São Paulo medical journal = Revista paulista de medicina
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With the emergence of the acquired immunodeficiency syndrome (AIDS) in 1981, infectologists' care practices went through great changes. The objective of this study was to describe and analyze the experiences of infectologists in dealing with death and dying among their patients, over the course of the AIDS epidemic in the city of São Paulo. ⋯ This study shows the importance of considering the distress, emotional overload and adaptive mechanisms relating to death and dying among patients, both in training and in professional practice.
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Review Case Reports
Vulvar melanoma: report on eleven cases and review of the literature.
Vulvar melanoma is a rare disease. We describe the experience of a single institution and review the literature. ⋯ The prognosis for patients with vulvar melanoma is generally poor, with a high tendency towards regional and distant recurrence. Depth of invasion and lymph node involvement are the most important prognostic factors. In most cases, resection of the lesion with adequate margins may replace vulvectomy. Elective inguinal femoral lymphadenectomy remains the standard lymph node staging procedure. Sentinel lymph node investigation is feasible and should be performed by a multidisciplinary team with experience of this method.
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Review Case Reports
Squamous cell carcinoma arising from chronic lymphedema: case report and review of the literature.
Squamous cell carcinoma arising from chronic lymphedema has only been reported in the literature 11 times (12 cases). Some aspects of its pathogenesis remain unclear and, for the first time, attention has been drawn to epidemiological data. ⋯ A 90-year-old white female with chronic unilateral lower-limb lymphedema, secondary to trauma 20 years earlier, presented with a three-month history of a vegetating cutaneous lesion. There had not been any previous local ulceration. The tumor was completely excised and the histopathological analysis showed that it was an infiltrating squamous cell carcinoma. A literature review in the Medline (Medical Literature Analysis and Retrieval System Online) and Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) databases using the MeSH (Medical Subject Heading) terms "Carcinoma, Squamous Cell" AND "Lymphedema" identified 112 references and found 12 similar case reports.
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the biologic disease-modifying anti-rheumatic drugs (DMARDs) are very effective in treating rheumatoid arthritis (RA), however there is a lack of head-to-head comparison studies. ⋯ based upon indirect comparisons, anakinra seemed less efficacious than etanercept, adalimumab and rituximab and etanercept seemed to cause fewer withdrawals due to adverse events than adalimumab, anakinra and infliximab. Significant heterogeneity in characteristics of trial populations imply that these finding must be interpreted.