Fibroma periférico odontogénico em cão : relato de caso

Os tumores odontogénicos são neoplasias derivadas da ectoderme ou dos componentes mesenquimais do periodonto. As lesões possuem características clínicas similares aos tumores odontogénicos, sendo a diferenciação histopatológica essencial para o diagnóstico. Existe controvérsia em relação aos nomes, as características clínicas e histopatológicas dos mesmos. Por outro lado, a maioria dos cirurgiões removem-nos sem exame histopatológico pré-cirúrgico. O objetivo do trabalho foi relatar um caso de fibroma periférico odontogénico (FPO) em um cão castrado, sem raça definida, 11 anos de idade. O paciente apresentava uma massa ao redor do segundo, terceiro e quarto dente pré-molar da maxila direita. Foi realizado o hemograma, bioquímica sérica, exame de urina e a biópsia da massa enviada para a histopatologia, sendo o diagnóstico pré-cirúrgico de fibroma periférico odontogénico. O tratamento foi cirúrgico, utilizando o bisturi elétrico. O presente relato de caso permitiu concluir que o exame histopatológico pré-cirúrgico é importante para o diagnóstico do tumor e a exérese total da massa tumoral é o tratamento de eleição.

Effect of patient age on management decisions in breast cancer: consensus from a national consultation

This qualitative study investigated the attitudes, perceptions, and practices of breast cancer specialists with reference to the effect of patient age on management decisions in breast cancer, and attempted to identify national consensus on this issue. One hundred thirty-three relevant specialists, including 75 surgeons and 43 oncologists, participated in a virtual consultation using e-mailed questionnaires and open-ended discussion documents, culminating in the development of proposed consensus statements sent to participants for validation. A strong consensus was seen in favor of incorporating minimum standards of diagnostic services, treatment, and care for older patients with breast cancer into relevant national guidance, endorsed by professional bodies. Similarly, an overwhelming majority of participants agreed that simple, evidence-based protocols or guidelines on standardizing assessment of biological and chronological age should be produced by the National Institute for Health and Clinical Excellence and the Scottish Medicines Consortium, developed in collaboration with specialist oncogeriatricians, and endorsed by professional bodies. A further recommendation that all breast cancer patient treatment and diagnostic procedures be undertaken in light of up-to-date, relevant scientific data met with majority support. This study was successful in gauging national specialist opinion regarding the effect of patient age on management decisions in breast cancer in the U.K.

Caso para Diagnóstico

Descreve-se caso clínico de paciente do sexo masculino, jovem, imunocompetente, portador de melanoníquia fúngica no terceiro pododáctilo causado por Scytalidium dimidiatum. Discutem-se a semiotécnica diagnóstica, seus diferenciais e a terapêutica adequada. Os autores destacam que a etiologia fúngica deva ser considerada no diagnóstico das melanoníquias.

Discrepancies between clinical diagnoses and autopsy findings

Autopsy examination is considered to be an essential element for medical auditing and teaching. Despite the significant progress in diagnostic procedures, autopsy has not always confirmed the clinical diagnosis. In the present study, we compared the diagnosis recorded on medical charts with reports of 96 autopsies performed at the University Teaching Hospital of the Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil, between 1975 and 1982, and of 156 autopsies performed at the same institution between 1992 and 1996. The clinical diagnosis of the basic cause of death was confirmed at autopsy in 77% of cases. The percent confirmation fell to 60% when the immediate terminal cause of death was considered, and in 25% of cases, the terminal cause was only diagnosed at autopsy. The discrepancies between clinical and autopsy diagnosis were even larger for secondary diagnoses: 50% of them were not suspected upon clinical diagnosis. Among them, we emphasize the diagnosis of venous thromboses (83%), pulmonary embolisms (80%), bronchopneumonias (46%) and neoplasias (38%). Iatrogenic injuries were very frequent, and approximately 90% of them were not described in clinical reports. Our results suggest that highly sensitive and specific diagnostic tests are necessary but cannot substitute the clinical practice for the elaboration of correct diagnoses.

Observational study on efficacy of negative expiratory pressure test proposed as screening for obstructive sleep apnea syndrome among commercial interstate bus drivers - protocol study

Background: Obstructive sleep apnea (OSA) is a respiratory disease characterized by the collapse of the extrathoracic airway and has important social implications related to accidents and cardiovascular risk. The main objective of the present study was to investigate whether the drop in expiratory flow and the volume expired in 0.2 s during the application of negative expiratory pressure (NEP) are associated with the presence and severity of OSA in a population of professional interstate bus drivers who travel medium and long distances.Methods/Design: An observational, analytic study will be carried out involving adult male subjects of an interstate bus company. Those who agree to participate will undergo a detailed patient history, physical examination involving determination of blood pressure, anthropometric data, circumference measurements (hips, waist and neck), tonsils and Mallampati index. Moreover, specific questionnaires addressing sleep apnea and excessive daytime sleepiness will be administered. Data acquisition will be completely anonymous. Following the medical examination, the participants will perform a spirometry, NEP test and standard overnight polysomnography. The NEP test is performed through the administration of negative pressure at the mouth during expiration. This is a practical test performed while awake and requires little cooperation from the subject. In the absence of expiratory flow limitation, the increase in the pressure gradient between the alveoli and open upper airway caused by NEP results in an increase in expiratory flow.Discussion: Despite the abundance of scientific evidence, OSA is still underdiagnosed in the general population. In addition, diagnostic procedures are expensive, and predictive criteria are still unsatisfactory. Because increased upper airway collapsibility is one of the main determinants of OSA, the response to the application of NEP could be a predictor of this disorder. With the enrollment of this study protocol, the expectation is to encounter predictive NEP values for different degrees of OSA in order to contribute toward an early diagnosis of this condition and reduce its impact and complications among commercial interstate bus drivers.

Estrutura de uma comunidade arbórea de floresta estacional semidecídua não pertubada no noroeste paulista em relação à outra comunidade com indicadores de perturbação

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Estudo epidemiológico da raiva, caracterização antigênica de cepas do vírus da raiva isoladas na Amazônia brasileira

Com o objetivo de avaliar a epidemiologia da raiva, procedimentos complementares ao diagnóstico - caracterização antigênica e genética - foram incluídos neste estudo para investigar o perfil epidemiológico da raiva animal na Amazônia brasileira, entre janeiro de 2000 e julho de 2009. Foi realizada uma revisão cuidadosa das informações de amostras do sistema nervoso central (SNC) recebidas e analisadas no Laboratório de Raiva do Instituto Evandro Chagas. Um total de 265 cepas de vírus rábico isoladas de amostras do SNC de seres humanos (n=33) e animais domésticos/silvestres (n=232) foram caracterizadas antigenicamente por imunofluorescência indireta (IFI), utilizando um painel de oito anticorpos monoclonais preparados pelo CDC contra a nucleoproteína do vírus da raiva; Além disso, 21 delas tiveram a nucleoproteína (gene N) caracterizada geneticamente por sequenciamento nucleotídico parcial seguida de análise filogenética. As sequências obtidas foram comparadas entre si e com outras sequências de vírus da raiva do Brasil e outros países das Américas, utilizando os métodos de máxima verossimilhança e bayesiano. Foi observada uma menor transmissão do vírus da raiva em áreas urbanas; detecção do ciclo rural da raiva em quase todos os estados da Amazônia; ocorrência do ciclo aéreo nos estados do Pará e Amapá; identificação da variante antigênica 2 (AgV2) do vírus da raiva, entre cães e gatos domésticos como o principal mecanismo de transmissão viral, detecção de circulação de variantes antigênicas AgV3, AgV4 e variante "Eptesicus" entre animais silvestres e, finalmente, a redução da transmissão cão-homem do vírus da raiva, que foi substituído por um aumento da transmissão morcego-homem, especialmente no estado de Pará. Em conclusão, a associação de técnicas antigênica e moleculares permitiu uma melhor compreensão da epidemiologia molecular do vírus da raiva na Amazônia Brasileira.

Freqüência do parvovírus suíno em fetos mumificados, abortados e natimortos detectado através da reação em cadeia pela polimerase (PCR)

Porcine parvovirus (PPV) is associated with reproductive failure and it has been found worldwide, including Brazil. Many diagnostic procedures are used for its detection, for example, immunofluorescence, HA, HI and PCR and this is an important technique because it is very specific and sensitive. In this work, the presence of PPV in fetuses from swine farms with reproductive problems was detected by PCR. All of 170 samples from aborted fetuses, mummies or stillborns were sampled by PCR with primers designed to VP2 region of PPV and c-myc (endogenous control). Only 142 samples (83,53%) were positive for c-myc and among them six samples (4,22%) were positive for PPV which were tested in HA. In this test, erythrocytes suspension 1% was used and three samples (50%) agglutinated but they presented low titer (4). For this work, porcine parvovirus was detected in the samples analyzed by PCR and HA. It is important to emphasize the use of endogenous control when material with elevated degree of autolysis is examined

Monitoramento da Qualidade do leite: Procedimentos Diagnósticos

Means for milk, not otherwise specified, the product from complete and uninterrupted milking , in a hygienic, healthy cows, well fed and rested. The milk of other animals must be called according to origin of species. One of the main characteristics that defined the milk is the set of their sensory characteristics, and the main flavor. The control of milk quality in Brazil has been an important factor for the consolidation of the entire production chain, passing necessarily by the dairy industry. The production of milk with good quality guarantees, of course, food safety for consumers. The measures to obtain milk begin on the property, in carrying out correct procedures for milking, storage and transportation of the product also in the dairy. Later, in the laboratory evaluation of physicochemical properties, research fraud, and microbiological examinations. Finally, measures of health education are need for producers to become aware of the economic benefits by obtaining a better quality milk. The objective of this review is to emphasize the importance of using diagnostic procedures methods for the control of mastitis and consequently obtain better Milk quality

Pneumonia and bacteremia in a golden-headed lion tamarin (Leontopithecus chrysomelas) caused by Klebsiella pneumoniae subsp pneumoniae during a translocation program of free-ranging animals in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Mineral element and heavy metal poisoning in animals

Mineral elements are essential to animal health, survival and production because they are part of physiological, structural, catalytic and regulatory organism functions. Therefore, they should be present in diet. However, these minerals when ingested in excessive doses due to errors in balancing mineral supplements and/or complete ration, intake of plants with high mineral concentration, resulting from addition of fertilizers, herbicides, insecticides and fungicides in pasture or tillage where plants and/or grains will be used to feed animals, decomposition of urban and industrial wastes, leaks and accidental spills of pollutants may result in accumulation of toxic mineral elements in the environment poisoning the animals and may lead them to death. However, toxic doses, physiological changes during poisoning, symptoms and mineral concentration in tissues of poisoned animals to confirm diagnosis are not completely known. Thus, this study reviews mineral element doses that some authors considered toxic for animals intake, as its concentration in tissues of poisoned animals and its physiological effects, symptoms, diagnostic procedures and treatment for poisoning by cadmium, lead, copper, chromium, iodine, manganese, molybdenum, selenium and zinc.

Comparative Analysis of the Complications of 5347 Endomyocardial Biopsies Applied to Patients After Heart Transplantation and With Cardiomyopathies: A Single-center Study

Introduction. Endomyocardial biopsy (EMB) plays an important role in allograft surveillance to screen an acute rejection episode after heart transplantation (HT), to diagnose an unknown cause of cardiomyopathies (CMP) or to reveal a cardiac tumor. However, the procedure is not risk free. Objective. The main objective of this research was to describe our experience with EMB during the last 33 years comparing surgical risk between FIT versus no-HT patients. Method. We analyzed retrospectively the data of 5347 EMBs performed from 1978 to 2011 (33 years). For surveillance of acute rejection episodes after HT we performed 3564 (66.7%), whereas 1777 (33.2%) for CMP diagnosis, and 6 (1.0%) for cardiac tumor identification. Results. The main complications due to EMB were divided into 2 groups to facilitate analysis: major complications associated with potential death risk, and minor complications. The variables that showed a significant difference in the HT group were as follows: tricuspid Injury (.0490) and coronary fistula (.0000). Among the no-HT cohort they were insufficient fragment (.0000), major complications (.0000) and total complications (.0000). Conclusions. EMB can be accomplished with a low risk of complications and high effectiveness to diagnose CMP and rejection after HT. However, the risk is great among patients with CMP due to their anatomic characteristics. Children also constitute a risk group for EMB due to their small size in addition to the heart disease. The risk of injury to the tricuspid valve was higher among the HT group.

Análise dos resultados maternos e fetais dos procedimentos invasivos genéticos fetais: um estudo exploratório em Hospital Universitário

OBJETIVO: Caracterizar as indicações das gestantes que procuraram o serviço de Medicina Fetal do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo para realização de procedimentos invasivos diagnósticos e avaliar os resultados dos cariótipos fetais e de suas gestações. MÉTODOS: Estudo observacional retrospectivo das gestantes que realizaram biópsia de vilo corial (BVC), amniocentese e cordocentese no período de fevereiro de 2005 a dezembro de 2009. Não foram incluídos outros procedimentos diagnósticos ou procedimentos terapêuticos. O resultado da gestação foi obtido através de consulta de prontuário eletrônico e/ou físico e/ou contato telefônico. RESULTADOS: Foram realizados 713 procedimentos (113 BVC, 340 amniocenteses e 260 cordocenteses). A principal indicação para a realização dos procedimentos invasivos foi a presença de alterações estruturais nos fetos, seguido por valores aumentados da translucência nucal e pela idade materna avançada. O cariótipo fetal esteve alterado em 186 casos (26,1%). A trissomia do cromossomo 18 foi a aneuploidia mais comum, seguida pela trissomia do 21, a monossomia do X e a trissomia do cromossomo 13. Ocorreram 4,9% de abortamento, 25,7% de natimortos e 13% de neomortos. Oito gestantes optaram pela interrupção judicial, e 99% das gestantes cujos fetos não apresentavam malformação e que apresentavam cariótipo fetal normal tiveram nativivos.

Synthesis and Characterization of Gold/Alanine Nanocomposites with Potential Properties for Medical Application as Radiation Sensors

Radiation dose assessment is essential for several medical treatments and diagnostic procedures. In this context, nanotechnology has been used in the development of improved radiation sensors, with higher sensitivity as well as smaller sizes and energy dependence. This paper deals with the synthesis and characterization of gold/alanine nanocomposites with varying mass percentage of gold, for application as radiation sensors. Alanine is an excellent stabilizing agent for gold nanoparticles because the size of the nanoparticles does not augment with increasing mass percentage of gold, as evidenced by UV-vis spectroscopy, dynamic light scattering, and transmission electron microscopy. X-ray diffraction patterns suggest that the alanine crystalline orientation undergoes alterations upon the addition of gold nanoparticles. Fourier transform infrared spectroscopy indicates that there is interaction between the gold nanoparticles and the amine group of the alanine molecules, which may be the reason for the enhanced stability of the nanocomposite. The application of the nanocomposites as radiation detectors was evaluated by the electron spin resonance technique. The sensitivity is improved almost 3 times in the case of the nanocomposite containing 3% (w/w) gold, so it can be easily tuned by changing the amount of gold nanoparticles in the nanocomposites, without the size of the nanoparticles influencing the radiation absorption. In conclusion, the featured properties, such as homogeneity, nanoparticle size stability, and enhanced sensitivity, make these nanocomposites potential candidates for the construction of small-sized radiation sensors with tunable sensitivity for application in several medical procedures.

RHYTHM-AF: design of an international registry on cardioversion of atrial fibrillation and characteristics of participating centers

Background: Atrial fibrillation is a serious public health problem posing a considerable burden to not only patients, but the healthcare environment due to high rates of morbidity, mortality, and medical resource utilization. There are limited data on the variation in treatment practice patterns across different countries, healthcare settings and the associated health outcomes. Methods/design: RHYTHM-AF was a prospective observational multinational study of management of recent onset atrial fibrillation patients considered for cardioversion designed to collect data on international treatment patterns and short term outcomes related to cardioversion. We present data collected in 10 countries between May 2010 and June 2011. Enrollment was ongoing in Italy and Brazil at the time of data analysis. Data were collected at the time of atrial fibrillation episode in all countries (Australia, Brazil, France, Germany, Italy, Netherlands, Poland, Spain, Sweden, United Kingdom), and cumulative follow-up data were collected at day 60 (+/- 10) in all but Spain. Information on center characteristics, enrollment data, patient demographics, detail of atrial fibrillation episode, medical history, diagnostic procedures, acute treatment of atrial fibrillation, discharge information and the follow-up data on major events and rehospitalizations up to day 60 were collected. Discussion: A total of 3940 patients were enrolled from 175 acute care centers. 70.5% of the centers were either academic (44%) or teaching (26%) hospitals with an overall median capacity of 510 beds. The sites were mostly specialized with anticoagulation clinics (65.9%), heart failure (75.1%) and hypertension clinics (60.1%) available. The RHYTHM-AF registry will provide insight into regional variability of antiarrhythmic and antithrombotic treatment of atrial fibrillation, the appropriateness of such treatments with respect to outcomes, and their cost-efficacy. Observations will help inform strategies to improve cardiovascular outcomes in patients with atrial fibrillation.