INTRODUÇÃO: A insuficiência renal aguda (IRA) é uma complicação possível após intervenção coronária percutânea (ICP). O objetivo deste estudo foi avaliar a ocorrência e o impacto prognóstico da IRA pós-ICP em pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST (IMCSST). MÉTODOS: Registro unicêntrico, que analisou a evolução hospitalar de 501 pacientes admitidos com IMCSST submetidos à ICP primária, de resgate ou tardia. Foram avaliados a incidência e os preditores de IRA pós-ICP. RESULTADOS: A idade média foi 60,7 ± 12,6 anos e 67% eram do gênero masculino. A população apresentava características de alto risco cardiovascular, sendo 30% diabéticos e 7,4% com doença renal crônica (DRC) preexistente. A artéria descendente anterior foi a principal artéria culpada (49,4%) e 15% dos pacientes se apresentaram em Killip III ou IV. A IRA ocorreu em 24,7% dos pacientes, que, quando comparados àqueles sem IRA, eram significativamente mais idosos, diabéticos, com DRC e insuficiência cardíaca, além de apresentarem maior elevação enzimática e menor fração de ejeção. A mortalidade hospitalar foi maior nos pacientes que desenvolveram IRA (29% vs. 4,8%; P < 0,01). Os preditores independentes de IRA foram idade > 76 anos, DRC prévia, Killip III ou IV, necessidade de cirurgia vascular ou transfusão sanguínea. CONCLUSÕES: A disfunção renal aguda após ICP no IMCSST foi uma complicação frequente e associada com aumento da mortalidade hospitalar.

BACKGROUND: Acute renal failure (ARF) is a possible complication after percutaneous coronary intervention (PCI). The objective of this study was to evaluate the occurrence and prognostic impact of ARF after PCI in patients with ST segment elevation myocardial infarction (STEMI). METHODS: Single-center registry evaluating in-hospital outcomes of 501 patients admitted with STEMI undergoing primary, rescue or late PCI. The incidence and predictors of ARF after PCI were evaluated. RESULTS: Mean age was 60.7 ± 12.6 years and 67% were male. The population had high cardiovascular risk characteristics, with 30% of diabetics and 7.4% with preexisting chronic kidney disease (CKD). The left anterior descending artery was the culprit vessel in 49.4% of the cases and 15% of patients had Killip class III or IV. ARF was observed in 24.7% of patients, who were significantly older, had more diabetes, history of CKD or heart failure, had higher enzyme elevation and lower ejection fraction when compared to those without ARF. In-hospital mortality was higher in patients who developed ARF (29% vs. 4.8%; P < 0.01). Independent predictors of ARF were age > 76 years, previous CKD, Killip class III or IV, need of vascular surgery or blood transfusion. CONCLUSIONS: Acute renal failure after PCI in STEMI was a frequent complication and was associated with increased in-hospital mortality.

The objective of the current study was to evaluate the sensitivity, specificity and accuracy of fine needle aspiration biopsy (FNAB) of submucous nodules from the oral cavity and head and neck region as an auxiliary diagnostic tool. Fifty patients with nodule lesions in the oral cavity and the head and neck region were selected. All of them were submitted to FNAB and to either incisional or excisional biopsy. The diagnoses from the FNABs were compared with the biopsy diagnosis as the gold standard. All the cases of FNAB were analyzed by a single oral pathologist prior to the biopsy diagnosis. The results showed that the sensitivity of FNAB was 75%, its specificity was 96% and its accuracy was 58.8%. The false positive and false negative rates were 6.7% and 13.3%, respectively. The positive predictive value was 86% and the negative predictive value was 93%. The inconclusive rate was 16/50. FNAB displayed a high success rate for identifying both malignant and benign lesions, but a low accuracy for making a final diagnosis.

The aim of this study was to evaluate the effectiveness of acupuncture in minimizing the severity of radiation-induced xerostomia in patients with head and neck cancer. A total of 24 consecutive patients receiving > 5000 cGy radiotherapy (RT) involving the major salivary glands bilaterally were assigned to either the preventive acupuncture group (PA, n = 12), treated with acupuncture before and during RT, or the control group (CT, n = 12), treated with RT and not receiving acupuncture. After RT completion, clinical response was assessed in all patients by syalometry, measuring the resting (RSFR) and stimulated (SSFR) salivary flow rates, and by the visual analogue scale (VAS) regarding dry mouth-related symptoms. Statistical analyses were performed with repeated-measures using a mixed-effect modeling procedure and analysis of variance. An alpha level of 0.05 was accepted for statistical significance. Although all patients exhibited some degree of impairment in salivary gland functioning after RT, significant differences were found between the groups. Patients in the PA group showed improved salivary flow rates (RSFR, SSFR; p < 0.001) and decreased xerostomia-related symptoms (VAS, p < 0.05) compared with patients in the CT group. Although PA treatment did not prevent the oral sequelae of RT completely, it significantly minimized the severity of radiation-induced xerostomia. The results suggest that acupuncture focused in a preventive approach can be a useful therapy in the management of patients with head and neck cancer undergoing RT.

Schwannomas, also known as neurilemomas, are benign neoplasias with neural origin. They present painless growth despite its origin. Head and neck are very commom sites of development of this neoplasia and when seen intraorally, the sites of predilection are: tongue, palate, bucal mucosa, lips, gengiva and the floor of the mouth is rarely affected. In this case report we describe a schwannoma in an unusual localization and discuss its diagnosis and treatment.

Los schwannomas, también conocidos como neurilemomas, forman parte del grupo de las neoplasias benignas de origen neural. Son de crecimiento lento e indoloro, a pesar de su origen nervioso. La cabeza y cuello son regiones bastante comunes donde de desarrollan estas neoplasias y en la literatura se reporta que en la región bucal predominan en la lengua, paladar, mucosa yugal, labio y encía, con pocas manifestaciones en el piso bucal. En este trabajo se presenta un caso de schwannoma de rara localización, además de abordar las posibilidades diagnósticas y tratamiento.