Late recurrence of Burkitt’s lymphoma in the jaw: numb chin syndrome as the only symptom

The Numb Chin Syndrome (NCS) is defined as facial and oral numbness restricted to the mental nerve’s distribution involving the lower lip, skin of the chin, or gingiva of the lower anterior teeth. Hypoesthesia can occur unilaterally or bilaterally. Although this syndrome is rare, its importance is related to the fact that it represents the clinical manifestations of malignant diseases. Breast cancer and non-Hodgkin lymphoma are the most common cause of NCS. The patient, a 58-year-old woman, treated for a Burkitt Lymphoma (BL) nine years ago, described a two-week history of change in sensitivity and pain in the chin region, without relief with the use of analgesics. She had no headache, speech disturbance, dysphagia, visual disturbance, or other neurological symptoms. No surgical intervention has been performed recently. The intraoral examination revealed a healthy oral mucosa and a small area adjacent to the right mental nerve region that was uncomfortable to palpation. No changes were found in the bone trabeculae at cone-beam computed tomography. The contrasted magnetic resonance features made it possible to identify a change in the mandibular body extending to the entire right side, coinciding with the patient’s complaint, indicating a probable mandibular medullary invasion. The patient was submitted to a biopsy to rule out a possible recurrence of BL. The microscopic findings were consistent with the diagnosis of BL. The present report described a very unusual presentation of late recurrent BL nine years after the first treatment, which manifested as an NCS

PREVENÇÃO DE CÂNCER DE COLO UTERINO:: UMA EXPERIÊNCIA NA UNIDADE BÁSICA DE SAÚDE

OBJETIVO: Informar a experiência das acadêmicas na aplicação do processo de enfermagem durante a consulta à mulher que realiza citologia oncótica. METODOLOGIA: Trata-se de um relato de experiência ocorrido entre os meses de fevereiro a abril de 2014 em uma Unidade Básica de Saúde da Família localizada na Zona Leste de Teresina. As atividades foram executadas através da aplicação do processo de enfermagem. RESULTADO: A aplicabilidade da Sistematização da Assistência de Enfermagem ocorreu durante o Controle do Câncer do Colo do Útero na Estratégia Saúde da Família e procedeu-se por meio das cinco etapas do processo de enfermagem: coletas de dados, diagnóstico, planejamento, implementação e avaliação de enfermagem. Realizou-se uma busca ativa das mulheres para realização da citologia oncótica, pois anteriormente realizava-se de sete a dez citologias por mês, logo após implementação da atividade foram registrados entre doze e quatorze semanalmente. CONCLUSÃO: A aplicação do processo de enfermagem no momento da realização do exame papanicolau, foi de suma importância para as acadêmicas adquirirem e transmitirem maior conhecimento do câncer de colo uterino, bem como domínio da realização da coleta do material do colo uterino, avaliação cefalocaudal de cada paciente, em especial do aparelho genital. DESCRITORES: Enfermagem; Esfregaço Vaginal; Saúde da Mulher

A Rapid and Sensitive Single Residual Method for Determination of Ethephon in Grape by high performance liquid chromatography-tandem mass spectrometry/ Um método residual rápido e sensível para a determinação de Ethephon em uvas por cromatografia líquida de alta eficiência e espectrometria de massa em tandem

This paper describes a rapid (7.0 min) and sensitive (LLOQ 0.1 ng/mL) analytical method for the quantitation of Ethephon  in grape.  A new method for the detection and quantification of ETP residues in fruit and vegetables was developed. The present study indicates that fruit and vegetables require a rapid and simple cleanup step before using gas chromatograph/mass spectrometry. The recovery and precision of the new method were evaluated by spiking the fruit and vegetable samples with 0.01-0.1 μg/g of ETP. The method is based on High-performance Liquid chromatography-tandem mass spectrometry (LC-MS/MS).The chromatographic separation was achieved on a Hypercarb 2.1x 100 mm 5µm reversed-phase column and a mobile phase containing water/mathanol (97:3 v/v, add 1% acetic acid), in isocratic conditions. The target analytes were transferred into a triple quadrupole mass spectrometer equipped with an electrospray ionization source for mass detection. The ion transitions selected for MRM detection were:  m/z 142.8 106.8, m/z 144.8 106.8 and 106.878.8 for ETP. The linearity of the detector response was demonstrated in the range from 0.01 to 1 µg/g for each analyte with a coefficient of determination (R2) of ≥0.999. The method was successfully applied to determination of ethephon in bunch grapes from five free trade fairs in the city of Caruaru, Pernambuco, Brazil

Clinicopathological analysis of head and neck rhabdomyosarcoma : a series of 10 cases and literature review

To describe the clinicopathological characteristics of a series of head and neck rhabdomyosarcoma (RMS) and to review the literature. Cases diagnosed as RMS affecting the head and neck region were retrospectively retrieved from the files of two Brazilian institutions from January 2006 to January 2017. Data on clinical features (sex, age and affected site), microscopic subtype, immunohistochemical results, treatment employed and follow-up status were obtained from the patient?s medical charts. During the period considered, 10 cases of RMS were identified. Females predominated (4M:6F), the mean age at diagnosis was 16.5 years-old and the orbit was the most affected site (4 cases). Microscopically, most cases were classified as embryonal RMS (6 cases) and the Desmin/Myogenin/Myo-D1 immunohistochemical positivity was useful to confirm the diagnosis. Chemotherapy and radiotherapy were applied to 9 and 8 patients respectively, whereas 2 patients were treated by surgery. Recurrences occurred in 3 patients and distant metastasis in 2 cases. Nine patients were alive in their last follow-up, 3 of them with disease, whereas 1 patient died due to the disease. Head and neck RMS is an aggressive malignant neoplasm which demands especial concern to achieve early diagnosis and successful treatment

Influência da desigualdade socioeconômica na distribuição das internações e dos óbitos por covid-19 em municípios brasileiros, 2020: um estudo ecológico

Objective: to analyze the influence of socioeconomic inequality on COVID-19 distribution in Brazilian municipalities, controlling for effect of hospital infrastructure, comorbidities, and other variables. Methods: ecological study on hospitalizations and deaths from Covid-19 in 2020; outcome data obtained from Ministry of Health. Incidence ratio estimated via a generalized linear model with negative binomial distribution. Results: 291,073 hospitalizations and 139,953 deaths were identified; higher mortality rate in municipalities with highest proportion of non-white population (95%CI 1.01;1.16) and with more households with more than two people per room (95%CI 1.01;1.13); presence of sanitary sewage was protective (hospitalizations: 95%CI 0.87;0.99 – deaths: 95%CI 0.90;0.99) and higher proportion of population in subnormal agglomerations was a risk factor (hospitalizations: 95%CI 1.01;1.16 – deaths: 95%CI 1.09;1.21), with this variable interacting with the proportion of people with emergency assistance (hospitalizations: 95%CI 0.88;1.00 – deaths: 95%CI 0.89;0.98). Conclusion: Socioeconomic conditions affected illness and death from COVID-19 in BrazilObjetivo: analizar influencia de desigualdad socioeconómica en distribución de COVID-19 en municipios brasileños, controlando por infraestructura hospitalaria, comorbilidades y otras variables. Métodos: estudio ecológico sobre hospitalizaciones y muertes por COVID-19 en 2020; datos de resultado del Ministerio de Salud; razón de incidencia estimada a través de modelo lineal generalizado con distribución binomial negativa. Resultados: 291.073 hospitalizaciones y 139.953 defunciones; mayor tasa de mortalidad en municipios con mayor proporción de población no blanca (IC95% 1,01;1,16) y con más hogares con más de dos personas por habitación (IC95% 1,01;1,13); alcantarillado sanitario resultó protector (hospitalizaciones: IC95% 0,87;0,99 – muertes: IC95% 0,90;0,99) y mayor proporción de población en aglomeraciones subnormales fue factor de riesgo (hospitalizaciones: IC95% 1,01;1,16 – muertes: IC95% 1,09;1,21), interactuando con proporción de personas con asistencia de emergencia (hospitalizaciones IC95% 0,88;1,00, defunciones IC95% 0,89;0,98). Conclusión: Condiciones socioeconómicas afectaron enfermedad y muerte por COVID-19.Objetivo: analisar a influência da desigualdade socioeconômica na distribuição da covid-19 nos maiores municípios brasileiros (> 100 mil habitantes), controlando, pelo efeito da infraestrutura hospitalar, comorbidades e outras variáveis. Métodos: estudo ecológico sobre internações e óbitos por covid-19 em 2020; dados de desfecho obtidos do Ministério da Saúde; a razão de incidência foi estimada via modelo linear generalizado. Resultados: identificados 291.073 internações e 139.953 óbitos; encontrou-se maior taxa de mortalidade nos municípios com maior população não branca (IC95% 1,01;1,16) e nos domicílios com mais de duas pessoas por cômodo (IC95% 1,01;1,13); para ambos desfechos, esgotamento sanitário foi protetivo(internações: IC95% 0,87;0,99 – óbitos: IC95% 0,90;0,99), e população em aglomerados subnormais revelou-se fator de risco (internações: IC95% 1,01;1,16 – óbitos: IC95% 1,09;1,21) com interação, com a proporção de pessoas a receber auxílio emergencial (internações: IC95%0,88;1,00 – óbitos: IC95% 0,89;0,98). Conclusão: condições socioeconômicas afetaram o adoecimento e morte por covid-19 no Brasil

Epidemiological profile of 175 patients with Crohn's disease submitted to biological therapy

INTRODUCTION: There is currently an increasing use of biological agents in the management of Crohn's disease (CD). There is lack of data regarding the epidemiological profile of patients on infliximab (IFX) and adalimumab (ADA) for CD in Brazil. OBJECTIVE: To identify the epidemiological characteristics of patients with CD who underwent biological therapy. METHOD: Retrospective multicenter study, with CD patients on biological therapy. Analyzed variables: gender, age at treatment initiation, Montreal classification, concomitant perianal disease and smoking status. RESULTS: 175 patients without previous exposure to biological agents were included, 93 (53%) were male. The mean age at treatment initiation was 35.5 (2-79) years old an the mean disease duration was 46.9 (0-480) months. Overall, 117 (66.9%) patients used IFX and 58 (33.1%), ADA. Montreal classification: age at diagnosis ― A1 (n=21; 12%), A2 (n=102; 58.3%), and A3 (n=52; 29.7%). CD location ― L1 (n=42; 24%), L2 (n=51; 29.1%), L3 (n=81; 46.3%), and L4 (n=1, 0.6%). Phenotype ―B1 (n=59; 33.7%), B2 (n=46; 26.3%), and B3 (n=70; 40%). Perianal disease was found in 89 (50.9%) patients. CONCLUSIONS: The epidemiological profile of patients was similar to the literature. There was a high prevalence of patients with fistulizing CD.INTRODUÇÃO: Atualmente há uso crescente dos agentes biológicos no manejo da doença de Crohn (DC). Há escassez de dados referentes ao perfil epidemiológico dos usuários de infliximabe (IFX) e adalimumabe (ADA) para DC no Brasil. OBJETIVO: Identificar as características epidemiológicas dos pacientes com DC submetidos à terapia biológica. MÉTODO: Estudo retrospectivo, multicêntrico, com portadores de DC que utilizaram terapia biológica. Variáveis analisadas: gênero, idade ao início do tratamento, classificação de Montreal, doença perianal concomitante e tabagismo. RESULTADOS: Foram incluídos 175 pacientes, sem exposição prévia a biológicos, sendo 93 (53%) homens. A média de idade no início do tratamento biológico foi de 35,5 (2-79) anos. O tempo médio de doença ao início do tratamento foi de 46,9 (0-480) meses. Do total da amostra, 117 (66,9%) utilizaram IFX e 58 (33,1%) ADA. Classificação de Montreal: idade ao diagnóstico ― A1 (n=21; 12%), A2 (n=102; 58,3%) e A3 (n=52; 29,7%). Localização da DC ― L1 (n=42; 24%), L2 (n=51; 29,1%), L3 (n=81; 46,3%) e L4 (n=1; 0,6%). Forma de apresentação ― B1 (n=59; 33,7%), B2 (n=46; 26,3%) e B3 (n=70; 40%). Doença perianal foi encontrada em 89 (50,9%) dos pacientes. CONCLUSÕES: Os dados epidemiológicos dos pacientes foram compatíveis com os da literatura internacional. Houve uma alta prevalência de pacientes com a forma fistulizante da DC.39540

Conhecimento e uso dos contraceptivos de emergência por mulheres na ESF: Knowledge and use of two emergency contraceptives by women in the FHS

Esta pesquisa intitulada “Conhecimento e uso dos contraceptivos de emergência por mulheres na ESF” teve como objetivo geral: verificar o conhecimento e uso dos contraceptivos de emergência em mulheres atendidas na unidade de saúde, e como objetivos específicos: traçar o perfil social das entrevistadas; identificar o conhecimento das entrevistadas sobre o contraceptivo de emergência; averiguar o conhecimento das entrevistadas sobre os métodos anticoncepcionais; averiguar o uso do contraceptivo de emergência pelas as entrevistadas. A pesquisa foi do tipo descritiva que teve abordagem quantitativa, foi realizada na Unidade de Saúde da Família Ipiranga Integrada, localizados no município de João Pessoa – PB. A amostra foi constituída por 96 participantes que aceitaram participar do estudo. Foi possível identificar nesse estudo que muitas das mulheres entrevistadas tinham o conhecimento sobre o que era o contraceptivo de emergência, porém uma boa parte delas não sabia como se usava

Dental Biofilm Microbiota Dysbiosis Is Associated With the Risk of Acute Graft-Versus-Host Disease After Allogeneic Hematopoietic Stem Cell Transplantation

Acute graft-versus-host disease (aGVHD) is one of the major causes of death after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Recently, aGVHD onset was linked to intestinal microbiota (IM) dysbiosis. However, other bacterial-rich gastrointestinal sites, such as the mouth, which hosts several distinctive microbiotas, may also impact the risk of GVHD. The dental biofilm microbiota (DBM) is highly diverse and, like the IM, interacts with host cells and modulates immune homeostasis. We characterized changes in the DBM of patients during allo-HSCT and evaluated whether the DBM could be associated with the risk of aGVHD. DBM dysbiosis during allo-HSCT was marked by a gradual loss of bacterial diversity and changes in DBM genera composition, with commensal genera reductions and potentially pathogenic bacteria overgrowths. High Streptococcus and high Corynebacterium relative abundance at preconditioning were associated with a higher risk of aGVHD (67% vs. 33%; HR = 2.89, P = 0.04 and 73% vs. 37%; HR = 2.74, P = 0.04, respectively), while high Veillonella relative abundance was associated with a lower risk of aGVHD (27% vs. 73%; HR = 0.24, P < 0.01). Enterococcus faecalis bloom during allo-HSCT was observed in 17% of allo-HSCT recipients and was associated with a higher risk of aGVHD (100% vs. 40%; HR = 4.07, P < 0.001) and severe aGVHD (60% vs. 12%; HR = 6.82, P = 0.01). To the best of our knowledge, this is the first study demonstrating that DBM dysbiosis is associated with the aGVHD risk after allo-HSCT

Haplotypes of the bovine IgG2 heavy gamma chain in tick-resistant and tick-susceptible breeds of cattle

Bovines present contrasting, heritable phenotypes of infestations with the cattle tick, Rhipicephalus (Boophilus) microplus. Tick salivary glands produce IgG-binding proteins (IGBPs) as a mechanism for escaping from host antibodies that these ectoparasites ingest during blood meals. Allotypes that occur in the constant region of IgG may differ in their capacity to bind with tick IGBPs; this may be reflected by the distribution of distinct allotypes according to phenotypes of tick infestations. In order to test this hypothesis, we investigated the frequency of haplotypes of bovine IgG2 among tick-resistant and tick-susceptible breeds of bovines. Sequencing of the gene coding for the heavy chain of IgG2 from 114 tick-resistant (Bos taurus indicus, Nelore breed) and tick-susceptible (B. t. taurus, Holstein breed) bovines revealed SNPs that generated 13 different haplotypes, of which 11 were novel and 5 were exclusive of Holstein and 3 of Nelore breeds. Alignment and modeling of coded haplotypes for hinge regions of the bovine IgG2 showed that they differ in the distribution of polar and hydrophobic amino acids and in shape according to the distribution of these amino acids. We also found that there was an association between genotypes of the constant region of the IgG2 heavy chain with phenotypes of tick infestations. These findings open the possibility of investigating if certain IgG allotypes hinder the function of tick IGBPs. If so, they may be markers for breeding for resistance against tick infestations

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio