Desenvolvimento de um aplicativo para ensino de ultrassonografia pulmonar em emergência

Resumo: Introdução: A utilização de protocolos de ultrassonografia revolucionou o atendimento na medicina de emergência e pode auxiliar no diagnóstico de insuficiência respiratória no pronto atendimento. Assim, torna-se importante o treinamento médico para a utilização desses protocolos. Já foi demonstrado também que os aplicativos de smartphone médico têm resultados positivos na prática diária, além de serem uma ferramenta educacional potencialmente valiosa. Objetivo: Dessa forma, o objetivo deste estudo foi desenvolver um aplicativo em ultrassonografia pulmonar de emergência. O BLUE SIM é um aplicativo de celular que simula atendimentos de casos clínicos utilizando o protocolo Bedside Lung Ultrasound in Emergency, o qual pode auxiliar alunos e profissionais da área da saúde a usar a ultrassonografia pulmonar no atendimento da insuficiência respiratória aguda. A hipótese é que o BLUE SIM será um aplicativo usável e aceitável entre os usuários. Método: Após desenvolvido, avaliou-se o aplicativo com 36 voluntários: 18 fisioterapeutas, um médico, sete enfermeiros e dez acadêmicos de Medicina. Analisaram-se a usabilidade e a utilidade de uma aplicação móvel para o sistema iOS, utilizando como referências a escala de usabilidade System Utility Score (SUS) e o modelo de aceitação Technology Acceptance Model (TAM). Os dados obtidos foram tabulados e analisados pelo teste exato de Fisher ou Mann-Whitney. Resultado: Pela aplicação do questionário SUS (usabilidade), o aplicativo obteve um escore de 76,8%. Exclusivamente entre os fisioterapeutas, obteve-se um escore de 75%, não havendo diferença estatística entre o grupo geral de todos os profissionais emergencistas e o grupo somente de fisioterapeutas (p = 0,239). Segundo a análise de percepção de utilidade, 93,9% dos profissionais emergencistas responderam positivamente, enquanto, entre os fisioterapeutas, obteve-se um escore de 88,9% (p = 0,04). Conclusão: O aplicativo desenvolvido foi classificado de utilidade na aprendizagem do diagnóstico de insuficiência respiratória entre os profissionais, contudo eles consideraram que é necessário um treinamento para o uso da ferramenta

Squamous Cell Carcinoma in the Third Eyelid of a Dog

Background: Squamous cell carcinoma is a malignant neoplasm that originates from the keratinized stratified squamous epithelium and predominantly affect light-skinned animals. In dogs, breeds such as American Staffordshire Terriers, white or speckled Bull Terriers, and Beagles have a higher predisposition. Squamous cell carcinoma presents in the skin, at slightly pigmented or hairy sites, especially in digits, but also may occur in the nasal planum, oral mucosa, and rarely, in the eye. Considering that few reports have been published on eye neoplasms, the aim of this paper is to describe a dog with a lesion in the third eyelid of his right eye which was diagnosticated with squamous cell carcinoma. Case: A 10-year-old male American Staffordshire dog was admitted to the Veterinary Medical Teaching Hospital of the Veterinary Medicine and Zootechnics College, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Brazil with injury to the right eye. During the physical examination, there was also a non-adhered lump near the foreskin, measuring 1.5 cm in diameter. In addition, there was another lump in the third eyelid of the right eye, approximately 3 mm in diameter. Cytology of the dermal nodule was performed by fine-needle aspiration cytology; however, the sample was insufficient for cytological evaluation. Therefore, the animal was placed under general anesthesia for skin lump excision and for fine-needle aspiration cytology of the third eyelid nodule. The histopathological exam revealed high cellularity of epithelial cells, intense anisocytosis and pleomorphism, cytoplasmic basophilia and vacuolation, multiple evident nucleoli, and anisocariosis and coarse chromatin. These finds were compatible with squamous cell carcinoma, which was the same result suggested by fine-needle aspiration cytology of the third eyelid sample. Based on these results, the dog underwent a surgical procedure for enucleation and subsequent histopathological evaluation of the nodule in the third eyelid, which confirmed the squamous cell carcinoma diagnosis.Discussion: Squamous cell carcinoma is an extremely aggressive tumor with low metastatic potential, characterized by invasion of the dermis by proliferation of malignant epithelial cells from the prickly layer. It is most common in elderly animals, and American Staffordshires are among the breeds that are predisposed to develop this tumor. The clinical presentation is highly variable, depending on the tissue involved. In this case, the dermal nodule was an elevated area on the skin and the third eyelid nodule resembled an ulcerative mass. Cytological examination from the lesion located on the third eyelid, showed malignancies cytoplasmic changes frequently found in carcinomas such as anisocytosis, cytoplasmic basophilia, and cell pleomorphism. In addition, nuclear changes had also occurred, such as crass chromatin, multiple evident nucleoli, and multinucleated cells. A presumptive diagnosis was made based on cytology and was confirmed after biopsy and histopathological examination. Because it is uncommon in dogs, squamous cell carcinoma of the third eyelid may be misdiagnosed, delaying correct treatment, and accelerating the development of the tumor. Currently, various therapeutic approaches are available, such as surgical excision, electrosurgery, cryosurgery, radiation, and hyperthermia. The choice of treatment depends on the location and stage of the lesions. Surgical treatment should be aimed at removing sufficient tissue to leave surgical margins free of neoplastic cells

Evidências científicas sobre reparação robótica da hérnia ventral: Scientific evidence on robotic vental hernia repair

As hérnias ventrais são um problema comum, afetando até 50% de todos os pacientes. As hérnias ventrais são diversas em gravidade, variando de pequenos defeitos umbilicais a grande perda de domínio abdominal com ruptura completa da musculatura da parede abdominal. Quando o reparo cirúrgico é indicado, três opções de abordagem cirúrgica estão disponíveis: aberta, laparoscópica ou robótica. As hérnias ventrais variam em tamanho, desde defeitos muito pequenos até grandes rupturas da musculatura da parede abdominal. Além do tamanho, a localização anatômica da hérnia ao longo da parede abdominal ventral também varia. O reparo de hérnia minimamente invasivo tem a vantagem de potencialmente diminuir o risco de infecção do sítio cirúrgico. No entanto, o papel do reparo robótico como técnica minimamente invasiva não é claro. Dada a falta geral de dados prospectivos que distinguem as duas técnicas minimamente invasivas, a escolha entre reparo laparoscópico e robótico deve ser feita com base na experiência do cirurgião, disponibilidade de equipamentos e preferência do cirurgião/paciente

ANÁLISE DO USO DO SLEEVE GÁSTRICO NO TRATAMENTO DA OBESIDADE MÓRBIDA

The present study aims to analyze the effectiveness and safety of Sleeve Gastrectomy as a surgical technique for treating morbid obesity, comparing its outcomes with other bariatric methods and evaluating its impact on patients' quality of life. This research utilized a comprehensive literature review, encompassing studies published between 2000 and 2024 in English, Portuguese, and Spanish. Databases such as PubMed, Google Scholar, SciELO, as well as specialized scientific journals and academic repositories were consulted. The results indicate that Sleeve Gastrectomy is an effective technique for weight loss, showing outcomes comparable to other bariatric surgeries such as Roux-en-Y Gastric Bypass. Literature analysis revealed that Sleeve Gastrectomy provides significant short-term and long-term weight loss with lower incidence of postoperative complications compared to other techniques. Furthermore, patients' quality of life improved considerably after surgery, covering physical, psychological, and social aspects. It is concluded that Sleeve Gastrectomy is a viable and safe surgical option for treating morbid obesity, offering significant advantages in terms of weight loss and patient quality of life. However, further long-term studies are needed to fully compare this technique with other bariatric treatment modalities and assess the maintenance of weight loss and improvement of associated comorbidities.O presente estudo visa analisar a eficácia e a segurança do Sleeve Gástrico como técnica cirúrgica no tratamento da obesidade mórbida, comparando seus resultados com outros métodos bariátricos e avaliando seu impacto na qualidade de vida dos pacientes. Esta pesquisa utilizou uma revisão da literatura abrangente, incluindo estudos publicados entre 2000 e 2024 em inglês, português e espanhol. Foram consultadas bases de dados como PubMed, Google Acadêmico, SciELO, além de revistas científicas especializadas e repositórios acadêmicos. Os resultados indicam que o Sleeve Gástrico é uma técnica eficaz para a perda de peso, apresentando resultados comparáveis a outras cirurgias bariátricas como o Bypass Gástrico em Y de Roux. A análise da literatura revelou que o Sleeve Gástrico proporciona uma perda de peso significativa a curto e longo prazo, com menor incidência de complicações pós-operatórias em comparação com outras técnicas. Além disso, a qualidade de vida dos pacientes melhorou consideravelmente após a cirurgia, abrangendo aspectos físicos, psicológicos e sociais. Conclui-se que o Sleeve Gástrico é uma opção cirúrgica viável e segura para o tratamento da obesidade mórbida, oferecendo vantagens significativas em termos de perda de peso e qualidade de vida dos pacientes. No entanto, é necessário mais estudo de longo prazo para comparar plenamente esta técnica com outras modalidades de tratamento bariátrico e avaliar a manutenção da perda de peso e a melhoria das comorbidades associadas

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Communication of the cancer diagnosis to an elderly patient

Objective: to collect evidence on matters which involve cancer diagnosis disclosure to an elderly patient. Methods: integrative revision made in five important data bases in the area of health with seven selected articles. Results: it was noticeable that there are conflicts between family members and health professionals concerning cancer diagnosis disclosure to an elderly patient and that the preferences of those people on the disclosure of the diagnosis are similar to other patients. Conclusion: health professionals, especially the nurses, need training in order to have a secure and clarifying communication, matching the information to the specific needs of each patient, considering their reality and type of confrontation.

Squamous Cell Carcinoma in the Third Eyelid of a Dog

Background: Squamous cell carcinoma is a malignant neoplasm that originates from the keratinized stratified squamous epithelium and predominantly affect light-skinned animals. In dogs, breeds such as American Staffordshire Terriers, white or speckled Bull Terriers, and Beagles have a higher predisposition. Squamous cell carcinoma presents in the skin, at slightly pigmented or hairy sites, especially in digits, but also may occur in the nasal planum, oral mucosa, and rarely, in the eye. Considering that few reports have been published on eye neoplasms, the aim of this paper is to describe a dog with a lesion in the third eyelid of his right eye which was diagnosticated with squamous cell carcinoma. Case: A 10-year-old male American Staffordshire dog was admitted to the Veterinary Medical Teaching Hospital of the Veterinary Medicine and Zootechnics College, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Brazil with injury to the right eye. During the physical examination, there was also a non-adhered lump near the foreskin, measuring 1.5 cm in diameter. In addition, there was another lump in the third eyelid of the right eye, approximately 3 mm in diameter. Cytology of the dermal nodule was performed by fine-needle aspiration cytology; however, the sample was insufficient for cytological evaluation. Therefore, the animal was placed under general anesthesia for skin lump excision and for fine-needle aspiration cytology of the third eyelid nodule. The histopathological exam revealed high cellularity of epithelial cells, intense anisocytosis and pleomorphism, cytoplasmic basophilia and vacuolation, multiple evident nucleoli, and anisocariosis and coarse chromatin. These finds were compatible with squamous cell carcinoma, which was the same result suggested by fine-needle aspiration cytology of the third eyelid sample. Based on these results, the dog underwent a surgical procedure for enucleation and subsequent histopathological evaluation of the nodule in the third eyelid, which confirmed the squamous cell carcinoma diagnosis.Discussion: Squamous cell carcinoma is an extremely aggressive tumor with low metastatic potential, characterized by invasion of the dermis by proliferation of malignant epithelial cells from the prickly layer. It is most common in elderly animals, and American Staffordshires are among the breeds that are predisposed to develop this tumor. The clinical presentation is highly variable, depending on the tissue involved. In this case, the dermal nodule was an elevated area on the skin and the third eyelid nodule resembled an ulcerative mass. Cytological examination from the lesion located on the third eyelid, showed malignancies cytoplasmic changes frequently found in carcinomas such as anisocytosis, cytoplasmic basophilia, and cell pleomorphism. In addition, nuclear changes had also occurred, such as crass chromatin, multiple evident nucleoli, and multinucleated cells. A presumptive diagnosis was made based on cytology and was confirmed after biopsy and histopathological examination. Because it is uncommon in dogs, squamous cell carcinoma of the third eyelid may be misdiagnosed, delaying correct treatment, and accelerating the development of the tumor. Currently, various therapeutic approaches are available, such as surgical excision, electrosurgery, cryosurgery, radiation, and hyperthermia. The choice of treatment depends on the location and stage of the lesions. Surgical treatment should be aimed at removing sufficient tissue to leave surgical margins free of neoplastic cells

Diagnóstico Meteorológico dos Desastres Naturais Ocorridos nos Últimos 20 Anos na Cidade de Duque de Caxias

Resumo Este trabalho buscou auxiliar o planejamento de ações, medidas preventivas e mitigadoras, a desastres naturais para a Defesa Civil da cidade de Duque de Caxias, e utilizou a Classificação e Codificação Brasileira de Desastres (COBRADE) para identificação de 35 desastres naturais ocorridos entre os anos de 1996 a 2015, onde 74% desses eventos ocorreram entre os meses de novembro e fevereiro, sendo 20% ocorridos no ano de 2009. Para diagnosticar os sistemas meteorológicos, foram utilizados o Boletim de Climanálise do Centro de Previsão do Tempo de Estudos Climáticos – CPTEC, onde 57% dos desastres foram associados à Zona de Convergência do Atlântico Sul (ZCAS), 29% a passagem de frentes frias e 14% a áreas de instabilidade local. Objetivando subsidiar a confecção dos protocolos de acionamento de sirenes, foram analisadas a espacialização da precipitação ocorrida em 116 pluviômetros. Os resultados mostram que, para eventos de ZCAS, a faixa de maior frequência de acumulados diários de chuva variou entre 10 e 50 mm nas 24 h antecedentes, e entre 60 e 110 mm no dia do desastre. Para frentes frias, os acumulados variaram entre 40 e 110 mm, e para áreas de instabilidade entre 30 e 95 mm