Investor Presentaiton

IJMS INTERNATIONAL JOURNAL of MEDICAL STUDENTS XXI COMAPI Abstracts Abstracts nomegaly, recurrent bacterial infection and other symptoms. It is an important zoonosis and if not treated, it has high rate mortality. The protozoon found in Brazil, which causes the disease is the Leishma- nia chagasi and the predominant vector is Lutzomyia longipalpis, also known as birigui or straw mosquito. In urban area, the dog is the main source of infection and in the wild; foxes and marsupials replace it as the source. Piauí was the State with the highest rate of VL incidence of the Northeast Region in 2012. Objectives: The objecti- ve is the LD incidence rate analysis in Piauí during the period of 2008 at 2012, by gender and age. Methods: It is a descriptive study elabo- rated with the information analysis recorded in the Morbid Indicators data bank, which is available on the Department of Health System (DATASUS) of the Health Ministry. The incidence taxes of Leishman's Disease (cases/100.000 habitants) were analyzed on State of Piauí during 2008 until 2012, by gender and age. For the analysis exposi- tion were made graphics and tables on Microsoft Office Excel with the LD incidence rates. Also were made searches in Online Databa- ses: Scielo, Medline and PubMed for article selection between 2008 until 2014. The key words used were: "visceral" and "leishmaniasis". Results: In 2010, Piauí presented the lowest incidence rate (4, 78) of all Northeast States during the analysis period, but, in the following year it presented the highest rate (6, 37) on the period in analysis. The age lower than 1 year was the most committed of both genders and it had the highest rate (48,73) in 2011 and the lowest (27,28) in 2009. The least affected age was between 10 to 19 years for men and 40 to 59 years for women. Conclusion: The State of Piauí was high. incidence taxes of Leishman's disease, specially, for an age below 1 year and to the masculine gender. The vector control through the use of residual insecticides, detection and elimination of reservoirs plus active and passive detection of LD are of fundamental importance for disease control. 29 Intestinal Obstruction By Ovarian Malign Neoplasm: A Diag- nostic Approach Pablo Alberto Nolêto De Freitas; Francisco Mateus Alves De Morais Ferreira; João Paulo Araújo Alves Silva; Amanda Silva De Carli; Luiz Antônio De Alencar; Helder Do Espírito Santo França. Introduction: The ovarian cancer is the most lethal gynecological di- sease. A major cause for this is the asymptomatic evolution in the initials stages (I e II), which causes a late diagnostic in the advanced stages (III e IV). Therefore, the prognostic in this cases are, in ge- neral, negative, which is related a neoplasic dissemination in pelvic and peritoneal structures. Case report: Patient MRS, 47 years old, complains of abdominal pain and constipation. The patient informed that the pains start about twenty days, after flu. Besides, she was affected menorrhagia in the past month and hipomenorrhea in cu- rrent cicle. In the physical examination, she showed an abdominal distension and rigidity and complains of a burning pain in the area. The total abdominal ultrasonography showed a heterogeneous and complex collection in the pelvic area. Without a sure diagnostic, was made an exploratory laparotomy, which detected a multi septated ovarian cyst in the right. In the surgery, was found dissemination in others pelvic and abdominal structures, the cyst and omentum was excised and take to the histopatological exam, what show a peritoneal pseudomixom. The treatments of ovarian neoplasm are basically surgical, which might need of chemotherapy intervention, according the tumor stage. The case report shows rare because the intestinal obstruction causes by the cyst, what can confuses for others obstructions causes, like volvulus, adhesions and intussus- ceptions. However, this case is compatible with recent studies in which the ovarian cancer might be early diagnostic using key signals like abdominal pain and swelling. Despite the report case is about mucinous ovarian carcinoma, associate small lesions restricted to the ovarian, was found peritoneal pseudomixom. The wide heteroge- neity of histological subtypes, allied to clinical aspects and prognos- tics of which one them is a challenge for one clear diagnostic and treatment of ovarian cancer. 30 Invasive Aspergillosis Involving Brain In A Sus Patient: Case Report In A Patient With Diabetes And Leprosy Walber Emanuel Da Cruz Fontes; Almir José Guimarães Gou- veia; Carlos Alberto Rosado Da Silva Filho; Vicktor Bruno Pereira Pinto; João Batista Alvez Segundo; Maria Do Desterro Soares Brandão Nascimento. Introduction: Cerebral Aspergillosis (AC) is a rare disease and poor prognosis even with the use of antifungal agents. This infection of the central nervous system is usually a complication of invasive aspergillosis with blood spread pulmonary focal points mostly in the immunosuppressed. Clinical and laboratory diagnosis of AC is extre- mely complex and has very high mortality, even in cases diagnosed and treated appropriately. Thus, it is salutary an early and accurate diagnosis, given that can save countless lives. Case report: GMP, male, diabetic, leprosy, six months before seeking the health service complaining of headache, started having seizures being transferred to a neurologist who initiated anticonvulsants. After 3 months now presented confusion and was admitted to the Hospital San Marcos. Chest radiography showed pleural thickening with obliteration of the left costo-phrenic sinus; computed tomography (CT) and magnetic resonance imaging (MRI) of the brain showed infarction right cere- bral hemisphere, with luxury hyperemia, for carotid artery thrombo- sis and expansive sphenoid process with cavernous sinus invasion, basic meninges and hydrocephalus. After one month, underwent transsphenoidal biopsy whose pathological result showed inten- se inflammatory process Aspergillus spp. Antifungal (amphotericin B) was used for treatment, but there was worsening of symptoms lowering level of consciousness after intensification of convulsive seizures and vomiting. Submitted to the new neurosurgery, with implantation of subcutaneous Rickmann-Ommaya reservoir with in- traventricular catheter and collected ventricular CSF whose culture was negative. The CT scan showed infarction of the right cerebral hemisphere, catheter into the right lateral ventricle and reduction of hydrocephalus. Taken up antifungal treatment with 5 mg in the reservoir alteranados days. Progressively improved and absence sei- zures using specific. Conclusion: The definitive diagnosis of cerebral aspergillosis should not delay the treatment, which on a reasonable suspicion must be booted. The development of new diagnostic and therapeutic approaches (intraventricular injections of amphotericin B), facilitate to identify which patients are predisposed to diseases associated with aspergillosis. Aspergillosis of the CNS in immuno- compromised patients have a poor prognosis. 31 Investigation of Antiulcerogenic Effect Of The Oil - Resin Co- paifera Multijuga On Chronic Gastric Ulcers Induced By Acetic Acid In Rats Milena Braga Soares Da Silva; James Frederico Rocha Pache- co; Osyanne Timóteo De Sousa; Manoel Dias De Souza Filho, Maria Do Carmo De Carvalho E Martins. Introduction: Gastric ulcer is one of the most common gastrointes- tinal diseases, having a great importance for the costs related to the treatment of its symptoms and complications. The oleoresin of Copaifera multijuga Hayne is widely used in folk medicine as anti -inflammatory, antineoplastic, antiseptic and healing. Objective: To evaluate possible healing action of the oleoresin Copaifera multijuga Hayne in Rattus norvegicus. Methods: Adult male rats were randomly divided into four groups of 5 to 7 animals treated for seven days from the second day after the induction of gastric ulcer by oral adminis- tration, of 1% Tween80 (0.5 ml / 100 g - control) omeprazole 40 mg / kg and oleoresin of Copaifera multijuga Haynes 100 mg / kg (cop100 ) and 200 mg/kg (cop200). The induction of gastric ulcer was per- formed under anesthesia ip with Ketamine 40 mg / kg and xylazine 5 mg/kg by topical application to the stomach serosa of 500 ul 80% acetic acid for 1 minute. At the end of treatment, euthanasia of all animals was performed by administration of an overdose of sodium pentobarbital (100 mg / kg) and their stomachs were removed and opened by the lesser curve to determine the amount of ulcerative lesions (VLU). The lesions were measured considering length, width and depth, whose product is expressed in mm3. Statistical analysis was performed using ANOVA followed by Tukey post-test. This study was approved by the Ethics Committee on Animal experimentation of UFPI (No. 85/2010). Results: No statistically significant differences (p > 0.05) were found in the ulcer lesion volume between groups (control 26.09 ± 3.80; cop100 36.99 ± 7.96; cop200 19.97 ± 7.19; omeprazole 26.69 ± 12.19). The lack of volume reduction of the ul- cers in groups C100 and C200 observed here is discordant with other studies of experimental models using species of the genus Copaife- ra. CONCLUSION: The oil resin Copaifera multijuga Hayne at doses of 100 and 200 mg / kg showed no healing effect in an experimental model of chronic gastric ulcer induced by acetic acid. 32 Juvenile Systemic Lupus Erythematosus: A Study of 31 Cases Vítor Assunção Da Ponte Lopes; Catarina Fernandes Pires; Roberta Oriana Assunção Lopes De Sousa; Suelen Vieira Ri- beiro. Introduction: Juvenile systemic lupus erythematosus is an autoim- mune, with clinical manifestations chronic inflammatory disease. It is rare in childhood, and there is little research in order to investi- gate this disease in Brazil. Objectives: To identify the most common epidemiological, clinical and laboratory characteristics in disease in patients treated at Hospital Infantil Lucídio Portella, Teresina - PI between January 2008 and September 2013. Methodology: This study was descriptive and retrospective. Data were collected from medical records, registered in a file and processed with the SPSS 13.0. Re- sults: 31 charts were analyzed, there was a predominance of females (90.3%) and the majority coming from the interior of Piauí (38.7%). The average age of diagnosis was 126 months (10.5 years) and disea- se duration ranged between 1 and 84 months, with a median of 12 months. The clinical features in descending order of frequency were: fever (90.3%), arthritis (80.6%), malar rash (58.1%) and weight loss (41.9%). Among laboratory abnormalities, pathological casts was the most frequent (67.7%), followed by leukopenia and lymphopenia co- rresponding to approximately 55% and 42% respectively. Antinuclear antibodies was positive in all cases and the main autoantibodies were found anti-DNA (50%) and anti-Sm (27.6%). Conclusion: fever, arthritis, malar rash and pathological casts showed high frequency in the study, followed by leukopenia and lymphopenia. Antinuclear antibodies were positive in all cases and the major autoantibody were found anti-DNA and anti-Sm. The results obtained in this series are for the most part according to the literature studied. 33 Mediastinitis In Patients Undergoing To Coronary Artery Bypass Grafting In A Reference Hospital In Piauí Tiêgo Rodrigues De Oliveira Pires; Caio Bruno De Sousa Ba- rros; Rômulo Ferreira Rocha; Rodrigo Torres Da Costa; Edemir Veras De Carvalho Júnior; Luiz Evaldo De Moura Pádua. Introduction: One of the major risks of Coronary artery bypass graf- ting surgery (CABG) in postoperative period is the mediastinitis. Its prevalence varies between 0.4 and 5%, and it is increased by the presence of pre-existing conditions and other factors such as: obe- sity; diabetes mellitus (DM); CABG using both internal thoracic arte- ries (ITAS); long period of mechanical ventilation; chronic obstructive pulmonary disease (COPD); smoking; long period of preoperative hospitalization; among others. This study aims to establish rela- tionships between factors that may trigger mediastinitis in patients undergoing to CABG. Objectives: Establish relationships between risk factors and mediastinitis in patients undergoing to CABG in reference hospital of Piauí. Methods: Retrospective study from medical records of 303 patients who underwent to CABG between the years 2009 and 2013, obtaining: the number and degree of infection of sternotomy; coronary artery bypass grafting using both internal thoracic arteries (skeletonized without compromising venous drainage by the internal thoracic veins); DM; chronic obstructive pulmonary disease (COPD). The observations were analyzed using the Spearman's correlation test (rs) with p-value <0.05 for significance. The project was approved by the Research Ethics Committee of the São Marcos Hospital (Case No. 513 488 of 02/11/14). Results: The double mammary artery was used in 47.8% of patients. DM and COPD, were recorded in 38.6% and 7.3% of patients, respectively. No correlations with such risk fac- tors were found. Of 303 patients who underwent to CABG during the studied period, only 2 (0.66%) developed mediastinitis. Both were reoperated for cleaning the mediastinum and were discharged in good condition. Superficial sternal infections were observed in 4.6% of patients and were treated with antibiotic therapy, with complete resolution of the condition. It is suggested, on the basis of the- se data, the use of skeletonized double mammary arteries has no negative impact on the development of mediastinitis. Conclusion: Although the literature is emphatic in linking the use of double ITAS, DM and COPD with mediastinitis, it has not been proved in this refe- rence hospital studied. Keywords: Sternotomy, DM, COPD, internal thoracic artery. 34 Morel-Lavellée: A Case Report Luis Eduardo De Oliveira Lima; Antonio José Silva Meneses Filho; Anderson Batista Rodrigues; José Osvaldo Gomes Dos Santos; Marcelo Barbosa Ribeiro; Lina Gomes Dos Santos. Background: Morel-lavellée lesion is a traumatic separation between the skin and the subcutaneous tissue adjacent to fascia causing rup- ture of small blood vessels, resulting in a cavity which can be filled with blood, lymph or fat, sometimes necrotic and/or colonized with infectious agents. Usually, there is a formation of granulation tissue which can be organized in a pseudocapsule, causing the persistence of collections. Lesions can be painful or asymptomatic, most often affecting the lateral thigh, involving the greater trochanter. The diag- nosis is usually based on physical examination, when is possible to observe a greater mobility of the skin, subcutaneous fluctuation and decreased local sensitivity. MRI is the imaging test of choice on the evaluation of these lesions. The treatment is still controversial, but methods of aspiration, injection of sclerosing agents are used, as well as open or closed surgical drainage with debridement in the presence of fat and/or hematoma. Case report: Male patient, 43 years, refers appearance of nodulation on the lateral side of the right thigh for four years. He complains of severe pain in the progressive site, with difficulty in performing his usual activities. He presents a history of trauma in the right hip by a motorcycle accident eight years ago, when it underwent neurosurgery for head trauma. Phy- sical examination and MRI showed that it was a nodular lesion in the subcutaneous tissue of the thigh, indicative of Morel-Lavellée in- jury. Surgical procedure was performed and the macroscopic stu- dy of the specimen showed a nodular tissue formation measuring 13.5 x 8.7 x 3.5cm, whose histological study showed fibrous cyst wall filled by organized hematoma, xanthomatous histiocytes and cholesterol crystals, consistent with the diagnosis of Morel-Lavellée lesion. Conclusion: Morel-lavellée lesion was first described by the French physician Maurice Morel-Lavallée in 1853, affecting the hip and pelvis. It is hardly diagnosed in the first clinical evaluation and it has a high risk of infection, which was not observed in the case reported here. Exams can simulate a malignant neoplasm clinically and radiologically. Having diagnostic suspicion of this injury, the he- matoma should be drained and necrotic material debrided, because this injury may complicate with secondary infection. There are some controversies regarding the recommended definitive therapeutic ap- proach, however, in this case we opted for open surgical drainage, evolving without signs of infection two months after the diagnosis of this rare entity. 35 Mortality Of Diabetes Mellitus: Epidemiological Profile Rienny De Sousa E Silva; Rielly De Sousa E Silva; Lorayne De Araujo Costa Pereira; Antônio Guilherme Chagas Feitosa; Cíntia Maria De Melo Mendes. Introduction: Diabetes Mellitus (DM) is a metabolic disease charac- terized by hyperglycemia resulting from defects in insulin secretion and/or reduction of local tissue response. It can be classified into type I, autoimmune process; and type II, based on the interaction between hormonal resistance and insufficient secretory response. Chronic hyperglycemia favors the emergence of damages: retino- pathy, nephropathy, peripheral neuropathy, cardiovascular disease and dyslipidemia. According to the CDC, it was the 7th leading cause of death in the USA in 2010, however, it may be underreported as a cause of death. Objective: To evaluate the specific mortality rate of DM (SMR) according to age, sex and region of Brazil, between S48 INTERNATIONAL JOURNAL of MEDICAL STUDENTS www.ijms.info • 2015 Vol 3 Suppl 1 www.ijms.info . 2015 Vol 3 Suppl 1 INTERNATIONAL JOURNAL of MEDICAL STUDENTS XXI COMAPI S49