Nódulo benigno de Tireoide: Relato de caso

Nódulos tiroidianos normalmente possuem evolução insidiosa e podem se apresentar de forma assintomática. São achados clínicos comuns em idosos, mulheres, indivíduos com deficiência de iodo e também naqueles com histórico de exposição à radiação. Embora constituam uma situação clínica corriqueira, seu mecanismo de formação ainda não é entendido por muitos profissionais. A importância do seu manuseio reside no fato de que, apesar da maioria representar lesões benignas (cerca de 70%), é necessário descartar a hipótese de câncer da tireoide, e caracterizar os status funcional e anatômico desta glândula, por meio de uma história clínica completa, de um exame clínico cuidadoso, da realização de testes de função tiroidiana e de exames de imagem e, se necessário, a Punção Aspirativa por Agulha Fina (PAAF). Dentre os exames complementares, a dosagem de TSH e T4 livre devem obrigatoriamente fazer parte da avaliação inicial, assim como a ultrassonografia da tireoide, que é o melhor exame de imagem para detecção de nódulos pois sua sensibilidade é de, aproximadamente, 95%. Na presença de nódulos “suspeitos”, deve-se realizar a PAAF, que indiscutivelmente é o melhor método para a diferenciação entre lesões benignas e malignas da tireoide. Vale ressaltar ainda que na doença nodular da tireoide, é importante investigar os fatores de risco para malignidade, como gênero masculino, idade acima de 70 anos, exposição à radiação, história familiar de câncer da tireoide, nódulo duro e fixo, adenopatia cervical, rápido crescimento do nódulo, entre outros. Objetiva neste trabalho relatar um quadro de nódulo benigno da tireoide, encontrado durante a palpação da glândula de uma paciente de 70 anos do gênero feminino, que relatou queixa de “incômodo para engolir” e “pigarro” e apresentou tireoide de tamanho normal, com consistência elástica, e presença de pequeno, mole e único nódulo em lobo direito, descrevendo como foi conduzida a avaliação inicial, bem como a elaboração de diagnóstico, a classificação e o tratamento instituído. Estas informações contribuirão para que os profissionais, principalmente aqueles que se dedicam à clínica médica, atualizem seus conhecimentos acerca do tema e qualifiquem seu processo de trabalho no cotidiano da prática médica. Conclui-se que é imprescindível o acompanhamento regular do nódulo da tireoide, a fim de permitir a identificação de suposta malignidade, com consequentemente intervenção precoce, favorecendo o prognóstico e a recuperação do paciente

Bullous Keratopathy in a dog treated with Third Eyelid Flap and Autologous Serum Eye Drops

Background: Bullous Keratopathy (BK) is characterized by decompensation of the corneal stroma resulting in visual impairment by corneal opacity, discomfort, excessive tearing, blepharospasm and pain. The aim of this study was to report a case of BK in a dog and the complete recovery of the ocular structure and visual function, with a third eyelid flap associated with the use of autologous blood serum topically.Case: A 2-year-old Shih Tzu male dog, weighing 4.3 kg, with recurrent bilateral eye discomfort was brought to Ophthalmologist Veterinarian Assistance. The patient had already been seen by other veterinarians, but the signs returned in a short period of time after the prescription was suspended. During physical examination it was observed moderate blepharospasm in the right eye, epiphora in the left eye, and in both eyes was noted exophthalmos, medial corneal entropion, caruncle trichiasis and ectopic cilia in the upper and lower eyelids. Fluorescein test was positive in both eyes, and a large bullous, opaque and gelatinous lesion with irregular appearance was observed occupying a large part of the cornea of the right eye. Superficial corneal ulcer was diagnosed in left eye and BK in right eye, both probably in consequence of ectopic cilia presence. Surgical intervention was made, with the cauterization and excision of the ectopic cilia and third eyelid flap in the right eye. The cauterization of caruncle trichiasis was not authorized by the owner. Moxifloxacin eye drops in the dose of one drop four times a day in both eyes, lubricant based on hyaluronic acid in the dose of one drop four times a day in both eyes, and autogenous blood serum, obtained from the centrifugation of a blood sample of the dog itself, in the dose of one drop every hour in the right eye for 24 hours, and meloxicam in the dose of 0.1 mg/kg every 24 h for 3 days were prescribed. Elizabethan collar was recommended until removal of the third eye flap. During the surgery, a sample of eye secretion was collected and sent for culture and antibiogram and did not show growth of microorganisms. After seven days of the procedure, the animal did not show eye discomfort and corneal ulcer in the left eye was healed. The third eye flap remained stable until the return of 28 days and after removal of the capton, adhesions were identified, which were removed with Castroviejo scissors after application of topical anesthetic proxymetacaine hydrochloride eye drops. A fluorescein test was performed and the absence of corneal keratitis was confirmed. Discrete corneal scars (macula) were identified.Discussion: The patient in this report had several changes in ocular morphology that favored the formation of recurrent injuries which contributed to the formation of BK. The use of topical medications as unique treatment was not performed due to the severity of the lesion and the presence of alterations such as medial entropion, caruncle trichiasis and ectopic cilia that needed surgical corrections to resolve the causes of the lesions. In order to protect the cornea and provide compression of its epithelium, a third eyelid flap was performed, a low-invasive procedure that is quick and easy to perform. Ectopic cilia were cauterized to eliminate one of the causes of the corneal injuries, however, the other changes could not be corrected because they were not authorized by the owner. The adjuvant uses of ocular lubricant based on hyaluronic acid, a broad-spectrum topical antibiotic and mainly autogenous blood serum favored the epithelial reconstruction of the cornea by providing protection, vitamins, growth factors, immunoglobulins, anti-collagenolytic and bacteriostatic substances. The protocol used it enabled a rapid reduction in patient discomfort, reversal of injuries and recovery of visual function

Information and communication technology for obstetric good practices

Objective: to investigate the use of information and communication technologies in good obstetrical practices. Results and Discussion: the studies found have dealt with the use of different information technologies, demonstrating that they are essential to good obstetrical practices because they provide security and greater access to information, as well as provide a more efficient diagnosis and consequently an adequate treatment. Conclusion: It is essential to use the technologies to achieve good obstetric practices throughout the health team. However, it is still necessary to carry out studies, as well as the creation of software that gives greater security to the welfare practices.   Descriptors: Information Technology; Obstetrics; Software; Professional Practice

Age-Related Metabolic Pathways Changes in Dental Follicles: A Pilot Study

Aging is not a matter of choice; it is our fate. The “time-dependent functional decline that affects most living organisms” is coupled with several alterations in cellular processes, such as cell senescence, epigenetic alterations, genomic instability, stem cell exhaustion, among others. Age-related morphological changes in dental follicles have been investigated for decades, mainly motivated by the fact that cysts and tumors may arise in association with unerupted and/or impacted teeth. The more we understand the physiology of dental follicles, the more we are able to contextualize biological events that can be associated with the occurrence of odontogenic lesions, whose incidence increases with age. Thus, our objective was to assess age-related changes in metabolic pathways of dental follicles associated with unerupted/impacted mandibular third molars from young and adult individuals. For this purpose, a convenience sample of formalin-fixed paraffin-embedded (FFPE) dental follicles from young (<16 y.o., n = 13) and adult (>26 y.o., n = 7) individuals was selected. Samples were analyzed by high-performance liquid chromatography-mass spectrometry (HPLC-MS)-based untargeted metabolomics. Multivariate and univariate analyses were conducted, and the prediction of altered pathways was performed by mummichog and Gene Set Enrichment Analysis (GSEA) approaches. Dental follicles from young and older individuals showed differences in pathways related to C21-steroid hormone biosynthesis, bile acid biosynthesis, galactose metabolism, androgen and estrogen biosynthesis, starch and sucrose metabolism, and lipoate metabolism. We conclude that metabolic pathways differences related to aging were observed between dental follicles from young and adult individuals. Our findings support that similar to other human tissues, dental follicles associated with unerupted tooth show alterations at a metabolic level with aging, which can pave the way for further studies on oral pathology, oral biology, and physiology

Ticks as potential vectors of Mycobacterium leprae: Use of tick cell lines to culture the bacilli and generate transgenic strains.

Leprosy is an infectious disease caused by Mycobacterium leprae and frequently resulting in irreversible deformities and disabilities. Ticks play an important role in infectious disease transmission due to their low host specificity, worldwide distribution, and the biological ability to support transovarial transmission of a wide spectrum of pathogens, including viruses, bacteria and protozoa. To investigate a possible role for ticks as vectors of leprosy, we assessed transovarial transmission of M. leprae in artificially-fed adult female Amblyomma sculptum ticks, and infection and growth of M. leprae in tick cell lines. Our results revealed M. leprae RNA and antigens persisting in the midgut and present in the ovaries of adult female A. sculptum at least 2 days after oral infection, and present in their progeny (eggs and larvae), which demonstrates the occurrence of transovarial transmission of this pathogen. Infected tick larvae were able to inoculate viable bacilli during blood-feeding on a rabbit. Moreover, following inoculation with M. leprae, the Ixodes scapularis embryo-derived tick cell line IDE8 supported a detectable increase in the number of bacilli for at least 20 days, presenting a doubling time of approximately 12 days. As far as we know, this is the first in vitro cellular system able to promote growth of M. leprae. Finally, we successfully transformed a clinical M. leprae isolate by inserting the reporter plasmid pCHERRY3; transformed bacteria infected and grew in IDE8 cells over a 2-month period. Taken together, our data not only support the hypothesis that ticks may have the potential to act as a reservoir and/or vector of leprosy, but also suggest the feasibility of technological development of tick cell lines as a tool for large-scale production of M. leprae bacteria, as well as describing for the first time a method for their transformation

ENSINO E EXTENSÃO NA PERSPECTIVA INTERDISCIPLINAR: UMA EXPERIÊNCIA EM PORTO SEGURO

Este trabalho tem por objetivo relatar atividades realizadas através de observação durante aula de campo feita por discentes da turma do curso de Pedagogia da Universidade do Estado da Bahia – UNEB, em alguns espaços da cidade de Porto Seguro/BA. A referida atividade foi solicitada pela disciplina Pesquisa e Prática Pedagógica III, vinculando as disciplinas: História da Educação e Sociologia da Educação. Para tanto, foram empregadas práticas educativas como palestras e rodas de conversa. Os resultados evidenciaram que espaços com contexto histórico permitem aos discentes o aprendizado prático, baseado no exercício da observação e elaboração de relatórios, em que foi possível avaliar a eficiência do estudo de campo no que tange à visualização prática da teoria apresentada e estudada em sala de aula

Efeito da exposição ao material particulado 2,5 na neurodegeneração em ratos wistar - uma revisão sistemática

A evolução do padrão de vida da população global junto ao desenvolvimento tecnológico e as atividades industriais levou a um crescimento exponencial da demanda energética moderna sendo que, que cerca de 83% de toda a energia produzida no mundo advém da queima de combustíveis fósseis, um processo que libera uma enorme quantidade de poluentes, entre eles o material particulado fino (MP 2,5 ) que possui de 2,5 μm de diâmetro. Essa contaminação atmosférica, contribui para o desenvolvimento de doenças cardíacas, câncer de pulmão e outras doenças respiratórias. Além dessas afecções, o MP 2,5 pode se acumular no tecido neural e causar a formação de radicais livres. e uma vez depositado no cérebro, o poluente começaria um quadro pró-inflamatório e aumentaria o estresse oxidativo local, podendo contribuir para doenças neurodegenerativas como o Mal de Alzheimer e a Doença de Parkinson. Em vista disso, o presente estudo buscou encontrar, em estudos experimentais que usassem ratos wistar como modelo experimental, algum consenso quanto a relação entre a exposição ao Material Particulado 2,5 e a incrementação do estresse oxidativo neural, neuroinflamação e neurodegeneração

Serological and molecular detection of infection with Mycobacterium leprae in Brazilian six banded armadillos (Euphractus sexcinctus)

Federal Rural University of Rio de Janeiro. Institute of Veterinary Medicine. Department of Animal Parasitology. Multiuser Molecular Biology Laboratory. Seropédica, RJ, Brazil.Fundação Oswaldo Cruz. Oswaldo Cruz Institute. Laboratory of Cellular Microbiology. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Oswaldo Cruz Institute. Laboratory of Cellular Microbiology. Rio de Janeiro, RJ, Brazil.Federal Rural University of Semi-Árido. Hospital Veterinary. Rio Grande do Norte, RN, Brazil.Federal Rural University of Semi-Árido. Hospital Veterinary. Rio Grande do Norte, RN, Brazil.Federal Rural University of Semi-Árido. Hospital Veterinary. Rio Grande do Norte, RN, Brazil.National Hansen's Disease Program. Healthcare Systems Bureau. Health Resources and Services Administration. Department of Health and Humans Services. Baton Rouge, United States.National Hansen's Disease Program. Healthcare Systems Bureau. Health Resources and Services Administration. Department of Health and Humans Services. Baton Rouge, United States.National Hansen's Disease Program. Healthcare Systems Bureau. Health Resources and Services Administration. Department of Health and Humans Services. Baton Rouge, United States.Infectious Disease Research Institute. Seattle, United States.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Laboratório de Geoprocessamento. Ananindeua, PA, Brasil.Fundação Oswaldo Cruz. Oswaldo Cruz Institute. Laboratory of Molecular Biology Applied to Mycobacteria. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Oswaldo Cruz Institute. Laboratory of Molecular Biology Applied to Mycobacteria. Rio de Janeiro, RJ, Brazil.Federal Rural University of Rio de Janeiro. Institute of Veterinary Medicine. Department of Animal Parasitology. Multiuser Molecular Biology Laboratory. Seropédica, RJ, Brazil.Leprosy was recognized as a zoonotic disease, associated with nine-banded armadillos (Dasypus novemcinctus) in the Southern United States of America in 2011. In addition, there is growing evidence to support a role for armadillos in zoonotic leprosy in South America. The current study evaluated twenty specimens of the six-banded armadillo (Euphractus sexcinctus), collected from rural locations in the state of Rio Grande do Norte (RN), Brazil for evidence of infection with Mycobacterium leprae. Serum was examined using two "in-house" enzyme-linked immunosorbent assays (ELISAs) and via two commercially available (ML flow and NDO-LID®) immunochromatographic lateral flow (LF) tests, for detection of the PGL-I and/or LID-1 antigens of the bacterium. The presence of M. leprae DNA in liver tissue was examined using the multi-copy, M. leprae-specific repetitive element (RLEP), as target in conventional and nested PCR assays. Molecular and anti-PGL-I-ELISA data indicated that 20/20 (100 %) of the armadillos were infected with M. leprae. The corresponding detection levels recorded with the LF tests were 17/20 (85 %) and 16/20 (85 %), for the NDO-LID® and ML flow tests, respectively. Our results indicate that, in common with D. novemcinctus, six banded armadillos (a species hunted and reared as a food-source in some regions of Brazil, including RN), represent a potential reservoir of M. leprae and as such, their role in a possible zoonotic cycle of leprosy within Brazil warrants further investigation

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved