Brown spot (BS), caused by the fungus Bipolaris oryzae, is one of the most important diseases contracted by rice. We investigated the effect of magnesium (Mg) on the development of BS, caused by Bipolaris oryzae, and the effects of disease development on the photosynthetic performance of rice (Oryza sativa L.) plants (cv. Metica-1) grown in nutrient solutions containing 0.25 or 4.0 mM of Mg. Assessments of BS severity, leaf Mg and pigment concentrations (total chlorophylls and carotenoids), were carried out at 120 h after inoculation, in addition to gas exchange parameters,. Higher leaf concentration of Mg was observed in plants supplied with 4.0 mM Mg than in those supplied with 0.25 mM. The increase in leaf Mg was accompanied by a decrease in BS severity, higher concentration of total chlorophyll and better photosynthetic performance. Plants supplied with 4.0 mM Mg had higher average values for carbon assimilation, stomatal conductance and internal leaf CO2 concentration when compared with plants supplied with 0.25 mM Mg. Conversely, the concentration of carotenoids was lower in plants supplied with the higher Mg rate. These results suggest that Mg suppresses disease severity and preserves photosynthetic performance by allowing for better stomatal conductance and, consequently, greater availability of CO2 at the carboxylation sites.

This study investigated the effects of acibenzolar-S-methyl (ASM), ethylene (ET) and jasmonic acid (JA) on the resistance of two wheat cultivars (BRS-229 and BR-18) to infection by Pyricularia oryzae. The treatments included spraying plants with ASM (300 mg L-1), ET (0.5 mM), JA (0.1 mM) and distilled water (control) 48 h before inoculation with P. oryzae. Malondialdehyde concentration, an indicative of oxidative damage to the lipids in the leaf cells, was significantly higher for plants sprayed with ASM compared to plants sprayed with JA and ET. Plants sprayed with JA and ET showed reduced values for the number of lesions per cm² of leaf area and area under blast progress curve, but these hormones had no effect on the incubation period and lesion size (in mm). Plants sprayed with JA and ET showed reduce blast symptoms in comparison to plants sprayed with ASM due to greater peroxidase, polyphenoloxidase, chitinase and β-1,3-glucanase activities.

Paciente do sexo feminino, parda, de 27 anos de idade, apresentando há três anos, placas hipocrômicas planas, ovaladas, de superfície áspera, no dorso e membros superiores com aspecto que lembrava pitiríase versicolor. Refere história familiar de um irmão cujas lesões são semelhantes. Exames laboratoriais, incluindo anti-hiv, sem alterações e com histopatológico evidenciando queratinócitos, aumentados de volume, com citoplasma basofílico e microvacuolado ocupando a porção superior da camada espinhosa e a granulosa. Após correlação anátomo-clínica, confirmou-se o diagnóstico de epidermodisplasia verruciforme pitiríase versicolor like.

A 27-year-old mixed-raced (pardo) female patient presented with flat ovate hypochromic plaques with a rough surface on the back and upper limbs, with an aspect resembling pityriasis versicolor. She reports family history involving a brother with similar lesions. Lab tests, including anti-HIV, showed no alterations and a histopathological examination showed enlarged keratinocytes with basophilic and microvacuolated cytoplasm occupying the upper portion of the spinous layer and the granulous layer. After anatomic-clinical correlation, the diagnosis of epidermodysplasia verruciformis pityriasis versicolor like was confirmed.

FUNDAMENTOS: Doenças Sexualmente Transmissíveis em crianças permanecem um problema de saúde pública pouco estudado, sendo ainda necessários esclarecimentos sobre seu manejo e a relação destas com o abuso sexual infantil. OBJETIVOS: Descrever o perfil clínico-epidemiológico das Doenças Sexualmente Transmissíveis em crianças atendidas em centro de referência na cidade de Manaus. MÉTODOS: Realizou-se estudo descritivo exploratório para verificar características clínicas, epidemiológicas e laboratoriais das Doenças Sexualmente Transmissíveis em crianças atendidas durante o período de janeiro/2003 a dezembro/2007. RESULTADOS: Foram incluídas no estudo 182 crianças que apresentavam DST. A maioria era do sexo feminino (65,4%) e de cor parda; a média de idade foi de 8,5 anos; 89% eram procedentes da cidade de Manaus; os pais foram os principais acompanhantes na consulta; verruga genital foi o principal diagnóstico em ambos os sexos; e, 90,1% apresentavam apenas uma DST. CONCLUSÃO: As frequências e características clínicas das DST nas crianças do estudo não diferiram do encontrado na literatura. Embora, com base em sinais e sintomas referentes tão somente às DST nas crianças, não se tenham parâmetros fidedignos de confirmação de abuso, deve-se sempre estar alerta para esta possibilidade, visto que estas doenças podem ser sinalizadoras de ofensas sexuais, por vezes, dissimuladas e repetidas.

BACKGROUND: Sexually transmitted diseases in children remain a public health concern that is relatively ignored. Further data are required on the management of these diseases and their association with child sexual abuse. OBJECTIVES: To describe the clinical and epidemiological profile of sexually transmitted diseases in children receiving care at a referral center in the city of Manaus, Amazonas, Brazil. METHODS: A descriptive, exploratory study was conducted to evaluate the clinical, epidemiological and laboratory characteristics of the sexually transmitted diseases (STD) found in children who received care at this clinic between January 2003 and December 2007. RESULTS: A total of 182 children with STDs were included in the study. The majority were female (65.4%), dark-skinned and with a mean age of 8.5 years. Furthermore, 89% were from the city of Manaus and their parents were usually responsible for having brought them to the clinic. Genital warts constituted the principal diagnosis in children of both sexes and 90.1% of the children had only one STD. CONCLUSIONS: The frequencies and clinical characteristics of the STDs in the children in this study were similar to data reported in the literature. Although the signs and symptoms of the STDs found in these children do not, in themselves, constitute reliable parameters by which to confirm abuse, professionals should always be alert to this possibility, since these diseases may represent a sign of sexual offenses that may be dissimulated and repetitive.

Paciente do sexo feminino, 18 anos, apresentando única placa eritemato-descamativa, bem delimitada, na região abdominal com evolução de 1 ano e sem uso anterior de medicação. O histopatológico demonstrou infiltrado linfocítico com atipias acometendo principalmente derme superficial com epidermotrifismo e discreta espongiose. E a imunofenotipagem demonstrou predomínio de células CD3-positivo, confirmando o diagnóstico de Micose Fungóide.

An 18-year old female patient presented with a single, erythematous, desquamative plaque. The clearly outlined lesion was situated in the abdominal region. The patient reported that it had been present for the past year and that she had used no previous medication. Histopathology showed lymphocytic infiltration with atypia, principally affecting the superficial dermis with epidermotropism and mild spongiosis. Immunophenotyping revealed a predominance of CD3-positive cells, confirming the diagnosis of mycosis fungoides.

A ocronose exógena é uma dermatose, aparentemente pouco frequente, caracterizada por hiperpigmentação negro-azulada fuliginosa, localizada na região onde foi aplicado o agente causador. Pode ser causada por uso de medicamentos sistêmicos, os antimaláricos e de uso tópico, como fenol, resorcinol, benzeno, ácido pícrico e a hidroquinona - que é um composto fenólico, com propriedade despigmentante, muito utilizado em formulações dermatológicas para o tratamento de melasma e outras hiperpigmentações. A fisiopatogenia deste processo ainda não está esclarecida e as abordagens terapêuticas são insatisfatórias. Relatam-se quatro casos de pacientes do sexo feminino que, após uso de preparados contendo hidroquinona, desenvolveram hiperpigmentação acentuada na face, caracterizadas no exame dermatológico e histopatológico como ocronose. Enfatiza-se a possibilidade de casos de ocronose exógena estarem sendo diagnosticados erroneamente, como falha de tratamento de melasma, e também para os riscos do uso indiscriminado de formulações, contendo hidroquinona, muitas vezes, sem acompanhamento médico.

Exogenous ochronosis is an infrequent dermatosis characterized as a dark blue hyperpigmentation localized where the causing agent was applied. It may be caused by the use of systemic medication such as antimalarials and by the use of topic substances such as phenol, resorcinol, benzene, or hydroquinone, which is a fenolic compound with depigmentation action, largely used in the treatment of melasma and other hyperpigmentation. The physiopathology of this process is not well clear up to this moment, and the therapeutic measures are not satisfactory either. Here we present four cases of female patients that developed hyperpigmentation on their faces after the use of hydroquinone containing compounds, characterized clinically and histological as ochronosi. We emphasize the possibility of exogenous ochronosis cases being misdiagnosed as a melasma treatment failure. We also emphasize the risks of the indiscriminated use of hydroquinone containing compounds, used, in many instances, without medical prescription.

FUNDAMENTOS: A teledermatologia, pouco utilizada no Brasil e com iniciativas incipientes no Amazonas, necessita de estudos para demonstrar sua factibilidade e eficácia. OBJETIVOS: Avaliar a eficácia de um método assíncrono de teledermatologia, utilizando recursos tecnológicos simples e de baixo custo. MÉTODOS: Cento e setenta e quatro pacientes foram examinados por quatro dermatologistas; dois efetuaram diagnóstico presencial (A1 e A2) e dois por meio de imagens das lesões e história clínica (B1 e B2). Foi investigada a concordância entre as avaliações presenciais e por imagens. RESULTADOS: A concordância do diagnóstico principal entre os examinadores presenciais (A1 e A2) foi de 83,3% e entre os de imagens (B1 e B2), de 81%. A concordância entre o diagnóstico principal estabelecido pelo método presencial e o obtido por meio de imagens variou de 78,2% a 83,9%. CONCLUSÃO: O diagnóstico de doenças dermatológicas realizado por imagens digitais demonstrou concordância ótima quando comparado àquele realizado com a presença física do paciente.

BACKGROUND: Teledermatology is seldom used in Brazil, although some incipient initiatives have been implemented in the state of Amazonas. Further studies are still required to confirm the feasibility and efficacy of this diagnostic tool. OBJECTIVES: To evaluate the efficacy of an asynchronous method of teledermatology using simple, inexpensive technological resources. METHODS: One hundred and seventy-four patients were examined by four dermatologists, two clinic-based dermatologists, who diagnosed the patients following live examination (A1 and A2), and two consultant specialists in image dermatology, who reached diagnoses by examining images of the lesions and the patients' clinical histories (B1 and B2). The agreement between live examination and examination of images was evaluated. RESULTS: Agreement between the two live examiners (A1 and A2) with respect to the principal diagnosis was 83.3% compared to 81.0% between the physicians who diagnosed by examining images (B1 and B2). Agreement between the principal diagnosis established by live examination and that obtained from examining images ranged from 78.2% to 83.9%, CONCLUSION: Agreement between diagnoses of dermatological diseases reached following examination of digital images and those reached following live examination of the patient was excellent.

FUNDAMENTOS: No Brasil, doenças provocadas por picadas de insetos são frequentes, o que torna extremamente importante a execução de medidas profiláticas de forma adequada, sobretudo, em áreas endêmicas como a Amazônia, que recebe um grande contingente de visitantes, a trabalho ou turismo. OBJETIVOS: Avaliar o uso dos repelentes de insetos disponíveis no mercado por militares que costumam realizar missões em ambiente de selva, na região amazônica. MÉTODOS: Foram selecionados cinquenta e um militares da região amazônica que responderam um questionário em junho/2008. RESULTADOS: 63,7% dos militares usaram produtos contendo Deet na concentração máxima de apenas 15%, que possui mínima ação de repelência; 36% relataram usar protetor solar associado, o que levou a um risco maior de intoxicação; 36,4% fizeram uso de um repelente natural em suas missões; dois militares usaram vitamina B e consideraram a sua ação de repelência ineficaz. CONCLUSÕES: Os repelentes à base de Deet utilizados pelo grupo estudado apresentam concentrações inferiores às consideradas seguras para uso em ambiente de selva. Foi frequente a associação do Deet com protetor solar, que é uma combinação potencialmente tóxica. Os repelentes naturais à base de andiroba e copaíba apresentaram o maior grau de percepção de proteção.

BACKGROUND: In Brazil, diseases caused by insect bites are frequent. Therefore, it is extremely important that prophylatic measures are adequately carried out, especially in endemic areas such as the Amazon which receives a great number of visitors, for both business and tourism purposes.. OBJECTIVES: To evaluate the use of insect repellents available in the market by military personnel who often go in missions in the middle of the jungle, in the Amazon region. METHODOLOGY: Fifty - one militaries in the Amazon region were selected and they answered a questionnaire in June/2008. RESULTS: 63,7% of the militaries used products that contained Deet in the maximun concentration of only 15% that has minimum repellent action; 36% reported to combine these products with sun protective products which increased the risk of intoxication; 36,4% used a natural repellent during their missions; two of the militaries participants used vitamin B and considered their repellent action ineffective. CONCLUSION: The repellents that contain Deet and which were used by the group present concentrations that are lower than the concentrations considered safe for using in the jungle. It was frequent the combination of Deet with sun protective products ,which is a potentially toxic association. Natural repellents that have "andiroba" and" copaíba" as components presented a higher perception of protection from the participants.

FUNDAMENTOS - Observa-se comorbidade psiquiátrica em 40% dos pacientes dermatológicos adultos, sendo a acne vulgar de interesse da psicodermatologia por ter entre suas complicações seqüelas psicossociais. OBJETIVOS - Estabelecer a relação entre acne e o status de bem-estar. MÉTODOS - Estudo de caso-controle com dados coletados a partir do Índice de Bem-Estar da Organização Mundial da Saúde, por meio de entrevistas com dois grupos de 50 acadêmicos de medicina, sendo um com acne e outro sem acne. RESULTADOS - Foi verificado que 26% dos acadêmicos do grupo de casos e 24% do grupo controle apresentaram de 0 a 4 pontos em pelo menos um dos itens questionados. CONCLUSÕES - Apesar de a maioria dos pacientes apresentar atitudes e sentimentos desencadeados pela acne, não se demonstrou associação estatisticamente significativa entre essa dermatose e baixo nível de bem-estar.

BACKGROUND - Psychiatric comorbidity is observed in 40% of adult dermatological patients. Acne vulgaris, in particular, is in the interest of psychodermatology because of its psychological and social stigmas. OBJECTIVE - To establish the relation between acne and the state of well-being. METHODS - This consisted of a case-control study with data collected from the World Health Organization Well-being Index, through interviews with two groups of 50 medical students, one with and other without acne. RESULTS - It was verified that 26% of the students from the case group and 24% from the control group presented from 0 to 4 points in at least one item. CONCLUSIONS - Although the majority of the patients presented attitudes and feelings related to acne, a statistically significant association between this dermatosis and low level of well-being was not demonstrated.

Demonstra-se um caso de paquidermatoglifia adquirida em paciente do sexo masculino, de 67 anos, associada a carcinoma gástrico avançado. Trata-se de síndrome paraneoplásica com manifestações cutâneas que podem ser comparadas à superfície rugosa do estômago bovino.

We report the case of a 67-year-old man suffering from acquired pachydermatoglyphia associated with advanced gastric carcinoma. This is a paraneoplasic syndrome with skin manifestations that may be compared to the wrinkled surface of the bovine stomach.

Os autores relatam um caso de paciente de 17 anos, vítima de acidente automobilístico com impacto frontal, que apresentava, ao socorro médico, dor abdominal intensa e tatuagem transversa, em região infra-umbilical, causada pelo cinto de segurança. Foi submetida a laparotomia exploradora, que evidenciou pequena lesão lacerante de jejuno terminal, não sendo encontradas outras lesões à inspeção. Ao término da cirurgia, verificou-se cianose moderada em região plantar esquerda, com ausência de pulsos tibiais e poplíteos. O pulso da artéria femoral encontrava-se diminuído. A arteriografia realizada mostrou obstrução do fluxo em artéria ilíaca comum esquerda. A reconstrução foi realizada com interposição de prótese de Dacron de 6 mm.

The authors report a case of a 17-year-old female patient involved in a head-on motor vehicle collision. The patient presented to the emergency department complaining of severe abdominal pain. She also had a transverse bruise in the inferior anterior abdominal wall, suggesting a seat-belt sign. The patient underwent an exploratory laparotomy, which showed a small distal jejunal perforation. Other lesions were not found at inspection. At the end of the operation, moderate cyanosis of the plantar aspect of the left foot was observed, and popliteal and distal pulses were absent. The intensity of the femoral pulse was decreased. An arteriography revealed obstruction of the left common iliac artery. Repair was successfully achieved with a 6-mm Dacron graft interposition.