Representação do corpo na relação consigo mesma após mastectomia

Esta pesquisa objetivou compreender como a mulher mastectomizada representa o seu corpo nas relações consigo mesma. O referencial teórico-metodológico foram as representações sociais. Foram entrevistadas, no domicílio, dez mulheres mastectomizadas, no sétimo dia pós-alta e uma vez por mês, durante quatro meses de pós-operatório. Os conteúdos da representação do corpo consigo mesma convergiram para quatro unidades de significação: a) corpos mutilados, cuja percepção foi demonstrada de diferentes formas; b) sensação de impotência em diversos momentos do período pós-operatório; c) dor e limitação, principalmente no início de sua recuperação; d) cuidado com o corpo. Foi possível entender que o princípio do cuidado de si para as mulheres tomou a forma de uma atitude, desenvolvida em práticas que foram refletidas e ensinadas como um processo contínuo após a cirurgia. A percepção da relação de corpo/físico/mente/espírito permearam, todos os momentos, sua vivência. Os resultados oferecem importantes elementos para reflexão quanto à assistência às mulheres mastectomizadas.

O uso da gastrostomia percutânea endoscópica

A gastrostomia percutânea endoscópica foi introduzida na prática clínica como via alternativa de alimentação enteral. É procedimento que não necessita de anestesia ou laparotomia, como a gastrostomia cirúrgica. A gastrostomia percutânea endoscópica tem como objetivos a manutenção do aporte nutricional e a melhoria da qualidade de vida e sobrevida dos pacientes. É indicada quando o paciente necessita de dieta enteral por período superior a um mês. A freqüência de complicações varia de 1,0% a 10,0% e a mortalidade de 0,3% a 1,0%. É propósito deste trabalho abordar aspectos relevantes desse método de alimentação enteral, aprimorar seu manejo, bem como facilitar o manejo pelos pacientes que dele se utilizam. Para isso, vamos comentar as indicações e contra-indicações da gastrostomia percutânea endoscópica, técnica de colocação, material das sondas, antibiótico profilático, início de utilização, custo do procedimento, além de suas complicações, aspectos legais e éticos.

Blindness after laryngectomy and bilateral neck dissection in a diabetic patient: case report

CONTEXTO: O esvaziamento cervical que acompanha a ressecção da lesão primária no tratamento dos tumores malignos das vias aerodigestivas superiores possibilita o surgimento de complicações inerentes a ela ou ao prolongamento do tempo cirúrgico, aumentando os riscos para o paciente. Entre as complicações que podem ocorrer está a amaurose, de incidência rara. RELATO do CASO: Um paciente submetido a laringectomia total e esvaziamento cervical seletivo à esquerda e radical modificado à direita, que evoluiu com amaurose, provavelmente decorrente de hipotensão intra-operatória, com contribuição dos Diabetes Mellitus descompensado e trombose da veia jugular interna à direita. Discutem as possíveis causas, os fatores de risco e os cuidados que devem ser tomados para evitar essa rara, mas tão debilitante complicação.

Effects of lisinopril on experimental ischemia in rats. Influence of infarct size

OBJECTIVE - Angiotensin-converting enzyme inhibitors (ACEIs) have gained importance in preventing or attenuating the process of ventricular remodeling after myocardial infarction. The significance of infarct size in regard to the response to ACEIs, however, is controversial. This study aimed to analyze the effects of lisinopril on mortality rate, cardiac function, degree of cardiac hypertrophy and fibrosis in rats with different infarct sizes. METHODS - Lisinopril (20 mg/kg/day) dissolved in drinking water was administered to rats immediately after coronary artery occlusion. After being sacrificed, the infarcted animals were divided into two groups: one group of animals with small infarcts (< 40% of the left ventricle) and another group of animals with large infarcts (> 40% of the left ventricle). RESULTS - The mortality rate was 31.7% in treated rats and 47% in the untreated rats. There was no statistical difference between the groups with small and large infarcts in regard to myocardial concentration of hydroxyproline. In small infarcts, the treatment attenuated the heart dysfunction characterized by lower levels of blood pressure and lower values of the first derivative of pressure and of the negative derivative of pressure. The degree of hypertrophy was also attenuated in small infarcts. In regard to large infarcts, no differences between the groups were observed. CONCLUSION - Treatment with the ACEIs had no effect on mortality rate and on the amount of fibrosis. The protective effect of lisinopril on heart function and on the degree of hypertrophy could only be detected in small infarcts

Ventricular remodeling induced by retinoic acid supplementation in adult rats

Retinoic acid (RA) plays a role in regulating cardiac geometry and function throughout life. The aim of this study was to analyze the cardiac effects of RA in adult rats. Wistar rats were randomly allocated to a control group (n = 18) receiving standard rat chow and a group treated with RA (n = 14) receiving standard rat chow supplemented with RA for 90 days. All animals were evaluated by echocardiography, isolated papillary muscle function, and morphological studies. Whereas the RA-treated group developed an increase in both left ventricular (LV) mass and LV end-diastolic diameter, the ratio of LV wall thickness to LV end-diastolic diameter remained unchanged when compared with the control group. In the isolated papillary muscle preparation, RA treatment decreased the time to peak developed tension and increased the maximum velocity of isometric relengthening, indicating that systolic and diastolic function was improved. Although RA treatment produced an increase in myocyte cross-sectional area, the myocardial collagen volume fraction was similar to controls. Thus our study demonstrates that small physiological doses of RA induce ventricular remodeling resembling compensated volume-overload hypertrophy in rats.

Reusability of dictionaries in the compilation of NLP lexicons

This paper discusses particular linguistic challenges in the task of reusing published dictionaries, conceived as structured sources of lexical information, in the compilation process of a machine-tractable thesaurus-like lexical database for Brazilian Portuguese. After delimiting the scope of the polysemous term thesaurus, the paper focuses on the improvement of the resulting object by a small team, in a form compatible with and inspired by WordNet guidelines, comments on the dictionary entries, addresses selected problems found in the process of extracting the relevant lexical information form the selected dictionaries, and provides some strategies to overcome them.

Use of topical mitomycin C in myoplasty of the medial rectus muscle of rabbits

To possibly reduce postoperative adhesions that occur after ocular myoplasties, we investigated the topical effects of 0.04% mitomycin C on the repaired areas of the medial rectus muscle using an equine renal capsule preserved in 98% glycerin for reinforcement of the sutures. Twenty-four rabbits, divided into two groups of 12 animals each [untreated (control) and treated group (MMC)], were submitted to surgical rupture of the medial rectus muscle of one eye and repair of the defect 24 h later with sutures and an equine renal capsule. Post-operative prophylactic treatment of the two groups consisted of the administration of eye drops containing neomycin, polymyxin B and dexamethasone at regular 6-h intervals for eight consecutive days and daily rinsing with physiological saline. MMC animals received additional treatment with topical 0.04% mitomycin C every 6 h for 14 consecutive days. Slit lamp biomicroscopy showed greater irritation of the ocular surface in MMC animals during the first days post operatively. Adhesions were observed at 15 and 30 days of assessment in the two groups, but were more extensive in control animals at 60 days. Histopathology revealed inflammatory exudation in both groups, which was greater in MMC animals. Mitomycin C (0.04%) instilled at 6-h intervals for 14 consecutive days reduced the occurrence of fibrosis in the myoplastic areas. However, the equine renal capsule was found to be of little benefit for the reinforcement of myoplasties.

Myxedema ascites with elevated serum CA 125 concentration

We report a case of myxedema ascites and markedly elevated serum CA 125 concentration. The cause of ascites and elevated tumor markers in hypothyroidism remains unknown. Diagnosis was characterized by no evidence of malignancy seen by transvaginal ultrasonography or abdominal computed tomography and ascites resolution with serum CA 125 normalization after adequate hormonal treatment. Our data suggest that hypothyroidism should be considered in patients with ascites and elevated serum CA 125.

Homonymy in natural language processes: A representation using Pustejovsky's Qualia Structure and ontological information

This paper presents a proposal for the semantic treatment of ambiguous homographic forms in Brazilian Portuguese, and to offer linguistic strategies for its computational implementation in Systems of Natural Language Processing (SNLP). Pustejovsky's Generative Lexicon was used as a theoretical model. From this model, the Qualia Structure - QS (and the Formal, Telic, Agentive and Constitutive roles) was selected as one of the linguistic and semantic expedients for the achievement of disambiguation of homonym forms. So that analyzed and treated data could be manipulated, we elaborated a Lexical Knowledge Base (LKB) where lexical items are correlated and interconnected by different kinds of semantic relations in the QS and ontological information.

Uveodermatologic syndrome in a Brazilian Fila dog

A 5-year-old Brazilian Fila dog was presented with a history of vision loss, alopecia, and generalized depigmentation of the skin and hair. Clinical examination confirmed generalized depigmentation and pyodermitis. on ophthalmic examination there was depigmentation at the eyelid mucocutaneous junction, associated with anterior uveitis, and bilateral posterior synechia at 360degrees. Both the complete blood count and skin scraping were normal. Skin biopsy showed histiocytary lichenoid interface dermatitis with an absence of pigment within the queratinocytes, and a moderate lymphomononuclear infiltrate and predominance of histiocytes in the papilar derma suggestive of uveodermatologic syndrome. Clinical management consisted of oral and topical administration of prednisone, associated with 1% indometacine eye drops. Methylprednisone was also used twice via the subconjunctival route, at an interval of 15 days. To prevent the development of secondary glaucoma due to posterior synechiae, dorzolamide and timolol eye drops were indicated. Both dermatologic and ophthalmic signs showed good improvement, vision was preserved, and some repigmentation of the skin and hair occurred.