS: Fifty eight male Wistar rats were divided into 4 groups: SHAM, HP, PANTO and OMEP Groups. They were submitted to 67% partial hepatectomy (HP, PANTO and OMEP Groups) or laparotomy (SHAM Group). Their livers were removed 32 and 56 hours after the operation. Then, the animals were sacrificed. In all groups, the substances (saline solution, omeprazole and pantoprazole) were injected once daily from the moment they were operated on until the time of sacrifice. RESULTS: In SHAM Group the mitotic index was not significant. Thirty two hours after hepatectomy, the mitosis index was 1.2 ± 1.09 in HP Group, 1.2 ± 1.6 in OMEP Group and 2.6 ± 3.2 in PANTO Group. Concerning the 56-hour analysis, the values were 1.6 ± 0.89 in HP Group, 2 ± 1.8 in OMEP Group and 2.6 ± 0.54 in PANTO Group. These results were not statistically significant. CONCLUSION: Omeprazole and pantoprazole, proton pump inhibitors (H+, K+-ATPase), do not cause any change on liver regeneration 32 and 56 hours after 67% partial hepatectomy in rats.

Apresentamos o caso de mulher com 57 anos de idade apresentando polimiosite, associada a infecção pelo HTLV-I, sem manifestações clínicas de acomentimento do sistema nervoso central e periférico. Fazemos alguns comentários sobre os aspectos fisiopatológicos do envolvimento muscular nas infecções pelo HTLV-I.

We report the case of a 57 years-old woman presenting polymyositis associated to HTLV-I infection without clinical signs of involvement of the central and peripheral nervous system. Pathophysiologic aspects of muscular involvement in HTLV-I infection are discussed.