Apoplexia em tumor hipofisário

Pituitary tumor apoplexy is a medical emergency due to acute infarction or hemorrhage in the pituitary gland. In this review, the authors discuss the sellar anatomy, the pituitary gland and adenomas' vascularization and the general aspects of the syndrome such as its ethiopatogenesis, predisposing factors, clinical features, treatment and prognosis.A apoplexia em tumor hipofisário é uma emergência médica decorrente do infarto agudo ou hemorrágico na glândula hipófise. Nesta revisão os autores discutem a anatomia da região selar, a vascularização da hipófise e adenomas hipofisários, e demais aspectos da síndrome como etiopatogenia, fatores predisponentes, quadro clínico, tratamento e prognóstico

Pós operatório imediato de neurocirurgias: o papel do enfermeiro no planejamento da assistência de enfermagem a partir dos dados dos sinais vitais / Immediate post operative neurosurgery: the role of the nurse in planning nursing care from the data of vital signs

No presente trabalho apresenta-se o papel do enfermeiro em uma assistência pós operatório imediato de neurocirurgias, voltado para a atenção às necessidades do paciente a partir dos sinais e sintomas apresentados. O objetivo principal é evidenciar o levantamento de um planejamento de intervenção, em que o enfermeiro possa a partir dos dados obtidos do paciente, intervir, para que sua recuperação seja com totalidade. Para tanto, na metodologia utilizou-se a revisão bibliográfica com pesquisas em sites de buscas de fundamentação científica indexados em dados de base da SciELO – Scientific Electronic Library Online, BVS – Bases de dados internacional da Biblioteca Virtual em Saúde, LILACS – Literatura Latino Americana e do Caribe em Ciências da Saúde, BIREME – Biblioteca Regional de Medicina e Biblioteca Central da UMC – Universidade de Mogi das Cruzes. Como resultado e discussão obteve-se o conhecimento de valores normais e evidenciando possíveis alterações que possam ocorrer após esta cirurgia de grande complexidade, além de possibilitar a execução do levantamento de possíveis diagnósticos e intervenções na assistência de enfermagem. Concluiu-se a importância do planejamento de uma assistência segura com possíveis intervenções e a atuação do enfermeiro dentro da sala de recuperação pós anestésica imediato de neurocirurgias, tendo por objetivo analisar possíveis alterações a partir dos sinais vitais e de sintomas vinculados aos mesmos, com a finalidade de promover o bem estar do paciente

Epidemiology and conduct carried out during the internment of children with respiratory disorders in a reference hospital of Recife / Epidemiologia e condutas realizadas durante o internamento das crianças com afecções respiratórias em hospital de referência do Recife”

INTRODUCTION: Airway infections correspond to more than a third of medical consultations, representing 20% of the causes of pediatric death.  OBJECTIVES: To identify the length of hospital stay;  Report the drugs utilized, complementary tests and interventions performed during hospitalization;  describe mean ICU stay, type of discharge and incidence of death;  To report the presence of factors predisposing to the occurrence of Respiratory Infections.  METHODS: This was a retrospective cross-sectional, documentational study of the medical records of children between 0 and 10 years of age hospitalized with respiratory diseases at the Hospital Infantil Maria Lucinda, Recife, Pernambuco, Brazil in 2016. RESULTS: Of the 489, 182 medical records were analyzed.  The mean age was 1.96 years.  The frequency of hospitalizations was 6.7% for neonates, 60.89% for infants, 24.58% for preschool children and 7.82% for schoolchildren.  It was more prevalent among male children (53.8%).  The mean hospitalization by age group of the Neonates was 27.75 days, Infants 5.87, Pre-school children 5.57 and Schoolchildren 7,14.  The major cause of hospitalization was pneumonia (48.9%).  Among the patients who were discharged, the mean hospitalization was 6.95 days and those who died 14.33 days.  The main antibiotics used were Ampicillin (30.8%) and Cephalosporin of the 3rd generation (18.7%).  24 cases reported use of pre-hospital antibiotics, with a mean hospitalization of 6.75 days.  Hospital nebulization was performed in 74.7% of cases and corticosteroids in 59.3%.  23.1% of the cases performed some surgical procedure.  The most frequent exams were Hemogram and Chest X-ray.  6% progressed to ICU and 1.6% died.  Intubation was performed in 7.1%, re-intubations in 53.8% of these and high recumbency was not performed in 25.8%.  CONCLUSIONS: The majority of the children evolved well, but it is important to improve the filling in of medical records, since the lack of information makes it difficult to construct the medical knowledge and to exert proper management of the patients

Polymorphisms in VEGF and KDR genes in the development of endometriosis: a systematic review

Abstract Objectives: to review studies that used case-control design to verify the association of polymorphisms in VEGF an

Síndrome de Cushing como complicação do tratamento de líquen plano oral erosivo.

Oral lichen planus (OLP) is a chronic mucocutaneous inflammatory disease involving T cells-mediated immunity. Several drugs have been used to treat OLP, specially the erosive and ulcerative forms, with varying results. The aim of this paper was to describe and discuss one clinical case of erosive oral lichen planus treated with systemic corticosteroids that resulted in Cushing´s syndrome that maintained with topical corticosteroid.O líquen plano oral (LPO) é uma doença mucocutânea inflamatória crônica relacionada com alterações na imunidade mediada por células T. Diversos medicamentos têm sido utilizados no tratamento desta doença, especialmente nas formas erosivas e ulcerativas, com resultados variados. O objetivo deste trabalho é descrever e discutir um caso clínico de líquen plano oral erosivo tratado com corticóide sistêmico que resultou em Síndrome de Cushing, que se manteve com o uso de corticóide tópico

Transcriptomic changes in human breast cancer progression as determined by serial analysis of gene expression

INTRODUCTION: Genomic and transcriptomic alterations affecting key cellular processes such us cell proliferation, differentiation and genomic stability are considered crucial for the development and progression of cancer. Most invasive breast carcinomas are known to derive from precursor in situ lesions. It is proposed that major global expression abnormalities occur in the transition from normal to premalignant stages and further progression to invasive stages. Serial analysis of gene expression (SAGE) was employed to generate a comprehensive global gene expression profile of the major changes occurring during breast cancer malignant evolution. METHODS: In the present study we combined various normal and tumor SAGE libraries available in the public domain with sets of breast cancer SAGE libraries recently generated and sequenced in our laboratory. A recently developed modified t test was used to detect the genes differentially expressed. RESULTS: We accumulated a total of approximately 1.7 million breast tissue-specific SAGE tags and monitored the behavior of more than 25,157 genes during early breast carcinogenesis. We detected 52 transcripts commonly deregulated across the board when comparing normal tissue with ductal carcinoma in situ, and 149 transcripts when comparing ductal carcinoma in situ with invasive ductal carcinoma (P < 0.01). CONCLUSION: A major novelty of our study was the use of a statistical method that correctly accounts for the intra-SAGE and inter-SAGE library sources of variation. The most useful result of applying this modified t statistics beta binomial test is the identification of genes and gene families commonly deregulated across samples within each specific stage in the transition from normal to preinvasive and invasive stages of breast cancer development. Most of the gene expression abnormalities detected at the in situ stage were related to specific genes in charge of regulating the proper homeostasis between cell death and cell proliferation. The comparison of in situ lesions with fully invasive lesions, a much more heterogeneous group, clearly identified as the most importantly deregulated group of transcripts those encoding for various families of proteins in charge of extracellular matrix remodeling, invasion and cell motility functions

A importância da triagem neonatal como diagnóstico precoce da hiperplasia adrenal congênita / The importance of neonatal screening as an early diagnosis of congenital adrenal hyperplasia

INTRODUÇÃO: Exames de triagem neonatal são realizados nos primeiros dias de vida do recém-nascido, ajudam a identificar precocemente algumas doenças e a prevenir futuras consequências. Dentre os exames realizados nessa triagem, disponíveis na Atenção Primária à Saúde, tem-se o teste do pezinho, o qual é fundamental para identificação de distúrbios, como a hiperplasia adrenal congênita (HAC). METODOLOGIA: Trata-se de uma revisão narrativa da literatura com busca nas bases de dados U.S National Library of Medicine (PubMed) e Scientific Eletronic Library Online (SciELO) utilizando os descritores “Adrenal Hyperplasia, Congenital” e “Neonatal Screening”. RESULTADOS: Foram identificados seis artigos essenciais para o desenvolvimento deste estudo. Esses trabalhos ocorreram nos últimos três anos, sendo o ano de 2019 o de maior evidência. DISCUSSÃO: A hiperplasia adrenal congênita constitui-se como um grupo de doenças autossômicas recessivas que geram um comprometimento metabólico do cortisol e da aldosterona. Esta pode ser classificada em três tipos e cada uma se apresenta de uma forma no corpo. Nos casos mais graves, pode causar déficit cognitivo ou até a morte. CONCLUSÃO: A triagem neonatal é uma estratégia eficaz para o diagnóstico precoce da HAC e é benéfica no contexto da saúde pública e da qualidade de vida do paciente

Impairment of circulating endothelial progenitors in Down syndrome

<p>Abstract</p> <p>Background</p> <p>Pathological angiogenesis represents a critical issue in the progression of many diseases. Down syndrome is postulated to be a systemic anti-angiogenesis disease model, possibly due to increased expression of anti-angiogenic regulators on chromosome 21. The aim of our study was to elucidate some features of circulating endothelial progenitor cells in the context of this syndrome.</p> <p>Methods</p> <p>Circulating endothelial progenitors of Down syndrome affected individuals were isolated, <it>in vitro </it>cultured and analyzed by confocal and transmission electron microscopy. ELISA was performed to measure SDF-1α plasma levels in Down syndrome and euploid individuals. Moreover, qRT-PCR was used to quantify expression levels of <it>CXCL12 </it>gene and of its receptor in progenitor cells. The functional impairment of Down progenitors was evaluated through their susceptibility to hydroperoxide-induced oxidative stress with BODIPY assay and the major vulnerability to the infection with human pathogens. The differential expression of crucial genes in Down progenitor cells was evaluated by microarray analysis.</p> <p>Results</p> <p>We detected a marked decrease of progenitors' number in young Down individuals compared to euploid, cell size increase and some major detrimental morphological changes. Moreover, Down syndrome patients also exhibited decreased SDF-1α plasma levels and their progenitors had a reduced expression of SDF-1α encoding gene and of its membrane receptor. We further demonstrated that their progenitor cells are more susceptible to hydroperoxide-induced oxidative stress and infection with Bartonella henselae. Further, we observed that most of the differentially expressed genes belong to angiogenesis, immune response and inflammation pathways, and that infected progenitors with trisomy 21 have a more pronounced perturbation of immune response genes than infected euploid cells.</p> <p>Conclusions</p> <p>Our data provide evidences for a reduced number and altered morphology of endothelial progenitor cells in Down syndrome, also showing the higher susceptibility to oxidative stress and to pathogen infection compared to euploid cells, thereby confirming the angiogenesis and immune response deficit observed in Down syndrome individuals.</p

A sub-Neptune transiting the young field star HD 18599 at 40 pc

Transiting exoplanets orbiting young nearby stars are ideal laboratories for testing theories of planet formation and evolution. However, to date only a handful of stars with age &amp;lt;1 Gyr have been found to host transiting exoplanets. Here we present the discovery and validation of a sub-Neptune around HD 18599 , a young (300 Myr), nearby (d = 40 pc) K star. We validate the transiting planet candidate as a bona fide planet using data from the TESS , Spitzer , and Gaia  missions, ground-based photometry from IRSF , LCO , PEST , and NGTS , speckle imaging from Gemini, and spectroscopy from CHIRON , NRES , FEROS , and Minerva-Australis . The planet has an orbital period of 4.13 d , and a radius of 2.7 R⊕ . The RV data yields a 3-σ mass upper limit of 30.5 M⊕  which is explained by either a massive companion or the large observed jitter typical for a young star. The brightness of the host star (V∼9 mag) makes it conducive to detailed characterization via Doppler mass measurement which will provide a rare view into the interior structure of young planets