RESUMEN

BACKGROUND: Burkitt lymphoma rarely affects the central nervous system and ocular region. Under these conditions, computed tomography and (particularly) magnetic resonance imaging of the skull increase the diagnostic accuracy, as they objectively show the topography of lesions and the effect of neoplasia on structures. CASE REPORT: We report here the case of a 17-year-old male whose initial clinical manifestations were related to neurological impairment and to the ocular musculature and ocular innervation. The diagnosis of Burkitt lymphoma with leukemization and infiltration of the central nervous system was confirmed. CONCLUSIONS: In this case, it is important to recognize that the neuroimaging findings were fundamentally important in indicating the initial form of the disease and in directing the appropriate clinical management.

Asunto(s)

RESUMEN

Overgrowth syndromes comprise a heterogeneous group of diseases that are characterized by excessive tissue development. Some of these syndromes may be associated with dysfunction in the receptor tyrosine kinase (RTK)/PI3K/AKT pathway, which results in an increased expression of the insulin receptor. In the current review, four overgrowth syndromes were characterized (Proteus syndrome, Klippel-Trenaunay-Weber syndrome, Madelung's disease, and neurofibromatosis type I) and illustrated using cases from our institution. Because these syndromes have overlapping clinical manifestations and have no established genetic tests for their diagnosis, radiological methods are important contributors to the diagnosis of many of these syndromes. The correlation of genetic discoveries and molecular pathways that may contribute to the phenotypic expression is also of interest, as this may lead to potential therapeutic interventions.

RESUMEN

FUNDAMENTO: A redução da mortalidade por doenças cardiovasculares é observada no Brasil há anos, atribuída à queda nos fatores de risco, melhora na terapêutica e diminuição da mortalidade hospitalar. OBJETIVO: Comparar a mortalidade populacional, o coeficiente de internação e a mortalidade hospitalar em unidades do Sistema Único de Saúde, para doença isquêmica do coração (DIC), doenças cerebrovasculares (DCBV) e insuficiência cardíaca (IC), no município de Niterói, entre 1998 e 2007. MÉTODOS: Foram utilizados o número de óbitos e o de internações e mortalidade hospitalar de residentes em Niterói para o capítulo IX do CID10 e causas específicas disponíveis no Datasus, na população de 30 anos e mais. A diferença entre a magnitude dos indicadores foi calculada para homens e mulheres considerando a média do primeiro triênio menos a média do segundo triênio. RESULTADOS: Houve queda dos coeficientes de mortalidade populacional em homens e mulheres, para todas as faixas etárias, nos três grupos de causas e para o capítulo IX. A tendência à queda dos coeficientes diminuiu com a idade. Para DIC houve queda na mortalidade hospitalar. Para DCBV e IC, aumento. Os coeficientes de internação hospitalar por DIC diminuíram, com exceção de algumas faixas. CONCLUSÃO: O presente estudo permitiu esclarecer alguns aspectos da morbimortalidade cardiovascular em Niterói. A redução da mortalidade populacional e hospitalar por DIC indica haver melhor qualidade na abordagem dessa condição. O aumento da mortalidade hospitalar por DCBV e IC aponta para a necessidade de se dar maior atenção à qualidade do cuidado hospitalar para esses grupos de doenças.

BACKGROUND: The reduction in mortality from cardiovascular disease has been observed in Brazil for years, attributed to a fall in risk factors, improved treatment and reduced hospital mortality. OBJECTIVE: To compare the mortality, the rate of hospitalization and hospital mortality in hospitals belonging to the Brazilian Public Health System, for ischemic heart disease (IHD), cerebrovascular diseases (CVD) and heart failure (HF), in Niterói, between 1998 and 2007. METHODS: We used the number of deaths and hospitalizations and mortality of residents in Niterói for Chapter IX of ICD10 and specific causes available in Datasus, in population aged 30 and older. The difference between the magnitude of the indicators was calculated for men and women taking the average of the first three year period less the average of the second three year period. RESULTS: There was drop in population mortality rates in men and women for all age groups, in three groups of causes and for Chapter IX. The falling trend of rates decreased with age. For IHD there was a decrease in hospital mortality. For CVD and HF, there was an increase. The rates of hospitalization from IHD decreased, with exception of some ranges. CONCLUSION: This study has clarified some aspects of cardiovascular morbidity and mortality in Niterói. The reduction in population and hospital mortality from IHD indicates that there is a better approach in this condition. Increased mortality rate from cerebrovascular diseases and HF points to the need to give greater attention to the quality of hospital care for these groups of diseases.

FUNDAMENTO: La reducción de la mortalidad por enfermedades cardiovasculares se viene observando en Brasil desde hace años, se la asigna a un descenso en los factores de riesgo, a una mejora en el tratamiento y a una mortalidad hospitalaria reducida. OBJETIVO: Para comparar la mortalidad poblacional, el coeficiente de hospitalización y la mortalidad hospitalaria en unidades del Sistema Único de Salud, para la enfermedad cardíaca isquémica (ECI), enfermedades cerebrovasculares (ECV) e insuficiencia cardiaca (IC), en la ciudad de Niterói, entre 1998 y 2007. MÉTODOS: Se utilizó el número de muertes y el de las hospitalizaciones y la mortalidad hospitalaria de residentes en Niterói en el capítulo IX de CID10 y causas específicas disponibles en el Datasus, en la población de 30 años y más. La diferencia entre la magnitud de los indicadores se calculó para los hombres y mujeres tomando en consideración el promedio del primer trienio menos el promedio del segundo trienio. RESULTADOS: Hubo un descenso de los coeficientes de mortalidad poblacional en hombres y mujeres, para todos los grupos de edad, en tres grupos de causas y para el capítulo IX. La tendencia al descenso de los coeficientes ha disminuido de conformidad con la edad. Para EIC se registró una disminución de la mortalidad hospitalaria. Para ECV y IC se registró un aumento. Los coeficientes de hospitalización por EIC han disminuido, con la excepción de algunos grupos. CONCLUSIÓN: El presente estudio ha permitido aclarar algunos aspectos de la morbilidad y mortalidad cardiovascular en Niterói. La reducción de la mortalidad poblacional y hospitalaria por EIC indica que hay un mejor enfoque en esta condición. El incremento de la mortalidad hospitalaria por ECV e IC apunta a la necesidad de prestar mayor atención a la calidad del cuidado hospitalario para estos grupos de enfermedades.

Asunto(s)

RESUMEN

BACKGROUND: The reduction in mortality from cardiovascular disease has been observed in Brazil for years, attributed to a fall in risk factors, improved treatment and reduced hospital mortality. OBJECTIVE: To compare the mortality, the rate of hospitalization and hospital mortality in hospitals belonging to the Brazilian Public Health System, for ischemic heart disease (IHD), cerebrovascular diseases (CVD) and heart failure (HF), in Niterói, between 1998 and 2007. METHODS: We used the number of deaths and hospitalizations and mortality of residents in Niterói for Chapter IX of ICD10 and specific causes available in Datasus, in population aged 30 and older. The difference between the magnitude of the indicators was calculated for men and women taking the average of the first three year period less the average of the second three year period. RESULTS: There was drop in population mortality rates in men and women for all age groups, in three groups of causes and for Chapter IX. The falling trend of rates decreased with age. For IHD there was a decrease in hospital mortality. For CVD and HF, there was an increase. The rates of hospitalization from IHD decreased, with exception of some ranges. CONCLUSION: This study has clarified some aspects of cardiovascular morbidity and mortality in Niterói. The reduction in population and hospital mortality from IHD indicates that there is a better approach in this condition. Increased mortality rate from cerebrovascular diseases and HF points to the need to give greater attention to the quality of hospital care for these groups of diseases.

Asunto(s)