Leiomioma Intramural da Bexiga em Doente com Tumor Fibroso Pélvico - Caso Clínico

Introdução: O leiomioma vesical é um tumor benigno raro que representa,aproximadamente, 0,5% do total de neoplasias da bexiga. É frequentemente um achado imagiológico, sendo a sua localização e dimensões determinantes no desenvolvimento de sintomatologia e no tipo de procedimento a efectuar. Caso Clínico: Reporta-se o caso de um doente com queixas urinárias de disúria, polaquiúria e esforço miccional, inicialmente interpretadas como HBP. A investigação diagnóstica culminou com a enucleação de uma volumosa massa intramural da bexiga, com diagnóstico histológico de leiomioma, num doente com antecedentes de doença de Madelung e excisão prévia de um tumor fibroso paravesical. Discussão: O leiomioma vesical, embora apresentando características imagiológicas típicas, deve ser sempre biopsado para confirmação histológica da sua etiologia. O tumor fibroso pélvico apresenta sempre indicação cirúrgica pois, numa minoria de casos, pode apresentar comportamento agressivo com infiltração dos órgãos adjacentes.

Intramural Hematoma of the Esophagus After Thrombolysis for Ischemic Stroke

Intramural dissecting hematoma is an unusual esophageal condition with a threatening presentation but excellent prognosis when managed conservatively.We report the case of an 88-year-old woman who developed an intramural hematoma of the esophagus after intravenous thrombolysis for an acute ischemic stroke. Before thrombolysis, nasogastric intubation was attempted unsuccessfully. She was kept on nil by mouth, intravenous hydration, proton pump inhibitor, antiemetics,and an antibiotic initiated 2 days before for periodontal disease. The esophageal hematoma regressed, and she resumed oral diet asymptomatically.To our knowledge, this is the first report of this type of lesion after thrombolysis for an ischemic stroke. A brief discussion and literature review are presented.

Anomalous origin of the left coronary artery from the right pulmonary artery with intramural aortic trajectory. Clinicosurgical diagnostic implications

OBJECTIVE: Anomalous origin of the left coronary artery from the right pulmonary artery (AOLCARPA), is a rare entity that is usually associated with other defects. Of the 20 cases of AOLCARPA reported in the literature, 14 (70%) had associations. We describe four patients with AOLCARPA without associated defects, but with a peculiar intramural aortic trajectory. METHODS: Fifty-five patients with anomalous origin of the left coronary artery were operated upon at INCOR-FMUSP. Four of the patients had the anomalous origin from the right pulmonary artery (RPA) without associated defects but with intramural aortic trajectory. Clinical and laboratory examinations were analyzed, as well as surgical findings. RESULTS: All patients had congestive heart failure (CHF) and 3 also had angina pectoris. Two patients had a murmur of mitral regurgitation, signs of myocardial infarction on the ECG and cardiomegaly. The shortening fraction varied from 9% to 23%. The hemodynamic study confirmed the diagnosis of anomalous origin of the coronary artery, but the intramural trajectory and the origin from the RPA were established only at surgery. In 3 patients, the technique of side-to-side anastomosis was performed with a good outcome. One patient, who underwent end-to-side anastomosis, died 6 months after the surgery. CONCLUSION: Association with other defects usually occurs in the AOLCARPA, and the intramural aortic trajectory is difficult to clinically diagnose but easy to surgically correct.

Hematoma intramural duodenal como complicação de terapia anticoagulante com Warfarin: relato de caso e revisão da literatura

Relatamos o caso de uma paciente em terapia anticoagulante oral com Warfarin, apresentando obstrução intestinal aguda. A tomografia computadorizada revelou hematoma intramural duodenal. O tratamento baseou-se na correção das provas de coagulação e medidas expectantes. Este caso ilustra o valor da tomografia computadorizada e da abordagem conservadora nos pacientes em terapia anticoagulante com obstrução aguda do intestino delgado.

Examining sport commitment and intentions to participate in intramural sports : application of the Sport Commitment Model and the Theory of Planned Behaviour in a campus recreational sport setting

Fifty-six percent of Canadians, 20 years of age and older, are inactive (Canadian Community Health Survey, 200012001). Research has indicated that one of the most dramatic declines in population physical activity occurs between adolescence and young adulthood (Melina, 2001; Stephens, Jacobs, & White, 1985), a time when individuals this age are entering or attending college or university. Colleges and universities have generally been seen as environments where physical activity and sport can be promoted and accommodated as a result of the available resources and facilities (Archer, Probert, & Gagne, 1987; Suminski, Petosa, Utter, & Zhang, 2002). Intramural sports, one of the most common campus recreational sports options available for post-secondary students, enable students to participate in activities that are suited for different levels of ability and interest (Lewis, Jones, Lamke, & Dunn, 1998). While intramural sports can positively affect the physical activity levels and sport participation rates of post-secondary students, their true value lies in their ability to encourage sport participation after school ends and during the post-school lives of graduates (Forrester, Ross, Geary, & Hall, 2007). This study used the Sport Commitment Model (Scanlan et aI., 1993a) and the Theory of Planned Behaviour (Ajzen, 1991) with post secondary intramural volleyball participants in an effort to examine students' commitment to intramural sport and 1 intentions to participate in intramural sports. More specifically, the research objectives of this study were to: (1.) test the Sport Commitment Model with a sample of postsecondary intramural sport participants(2.) determine the utility of the sixth construct, social support, in explaining the sport commitment of post-secondary intramural sport participants; (3.) determine if there are any significant differences in the six constructs of IV the SCM and sport commitment between: gender, level of competition (competitive A vs. B), and number of different intramural sports played; (4.) determine if there are any significant differences between sport commitment levels and constructs from the Theory of Planned Behaviour (attitudes, subjective norms, perceived behavioural control, and intentions); (5.) determine the relationship between sport commitment and intention to continue participation in intramural volleyball, continue participating in intramurals and continuing participating in sport and physical activity after graduation; and (6.) determine if the level of sport commitment changes the relationship between the constructs from the Theory of Planned Behaviour. Of the 318 surveys distributed, there were 302 partiCipants who completed a usable survey from the sample of post-secondary intramural sport participants. There was a fairly even split of males and females; the average age of the students was twenty-one; 90% were undergraduate students; for approximately 25% of the students, volleyball was the only intramural sport they participated in at Brock and most were part of the volleyball competitive B division. Based on the post-secondary students responses, there are indications of intent to continue participation in sport and physical activity. The participation of the students is predominantly influenced by subjective norms, high sport commitment, and high sport enjoyment. This implies students expect, intend and want to 1 participate in intramurals in the future, they are very dedicated to playing on an intramural team and would be willing to do a lot to keep playing and students want to participate when they perceive their pursuits as enjoyable and fun, and it makes them happy. These are key areas that should be targeted and pursued by sport practitioners.

Peer Motivational Climate and its Relationship with Positive and Negative Affect in Intramural Sports

The study of peers as an influence on sport participation has received minimal exploration. The purpose of this cross-sectional study was to determine how peer created motivational climates (task-involved and ego-involved) impact positive and negative affective states of intramural sport participants post-participation. Three hundred and fifteen intramural sport participants (N=315) at a Canadian university completed a questionnaire after participating in their intramural sport. Hierarchical regression analyses and MANCOVAs were used to examine the effects of peer motivational climates on positive and negative affect. Results revealed that task-involved peer climates are more conducive of positive affective states post-participation whereas ego-involved climates result in lesser positive affective states and more negative affective states. Teams that promote improvement and effort instead of intra-team competition and conflict will have more positive recreational sport experiences. Future research should explore other psychological outcomes that can result from peer created motivational climates in recreational sport team settings.