PERFIL EPIDEMIOLÓGICO DE TUMORES INTRACRANIANOS METASTÁTICOS SUBMETIDOS À NEUROCIRURGIA

Introduction: Brain metastases are usually due to lung carcinoma, breast cancer and melanoma. The search to hospitals for neurological symptoms without prior knowledge of primary cancer is frequent. Objective: Analyze the epidemiological profile of patients with brain metastases. Method: This is a crosssectional study, with data collection from patients with brain metastases from the neurosurgery service, between 2010 and 2020. Results: The sample consisted of 114 patients and the main primary sites were lung (39 %), non-determined site (25%) and melanoma (15%). Most (61%) were unaware of the primary cancer. The most affected site was the frontal lobe (32%), on the right side (41%), and most lesions were single (68%). Conclusion: The epidemiological analysis corroborated most of the findings in the literature, with the primary pulmonary site and the discovery of metastasis before the primary cancer being the majority of cases.Introdução: As metástases cerebrais são, geralmente, decorrentes de carcinoma pulmonar, mama e melanoma. A procura ao hospital por sintomas neurológicos sem o conhecimento prévio do câncer primário é frequente. Objetivos: Analisar o perfil epidemiológico dos pacientes com metástase cerebral. Método: Trata-se de um estudo transversal, com coleta de dados dos pacientes com metástases cerebrais entre 2010 a 2020. Resultados: A amostra foi de 114 pacientes e os principais sítios primários foram pulmão (39%), sítio não determinado (25%) e melanoma (15%). A maior parte (61%) desconhecia o câncer primário. O local mais acometido foi lobo frontal (32%), do lado direito (41%), e a maioria das lesões eram únicas (68%). Conclusão: A análise epidemiológica corroborou com grande parte dos achados na literatura, sendo o sítio primário pulmonar e a descoberta da metástase antes do câncer primário a maioria dos casos

PREVALÊNCIA DA SÍNDROME DE BURNOUT EM PROFISSIONAIS DE SAÚDE DURANTE A PANDEMIA DE COVID-19

Introduction: Burnout syndrome in the professional context is a condition caused by long-term stress in the workplace. In the face of the COVID-19 pandemic it has been observed that healthcare workers have experienced psychological health issues. Objective: This study aims to analyze different professional categories and sectors, identifying the main risk factors and coping mechanisms adopted by healthcare professionals associated with Burnout syndrome. Method: A literature search was conducted, and an electronic form was administered to healthcare professionals who provided direct medical care to COVID-19 diagnosed and hospitalized patients in the city of Curitiba, Brazil, from March 2020 to November 2021. The questionnaire included personal and professional information, as well as specific conditions experienced during the pandemic, coping strategies, and the application of the Maslach Burnout Inventory - Human Services Survey (MBI-HSS) to assess the prevalence of Burnout syndrome. Results: The sample consisted of 89 healthcare professionals, and a prevalence of 48.31% for Burnout syndrome was identified. No statistically significant results were found when analyzing different professional categories and sectors. However, changing sectors during the pandemic was statistically significant (p=0.0245), as well as seeking emotional/psychiatric/psychological support (p=0.0004), and the importance of using mediation during the pandemic (p=0.0027). Conclusions: Changing sectors during the pandemic was identified as the only risk factor in this study. The main coping mechanisms adopted by healthcare professionals during the COVID-19 pandemic to address Burnout syndrome included seeking emotional, psychological, and psychiatric support, as well as an increased use of psychotropic medication.Introdução: A síndrome de Burnout no ambiente profissional é uma condição causada por estresse de longo prazo no local de trabalho e que diante da pandemia causada pela COVID-19, foram evidenciados agravos à saúde psíquica do trabalhador da saúde. Objetivo: Analisar as diferentes categorias e setores de atuação profissional, elencando os principais fatores de risco e as principais formas de enfrentamento adotadas pelos profissionais de saúde associados à síndrome de Burnout. Método: Foi realizada busca bibliográfica e aplicação de formulário eletrônico, aos profissionais de saúde que prestaram assistência médica direta a pacientes internados e hospitalizados com COVID-19 no município de CuritibaPR entre o período de março de 2020 a novembro de 2021; contendo comandos com informações pessoais,profissionais e relacionados com as condições específicas vivenciadas durante a pandemia/ medidas de enfrentamento e aplicação do teste Maslach Burnout Inventory – Human Services Survey (MBI-HSS) para análise da prevalência do Síndrome de Burnout. Resultados: A amostra foi composta por 89 profissionais de saúde. Evidenciou-se uma prevalência de 48,31% de Síndrome de Burnout. Não foram encontrados resultados estatisticamente ao analisar diferentes categorias profissionais e setores de atuação. A mudança de setor durante a pandemia foi estatisticamente significativa (p=0,0245), assim como a busca por apoio emocional/psiquiátrico/psicológico (p=0,0004) e seguro acerca do uso de mediação durante a pandemia (p= 0,0027). Conclusões:A mudança de setor durante uma pandemia foi considerada o único fator de risco encontrado no estudo. As principais formas de enfrentamento ao Síndrome de Burnout adotadas pelos profissionais de saúde durante a pandemia de COVID-19 foram a busca por apoio emocional, psicológico, psiquiátrico e aumento do uso de medicação psicotrópic

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

Immunohistochemical expression of Ki67, EGFR and TRKC and their correlation with prognostic factors in medulloblastoma

Introduction: Medulloblastoma is a malignant embryonal tumor of the cerebellum with poor prognosis. The treatment is based only on clinical criteria, such as risk group that only considers age, extent of tumor resection, recurrence, and metastasis. Objective: To evaluate a possible relationship between the immunoexpression of biomarkers (Ki67, receptor neutrophin-3 [TRKC], epidermal growth factor receptor [EGFR], B-cell lymphoma 2 [Bcl-2], and cyclin-D1), and the classical clinical prognostic factors of medulloblastoma. Material and method: thirty-five samples of pediatric medulloblastoma free of neoadjuvant chemotherapy were separated and reviewed for their histopathological classification; two areas representative of tumor were used in the construction of tissue microarrays. The following clinical data from 29 patients were used for comparison with the biomarkers expression: patient's age, presence or absence of complete tumor resection, staging patient's risk group, presence or absence of metastases, presence or absence of postoperative chemotherapy, and presence or absence of recurrence. Clinical follow-up of the study ranged from two to thirteen years, and cases with fatal outcome were also analyzed. Results: Patients with upper age showed higher expression of TRKC (p = 0.033). There was inversely proportional and statistically significant correlation between TRKC and Ki67 (p = 0.027). There was no statistical significance in the analysis of EGFR, Bcl2, and cyclin-D1. Conclusion: The immunoexpression of TRKC might be considered a biomarker related to tumors with better prognosis in patients with medulloblastoma, contributing to better risk groups' stratification

Biocompatibilidade do polímero da mamona comparada ao implante de titânio para corações artificiais: estudo experimental em cobaias Biocompatibility of Ricinus comunnis polymer compared to titanium implant used in artificial hearts: experimental study in guinea pigs

OBJETIVO: Determinar se a reação tecidual do implante retroperitoneal do polímero de óleo de mamona (Pm) é significativa ou não por meio de análise histopatológica, tendo como controle o implante de titânio (Ti). MÉTODOS: Estudo experimental, intervencionista e randomizado com 32 cobaias. Os animais foram divididos em quatro grupos iguais e eutanasiados com 7, 20, 30 e 40 dias após o ato cirúrgico. Foram confeccionadas lâminas em hematoxilina-eosina e em tricrômio de Masson. Na comparação dos tipos de material em relação a variáveis quantitativas, foi considerado o teste não-paramétrico de Wilcoxon. Em relação a essas variáveis, os grupos definidos pelo dia do sacrifício foram comparados usando-se o teste não-paramétrico de Kruskal-Wallis. Os resultados obtidos no estudo da fibrose foram expressos por frequ��ncias e percentuais. Para a comparação entre os grupos definidos pelo dia do sacrifício, em relação a variáveis qualitativas dicotômicas da fibrose, foi considerado o teste exato de Fisher. Para avaliar a diferença entre os materiais titânio e polímero em cada grupo, ainda em se tratando da fibrose, foi considerado o teste binomial. Valores de P<0,05 indicaram significância estatística. RESULTADOS: A análise das variáveis quantitativas não demonstrou diferença nas reações teciduais entre os materiais (P>0,05). A análise da variável qualitativa também não demonstrou diferença entre as reações teciduais dos materiais (P>0,05). CONCLUSÃO: Não foi encontrada significância estatística entre a reação tecidual do Pm e do Ti.<br>OBJECTIVE: The aim of the present investigation is to determine if the tissue reaction to the Riccinus communis (mamona) polymer has significant statistical difference compared to the tissue reaction provoked by the titanium implant. METHODS: Thirty two Cavia porcellus were divided into four groups containing eight animals each one. We implanted the two types of materials in the retroperitoneal space of all the animals. They were sacrificed at 7, 20, 30 and 40 days after surgery and the samples were submitted to histological study. RESULTS: The quantitative analysis did not show difference between the tissue reaction of the two materials (P>0.05). The analysis of the qualitative variable also did not show difference between the tissue reaction of the materials (P>0.05). CONCLUSION: Macroscopic and microscopic results showed that the castor oil polymer implant has no significant statistical difference compared to the titanium implant tissue reaction

Comparison of polyurethane with cyanoacrylate in hemostasis of vascular injury in guinea pigs

Objective: To evaluate the behavior of castor oil-derived polyurethane as a hemostatic agent and tissue response after abdominal aortic injury and to compare it with 2-octyl-cyanoacrylate. Methods: Twenty-four Guinea Pigs were randomly divided into three groups of eight animals (I, II, and III). The infrarenal abdominal aorta was dissected, clamped proximally and distally to the vascular puncture site. In group I (control), hemostasis was achieved with digital pressure; in group II (polyurethane) castor oil-derived polyurethane was applied, and in group III (cyanoacrylate), 2-octyl-cyanoacrylate was used. Group II was subdivided into IIA and IIB according to the time of preparation of the hemostatic agent. Results: Mean blood loss in groups IIA, IIB and III was 0.002 grams (g), 0.008 g, and 0.170 g, with standard deviation of 0.005 g, 0.005 g, and 0.424 g, respectively (P=0.069). The drying time for cyanoacrylate averaged 81.5 seconds (s) (standard deviation: 51.5 seconds) and 126.1 s (standard deviation: 23.0 s) for polyurethane B (P=0.046). However, there was a trend (P=0.069) for cyanoacrylate to dry more slowly than polyurethane A (mean: 40.5 s; SD: 8.6 s). Furthermore, polyurethane A had a shorter drying time than polyurethane B (P=0.003), mean IIA of 40.5 s (standard deviation: 8.6 s). In group III, 100% of the animals had mild/severe fibrosis, while in group II only 12.5% showed this degree of fibrosis (P=0.001). Conclusion: Polyurethane derived from castor oil showed similar hemostatic behavior to octyl-2-cyanoacrylate. There was less perivascular tissue response with polyurethane when compared with cyanoacrylate

Citologia do derrame papilar

INTRODUÇÃO: A avaliação citológica do derrame papilar é um método bem estabelecido para o diagnóstico rápido de carcinoma mamário em mulheres. OBJETIVOS: Estabelecer a freqüência das diferentes categorias diagnósticas, as características citomorfológicas das descargas papilares e, ainda, a relação entre o aspecto macroscópico dessas secreções e o citodiagnóstico. MATERIAL E MÉTODO: O presente estudo analisou o resultado obtido do derrame papilar de 423 pacientes no período de janeiro de 1997 a abril de 2002. Os derrames foram classificados em positivo, negativo ou suspeito para células neoplásicas. RESULTADOS: Dos 423 casos analisados, os derrames papilares foram positivos em quatro casos, suspeitos em 11 e negativos em 408. O aspecto macroscópico hemorrágico esteve presente em dois casos positivos, sete suspeitos e 62 negativos. Os achados citológicos mais freqüentes, nos casos positivos ou suspeitos, foram de grupamentos papilares de células epiteliais com hemácias ou células ductais com atipias. DISCUSSÃO E CONCLUSÕES: Com base nessa experiência, conclui-se que os esfregaços catalogados como hemorrágicos, macroscópica ou microscopicamente, devem ser cuidadosa e sistematicamente analisados, pois neles há uma maior possibilidade de serem detectadas lesões significativas

Efeito da trimegestona sobre o tecido mamário de ratas castradas Effect of trimegestone on mammary gland of castrated rats

OBJETIVO: Avaliar o efeito da trimegestona sobre a proliferação celular do tecido mamário de ratas castradas. MÉTODOS: Foram utilizadas 45 ratas adultas e virgens, da linhagem Wistar, submetidas à castração. Após o 60º dia da castração, confirmado o hipoestrogenismo, os animais foram divididos aleatoriamente em três grupos, conforme o tratamento proposto: controle (n=15) recebeu soro fisiológico 0,9%; estrogênio (n=15) recebeu 17 beta-estradiol; e combinado (n=15) recebeu 17 beta-estradiol associado à trimegestona, todos por 60 dias consecutivos. Após o término do tratamento, procedeu-se a exérese das mamas inguinais, destinadas a análise morfométrica pela coloração de hematoxilina e eosina (HE) e imuno-histoquímica pela quantificação do anticorpo anti-PCNA no tecido mamário, seguido de eutanásia. Os parâmetros morfométricos avaliados foram: proliferação celular epitelial, atividade secretora e alteração do estroma mamário. Ocorreram nove óbitos durante o experimento. As variáveis foram submetidas à análise estatística adotando-se como significante pPURPOSE: To evaluate the efect of trimegestone on the histological changes of the mammary tissue of castrated rats. METHODS: Forty-five virgin female Wistar rats were used after oophorectomy. Sixty days after surgery, with hypoestrogenisms confirmed, the experimental rats were randomly assigned to three groups of 15 animals each, when then the specific treatment for each group was started. The control group (C) and experimental groups 1 and 2 respectively received 0.9% saline solution, 17-beta-estradiol and 17-beta-estradiol in combination with trimegestone for 60 consecutive days. After the end of treatment , the inguinal mammary glands were removed, stained with hematoxylin and eosin (HE) for morphometry and examined by immunohistochemistry for the quantification of anti-PCNA antibody in the mammary tissue, followed by euthanasia. The morphometric parameters evaluated were: epithelium cell-proliferation, secretor activity and mammary stroma changes. There were nine deaths during the experiment. The variables were submitted to statistical analysis adopting the 0.05 level of significance. RESULTS:Histological changes were observed in 16/36 rats, mild epithelial hyperplasia in 13/36, moderate epithelial hyperplasia in 3/36, with no cases of severe epithelial hyperplasia. Stromal fibrosis was found in 10/36 and secretory activity in 5/36 rats. All morphometric variables were significant in the estrogen group compared to control (p=0.0361), although there were no difference between the group receiving combined treatment and the controls (p=0.405). The immunohistochemical analysis showed no difference between groups. CONCLUSIONS:The hormones administered to castrated rats, i.e., 17 beta-estradiol alone or in combination with trimegestone, increased the proliferation of breast cells, but this effect appeared to be lower in the combined treatment, the same occurring regarding fibrosis of the mammary stroma