Neoplasias Trofoblásticas Gestacionais e importância do seguimento pós molar

Introdução: As neoplasias trofoblásticas gestacionais (NTG) são patologias que abrangem os tumores trofoblásticos, benignos e malignos. Objetivo: Discorrer sobre a neoplasia trofoblástica gestacional em paciente internada no Serviço de Obstetrícia e Ginecologia do HUUFMA. Resultado: A paciente evoluiu de forma persistente verificada pelo acompanhamento das dosagens do gonadotrofina coriônica humana (hCG) e que necessitou de tratamento quimioterápico. A dosagem seriada do hCG no seguimento pós-molar é o fator prognóstico mais importante para detecção precoce da involução e evolução da doença. Conclusão: O caso relatado demonstra evolução de paciente com mola hidatiforme completa para coriocarcinoma quando há falha de seguimento.Palavras-chaves: Gestação Trofoblástica. Neoplasia. Coriocarcinoma. Seguimento.Abstract Introduction: Gestational trophoblastic neoplasias (GTN) are diseases that comprise the benign and malignant trophoblastic tumors. Objective:  To discuss about gestational trophoblastic neoplasia in a patient hospitalized in the obstetrics and gynecology service of HUUFMA. Results: The patient evolved persistently, which was verified by monitoring the human chorionic gonadotropin (hCG) and the patient required chemotherapy. The serial hCG level in follow-up of molar disease is the most important prognostic factor for early detection of involution and evolution of the disease. Conclusion: The reported case demonstrates the evolution to choriocarcinoma of a patient with complete hydatidiform mole when there is failure in the follow-up.Keywords: Gestational trophoblastic disease. Neoplasia. Choriocarcinoma. Follow up

Mitos e verdades [Câncer de mama]

Apresentação e discussão do tema. É uma oferta educacional com fim de desenvolver conhecimentos específicos, aprendizagem ativa, provendo troca de experiência e reflexão sobre o cotidiano do trabalho.Víde

How to keep medical preceptors effectively motivated in a web-learning environment? An overview

Distance learning has strengthened medical education, especially in geographically extensive regions. Despite the many characteristics of these web-based resources, the motivation of students to perform effectively in virtual educational programs remains a challenge. Resumen: La educación a distancia ha permitido potenciar la educación médica, especialmente en regiones geográficas más extensas. A pesar de la gran cantidad de propiedades de los recursos Web, los aspectos motivacionales de los alumnos para un desempeño efectivo en los programas de educación virtual siguen siendo un desafío. Keywords: Distance education, Medical education, Preceptorship, Palabras clave: Educación a distancia, Educación médica, Preceptorí

Practice-based analysis of direct posterior dental restorations performed in a public health service: Retrospective long-term survival in Brazil.

The aim of this retrospective study was to evaluate the survival and associated factors for the longevity of direct posterior restorations and to verify whether the geographic location of public health units could influence the long-term survival of such restorations. Data were extracted from electronic patient files of the Brazilian public oral health services. The sample comprised 2,405 class I and II restorations performed 4 to 24 years ago (mean, 8.9 years) in 351 patients (6.8 teeth/patient) across 12 public health units located in different city regions (42 professionals-55 restorations). The restoration was considered successful if it had not been repaired or replaced at the time of evaluation; failure was defined as replacement of the restoration, the need for endodontic treatment, tooth/restoration fracture or tooth extraction. Data were analyzed using the Kaplan-Meier test for restoration survival and Cox regression to evaluate the factors associated with failure. The majority of the restorations involved the use of amalgam (85%), involved a single face (70%), and were without pulp/dentin capping (85%). The overall survival rate was 95%, and the mean observation time was 8.9 years. The restoration survival was 79% (95% CI: 60.6-89.5) over 24 years, and the mean survival time was 22.2 years (95% CI: 21.9-22.6 years). The annual failure rate up to 24 years was 0.9%. After the adjustment, only the number of restored faces and the geographic location where the restoration was performed remained associated with failure of the restoration. The direct posterior restorations performed at the evaluated public health service units presented high survival rates. The restorations of people with lower access to POHS had lower survival rates. Class I restorations presented higher survival rates than class II restorations with two or more faces, regardless of the restorative material used

Additional file 1 of Management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the Brazilian Society of Mastology

Additional file 1: Table S1. Profile of the panelists (n = 27) and of the SBM affiliated breast surgeons (n = 214) who participated in the survey

Additional file 5 of Management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the Brazilian Society of Mastology

Additional file 5: Table S5. Summary of the consensus among the SBM affiliated breast surgeons

Additional file 7 of Management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the Brazilian Society of Mastology

Additional file 7: Table S7.1. Comparison between the panelists and the SBM affiliated breast surgeons regarding the questions related to diagnosis. Table S7.2. Comparison between the panelists and the SBM affiliated breast surgeons regarding the questions related to surgery. Table S7.3. Comparison between the panelists and the SBM affiliated breast surgeons regarding the questions related to radiotherapy. Table S7.4. Comparison between the panelists and the SBM affiliated breast surgeons regarding the questions related to systemic treatment