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O leite materno é de suma importância e traz inúmeros benefícios para o bebê. A dor ao amamentar e as fissuras mamárias são recorrentes. Este estudo visou avaliar a eficácia do laser no tratamento de fissuras mamilares. Trata-se de uma pesquisa de campo, estudo de caso, experimental e de abordagem quali-quantitativa. Foi realizado na cidade de Patos- PB na Clínica Escola de Fisioterapia do Centro Universitário de Patos com um total de 3 puérperas. As participantes receberam como tratamento aplicação do laser de baixa potência com uma ponteira de 660nm, com parâmetros de 6J/cm2 com intervalo de 24 a 48 horas realizando de duas a três sessões, resultando nas puérperas uma melhora do quadro álgico e do processo de cicatrização da fissura, o qual foi relatado pela paciente na primeira sessão a diminuição da dor, com um nível inicialmente de 10 na Escala EVA diminuindo para 0 após a última sessão. Conclui-se que a laserterapia é um meio de tratamento eficaz e seguro, pois promove diminuição do quadro álgico, acelera o processo de cicatrização das fissuras mamilares e tornou-se um meio de prolongar a amamentação e evitar o desmame precoce.

Blocking the catalytic activity of urease has been shown to have a key role in different diseases as well as in different agricultural applications. A vast array of molecules have been tested against ureases of different species, but the clinical translation of these compounds has been limited due to challenges of potency, chemical and metabolic stability as well as promiscuity against other proteins. The design and development of new compounds greatly benefit from insights from previously tested compounds; however, no large-scale studies surveying the urease inhibitors' chemical space exist that can provide an overview of developed compounds to data. Therefore, given the increasing interest in developing new compounds for this target, we carried out a comprehensive analysis of the activity landscape published so far. To do so, we assembled and curated a data set of compounds tested against urease. To the best of our knowledge, this is the largest data set of urease inhibitors to date, composed of 3200 compounds of diverse structures. We characterized the data set in terms of chemical space coverage, molecular scaffolds, distribution with respect to physicochemical properties, as well as temporal trends of drug development. Through these analyses, we highlighted different substructures and functional groups responsible for distinct activity and inactivity against ureases. Furthermore, activity cliffs were assessed, and the chemical space of urease inhibitors was compared to DrugBank. Finally, we extracted meaningful patterns associated with activity using a decision tree algorithm. Overall, this study provides a critical overview of urease inhibitor research carried out in the last few decades and enabled finding underlying SAR patterns such as under-reported chemical functional groups that contribute to the overall activity. With this work, we propose different rules and practical implications that can guide the design or selection of novel compounds to be screened as well as lead optimization.

Necroptosis has emerged as an exciting target in oncological, inflammatory, neurodegenerative, and autoimmune diseases, in addition to acute ischemic injuries. It is known to play a role in innate immune response, as well as in antiviral cellular response. Here we devised a concerted in silico and experimental framework to identify novel RIPK1 inhibitors, a key necroptosis factor. We propose the first in silico model for the prediction of new RIPK1 inhibitor scaffolds by combining docking and machine learning methodologies. Through the data analysis of patterns in docking results, we derived two rules, where rule #1 consisted of a four-residue signature filter, and rule #2 consisted of a six-residue similarity filter based on docking calculations. These were used in consensus with a machine learning QSAR model from data collated from ChEMBL, the literature, in patents, and from PubChem data. The models allowed for good prediction of actives of >90, 92, and 96.4% precision, respectively. As a proof-of-concept, we selected 50 compounds from the ChemBridge database, using a consensus of both molecular docking and machine learning methods, and tested them in a phenotypic necroptosis assay and a biochemical RIPK1 inhibition assay. A total of 7 of the 47 tested compounds demonstrated around 20–25% inhibition of RIPK1’s kinase activity but, more importantly, these compounds were discovered to occupy new areas of chemical space. Although no strong actives were found, they could be candidates for further optimization, particularly because they have new scaffolds. In conclusion, this screening method may prove valuable for future screening efforts as it allows for the exploration of new areas of the chemical space in a very fast and inexpensive manner, therefore providing efficient starting points amenable to further hit-optimization campaigns.

Glycogen phosphorylase (GP) is a key enzyme in the glycogenolysis pathway. GP inhibitors are currently under investigation as a new liver-targeted approach to managing type 2 diabetes mellitus (DM). The aim of the present study was to evaluate the inhibitory activity of a panel of 52 structurally related chromone derivatives; namely, flavonoids, 2-styrylchromones, 2-styrylchromone-related derivatives [2-(4-arylbuta-1,3-dien-1-yl)chromones], and 4- and 5-styrylpyrazoles against GP, using in silico and in vitro microanalysis screening systems. Several of the tested compounds showed a potent inhibitory effect. The structure–activity relationship study indicated that for 2-styrylchromones and 2-styrylchromone-related derivatives, the hydroxylations at the A and B rings, and in the flavonoid family, as well as the hydroxylation of the A ring, were determinants for the inhibitory activity. To support the in vitro experimental findings, molecular docking studies were performed, revealing clear hydrogen bonding patterns that favored the inhibitory effects of flavonoids, 2-styrylchromones, and 2-styrylchromone-related derivatives. Interestingly, the potency of the most active compounds increased almost four-fold when the concentration of glucose increased, presenting an IC50 < 10 µM. This effect may reduce the risk of hypoglycemia, a commonly reported side effect of antidiabetic agents. This work contributes with important considerations and provides a better understanding of potential scaffolds for the study of novel GP inhibitors.

Cutaneous manifestations of tuberculosis (TB) are rare, particularly from an exogenous source. Involvement of the nail apparatus is extremely rare and has only previously been reported as a secondary involvement. We report the case of a 76-year-old female patient referred to our department with onychodystrophy with purulent drainage of the first left finger, which had developed during the preceding year. She had no previous traumatic history and had received treatment with multiple cycles of oral antibiotics and antimycotics, with no clinical improvement. Physical examination showed paronychia and onychodystrophy of the entire nail plate. Biopsy evaluation revealed epithelioid granulomas with central foci of necrosis, and laboratory cultures were positive for Mycobacterium tuberculosiscomplex. Chest computed tomography excluded primary pulmonary TB. X-ray of the left hand revealed the presence of dactylitis on the distal phalanx. Based on these findings, the patient was treated with rifampicin, isoniazid, pyrazinamide, and ethambutol for 2 months and with rifampicin and isoniazid for 7 months, resulting in complete resolution of the lesions. Cutaneous TB is a diagnostic challenge, particularly in rare cases such as involvement of the nail apparatus. It should be considered as a diagnostic hypothesis in cases of painless paronychia with refractory purulent drainage and associated onychodystrophy.

Dentre as atividades da profissão farmacêutica, destaca-se a pesquisa, o desenvolvimento e a produção de novas drogas, utilizando-se como fonte plantas, animais e minerais, o que torna a Farmacologia uma das principais disciplinas do Curso de Farmácia, uma vez que estuda as substâncias que interagem com sistemas vivos por meio de processos químicos, ligando-se especificamente a moléculas reguladoras e ativando ou inibindo processos corporais normais. Diante desse pressuposto, este trabalho objetivou avaliar o estudo da disciplina de Farmacologia nos cursos de graduação em Farmácia da região sudeste do Brasil. Pela busca interativa, selecionaram-se os cursos de Farmácia cadastrados nos estados do sudeste do Brasil: Minas Gerais, Espirito Santo, Rio de Janeiro e São Paulo. Foram avaliados pontos como a nomenclatura que a disciplina recebe, carga horária total da disciplina, e a sua distribuição em aulas teóricas e/ou práticas, além do período em que a disciplina é oferecida. A análise das informações obtidas com a pesquisa demonstrou a necessidade de uma reavaliação da grade curricular para a oferta de disciplinas relacionadas com a farmacologia e, consequente dos seus planos de ensino e ementa da disciplina, nos cursos de graduação em Farmácia do Sudeste do Brasil.

Authors report the case of a male patient treated in the Dermatology Department for cutaneous leprosy, and then sent to the Plastic Surgery Department for excisional biopsy of a giant shoulder nodule unresponsive to antibacilar chemotherapy and interpreted as a leprosy reaction. The extemporary histological result was of a cutaneous lymphoma and the defect was reconstructed with two random regional fasciocutaneous flaps, a rotation scapular flap and a transposition anterior brachial flap. The rarity of this association, not previously reported in the literature, and the success of the chosen surgical treatment motivated us to publish the case. We present the clinical evolution of the lesion, the surgical reconstructive option and the final result which we consider excellent from clinical, aesthetic and functional points of view.

Cytochrome bc1 is a validated drug target of Plasmodium falciparum, the parasite that causes the most lethal form of malaria. The inhibition of cytochrome bc1 leads to the shutdown of the mitochondrial metabolism and the consequent arrest of pyrimidine biosynthesis essential for parasite development. Aiming to rationalize the stereoelectronic properties and extend the knowledge on a novel series of 4-pyridonimines guiding the search of antimalarial drugs, we carried out an extensive DFT comparative characterization. Results show electronic similarity with clopidol, a known bc1 complex inhibitor containing the 4(1H)-pyridone scaffold. V C 2010 Wiley Periodicals, Inc. Int J Quantum Chem 111: 1196-1207, 2011

Introdução: O tabaco é actualmente um dos maiores problemas de saúde pública. Desta forma, o conhecimento do perfil do fumador é essencial para poder adequar estratégias de intervenção, sendo fundamental avaliar a sua motivação. Objectivos: Calcular a prevalência de fumadores de quatro ficheiros de três centros de saúde do distrito de Coimbra e caracterizá-los em termos demográficos, padrão de consumo, motivação para a cessação tabágica e comorbilidades. Determinar a relação entre motivação para deixar de fumar e idade, sexo, idade de início e quantidade do consumo, co morbilidades cardiovasculares, respiratórias e psiquiátricas associadas. Metodologia: Estudo descritivo com componente analítico. População acessível: utentes entre 15 e 65 anos, utilizadores da consulta de quatro ficheiros de três centros de saúde do distrito de Coimbra entre Junho e Agosto de 2007. Tratamento de dados: SPSS17. Resultados: Duzentos e vinte e quatro entrevistados aleatoriamente, 64,3% mulheres, com idade média de 44,9 anos. A prevalência de fumadores foi de 17% (52,63% mulheres). A idade média dos fumadores foi de 39,4 anos. A idade média de início de consumo tabágico foi de 17,2 anos. A quantidade média de cigarros consumidos foi de 17,5/dia. Dos fumadores, 50% eram portadores de comorbilidades. Não foi encontrada associação estatisticamente significativa de nenhum destes factores com a motivação para deixar de fumar. Discussão/conclusão: Os resultados obtidos são sobreponíveis a outros estudos nacionais. Entre os jovens, há mais mulheres fumadoras, e as mulheres fumam menos cigarros/dia. Das co morbilidades estudadas, as mais frequentes foram as cardiovasculares e as psiquiátricas. Apenas metade dos fumadores estavam motivados para a cessação tabágica.Background: Smoking is currently a leading public health priority. Profiling smokers allows for adequate intervention strategies and it is important to assess smokers’ motivation. Aims: To calculate the rate of smokers in 4 files from 3 Health Centres in Coimbra and characterise smokers in terms of demographics, consumption pattern, motivation for smoking cessation and co-morbidities. Investigate the relationship between motivation to stop smoking and age, gender, consumption and age at starting smoking and cardiovascular, respiratory and psychiatric co-morbidities. Methods: Descriptive study with analytical component. Accessible population: 15-65 year old patients from 4 files from 3 Health Centres in Coimbra seen July - August 2007. Data treatment: SPSS 17. Results: 224 randomly interviewed patients, 64.3% women; mean age 44.9 years old. Rate of smokers was 17% (52.63% female). Smokers’ mean age was 39.4 years old. The mean age at starting smoking was 17.2 years old (16.4 in men). Mean cigarette consumption was 17.5/day (13.3 in women). 47.4% was poorly motivated, 52.6% moderate/highly motivated. 50% of the smokers had co-morbidities. There was no association between any of these factors and smoking cessation motivation. Discussion/conclusions: The results are similar to other national studies. There were more younger female smokers than male, but females smoked fewer cigarettes/day. In this study the most frequent co-morbidities were cardiovascular and psychiatric. Only half of the smokers were motivated to stop smoking.

Background: Smoking is currently a leading public health priority. Profiling smokers allows for adequate intervention strategies and it is important to assess smokersâ motivation. Aims: To calculate the rate of smokers in 4 files from 3 Health Centres in Coimbra and characterise smokers in terms of demographics, consumption pattern, motivation for smoking cessation and co-morbidities. Investigate the relationship between motivation to stop smoking and age, gender, consumption and age at starting smoking and cardiovascular, respiratory and psychiatric co-morbidities. Methods: Descriptive study with analytical component. Accessible population: 15â65 year old patients from 4 files from 3 Health Centres in Coimbra seen July â August 2007. Data treatment: SPSS 17. Results: 224 randomly interviewed patients, 64.3% women; mean age 44.9 years old. Rate of smokers was 17% (52.63% female). Smokersâ mean age was 39.4 years old. The mean age at starting smoking was 17.2 years old (16.4 in men). Mean cigarette consumption was 17.5/day (13.3 in women). 47.4% was poorly motivated, 52.6% moderate/highly motivated. 50% of the smokers had co-morbidities. There was no association between any of these factors and smoking cessation motivation. Discussion/conclusions: The results are similar to other national studies. There were more younger female smokers than male, but females smoked fewer cigarettes/day. In this study the most frequent co-morbidities were cardiovascular and psychiatric. Only half of the smokers were motivated to stop smoking. Resumo: Introdução: O tabaco é actualmente um dos maiores problemas de saúde pública. Desta forma, o conhecimento do perfil do fumador é essencial para poder adequar estratégias de intervenção, sendo fundamental avaliar a sua motivação. Objectivos: Calcular a prevalência de fumadores de quatro ficheiros de três centros de saúde do distrito de Coimbra e caracterizá-los em termos demográficos, padrão de consumo, motivação para a cessação tabágica e comorbilidades. Determinar a relação entre motivação para deixar de fumar e idade, sexo, idade de início e quantidade do consumo, co morbilidades cardiovasculares, respiratórias e psiquiátricas associadas. Metodologia: Estudo descritivo com componente analítico. População acessível: utentes entre 15 e 65 anos, utilizadores da consulta de quatro ficheiros de três centros de saúde do distrito de Coimbra entre Junho e Agosto de 2007. Tratamento de dados: SPSS17. Resultados: Duzentos e vinte e quatro entrevistados aleatoriamente, 64,3% mulheres, com idade média de 44,9 anos. A prevalência de fumadores foi de 17% (52,63% mulheres). A idade média dos fumadores foi de 39,4 anos. A idade média de início de consumo tabágico foi de 17,2 anos. A quantidade média de cigarros consumidos foi de 17,5/dia. Dos fumadores, 50% eram portadores de comorbilidades. Não foi encontrada associação estatisticamente significativa de nenhum destes factores com a motivação para deixar de fumar. Discussão/conclusão: Os resultados obtidos são sobreponíveis a outros estudos nacionais. Entre os jovens, há mais mulheres fumadoras, e as mulheres fumam menos cigarros/dia. Das co morbilidades estudadas, as mais frequentes foram as cardiovasculares e as psiquiátricas. Apenas metade dos fumadores estavam motivados para a cessação tabágica. Key-words: Smoking cessation, motivation, smoking epidemiology, Palavras-chave: Cessação tabágica, motivação, caracterização, fumadores

Synthetic superoxide dismutase mimetics have emerged as a potential novel class of drugs for the treatment of oxidative stress related diseases. Among these agents, metal complexes with macrocyclic ligands constitute an important group. In this work we synthesized five macrocyclic copper(II) complexes and evaluated their ability to scavenge the superoxide anions generated by the xanthine-xanthine oxidase system. Two different endpoints were used, the nitro blue tetrazolium (NBT) reduction assay (colorimetric method) and the dihydroethidium (DHE) oxidation assay (fluorimetric method). IC(50) values in the low micromolar range were found in four out of five macrocyclic complexes studied, demonstrating their effective ability to scavenge the superoxide anion. The IC(50) values obtained with the NBT assay for the macrocyclic copper(II) complexes, were consistently higher, approximately threefold, than those obtained with the DHE assay. Spectroscopic and electrochemical studies were performed in order to correlate the structural features of the complexes with their superoxide scavenger activity. Cytotoxicity assays were also performed using the MTT method in V79 mammalian cells and we found that the complexes, in the range of concentrations tested in the superoxide scavenging assays were not considerably toxic. In summary, some of the presented macrocyclic copper(II) complexes, specially those with a high stability constant and low IC(50), appear to be promising superoxide scavenger agents, and should be considered for further biological assays.

Cutaneous infections with the human papilloma virus, despite being almost always asymptomatic, can induce slow-growing lesions knowed as warts that can remain subclinical for long periods of time. There are several therapeutical options namely keratolytics, retinoids, imiquimod, cryotherapy, electrosurgery, lasers and classic surgery, but none has antiviral effects. We describe the case of a patient with large warts located on the dorsal surface of the right hand, treated with cryotherapy, CO2 laser and topical imiquimod having either no clinical response or quick relapse. Treatment with PDL was started and after 13 sessions, the patient was without lesions, with a good cosmetic result and so far without relapse. This case report is relevant to us and deserves to be published because of the size of the lesions and the great response to PDL despite all the failures with the other treatments.

Dowling-Degos disease is a rare autosomal dominant inherited pigmentary disorder, mostly confined to the flexures. Diagnosis is established based on the clinical and histopathological correlation. The authors describe the clinical case of a female patient with vulvar involvement and multiple seborrhoeic keratoses on her face, neck, and upper trunk. Major and minor clinical manifestations of Dowling-Degos disease are discussed, with particular emphasis on the genital location of the lesions, which is a rare finding. Also the presence of seborrhoeic keratosis is discussed as a coincidence or a true-associated phenomenon.

Mestrado em Estudos Editoriais O mercado editorial tem sofrido, nos últimos tempos, uma mudança profunda no seu funcionamento, com o crescimento e consolidação dos grandes grupos editoriais e com a consequente extinção das pequenas editoras. Temos, atualmente, um mercado liderado por dois grandes grupos que monopolizam as vendas, deixando pouco espaço de manobra para as pequenas empresas da área que tentam subsistir. Por outro lado, a edição para a infância conhece nos últimos anos um crescimento sem igual, com a integração de autores e ilustradores de qualidade, que emergem no mercado através das pequenas empresas que investem neles. Assistimos a uma importância acrescida ao livro infantil que até aqui era inexistente e a um crescimento e desenvolvimento do setor. Assim, no presente trabalho, queremos, através de uma análise de um exemplo concreto, mostrar que, apesar de todas as dificuldades não só financeiras mas também de visibilidade no mercado, é possível que existam pequenos editores dedicados à literatura para a infância que, em nichos muito específicos de mercado, atuam neste setor da edição. Iremos, através de uma análise do mercado editorial e mais aprofundadamente do setor da edição para a infância, analisar o exemplo de uma pequena editora - a Bruaá, especializada principalmente na tradução de livros estrangeiros para a infância de modo a perceber as estratégias de subsistência das pequenas empresas neste setor, o seu comportamento no mercado, o que as diferencia e a forma como se relacionam entre si. The publishing industry has been suffering a profound change, with the growth and consolidation of the major publishing groups and the consequent extinction of small publishers. We now have a market led by two large groups that, together, monopolize sales, leaving little space for small publishers trying to survive. Nonetheless, literature for children has been growing like never before in recent years, accompanied by the blending of fine authors and illustrators that emerge in the market through the small companies that invest in them. We are witnessing to an ever increasing importance regarding books for children, that until recently did not exist, and to the growth and development of this sector. Here, through a practical case analysis, we propose to show that despite financial and market visibility difficulties, it is possible for small publishers, which dedicate to literature for children, to exist in specific market gaps. We analyze the publishing market, specifically the literature for children publishing sector, considering the case of a small publisher – Bruaá, which mainly specializes in translating books for children published outside of Portugal, in order to understand some survival strategies that small publishers use in this industry, their market behavior, what makes them different and how they relate between each other.

Relatório de estágio de mestrado em Ensino do 1.º e 2.º Ciclo do Ensino Básico, Esta investigação teve como propósito compreender o desenvolvimento da explicitação do raciocínio matemático, com alunos do Ensino Básico, ao longo da realização de uma sequência de tarefas. Com esta experiência pretendeu-se criar condições para que os alunos desenvolvessem o raciocínio através da sua explicitação. Neste sentido, durante a investigação realizada estiveram presente as seguintes questões de investigação: i) quais as dificuldades com que os alunos se depararam na resolução das tarefas e na explicitação do raciocínio?; ii) como é que os alunos evoluíram, ao longo da intervenção pedagógica, na sua capacidade de explicitar os seus raciocínios? Todo o estudo desenvolveu-se de acordo com a metodologia de investigação-ação de cariz qualitativo, recorrendo sempre ao ciclo de planificação, ação, observação e reflexão. Os instrumentos de recolha de dados foram vários: a observação participante com o apoio de gravações áudio e vídeo, os registos escritos em forma de diários da professora investigadora, as produções dos alunos ao longo das aulas e uma ficha de reflexão, realizada no final da intervenção. É de salientar que se optou por diferentes formas de trabalho, tendo os alunos realizado atividades individuais e em grupo. Com este estudo foi possível compreender que o trabalho colaborativo ajudou a desenvolver nos alunos a capacidade de raciocinar e de explicitar os seus raciocínios, tendo-se verificado que a interação entre os alunos foi promotora de uma aprendizagem significativa. Além disso, perante os resultados obtidos, conclui-se que os alunos desenvolveram a capacidade de explicitar os seus raciocínios, seguindo os padrões de raciocínio identificados na educação matemática, justificando as suas posições. Globalmente, este projeto contribuiu para o enriquecimento curricular dos alunos pois, adquiriram novos conhecimentos na área da matemática, desenvolveram o raciocínio matemático e vivenciaram uma diversidade de situações e experiências proporcionadas pelas interações., This research aimed to understand the development of explicit mathematical reasoning, within students of basic education, along the accomplishment of a task sequence. With this experience was intended to create conditions for students to develop reasoning through its explicitness. In this sense, during this investigation the following research questions were taken under consideration: i) what difficulties students encountered in the resolution of tasks and explanation of reasoning? ii) how do students progressed through the educational intervention in their ability to explain their reasoning? The entire study was carried out according to the methodology of action research of a qualitative nature, always resorting to the planning, action, and observation and reflection cycle. The instruments for data collection were several: participant observation supported by audio and video recordings, records taken as diaries by the teacher researcher, students/productions during classes and a reflection rubric at the end of intervention. Note that different ways to work with students were held and the students developed/conducted individual and group activities. With this study it was possible to understand that the collaborative work helped students developing their ability to reason and explain their reasoning, and it was found that the interaction between students was a significant promoter of learning. Furthermore, with the results we concluded that students developed the ability to explain their reasoning, following the patterns of reasoning identified in mathematical education, justifying their positions. Overall, this project has contributed to the curriculum enrichment because students have acquired new mathematical knowledge, have developed mathematical reasoning and have experienced a variety of situations and experiences provided by the interactions., Fundação para a Ciência e Tecnologia (FCT) - Projeto LiDEs – a literacia das disciplinas escolares: Características e desafios para mais engagement e aprendizagem (FCOMP-01-0124-FEDER-041405 (Refª. FCT, EXPL/MHC-CED/0645/2013)).

Background Non-attendance of scheduled appointments is a serious issue in dermatology hospital practice with implications in patient care. Herein we aim to characterize the population of non-attendees of dermatology appointments at a general hospital. Material and methods A prospective study was carried out of the reschedule requests received from January to December 2009 at a dermatology outpatient department of a general hospital. Variables such as gender, age, type of consultation, justification for non-attendance, timing between missed appointments and the reschedule request as well as rates of other missed appointments were analyzed. Results Throughout the study period, 265 patients filed a written request to reschedule a missed appointment, of whom 165 were female and 100 were male. The age distribution displayed two peaks, one in the second and the other in the sixth decade. Regarding the type of consultation, there was a clear predominance of missed follow-up consultations. Confusion and illness were the most frequent excuses for non-attendance. Conclusion We propose to identify patients at risk of missed appointments and suggest interventions to overcome this pitfall and improve patient outcomes.

Introdução: Estudos recentes têm apontado para um aumento da incidência de infecções por Chlamydia trachomatis (CT) e Neisseria gonorrhoeae (NG). Objetivos: Determinar a prevalência de infecção por CT e NG em utentes de uma consulta de Doenças de Transmissão Sexual (DST) num Hospital Universitário. Métodos: Foi realizado um estudo transversal nos utentes de uma clínica de DTS ao longo de um período de 10 anos. Os diagnósticos foram efectuados recorrendo a análise de amplificação de ácidos nucleicos (PCR). Resultados: Na população estudada houve um predomínio do sexo masculino (83,3%). A prevalência global da infecção por CT e NG foi de 1,6% e 0,8%, respectivamente, e após implementação do rastreio a todos os utentes observados, a prevalência de infecção por CT subiu para 3%. Adicionalmente, 53% dos utentes assintomáticos foram diagnosticados como portares da infecção, 78% com infecção por CT e 22% com infecção por NG (p

Tumor necrosis factor alfa (TNF-α) is a cytokine with a central role in inflammation. Its blockade can be achieved by using specific inhibitors like etanercept. At present, etanercept is approved for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis and psoriasis treatment. However, it has been used with promising results in other inflammatory dermatoses. A case is presented of a 54-year-old man diagnosed with pyoderma gangrenosum. He completed treatment with oral prednisolone with favorable outcome, but with recurrence after glucocorticoid therapy withdrawal. Thalidomide was introduced, but after complaints of glove and sock paresthesia and hypoesthesia, the drug was discontinued. Taking into account the favorable outcome with thalidomide and the necessity of drug withdrawal, it was decided to introduce therapy acting on the same step in the inflammation cascade. In this regard, etanercept was initiated. The aim of this article is to present an alternative therapy for refractory pyoderma gangrenosum, along with a literature review.

ejd.2012.1672 Auteur(s) : Rita Venina de Amaral Pereira Guedes ritapereiraguedes@gmail.com, Nuno Miguel Noronha de Menezes, Ines Brandao Leite, Manuel Armando Baptista Dermatology Department Centro Hospitalar de Vila Nova de Gaia Rua Conceicao Fernandes 4434-502 Vila Nova de Gaia, Portugal Benign fibrous histiocytoma (BFH) is a common neoplasm diagnosed by clinical features. Dermatoscopy can be a useful tool for confirmation of a clinical suspicion [1]. However, there are some atypical lesions, [...]

O eczema atópico é uma dermatose inflamatória crónica, que atinge sobretudo crianças. Na maior parte dos casos pode ser controlado apenas com terapêutica tópica, mas numa percentagem significativa é necessário recorrer a tratamento sistémico. Os efeitos secundários associados a tratamentos sistémicos de longa duração e a insuficiente resposta terapêutica em alguns doentes têm obrigado à procura de novas alternativas terapêuticas. Descreve-se o caso clínico de uma criança com eczema atópico grave sem resposta satisfatória com a medicação instituída. Iniciou micofenolato de mofetil aos 6 anos de vida, com total resolução das lesões inflamatórias aos 5 meses de tratamento. Os resultados terapêuticos apresentados neste caso clínico levantam novas questões sobre a imunossupressão na dermite atópica e sugerem uma alternativa terapêutica promissora para casos refractários aos tratamentos clássicos. Até à data está publicado apenas um trabalho reportando o tratamento em idade pediátrica com este fármaco numa pequena série de doentes.PALAVRAS-CHAVE – Eczema Atópico; Criança; Imunossupressores; Micofenolato de Mofetil.

Erythroplasia of Queyrat is a rare in situ carcinoma of the uncircumcised man and its treatment depends on the extent and location of the lesion. We describe the case of a 68 years old patient, with clinical and histological diagnosis of Erythroplasia of Queyrat. Given the size and location of the lesion, preventing the surgical option, we performed the treatment with CO2 laser. The patient underwent a single session of laser therapy with complete resolution of the lesion. The authors aim with this paper is to remember this surgical technique in the effective treatment of Erythroplasia Queyrat. To date there are only four published studies reporting the use of CO2 laser in the treatment of this lesion. KEYWORDS – Erythroplasia; Lasers; Laser Therapy; Carbon Dioxide.

Granuloma faciale (GF) is an uncommon dermatosis with characteristic clinicopathological features. Extrafacial isolated GF is extremely rare. Pulsed dye laser (PDL) is a treatment option for GF to minimize the risk of scarring. We report a case of a 78-year-old male with an extensive GF of the scalp successfully treated with pulsed dye laser (PDL).

Pityriasis rubra pilaris (PRP) or Devergie's disease is a chronic and rare papulosquamous disorder of unknown etiology characterized by reddish orange scaly plaques, palmoplantar keratoderma, and keratotic follicular papules. The present authors report a case of a 30-year-old woman with clinical and histologic signs of PRP (type I adult onset, Griffith's classification). After a few unsuccessful treatments, the present authors chose to start etanercept. Total clearing of the lesions was achieved 5 months after starting the drug. Etanercept is a TNF-α inhibitor, and today it is largely used in the treatment of several dermatological diseases through blockage of the inflammatory cytokine. The true mechanism of action in PRP remains to be explained; however, the favorable results in our case raise new questions about TNF-α's role in PRP and suggest a therapeutic alternative for resistant cases to classic treatments. To date, there are only three case reports of PRP treated with etanercept in the literature.

Rhinophyma is a slowly progressive, benign dermatological disorder of the nose. The most widely accepted theory is that rhinophyma is the end stage of chronic rosacea. The primary reason for its excision is cosmetic deformity. Many treatment modalities have been described, including CO(2) laser. This method provides a very dry surgical field, which allows the sculpting of the hypertrophic areas. Pulsed dye laser (PDL) is a safe and effective treatment, resulting in a significant improvement in erythema, telangiectases, symptoms and quality of life. We report the case of a 63-year-old Caucasian man with a 2-year history of rapid progression rhinophyma. The patient was submitted to five CO(2) laser sessions, followed by three PDL sessions. Favourable re-epithelization of the surfaces treated with CO(2) laser was achieved within a very short period of time. PDL post-treatment purpura lasted a medium of 12 days. After 12 months of follow-up the patient remains without evidence of relapse. To our knowledge, this is the first case described of treatment using a combination of the CO(2) laser and PDL.

Smoking is currently a leading public health priority. Profiling smokers allows for adequate intervention strategies and it is important to assess smokers' motivation.To calculate the rate of smokers in 4 files from 3 Health Centres in Coimbra and characterise smokers in terms of demographics, consumption pattern, motivation for smoking cessation and co -morbidities. Investigate the relationship between motivation to stop smoking and age, gender, consumption and age at starting smoking and cardiovascular, respiratory and psychiatric co -morbidities.Descriptive study with analytical component. Accessible population: 15 -65 year old patients from 4 files from 3 Health Centres in Coimbra seen July - August 2007. Data treatment: SPSS 17.224 randomly interviewed patients, 64.3% women; mean age 44.9 years old. Rate of smokers was 17% (52.63% female). Smokers' mean age was 39.4 years old. The mean age at starting smoking was 17.2 years old (16.4 in men). Mean cigarette consumption was 17.5/day (13.3 in women). 47.4% was poorly motivated, 52.6% moderate/highly motivated. 50% of the smokers had co -morbidities. There was no association between any of these factors and smoking cessation motivation.The results are similar to other national studies. There were more younger female smokers than male, but females smoked fewer cigarettes/day. In this study the most frequent co- -morbidities were cardiovascular and psychiatric. Only half of the smokers were motivated to stop smoking.

Sumatriptan is a potent and selective 5-HT(1B) and 5-HT(1D )agonist used in the symptomatic treatment of migraine; it shows poor oral bioavailability ascribed, in part, to its low lipophilicity. In an attempt to develop acyloxymethyl prodrugs of sumatriptan suitable for oral administration, we carried out the reaction of sumatriptan with chloromethyl esters. To our surprise, acyloxymethylation occurred preferentially at the indole nitrogen rather than at sulfonamide nitrogen, reflecting a difference either in product stability or in the nucleophilicities of the indole and sulfonamide anions. The hydrolysis of the corresponding N(1)-acyloxymethyl derivatives was studied in aqueous buffers and in human plasma, by HPLC. N(1)-Acyloxymethyl derivatives of sumatriptan are rapidly hydrolysed to the chemically stable N(1)-hydroxymethylsumatriptan at pH 1-13. Slow formation of the parent drug was observed only at high pH values. Hydrolysis of sumatriptan derivatives is slower in human plasma than in phosphate buffer and also generates N(1)-hydroxymethylsumatriptan rather than the parent drug. These results indicate that N(1)-acyloxymethyl derivatives of sumatriptan cannot be considered as true prodrugs of sumatriptan.

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Ciência de Computação. O objetivo deste trabalho é propor um protocolo criptográfico para auditoria de publicidade na Web.

Dear Editor, We describe the clinical case of a 79-year-old woman, phototype I, who wanted to have removed an orange eyebrow tattoo that had been placed years previously (Fig. 1). After treating a test area, we treated the tattoo with a Q-switched Nd:YAG laser (532 nm, 3 mm beam, mean fluence 2.5 J/ cm) in a single session. The procedure was well tolerated, and healing occurred within 2 weeks. Two months later the patient was re-examined and had no visible pigment (Fig. 1). The first procedures used in the removal of tattoos were classic surgery and cryosurgery [1]. However, these were associated with permanent side effects, particularly scarring and alopecia of pilose areas. The advent of laser therapy opened new perspectives in this field. Currently available laser include Q-switched Nd:YAG, alexandrite, ruby, pulsed dye green light and carbon dioxide laser. The absorption spectra of tattoo pigments are variable with some pigments reacting differently to the various devices. As a result, a combination of laser systems can be used sequentially to remove a single polychromatic tattoo [2]. Some pigments, such as green, sky blue and yellow, are more resistant to laser treatment [1]. Laser removal of eyebrow tattoos is a challenge due to the potential for damage to follicles. For this purpose, a Qswitched Nd:YAG laser at a wavelength of 1064 nm has been used to minimize absorption by the eyebrow hair. This is an excellent choice for removing black pigment, but it produces less satisfactory results with other pigments. Usually multiple treatments are necessary (four to six for