A case report of thyroid carcinoma confined to ovary and concurrently occult in the thyroid. Is conservative treatment always advised?

Introduction: Struma ovarii is an ovarian teratoma, represented in more than 50% by thyroid tissue. Five percent of struma ovarii cases have been proven to be malignant and, as in the thyroid gland, papillary thyroid carcinoma is the most common histotype arising in struma ovarii. Because of the unusual occurrence of this tumor, its management and follow-up after pelvic surgery is still controversial. Usually, total thyroidectomy followed by radioiodine treatment is the choice treatment in metastatic malignant struma ovarii, while these procedures are still controversial in non-metastatic thyroid cancer arising in struma ovarii. Case Presentation: We report a female with follicular variant of papillary thyroid carcinoma arising in struma ovarii. After pelvic surgery, thyroid morphofunctional examinations were performed and a single nodular lesion in the left lobe was discovered. The patient underwent total thyroidectomy and histological examination showed a papillary carcinoma. Radioiodine-ablation of residual thyroid tissue was performed and levothyroxine mildly-suppressive treatment was started. Conclusions: A more aggressive treatment should not be denied for malignant struma ovarii without any evidence, even when apparently confined into the ovary. However, in selected cases, aggressive treatment may be advisable to decrease the risk of recurrence and to allow an accurate follow-up

Lípidos estructurados obtenidos por interesterificación de las mezclas binarias y ternarias de las grasas de palma, semilla de palma y triglicéridos de cadena media

Structured lipids are modified triacylglycerols to alter the fatty acid composition and/or their distribution into the glycerol molecules, by using enzymatic or chemical methods. Some of them can be classified as functional foods or nutraceuticals because they are directly associated to the prevention and treatment of many diseases. The objectives of this paper were to obtain and to characterize structured lipids by chemical interesterification of binary and ternary mixtures of vegetable fats (palm and palm kernel) and medium chain triacylglycerols (Trigliceril CM). Ten samples consisting of three individual samples, three binary mixtures, and four ternary mixtures were studied. The fatty acid composition, solid fat content and consistency at the temperatures from 10ºC to 35ºC were analysed. A mathematical model of multiple regression of the special cubic type was applied, and from the significant coefficients triangular diagrams were confectioned, which indicate curves of levels. The results showed that the interactions between the three components were not significant. The solid fat content depended on the palm and palm kernel fats, and on the binary interactions between them. The negative coefficients for the interactions showed an antagonic effect, which is characteristic of eutectic interactions between fats.Los lípidos estructurados son triglicéridos modificados por la alteración de su composición en cuanto a los ácidos grasos y/o su distribución en las moléculas de glicerol, por métodos químicos o enzimáticos. Son obtenidos por interesterificación química o enzimática. Algunos de estos lípidos pueden ser clasificados como alimentos funcionales o nutracéuticos, por estar directamente asociados a la prevención o tratamiento de diversas enfermedades. Los objetivos de este trabajo fueron el de obtener y caracterizar los lípidos estructurados por medio de la interesterificación química de las mezclas binarias y ternarias de las grasas (palma y semilla de palma) y triglicéridos de cadena media (Trigliceril CM). Fueron estudiadas 10 muestras representadas por 3 muestras individuales, 3 muestras binarias y 4 muestras ternarias. Se determinaron la composición en ácidos grasos, el contenido en grasa sólida y la consistencia en el intervalo de temperaturas entre 10ºC y 35ºC. Se aplicó un modelo de regresión múltiple del tipo cúbico especial, siendo que a partir de los coeficientes significativos, se establecieron diagramas triangulares, donde fueron indicadas curvas de nivel. Los resultados demostraron que las interacciones entre los tres componentes no fueron significativas. El contenido en grasa sólida dependió de las grasas de palma y de la semilla de palma y de las interacciones binarias entre ellas. Los coeficientes negativos para esta propiedad demostraron un efecto antagónico, característico de las interacciones eutécticas entre grasas

Correlation between Chest Computed Tomography Score and Laboratory Biomarkers in the Risk Stratification of COVID-19 Patients Admitted to the Emergency Department

background: it has been reported that mid-regional proadrenomedullin (MR-proADM) could be considered a useful tool to stratify the mortality risk in COVID-19 patients upon admission to the emergency department (ED). during the COVID-19 outbreak, computed tomography (CT) scans were widely used for their excellent sensitivity in diagnosing pneumonia associated with SARS-CoV-2 infection. however, the possible role of CT score in the risk stratification of COVID-19 patients upon admission to the ED is still unclear. aim: the main objective of this study was to assess if the association of the CT findings alone or together with MR-proADM results could ameliorate the prediction of in-hospital mortality of COVID-19 patients at the triage. moreover, the hypothesis that CT score and MR-proADM levels together could play a key role in predicting the correct clinical setting for these patients was also evaluated. methods: epidemiological, demographic, clinical, laboratory, and outcome data were assessed and analyzed from 265 consecutive patients admitted to the triage of the ED with a SARS-CoV-2 infection. results and conclusions: the accuracy results by AUROC analysis and statistical analysis demonstrated that CT score is particularly effective, when utilized together with the MR-proADM level, in the risk stratification of COVID-19 patients admitted to the ED, thus helping the decision-making process of emergency physicians and optimizing the hospital resources

Aspectos estratégicos e relacionais das alianças do tipo joint-venture: o caso de dois fabricantes da indústria automobilística [doi: 10.5329/RECADM.2014012]

Este artigo tem como objetivo analisar a formação de joint-ventures de dois fabricantes da indústria automobilística, compreendendo aspectos estratégicos e relacionais destas alianças. A pesquisa caracterizou-se por ser um estudo de casos múltiplos, qualitativo e exploratório, onde foi possível realizar uma melhor compreensão das duas subsidiárias nacionais e suas respectivas joint-ventures localizadas nos Estados Unidos (EUA), Alemanha, México e Egito. A coleta dos dados foi feita por meio da observação participante e roteiro de entrevista semi-estruturado. Os dados foram analisados por meio da análise de conteúdo. Dentre os resultados, foi identificado como primordial para o sucesso da implementação deste tipo de aliança, a realização de um detalhado estudo de viabilidade que deve anteceder a formação da joint-venture, seguido de um alinhamento entre os interesses das sócias. As adaptações aos aspectos culturais aparecem como um ponto forte para a sobrevivência das joint-ventures. As informações obtidas neste estudo convergem com a teoria estudada e conduzem a novas oportunidades de pesquisas relacionadas ao tema.   Palavras-chave: Aliança estratégica. Joint-venture. Indústriaautomobilística.     STRATEGIC AND RELATIONAL ASPECTS OF JOINT-VENTURE ALLIANCES: THE CASE OF TWO MANUFACTURERS OF THE AUTOMOTIVE INDUSTRY   ABSTRACT This article aims to analyze the formation of joint ventures formed by two manufacturers from automobile industry, understanding strategic and relational aspects of these alliances. This research is characterized by a qualitative and exploratory multiple case study, where it was possible to conduct a comparison of two subsidiary and their joint ventures located in the United States (USA), Germany, Mexico, and Egypt. The data collection was done through participant observation and semi-structured interviews. The data were analyzed using content analysis technique. Among results, it was identified as essential for the successful implementation of this type of alliance, to conduct a detailed feasibility study which must precede the formation of the joint venture, followed by an alignment between the interests of the partners. Adaptations to the cultural aspects seem as a strong point for survival of joint ventures. Information obtained in this study converges with the theory studied and lead to new research opportunities regarding to the theme.   Keywords: Strategic alliance. Joint-venture.Automobileindustry.</p

Modo de aplicação de fertilizantes nitrogenados na qualidade fisiológica de sementes de milho

A recomendação de adubação é complexa, devido à dinâmica das transformações do nitrogênio no solo, a sua mobilidade e aos fatores que influem no aproveitamento pelas plantas. Transformações e perdas de nitrogênio no solo podem ocorrer através de processos conhecidos como: mineralização e imobilização, nitrificação e desnitrificação, lixiviação e volatilização. Quando se utiliza a uréia, como fonte de nitrogênio na superfície do solo, ocorre processo de volatilização; perda de nitrogênio na forma de gás amônia (NH3). O objetivo deste trabalho foi de verificar a influencia de fontes nitrogenadas na qualidade fisiológicas de sementes de milho na região de Campo Grande - MS em um Latossolo Vermelho distroférrico, utilizando 120 kg/ha de N, alternando a quantidade aplicada na semeadura e em cobertura. Foram avaliados: teste de germinação, germinação na primeira contagem, condutividade elétrica, peso de mil sementes, teste de frio e emergência à campo. O uso do N de liberação lenta proporciona melhoria na qualidade fisiológica das sementes de milho, além de possibilitar a aplicação desta fonte toda na semeadura