Abordagem do trauma renal - artigo de revisão: review of the literature

A incidência de traumatismo é uma realidade crescente nos dias de hoje. O acometimento dos reina ocorre em cerca de 10% dos pacientes com trauma abdominal fechado ou penetrante, podendo elevar muito a morbimortalidade quando não bem conduzido. Os autores fizeram um levantamento de artigos recentes para esclarecimentos no diagnóstico e na conduta no traumatismo renal, desde os detalhes anatômicos até o tratamento definitivo. A correta condução do paciente é fundamental para a preservação e manutenção da função do órgão, sobretudo da vida, após o evento traumático.

Estudo descritivo dos casos de câncer de mama em Goiânia, entre 1989 e 2003

OBJETIVO: Descrever os casos de câncer de mama nas mulheres residentes em Goiânia no período 1989-2003. MÉTODOS: Estudo retrospectivo, descritivo, que incluiu todos os casos de câncer de mama ocorridos nas moradoras de Goiânia, identificados pelo Registro de Câncer de Base Populacional de Goiânia (RCBPGO), no período de 1989 a 2003. As variáveis estudadas foram: idade, método de diagnóstico, localização topográfica, morfologia e extensão do câncer de mama. Foram utilizadas frequências e taxas percentuais, além da regressão de Poisson para determinação da mudança percentual anual (MPA). RESULTADOS: Foram identificados 3204 casos de câncer de mama. A localização topográfica mais frequente foi o quadrante superior lateral (53,7%). O carcinoma ductal infiltrante (CDI) foi o mais freqüente, com 2582 casos (80,6%), seguido pelo carcinoma lobular infiltrante (CLI), com 155 casos (4,8%). Houve aumento significante tanto do CDI quanto do CLI, sendo a MPA de 11,0 % e de 15,4%, respectivamente. A proporção entre CDI e CLI não foi influenciada pela idade (p=0,98). Quanto à extensão do tumor ao diagnóstico, 45,6% dos casos eram localizados na mama, sendo que a MPA foi de 16,1% (IC= 12,4 a 20,0; p<0,001). Houve tendência de redução da MPA dos casos metastáticos (-3,8; IC= -8,6 a 1,2; p=0,12). CONCLUSÃO: A localização topográfica e o tipo histológico do câncer de mama, na cidade de Goiânia, seguem o padrão de outros países. Os principais tipos morfológicos não foram influenciados pela idade. Houve grande aumento de casos iniciais.

Surgical techniques for maxillary bone grafting - literature review

For oral rehabilitation with implant-supported prostheses, there are required procedures to create the bone volume needed for installation of the implants. Thus, bone grafts from intraoral or extraoral donor sites represent a very favorable opportunity. This study aimed to review the literature on the subject, seeking to discuss parameters for the indications, advantages and complications of techniques for autogenous bone grafts.

Laparoscopy in uterine cervical cancer. Current state and literature review

Cervical cancer remains the most frequent gynecological tumor in Brazil and other developing countries. Minimally invasive techniques, especially laparoscopy, have been increasingly employed in such tumors. This article aims to describe the main applications of laparoscopy in the treatment and staging of cervical cancer. In the early stages, it is possible to provide a fertility-preserving surgery in the form of radical trachelectomy and, in a study protocol, the function-preserving surgery, avoiding parametrectomy and the associated morbidity. A fully laparoscopic radical hysterectomy is fairly standard in the literature and has the tendency to become the standard of care in early cases, for patients who want to bear no more children. In advanced stages, minimally invasive surgery can offer ovarian transposition, with intent to prevent actinic castration, without upsetting the time for the start of radiotherapy and chemotherapy. Staging laparoscopic surgery, including pelvic and para-aortic lymphadenectomy, has been the subject of studies, since it has the potential to modify the extension of radiotherapy depending on the extent of lymph node spread.

Sawfly larval poisoning in cattle: Report on new outbreaks and brief review of the literature

Sawfly larval poisoning (SLP) is an acute hepatotoxicosis documented in livestock in Australia, Denmark and in countries of South America. It is caused by the ingestion of the larval stage of insects of the suborder Symphyta, order Hymenoptera, commonly known as "sawfly". Three species of sawfly are reportedly involved in the toxicosis. The insect involved in Australian SLP is Lophyrotoma interrupta (Pergidae), in Denmark the cause of SLP is the ingestion of the larvae Arge pullata (Argidae), and in South American countries documented outbreaks of SLP were caused by the ingestion of yet another sawfly, Perreyia flavipes (Pergidae). In all geographical areas where it occurred, SLP causes important livestock losses. In cattle, as well as in other affected species, the disease has a short clinical course and in many outbreaks affected cattle can be found dead. When observed, clinical signs include apathy, recumbence, tremors, paddling movements and death in 24-48 hours. Neurological signs such aggressiveness attributable to hepatic encephalopathy are also observed. In cases with a more protracted course icterus and photodermatitis may develop. Gross findings included ascites, petechiae and ecchymosis over serosal surfaces of thoracic and abdominal cavities, and an enlarged liver that displays accentuation of the lobular pattern and edema of the gall bladder wall. Sawfly larval body fragments and heads are consistently found in the fore stomachs and occasionally abomasum of affected cattle. Main microscopic lesions are restricted to the liver and consist of centrolobular (periacinar) to massive hepatocellular necrosis. In most lobules necrotic areas extended up to the portal triads where only a few viable hepatocytes remain. Mild to moderate lymphocyte necrosis is seen in lymphatic tissues. Cases occur in the winter months when the larval stages of the sawfly are developing. D-amino acid-containing peptides have been found to be the toxic principle in each sawfly involved in SLP. The octapeptide lophyrotomin is the major toxin in the in the larvae of Australian and Danish sawflies and is present in small amounts in the larvae of South American sawfly. The heptadecapeptide pergidin is the main toxin in the South American sawfly while small amounts of pergidin have been found in the other two species of toxic sawfly. During the winter of 2011 (July-August) four outbreaks of SLP were diagnosed in the State of Rio Grande do Sul, Brazil. The findings in those outbreaks are reported here and a brief review of the literature regarding SLP around the world is provided.