Squamous Cell Carcinoma in a Pig

 Background: Squamous cell carcinoma (SCC) is a malignant neoplasm of epidermal cells that exhibits keratinocyte differentiation. These neoplasms are common in dogs, cats, horses, and cattle, relatively uncommon in sheep, and rarely affect goats and pigs. There are several factors that are associated with the development of SCC, including prolonged exposure to ultraviolet light, lack of pigment in the epidermis, and sparse coating or lack of fur at the affected sites. The aim of this study was to report the occurrence of squamous cell carcinoma in a domestic pig.Case: A surgically removed nodule from the left ear of a female, light-colored, three-year-old pig, which breed was not defined, was submitted for histopathological analysis. The sample was fixed in 10% formalin, analyzed macroscopically, routinely processed for histology, sectioned at five microns and stained with hematoxylin and eosin. Additionally, anticytokeratin (AE1/AE3) and anti-vimentin immunohistochemical assays were performed. All additional information was provided by the animal’s owner. According to the history obtained, the animal belonged to a herd made up of five females and one boar. For four months, multiple nodules started to grow on the outer surface of the pig’s ear and in many occasions exhibited ulceration and bleeding. One of the nodules was submitted for histopathology examination. Macroscopically it measured 3 cm in diameter, had an irregular and ulcerated surface, and a wide base. Cut surface had a firm consistency and whitish color. Microscopic examination revealed proliferation of neoplastic epithelial cells arranged in islands and trabeculae, with slightly eosinophilic cytoplasm, pleomorphic, round, reniform nucleus, with loose chromatin and 1-3 nucleolus. Mitotic figures were infrequent. In the central area of the islands, there was individual cell keratinization. There was a moderate, fibrovascular supporting stroma with intense inflammatory infiltrate composed of lymphocytes, plasma cells and eosinophils. Anti-cytokeratin (AE1/AE3) immunohistochemical assay (IHC) revealed a strong diffuse positive staining on the cytoplasm of tumoral epithelial cells, and anti-vimentin IHC showed positive staining on the supporting tissue cells (fibroblasts and endothelial cells).Discussion: The diagnosis of squamous cell carcinoma in this pig was based on clinical and pathological findings since it was observed proliferation of neoplastic epithelial cells often forming “keratin pearls” and immunohistochemistry positive for cytokeratin was immunostaining in the cytoplasm of tumor cells. Information on the occurrence of SCC in pigs is scarce in the literature, especially in Brazil. In a survey of neoplasms in farm animals in Southern Rio Grande do Sul with cases from 1978 to 2002, neoplasms in pigs represented 0.6% of the diagnoses when compared to the number of neoplasms in cattle and horses. The low number of cases in this species is due to the fact that a large proportion of the population is slaughtered at a young age and therefore the chances to develop neoplasms are lower. The main SCC growth sites include areas deprived of hair, especially in animals with unpigmented skin. In the pig described here, the neoplasm was located on the outer surface of the ear, which was exposed to ultraviolet rays. Granuloma, papilloma, and basal cell tumor should be considered in the list of differential diagnosis when SCC is suspected. Neoplasms in pigs are scarcely reported.Keywords: neoplasm, carcinoma, pig, immunohistochemical

PARQVE III - Arthrosis Project Recovering Quality of Life through Education: study comparing the multiprofessional educational program with and without group activities

INTRODUÇÃO: A osteoartrite (OA) é a doença articular mais comum no mundo. Aproximadamente 20% da população mundial acima de 60 anos apresenta OA, com grande impacto sobre a qualidade de vida. O número de pessoas com OA de joelho sintomática deve aumentar devido ao envelhecimento da população e pela epidemia de obesidade. MÉTODOS: Estudo clínico prospectivo randomizado com 99 pacientes com OA generalizada e OA de joelho graus I a III de Kellgren e Lawrence foram randomizados em dois grupos: Grupo Controle (GC) - atendimento habitual e dois dias de palestras, com dois meses de intervalo, sobre osteoartrite com um grupo multiprofissional; e Grupo Estudo (GE) - GC associado a atividades em grupo, sendo sete sessões de fisioterapia, sete sessões com educador físico, três sessões em grupo de discussão sobre dieta com uma nutricionista e uma terapia em grupo sobre o engajamento do programa com a psicóloga, durante os primeiros seis meses do programa. Índice de massa corpórea (IMC), peso corporal, escala de classificação numérica da dor (ECN), \"Western Ontario and Mcmaster Universities Osteoarthritis Index\" (WOMAC) total e subdomínios, normalizada para 0-100, desempenhos nos testes funcionais \"Timed up and go\" (TUG) e tempo de senta e levanta em 30 segundos (TSL30) e escore de EQ-5D, obtido por uma função do WOMAC, foram obtidos no início, em seis, 12 e 24 meses do estudo. Os dois grupos foram orientados a continuar dieta e exercícios nas academias locais ou em casa. RESULTADOS: Não houve diferença no IMC, peso, WOMAC dor, ECN e TUG entre os grupos, mas apenas o GE diminuiu o IMC (P=0,05) entre o início e os demais momentos. Para WOMAC dor (p<0,001), a média do pré foi inferior aos demais momentos, enquanto para ECN (p<0,001), a média do pré foi superior ao dos seis meses que, por sua vez, foi superior aos dos 24 meses nos dois grupos. Para WOMAC função (p=0,005), WOMAC total (p=0,09), WOMAC rigidez (p=0,04), e EQ-5D (p=0,03), o GE apresentou resultados melhores que o GC aos 6 meses. Para TSL30, o GE apresentou resultados melhores aos seis (p=0,02) e 12 meses (P=0,40). Não houve diferença entre os grupos para nenhuma variável aos 24 meses. CONCLUSÕES: O programa de educação e atendimento multiprofissional com aulas em grupo não diminuiu o IMC quando comparado ao Grupo Controle. Não houve diferença entre os grupos ao final do estudo graças à melhora constante do Grupo Controle. Contudo, o Grupo Estudo apresentou melhora funcional estatística e clinicamente relevante enquanto aconteceram as atividades em grupoINTRODUCTION: Osteoarthritis (OA) is the most common joint disease in the world. Approximately 20% of the world population over 60 years old has OA, with a great impact on quality of life. The number of people with symptomatic knee OA is expected to increase due to the aging population and the obesity epidemic. METHODS: Prospective randomized clinical study with 99 patients with polyOA and Kellgren and Lawrence grades I to III knee OA were randomized into two groups: Control Group (CG) - usual care and two days of lectures, two months apart, on osteoarthritis with a multiprofessional group; and Study Group (SG) - CG associated with group activities, as follows: seven physiotherapy sessions, seven sessions with a physical educator, three group sessions on diet discussion with the nutritionist and a group therapy on program engagement with psychologist during the first six months of the program. Body mass index (BMI), body weight, numerical Pain Rating Scale (NRS), \"Western Ontario and Mcmaster Universities Osteoarthritis Index\" (WOMAC) total and subdomains, normalized to 0-100, performance in \"Timed up and go\" (TUG) and 30-second sit-tostand test (TSL30) and EQ-5D score, obtained by a WOMAC function, were obtained at baseline, six, 12, and 24 months of the study. Both groups were instructed to continue diet and exercises at local gyms or at home. RESULTS: There was no difference in BMI, weight, WOMAC pain, NRS and TUG between the groups, but only the SG decreased the BMI (P=0.05) between the beginning and the other moments. For WOMAC pain (p<0.001), the mean at baseline was lower than the other moments, while for NRS (p<0.001) the mean at baseline was higher than that of six months, which in turn was higher than that of 24 months, in both groups. For WOMAC function (p=0.005), WOMAC total (p=0.09), WOMAC stiffness (p=0.04), and EQ-5D (p=0.03), the SG presented better results than the CG at 6 months. For TSL30, the SG presented better results at six (p=0.02) and 12 months (p=0.40). There was no difference between groups for any variable at 24 months. CONCLUSIONS: The multiprofessional education and care program with group classes did not decrease BMI when compared to the control group. There was no difference between the groups at the end of the study thanks to constant improvement in the control group. However, the study group showed statistically and clinically relevant functional improvement while the group activities took plac

Double femoral osteotomy fixed with a Puddu plate and a retrograde intramedullary nail to treat biapical deformity of the femur

ABSTRACT Biapical femoral deformities are challenging to treat. In order to correct concomitant metaphyseal and diaphyseal deformities of the femur, the authors propose a double femoral controlled osteotomy with combined internal fixation, consisting of a Puddu plate and an intramedullary nail. The method was described in two patients. Results were analyzed using a visual analog scale (VAS), the Lysholm score, and SF-36. No complications were found. Complete consolidation of the osteotomies and radiographic alignment correction were achieved. Results were obtained with a minimum follow-up of 66 months. Both patients had improved for pain (VAS from 60 to 40 and from 50 to 20 at reassessment), function (Lysholm score from 78 to 93 and from 55 to 73) and quality of life (SF-36, both mental – from 40.7 to 57.1 in case one and from 24.7 to 59.7 in case two – and physical – from 27.7 to 45.6 and from 28.2 to 46.8). The authors have found that this technique is a reliable, accurate, and reproducible solution for biapical deformities of the femur

PROFILE OF PATIENTS WITH OSTEOPOROTIC FRACTURES AT A TERTIARY ORTHOPEDIC TRAUMA CENTER

<div><p>ABSTRACT Objective: To evaluate the profile of patients with osteoporotic fractures treated at a tertiary orthopedic hospital. Methods: Using questionnaires, 70 patients with osteoporotic fractures (OF) were compared with 50 outpatients with multiple osteoarthritis (OA) followed through an outpatient clinic. Results: The OF group was older (p <0.001), less heavy (p=0.003), had lower BMI (p=0.006), was more likely to be white (p=0.011), was less likely to be married (p=0.008), and had previous falls, previous fractures, old fractures (>1 year), falls in the last 12 months, fractures due to falls, and needed more assistance (p<0.05). They also had lower Lawton & Brody Instrumental Activities of Daily Living scores (p <0.05) and reported less lower limb disability, foot pathology, muscle weakness, hypothyroidism, and vitamin D intake than patients in the OA group. White race, previous falls, and previous fractures increase the risk of osteoporotic fractures by 10.5, 11.4, and 4.1 times, respectively. The chance of fracture dropped 29% for each one-unit increase in Lawton & Brody IADL score. Married participants had fewer fractures than participants with other marital status. Conclusion: Together, race, marital status, previous falls, foot pathologies, previous fractures, and IADL scores define the profile of patients with osteoporotic fractures. Level of Evidence III; Case control study.</p></div