O significado da vacina contra rubéola para as mulheres grávidas

Se trató de describir el significado de la vacuna contra la rubeola para las mujeres que se enteraron del embarazo después de recibir la vacuna dupla viral, debido a la campaña contra la rubeola-2001, en la DIR XX de São João da Boa Vista. Fue adoptada como referencia la Teoría de la Representaciones Sociales. La colección de datos fue realizada a través de la técnica de Discurso del Sujeto Colectivo con 18 gestantes y mujeres embarazadas hasta 30 días después de la aplicación de la vacuna, consideradas suceptibles a la rubeola, habitantes de 10 municipios de la región. Considerando los discursos de las mujeres, fue posible detectar los diferentes resultados de la vacuna contra la rubeola cuando es aplicada durante la gestación, representada como amenaza a su integridad, a la de su hijo y a su relación conyugal. Esos significados se constituyen en importante fuente de información que brinda a los profesionales de la salud y gestores una reflexión sobre desempeño de su papel como agentes promotores de la salud.Buscou-se descrever o significado da vacina contra rubéola para mulheres que se descobriram grávidas após receberem a vacina dupla viral, por ocasião da campanha contra rubéola-2001, na DIR XX de São João da Boa Vista, SP. Adotou-se como referencial a Teoria das Representações Sociais. A coleta de dados foi realizada através da técnica do Discurso do Sujeito Coletivo com 18 mulheres grávidas e que engravidaram até 30 dias após aplicação da vacina, consideradas suscetíveis à rubéola, residentes em 10 municípios da região. Através dos discursos das mesmas, foi possível desvelar a diversidade de significados da vacina contra a rubéola quando aplicada durante a gravidez, representada como ameaça à sua integridade, à de seu filho e ao seu relacionamento conjugal. Esses significados constituem-se em importante fonte de informação que propicia aos profissionais de saúde e gestores reflexão sobre o seu papel como agentes promotores de saúde.The research was aimed at describing the meaning of the rubella vaccine to women who were discovered pregnant after having received the measles-rubella vaccine during the 2001 campaign against rubella, and who lived in 10 cities within the region of DIR XX from São João da Boa Vista. The theory of Social Representation was used as a reference framework for the research, and data were collected through the Collective Subject Discourse technique, involving 18 women who either were pregnant or became pregnant within 30 days after having received the vaccine. Through their discourse, it was possible to unveil the diversity of meanings the rubella vaccine has when dispensed during pregnancy, characterized as a threat to their and their children's physical integrity and to their conjugal relationship. The meanings constitute an important source of information that allows health professionals and administrators to reflect, so they can reconsider their role as health promoters

Curative resection of a primarily unresectable acinar cell carcinoma of the pancreas after chemotherapy

<p>Abstract</p> <p>Background</p> <p>Acinar cell carcinoma (ACC) represents only 1–2% of pancreatic cancers and is a very rare malignancy. At the time of diagnosis only 50% of the tumors appear to be resectable. Reliable data for an effective adjuvant or neoadjuvant treatment are not available.</p> <p>Case presentation</p> <p>A 65-year old male presented with obstructive jaundice and non-specific upper abdominal pain. MRI-imaging showed a tumor within the head of the pancreas concomitant with Serum-Lipase and CA19-9. During ERCP, a stent was placed. Endosonographic fine needle biopsy confirmed an acinar cell carcinoma. Laparotomy presented an locally advanced tumor with venous infiltration that was consequently deemed unresectable. The patient was treated with five cycles of 5-FU monotherapy with palliative intention. Chemotherapy was well tolerated, and no severe complications were observed. Twelve months later, the patient was in stable condition, and CT-scanning showed an obvious reduction in the size of the tumor. During further operative exploration, a PPPD with resection of the portal vein was performed. Histopathological examination gave evidence of a diffuse necrotic ACC-tumor, all resection margins were found to be negative. Eighteen months later, the patient showed no signs of recurrent disease.</p> <p>Conclusion</p> <p>ACC responded well to 5-FU monochemotherapy. Therefore, neoadjuvant chemotherapy could be an option to reduce a primarily unresectable ACC to a point where curative resection can be achieved.</p

Positioning the principles of precision medicine in care pathways for allergic rhinitis and chronic rhinosinusitis - A EUFOREA-ARIA-EPOS-AIRWAYS ICP statement.

Precision medicine (PM) is increasingly recognized as the way forward for optimizing patient care. Introduced in the field of oncology, it is now considered of major interest in other medical domains like allergy and chronic airway diseases, which face an urgent need to improve the level of disease control, enhance patient satisfaction and increase effectiveness of preventive interventions. The combination of personalized care, prediction of treatment success, prevention of disease and patient participation in the elaboration of the treatment plan is expected to substantially improve the therapeutic approach for individuals suffering from chronic disabling conditions. Given the emerging data on the impact of patient stratification on treatment outcomes, European and American regulatory bodies support the principles of PM and its potential advantage over current treatment strategies. The aim of the current document was to propose a consensus on the position and gradual implementation of the principles of PM within existing adult treatment algorithms for allergic rhinitis (AR) and chronic rhinosinusitis (CRS). At the time of diagnosis, prediction of success of the initiated treatment and patient participation in the decision of the treatment plan can be implemented. The second-level approach ideally involves strategies to prevent progression of disease, in addition to prediction of success of therapy, and patient participation in the long-term therapeutic strategy. Endotype-driven treatment is part of a personalized approach and should be positioned at the tertiary level of care, given the efforts needed for its implementation and the high cost of molecular diagnosis and biological treatment