Dor Pélvica e Dispareunia : relato de um caso de mesotelioma cístico benigno

Benign cystic mesothelioma is a rare tumor originated from mesenchymal cells of the abdominal and pelvic peritoneum. This rare tumor should be considered in the differential diagnosis of young women presenting with abdominal pain and a multicystic abdominal mass.O mesotelioma cístico benigno é um tumor raro originado de células mesenquimais do peritônio abdominal e pélvico. Este tumor raro deve ser considerado no diagnóstico diferencial de mulheres jovens apresentando dor abdominal e massa abdominal multicística

PELVIC PAIN AND DISPAREUNIA: A BENIGN CYSTIC MESOTHELIOMA CASE REPORT

Benign cystic mesothelioma is a rare tumor originated from mesenchymal cells of the abdominal and pelvic peritoneum. This rare tumor should be considered in the differential diagnosis of young women presenting with abdominal pain and a multicystic abdominal mass.Keywords: Benign cystic mesothelioma; pelvic pain; dispareuni

DIFFERENT FEATURES OF BUSCHKE-LÖWENSTEIN CARCINOMA

Buschke-Löwenstein carcinomas are rare manifestations of condyloma acuminatum.This study presents two different clinical manifestations of Buschke-Löwenstein arcinoma. Correct diagnosis is a challenge. Despite the absence of histological signs of malignancy, malignant transformation into invasive squamous cell carcinoma may occur. Early and radical excision remains as the treatment of choice.Key words: Buschke-Löwenstein carcinoma; verrucous carcinoma; human papillomavirus; gynecological oncolog

A Descriptive Analysis of 1251 Solid Organ Transplant Visits to the Emergency Department

Background: As solid organ transplants become more common, recipients present more frequently to the emergency department (ED) for care.Methods: We performed a retrospective medical record review of ED visits of all patients who received an organ transplant at our medical center from 2000-2004, and included all visits following the patients’ transplant surgery through December 2005 or until failed graft, lost to follow up, or death. Clinically relevant demographic variables, confounding and outcome variables were recorded. Kidney, liver and combined kidney with other organ transplant recipients were included.Results: Five hundred ninety-three patients received kidney (395), liver (161), or combined renal (37) organ transplants during the study period, resulting in 1,251 ED visits. This represents 3.15 ED visits/patient followed over a mean of 30.8 months. Abdominal pain/gastrointestinal (GI) symptoms (31.3%) and infectious complaints (16.7%) were the most common presentations. The most common ED discharge diagnoses were fever/infection (36%), GI/Genitourinary (GU) pathology (20.4%) and dehydration (15%). Renal transplant recipients were diagnosed with infectious processes most often, despite time elapsed from transplant. Liver transplant patients had diagnoses of fever/infection most often in their first 30 days post transplant. Thereafter they were more likely to develop GI/GU pathology. After the first year of transplantation, cardiopulmonary and musculoskeletal pathology become more common in all transplant organ groups. Of the 1,251 ED visits, 762 (60.9%) resulted in hospitalization. Chief complaints of abdominal pain/GI symptoms, infectious complaints, cardiovascular and neurologic symptoms, and abnormal laboratory studies were significantly likely to result in hospitalization.Conclusions: This study demonstrates a significant utilization of the ED by transplant recipients, presenting with a wide variety of symptoms and diagnoses, and with a high hospitalization rate. As the transplant-recipient population grows, these complex patients continue to present diagnostic and treatment challenges to primary care and emergency physicians.[WestJEM. 2009;10:48-54.

Desenvolvimento da liderança formal: o modelo de gestão da Siemens

Neste trabalho apresentamos um estudo de caso, realizado na Siemens do Brasil, que abrange as fases iniciais de um projeto de desenvolvimento da ação da liderança formal com o intuito de melhorar os resultados corporativos e, ao mesmo tempo, consolidar a qualidade dos relacionamentos interpessoais, grupais e intergrupais. A liderança tem sido discutida ao longo dos anos abordando-se as características dos líderes, as relações de poder e autoridade, as contingências que afetam o seu exercício e a necessidade de que os objetivos organizacionais sejam alcançados. O projeto em implantação na Siemens do Brasil busca incorporar aspectos dessas várias abordagens e operacionalizá-las em um modelo de gestão. Esse modelo contempla a utilização de um conjunto de competências, formatado conforme seu contexto empresarial, que permita à sua liderança formal criar e desenvolver visões inspiradoras e planos compartilhados, bem como liderar a ação, alcançando resultados controlados com o uso do Balanced Scorecard

Vírus da cinomose canina: detecção do RNA viral pelo Nested RT-PCR em cães com diagnóstico clínico

Canine distemper virus (CDV) is a pathogen which affects dogs and causes severe disease leading to death. Dogs infected with CDV can be diagnosed by RNA detection by Nested PCR technique. The following study proposed to valuate CDV RNA in blood, urine and saliva samples. The Nested-PCR technique was able to detect CDV RNA in different types of biologic samples. The higher number of positive results was obtained in urine samples.O vírus da cinomose canina (CDV) é um patógeno que afeta cães, causando doença grave e que pode levar a morte. Os cães infectados pelo CDV podem ser diagnosticados pela detecção do RNA utilizando-se a técnica de Nested-PCR. O presente estudo teve como objetivo avaliar o RNA do CDV no sangue, urina e saliva em cães com diagnóstico clínico de cinomose. A técnica de Nested-PCR foi capaz de detectar o RNA em diferentes tipos de amostras biológicas. Obteve-se um maior número de resultados positivos em amostras de urina

Alterações nos vícios refracionais em crianças com exotropia intermitente submetidas ao tratamento por meio da hipercorreção com lentes negativas

PURPOSE: Intermittent exotropia may be decreased by stimulation of accommodative convergence. Once excessive accommodation has been related to myopia, our objective was to evaluate refractive errors changes in children under overcorrecting minus lens therapy. METHODS: A retrospective chart review of 21 children with intermittent exotropia was performed. All patients were treated with occlusion, and a 13-patient subset of them received overminus lens therapy (group A). Eight children received spectacles as necessary (group B). Initial age, age interval, initial spherical equivalent (SE), and magnitude of overcorrection were considered as co-variables of the mean variation in refractive error (SE of each eye) between groups, through a multivariate analysis. RESULTS: Overcorrection used in group A ranged from 0.5 D to 3.5 D (2.46 ± 0.87 D). Although initial SE of each eye was significant different between group A and B (OD - p=0.02; OS - p=0.01), initial age (p=0.69), age interval (p=0.90), and mean variation in refractive errors (p=0.36) did not differ between groups. Multivariate analysis with linear regression showed no significantly difference regarding all co-variables enrolled. CONCLUSIONS: Treatment of intermittent exotropia with overcorrecting minus lens did not induce refractive errors changes, even considering age, treatment period, initial spherical equivalent and overcorrection magnitude used.OBJETIVO: A exotropia intermitente pode ser diminuída pela estimulação da convergência acomodativa. Uma vez que uma acomodação excessiva tem sido relacionada à miopização, o objetivo deste trabalho foi o de avaliar alterações nos vícios de refração de crianças submetidas à hipercorreção com lentes negativas. MÉTODOS: Foi realizada revisão dos prontuários de 21 crianças com exotropia intermitente. Todos os pacientes foram tratados com oclusão, sendo que 13 deles foram submetidos à hipercorreção com lentes negativas (grupo A). As 8 crianças restantes receberam prescrições ópticas conforme necessário pelas suas ametropias (grupo B). A idade inicial, tempo de tratamento, equivalente esférico (EE) inicial e magnitude da hipercorreção foram considerados como covariáveis na análise das diferenças das médias de erro refrativo (EE de cada olho) entre os grupos, pela análise multivariada. RESULTADOS: A hipercorreção utilizada no grupo A variou entre 0,5 D e 3,5 D (2,46 ± 0,87 D). Embora o EE inicial de cada olho ter sido significativamente diferente entre os grupo A e B (olho direito - p=0,02; olho esquerdo - p=0,01), a idade inicial (p=0,69), o tempo de tratamento (p=0,90) e a variação média nos erros refrativos (p=0,36) não diferiram entre os grupos. A análise multivariada com regressão linear não mostrou diferença significativa, considerando as covariáveis em questão. CONCLUSÕES: O tratamento de crianças com exotropia intermitente por meio de hipercorreção óptica com lentes negativas não induziu alterações nos vícios de refração, mesmo considerando fatores como idade inicial, o tempo de tratamento, equivalente esférico inicial e a magnitude da hipercorreção utilizada

Fungicidas a base de azufre y bacillus sp. en manejo integrado de Sigatoka Negra

En Ecuador, en el cultivo de Banano (Musa spp.), la principal enfermedad es la Sigatoka negra, causada por el hongo Mycosphaerella fijiensis Morelet, se caracteriza por tener reproducción sexual y asexual (Paracercospora fijiensis), ocasionando una alta diseminación de esporas dentro de las plantaciones bananeras. La investigación tuvo como objetivo evaluar alternativas de fungicidas protectantes azufrados y microbiológicos, dentro de las combinaciones de fungicidas, como estrategias de control de la Sigatoka negra. Se utilizó un Diseño de bloques Completamente al Azar, conformado por 7 tratamientos y 10 repeticiones, el análisis estadístico se realizó mediante el análisis de varianza ANOVA y los promedios fueron comparados mediante la prueba de Tukey. Las variables evaluadas fueron porcentaje de área foliar afectada y el área bajo la curva del progreso de la enfermedad (ABCPE) durante toda la epidemia, evidenciándose el tratamiento T7 como la mejor estrategia de control frente a la enfermedad. Los resultados sugieren que el azufre elemental 800 gr/Kg a una dosis 3Kg/ha, puede integrarse en las combinaciones de fungicidas, como estrategia de control de la sigatoka negra, obteniendo buenos niveles de control

Interventions conducted with groups of caregivers of elderly with dementia: a systematic review

Introduction: Brazil presents a vertiginous population growth in relation to the group of people aged 60 years or older. In this scenario, a high prevalence of chronic degenerative diseases that require care, including dementia, is identified. Objective: Identify and analyze studies that present model, feature, and results of non‑pharmacological interventions in informal caregivers of elderly people with dementia syndrome. Method: Articles were selected according to the methodology proposed by the Cochrane Handbook for Systematic Reviews in a search at the PubMed, LILACS and SciELO databases using the following descriptors: caregivers, elderly, intervention, and dementia. Results: Of the 1069 studies found, 38 articles were selected after application of the inclusion and exclusion criteria, and only 12 of them were included in the final analysis. Randomized studies with control group accounted for 58% (n = 07) of the analyzed articles, whereas studies classified as quasi-experimental were 42% (n = 05). It was also identified that 41.6% (n = 05) of the interventions were classified as Psycho-educational, 33.4% (n = 04) as Behavioral Cognitive Therapy actions, 16.6% (n = 02) as Psychosocial, and 8.4% (n = 01) as Mindfulness therapy. Conclusion: After evaluation of the articles, it was possible to conclude that most of the studies obtained significant results and contributed to reduce some aspects such as depression, stress, and physical and emotional overload, in addition to acquiring skills and knowledge about dementia syndrome. Thus, this study evidences the importance of conducting new research in this scenario