Peripheral Nerve Sheath Tumor in the Upper Eyelid in a Dog

Background: Schwannomas are benign neurogenic tumours of peripheral nerves. They originate from Schwann cells, which form the neural sheath.Peripheral nerve sheath tumors are most commonly found on the head and neck regions of both dogs and people. Schwannomas are rarely observed in ophthalmic areas. When they occur, ocular Schwannomas are usually located in the orbit, uveal tract and conjunctiva. The occurrence of uveal schwannoma, a subset of PNST has been well documented in the veterinary literature. This is the first report of a palpebral PNST in the dog. The lip-to-lid flap is a feasible technique to reconstruct the upper eyelid following wide surgical removal of a tumor in the dog.Case: A 9-year-old, spayed female mixed-breed dog was referred for evaluation of a large mass involving the right upper eyelid for a duration of approximately one month. The inspection revealed sero-sanguinolent discharge and an oval-shaped mass occupying more than 70% of the right upper eyelid. The dog was alert and the ophthalmic and general physical examination did not revealed abnormalities. Ocular ultrasonography did not show significant findings. A fine-needle aspirate of the palpebral tumor was not elucidative, even so, a presumptive diagnosis of eyelid neoplasia was considered most likely. Excision of the entire mass with a 2 cm margin was performed. The third eyelid and dorso-medial bulbar conjunctiva were also removed. Upper eyelid reconstruction was performed based on a similar technique previously described in cats (lip-to-lid flap). As a result, neoplastic spindle cells exhibited immunoreactivity for S100 and intense cytoplasmic staining for vimentin, supporting the diagnosis of schwannoma. Fifteen days later, the margins of the subdermal pattern flap were healed and skin sutures were removed. On the last follow-up, 9 months post-surgery, the dog was visual, and the flap was well incorporated and covered the ocular surface. Ten months later, another large mass arising from the right inferior palpebral conjunctiva was observed. Once ultrasound revealed orbital invasion exenteration combined with orbitectomy were performed, and the defect was covered with an auricular axial pattern flap. Although the second tumor had the same histological and immunohistochemical characteristics of the first mass additional staining for Ki67 was used to investigate the biological behavior of both masses.Discussion: Reported eyelid neoplasms in dogs include adenomas and adenocarcinomas of the meibomian glands, melanomas, fibroma, fibrosarcoma, histiocytoma, mastocytoma, lipomas, papillomas, and squamous cell carcinomas. To the author´s knowledge, however, this is the first case description of a PNST affecting the eyelid in a dog. The histologic distinction between PNSTs and other spindle cell tumors, including myxosarcoma, fibrosarcoma, leiomyosarcoma, hemangiopericytoma, and melanoma can be challenging and requires immunohistochemical stainin. S100 is an acidic protein that identifies various nervous tissue cells, including Schwann cells, and the majority of canine PNSTs diffusely express this molecule. As in the case presented here, neoplastic cells of different ocular and adnexal structures were also positive for S100 and vimentin in all PNSTs previously reported in the veterinary literature. This is the first report of PNST affecting the eyelid in a dog. The lip-to-lid flap is a feasible technique to reconstruct the upper eyelid following wide surgical removal of a tumor in dogs. However, the authors suggest radical surgery combining orbitectomy, exenteration and a miocutaneous flap if PNST is diagnosed in the eyelids of dogs. They also caution once recurrence is possible and can be more aggressive.Keywords: lip-to-lid transposition, S100, vimentin, desmin, Ki67, dog

Peripheral nerve sheath tumor in the upper eyelid in a dog

Background: Peripheral nerve sheath tumors are most commonly found on the head and neck regions of both dogs and people. Schwannomas are rarely observed in ophthalmic areas. When they occur, ocular Schwannomas are usually located in the orbit, uveal tract and conjunctiva. The occurrence of uveal schwannoma, a subset of PNST has been well documented in the veterinary literature. PNST has never been observed in the eyelids of dogs. Therefore, the present report aimed to describe the surgical treatment and outcome of a PNST located in the upper eyelid of a dog. Case: A 9-year-old, spayed female mixed-breed dog was referred for evaluation of a large mass involving the right upper eyelid for a duration of approximately one month. The inspection revealed sero-sanguinolent discharge and an oval-shaped mass occupying more than 70% of the right upper eyelid. A presumptive diagnosis of eyelid neoplasia was considered most likely. Excision of the entire mass with a 2 cm margin was performed. The third eyelid and dorso-medial bulbar conjunctiva were also removed. Upper eyelid reconstruction was performed based on a similar technique previously described in cats (lip-to-lid flap). As a result, neoplastic spindle cells exhibited immunoreactivity for S100 and intense cytoplasmic staining for vimentin, supporting the diagnosis of schwannoma. Fifteen days later, the margins of the subdermal pattern flap were healed and skin sutures were removed. On the last follow-up, 9 months post-surgery, the dog was visual, and the flap was well incorporated and covered the ocular surface. Ten months later, another large mass arising from the right inferior palpebral conjunctiva was observed. Once ultrasound revealed orbital invasion exenteration combined with orbitectomy were performed, and the defect was covered with an auricular axial pattern flap. The second tumor had the same histological and immunohistochemical characteristics of the first mass. Both tumors expressed Ki67; however, the PI in the second mass was higher (7.9%) than the first (3.4%). Discussion: Reported eyelid neoplasms in dogs include adenomas and adenocarcinomas of the meibomian glands, melanomas, fibroma, fibrosarcoma, histiocytoma, mastocytoma, lipomas, papillomas, and squamous cell carcinomas. To the author’s knowledge, however, this is the first case description of a PNST affecting the eyelid in a dog. The histologic distinction between PNSTs and other spindle cell tumors, including myxosarcoma, fibrosarcoma, leiomyosarcoma, hemangiopericytoma, and melanoma can be challenging and requires immunohistochemical stainin. S100 is an acidic protein that identifies various nervous tissue cells, including Schwann cells, and the majority of canine PNSTs diffusely express this molecule. As in the case presented here, neoplastic cells of different ocular and adnexal structures were also positive for S100 and vimentin in all PNSTs previously reported in the veterinary literature. This is the first report of PNST affecting the eyelid in a dog. The lip-to-lid flap is a feasible technique to reconstruct the upper eyelid following wide surgical removal of a tumor in dogs. However, the authors suggest radical surgery combining orbitectomy, exenteration and a miocutaneous flap if PNST is diagnosed in the eyelids of dogs. They also caution once recurrence is possible and can be more aggressive

Gestão Autônoma da Medicação: estratégia territorial de cogestão no cuidado

A estratégia Gestão Autônoma da Medicação -Brasil tem experimentado diferentes modos de ampliação, tanto em relação aos contextos regionais quanto às modalidades de serviços (como Unidades Básicas de Saúde e Centros de Atenção Psicossocial Álcool e outras drogas). Neste texto apresentaremos a experiência de uma equipe que articula pesquisa, ensino e extensão num território sanitário do município de São Paulo, tendo como eixo de intervenção o cuidado em saúde mental e a GAM como estratégia. O Coletivo GAM, que reúne todas as equipes do território, tem evidenciado os principais efeitos da estratégia em sua força alterativa e formativa: sua dimensão crítica à medicalização; sua inclinação radical à Reforma em Saúde Mental e sua força política em relação às grupalidades e aos coletivos que aciona. Neste percurso, afirma-se como estratégia territorial e cogestionária de formação e cuidado em saúde mental, que põe no centro de sua experiência a participação do usuário

OSTEOCHONDRAL AUTOLOGOUS TRANSPLANTATION FOR TREATING CHONDRAL LESIONS IN THE PATELLA

ABSTRACTObjective: The primary aim of this study was to assess the clinical and functional evolution of patients with total-thickness symptomatic cartilaginous injury of the patellar joint surface, treated by means of osteochondral autologous transplantation. Methods: This prospective study was conducted from June 2008 to March 2011 and involved 17 patients. The specific questionnaires of Lysholm, Kujala and Fulkerson were completed preoperatively and one year postoperatively in order to assess the affected knee, and SF-36 was used to assess these patients’ general quality of life. The nonparametric paired Wilcoxon test was used for statistical analysis on the pre and postoperative questionnaires. The data were analyzed using the SPSS for Windows software, version 16.0, and a significance level of 5% was used. Results: The Lysholm preoperative and postoperative average scores were 54.59 and 75.76 points (p < 0.05). The Fulkerson pre and postoperative average scores were 52.53 and 78.41 points (p < 0.05). Conclusions: We believe that autologous osteochondral transplantation is a good treatment method for total-thickness symptomatic chondral lesions of the joint surface of the patella

The autonomous medication management (AMM) model as a generator of autonomy in mental health care

En este texto presentamos una aproximación al concepto de autonomía aplicado al campo de la salud mental tomando como marco la 'Guía para la gestión autónoma de la medicación' (GAM) y su despliegue en Brasil y España. La estrategia GAM plantea una comprensión de la autonomía alejada de una visión individualista para aproximarse a una perspectiva social y colectiva. En este artículo vamos a evidenciar los posibles desplazamientos y las tensiones generadas, así como los efectos de autonomización que conlleva su implementación en salud mental. En la experiencia brasileña, se observa ese desplazamiento desde el lugar del saber-poder, propio de los profesionales, mientras la experiencia española muestra cómo la adaptación de la herramienta parte de la necesaria implicación de los profesionales, de los usuarios/as, sus familias y su red social en un proceso conjunto de trabajo y cuidado colectivo

De Novo Assembly And Transcriptome Analysis Of The Rubber Tree (hevea Brasiliensis) And Snp Markers Development For Rubber Biosynthesis Pathways.

Hevea brasiliensis (Willd. Ex Adr. Juss.) Muell.-Arg. is the primary source of natural rubber that is native to the Amazon rainforest. The singular properties of natural rubber make it superior to and competitive with synthetic rubber for use in several applications. Here, we performed RNA sequencing (RNA-seq) of H. brasiliensis bark on the Illumina GAIIx platform, which generated 179,326,804 raw reads on the Illumina GAIIx platform. A total of 50,384 contigs that were over 400 bp in size were obtained and subjected to further analyses. A similarity search against the non-redundant (nr) protein database returned 32,018 (63%) positive BLASTx hits. The transcriptome analysis was annotated using the clusters of orthologous groups (COG), gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Pfam databases. A search for putative molecular marker was performed to identify simple sequence repeats (SSRs) and single nucleotide polymorphisms (SNPs). In total, 17,927 SSRs and 404,114 SNPs were detected. Finally, we selected sequences that were identified as belonging to the mevalonate (MVA) and 2-C-methyl-D-erythritol 4-phosphate (MEP) pathways, which are involved in rubber biosynthesis, to validate the SNP markers. A total of 78 SNPs were validated in 36 genotypes of H. brasiliensis. This new dataset represents a powerful information source for rubber tree bark genes and will be an important tool for the development of microsatellites and SNP markers for use in future genetic analyses such as genetic linkage mapping, quantitative trait loci identification, investigations of linkage disequilibrium and marker-assisted selection.9e10266

Intervenções de enfermagem prescritas para pacientes adultos internados em unidade de terapia intensiva

Objective: to identify the nursing interventions prescribed for adult patients hospitalized in the Intensive Care Unit. Method: documentary, cross-sectional and cross-mapping study conducted at a public teaching hospital. A total of 29 records with nursing prescriptions at the patient's admission to the unit were evaluated. The prescribed interventions (n = 725) were mapped according to Nursing Interventions Classification and analyzed using descriptive statistics. Results: The 725 prescribed interventions were in 18 “nursing interventions”, nine “classes” and three “domains”. The interventions “Skin/wound care”, “Pressure Management”, “Monitoring” and “Infection Control”; the classes “Skin/Wound Management” and “Self-Care Facilitation” and “Complex Physiological” and “Basic Physiological” domains were the most frequent. Conclusions: the prescriptions made by intensive care nurses were related to the promotion and maintenance of human physiological and safety needs.Descriptors: Nursing; Nursing Process; Critical Care; Classification; Intensive Care UnitsObjetivo: identificar las intervenciones de enfermería prescritas para pacientes adultos internados en Unidad de Terapia Intensiva. Método: estudio documental, transversal, del tipo mapeo cruzado, realizado en un hospital público de enseñanza. Fueron evaluados 29 prontuarios con registros de prescripciones de enfermería realizados en la admisión del paciente en la referida unidad. Las intervenciones prescritas (n = 725) fueron mapeadas de acuerdo con la Nursing Interventions Classification y analizadas por estadística descriptiva. Resultados: las 725 intervenciones prescritas estaban contenidas en 18 "intervenciones de enfermería", nueve "clases" y tres "dominios". Las intervenciones "Cuidado de la Piel: tratamientos tópicos", "Control de la Presión", "Supervisión" y "Control de Infección"; las clases "Control de Piel/Heridas" y "Facilitación del Autocuidado" y los dominios "Fisiológico Complejo" y "Fisiológico Básico" fueron los más frecuentes. Conclusiones: las prescripciones de los enfermeros intensivos se relacionan con la promoción y el mantenimiento de las necesidades humanas fisiológicas y de seguridad.Objetivo: identificar as intervenções de enfermagem prescritas para pacientes adultos internados em Unidade de Terapia Intensiva. Método: estudo documental, transversal,  do tipo mapeamento cruzado, realizado em hospital público de ensino. Foram avaliados 29 prontuários que continham registros de prescrições de enfermagem realizados na admissão do paciente na referida unidade. As intervenções prescritas (n=725) foram mapeadas de acordo com a Nursing Interventions Classification e analisadas por estatística descritiva. Resultados: as 725 intervenções prescritas estavam contidas em 18 “intervenções de enfermagem”, nove “classes” e três “domínios”. As intervenções “Cuidados da Pele: tratamentos tópicos”, “Controle da Pressão”, “Supervisão” e “Controle de Infecção”; as classes “Controle de Pele/Feridas” e “Facilitação do Autocuidado” e os domínios “Fisiológico Complexo” e  “Fisiológico Básico” foram os mais frequentes. Conclusões: as prescrições dos enfermeiros intensivistas relacionavam-se à promoção e manutenção das necessidades humanas fisiológicas e de segurança

Enxaqueca hemiplégica familiar - um relato de caso / Familial hemiplegic migraine - a case report

A enxaqueca hemiplégica familiar (EHF) é um subtipo de enxaqueca com aura, caracterizado por fraqueza motora, em que ao menos um familiar de primeiro ou segundo grau também possua o mesmo diagnóstico. A sua sintomatologia está relacionada aos sintomas clássicos da aura, descritos acima, e à cefaleia, logo, o paciente pode apresentar perturbações na consciência, hemianopsia, afasia, letargia, hemiparesia, disfagia, febre, confusão mental, sendo, muitas vezes, confundida e tratada como epilepsia (2–6)

Fratura coronorradicular na dentição decídua com tratamento tardio: relato de caso clínico

As lesões dentárias traumáticas são uma urgência odontológica comum, sendo a fratura coronorradicular considerada relativamente rara, representando 2,5% dos casos de traumatismos dentários. Na dentição decídua, a prevalência do traumatismo dental é de 22,7%. O presente caso clínico relata o caso de uma criança de três anos de idade que compareceu à Clínica de Odontopediatria com fratura coronorradicular no dente 61 ausente de tratamento por dois anos. Clinicamente, observa-se a falta da coroa do dente 61 e a presença de um pólipo pulpar com coágulo sanguíneo em sua superfície. O exame radiográfico foi realizado apenas dois anos após o primeiro trauma, foi constatada a presença de reabsorção radicular extensa, não fisiológica e a impossibilidade de reabilitação estético-funcional fixa, indicando a necessidade de extração do fragmento radicular. Realizou-se a extração do fragmento e acompanhamento após a intervenção. Apesar da paciente apresentar inexistência de alterações clínicas no dente permanente, o trauma dentário deve ser diagnosticado e tratado de forma imediata, pois sabe-se que um bom prognóstico está diretamente relacionado com o tempo entre a ocorrência do trauma e a intervenção odontológica

Riscos ocupacionais para os profissionais de enfermagem e medidas preventivas: Uma revisão das produções científicas brasileiras no período de 2014 a 2019 / Occupational risks for nursing professionals and preventive measures: A review of brazilian scientific productions in the period from 2014 to 2019

Este projeto, visa ilustrar os riscos ocupacionais inerentes a atuação em saúde, bem como as práticas de campanhas e atualizações junto a equipe profissional, com o intuito de garantir a maximização da proteção dos profissionais e diminuição de incidentes laborais.