São Paulo medical journal = Revista paulista de medicina
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Selection of healthy blood donors is essential to ensure blood safety. A confidential self-exclusion (CSE) system was designed so that high-risk donors could confidentially exclude their blood from use in transfusions. This study aimed to compare the demographic characteristics and the results from human immunodeficiency virus (HIV), hepatitis B surface (HBS) and hepatitis C virus (HCV) screening tests on donors who opted to get into and out of CSE. ⋯ Because of the higher prevalence of HBS, HCV and HIV positivity in blood donors who chose the CSE option, offering CSE to blood donors could be a potentially useful method for improving blood safety, since it could increase the detection of infected blood during the window period.
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Case Reports
Synchronous thyroid and colon metastases from epidermoid carcinoma of the lung: case report.
Non-small cell lung cancer (NSCLC) progresses to distant metastases in most cases. The most frequent sites for distant metastases are the bones, central nervous system, adrenal glands and liver. Dissemination to the skin, myocardium, thyroid gland and intestine may occur, but is rare. ⋯ We describe a case of squamous cell carcinoma in the lungs, with metastases in the colon and thyroid, in a 66-year-old female patient. The lesion was unresectable and chemotherapy was started. The patient evolved with intestinal subocclusion, and colonoscopy showed the presence of a polyp. Biopsy and immunohistochemical analysis on the polyp showed that it was compatible with squamous cell carcinoma of pulmonary origin. At a follow-up consultation, the patient presented a thyroid nodule. A aspiration biopsy and cellblock immunohistochemistry confirmed the squamous cell carcinoma of pulmonary origin. After third-line chemotherapy, the patient progressed with acute obstructive abdomen due to a retroperitoneal mass. She underwent exploratory laparotomy and died due to surgical complications. Metastases to the thyroid and colon are rarely reported in cases of epidermoid carcinoma of the lungs. Gastrointestinal involvement in pulmonary metastases may affect the stomach, small intestine and colon, and cases of bleeding and perforation have already been reported. Although richly vascularized, the thyroid is an infrequent site for metastases. Such sites reflect poor prognoses for the clinical evolution. We did not find any previous reports in the literature, on lung cancer with metastases concomitantly in the colon and thyroid, in a single patient.
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The main causes of hepatic steatosis (HS) are alcoholic liver disease and nonalcoholic fatty liver disease (NAFLD). Although liver biopsy is the gold standard for NAFLD diagnosis, the finding of abnormal aminotransferases in abstinent individuals, without known liver disease, suggests the diagnosis of NAFLD in 80-90% of the cases. Identification of clinical factors associated with HS on abdominal ultrasound may enable diagnoses of fatty liver non-invasively and cost-effectively. The aim here was to identify clinical variables associated with HS in individuals with elevated alanine aminotransferase (ALT) levels. ⋯ Simple clinical findings such as history of diabetes and high BMI may predict the presence of HS on ultrasonography in individuals with elevated ALT and negative serological tests for hepatitis.
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Many factors influence occurrences of vulvovaginitis. The aims here were to assess skin color and age-related differences in the vaginal flora and occurrences of vulvovaginitis. ⋯ There are differences in vulvovaginitis occurrence relating to skin color, which may be associated with variations in vaginal flora.
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High-resolution computed tomography (HRCT) is considered to be the best method for detailed pulmonary evaluation. The aim here was to describe a scoring system based on abnormalities identified on HRCT among premature infants, and measure the predictive validity of the score in relation to respiratory morbidity during the first year of life. ⋯ The scoring system is reproducible, easy to apply and allows HRCT comparisons among premature infants, by identifying patients with greater likelihood of respiratory morbidity during the first year of life. Its use will enable HRCT comparisons among premature infants with different risk factors for respiratory morbidity.