Although the mortality rate of oropharyngeal squamous cell carcinoma (OPSCC) has been decreasing over the last 30 years, there has been a significant increase in the frequency of diagnosis of this type of cancer in several countries. Beyond the classic prognostic factors, such as TNM stage, there is a lack of predictive factors for recurrence and treatment response. A retrospective analysis of patients with OPSCC treated at the Oncology Department of the Santa Terezinha University Hospital between 2007 and 2012 was performed, with the aim of identifying new prognostic factors. In addition to the significance of clinical stage as a prognostic factor for recurrence, OPSCC patients with advanced TNM stage and those treated with radiotherapy, chemoradiation or palliative measures, had a worse prognosis. Patients with moderate or severe weight loss (>5%) at diagnosis had a higher tumor recurrence rate compared with those with mild or no weight loss (P=0.007). Furthermore, 76.9% of patients with moderate or severe weight loss, as opposed to 13.3% of patients with mild or no weight loss, eventually succumbed to the disease (P=0.0001). These data suggest that moderate and severe weight loss at diagnosis is a prognostic factor for OPSCC and it is associated with disease recurrence.

The do-not-resuscitate order is the explicit statement by patients with advanced disease in progression refusing cardiopulmonary resuscitation. This study aimed to describe the attitude of physicians in relation to the this order and the need for its regulation. A questionnaire was applied to 80 physicians in the medical bureau of the Regional Council of Medicine of Joacaba/SC, Brazil. It was found that 90% of the respondents knew the meaning of do-not-resuscitate, 86.2% agreed to respect it, 91.2% considered it important to be registered in medical records and 92.5% understood as opportune the issuance of a regulation in this regard. It was concluded that most doctors knew about the do-not-resuscitate order, agreed to respect it, valued its registration in medical records and wanted its regulation by the relevant bodies. Keywords: Terminally ill. Bioethics. Resuscitation orders. Heart massage. Respiration, artificial. Medical futility. ResumoOrdem de não reanimar pacientes em fase terminal sob a perspectiva de médicos Ordem de não reanimar consiste na manifestação expressa da recusa de reanimação cardiopulmonar por paciente com doença avançada em progressão. Objetivou-se descrever a atitude dos médicos em relação à ordem de não reanimar e à necessidade de sua normatização. Foi aplicado questionário a 80 médicos inscritos na delegacia do Conselho Regional de Medicina de Joaçaba/SC, Brasil. Verificou-se que 90% dos participantes conheciam o significado dessa ordem, 86,2% concordavam em acatá-la, 91,2% consideravam importante seu registro em prontuário e 92,5% consideravam oportuna a emissão de normatização a respeito. Concluiu-se que a maioria dos médicos tinha conhecimento sobre Ordem de Não Reanimar, concordava em respeitá-la, valorizava seu registro em prontuário e desejava a normatização por parte dos órgãos competentes. Palavras-chave: Doente terminal. Bioética. Ordens de não ressuscitar. Massagem cardíaca. Respiração artificial. Futilidade médica. ResumenLa orden de no reanimar a los pacientes en fase terminal bajo la perspectiva de los médicos La orden de no reanimar es la manifestación expresa de rechazo de la reanimación cardiopulmonar por parte de pacientes portadores de una enfermedad avanzada en progresión. Este estudio tuvo como objetivo describir la actitud de los médicos con respecto a esta orden y la necesidad de su regulación. Se aplicó un cuestionario a 80 médicos inscriptos en el distrito del Consejo Regional de Medicina de Joaçaba/SC, Brasil. Se encontró que el 90% de los encuestados conocían el significado de esta orden, el 86,2% estaban de acuerdo en cumplirla, el 91,2% consideraban importante el registro en el historial médico y el 92,5% juzgaban oportuna la existencia de una regulación al respecto. Se concluyó que la mayoría de los médicos tenía conocimiento de la orden de no reanimar, estaba de acuerdo en respetarla, valoraba su registro en el historial médico y deseaba su regulación por parte de las instituciones competentes. Palabras clave: Enfermo terminal. Bioética. Órdenes de...

Rosai-Dorfman disease is a benign lymphoproliferative disease with rare occurrence in the overall population. The characteristic findings of the disease are emperipolesis on microscopy and S-100 protein positivity on immunohistochemistry. The present report describes the case of a 57-year-old man who presented with repeated seizures, urinary retention, and ataxia. Satisfactory results were obtained with surgical treatment. The diagnosis was confirmed by immunohistochemistry.