Investor Presentaiton
IJMS
INTERNATIONAL JOURNAL of
MEDICAL STUDENTS
XXI COMAPI
S44
Abstracts
Abstracts
medical records of patients who underwent to CABG during were
analyzed during the study period. From these, 231 patients (76.2%)
were operated by the public health system (SUS and PLAMTA). The
rest (23.8%), the several private pension plans health. The EuroSCO-
RE was homogeneous in both groups (p = 0.85). Of total procedures,
20 had death outcome: 3 emergently, 2 in urgent and 15 elective.
Death Outcomes in public systems were 15 (75%) and private it were
5 (25%). The Chi-Squared test (c2) showed no difference between
public and private (p = 0.89) systems. The age and gender did not
reveal associations (p = 0.39) and (p = 0.68), respectively. Conclu-
sion: In reference hospital studied, there was no significant differen-
ce between the mortality after CABG in patients operated by public
and private health system, framing up the service on the principle of
quality and equality of service between them.
Keywords: CABG mortality, Public Health System.
15
Distal Epithelioid Sarcoma
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: Epithelioid sarcoma is an extremely rare subtype of soft
tissue sarcoma, showing atypical clinical outcome when compared to
other types of sarcomas. May be present in any anatomical region,
preferentially affecting end of the upper limbs and rarely the head
and neck, predominantly affecting young males, and rarely affect
other sites as perineum, penis and vulva. Most of these tumors are
presented as a palpable mass in the subcutaneous tissue. The high
rate of metastasis to regional lymph nodes cause tumor resection or
even amputation the therapeutic procedures adopted in most cases.
We report one such rare case of epithelioid sarcoma of soft tissues
in the thenar region of the left hand. Case report: Male patient, 11
years, looked for health service due to a large tumor in his left hand,
with slow and progressive growth and clearance of sanguinolent se-
cretion about 1 year ago. He refers itchy and local pain at night and
nocturnal dry cough two weeks ago. He underwent partial surgical
resection of the lesion 2 months ago without pathological study,
and local recurrence of the injury. The patient underwent incisional
biopsy which showed that it was high-grade epithelioid sarcoma.
Radiographs of the chest showed multiple pulmonary nodules of
varying sizes, not calcified distributed randomly throughout the pul-
monary parenchyma bilaterally, and left axillary lymphadenopathy
suggestive of metastatic disease. He started chemotherapy with mi-
nimal tumor regression. Despite the presence of lung metastases,
palliative amputation of his left hand was indicated. The surgical
specimen showed extensive vegetating and ulcerated tumor located
in the palmar face, thenar region of the right hand measuring 6.0 x
4.5 x 5.0cm, whose histological study showed neoplasm composed
of atypical proliferation of epithelioid cells arranged in short bundles
and organoid arrangements. The tumor cells were positive for AE1/
AE3, EMA, and CD34, confirming the diagnosis of distal epithelioid
sarcoma. Four months after resection of the lesion, the patient keeps
no signs of local recurrence of the tumor. Conclusion: Epithelioid sar-
coma accounts for a minority of all subtypes of soft tissue sarcoma
and displays histological pattern both epithelial and mesenchymal. It
has a high rate of local recurrence after resection and has a tendency
to metastasize to regional lymph nodes and lungs, which have been
reported in about 40 to 50% of cases. The recommended therapeutic
approach should be to wide surgical resection with adequate mar-
gins, or even amputation may be used in some advanced cases,
when there are morphological and immunohistochemical diagnostic
confirmation, which occurred in the case reported here.
16
Early Onset Of Schizophrenia
Clara Maria Barbosa; Máximo Peixoto Rocha Neto; Adriana
Maria Lima Lustosa; Daianny Macedo De Sousa Rego; Raissa
Fontenele Belchior Cabral; Krieger Rhelyni De Sousa Olinda.
Introduction: Schizophrenia is a psychotic disorder that has preva-
lence between 0.5% and 1.5%, with incidence from 0.5 to 5 cases per
10,000 inhabitants. The onset before age 10 or after age 60 is extre-
mely rare. The onset before age 17-18 characterizes the early onset
schizophrenia and before age 13 the very early onset schizophrenia,
and 0.1% to 1% of cases of schizophrenia begins before age 10.
The diagnosis is made by the presence and duration of symptoms:
delusions, hallucinations, disorganized speech or behavior, negative
symptoms (affective flattening, alogia, avolition); associated to social
/ occupational dysfunction. The objective of this paper is to describe
a case of very early onset schizophrenia, extremely rare situation.
Case report: Patient 20 year old female with prior learning difficulty,
presented the 10-year framework of social withdrawal, disorganized
speech, food refusal, unmotivated laughter, hygiene under encou-
ragement and mutism associated to walking difficulty. Gradually
returned to communicate and ambulate after 5 years and 1 year res-
pectively. In 2013, she was admitted for the first time in a psychia-
tric hospital, having her second hospitalization in 2014, presenting
heteroaggressiveness, impulsiveness, irritability, social withdrawal,
disorganized behavior, actions of breaking everything, various delu-
sions and cenesthesic and visual hallucinations. After treatment with
chlorpromazine, risperidone, promethazine, diazepam, valproic acid,
olanzapine, clozapine and clonazepam, suspended or reduced as ne-
eded, she showed no aggression, and behavioral improvements and
in executive functions. She kept intolerance to frustration, unmo-
tivated laughter, euphoria and affective incongruity, delusions and
hallucinations. She was discharged after 122 days of hospitalization.
Final thoughts: This paper presents a very rare case, the onset of
schizophrenia before age 10 very early onset schizophrenia - (0.1
to 1% of cases of schizophrenia). The onset of schizophrenia in chil-
dhood is severe, most likely to: poor premorbid adjustment, lower
educational performance, structural brain abnormalities, cognitive
impairment, relatives with schizophrenia and refractory treatment.
17
Effect of Feed Enriched With Almond Coconut Babassu On
Lipid Profile In Experimental Obesity
Milena Braga Soares Da Silva; Ana Larisse Gondim Barbosa;
Maria Clara Chaves; Mariana Soares Ferreira; Lara Arrais Cha-
ves Cronemberger; Maria Do Carmo De Carvalho E Martins.
Introduction: Excess body fat, especially abdominal fat, is closely
linked to dyslipidemia .Dietary lipids are an important way to affect
the lipoprotein metabolism, wherein the polyunsaturated fatty acids
may reduce hepatic production of VLDL, the precursor to LDL, and
cholesterol influence. Approximately 85 % of almond oil comprises
babassu nut saturated fatty acids being lauric main ( 44-46 %), sa-
turated fatty acid which is an exception with respect to deleterious
effects by being easily oxidized. Objective: To evaluate the effects
of consumption of babassu coconut almond on the lipid profile in
experimental obesity model. Methods: Obesity was induced by neo-
natal administration of monosodium glutamate sodium ( 4 mg/g)
in rats, males and females. In three months, groups of 5-7 animals
were treated with standard chow (control) or chow plus 10 % of
babassu coconut almond (rubs). After 30 days of treatment, blood
samples were obtained To determine the serum concentration ( mg
/dL) triglyceride, total cholesterol and fractions. Statistical analysis
was performed using ANOVA and Tukey test. This study was appro-
ved by the Ethics Committee on Animal Use of the University Center
UNINOVAFAPI (No. 0002/13). Results: The levels of HDL cholesterol
were significantly higher (p < 0.001) in Babaçu (37.74 ± 0.92) com-
pared to the control group (27.40 ± 1.66). There was no significant
difference between groups with respect to total cholesterol (control
87.6 ± 4.9, 119.6 ± rubs = 25.49) and LDL cholesterol (control =
46.96 ± 5.03; rubs=74,31+25,28). The Babassu (367.2+114.6) group had
significantly higher triglycerides (p<0.05) compared to control (66.2 ±
12.97) group. Conclusion: Supplementation with almond babassu in
obese animals, the quantity supplied, improved HDL levels. However,
also caused large increases in triglycerides.
18
Electrical storm: recurrent ventricular tachycardia in patient
with structural heart disease and implantable cardioverter-
defibrillator (ICD) in the treatment of pulmonary tuberculosis
with rifampicin and isoniazid.
Igor Ramon De Melo Batista; Fernando Teixeira De Morais
Freire; Carlos Eduardo Batista De Lima.
Introduction: Electrical storm is defined as three or more episodes
of ventricular tachycardia (VT), ventricular fibrillation (VF) or shock
therapy with implantable cardioverter defibrillator (ICD) in 24h. There
is no description in the literature of occurrence of severe ventricular
arrhythmia associated with the use of rifampicin or isoniazid. Case
report: ACCA, male, 64 years old with a congenital heart disease
with anomalous origin of the right coronary artery and persistent left
superior vena cava with idiopathic ventricular dilatation. 3 years ago
underwent implantation of an implantable cardioverter defibrillator
(ICD) due to spontaneous VT with hemodynamic instability. In daily
use of 400 mg of amiodarone, had no recurrence of arrhythmias.
In the past year showed poor general condition with weight loss
(weight loss of 62 to 45 kg) and lung nodules. After further investiga-
tion, the pacient was diagnosed with pulmonary tuberculosis. In the
first 2 months of conventional treatment, he presented weakness
and paresthesia in the legs. Amiodarone was suspended due to a
possibility of secondary peripheral neuropathy. In the third month of
treatment, the therapy for tuberculosis was ajusted to isoniazid and
rifampicin in normal doses. The patient developed recurrent episo-
des of VT with repeated ICD shock therapies despite antiarrhythmic
therapy optimization with amiodarone 800 mg daily in combination
or not with venous lidocaine and hidantal, and evolved with periods
of improvement and recurrences. In the last week of the treatment
for tuberculosis, the pacient presented electrical storm with over
15 TV episodes receiving repeated shock therapy of CDI. We chose
to optimize treatment with intravenous amiodarone, propafenone,
and suspension of drugs for tuberculosis treatment. In addition, the
patient underwent catheter ablation of TV uneventful, though of du-
bious success due to different morphologies of ventricular ectopic
beats evidenced in the exam. Improved clinically, with no recurren-
ces of TV since then. Final considerations: The temporal relationship
established by the begin and end of the electrical storm with the du-
ration of treatment for tuberculosis suggests a possible arrhythmo-
genic activity of this therapy in patients with individual risk factors
for ventricular arrhythmias. It is also important to question the role
of ablation and the association with propafenone, which are effective
therapies in these cases, as possible improvement factors isolated
or in combination.
19
Epidemiological Profile Of Patients Diagnosed With Leprosy,
In Piaui, 2004 TO 2014
Rayra Gomes Ribeiro; Amanda Tauana Oliveira E Silva; Cibele
Carina Souza Silva; Monah Ilka Feitosa Ferreira; Ânderson
Batista Rodrigues; Lauro Lourival Lopes Soares Filho.
Introduction: Leprosy, a chronic infectious disease caused by Myco-
bacterium leprae, primarily affects the skin, but also eyes, peripheral
nerves and, incidentally, other organs. Transmitted by saliva droplets
of contaminated patient, presenting four different clinical forms.
Objectives: To describe and analyze the epidemiological profile of
patients with leprosy in Piaui. Methods: A descriptive, retrospective
study, quantitative analysis of data from January 2004 to May 2014,
in the State of Piaui, of reported cases of leprosy. The epidemiologi-
cal survey was done through the Communicable Disease Information
System (CDIS). Data were analyzed using Microsoft Excel 2010. Re-
sults: 21100 cases have been reported in Piaui in the period analy-
zed. Regarding gender, there was a predominance of males (59.4% of
cases). As for the operating class, the paucibacillary was diagnosed
in 11 816 (56%) cases, Multibacillary in 9251 (43.8%) and was ignored
in 33 (0.2%). The smear was positive in 1991 (9.4%) cases, negative
in 1878 (8.9%), not held in 4522 (21.4%), ignored in 3226 (15.3%)
and not reported in 9483 (44.5%). Regarding clinical form, the Inde-
terminate was diagnosed in 4743 (22.5%) cases, Tuberculoid in 3552
(16.8%), borderline in 7402 (35.1%), Lepromatous in 2987 (14 2%),
unclassified in 1775 (8.4%), ignored in 6 (0.03%) and not reported in
635 (3%) cases. Regarding the number of lesions, there 927 (4.4%)
patients with no lesion 17632 (83.6%) up to 10 lesions, 1612 (7.6%)
with 10 to 20 injuries, 238 (1.1%) with 20 to 30 lesions, 84 (0.4%) with
30 to 40 injuries, 149 (0.7%) more than 40 lesions, and 457 (2.2%)
patients without such a specification. Regarding the assessment of
the physical, 15014 disability (71.2%) cases showed zero degree of
disability, 3562 (16.9%) grade 1, 1040 (4.9%) grade II, 1132 (5.4%) not
assessed and 352 (1.6%) not reported. Regarding the type of output,
healing corresponded to 16 546 (78.4%) cases; transfer to another
unit of the same municipality, 284 (1.3%); to another municipality,
540 (2.6%); to another state, 341 (1.6%), and to another country
to 15 (0.07%), death accounted for 211 (1%) cases abandonment
of treatment, 754 (3.6%), the error of diagnosis, 353 (1.8%), was
ignored in 450 (2.1%) and was not notified in 1606 (7.6%). Conclu-
sion: After analysis, it was perceived prevalence of leprosy in males,
paucibacillary and diforma with low degree of physical disability. In
addition, there were errors in filling data and underreporting.
20
Epidemiological Profile Of The Incidence of Aids In Children.
In Teresina-Pi
Lorayne De Araujo Costa Pereira; Antonio Guilherme Chagas
Silva Feitosa; Luiz Euripedes Almondes Santana Lemos;
Rienny De Sousa E Silva; Máximo Peixoto Rocha Neto; Cintia
Maria De Melo Mendes.
Introduction: AIDS is classified as a sexually transmissible disease
that has spread widely around the world since the 1980s, affecting
all the socioeconomic classes, genders and ages. HIV attacks the im-
mune cells of the body, depressing the immune system and making
its carriers more susceptible to infections. The vertical transmission
is the main route of children infection, hence the importance of con-
ducting a safe medical monitoring of pregnants, screening for HIV-
infected women and better prevention the transmission to children.
Objectives: analyze the incidence of reported cases of AIDS in chil-
dren under 5 years of age in Teresina-PI, from 2002 to 2012. Methods:
Has been done an analysis of data provided by SINAN concerning to
notifications of AIDS in Teresina, in the period from 2002 to 2012. In
addition, has been performed a search in the electronic databases
Medline and SciELO, gathering articles with full text available, publis-
hed between 2009-2013, in English or Portuguese, that documented
disease-related characteristics. The following descriptors were used:
"AIDS" and "children". Studies focusing on other subjects and studies
that included adult or old age were excluded. Results: 93.33% of
HIV-children infected cases is due to the category of vertical expo-
sure. Between 2002 and 2012 the incidence rate (cases per 100 000
inhabitant) of AIDS in children under five years in Teresina was 3.81,
with 3.73 for male population and 3.89 for female population. There
was an increase in this rate from 2002 to 2004, declining in 2005 and
rising again from 2006 to 2010; 2010 to 2012 fell from 5.08 to 3.32. The
years with the highest incidence were 2004 (7.49); 2010 (5.08); and
2011 (5.03). The lowest rates were in 2005 (1.51); 2006 (2.70); 2007
(2.72); and 2008 (2,83). Conclusion: The study illustrates the vertical
transmission as largely responsible for the incidence of AIDS in chil-
dren. Although declining over the years, the rates illustrate that HIV
infection in this age group have to be combated with specialized
care to mothers with the virus. Adherence to treatment is relevant
in the context, since the current diagnostic methods and the broad
spectrum of antiretroviral drugs relate better quality of life.
21
Epidemiological Study of Mortality Due To Ischemic Heart
Disease In Piauí
Antonio Guilherme Chagas Silva Feitosa; Luiz Euripedes Al-
mondes Santana Lemos; Rienny De Sousa E Silva; Lorayne De
Araujo Costa Pereira; Máximo Peixoto Rocha Neto; Francisco
Das Chagas Araujo Sousa.
Introduction: The circulatory system diseases (CSD) are the leading
cause of deaths in Piauí. In the state of Piauí, in the period of 2001
to 2011, that is available on Datasus, CSD accounted 31.36% of total
deaths, being the ischemic heart diseases (IHD), mainly acute myo-
cardial infarction (AMI) and cerebrovascular disease its major com-
ponents. However, a reduction in mortality due to these diseases in
countries like United States and United Kingdom has been observed,
as well as a reduction in IHD in the more developed regions of the
country, while these have been rising in the Northeast and North re-
gions. Objectives: Describe the epidemiological profile of deaths due
to ischemic heart disease in Piauí, predicting most current forecasts
using data from 2001 to 2011, and see if the trend toward increased
mortality due to IHD can be affirmed in the Northeast of the state.
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2015 Vol 3 Suppl 1
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2015 Vol 3 Suppl 1
XXI COMAPI
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