Case Report: Fourth Branchial Cleft Cyst: A Case of Acute Suppurative Thyroiditis

This case report presents a 4 year-old-female patient with a neck mass who was diagnosed with an infected fourth branchial cleft cyst with left thyroid lobe involvement through fistulation. The case emphasizes the importance of considering uncommon etiologies, such as congenital anomalies, as a differential diagnosis when evaluating pediatric neck masses. The patient was prescribed broad-spectrum antibiotics, which led to the regression of the mass and inflammatory signs. Close follow-up in endocrinology and otorhinolaryngology appointments was maintained, and after 7 months, hypoplasia of the left lobe was observed. Thyroid function was reevaluated, and after two years, no recurrences were noted. The case highlights the significance of a comprehensive examination and assessment of corresponding clinical features, which can significantly reduce the rate of misdiagnoses and achieve an individualized diagnosis.info:eu-repo/semantics/publishedVersio

A visual scan analysis protocol for postural assessment at school in young students

© 2020 The Authors. Published by MDPI. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.3390/ijerph17082915© 2020 by the authors. Licensee MDPI, Basel, Switzerland. The aim of this study was to compare the X-ray diagnosis with a non-invasive method for spine alignment assessment adopting a visual scan analysis with a plumb line and simetograph in middle-school students. The sample of this study was composed of 31 males and 50 females with an average age of 14.23 (± 3.11) years. The visual scan analysis was assessed at a school; whereas, the X-ray was performed in a hospital. The Wilcoxon signed-rank test was used to assess the differences between methods and scoliosis classifications (non-accentuated 10º), and the Kappa was used to assess the agreement between methods. The comparisons between the methods revealed non-significant differences (z = −0.577; p = 0.564), with almost perfect agreement between tests (K = 0.821; p < 0.001). Moreover, no statistical significance was observed between methods by the scoliosis classification (z = −1.000; p = 0.317), with almost perfect agreement between tests (K = 0.888; p < 0.001). This research supports the conclusion that there are no significant differences between the two methods. Therefore, it should be highlighted that this field test should be used by physical education teachers in their classes, or in a school context, in order to determine misalignments or scoliosis prevalence among middle-school students.Published versio

Atypical presentation of erythema multiforme

info:eu-repo/semantics/publishedVersio

New Insights From Pre-Columbian Land Use and Fire Management in Amazonian Dark Earth Forests

This is the final version of the article. Available from Frontiers Media via the DOI in this record.Anthropogenic climate change driven by increased carbon emissions is leading to more severe fire seasons and increasing the frequency of mega-fires in the Amazon. This has the potential to convert Amazon forests from net carbon sinks to net carbon sources. Although modern human influence over the Earth is substantial, debate remains over when humans began to dominate Earth's natural systems. To date, little is known about the history of human land use in key regions like the Amazon. Here, we examine the history of human occupation from a ~8,500 year-old sediment core record from Lake Caranã (LC) in the eastern Amazon. The onset of pre-Columbian activity at LC (~4,500 cal yr B.P.) is associated with the beginning of fire management and crop cultivation, later followed by the formation of Amazonian Dark Earth soils (ADEs) ~2,000 cal yr B.P. Selective forest enrichment of edible plants and low-severity fire activity altered the composition and structure of forests growing on ADEs (ADE forests) making them more drought susceptible and fire-prone. Following European colonization (1661 A.D.), the Amazon rubber boom (mid-1800s to 1920 A.D.) is associated with record-low fire activity despite drier regional climate, indicating fire exclusion. The formation of FLONA Reserve in 1974 A.D. is accompanied by the relocation of traditional populations and a fire suppression policy. Despite suppression efforts, biomass burning and fire severity in the past decade is higher than any other period in the record. This is attributed to combined climate and human factors which create optimal conditions for mega-fires in ADE forests and threatens to transform the Amazon from a net carbon sink to a net carbon source. To help mitigate the occurrence of mega-fires, a fire management policy reducing fire-use and careful fire management for farming may help to reduce fuel loads and the occurrence of mega-fires in fire-prone ADE forests. As both natural and anthropogenic pressures are projected to increase in the Amazon, this study provides valuable insights into the legacy of past human land use on modern ADE forest composition, structure, and flammability that can inform ecological benchmarks and future management efforts in the eastern Amazon.Funding for this research was supported by the PAST (Pre-Columbian Amazon-Scale Transformations) European Research Council Consolidator Grant to JI (ERC_Cog 616179). Research was conducted under permit 01506.004836/2014-69 from the Instituto do Patrimônio Histórico e Artístico Nacional (IPHAN) and ICMBio permit 106/14-FNT. We thank all residents of Maguarí and Jamaraquá community for their hospitality and help

DISCURSIVE PROOF OF Tender for attendant Reintegration SOCIAL EDUCATION: PROTECTION INTEGRAL TO CHILD AND TEENAGER - RESPONSIBILITY OF ALL SOCIETY

Este artigo discutirá a prova discursiva do concurso para o cargo de atendente de reintegração socioeducativo em 2015 pela Fundação Universa.Os objetivos deste artigo são: analisar os critérios avaliativos da banca Fundação Universa no concurso para Atendente de Reintegração Social; comparar o padrão de respostas oferecido pela banca examinadora com as orientações de produção textual dos especialistas no assunto; e comentar uma das redações aprovadas neste concurso. A metodologia abordou os tipos de pesquisa teórica, social e de campo.This article will discuss the discursive proof of the contest for the position of social and educational reintegration attendant in 2015 by Universa Foundation. The objectives of this article are: to analyze the evaluative criteria of Universa Foundation Board in the competition for Attendant Social Reintegration; compare the pattern of responses offered by the examination board with the text production guidance of experts in the field; and comment on one of the essays approved in this contest. Themethodology addressed the types of theoretical, social and field research

Trissomia do Cromossomo 21: Atenção Farmacêutica para Portadores de Cuidados Especiais / Trissomy of Chromosus 21: Pharmaceutical Care for Special Care Patients

Trissomia do 21, ou como é conhecida, síndrome de Down (SD), é a principal causa genética da deficiência intelectual com graus variáveis de dificuldades físicas, motoras e cognitivas. Apesar da existência de casos hereditários, na maioria das vezes essa alteração se dá devido a uma nova mutação. Trata-se de uma pesquisa do tipo bibliográfica realizada com a utilização de livros, artigos científicos já publicados através da busca no banco de dados do scielo e da bireme, a partir das fontes Medline e Lilacs e periódicos. Sabe-se que essa condição genética faz com que o indivíduo apresente algumas características especificas, necessitando de uma visão holística por meio dos profissionais de saúde, em especial o farmacêutico, que está ligado direto ou indiretamente aos cuidados através de fármacos

False Lumen Branched Stent Graft Implantation for Repair of a Dissecting Thoracoabdominal Aortic Aneurysm

Introdução: A degenerescência aneurismática em doentes com dissecção crónica tipo B (CTBAD) ocorre em aproxima damente 20 a 40% dos casos. O tratamento endovascular usualmente implica o implante de endoprótese no verdadeiro lúmen com o objetivo de excluir o falso lúmen. Os autores descrevem um caso em que o implante foi programado e executado no falso lúmen, devido às características anatómicas do doente. Caso clínico: Doente de 65 anos, sexo masculino, com antecedentes pessoais de HTA, dislipidémia e DRC. Foi referenciado ao nosso centro por achado em angioTC que revelou CTBAD, com dilatação aorta toracoabdominal secundária (aneurisma tóraco-abdominal tipo II de Crawford) com diâmetro máximo de 85mm. O tronco celíaco, artéria mesentéria superior e artéria renal direita emergiam do falso lúmen, e a artéria renal esquerda do verdadeiro lúmen. Foi programado o tratamento em 3 tempos distintos. Primeiro, o doente foi submetido a bypass carotido-subclávia. Seguiu-se frozen elephant trunk (FET), sendo que o componente de endoprótese foi intencionalmente implantado no falso lúmen. Seguidamente, procedeu-se ao implante de endoprótese ramificada customizada no falso lúmen da dissecção, cateterizando a artéria renal esquerda através de uma fenestração criada para o efeito e excluindo assim o verdadeiro lúmen da circulação. A selagem distal foi obtida numa zona não dissecada da aorta infra-renal. O angioTC 1 mês apresentava adequada zona de selagem proximal e distal e ramos viscerais permeáveis. O verdadeiro lúmen apresentava trombose parcial. Conclusão: O implante de uma endoprótese ramificada/fenestrada no falso lúmen é possível, e pode ser uma solução em casos selecionados de forma a ultrapassar complexidades anatómicas e eficazmente excluir o segmento aórtico aneurismático. A durabilidade deste procedimento ainda não se encontra completamente estabelecida, pelo que um follow-up cauteloso é recomendado.Introduction: It is estimated that approximately 20 to 40% of patients with chronic type B aortic dissection (CTBAD) develop enlargement of the FL that warrants treatment. The standard endovascular treatment usually involves implant of a stent graft into the true lumen of the dissection in an effort to exclude the false lumen, with less morbidity than open surgery. Clinical case: The patient was a 65 year old male, with a prior history of hypertension, dyslipidemia and chronic kidney disease. He was referred to our vascular center for a CTBD, with thoracoabdominal aneurysm degeneration (Crawford type II)with a maximum diameter of 85mm. The celiac trunk, superior mesenteric and right renal artery arose from the false lumen and left renal artery from the true lumen. A three stage procedure was planned. The patient was first submitted to a carotid-subclavian bypass. Subsequently, a frozen elephant trunk procedure was undertaken and the TEVAR component was intentionally deployed on the false lumen. Lastly, a customized branched stent graft was implanted into the false lumen, with the right renal artery catheterized through a fenestration created for the effect. The angioCT at 1 month showed adequate proximal and distal sealing and permeable visceral branches. The true lumen was partially thrombosed. Conclusion: Implant of a branched graft into the false lumen of an aortic dissection in order to exclude a thoracoab dominal aortic aneurysm is possible, and can be a solution, with successful exclusion of the aneurysmal degeneration. The durability of this solution remains largely unknown and cautious follow-up is needed.info:eu-repo/semantics/publishedVersio