DRESS syndrome (drug rash, eosinophilia and systemic symptoms) is an idiosyncratic drug reaction ... more DRESS syndrome (drug rash, eosinophilia and systemic symptoms) is an idiosyncratic drug reaction characterised by rash, fever, lymphadenopathy and internal organ involvement. The authors report a case of this syndrome presenting with fever, generalised pruritus, macular rash and cholestatic hepatitis during allopurinol treatment. This case resolved with drug withdrawal, but the death rate in the setting of hepatic failure can reach 10%. Rapid diagnosis is crucial as prompt withdrawal of the offending drug is the key of the treatment, while the potential role of corticosteroids remains controversial.
Journal of gastrointestinal and liver diseases : JGLD, 2014
A recent review of economic studies relating to gastric cancer revealed that authors use differen... more A recent review of economic studies relating to gastric cancer revealed that authors use different tests to estimate utilities in patients with and without gastric cancer. Our aim was to determine the utilities of gastric premalignant conditions and adenocarcinoma with a single standardized health measure instrument. Cross-sectional nationwide study of patients undergoing upper endoscopy (n=1,434) using the EQ-5D-5L quality of life (QoL) questionnaire. According to EQ-5D-5L, utilities in individuals without gastric lesions were 0.78 (95% confidence interval: 0.76-0.80), with gastric premalignant conditions 0.79 (0.77-0.81), previously treated for gastric cancer 0.77 (0.73-0.81) and with present cancer 0.68 (0.55-0.81). Self-reported QoL according to the visual analogue scale (VAS) for the same groups were 0.67 (0.66-0.69), 0.67 (0.66-0.69), 0.62 (0.59-0.65) and 0.62 (0.54-0.70) respectively. Utilities were consistently lower in women versus men (no lesions 0.71 vs. 0.78; premalignan...
Rosacea is a very common skin disorder in the clinical practice that primarily affects the convex... more Rosacea is a very common skin disorder in the clinical practice that primarily affects the convex areas of the face. Extrafacial rosacea lesions have occasionally been described, but extensive involvement is exceptional. In the absence of its typical clinical or histological features, the diagnosis of extrafacial rosacea may be problematic. We describe an unusual case of rosacea with very exuberant extrafacial lesions, when compared with the limited involvement of the face.
Reproductive isolation is pivotal to maintain species separation and it can be achieved through a... more Reproductive isolation is pivotal to maintain species separation and it can be achieved through a plethora of mechanisms. In addition, the development of barriers to gamete interaction may drive speciation. Such barriers to interspecific gamete interaction can be prezygotic or postzygotic. Considering the great diversity in animal species, it is easy to assume that regulation of the early steps of fertilization is critical to maintain species identity. One prezygotic mechanism that is often mentioned in the literature is that gamete interaction is limited to gametes of the same species. But do gametes of all animals interact in a species-specific way? Are gamete interactions completely species-specific or perhaps just species-restricted? In species in which species-restrictions have been described, is the interspecies barrier at one major step in the fertilization process or is it a combination of partially restricted steps that together lead to a block in interspecific fertilization? Are the mechanisms used to avoid interspecific crosses different between free-spawning organisms and those with internal fertilization? This review will address these questions, focusing on prezygotic barriers, and will describe what is known about the molecular biology that may account for species-limited gamete recognition and fertilization.
Journal of the American Academy of Dermatology, 2005
Elastoderma is an exceedingly rare condition characterized clinically as an acquired localized la... more Elastoderma is an exceedingly rare condition characterized clinically as an acquired localized laxity of skin and, histologically, as an excessive accumulation of pleomorphic elastic structures within the dermis. We report the case of a 16-year-old white man with a 2-year history of progressive laxity, extensibility, and wrinkling of the skin localized to the anterior aspect of the neck. Histologic examination of specimens from the affected area showed dense aggregates of eosinophilic material present within the dermis. Transmission and scanning electron microscopic examination demonstrated apposition of abnormal elastic structures at the periphery of elastic tissue fibers, with grapelike globular structures. To our knowledge, we report the third case of elastoderma.
DRESS syndrome (drug rash, eosinophilia and systemic symptoms) is an idiosyncratic drug reaction ... more DRESS syndrome (drug rash, eosinophilia and systemic symptoms) is an idiosyncratic drug reaction characterised by rash, fever, lymphadenopathy and internal organ involvement. The authors report a case of this syndrome presenting with fever, generalised pruritus, macular rash and cholestatic hepatitis during allopurinol treatment. This case resolved with drug withdrawal, but the death rate in the setting of hepatic failure can reach 10%. Rapid diagnosis is crucial as prompt withdrawal of the offending drug is the key of the treatment, while the potential role of corticosteroids remains controversial.
Journal of gastrointestinal and liver diseases : JGLD, 2014
A recent review of economic studies relating to gastric cancer revealed that authors use differen... more A recent review of economic studies relating to gastric cancer revealed that authors use different tests to estimate utilities in patients with and without gastric cancer. Our aim was to determine the utilities of gastric premalignant conditions and adenocarcinoma with a single standardized health measure instrument. Cross-sectional nationwide study of patients undergoing upper endoscopy (n=1,434) using the EQ-5D-5L quality of life (QoL) questionnaire. According to EQ-5D-5L, utilities in individuals without gastric lesions were 0.78 (95% confidence interval: 0.76-0.80), with gastric premalignant conditions 0.79 (0.77-0.81), previously treated for gastric cancer 0.77 (0.73-0.81) and with present cancer 0.68 (0.55-0.81). Self-reported QoL according to the visual analogue scale (VAS) for the same groups were 0.67 (0.66-0.69), 0.67 (0.66-0.69), 0.62 (0.59-0.65) and 0.62 (0.54-0.70) respectively. Utilities were consistently lower in women versus men (no lesions 0.71 vs. 0.78; premalignan...
Rosacea is a very common skin disorder in the clinical practice that primarily affects the convex... more Rosacea is a very common skin disorder in the clinical practice that primarily affects the convex areas of the face. Extrafacial rosacea lesions have occasionally been described, but extensive involvement is exceptional. In the absence of its typical clinical or histological features, the diagnosis of extrafacial rosacea may be problematic. We describe an unusual case of rosacea with very exuberant extrafacial lesions, when compared with the limited involvement of the face.
Reproductive isolation is pivotal to maintain species separation and it can be achieved through a... more Reproductive isolation is pivotal to maintain species separation and it can be achieved through a plethora of mechanisms. In addition, the development of barriers to gamete interaction may drive speciation. Such barriers to interspecific gamete interaction can be prezygotic or postzygotic. Considering the great diversity in animal species, it is easy to assume that regulation of the early steps of fertilization is critical to maintain species identity. One prezygotic mechanism that is often mentioned in the literature is that gamete interaction is limited to gametes of the same species. But do gametes of all animals interact in a species-specific way? Are gamete interactions completely species-specific or perhaps just species-restricted? In species in which species-restrictions have been described, is the interspecies barrier at one major step in the fertilization process or is it a combination of partially restricted steps that together lead to a block in interspecific fertilization? Are the mechanisms used to avoid interspecific crosses different between free-spawning organisms and those with internal fertilization? This review will address these questions, focusing on prezygotic barriers, and will describe what is known about the molecular biology that may account for species-limited gamete recognition and fertilization.
Journal of the American Academy of Dermatology, 2005
Elastoderma is an exceedingly rare condition characterized clinically as an acquired localized la... more Elastoderma is an exceedingly rare condition characterized clinically as an acquired localized laxity of skin and, histologically, as an excessive accumulation of pleomorphic elastic structures within the dermis. We report the case of a 16-year-old white man with a 2-year history of progressive laxity, extensibility, and wrinkling of the skin localized to the anterior aspect of the neck. Histologic examination of specimens from the affected area showed dense aggregates of eosinophilic material present within the dermis. Transmission and scanning electron microscopic examination demonstrated apposition of abnormal elastic structures at the periphery of elastic tissue fibers, with grapelike globular structures. To our knowledge, we report the third case of elastoderma.
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Papers by Ana Vieira