Cistadenocarcinoma papilar mucinoso: tumor maligno raro em glândula salivar menor

Clinical case description of a papillary mucinous cystadenocarcinoma, extremely rare malignant tumor in the salivary gland and difficult to diagnose, in geriatric patient. Patient with 86 years old was referred for treatment with nodular lesion on the inner side of left lower lip extending to the bucal mucosa, without any clinical appearances of malignancy. The lesion was asymptomatic, had flabby consistency and slow growth. Despite the favorable clinical features, after surgical removal, was diagnosed as papillary mucinous papillary mucinous cystadenocarcinoma. Nonetheless, the cellular atypia found was considered to be mild and immunohistochemical evaluation the reaction to Ki-67 was low, indicating a low rate of proliferation of the tumor. Medical evaluation confirmed the absence of systemic disorders or distant metastases. Although it is a malignant lesion, due to low degree of proliferation of lesion and the careful follow-up carried out, there was a favorable evolution after conservative treatment in a follow-up period of 11 years and six months.Descrição do caso clínico de um cistadenocarcinoma papilar mucinoso, tumor maligno extremamente raro em glândula salivar e de difícil diagnóstico, em um paciente geriátrico. Paciente com 86 anos foi encaminhado para tratamento com lesão nodular na parte interna do lábio inferior do lado esquerdo estendendo-se para a mucosa jugal sem qualquer aspecto clínico de malignidade. A lesão era assintomática, apresentava consistência flácida e crescimento lento. Apesar das características clínicas favoráveis, após a remoção cirúrgica, o diagnóstico foi de cistadenocarcinoma papilar mucinoso. Entretanto, a atipia celular encontrada foi considerada leve e a reação imunohistoquímica para o Ki67 baixa, indicando uma baixa taxa de proliferação do tumor. A avaliação médica confirmou a ausência de transtornos sistêmicos e de metástases a distância. Apesar de se tratar de uma lesão maligna, devido ao baixo grau de proliferação do tumor e o acompanhamento cuidadosos realizado houve uma evolução favorável após o tratamento conservador após um período de acompanhamento de 11 anos e 6 meses.64220721

Cistadenocarcinoma Papilar Mucinoso: Tumor Maligno Raro Em Glândula Salivar Menor

Clinical case description of a papillary mucinous cystadenocarcinoma, extremely rare malignant tumor in the salivary gland and difficult to diagnose, in geriatric patient. Patient with 86 years old was referred for treatment with nodular lesion on the inner side of left lower lip extending to the bucal mucosa, without any clinical appearances of malignancy. The lesion was asymptomatic, had flabby consistency and slow growth. Despite the favorable clinical features, after surgical removal, was diagnosed as papillary mucinous papillary mucinous cystadenocarcinoma. Nonetheless, the cellular atypia found was considered to be mild and immunohistochemical evaluation the reaction to Ki-67 was low, indicating a low rate of proliferation of the tumor. Medical evaluation confirmed the absence of systemic disorders or distant metastases. Although it is a malignant lesion, due to low degree of proliferation of lesion and the careful follow-up carried out, there was a favorable evolution after conservative treatment in a follow-up period of 11 years and six months.64220721

Validação da Versão Portuguesa da Center for Epidemiologic Studies Depression Scale for Children (CES-DC)

A Depressão na infância e adolescência, tal como na população adulta, é uma das perturbações mentais mais comuns. Uma vez que o seu aparecimento nestas faixas etárias conduz a graves consequências na idade adulta, é fundamental identificar os sintomas depressivos precocemente. Desta forma, os instrumentos de autorrelato têm um papel fundamental, uma vez que permitem com facilidade, de forma fidedigna e válida, ter acesso a formas de pensar, sentir e agir dos sujeitos. O objetivo do presente trabalho consistiu na tradução, adaptação e estudo da Center for Epidemiological Studies Depression Scale for Children (CES-DC) (Weissman, Orvash & Padian, 1980) para os adolescentes portugueses. A amostra é constituída por 417 adolescentes, com idades compreendidas entre os 12 e os 18 anos a frequentar o 3º ciclo do ensino básio e ensino secundário. Para o estudo da validade convergente e divergente da CES-DC, foram utilizados a Depression Anxiety Stress Scales (DASS 21) (Lovibond & Lovibond, 1995), o Children's Depresssion Inventory (CID) (Marujo, 1994) e a Students' Life Satisfaction Scale (SLSS) (Marques, Pais-Ribeiro & Lopez, 2007) que avaliam, respetivamente, os estados emocionais negativos (depressão, ansiedade e stress), a sintomatologia depressiva e a satisfação global com a vida. Os resultados obtidos mostram que a escala possui uma boa consistência interna, uma estabilidade temporal adequada, assim como uma boa validade. Sugerem, ainda, tratar-se de uma escala tridimensional: fator humor, fator interpessoal e fator felicidade. Estes dados permitem o avanço da Psicologia, no que diz respeito à avaliação e prática clínica com adolescentes. A utilidade do questionário deve ser verificada noutras faixas etárias, principalmente, nas de menos de 12 anos de idade, e também numa amostra clínica. Não obstante as limitações apontadas, os resultados sugerem que a CES-DC é um questionário útil na avaliação de sintomas depressivos nos adolescentes. / Depression in children and adolescents, as well as in adults, is one of the most common mental disorders. Since its appearance in these age groups leads to serious consequences in adulthood, it is critical to identify depressive symptoms in early stages. Therefore, self-report instruments play a key role in this contexto since they allow to easily, reliably and validly have access to ways the subject thinks, feels and acts. The aim of this study was to translate, adapt and study the Center for Epidemiological Studies Depression Scale for Children (CES-DC) (Weissman, Orvash & Padian, 1980) for portuguese adolescents. The sample consists of 417 adolescents, aged between 12 and 18 years old, attending the 3rd cycle of basic education and secondary education schools. To study the convergent and divergent validity of the CES-DC, the Depression Anxiety Stress Scales (DASS 21) (Lovibond & Lovibond, 1995) was used, along with the Children's depression Inventory (CDI) (Sailor, 1994) and the Students' Life Satisfaction Scale (SLSS) (Marques, Pais-Ribeiro & Lopez, 2007) that evaluate, respectively, the negative emotional states (depression, anxiety and stress), depressive symptoms and overall satisfaction with life. The results show that the evaluated scale presents a good internal consistency, an adequate temporal stability as well as good validity. They also suggest that this is a three-dimensional scale: humor factor, interpersonal factor and happiness factor. These data allow for the progress of psychology, regarding the assessment and clinical practice among adolescents. The usefulness of the questionnaire should be verified in other age groups, especially in children with less than 12 years old and in a clinical sample. Despite these limitations, the results suggest that CES-DC is useful in the assessment questionnaire of depressive symptoms in adolescents

Extraoral surgical access for removal of intraparotid giant sialolith in young patient. A case report

AbstractSialolithiasis is one of the most common diseases of salivary glands. Sialoliths mainly develop in the submandibular gland with few cases described in the parotid and sublingual glands. They are more common in adults between the third and fourth decades of life, and can affect the elderly and rarely children and adolescents. In most cases, they are located in the ducts, but parenchymal location is unusual. Clinical signs of sialolithiasis are well known; however, they may appear in atypical sites, making it difficult to locate and diagnose them precisely. In these cases, the use of complementary imaging examinations, such as computerized tomography, is critical to delimit the lesion and determine the treatment plan. Therefore, the description of this clinical case of a parotid sialolith, with atypical location, in a 17-year-old patient, that was surgically removed by extraoral access after determining its correct location by using computerized tomography imaging is relevant and important

Representations of tattoo and piercing use

El presente estudio investigó diversas representaciones de identidad a través del tatuaje y del piercing para sus usuarios, así como los preconceptos relacionados a éstos. Para eso, fueron entrevistados 10 sujetos portadores de tales adornos. Los resultados apuntaron tres diferentes categorías de representaciones para los portadores de adornos: complemento estético, significación pre-establecida del dibujo y marca permanente de un momento significativo en la vida. Divergencias en las representaciones de estos tipos de adereces son responsables de generar actitudes prejuiciosas para con aquéllos que les poseen. Mismo frente a la discriminación y al carácter estigmatizado traído por los adornos, los entrevistados relataron no haber arrepentimiento por optaren por su uso, lo que puede ser considerado un factor constituyente de la identidad, sea esta personal o grupal.The present study has investigated several tattoo and piercing identity representations for their users, as well as prejudices related to them. We have interviewed 10 individuals with such ornaments. The results showed three different categories of representations for people with ornaments: aesthetic, predetermined design significance and permanent mark of a significant moment in life. Divergences in representations of these types of ornaments are responsible for generating prejudiced attitudes towards those who have them. Even facing discrimination and stigmatized character brought by ornaments, the interviewers reported they had not regret by opting for their use, which can be considered an identity factor, either personal or group.O presente estudo investigou diversas representações identitárias da tatuagem e do piercing para seus usuários, bem como os preconceitos relacionados a esses. Para isso, foram entrevistados 10 sujeitos portadores de tais adornos. Os resultados apontaram três diferentes categorias de representações para os portadores de adornos: complemento estético, significação pré-estabelecida do desenho e marca permanente de um momento significativo na vida. Divergências nas representações desses tipos de enfeites são responsáveis por gerar atitudes preconceituosas para com aqueles que os possuem. Mesmo frente à discriminação e ao caráter estigmatizado trazido pelos adornos, os entrevistados relataram não terem se arrependido por optar pelo seu uso, o que pode ser considerado um fator constituinte da identidade, seja essa pessoal ou grupal

Hantavirus pulmonary syndrome in children: case report and case series from an endemic area of Brazil

Hantavirus Cardiopulmonary Syndrome (HCPS) is an important emergent zoonosis associated with wild rodents in Brazil, where this viral infection in children is generally rare. We present HCPS in a child from the Pantanal Biome and a review of all reported pediatric cases in Mato Grosso State, an endemic area for HCPS in Brazil. The investigation used the Information System for Notifiable Diseases database (SINAN). A 12-year-old boy was hospitalized with fever and respiratory failure and hantavirus IgM and IgG antibodies were detected by ELISA in serum samples. During the period of 1999 to 2016, 32 HCPS pediatric cases confirmed by serology were reported to SINAN with a mortality rate of 34.4%. The possibility of hantavirus infection in children with acute febrile illness associated with respiratory failure should be considered mainly in recognized endemic areas as Mato Grosso State, contradicting a hypothesis that children are more protected from lung involvement

Displasia do desenvolvimento do quadril, relação entre via de parto e impacto no tempo de tratamento: dysplasia of hip development, relationship between way of living and impact on time of treatment

Como uma das anomalias esqueléticas mais frequentes, a displasia do desenvolvimento do quadril (DDQ) é caracterizada por uma gama considerável de patologia, desde a frouxidão menor dos ligamentos na articulação do quadril até a luxação completa. Acredita-se que a detecção precoce e o tratamento subsequente da displasia do desenvolvimento do quadril (DDQ) melhorem seu prognóstico. Os fatores de risco frequentemente relatados para DDQ são história familiar positiva de DDQ, sexo feminino e apresentação pélvica, mas não há muito conhecimento sistemático sobre os fatores de risco, tempo de tratamento para DDQ com relação a via de parto. O objetivo deste estudo é verificar na literatura as possíveis relações entre DDQ e as via de parto, bem como sua influência no tempo de tratamento desses pacientes. Trata-se de uma revisão como bases publicações, dos último cinco anos, que abordem a relação entre via de parto e o tempo de tratamento da DDQ, extraídas de bases de dados eletrônicas como Scielo, PubMed, Lilacs, BVS, Embase e Medline, em língua inglesa e portuguesa. Dos estudo que se aproximaram do objetivo da pesquisa, muitos não relataram a estreita relação entre via de parto e tratamento da DDQ e aqueles que de alguma forma relataram, alegaram não haver uma relação direta entre as variáveis, pois a DDQ é multifatorial. Assim, espera-se que este estudo sirva de incentivo para que mais estudos sejam realizados sobre essa temática afim de estabelecer e conhecer se há alguma relação entre via de parto e tempo de tratamento de pacientes com DDQ

Measurement of the cosmic ray spectrum above 4×10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

A measurement of the cosmic-ray spectrum for energies exceeding $4{\times}10^{18}$ eV is presented, which is based on the analysis of showers with zenith angles greater than $60^{\circ}$ detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above $5.3{\times}10^{18}$ eV, the "ankle", the flux can be described by a power law $E^{-\gamma}$ with index $\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)}$ followed by a smooth suppression region. For the energy ($E_\text{s}$) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find $E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19}$ eV.Comment: Replaced with published version. Added journal reference and DO

Energy Estimation of Cosmic Rays with the Engineering Radio Array of the Pierre Auger Observatory

The Auger Engineering Radio Array (AERA) is part of the Pierre Auger Observatory and is used to detect the radio emission of cosmic-ray air showers. These observations are compared to the data of the surface detector stations of the Observatory, which provide well-calibrated information on the cosmic-ray energies and arrival directions. The response of the radio stations in the 30 to 80 MHz regime has been thoroughly calibrated to enable the reconstruction of the incoming electric field. For the latter, the energy deposit per area is determined from the radio pulses at each observer position and is interpolated using a two-dimensional function that takes into account signal asymmetries due to interference between the geomagnetic and charge-excess emission components. The spatial integral over the signal distribution gives a direct measurement of the energy transferred from the primary cosmic ray into radio emission in the AERA frequency range. We measure 15.8 MeV of radiation energy for a 1 EeV air shower arriving perpendicularly to the geomagnetic field. This radiation energy -- corrected for geometrical effects -- is used as a cosmic-ray energy estimator. Performing an absolute energy calibration against the surface-detector information, we observe that this radio-energy estimator scales quadratically with the cosmic-ray energy as expected for coherent emission. We find an energy resolution of the radio reconstruction of 22% for the data set and 17% for a high-quality subset containing only events with at least five radio stations with signal.Comment: Replaced with published version. Added journal reference and DO