Indicador de flebite e cuidados de enfermagem em crianças e adolescentes com cateter central de inserção periférica

The aim of this study was to analyze the prevalence of phlebitis in children and adolescents who used a peripheral venous catheter and a peripherally inserted central catheter (PICC), using the Maddox scale. This is an exploratory-descriptive, retrospective and documentary study, with quantitative clarifications. Ethical-legal precepts were contemplated. A general mean incidence of phlebitis of 0.20% was evidenced. There was a higher incidence of grade 3+ phlebitis in 16 (50%) in children using PICC. Given the above, it is suggested that health teams should institute indicators of adverse events in phlebitis, aiming at prevention and early detection for better care quality. Despite the 48 conducts used by Nursing in the research scenario, it is necessary to establish protocols based on scientific evidence. That is: Apply cold compresses alternating with warm compresses; swabs with chamomile infusion.Objetivou-se analisar a prevalência de flebite em crianças e adolescentes que fizeram uso de cateter venoso periférico e cateter central de inserção periférica (PICC), utilizando Escala de Maddox. Trata-se de um estudo exploratório-descritivo, retrospectivo e documental, com elucidações quantitativas. Foram contemplados os preceitos ético-legais. Evidenciou-se uma média geral de incidência de flebite de 0,20%. Houve maior incidência de flebite grau 3+, em 16 (50%) em crianças utilizando PICC. Levando em consideração os achados do estudo sugere-se que as equipes de saúde devam instituir indicadores de eventos adversos em flebites, visando a prevenção e a detecção precoce para melhor qualidade assistencial. Apesar das 48 condutas utilizadas pela Enfermagem do cenário da pesquisa, faz-se necessário estabelecer protocolos baseados em evidências cientificas. Quais sejam: Aplicar em sítio compressas frias alternadas com mornas; compressas com infuso de camomila

Case report sustained by literature review on the major approaches of the granular esophageal cell tumor

Background: Granular Cell Tumors (GCT) are rare benign neoplasms with an estimated prevalence of 0,4% in retrospective series. About 8% of GCT are located in the gastrointestinal tract, having the esophagus as the main affected area. Malignancy was reported in 2-4% of cases and there are no well established treatment protocols. Case summary: It was present an oligo-symptomatic female patient with diagnosis of GCT presented on the endoscopy. Complementary investigation was based on endoscopic ultrasound (EUS). The treatment consisted of mucosectomy and endoscopic variceal ligation, evolving with a favorable outcome. Conclusion: Despite disagreement on protocols for treatment of GCT, mucosectomy appears to be an effective option

Pre-operative sera levels of CEA and CA19-9 and tissular distribution of tumor marker CA19-9 in colorectal carcinoma: correlation with morphological features of neoplasia

OBJETIVO: Comparar os níveis séricos de CA19-9 e CEA e a expressão tecidual do CA19-9 e relacioná-los com os aspectos morfológicos do carcinoma colorretal. MÉTODOS: Quarenta e cinco pacientes com carcinoma colorretal foram operados com coleta de CEA e CA19-9 séricos pré-operatórios. Valores séricos de CEA = 5,0ng/mL e de CA19-9 = 37UI/mL foram considerados aumentados. A avaliação da imunoexpressão do CA19-9 no tecido neoplásico foi realizada por meio de estudo imunoistoquímico com anticorpo monoclonal anti-CA19-9. A intensidade de expressão do CA19-9 no tecido neoplásico foi semiquantificada em leve(+/+++), moderada(++/+++), intensa(+++/+++) e ausente. RESULTADOS: Os valores do CA19-9 sérico foram progressivamente maiores conforme o aumento da expressão do CA19-9 no tecido neoplásico, porém sem significância (p=0,06). O aumento do nível sérico do CA19-9 foi acompanhado de elevação significante (p<0,001) do nível sérico do CEA. O nível sérico do CA19-9, a imunoexpressão tecidual do CA19-9 e o nível sérico do CEA não apresentaram associação significante com características morfológicas do carcinoma colorretal. CONCLUSÃO: As expressões sérica e tissular do CA19-9 demonstraram relação diretamente proporcional entre si, enquanto que os aspectos morfológicos da neoplasia não tiveram influência no CEA e CA19-9 séricos ou na imunoexpressão do CA19-9 tissular.OBJECTIVE: To compare sera levels of CEA and CA19-9 and tissular expression of the CA19-9 and to correlate these with morphological features of the colorectal carcinoma. METHODS: Forty five patients with colorectal carcinoma underwent surgical treatment following measurement of pre-operative levels of CA19-9 and CEA. Sera levels of CEA = 5.0ng/ml and CA19-9 = 37UI were deemed high values. Evaluation of CA19-9 immunoexpression in neoplastic tissue was carried through by means of immunohistochemical study with monoclonal antibody anti-CA19-9. The intensity of expression of CA19-9 in neoplastic areas was semi-quantified in each area of tumor differentiation into mild(+/+++), moderate(++/+++), intense(+++/+++) or absent. RESULTS: Sera CA19-9 values were progressively higher in the presence of elevated CA19-9 immunoexpression in colorectal carcinoma tissue, although not significant (p=0.06). Increased sera CA19-9 levels were found to be associated with significantly elevated (p<0.001) sera CEA levels. Levels of sera CA19-9, tissular immunoexpression of CA19-9 and sera levels of CEA presented no significant association with morphological features of the colorectal carcinoma. CONCLUSION: Sera and tissular levels of the CA19-9 marker exhibited, each other, a directly proportional relationship. The morphological features of the neoplasia had no influence on sera CEA or CA19-9 levels or tissular immunoexpression of CA19-9

Tissue expression of CD10 protein in colorectal carcinoma: correlation with the anatomopathological features of the tumor and with lymph node and liver metastases

BACKGROUND: The reduced expression of CD10 may be related to unfavorable prognosis of patients with colorectal carcinoma. The authors analyzed the tissue immunostaining of CD10 protein in colorectal carcinoma and its relationship to clinicopathologic features. METHOD: In 130 patients submitted to colorectal carcinoma surgery, a tissue microarray block was obtained from the tumor and adjacent non-neoplastic mucosa and submitted to immunohistochemistry with monoclonal antibody CD10. The immunostaining was evaluated by semi-quantitative method, with stained cell count in percentage. The results were related to the location, anatomopathological features, presence of lymph node and hepatic metastases and TNM staging of the colorectal neoplasm. The statistical analysis was performed with the Mann-Whitney, Kruskal-Wallis and Fisher exact tests. RESULTS: The expression of CD10 marker was higher in colorectal tumor tissue than in adjacent non-neoplastic mucosa (p<0.0001) and was higher than in exophytic lesions (p=0.04). The expression of CD10 protein was not associated with other clinical and pathological aspects of colorectal neoplasm. CONCLUSIONS: The expression of CD10 protein was more intense in tumor tissue of colorectal carcinoma than in adjacent non-neoplastic mucosa and was related to the exophytic appearance of the tumor.INTRODUÇÃO: A expressão reduzida de CD10 pode estar relacionada com prognóstico desfavorável de doentes com carcinoma colorretal. Analisou-se a imunoexpressão tecidual da proteína CD10 no carcinoma colorretal e sua relação com os aspectos clinicopatológicos. MÉTODO: Em 130 doentes operados por carcinoma colorretal, um bloco de tissue microarray foi obtido do tecido neoplásico e da mucosa não neoplásica adjacente e submetido ao estudo imuno-histoquímico com anticorpo monoclonal CD10. Avaliou-se a imunoexpressão por método semiquantitativo, com contagem do percentual de células coradas. Os resultados foram relacionados com a localização, aspectos anatomopatológicos, presença de metástases linfonodais e hepáticas e estadiamento TNM da neoplasia. O estudo estatístico foi realizado com os testes de Mann-Whitney, Kruskal-Wallis e exato de Fisher. RESULTADOS: A expressão do marcador CD10 foi maior no tecido do carcinoma colorretal do que na mucosa não neoplásica adjacente (p<0,0001) e foi maior nas lesões exofíticas (p=0,04). A expressão da proteína CD10 não apresentou relação com os demais aspetos clínicos e patológicos da neoplasia colorretal. CONCLUSÕES: A expressão da proteína CD10 foi mais intensa no tecido neoplásico do carcinoma colorretal do que na mucosa não neoplásica adjacente e relacionou-se com o aspecto exofítico do tumor.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Department of SurgeryUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Department of PathologyUNIFESP, EPM, Department of SurgeryUNIFESP, EPM, Department of PathologySciEL

Immunohistochemical study of the canonical and non-canonical Wnt signaling pathway in colorectal carcinoma and non-neoplastic mucosa

AbstractColorectal cancer is linked to several signaling pathways such as Wnt pathway. Our objective is to detect and verify the integrity of protein members of Wnt signaling pathway in colorectal carcinoma and non-neoplastic colorectal tissue. Sixty-four patients with colorectal carcinoma provided samples of colorectal neoplasia and non-neoplastic tissues, which were prepared in tissue microarray blocks and subjected to immunohistochemical analysis. The primary antibodies used were Wnt-1, Wnt-2, Wnt-5a Frizzled-1, Frizzled-5 and axin. Immunoexpression of Wnt-2 protein was significantly lower in colorectal tumor tissue and axin protein immunoexpression was significantly higher in tumor tissue. There was no significant difference in the expression of Wnt-1, Wnt-5a, Frizzled-1 and Frizzled-5 proteins in both tissues. The higher expression of Wnt-2 protein in non-neoplastic colorectal tissue suggests the participation during the hyperproliferative stage of colorectal mucosa. The increased axin protein immunoexpression in colorectal tumor suggests a decrease in the formation of the β-catenin destructor complex

Expressão da e-caderina e das proteínas da via de sinalização wnt betacatenina, apc, tcf-4 e survivina no adenocarcinoma gástrico: implicações clínica e patológica

Background: Gastric cancer is the fifth most frequent cancer and the third most common cause of cancer-related deaths worldwide. It has been reported that Wnt/betacatenin pathway is activated in 30-50% of these tumors. However, the deregulation of this pathway has not been fully elucidated. Aim: To determine the expression of E-cadherin, betacatenin, APC, TCF-4 and survivin proteins in gastric adenocarcinoma tissues and correlate with clinical and pathological parameters. Method: Seventy-one patients with gastric adenocarcinoma undergoing gastrectomy were enrolled. The expression of E-cadherin, betacatenin, APC, TCF-4 and survivin proteins was detected by immunohistochemistryand related to the clinical and pathological parameters. Results: The expression rates of E-cadherin in the membrane was 3%betacatenin in the cytoplasm and nucleus were 23,4% and 3,1% respectivelyAPC in the cytoplasm was 94,6%TCF-4 in the nucleus was 19,4%and survivin in the nucleus 93,9%. The expression rate of E-cadherin was correlated with older patients (p=0,007), while betacatenin with tumors <5 cm (p=0,041) and APC with proximal tumors (p=0,047). Moreover, the expression of TCF-4 was significantly higher in the diffuse type (p=0,017) and T4 tumors (p=0,002). Conclusion: The Wnt/betacatenin is not involved in gastric carcinogenesis. However, the high frequency of survivin allows to suggest that other signaling pathways must be involved in the transformation of gastric tissue.Racional: O câncer gástrico encontra-se entre as principais neoplasias malignas do mundo sendo o quinto mais incidente e o terceiro em relação ao índice de mortalidade. Acredita-se que a via Wnt/betacatenina esteja ativada em 30-50% desses tumores, porém a desregulação dela ainda não está completamente esclarecida. Objetivo: Avaliar a imunoexpressão das proteínas E-caderina, betacatenina, APC, TCF-4 e survivina em tecidos de adenocarcinoma gástrico e correlacioná-las com as variáveis clínicas dos doentes e anatomopatológicas do tumor. Método: Foram coletados os dados clínicos e anatomopatológicos dos prontuários de 71 doentes com adenocarcinoma gástrico submetidos à gastrectomia. O material obtido na operação foi submetido à análise imunoistoquímica e a frequência da expressão de cada proteína pôde ser analisada de acordo com a sua localização na célula e relacionada com as variáveis clinicopatológicas. Resultados: A graduação percentualda expressão e da localização das proteínas foi a seguinte: E-caderina em 3% na membrana; betacatenina em 23,4% no citoplasma e 3,1% no núcleo; APC em 94,6% no citoplasma; TCF-4 em19,4% no núcleo; e survivina em 93,9% no núcleo. Houve relação entre expressão da proteína E-caderina com a idade mais avançada (p=0,007); betacatenina com tumores <5 cm de diâmetro (p=0,041);APC com tumores proximais (p=0,047); e TCF-4 com tipo difuso da classificação de Lauren (p=0,017) e com o grau de penetração tumoral (p=0,002). Conclusão: A via Wnt/betacatenina não está envolvida na carcinogênese gástrica. Porém, a frequência elevada de survivina permite sugerir que outras vias sinalizadoras devam estar envolvidas na transformação do tecido gástrico.Univ Sao Paulo UNIFESP, Postgrad Program Interdisciplinary Surg Sci, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Pathol, Sao Paulo, SP, BrazilABC Med Sch, Discipline Pathol, Santo Andre, SP, BrazilPrograma de Pós Graduação em Ciência Cirúrgica Interdisciplinar, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, BrasilDepartamento de Patologia, UNIFESP, São Paulo, SP, BrasilWeb of Scienc