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São Paulo, Brazil

Girardi F.M.,Head and Neck Surgeon at the Santa Rita Hospital | Zanella V.G.,Head and Neck Surgeon at the Santa Rita Hospital | Kroef R.G.,Hospital Santa Rita
Brazilian Journal of Otorhinolaryngology

The importance of having tumor-free margins when resecting oral neoplasms has been known for decades. Objective: To correlate clinical and pathology data to surgical margin status in patients with squamous cell carcinoma of the tongue and floor of the mouth. Method: This historical cohort cross-sectional study included all patients submitted to squamous cell carcinoma resection for tumors of the oral tongue and floor of the mouth between 2007 and 2011 at the Head and Neck Surgery service of our institution. Results: In the 117 cases included, 68.3% had tongue tumors. The male-to-female ratio was 2.3:1 and patient mean age was 57.6 years. Broad free resection margins were seen in 23.0% of the cases; narrow margins in 60.6% of the cases; and compromised margins in 16.2%. Tumor diameter and thickness were correlated to resection margins. Tumors in more advanced T-stages presented more unsatisfactory margins. Patients operated with broad free margins had their tumors resected more commonly through transoral approaches. Conclusions: Tumors of larger volume both in terms of diameter and thickness were more correlated to unsatisfactory resection margins. Higher complexity procedures were not associated with better resection margins. Source

de Castro E.K.,University of the Rio dos Sinos Valley | Aretz M.,University of the Rio dos Sinos Valley | Lawrenz P.,University of the Rio dos Sinos Valley | Bittencourt Romeiro F.,University of the Rio dos Sinos Valley | Abduch Haas S.,Hospital Santa Rita

Purpose: to compare the perceptions about cervical cancer in: 1) women with cervical cancer, 2) women with precursory lesions; and 3) healthy women. Participants were 150 adult women from southern Brazil. Measures: Sociodemographic and Clinical Data sheet, Illness Perception Questionnaire - Revised and Illness Perception Questionnaire for healthy people. Results showed significant differences between groups in the dimensions of timeline cyclic and identity, indicating that healthy women perceived more symptoms, but as more cyclical (acute/chronic) compared to the other two groups. With regard to the causes of illness, women with cancer more often attributed it to their emotional state/stress/concerns than healthy women or those with precursory lesions. Source

Lisboa T.,Hospital Santa Rita | Waterer G.W.,University of Western Australia | Lee Y.C.G.,University of Western Australia

The incidence of pleural infection continues to rise worldwide. Identifying the causative organism(s) is important to guide antimicrobial therapy. The bacteriology of pleural infection is complex and has changed over time. Recent data suggest that the bacterial causes of empyema are significantly different between adult and paediatric patients, between community-acquired and nosocomial empyemas and can vary among geographical regions of the world. Since the introduction of pneumococcal vaccines, a change has been observed in the distribution of the serotypes of Streptococcus pneumoniae in empyema. These observations have implications on therapy and vaccine strategies. Clinicians need to be aware of the local bacteriology of empyema in order to guide antibiotic treatment © 2011 Asian Pacific Society of Respirology. Source

Garrido Jr. A.B.,Instituto Garrido | Rossi M.,Hospital Neomater | Lima Jr. S.E.,Hospital Mandaqui | Brenner A.S.,Hospital de Clinicas | Gomes Jr. C.A.R.,Hospital Santa Rita
Arquivos de Gastroenterologia

Context - Causal factors of gastrojejunal ulcers after Roux-en-Y gastric bypass include peptic acid secretion from the gastric pouch. Esomeprazole is a potent inhibitor of acid secretion. Objective - To assess the occurrence of dyspepsia and gastrojejunal ulcers within the first 2 months after Roux-en-Y gastric bypass during the use of esomeprazole. Methods - One hundred eighteen morbid obese subjects were submitted to Roux-en-Y gastric bypass. Preoperative upper gastrointestinal tract endoscopy was negative for H. pylori. All subjects received esomeprazole for 60 days after surgery. Results - Two weeks after surgery only 13 mild symptoms were reported. After 2 months, 17 also moderate complaints were registered. Endoscopy around the 60th day showed esophagitis in 10 (8.5%), hiatal hernia in 2 (1.7%), foreign body in the anastomotic line in 12 (10.2%) and gastrojejunal ulcers was observed in 9 (7.6%) subjects, 2 of which had a suture material or metallic staple granuloma in the gastrojejunostomy. Ten subjects took non-steroidal anti-inflammatory drugs at least once during study, but none of them developed ulcer. None of the subjects with ulcer had dyspeptic symptoms. Conclusion - The incidence of ulcer in the gastrojejunal anastomosis within the first 2 months following Roux-en-Y gastric bypass under proton pump inhibitors is considerable. It was not related to the use of non-steroidal anti-inflammatory drugs, highlighting the possibility of ischemia and foreign body as causal factors. The ulcers were asymptomatic, and all post-surgical dyspeptic symptoms were moderate in severity. Source

Dall Bello A.G.,Federal University of Rio Grande do Sul | Severo C.B.,Hospital Santa Rita | Schio S.,Hospital Santa Rita | Severo L.C.,Brazilian National Council for Scientific and Technological Development
Dermatology Online Journal

Cryptococcus gattii are closely related species of encapsulated yeast-like fungi involved in the etiology of cryptococcosis, especially in immunocompetent individuals. Dissemination with involvement of many organ systems is common. On the other hand, cellulitis in an immunossupressed patient caused by C. gattii is rare. We present a case of disseminated disease caused by Cryptococcus gattii in a lung transplant recipient who manifested cellulitis. The disease was also complicated by a lung carcinoma. We emphasize that cryptococcal cellulitis related to C. gattii in solid organ transplant (SOT) recipients should be considered in the differential diagnosis of acute bacterial skin infections. © 2013 by the article author(s). Source

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