Abstract Genital ulcers (GUs) represent a diagnostic challenge and can be secondary to neoplastic and inflammatory processes of different causes. Among those of infectious etiology, there are sexually transmitted infections (STIs), a very frequent reason for seeking the health service. The most common agents are herpes simplex virus and Treponema pallidum and, more rarely, Haemophilus ducreyi, Klebsiella granulomatis and Chlamydia trachomatis. A careful dermatological examination offers important diagnostic elements; however, atypical manifestations are very common. Distinctive characteristics of ulcers to look out for include their margin, edge, bottom, and base. Regional lymph node chain alterations should be evaluated regarding their number, size, mobility, consistency, inflammation, and pain on palpation. Diagnostic tests have variable sensitivity and specificity, and molecular tests are currently considered the reference exams. The rapid immunochromatographic tests represented a significant advance, as they can be performed with blood obtained from the digital pulp, offer results in up to 30 minutes, and do not require a laboratory structure. The treatment of persons affected by GU/STIs must be immediate, as it aims to prevent complications, as well as reduce transmission. It is not always considered that people with GUs/STIs have varying degrees of depression, anxiety, and self-reproach, with an impact on relationships. Establishing a bond and trusting the professional is essential for adherence to treatment and preventive measures that must be discussed individually.

Abstract This study aims to analyze the length-weight relationship (LWR) of 22 fish species collected in the surf zone of Ponta de Pedras, northern coast of Pernambuco, Northeastern Brazil. The specimens were collected between August 2013 and July 2014 using a beach seine net, and their biometry were recorded in laboratory. The LWR was calculated using linear regression and, confidence intervals were estimated for the regression parameters a and b. A total of 1,433 specimens belonging to 22 species, 12 families, and six orders were collected. All species had b values within the expected range of 2.5-3.5 (except for S. plagusia). Additionally, 11 species have hyperallometry, eight have isometry, and three have hypoallometry. Herein, we present values of LWR for Lycengraulis grossidens, Trachinotus goodei, and Umbrina coroides, which are new to Northeastern Brazil, and Albula vulpes and Sparisoma radius which are new for the Brazilian coast.

Abstract Leprosy is a chronic infectious disease caused by Mycobacterium leprae and, depending on the host immune status, presents different clinical forms. This report describes the case of a 46-year-old man who had hypoesthetic lesions in the infrahyoid region for 30 days. The bacilloscopy was negative. The anatomopathological examination showed alterations corresponding to the tuberculoid pole (epithelioid histiocytes) and virchowian pole (foamy histiocytes), compatible with borderline-virchowian leprosy (Ridley and Jopling classification). Rapid tests for HIV I, II, and syphilis were positive, with a CD4 count of 223. The patient started treatment with multibacillary multidrug therapy, antiretroviral therapy, and benzathine penicillin, with marked clinical improvement in two months.

INTRODUÇÃO: A realização do cateterismo cardíaco diagnóstico e da intervenção coronária percutânea (ICP) no mesmo procedimento (ICP ad hoc) tem sido uma prática crescente. Estudos têm apontado como vantagens dessa estratégia a redução dos custos hospitalares, a maior comodidade para o paciente e a diminuição das complicações vasculares. MÉTODO: Neste estudo, 651 pacientes com angina estável foram randomizados para ICP ad hoc ou ICP estagiada. O desfecho primário foi a composição de: morte cardíaca, infarto agudo do miocárdio (IAM), cirurgia cardíaca de urgência, acidente vascular cerebral (AVC) ou complicações hemorrágicas. RESULTADOS: O desfecho primário ocorreu em 2,9% na ICP ad hoc vs. 4,4% na ICP estagiada (P = 0,406). A análise isolada dos eventos clínicos não evidencia diferenças significativas entre os grupos: morte por causa cardíaca ocorreu em 1% na ICP ad hoc vs. 0,3% na ICP estagiada (P = 0,354); IAM ocorreu em 1,3% na ICP ad hoc vs. 1,2% na ICP estagiada (P > 0,99) e AVC ocorreu em 0,3% na ICP ad hoc vs. 0,3% na ICP estagiada (P > 0,99). A taxa de complicações hemorrágicas foi significativamente maior na ICP estagiada (1% vs. 3,5%; P = 0,035). Os preditores independentes do desfecho primário foram: IAM prévio (odds ratio [OR] = 6,287; intervalo de confiança de 95% [IC 95%] 1,62-24,36; P = 0,008), vasculopatia periférica (OR = 16,97; IC 95% 6,39-45,01; P = 0,0001) e doença coronária multiarterial (OR = 13,97; IC 95% 3,65-53,50; P = 0,0001). CONCLUSÃO: O estudo demonstrou que a ICP ad hoc é tão segura e eficaz quanto a ICP estagiada em pacientes com angina estável, e está associada a taxa significativamente menor de complicações hemorrágicas relacionadas ao acesso vascular.

INTRODUCTION: Performing diagnostic cardiac catheterization and percutaneous coronary intervention (PCI) in the same procedure (ad hoc PCI) has been an increasing practice. Studies have indicated a reduction in hospital costs, greater patient commodity and less vascular complications as advantages of this strategy. METHODS: Six hundred and fifty-one patients with stable angina were randomized to ad hoc PCI or staged PCI. Primary endpoint was the composition of cardiac death, acute myocardial infarction (AMI), urgent cardiac surgery, stroke, or hemorrhagic complications. RESULTS: Primary endpoint was observed in 2.9% for ad hoc PCI versus 4.4% for staged PCI (P = 0.406). Analysis of isolated clinical events did not find significant differences between groups: death from cardiac cause was observed in 1% for ad hoc PCI versus 0.3% for staged PCI (P = 0.354); AMI in 1.3% for ad hoc PCI versus 1.2% for staged PCI (P > 0.99), and stroke in 0.3% for ad hoc PCI versus 0.3% for staged PCI (P > 0.99). The rate of hemorrhagic complications was significantly greater for staged PCI (3.5% versus 1%; P = 0.035). Independent predictors of primary endpoint were: previous myocardial infarction (OR = 6.287; CI 95% 1.62-24.36; P = 0.008), peripheral vascular disease (OR = 16.97; CI 95% 6.3945.01; P = 0.0001), and multiple coronary artery disease (OR = 13.97; CI 95% 3.65-53.50; P = 0.0001). CONCLUSION: The study showed that ad hoc PCI is as safe and efficient as staged PCI in patients with stable angina, and it is associated to a significantly lower rate of hemorrhagic complications related to vascular access.