O objetivo deste estudo foi analisar a percepção dos funcionários da limpeza em uma instituição pública de ensino superior sobre condições de trabalho e saúde no meio universitário, comênfase para os aspectos físico-ambientais e psicossociais que determinam a saúde deste grupo no ambiente onde estão inseridos. Foi conduzida uma pesquisa qualitativa, utilizando-se a técnica de entrevista em profundidade junto a 16 funcionários da limpeza de ambos os sexos. Os trabalhadores têm a percepção de que não são devidamente valorizados. A maioria afirmou que o trabalho influencia negativamente a saúde, principalmente devido a dores osteomusculares, alergia aos produtos químicos de limpeza, exaustão e estresse pela sobrecarga de trabalho e falta de colaboração da comunidade universitária. Além disso, todos possuem percepção negativa da terceirização, em decorrência da alta rotatividade de empresas que inviabiliza o cumprimento de direitos trabalhistas, como férias regulares e décimo terceiro salário. Conclui-se que os trabalhadores da limpeza estão submetidos a condições desfavoráveis de trabalho, de modo que a consolidação de um ambiente universitário promotor de saúde para o trabalhador pressupõe uma construção conjunta que envolva o trabalhador, o âmbito comunitário e o administrativo. Faz-se necessário o desenvolvimento de modelos de promoção de saúde para os trabalhadores terceirizados no ambiente estudado.

Pheochromocytoma (PCC) is a tumor derived from adrenomedullary chromaffin cells. Prognosis of malignant PCC is generally poor due to local recurrence or metastasis. We aim to report a case of malignant PCC with 18-year survival and discuss which factors may be related to mortality and long-term survival in malignant pheochromocytoma. The patient, a 45-year-old man, reported sustained arterial hypertension with paroxysmal episodes of tachycardia, associated with head and neck burning sensation, and hand and foot tremors. Diagnosis of PCC was established biochemically and a tumor with infiltration of renal parenchyma was resected. No genetic mutation or copy number variations were identified in SDHB, SDHD, SDHC, MAX and VHL. Over 18 years, tumor progression was managed with 131I-MIBG (iodine-metaiodobenzylguanidine) and 177Lutetium-octreotate therapy. Currently, the patient is asymptomatic and presents sustained stable disease, despite the presence of lung, para-aortic lymph nodes and femoral metastases. Adequate response to treatment with control of tumor progression, absence of significant cardiovascular events and other neoplasms, and lack of mutations in the main predisposing genes reported so far may be factors possibly associated with the prolonged survival in this case. Early diagnosis and life-long follow-up in patients with malignant pheochromocytoma are known to be crucial in improving survival.

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Solitary fibrous tumor (SFT) is a rare fibroblastic mesenchymal neoplasm with an estimated annual incidence of 0.35 per 100,000 individuals. Doege-Potter syndrome is a paraneoplastic syndrome related to solitary fibrous tumor clinically characterized by hypoglycemia, occurring in less than 5% of cases. Herein, we report a case of metastatic SFT associated with recurrent severe hypoglycemia. A 43-year-old male with a noncontributory medical history presented with a painless and progressive growing mass in the right thigh. The histological evaluation rendered the diagnosis of SFT, and tumor resection was performed. One year after the operation, on the oncological follow-up, he was admitted to the emergency unit, manifesting an early-morning seizure associated with a severe hypoglycemia. The laboratory findings of non-islet cell tumor hypoglycemia (NICTH) in the background of a relapsed metastatic solitary fibrous tumor were consistent with the diagnosis of Doege-Potter syndrome. Hepatic embolization associated with oral glucocorticoid was an efficient palliative treatment to control the hypoglycemic crisis and allow hospital discharge.

Prosthetic valve endocarditis is an infrequent complication of valve replacement. Surgical treatment has mortality rates compatible with the severity of patients' conditions. Surgical indication should not be delayed when clinical treatment has been ineffective.