Atypical Spleen Hemophagocytic Histiocytic Sarcoma in a Dog

Background: The histiocytic sarcoma (HS) complex is a set of malignant neoplasms originating from interstitial dendritic cells or macrophages. When it involves macrophages of the splenic red pulp and bone marrow, it is referred to as hemophagocytic histiocytic sarcoma (HHS). HHS behaves more aggressively than HS and is usually fatal. HHS can be diagnosed by cytological and histopathological examination of neoplastic tissue. HHS is confirmed by immunohistochemistry using an anti-CD11d antibody. This neoplasm is often confused with immune-mediated hemolytic anemia or Evans syndrome due to erythrophagocytosis and platelet consumption. The clinical presentation of the animals progresses with evident anemia and thrombocytopenia, leading to signs such as prostration, inappetence, and pale mucosa, making diagnosis challenging and often late. This study aimed to report the clinic-pathological aspects of a canine with atypical hemophagocytic splenic HS.Case: A 4-year-old male Shih-Tzu canine was referred to the Veterinary Hospital with a history of prostration and anorexia. Pale mucous membranes were observed on physical examination. Blood tests revealed non-regenerative anemia, leukopenia, and thrombocytopenia. Serum protein levels were below the reference values for the species in biochemical examinations. Hemoparasitosis was suspected; however, the result of the polymerase chain reaction was negative. Abdominal ultrasound revealed a splenomegaly with heterogeneous parenchyma and a slightly irregular surface, but no visible mass in the spleen. Due to the difficulty of stabilizing the patient, even after successive transfusions, the animal underwent exploratory laparotomy with medial access and posterior splenectomy. Subsequently, the spleen was surgically removed, fixed in 10% buffered formalin, and processed routinely. Macroscopically, it had an irregular reddish-brown capsular surface. Histopathological examination of the spleen revealed a densely cellular neoplasm composed of round to spindle cells (histiocytes) arranged haphazardly in variably sized sheets separating the pre-existing spleen stroma. These histopathological findings were consistent with a histiocytic malignant neoplasm. Immunohistochemical analysis was performed to better define the origin of the histiocytic neoplasm. Neoplastic cells showed positive immunostaining of more than 80% of tumor cells for the CD11d antibody and weak immunostaining for CD11c and lysozyme. The patient survived for less than 30 days after the first hospital visit.Discussion: The diagnosis of HHS was based on the histological characteristics and positive immunostaining of more than 80% of the tumor cells for the CD11d antibody. HHS is an extremely aggressive and rare tumor that affects elderly dogs of any breed. In this study, HHS had atypical histologic characteristics, in which erythrophagocytosis and hemosiderin were not observed within macrophages. HHSs arise from macrophages of the red pulp of the spleen or bone marrow and express the b2 integrin, CD11d, and have low expression of CD1 and CD11c, which are predominantly expressed by non-hemophagocytic HS. The hematological and biochemical changes observed in this case were similar to those described in other dogs with HHS. Treatment of HHS is only palliative. Erlichia ewingii, E. canis, Anaplasma phagocytophilum, A. platys, Borrelia burgdorferi, Dirofilaria immitis, Leishmania infantum and immune-mediated hemolytic anemia are the main differential diagnoses because they cause anemia and thrombocytopenia accompanied by splenomegaly.Keywords: histiocytic sarcoma, spleen, immunohistochemistry, splenectomy, erythrophagocytosis

Presencia y extensión de los atributos de la atención primaria de salud en servicios dentales públicos de Porto Alegre, Río Grande do Sul, Brasil

The objective was to compare the presence and extension of primary health care (PHC) in oral health services using the PHC attributes according to three different types of PHC organizational arrangements: Family Health Strategy (FHS), Community Health Service (CHS) and Traditional Primary Care (TPC). This is a cross-sectional study carried out between 2011-2013, following a cluster random sampling strategy. Adult users were interviewed from 15 health services of that 6 were managed by the CHS, 4 by the FHS and 5 by the TPC and which had the same oral health team for at least two years. The final sample was 407 users interviewed using the Primary Care Assessment Tool - Oral Health of Adults evaluation instrument and a sociodemographic questionnaire. PHC scores were calculated and transformed on a scale ranging from 0 to 10. For high scores, the cut-off point > 5.5 was used. Most of the interviewees were females, for the three types of services. The performance of CHS and FHS was higher than those of TPC in almost all attributes (p 5,5. Nos três tipos de serviços, a maioria dos entrevistados era do sexo feminino. Em quase todos os atributos, o desempenho dos SSC e da ESF foi superior àquele da APT (p 5.5. La mayoría de los entrevistados fueron mujeres en los tres tipos de servicios. El desempeño de los SCS y ESF fue mayor que en la APS en casi todos los atributos (p < 0,05). La extensión de los atributos de la APS en servicios fue escasa (la puntuación general más alta fue 5,75 en SCS). El SCS fue el único servicio con la mitad de usuarios (83; 49,1%) servicios cualificados de salud bucal, contando con una puntuación general alta para APS. Por lo que se concluye que existen diferencias entre los modelos organizativos de APS, respecto a los servicios orales de salud. No obstante, hay muchas cosas que deben ser mejoradas en la orientación de los servicios orales de salud relacionados con la APS. Se necesitan más estudios para evaluar las diferencias en los servicios de APS en relación con la salud bucal

Construcción de un mapa genético preliminar de yerba mate (Ilex paraguariensis): construction of a preliminary genetic linkage map of yerba mate (Ilex paraguariensis)

Las hojas de la yerba mate se utilizan para la preparación del mate, una infusión de profunda raigambre histórica, social y cultural en sudamérica. Su cultivo reviste importancia estratégica para varios países de la región, especialmente Argentina, Brasil y Paraguay. Nuestro objetivo fue establecer una población segregante y construir un mapa de ligamiento genético preliminar de esta especie para facilitar la futura identificación de loci asociados con caracteres de interés agronómico. Dos genotipos genéticamente divergentes con comportamiento contrastante respecto a la tolerancia a sequía se seleccionaron como progenitores femenino y masculino. Mediante cruzamientos controlados y rescate de embriones, se estableció una población F tipo 1 ?pseudo-test cross? de 700 individuos, con potencial para extenderse hasta 1900. Un subgrupo de 117 plantas fue empleado para construir un mapa genético marco. Se ensayaron 5 combinaciones de cebadores de AFLP y 16 cebadores de RAPDs, para generar 119 marcadores informativos, de los cuales el 68,9% se ajustó a los valores de segregación mendeliana esperados. El análisis de ligamiento se realizó con el programa JoinMap 3.0. Los marcadores originados en cada progenitor se analizaron independientemente para generar un mapa femenino formado por 11 grupos de ligamiento y otro masculino con 16 grupos. Las distancias genéticas cubiertas por los mismos fueron de 223 cM y 678 cM, respectivamente. Este trabajo permitió establecer una progenie de mapeo segregante para yerba mate y construir un mapa genético preliminar que podrá usarse como base para la futura identificación de marcadores ligados a genes de interés agronómico.The “yerba mate” leaves are used to make an infusion named “mate tea”, which is deeply rooted in the historical, social and cultural tradition of South America. Its sustainable use is of strategic significance to several countries of this region, particularly Argentina, Brazil and Paraguay. Our objective was to establish a segregating population and build a framework genetic map, in order to contribute to the future identification of loci associated with desirable traits. Two genetically divergent genotypes with contrasting drought tolerance capacity were selected as female and male parents. A “pseudo-test cross” F1 population of 700 individuals, with potential to be extended to 1900 individuals, was produced after controlled crossing followed by embryo rescue. A subset of 117 plants was used to produce a framework genetic map. Five AFLP primer combinations and 16 RAPD primers generated 119 informative markers, out of which 68.9% showed the expected Mendelian segregation values. Linkage analyses were carried out by using Joinmap 3.0. Markers originated from each progenitor were independently evaluated to generate a female map including 11 linkage groups and a male one with 16 linkage groups. Total genetic distances covered by the female and male maps were 223 cM and 678 cM, respectively. This work allowed the establishment of a yerba mate segregating population and the construction of a preliminary genetic map, which will be used as a framework for the future identification of markers linked to genes of interest.Fil: Stein, Juliana. Universidad Nacional de Rosario. Facultad de Ciencias Agrarias; ArgentinaFil: Luna, Claudia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Nordeste. Instituto de Botánica del Nordeste (i); ArgentinaFil: Espasandin, Fabiana Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Nordeste. Instituto de Botánica del Nordeste (i); ArgentinaFil: Sartor, Maria Esperanza. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Nordeste. Instituto de Botánica del Nordeste (i); ArgentinaFil: Espinoza, Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Nordeste. Instituto de Botánica del Nordeste (i); ArgentinaFil: Ortiz, Juan Pablo Amelio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Nordeste. Instituto de Botánica del Nordeste (i); Argentina. Universidad Nacional de Rosario. Facultad de Ciencias Agrarias; ArgentinaFil: Sansberro, Pedro Alfonso. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Nordeste. Instituto de Botánica del Nordeste (i); ArgentinaFil: Pessino, Silvina Claudia. Universidad Nacional de Rosario. Facultad de Ciencias Agrarias; Argentin

MINIMUM VIABLE PRODUCT FOR SUPPORT APPLICATION: NURSING CARE MANAGEMENT OF THE AGED SKIN

Objective: to describe the construction steps of a Minimum Viable Product for a decision support application for nurses for prevention, nursing diagnosis, and treatment of friction injury/pressure injury in the elderly people.Method: qualitative study with technological production by the Lean Startup method. Qualitative research was conducted in a municipality in southern Brazil and integrative review for content definition. Product developed in Hyper Text Markup Language format, through the Net Beans tool. Usability Test applied.Results: 25 nurses participated. The functionalities were organized into a navigation map containing selection boxes for risk factors and care plan, nursing diagnoses, injury staging and treatment suggestions. After usability testing, it was identified the need for adjustments in content and functionalities, which were corrected, resulting in a final version.Conclusion: the model constitutes a feasible proposal for nursing decision making, allowing critical judgment, based on clinical findings.Objetivo: Describir las etapas de construcción de un Producto Mínimo Viable para la aplicación de apoyo a la decisión de los enfermeros para la prevención, el diagnóstico de la enfermedad y el tratamiento de la úlcera por presión/fricción en los ancianos. Método: estudio cualitativo con producción tecnológica por el método Lean Startup. Se realizó una investigación cualitativa en un municipio del sur de Brasil y una revisión integradora para definir el contenido. Producto desarrollado en formato Hyper Text Markup Language, a través de la herramienta Net Beans. Prueba de usabilidad aplicada. Resultados: participaron 25 enfermeras. Las funcionalidades se organizaron en un mapa de navegación que contenía casillas de selección para los factores de riesgo y el plan de atención, los diagnósticos de enfermería, la estadificación de las lesiones y las sugerencias de tratamiento. Tras las pruebas de usabilidad, identificamos la necesidad de realizar ajustes en el contenido y las funcionalidades, que se corrigieron, dando lugar a la versión final. Conclusión: el modelo constituye una propuesta factible para la toma de decisiones de enfermería, permitiendo un juicio crítico, basado en los hallazgos clínicos.Objetivo: descrever as etapas de construção de um Mínimo Produto Viável para aplicativo de apoio à decisão a enfermeiros para prevenção, diagnóstico de enfermagem e tratamento de lesão por fricção/pressão em idosos.Método: estudo qualitativo com produção tecnológica pelo método Lean Startup. Realizou-se investigação qualitativa em um município do Sul do Brasil e revisão integrativa para definição de conteúdo. Produto desenvolvido em formato Hyper Text Markup Language, por meio da ferramenta Net Beans. Aplicado Teste de Usabilidade.Resultados: participaram 25 enfermeiros. As funcionalidades foram organizadas em mapa de navegação contendo caixas de seleção para fatores de risco e plano de cuidados, diagnósticos de enfermagem, estadiamento das lesões e sugestões de tratamento. Após teste de usabilidade, identificou-se necessidade de ajustes no conteúdo e funcionalidades, que foram corrigidos, originando versão final.Conclusão: o modelo constitui uma proposta factível à tomada de decisão de enfermagem, permitindo julgamento crítico, fundamentado em achados clínicos

Construction of a preliminary genetic linkage map of yerba mate (Ilex paraguariensis)

Las hojas de la yerba mate se utilizan para la preparación del mate, una infusión de profunda raigambre histórica, social y cultural en Sudamérica. Su cultivo reviste importancia estratégica para varios países de la región, especialmente Argentina, Brasil y Paraguay. Nuestro objetivo fue establecer una población segregante y construir un mapa de ligamiento genético preliminar de esta especie para facilitar la futura identificación de loci asociados con caracteres de interés agronómico. Dos genotipos genéticamente divergentes con comportamiento contrastante respecto a la tolerancia a sequía se seleccionaron como progenitores femenino y masculino. Mediante cruzamientos controlados y rescate de embriones, se estableció una población F tipo 1 “pseudo-test cross” de 700 individuos, con potencial para extenderse hasta 1900. Un subgrupo de 117 plantas fue empleado para construir un mapa genético marco. Se ensayaron 5 combinaciones de cebadores de AFLP y 16 cebadores de RAPDs, para generar 119 marcadores informativos, de los cuales el 68,9% se ajustó a los valores de segregación mendeliana esperados. El análisis de ligamiento se realizó con el programa JoinMap 3.0. Los marcadores originados en cada progenitor se analizaron independientemente para generar un mapa femenino formado por 11 grupos de ligamiento y otro masculino con 16 grupos. Las distancias genéticas cubiertas por los mismos fueron de 223 cM y 678 cM, respectivamente. Este trabajo permitió establecer una progenie de mapeo segregante para yerba mate y construir un mapa genético preliminar que podrá usarse como base para la futura identificación de marcadores ligados a genes de interés agronómico.Fil: Stein, Juliana. Universidad Nacional de Rosario; ArgentinaFil: Luna, Claudia Verónica. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Espasandin, Fabiana Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Sartor, Maria Esperanza. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Espinoza, Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Ortiz, Juan Pablo Amelio. Universidad Nacional de Rosario. Facultad de Ciencias Agrarias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Sansberro, Pedro Alfonso. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Pessino, Silvina Claudia. Universidad Nacional de Rosario. Facultad de Ciencias Agrarias; Argentin

TÉCNICAS FISIOTERAPÊUTICAS EM MULHERES COM CÂNCER DE MAMA

O câncer de mama (CM) é uma doença que apresenta altos índices de mortalidade e morbidade entre as mulheres, tendo como principal sintoma a presença de nódulos no seio, os quais podem ou não apresentar quadros álgicos. A fisioterapia através de suas diversas técnicas desempenha um papel importante no tratamento de mulheres com CM que foram submetidas a um processo cirúrgico. Este estudo de revisão da literatura tem como objetivo avaliar as técnicas de cinesioterapia, cinesioterapia associada a outros métodos, terapia manual, estimulação sensitiva e também hidroterapia na melhora das alterações funcionais decorrentes do câncer de mama em mulheres. A busca dos artigos foi realizada através de uma revisão da literatura nas bases de dados científicos eletrônicos Scielo, Lilacs e Bireme, entre os anos de 2009 a 2017, os descritores foram: Fisioterapia, Tratamento e Câncer de Mama. Ao final observou-se que as técnicas fisioterapêuticas utilizadas com o objetivo de proporcionar uma melhora no quadro de dores, ganho de amplitude de movimento funcional, melhora na sensibilidade e na qualidade de vida destas mulheres, em grande maioria obtiveram resultados positivos diante destas alterações. Sendo assim, a partir deste estudo pode-se concluir que as técnicas fisioterapêuticas citadas influenciaram na melhora das alterações funcionais decorrentes do câncer de mama de forma positiva, incentivando desta forma a realização de mais pesquisas relacionadas a este tema

Mental health, human rights, and legal capacity

In September, 2021, our edited volume Mental Health, Human Rights and Legal Capacity was published. The book takes an interdisciplinary approach to engage with evolving debates related to legal capacity in the field of mental health care, documenting perspectives from legal scholars, practitioners, policy makers, advocates, and people with lived experience of mental health conditions from diverse regions worldwide. The volume is intended to stimulate a conversation. Its objective is to document good practices while also recognising that there remain considerable barriers to the implementation of non-coercive models of mental health support, as required by the 2006 UN Convention on the Rights of Persons with Disabilities (CRPD). Ultimately, our aim is to illustrate that ending coercion in mental health care is both necessary and possible, and that supported decision making in community-based mental health settings is the way of the future.http://www.thelancet.com/psychiatryhj2023Centre for Human Right

Maternidade na adolescência inicial : estudo caso-controle no sul do Brasil

This paper investigates factors associated with motherhood among adolescents from 14 to 16 years of age in Porto Alegre, Brazil. This is a case-control study with 431 adolescent mothers (cases) and 862 adolescents who had never given birth (controls). Data were obtained through home visits by an interviewer-applied questionnaire. Sociodemographic characteristics, quality of social and family relationships, lifestyle and history of abuse were studied as potential determinants to early adolescent motherhood. Conditional logistic regression was used for data analysis according to a two-stage hierarchical model. Results showed that lower economic class, schooling failure, tobacco consumption, alcoholic drunkenness at least once in life and having a mother who gave birth before 20 years of age were positively associated with early adolescent motherhood. Later menarche and having relatives or having friends in whom to trust remained as protective factors. Schooling failure, which obtained the highest risk, points to the important role of the school in this population’s development and its potential to stimulate healthy life habits.Este artigo visa investigar fatores associados à maternidade em adolescentes moradoras em Porto Alegre, com idade entre 14 e 16 anos. Estudo caso-controle com 431 mães adolescentes (casos) e 862 adolescentes que nunca tiveram filho (controles). Os dados foram obtidos através de visitas domiciliares e mediante aplicação de questionário estruturado. Foram estudadas variáveis sociodemográficas, qualidade das relações sociais e familiares, estilo de vida e histórico de abuso como possíveis determinantes da maternidade na adolescência. Os dados foram analisados através de regressão logística condicional, utilizando modelo hierarquizado. Os resultados mostram que pertencer aos estratos socioeconômicos mais baixos, possuir mãe que teve o seu primeiro filho até os 19 anos, defasagem escolar, uso de tabaco e embriaguez alcóolica pelo menos uma vez na vida foram positivamente associados à maternidade na adolescência. Menarca mais tardia e ter familiares ou ter amigos em quem confiar foram fatores de proteção. Defasagem escolar, que obteve razão de odds mais elevada, aponta o importante papel da escola na formação desta população e no seu potencial para estimular hábitos de vida sadios

Early intervention for obsessive compulsive disorder : An expert consensus statement

© 2019 Elsevier B.V.and ECNP. All rights reserved.Obsessive-compulsive disorder (OCD) is common, emerges early in life and tends to run a chronic, impairing course. Despite the availability of effective treatments, the duration of untreated illness (DUI) is high (up to around 10 years in adults) and is associated with considerable suffering for the individual and their families. This consensus statement represents the views of an international group of expert clinicians, including child and adult psychiatrists, psychologists and neuroscientists, working both in high and low and middle income countries, as well as those with the experience of living with OCD. The statement draws together evidence from epidemiological, clinical, health economic and brain imaging studies documenting the negative impact associated with treatment delay on clinical outcomes, and supporting the importance of early clinical intervention. It draws parallels between OCD and other disorders for which early intervention is recognized as beneficial, such as psychotic disorders and impulsive-compulsive disorders associated with problematic usage of the Internet, for which early intervention may prevent the development of later addictive disorders. It also generates new heuristics for exploring the brain-based mechanisms moderating the ‘toxic’ effect of an extended DUI in OCD. The statement concludes that there is a global unmet need for early intervention services for OC related disorders to reduce the unnecessary suffering and costly disability associated with under-treatment. New clinical staging models for OCD that may be used to facilitate primary, secondary and tertiary prevention within this context are proposed.Peer reviewe

Exercise training modalities for heart transplant recipients : a systematic review and network metaanalysis protocol

Introduction Heart transplantation is the gold standard treatment for selected patients with end-stage heart failure. Although this procedure can improve quality and prolong life expectancy, several of these patients persist with decreased exercise tolerance. Evidence suggests that exercise training can bring multifactorial benefits to heart transplant (HTx) recipients. However, it is unclear that exercise modality should be preferred. Therefore, the aim of this systematic review and network meta-analysis is to compare the efficacy and safety of different training modalities in HTx recipients. Methods and analysis We will perform a comprehensive literature search in PubMed/MEDLINE, Embase, The Cochrane Library, CINAHL, Scopus, SportDISCUS, Web of Science Core Collection and PEDro from inception until November 2020. Two registries (ClinicalTrials.gov and REBEC) will also be searched for potential results in unpublished studies. There will be no restriction on language, date of publication, publication status or sample size. We will include randomised controlled trials enrolling adult HTx recipients with the presence of at least one exercise training group, which might be compared with another training modality and/or a non-exercise control group for a minimum of 4 weeks of intervention. The primary outcomes will be peak oxygen consumption and occurrence of adverse events. As secondary outcomes, the interaction between pulmonary ventilation, pulmonary perfusion and cardiac output, oxygen uptake efficiency slope, heart rate response, oxygen pulse, peak blood pressure and peak subjective perception of effort. In addition, we will evaluate the 6min walking distance, health-related quality of life, endothelial function, muscle strength, body fat percentage and lean mass. Risk of bias will be assessed using the Cochrane RoB V.2.0 tool, and we plan to use the Confidence in Network Meta-Analysis tool to assess confidence in the results