Sister Mary Joseph Nodule and peritoneal carcinomatosis from squamous cell cervical carcinoma

Sister Mary Joseph nodule is an eponym assigned to a nurse, first reported in 1949, denoting a rare form of cutaneous umbilical metastasis. The primary neoplasm is usually adenocarcinoma and the gastrointestinal tract is the most common primary site. The present case report describes a 79 year old woman with squamous cell cervical carcinoma. Her disease was managed with radiation and concurrent chemotherapy and no evidence of loco-regional recurrent disease was noted on follow-up examination. Eight months after treatment, gynecological examination suggested recurrent disease. Three weeks later, the patient presented with a painless umbilical nodule and the biopsy revealed a poorly differentiated carcinoma. Computed tomography showed ascites, diffuse peritoneal carcinomatosis including an umbilical nodule, multiple pulmonary nodules, bilateral pleural effusion, and retroperitoneal lymphadenopathy. She died 63 days after this manifestation. Review of the literature shows that a Sister Mary Joseph nodule is a sign of advanced neoplastic disease and is associated with poor prognosis. The treatment remains palliative either by radiation, chemotherapy or surgery

VOZES, SENTIDOS E EXPERIÊNCIAS NA EXTENSÃO UNIVERSITÁRIA: O QUE DIZEM AS CRIANÇAS SOBRE O BRINCAR

Este texto aborda a experiência de extensão universitária “Ciranda do Brincar FACED", cujo compromisso foi dialogar e vivenciar o brincar como atividade de cunho estético e cultural, assim como direito fundamental de toda a criança. Na versão apresentada, a experiência extensionista foi organizada com diferentes espaços e formas de produção do conhecimento em Rodas de Conversa, Oficinas, Instalação, Intervenções brincantes e palestras, compostas por palestrantes-crianças, além de espaço para as crianças brincarem livremente em uma escola pública da cidade de Salvador-Bahia. É uma ação que tem como referência o movimento Semana Mundial do Brincar inaugurado pela Aliança pela Infância e diversos parceiros de todo o mundo. A atividade foi tomada como objeto de estudo, tendo como recorte a análise das falas das crianças em uma mesa redonda sobre o brincar, o lugar onde se brinca e de que forma este brincar influencia as representações e entendimentos do lugar onde vivem. Os principais resultados da pesquisa reiteram a ideia de que a criança produz cultura, por meio de formas próprias de criação e de intervenções, se apropriando e transformando o lugar em que vivem. Observou-se também que através do brincar a criança percebe a importância do mundo em seu viver, influenciando suas brincadeiras, podendo inclusive modificar a forma como os adultos vivem a sua ludicidade

Differences in HPV infection and HPV-related lesions between the cervix and anus in hiv-positive women

Introduction: the prevalence of cervical and anal human papillomavirus (HPV) infection in women infected with human immunodeficiency virus (HIV) is high. However, little is known about the differences in the susceptibility of these infections and related lesions. The aim of this study was to describe the association between the prevalence of cervical and anal HPV infection and HPV-related lesions in HIV-positive women. Methods: this study included 88 HIV-positive women attending an outpatient clinic in a university hospital. Ectocervical, endocervical, and anal samples were collected for colpocytology and anal cytology. A polymerase chain reaction-based technique was used to detect HPV deoxyribonucleic acid in endocervical and anal swab samples. Results: the cervical and anal HPV positivity rates were 35.21% and 78.8%, respectively. The presence of HPV-related lesions on colpocytology was associated with anal HPV positivity (P = 0.027). The ratio between cervical HPV infection and cervical HPV-related lesions was 2.5. The ratio between anal HPV infection and anal HPV-related lesions was 4.3. Overall, 30% had concomitant HPV DNA in the cervix and anus. Conclusion: there are differences in the susceptibility of infections and related lesions between the cervix and anus. Despite a higher incidence of anal HPV, the progression to HPV-related lesion does not occur via the same manner in the cervix and anus. Moreover, cervical HPV-related lesions in HIV-positive women may serve as a cue for anal preventive strategies, and further investigations in these women may be useful.

ABSCESSO DE PSOAS SIMULANDO MASSA ANEXIAL: RELATO DE CASO

O abscesso de iliopsoas é uma condição rara.  Suas características clínicas inespecíficas podem levar a atrasos no diagnóstico. Relatamos o caso de uma paciente de 37 anos com indicação de cirurgia para massa anexial que, durante o ato operatório, pela ausência de tumor abdominal, descobriu tratar-se de abscesso de iliopsoas. O achado de níveis elevados de CA 19-9, isoladamente, resultou em outras hipóteses diagnósticas, sugerindo que a adoção de outros exames de imagem poderia ter auxiliado no diagnóstico mais rapidamente.PSOAS ABSCESS SIMULATING ADNEXAL MASS: CASE REPORTABSTRACTIliopsoas abscess is a rare condition. Its nonspecific clinical characteristics can lead to diagnostic delays. It is a case report: A 37-year-old patient presented for surgery with an adnexal mass. However, during the procedure, it was found to be an iliopsoas abscess rather due to the absence of an abdominal tumor. The finding of high CA 19-9 levels should result in other diagnostic hypotheses, and the analysis of other imaging tests could have aided the diagnosis

Orofacial manifestations in violent children sexually: the role of dentist surgeon in diagnosis: Manifestações orofaciais em crianças violentadas sexualmente: o papel do cirurgião dentista no diagnóstico

Sexual abuse against children and adolescents is one of the main public health problems around the world that can cause physical and psychological short and long-term consequences. The objective of this study is to review the literature on signs and symptoms related to sexual abuse in children and adolescents that can be identified by the dentist. The most common orofacial manifestations are composed of lacerations, bruises or abrasions on the lip, tongue, labial and lingual frenums, gingiva, oral mucosa, dental trauma, ecchymosis, bites and scratches. Oral lesions from sexual violence are difficult to diagnose, because they can be confused with accident or disease, but signs such as erythema, ulcer, petechiae on the palate can be a sign of sexual practice through forced oral sex, in addition to the presence of symptoms of sexually transmitted infections in the orofacial and oropharyngeal region. Many victims do not show the physical signs mentioned above, therefore, the psychological aspects must be taken into account. The fear on the part of healthcare professional of seeing violence is a fact, since they fear the reaction of family members, the incorrect diagnosis and lack of knowledge of how to carry out the notification. In cases of suspected sexual abuse, the dentist must record it in the patient's medical record, followed by notification to Organs. It is concluded that the dentist is a professional capable of acting in the identification of cases involving child sexual abuse

Functional electrical stimulation in upper extremity recovery of hemiparetic patients after stroke

A reabilitação do membro superior de pacientes hemiparéticos por acidente vascular encefálico (AVE) é um grande desafio. Dentre os recursos terapêuticos utilizados, a estimulação elétrica funcional (EEF) tem sido um recurso bastante explorado nos programas de tratamento desses pacientes. Objetivo: Avaliar os efeitos da EEF nos extensores de punho e dedos numa tarefa especifica (TE). Método: Foi realizado um estudo pré-experimental (pré e pós-testes) com oito pacientes crônicos com idade média de 63,4 ± 6,1 anos. Os parâmetros de avaliação foram a motricidade da mão através da escala de movimentos da mão (EMM), a força de preensão pela dinamometria (Din), a destreza do membro superior pelos testes de caixa e blocos (CB) e dos 9 pinos e buracos (9PB), a espasticidade pela escala de Ashworth modificada (EAM) e a independência funcional pelo índice de Barthel (IB). A TE era realizar o movimento de alcance e preensão de garrafas plásticas de diferentes tamanhos com o membro superior afetado em diferentes combinações de posições, num total máximo de 54 repetições por sessão. A EEF era usada para auxiliar a mão para pegar e soltar o objeto durante a TE. Foram realizadas em média 20 sessões com frequência de 2x/semana. Resultados: Demonstraram melhora em todos os parâmetros avaliados, a diferença foi estatisticamente significativa nos testes, exceto para a Din. Conclusão: No grupo estudado, a EEF na TE proposta resultou em melhora o desempenho na função do membro superior dos pacientes submetidos ao tratamento.The rehabilitation of the upper limb of hemiparetic patients by stroke is a major challenge. Among the various therapeutic resources used, functional electrical stimulation (FES) has been a popular avenue explored in treatment programs for these patients. Objective: To evaluate the effects of FES on wrist and finger extensors in a specific task (ST). Methods: We conducted a pre-experimental study (pre and post-tests) with eight chronic patients with a mean age of 63.4 years (± 6.1). The evaluation parameters were for manual mobility by the hand movement scale (EMM), grip strength by dynamometry (Din), dexterity of the upper limb by the box and blocks test (CB) and the 9-pin and holes test (9PB), spasticity by the modified Ashworth scale (MAS), and functional independence by the Barthel index (BI). The ST chosen was performing the movement of reaching and grasping plastic bottles of different sizes with the affected upper limb in different combinations of positions for a total maximum of 54 repetitions per session. FES was used to assist the hand in grabbing and holding the object during the ST. There was a mean of 20 sessions with attendance twice a week. Results: The results showed improvement in all parameters, the difference was statistically significant in all the tests, except for Din. Conclusion: In this sample, FES in the proposed ST resulted in improved performance in the upper limb function of patients undergoing treatment

Knowledge on the HPV vaccine among university students

The objective is to evaluate knowledge on HPV vaccine and its use among university students. This is a cross-sectional study with 301 participants, of which 202 medical students from UERJ and UNIFESO (101 freshmen = M1 and 101 from the 6th year = M2) and 99 UERJ literature students (50 freshmen = L1 and 49 of the last year = L2). Information was obtained by questionnaires. Input and statistical analysis were carried out with the EPI-INFO 3.5.2 Program. Results showed that, among medical students, 21% of M1 and 16% of M2 used the HPV vaccine (p=0.35), mostly adopted by women (M1=29.7% and M2=21.3%) than men (M1=5.4% and M2=7.5%). Similarly, female students showed more interest in using the vaccine (M1=85.1% and M2=80%) than male (M1=56.2% and M2=20.5%). Among literature students, only women received the vaccine (L1=6.5% and L2=22.2%) and no men were vaccinated (p=0.04). More women expressed interest in receiving the vaccine than men (♀ L1=76%, L2=65% and ♂ L1=47%, L2=40%). Comparison among genders regardless of the course showed that the vaccination rate is higher among women (p<0.001), as is the interest in being vaccinated (p=0.004). We concluded that the majority of male university students know less about the HPV vaccine than the female ones, use less and are less interested in being vaccinated, in all the groups interviewed. Vaccination coverage is low among the university population and is higher among medical students

A qualidade de vida dos estudantes de medicina durante o ensino remoto no período da pandemia da COVID-19

Objective: to characterize the quality of life of medical students from a federal university in the interior of Minas Gerais, enrolled during remote education, during the COVID 19 pandemic period. Methods: cross-sectional study with application of online questionnaires adapted from V National Survey of the Socioeconomic and Cultural Profile of Undergraduates from Federal Institutions of Higher Education, the National Survey of Household Samples and the WHOQOLbref. Absolute and relative frequencies and means of sociodemographic and epidemiological variables were calculated, in addition to the scores of the questionnaire referring to quality of life. Results: 179 students participated, aged between 19 and 44 years (Me=23.6). Most were female (67.7%), 52.6% self-declared white race/color, 97.2% single, 98.8% from Brazilian states and two from other countries (1.2%). In relation to quality of life, the following domains were observed among the participants: physical – good (4.05), environment – good (4.04), social relationships – regular (3.85) and psychological – regular (3.68). The score related to general quality of life was 3.90, being considered regular. Final considerations: despite the fact that the physical and environmental domains obtained a good classification, the social and psychological relationships domains were considered regular, as well as general quality of life. It is suggested that this study serve as a subsidy to the coordination and direction of medical courses. Because, the planning and implementation of pedagogical and administrative interventions, related to the health problems of mental disorders and the impact of the COVID-19 pandemic, are essential to improve the quality of life of students.Objetivo: caracterizar a qualidade de vida dos estudantes do curso de medicina, de uma universidade federal do interior de Minas Gerais, matriculados durante o ensino remoto, no período da pandemia da COVID 19. Métodos: estudo transversal com aplicação de questionários online adaptados da V Pesquisa Nacional de Perfil Socioeconômico e Cultural dos Graduandos das Instituições Federais de Ensino Superior, da Pesquisa Nacional de Amostras de Domicílio e do WHOQOL-bref. Foram calculadas as frequências absolutas e relativas e as médias das variáveis sociodemográficas e epidemiológicas, além dos scores do questionário referente à qualidade de vida.Resultados: participaram 179 estudantes, com idades entre 19 e 44 anos (Me=23,6). A maioria do sexo feminino (67,7%), 52,6 % autodeclarados da raça/ cor branca, 97,2% solteiros, 98,8% naturais de estados brasileiros e dois naturais de outros países (1,2%). Observou-se entre os participantes, em relação à qualidade de vida, os seguintes domínios:  físico – boa (4,05), ambiente – boa (4,04), relações sociais – regular (3,85) e psicológico – regular (3,68). O escore relacionado à qualidade de vida geral, foi 3,90, sendo considerada regular. Considerações finais: apesar da constatação dos domínios físico e ambiental terem obtido boa classificação, os domínios relações sociais e psicológico foram considerados regulares, assim como qualidade de vida geral. Sugere-se que este estudo sirva de subsídio às coordenações e direções dos cursos de medicina. Pois, o planejamento e implementação de intervenções pedagógicas e administrativas, relacionadas aos agravos dos transtornos mentais e o impacto da pandemia da Covid -19, são fundamentais para melhorias da qualidade de vida dos estudantes

CARCINOMA BASOCELULAR EM SUPERCÍLIO RECONSTRUÇÃO COM RETALHO BILATERAL: UM RELATO DE CASO

O carcinoma basocelular (CBC) é a neoplasia maligna mais comum em humanos e sua incidência vem aumentando nas últimas décadas. Apesar das baixas taxas de mortalidade e de rara ocorrência de metástases, o tumor pode apresentar comportamento invasivo local e recidivas após o tratamento, provocando importante morbidade. Exposição à radiação ultravioleta representa o principal fator de risco ambiental associado a sua gênese, sendo portanto, um fator prevenível. O presente trabalho visa relatar o caso de uma paciente diagnosticada com carcinoma basocelular do tipo infiltrativo em supercílio, que foi submetida à cirurgia de retirada da lesão utilizando-se a técnica de reconstrução com retalho bilateral. Tal procedimento foi acompanhado pelos estudantes autores do trabalho, que aprofundaram-se no tema e realizaram uma extensa revisão relacionada ao mesmo. Foi também explorada a dificuldade de reconstrução do local acometido, que representa um desafio ao cirurgião, tanto pelo baixo número de opções corretivas quanto pela região esteticamente crucial ao paciente. Concluiu-se que além de um diagnósico precoce, é fundamental que o tratamento adequado seja implementado, e posteriormente, um acompanhamento ambulatorial rigoroso deve ser realizado