Tumores da glandula tireoide. Estudo retrospectivo de 130 casos com enfase especial em biopsia aspirativa, biopsia de congelacao e exame histopatologico

The authors studied retrospectively 130 patients with thyroid tumors comparing the histopathologic diagnoses with fine needle aspirate (FNA) and frozen section results. FNA was performed in 118 patients with the following results: 75 (63.6%) benign, 21 (17.8%) malignant and 22 (18.6%) not conclusives. In seven cases false-negative result was obtained and there were six false-positive. These data reveals some drawbacks of this procedure. These results indicated that frozen as well as FNA are useful diagnostic procedure in helping to choose the most appropriate therapy in patients with thyroid tumors. On the other hand, traditional methods seems to be also important methods, such as scintilography, in the evaluation of thyroid diseases.

Reducao fechada e fixacao percutanea em fraturas supracondilianas do umero em criancas. Estudo retrospectivo de 32 casos

This retrospective study evaluated 32 cases of supracondylar fractures of the humerus in children, according to percutaneous crossed Kirschner-wire fixation. Follow-up was performed by radiographs of Baumann's angle and clinical evaluation of joint movement and carrying angle. According to Flynn's criteria, results were satisfactory in all cases, indicating that this method is a safe and efficient method in the treatment of such fractures.

Observações clínicas, anatomopatológicas e tratamento de seis casos de dermovilite exsudativa vegetante crônica (cancro da ranilha) de cqüinos

Chronic hypertrophic pododermatitis cases in six horses of different breeds, aging 14 months to 19 years are described. The lesion begun with a infiltrative tissue in the frog and sole regions of the hoof, characterized by a fast and disorganized growth, with a papillary aspect, white colored in the roots and dark on the extremity, with a necrotic secretion and an extremely fetid odor. Microscopically, an exuberant epidermic proliferative tissue was observed, intermingled with little connective tissue. The horses were divided into two treatment groups. In the first group, including three young mares and a foal, showing lesions in only one limb, a surgical resection of the invasive mass was performed, followed by cauterization of the remaining edges and subsequent daily local application of antiseptic substances. In three of these horses, recurrence of the initial lesion occurred, with fast growth of hyperplasic tissue, affecting almost all the frog and half of the sole. Two horses developed contraction deformities of the hoof. In the second group, one male and one female, each with lesions in two limbs, after surgical debridement of the tissue, the animals received daily applications of picric acid 5%, associated to local use of oxitetracyclin. Although one of these cases required a second surgical intervention for removal of the mass, the horses showed after a period of two to three months total absence of the infiltrative tissue. The use of local picric acid 5% and oxitetracyclin associated to previous surgical debridement showed to be more efficient than the use of antiseptic substances in the treatment of chronic hypertrophic pododermatitis.

Etiologia e incidência das fraturas faciais em adultos e crianças: Experiência em 513 casos

Facial trauma has presented an increasing occurrence in the last four decades, due especially to the growth of accidents with automobiles as well as to the urban violence. Both of which continue being the main cause of such traumas. Aim: To evaluate the features of the population victim of facial trauma as to gender, age, occupation, origin, type of fracture and its cause. Design study: retrospective clinical with transversal cohort. Material and Method: Retrospective study consulting hospital registers of 513 patients victms of the facial trauma. Results: There was a higher incidence of facial trauma on men (84,9%), white (82,7) and with an average age of 29. Regarding occupation, the trauma was mostly occurred to students (16,6%) and Masons (11,2%). The jaw was the most affected place (35%), followed by zygoma (24%) and by the nose (23%), though most patients presented a single facial fracture (82,5%). Among the causes, accidents with automobiles (28,3%), aggressions (21%) and accidental fall s (19,5%) were the most common. Conclusions: Accidents with automobiles continue being the main cause of facial trauma, especially of multiple factures due to the great transmission of kinetic energy.

Estudo da distribuição dos casos de Diabetes Mellitus em Presidente Prudente - SP

The main causes of illness and consequent death in patients affected by Diabetes Mellitus are the long-term complications. Depression can make it harder to control the level of glucose in the blood, as well as intensifying and worsening the clinical complications, thus reducing the quality of life. The aim of this study was to estimate the incidence of Diabetes Mellitus in Public Health Clinic in Presidente Prudente (SP) in patients enrolled in the Hiper-Dia Program. From October 2003 to July 2004, a descriptive survey was carried out. Data were obtained from doctor's records of 50 diabetes patients and also their answers to a specific questionnaire. The majority of the patients were female, had not completed elementary school, with a family income below five minimum wages, a nationally-defined amount related to the poverty line. It was observed that 24% of the patients had depression and 76% never followed a controlled diet. Pharmacological treatment was prescribed for 82% of the patients. Twenty-eight patients were receiving psyicological treatment, together with oral hypoglycemic agents. The glycated hemoglobin was measured in 68%. The association between depression and submission to treatment was not significant. No statistical association was found between the psychologically assisted patient's group and glucose control (p= 0.40), diet control (p= 0.37) and physical activities (p= 0.77). It was concluded that 24% patients had depression and the majority not under diet control, but 82% were under pharmacological treatment.

Adenocarcinoma de apêndice: Relato de dois casos e revisão da literatura

Background: The adenocarcinoma of the appendix is a rare disease, generally identified as an acute appendicitis in the clinical presentation. Preoperative diagnosis is extremely difficult and uncommon. Objective: To present two cases of adenocarcinoma of the appendix, unique for presenting in early ages, and a complete literature review on this topic. Cases report: First case: a 24-year-old man submitted to appendectomy for acute inflammatory abdomen. Sent to hospital due to a histopathological diagnosis of mucinous adenocarcinoma of the appendix. Right hemicolectomy, epiploectomy, ganglion and partial abdominal wall resection were performed. The patient is now in chemotherapy. Second case: a 32-year-old man presented, during appendectomy, with vegetant lesion on the apex of the appendix. The histopathological study revealed the presence of adenocarcinoma of the appendix. Right hemicolectomy with ganglion resection was performed. The patient does not present signs of recurring disease. Conclusion: The macroscopic and clinical similarity between adenocarcinoma of the appendix and acute appendicitis makes it important to check out histopathological study results. The cases above reinforce this requirement, as the authors have found adenocarcinoma of the appendix in young patients.

Polineuropatia associada a hipotireoidismo em cães: Relato de seis casos

Six Doberman Pinscher, between six and eight years of age, were presented to the Veterinary Hospital from Faculty of Veterinary Science of The University of Buenos Aires. Neurological examination revealed tetraparesis with inability to walk, decreased muscle tonus and myotatic reflexes in all dogs. Serum cholesterol levels, creatine kinase and alkaline phosphatase activities were mildly to markedly elevated, and tibial motor nerve conduction velocities were slow in all dogs. Basal measurements of free T4 and TSH were determined by radioimmunoassay. Although fT4 values were within normal range, in all dogs TSH values were elevated. Based on this results, hypothyroidism was diagnosed and a supplementation therapy was established with oral levothyroxine (T4). Two weeks after treatment has been started, all patients had an improvement in clinical signs, and within a month gait became normal, as well as muscular tonus and spinal reflexes.

Dermatopatias em cães: Revisão de 257 casos

The purpose of this study was to collect data on skin diseases in dogs evaluated at the Veterinary Hospital of the Northern Parana State University (UENP), in Bandeirantes, Parana, Brazil. Dermatological conditions amounted to 31.38% of all consultations in dogs, and the most common skin conditions observed were, from the most to the least common: bacterial, parasitic, fungal, immune, and keratinization disorders; general skin diseases and psychogenic conditions. The highest scoring diseases, in number of occurrences were, in descending order: Superficial folliculitis, demodicidosis, dermatophytosis, bacterial otitis, deep folliculitis, dry dekeratinization, allergic dermatitis caused by flea bites, fungal ear infections, scabies, impetigo, malassezia dermatitis, parasitical otitis, pad dermatitis, and atopic dermatitis.

Carcinoma de células transicionales en perros: Un informe de dos casos, madre e hija

The transitional cell carcinoma is usually located in the trigone region of the bladder, and shows nonspecific clinical signs of the lower urinary tract such as hematuria, strangury, pollakiuria and urinary incontinence. The urethral and ureteral obstructions occur in some cases. Etiological factors such as endogenous and iatrogenic have been listed as the cause of disease. The objective of this report is to describe the process and treatment of two cases of transitional cell carcinoma presented simultaneously in two dogs, mother and daughter, that showed hematuria and post-renal azotemia, both with tumor in the trigone of bladder. After partial cystectomy ureteroneocistostomia, the diagnosis of transitional cell carcinoma was confirmed by histopathological analysis of bladder tissue. Patients received firocoxib as adjuvant to surgery. It is concluded that the surgical procedure associated with the use of specific anti-inflammatory COX-2 provided a better quality of life in both patients.

Enfisema lobar congênito: série de casos de 30 anos em dois hospitais universitários

Objetivo: Revisar os casos de enfisema lobar congênito (ELC) operados nos últimos 30 anos em dois hospitais universitários. Métodos: Foram revistos os prontuários médicos das crianças com ELC operadas no Hospital das Clínicas da Faculdade de Medicina de Botucatu e no Hospital da Universidade de Mogi das Cruzes entre 1979 e 2009. Dados sobre sintomas, exame físico, achados radiológicos, diagnóstico, tratamento cirúrgico e seguimento pós-operatório mediato e tardio foram analisados. Resultados: Durante o período estudado, 20 crianças com ELC foram submetidas a tratamento cirúrgico. A média de idade dos pacientes no momento da cirurgia foi 6,9 meses (variação, 9 dias a 4 anos). Todos os casos apresentaram sintomas ao nascimento ou nos primeiros meses de vida. Em todos os casos, a radiografia simples de tórax foi importante na definição do diagnóstico. Em casos de dificuldade respiratória moderada, a TC de tórax auxiliou no diagnóstico. Um paciente com desconforto respiratório grave foi diagnosticado erroneamente com pneumotórax hipertensivo e submetido a drenagem torácica. A broncoscopia só foi realizada nos pacientes com dificuldade respiratória moderada e não foram encontrados sinais de anomalias traqueobrônquicas. A abordagem cirúrgica foi realizada através de toracotomia lateral poupadora de músculo. O lobo superior esquerdo e o lobo médio foram os mais afetados, seguidos pelo lobo superior direito. A lobectomia foi realizada em 18 casos, enquanto a bilobectomia foi realizada em 2 casos (com ressecção de cisto broncogênico em 1 desses). Complicações pós-operatórias não foram observadas. O acompanhamento pós-operatório foi de pelo menos 24 meses (média, 60 meses) e não foram observadas complicações tardias nesta série. Conclusões: O ELC é uma doença pouco comum, ainda negligenciada, de etiologia incerta, mas de fácil diagnóstico radiológico e tratamento cirúrgico eficaz.

Encalhes de tubarões anequins e de raias-pretas no litoral do estado de São Paulo, sudeste do Brasil: Relato de casos

Stranding of oceanic-pelagic elasmo branchs in the southeastern Brazil are reported. Data comes from animals observed in the coast of São Paulo state, between 1999 and 2012. Nine individuals of two species were recorded: Pteroplatytrygon violacea (n = 5; mostly during the winter) and Isurus oxyrinchus (n = 4; two in the winter and two in the summer). For P. violacea the strandings restricted to the austral winter suggest that the species follows the intrusion of high temperatures water masses recorded in southeastern Brazil during this season, bringing some individuals to shallow waters. For I. oxyrinchus is possible that individuals escaped from hooks of the commercial pelagic long line fishery and suffered injuries in the esophagus and in the gastric wall, stranding due to difficulties in locomotion and feeding. As these stranded sharks were not necropsied and only two animals were observed during the austral summer, we cannot exclude other causes of beaching such diseases or the intrusion of cold water masses in the continental shelf during this season.

O sentido da autoridade nas destituições do poder familiar em Marília a partir dos relatos dos operadores do direito na perspectiva do gênero

Pós-graduação em Ciências Sociais - FFC