Late recurrence of low-grade serous carcinoma of the ovary mimicking colorectal neoplasia

A case report (images in medicine) of late recurrence of low grade serous carcinoma of the ovary mimicking colorectal neoplasia

FATORES QUE INFLUENCIAM A BULIMIA NERVOSA EM ADOLESCENTES: REVISÃO INTEGRATIVA

This study aims to verify the factors that lead an adolescent to develop Bulimia Nervosa.The research included articles published from 2011 to 2021, in Portuguese and English, comprising fields of field research and that contribute to the suggested theme.Twenty articles were found in SCIELO, 20 in LILACS and 05 in PUBMED, totaling 45 studies, of these articles found, only 08 were included in the study because they relate to the theme in question. In view of the results obtained, it is noted that society, socio-cultural factors, the media and the lack of nutritional education in schools, leads to the emergence of psychological disorders and compulsive eating, especially bulimia nervosa, which arises from social pressure and body dissatisfaction in adolescents. The media is one of the factors that must be taken into account in the development of eating disorders. The promotion of nutritional educational strategies in schools, with lectures, information leaflets, guidance from teachers and other actions, bring important information about self-acceptance, good eating habits and healthy communication with the family, which can guarantee teenagers a greater view on the emergence and consequences of eating disorders, especially bulimia nervosa.Este estudio tiene como objetivo verificar los factores que llevan a un adolescente a desarrollar Bulimia Nerviosa. La investigación incluyó artículos publicados de 2011 a 2021, en portugués e inglés, que comprenden campos de investigación de campo y que contribuyen al tema propuesto.Se encontraron 20 artículos en SCIELO, 20 en LILACS y 05 en PUBMED, totalizando 45 estudios, de estos artículos encontrados, solo 08 fueron incluidos en el estudio por relacionarse con la temática en cuestión.A la vista de los resultados obtenidos, se observa que la sociedad, los factores socioculturales, los medios de comunicación y la falta de educación nutricional en las escuelas, conduce a la aparición de trastornos psicológicos y de alimentación compulsiva, especialmente bulimia nerviosa, que surge de la presión sociale insatisfacción corporal en adolescentes. Los medios de comunicación son uno de los factores que se deben tener en cuenta en el desarrollo de los trastornos alimentarios. La promoción de estrategias de educación nutricional en las escuelas, con conferencias, folletos informativos, orientación de los docentes, entre otras acciones, aportan información importante sobre la auto aceptación del cuerpo, los buenos hábitos alimentarios y la comunicación saludable con la familia, lo que puede garantizar a los adolescentes una mayor visión de la aparición y las consecuencias de los trastornos alimentarios, especialmente la bulimia nerviosa.Esse estudo tem como objetivo verificar os fatores que levam um adolescente a desenvolver a Bulimia Nervosa. Na pesquisa foi incluso artigos publicados no período de 2011 a 2020, no idioma português e inglês, compreendendo âmbitos de pesquisa de campo e que contribuem com o tema sugerido. Foram encontrados 20 artigos na SCIELO, 20 no LILACS e 05 na PUBMED, totalizando 45 estudos, desses artigos encontrados, apenas 08 foram incluídos no estudo por relacionarem com a temática em questão. Diante dos resultados obtidos, nota-se que a sociedade, os fatores socioculturais, a mídia e a falta de educação nutricional nas escolas, leva ao surgimento de transtornos psicológicos e compulsão na alimentação, principalmente a bulimia nervosa, que surge a partir da pressão social e a insatisfação corporal nos adolescentes. A mídia é um dos fatores que deve ser levado em consideração no desenvolvimento de transtornos alimentares. A promoção de estratégias educativas nutricionais nas escolas, com palestras, folhetos informativos, orientação dos docentes entre outras ações, levam informações importantes sobre à autoaceitação corporal, bons hábitos alimentares e uma comunicação saudável com a família, podendo garantir aos adolescentes uma visão maior sobre o surgimento e as consequências dos transtornos alimentares, em especial a bulimia nervosa

GQ-16, a TZD-derived partial PPARγ agonist, induces the expression of thermogenesis- related genes in brown fat and visceral white fat and decreases visceral adiposity in obese and hyperglycemic mice

Background Beige adipocytes comprise a unique thermogenic cell type in the white adipose tissue (WAT) of rodents and humans, and play a critical role in energy homeostasis. In this scenario, recruitment of beige cells has been an important focus of interest for the development of novel therapeutic strategies to treat obesity. PPARγ activation by full agonists (thiazolidinediones, TZDs) drives the appearance of beige cells, a process so-called browning of WAT. However, this does not translate into increased energy expenditure, and TZDs are associated with weight gain. Partial PPARγ agonists, on the other hand, do not induce weight gain, but have not been shown to drive WAT browning. The present study was designed to investigate the effects of GQ-16 on BAT and on browning of WAT in obese mice. Methods Male Swiss mice with obesity and hyperglycemia induced by high fat diet were treated with vehicle, rosiglitazone (4 mg/kg/d) or the TZD-derived partial PPARγ agonist GQ-16 (40 mg/ kg/d) for 14 days. Fasting blood glucose, aspartate aminotransferase, alanine aminotransferase and lipid profile were measured. WAT and brown adipose tissue (BAT) depots were excised for determination of adiposity, relative expression of Ucp-1, Cidea, Prdm16, Cd40 and Tmem26 by RT-qPCR, histological analysis, and UCP-1 protein expression analysis by immunohistochemistry. Liver samples were also removed for histological analysis and determination of hepatic triglyceride content. Results GQ-16 treatment reduced high fat diet-induced weight gain in mice despite increasing energy intake. This was accompanied by reduced epididymal fat mass, reduced liver triglyceride content, morphological signs of increased BAT activity, increased expression of thermogenesis- related genes in interscapular BAT and epididymal WAT, and increased UCP-1 protein expression in interscapular BAT and in epididymal and inguinal WAT. Conclusion This study suggests for the first time that a partial PPARγ agonist may increase BAT activity and induce the expression of thermogenesis-related genes in visceral WAT. General Significance These findings suggest that PPARγ activity might be modulated by partial agonists to induce WAT browning and treat obesity

Aspectos sociodemográficos, história sexual reprodutiva e conhecimento contraceptivo de puérperas adolescentes e adultas

Objetivo: descrever e comparar os aspectos sociodemográficos, a história sexual e reprodutiva e o conhecimento contraceptivo de puérperas adolescentes e adultas que tiveram seus partos numa maternidade de referência para a macrorregião de saúde. Métodos: foi realizada entrevista individual com um instrumento semiestruturado contendo questões relativas aos aspectos estudados. Resultados: a média de idade das puérperas foi de 26,74 anos. Dentre os métodos contraceptivos, a pílula foi apontada como mais conhecido. Houve associação estatisticamente significante entre o período fértil e a idade da puérpera e a renda. A mediana de idade em que as puérperas tiveram sua primeira relação sexual foi de 17 anos. A associação idade da puérpera e idade da primeira relação sexual (

Morphological patterns and malignancy criteria of transmissible venereal tumor in cytopathological and histopathological exams

The aim of this study was to identify morphological patterns and malignancy criteria of the TVT in cytopathological and histopathological evaluations and relate these characteristics to clinical evolution and response to chemotherapy. Regarding studied animals, sixteen dogs were female and four were male. The age of the animals ranged between one and ten years old. Considering breed, 80% of the dogs were mongrel dogs and 20% were of other breeds. It was found that the cytological samples allowed a better characterization of the cell type than histological ones. The plasmacytoid was the most common morphological type of TVT, followed by the lymphocytoid and mixed standards. There was no difference among the scores for the malignancy criteria and morphological types of TVT. Regarding response to chemotherapy, no morphological type of the TVT showed any difference, but the TVT presents morphological peculiarities that may interfere with tumor behavior, especially those related to increased aggressiveness and that are observed in the plasmacytoid TVT.Este estudo teve por objetivo identificar os padrões morfológicos e os critérios de malignidade do TVT aos exames citológico e histopatológico e relacionar essas características à evolução clínica e à resposta à quimioterapia. Dos animais estudados, dezesseis cães eram fêmeas e quatro machos. A idade dos animais variou entre um e dez anos de idade. Quanto à raça, 80% dos cães eram sem raça definida e 20% de outras raças. Constatou-se que as amostras citológicas permitiram melhor caracterização do tipo celular do que as histológicas. O TVT tipo plasmocitoide foi o de maior ocorrência, seguido pelos padrões linfocitoide e misto. Não houve diferença entre os escores estabelecidos para os critérios de malignidade e os tipos do TVT. Nenhum tipo morfológico do TVT diferiu quanto à resposta quimioterápica, mas o TVT apresenta particularidades morfológicas que podem interferir no comportamento tumoral, especialmente aquelas relacionadas à maior agressividade, e que são observadas no TVT plasmocitoide

Dermatopathy Caused by Enterobacter aerogenes and Pseudomonas aeruginosa in Boa constrictor amarali

Background: Bacterial diseases are the main cause of the high mortality rates of snakes, especially those caused by gramnegative agents. However, studies on dermatopathy caused by these bacterial agents in snakes are scarce; and no reports have been found on Enterobacter aerogenes as causative agent of dermatopathy in snake species. Thus, the objective of this study was to describe the clinical signs, and lesion evolution of a dermatopathy in a male snake (Boa constrictor amarali) specimen of approximately seven years old; and to describe the isolation and identification of the Enterobacter aerogenes and Pseudomonas aeruginosa agents involved in the cause of this disease.Case: The Boa constrictor amarali evaluated presented blackened cutaneous lesions in the dorsal, snout-vent and tail regions; and well-defined subcutaneous nodules of 2.0-3.0 cm diameter, with soft consistency, reddish color, cutaneous flaccidity, and areas of scale ulceration in the dorsolateral region. The clinical evaluation of the animal showed dehydration signs and pale mucous membranes. The blackened lesions were subjected to mycological analysis - after procedure of deep scale scraping - which showed presence of septate hyphae. The nodule was punctured for microbiological and biochemical analysis. The sample was collected with a sterilized alginate cotton tip swab, and was stored in a plastic tube containing a semi-solid Stuart transport medium, for microbiological analysis. Then, this sample was incubated in a bacteriological oven at 37°C for 24 h. Typical colonies of Pseudomonas and Enterobacter grew on MacConkey agar medium; these bacteria were identified by the colony morphology and their typical odor. The colonies grown in MacConkey agar were also identified through biochemical tests in the mediums: Phenol red, Lysine, Phenylalanine, Citrate, Urea and SIM (Sulfide, Indole, Motility). The results of these tests were able to confirm and identify the P. aeruginosa and E. aerogenes species. The animal died within 36 h, before the identification of the causative agents of the disease, thus, no pharmacological interference was possible.Discussion: Immunodepression, malnutrition, and temperatures and humidity outside the animal thermal comfort zone, are predisposing factors for the development of bacterial diseases in reptiles. Little information about pathogen agents affecting Boa constrictor specimens in their native area is available; however, captive snakes are subject to a wide variety of diseases - most of which caused or intensified by the captivity conditions. Among the bacteria involved in reptile diseases, few are primary causative agents. In general, clinical bacterial infections tend to be secondary to viral infections. The bacterial agents found in this study are commonly described in scientific literature with location in the oral cavity, differently from the results found in this study. Moreover, the bacterium E. aerogenes has not yet been described in other studies as a causative agent of dermatopathy. Reptiles are considered reservoirs of important zoonotic microorganisms, such as P. aeruginosa, which can be transmitted by fecal contact, bites and wounds. However, the little information on P. aeruginosa in captive reptiles indicates the need for further studies to establish its zoonotic potential. A most adequate management conditions for the snake species could have decreased the severity of the lesions. The occurrence of P. aeruginosa and E. aerogenes found in this work may alert professionals for future clinical suspicions and adequate therapeutic management

Caseous Stomatitis Caused by Pseudomonas aeruginosa in Boa constrictor amarali

Background: Pseudomonas aeruginosa is a bacterium that belongs to the microbiota of snakes, but it may also be an opportunistic pathogen and contaminate humans through fecal contact, bites, and injuries. In snakes, this microorganism may present high pathogenicity at certain conditions and have been associated with high morbidity and mortality. Reports of infection of Boa constrictor by this pathogen are rare. Thus, this study aimed to describe the P. aeruginosa oral infection in a snake specimen (Boa constrictor amarali), approaching the isolation and identification of the infectious agents involved, the antimicrobial sensitivity and resistance, and the therapeutic protocol adopted.Case: A free-living adult female specimen of Boa constrictor amarali (Amaral's boa), with no described previous history was rescued in an urban area by the Environmental Police. Clinical evaluations showed structures of caseous aspect in the oral cavity, with hyperemia spots in the mucosa. Samples of these lesions were sent for mycological examination, and fungal forms were not found. Samples were collected for isolation and culture. The antimicrobial susceptibility of the isolated microorganisms was determined by the modified Kirby-Bauer disk diffusion method. P. aeruginosa was isolated and showed susceptibility to amikacin, gentamicin, and polymyxin-B; intermediate susceptibility to azithromycin, and ciprofloxacin; and resistance to cephalexin, ceftiofur, chloramphenicol, and enrofloxacin. The treatment consisted of cleaning of the oral cavity, local infiltration of lidocaine for debridement of the caseous area that were later cauterized with iodine. Systemic antibiotic therapy was used, with intramuscular administration of amikacin (5 mg/kg) for the first dose and (2.5 mg/kg) for the other doses with intervals of 72 h, and oral administration of metronidazole (20 mg/kg) with intervals of 48 h, both during 21 days. Daily subcutaneous fluid therapy was performed as support treatment, using Lactated Ringer's solution (25 mg/kg) and Vitamin C (10 mg/kg) with intervals of 24 h, being the cure observed at the end of treatment.Discussion: This paper presents the pathological findings of the Pseudomonas aeruginosa oral infection in a B. constrictor amarali. This bacterium is an opportunistic pathogen that is commonly found  in snakes, thus, humans in contact with these animals may be contaminated with this pathogen. However, oral cavity lesions associated with P. aeruginosa had not yet been related to Boa constrictor amarali, which is a non-venomous species. Few bacteria associated with reptile diseases are primary causative agents. Clinical bacterial infections generally tend to be secondary to viral infections. Predisposing factors for the development of bacterial diseases in these reptiles include immunodepression, malnutrition, poor adaptation to captivity, and the maintenance of these animals at temperatures and humidities outside their thermal comfort range. In the present study, the P. aeruginosa behaved as an opportunistic pathogen, resulting in clinical manifestations with caseous lesions in the oral cavity, probably due to an imbalance of the microbiota caused by stress or immunodepression. The antibiogram allowed the adoption of a correct therapeutic protocol based on the susceptibility of the pathogen, resulting in remission of lesions and clinical signs after 21 days of treatment

Violência sexual feminina: um crime intradomiciliar recorrente / Sexual violence against women: a recurrent domestic crime

Introdução: A violência sexual é um problema de saúde e segunça pública, de notificação compulsória, com pena prevista em lei e graves repercussões psicossociais. Apesar disso o acolhimento à vítima e o ídice de denúcia são, ainda, insuficientes. Objetivo: Avaliar o perfil sociodemográfico, as características da violência sexual e o caráter de atendimento de emergência das vítimas de violencia sexual atendidas em dois centros de referência do estado de Sergipe, Brasil. Metodologia: Trata-se de um estudo documental que avaliou todas as mulheres vítimas de violência sexual do estado de Sergipe atendidas de julho a dezembro de 2018 nos centros e referência avaliados. O questionário de coleta incluiu aspectos sociodemográficos, dados da violência sofrida, informações sobre atendimento de emergência e o desfecho. A amostra mínima de 222 participantes foi calculada pela fórmula de Pocock. A associação entre as variáveis categóricas foi realizada pelo teste qui-quadrado. Adotou-se intervalo de confiança de 95% e significância quando p < 0,05. Resultados: As vítimas eram em sua maioria menores de 14 anos, pardas, solteiras, estudantes, com ensino fundamental incompleto, sem prole constituída e sem relação sexual anterior ao evento. A violência mais cometida foi o estupro e a maior parte dos delitos foram intradociliares e por único agressor. A procura por atendimento ocorreu após 72 horas na maioria dos casos. Os exames mais realizados foram sorológicos, BHCG e citologia. Os abortamentos foram executados majoritariamente após a 12° semana de gestação. A maioria das vítimas evadiram. Conclusão: A maioria das vítimas é jovem. Os crimes são reincidentes e intradomiciliares. A complexidade biopsicossocial da violência sexual torna imprescindível a capacitação dos profissionais e o acolhimento do primeiro atendimento à vítima