HEMANGIOMA MAMÁRIO: UMA FORMA BENIGNA DE NEOPLASIA VASCULAR DA MAMA.

Vascular neoplasms of the breast are defined by vascular lesions that can be located in the extraparenchymal region (in the subcutaneous adipose tissue), usually benign or intraparenchymal (to the superficial fascia), most of which are malignant. 2 They are classified according to the histopathological examination that defines the malignant characteristic, such as: angiosarcomas, epithelioid hemangioendothelioma, or benign, such as: hemangiomas, lymphangioma, angiolipoma.5 The diagnosis is challenging because the pathology is extremely rare and the radiological findings are not very specific.2 A core needle biopsy can be used to confirm the diagnosis.5 However, excision should be considered to exclude possible angiosarcoma, which is a malignant tumor that originates from vascular lining endothelial cells.Hemangiomas are benign vascular tumors. They are common in early and middle childhood, but are extremely rare when they appear in the breast, representing approximately 0.4% of breast tumors.9,10 The aim of this case report is a retrospective, cross-sectional study, analyzing the medical records of a patient with a vascular neoplasm of the breast with atypia in the initial analysis, defined as a breast hemangioma without atypia after complete excision and immunohistochemical complementation. The data reported was obtained by accessing the patient's medical records. A bibliographic review was carried out on the PubMed, Scielo, Google Scholar, Sociedade Brasileira De Mastologia Regional São Paulo and FEBRASGO - Federação Brasileira das Associações de Ginecologia e Obstetrícia research platforms. The clinical case describes a vascular neoplasm in the left breast in a 49-year-old female patient who, after investigation, underwent complete excision of the lesion with a safety margin. This is a rare and unusual case with a final diagnosis of breast hemangioma. The patient's post-operative evolution was favorable and without any complications, and she was discharged from hospital and re-evaluated at the mastology outpatient clinic. Breast hemangioma is a rare, benign and uncommon vascular neoplasm of the breast that can mimic malignant tumors. It is extremely important to carry out a detailed investigation in the event of any alteration, both in the physical examination and in breast screening and diagnosis tests, always with the aim of excluding malignancy, since among vascular neoplasms of the breast we have, for example, angiosarcoma, which has a worse prognosis.As neoplasias vasculares da mama são definidas por lesões vasculares que podem ser localizadas na região extraparenquimatosa (no tecido adiposo subcutâneo), geralmente benignos, ou intraparenquimatoso (à fáscia superficial), o qual a maioria é de caráter maligno.2 São classificadas de acordo com o exame histopatológico que define a característica maligna, como exemplos: angiosarcomas, hemangioendotelioma epitelióide ou, benigna como: hemangiomas, linfangioma, angiolipoma.5 Possui diagnóstico desafiador tendo em vista a patologia ser extremamente rara e seus achados radiológicos serem poucos específicos.2 A biópsia por agulha grossa pode ser utilizada como exame para confirmação do diagnóstico.5 Contudo a excisão deve ser ponderada para exclusão de possível angiossarcoma, o qual, é um tumor maligno, que tem origem em células endoteliais de revestimento vascular. Os hemangiomas são tumorações vasculares benignas. Eles são comuns na primeira e segunda infância, todavia são extremamente raros quando aparecem na mama, representando aproximadamente 0,4% das tumorações mamárias.9,10 O relato de caso tem como objetivo um estudo retrospectivo e transversal, com análise do prontuário do paciente com neoplasia vascular da mama com atipia em análise inicial definida como hemangioma mamário sem atipias após exérese completa e complementação imuno-histoquímica. Os dados relatados foram obtidos por meio do acesso ao prontuário médico do paciente. Fora realizada revisão bibliográfica nas plataformas de pesquisa PubMed, Scielo, Google Acadêmico, Sociedade Brasileira De Mastologia Regional São Paulo, FEBRASGO – Federação Brasileira das Associações de Ginecologia e Obstetrícia. O caso clínico descreve neoplasia vascular na mama esquerda em paciente do sexo feminino de 49 anos, submetida após investigação, à exérese completa da lesão com margem de segurança. Ressalta-se um caso raro e incomum com diagnóstico final de hemangioma mamário. A evolução da paciente no pós-operatório foi favorável e sem qualquer intercorrência, com alta hospitalar e reavaliação médica no ambulatório de mastologia. O hemangioma mamário é uma neoplasia vascular da mama rara, benigna e incomum que pode simular tumores malignos. É de extrema importância a investigação detalhada diante de qualquer alteração tanto no exame físico quanto em exames de rastreio e diagnóstico mamário, sempre com o objetivo de excluir malignidade, uma vez que, dentre as neoplasias vasculares da mama temos por exemplo, o angiosarcoma que possui um pior prognóstico

POLITRAUMA PEDIÁTRICO: RELATO DE CASO

Polytrauma is characterized as multiple injuries to at least two organs or two distinct parts of the body caused by an external force of a physical or chemical nature.2 It is considered the leading cause of death in the first four decades of life.3 Thus, Pediatric Advanced Life Support (PALS) assists in care by standardizing initial care for pediatric polytrauma and defines priorities in the approach.1 The aim of this case report is a retrospective, cross-sectional study, with an analysis of the polytrauma patient's medical records, highlighting the importance of adequate initial care standardized by PALS and its prevention, contributing to a positive prognosis. The data reported was obtained by accessing the patient's medical records and interviewing the patient's mother. A bibliographic review was carried out on the Scielo, Google Scholar, Brazilian Society of Pediatrics periodicals and Pediatric advanced life support (PALS) research platforms. The clinical case describes a pediatric polytrauma victim of a pedestrian-car accident, with pulmonary contusion, right pneumothorax, right rib fracture and right clavicle fracture, in a male patient aged 4 years and 11 months. The initial care was based on the PALS, consisting of a systemic approach to the seriously ill child. Based on this approach, with laboratory tests and imaging exams, the treatment was conservative, with the use of a sling, asymptomatic and oxygen therapy. The outcome was favorable, and the patient was discharged after 5 days in the Intensive Care Unit, with a referral to the attending pediatrician.The case report evaluates pediatric polytrauma, demonstrating the need for a systemic approach, so that it is possible to quickly recognize signs of respiratory distress, respiratory failure and shock, and immediately carry out interventions. In addition, it is necessary to emphasize the need for preventive measures since the majority of pediatric traumas in Brazil are avoidable.O politraumatizado é caracterizado como múltiplas lesões, de ao menos dois órgãos ou duas partes distintas do corpo causadas por força externa de natureza física ou química.2 Sendo o mesmo considerado a principal causa de morte nas primeiras quatro décadas de vida.3 Assim, o Pediatric Advanced Life Support (PALS) auxilia na assistência através da padronização do atendimento inicial ao politraumatizado pediátrico e define prioridades na abordagem. 1O relato de caso tem como objetivo um estudo retrospectivo e transversal, com análise do prontuário do paciente de politrauma; evidenciando a importância do atendimento inicial adequado padronizado pelo PALS e sua prevenção, contribuindo com prognóstico positivo. Os dados relatados foram obtidos por meio do acesso ao prontuário médico do paciente e entrevista à progenitora do mesmo. Fora realizada revisão bibliográfica nas plataformas de pesquisa Scielo, Google Acadêmico, Revistas Periódicas da Sociedade Brasileira de Pediatria e Pediatric advanced life support (PALS). O caso clínico descreve o politraumatizado pediátrico, vítima de atropelamento de carro x pedestre, com presença de: contusão pulmonar; pneumotórax a direita; fratura de costelas a direita e fratura de clavícula a direita, em paciente do sexo masculino, com 4 anos e 11 meses. Ressaltando-se o atendimento inicial fundamentado no PALS, consistindo numa abordagem sistêmica da criança gravemente enferma. A partir desta abordagem, com a realização de exames laboratoriais e exames de imagem, o tratamento realizado foi conservador, instituindo-se uso de tipóia, assintomáticos e oxigenioterapia. A evolução foi favorável, com alta médica após 5 dias de hospitalização em Unidade de Terapia Intensiva, com encaminhamento ao pediatra assistente. Logo, o relato de caso avalia o politraumatizado pediátrico, demonstrando a necessidade de uma abordagem sistêmica, de forma que seja possível reconhecer rapidamente sinais de desconforto respiratório, insuficiência respiratória, choque e realizar, imediatamente, intervenções. Além disso, é necessário ressaltar a necessidade de medidas preventivas uma vez que a maioria dos traumas pediátricos no Brasil são evitáveis

Adjuvant Effect of Killed Propionibacterium acnes on Mouse Peritoneal B-1 Lymphocytes and Their Early Phagocyte Differentiation

B-1 lymphocytes are the predominant cells in mouse peritoneal cavity. They express macrophage and lymphocyte markers and are divided into B-1a, B-1b and B-1c subtypes. The role of B-1 cells is not completely clear, but they are responsible for natural IgM production and seem to play a regulatory role. An enriched B-1b cell population can be obtained from non-adherent peritoneal cell cultures, and we have previously demonstrated that these cells undergo differentiation to acquire a mononuclear phagocyte phenotype upon attachment to the substrate in vitro. Nevertheless, the B-1 cell response to antigens or adjuvants has been poorly investigated. Because killed Propionibacterium acnes exhibits immunomodulatory effects on both macrophages and B-2 lymphocytes, we analyzed whether a killed bacterial suspension or its soluble polysaccharide (PS) could modulate the absolute number of peritoneal B-1 cells in BALB/c mice, the activation status of these cells and their ability to differentiate into phagocytes in vitro. In vivo, P. acnes treatment elevated the absolute number of all B-1 subsets, whereas PS only increased B-1c. Moreover, the bacterium increased the number of B-1b cells that were positive for MHC II, TLR2, TLR4, TLR9, IL-4, IL-5 and IL-12, in addition to up-regulating TLR9, CD80 and CD86 expression. PS increased B-1b cell expression of TLR4, TLR9, CD40 and CD86, as well as IL-10 and IL-12 synthesis. Both of the treatments decreased the absolute number of B-1b cells in vitro, suggesting their early differentiation into B-1 cell-derived phagocytes (B-1CDP). We also observed a higher phagocytic activity from the phagocytes that were derived from B-1b cells after P. acnes and PS treatment. The adjuvant effect that P. acnes has on B-1 cells, mainly the B-1b subtype, reinforces the importance of B-1 cells in the innate and adaptive immune responses

Sepsis Impairs Thyroid Hormone Signaling and Mitochondrial Function in the Mouse Diaphragm

Background: Sepsis can cause the nonthyroidal illness syndrome (NTIS), resulting in perturbed thyroid hormone (TH) signaling and reduced thyroxine (T4) levels. TH is a major regulator of muscle function, via its influence on mitochondria. This study aimed at evaluating the relationship between TH signaling, mitochondrial function, and the antioxidant defense system in the diaphragms of septic mice. Methods: Male C57Bl/6 mice were divided into two groups: cecal ligation and puncture (CLP) and sham. Twenty-four hours after surgery, plasma, diaphragms, and livers were collected. TH metabolism and responses were analyzed by measuring messenger RNA (mRNA) expression of Dio1 in the liver, and Thra, Thrb, Dio2, Slc16a10, and Slc16a2 (encodes MCT 10 and 8), in the diaphragm. T4 plasma levels were measured by radioimmunoassay. Damage to diaphragm mitochondria was assessed by electron microscopy and real-time polymerase chain reaction (qPCR), and function with oxygraphy. The diaphragm antioxidative defense system was examined by qPCR, analyzing superoxide dismutase (SOD) 1 (Sod1), mitochondrial superoxide dismutase (SOD 2; Sod2), extracellular superoxide dismutase (SOD 3; Sod3), glutathione peroxidase 1 (Gpx1), and catalase (Cat) expression. The effect of TH replacement was tested by treating the mice with T4 and triiodothyronine (T3) (CLP+TH) after surgery. Results: CLP mice presented reduced total plasma T4 concentrations, downregulated Dio1, and upregulated Il1b mRNA expression in the liver. CLP mice also displayed downregulated Thra, Thrb, Slc16a10, and Slc16a2 expression in the diaphragm, suggesting that TH signaling was compromised. The expression of Ppargc1a (encoding PGC1a) was downregulated, which correlated with the decrease in the number of total mitochondria, increase in the percentage of injured mitochondria, downregulation of respiratory chain complex 2 and 3 mRNA expression, and reduced maximal respiration. In addition, septic animals presented a three-fold increase in Ucp3 and G6pdh expression; downregulated Sod3, Gpx1, and Cat expression; and upregulated Sod2 expression, potentially due to elevated reactive oxygen species levels. The mitochondrial number and the percentage of injured mitochondrial were similar between sham and CLP+TH mice. Conclusions: Sepsis induced responses consistent with NTIS, resulted in mitochondrial damage and functional impairment, and modulated the expression of key antioxidant enzymes in the diaphragm. Thus, impaired diaphragm function during sepsis seems to involve altered local TH signaling, mitochondrial dysfunction, and oxidative stress defense

Neotropical freshwater fisheries : A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data