HighlightsWe presented a dengue hemorrhagic fever case that evolved with sudden deafness.Dengue hemorrhagic is a vascular leak syndrome.The etiology of sudden deafness is not well established in literature.Viral and vascular are possible causes of sudden deafness.The association of sudden deafness with dengue is been questioned.

Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is a fast and minimally invasive methodology with a crucial impact on patients' management. It has an important and established role in the diagnosis and staging of mediastinal and abdominal malignancies, but little is discussed in the literature on the usefulness of this technique in the diagnosis of infectious diseases. In the current report, we present three different cases where EUS was essential for reaching the diagnosis of tuberculosis and paracoccidiodomicosis in cases otherwise seen as malignant. In conclusion, EUS was successful not only in obtaining enough cells for morphological analysis, but also for the production of cell blocks and assessment of the presence of the microorganisms by special stains. EUS allied to fine needle biopsy was an important tool in determining diagnoses of enlarged lymph nodes, revealing the diagnosis of infectious diseases in cases otherwise seen as malignant. The wide use of this methodology in cases such as those reported here cannot only rule out malignancy, but also aid critically ill patients by installing early proper therapy without the need for aggressive interventions.

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Introduction Previous studies in developed countries have documented associations between air pollution and risk of some neoplasms. We explored the association of traffic-related air pollution with hospitalisations for cancer groups. Methods Our analysis included all individuals admitted to public or private hospitals in São Paulo from 2004 to 2006 with a main diagnosis of primary invasive cancer. Only the first individual admission was considered, from which age, sex, diagnosis and home address were extracted. We calculated total, gasoline and diesel vehicles traffic density, from traffic counts data, for 4964 geographical units with a population of 20 or more inhabitants, formed by a grid of 500 by 500 m. We used logistic regression models adjusted by the Human Development Index of the area for groups of cancer.Results There was an increased risk of hospitalisation for respiratory neoplasms in adults and for haematologic neoplasms in children and adolescents associated with living in areas with higher total traffic density and traffic density for vehicles powered by gasoline and diesel, with a clear dose-response gradient. The Rate ratios of these neoplasms for the highest category of exposure to total density traffic were, respectively, 3.31 (95% CI 2.26 to 4.87) and 2.35 (95% CI 1.59 to 3.49). Conclusion Our study suggests an association between traffic air pollution and hospital admissions for respiratory and haematologic cancers. The adjustment for potential confounding variables, the use of more sophisticated exposure assessment models and of incidence data are needed to more directly investigate the cause and effect relationship. Introduction Alcohol and tobacco are the most important risk factors for head and neck cancers (HNC). However, in some countries, it has been observed an increase in incidence rates, particularly among young people and among non-drinkers and non-smokers. These trends have increased the debate about the role of human papillomavirus (HPV) and several studies suggest that this infection may play a causative role in oropharyngeal tumours. This study aims to assess the magnitude of cancers potentially related to HPV in Brazil. Methods Time series study including deaths due to HNC registered in Brazil, from 1980 to 2007. Age-adjusted mortality rates are described for 100 000 people, according to tumour site (HPV-related or non-HPV related) and sex. Annual percentage change (APC) was calculated through Joinpoint modeling method, using the calendar year as regressor variable. Results We observed a statistically significant increasing trends in mortality rates due to HPV-related HNC among males in the periods of 1980e1994 (APC¼2.4, 95% CI 1.0 to 3.8) and 1997e2005 (APC¼4.0, 95% CI 0.8 to 7.4), followed by a decrease in 2005e2007 (APC¼À27.2, 95% CI À44.6 to À4.4), while for females a significant increase in rates was observed between 1980 and 1998 (APC¼7.6, 95% CI 0.3 to 15.4), followed by a decreasing trend in the period 1998e2007 (APC¼À2.7, 95% CI À4.2 to À1.3). Regarding non-HPV P2-255...