Superior vena cava syndrome in childhood

The authors describe a case of benign superior vena cava syndrome post phlebotomy in childhood, including exams for diagnosis and possible treatment.Universidade Estadual de Maringá Curso de MedicinaUNIFESP-EPMHURM Hospital Universitário Regional de MaringáUNIFESP, EPMSciEL

Um estudo introdutório acerca dos processos de conhecimento

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Epistemologias subjacentes a projetos de cursos de formação de professores a distância

14

Pectus Excavatum and Pectus Carinatum in dogs

Background: Deformities of the anterior thoracic wall are called pectus: pectus excavatum and pectus carinatum. Pectus excavatum is characterised by dorsal deviation of the caudal region of the sternum while pectus carinatum consists of protrusion of the sternum and/or adjacent cartilage. Both defects may remain symptom-free, but respiratory and cardiac abnormalities have been reported. Another deformity observed in dogs is the swimming dog syndrome, which consists of the lateral opening of the thoracic and pelvic limbs, associated with the pedalling movement. These disorders are frequently reported in medical practice, are considered rare among canines. This report aims to describe a case of pectus excavatum associated with the swimming dog syndrome (Case 1) and another case of pectus carinatum (Case 2).Case: In Case 1, an approximately 45-day-old male American Pitbull canine had difficulty standing. Physical examination revealed hyperextension of the thoracic and pelvic limb joints and flattening of the thorax. After radiographic examination, pectus excavatum and the swimming dog syndrome were confirmed. The conservative treatment with splinting and hydrotherapy was chosen. At the 3-month follow-up, slight improvement in the limbs and irregular and unsatisfactory growth of the thorax leading to episodes of dyspnoea were observed. In Case 2, a female Pug, approximately 2 months old, had a thorax deformity. Physical examination revealed thorax protrusion, confirmed on radiography as pectus carinatum. Conservative therapy was provided using compressive bandage. One month later, the tutor reported improvement in the condition and absence of respiratory changes.Discussion: Pectus deformities has low incidence, and cases to pectus carinatum, there is a sexual predisposition, that is, males are more predisposed, differing from Case 2, a female dog. In the cases of pectus excavatum, no genetic alteration was directly related to its occurrence, although familial occurrence is reported in humans, as in Case 1, in which the patient was the only one of this litter to present this deformity. Though the possibility is lower, the acquired aetiology has been described in other cases. In pectus carinatum, there is the possibility of an acquired aetiology, which corroborates Case 2, considering that the canine had no history of inbreeding, nor family history. However, it is important consider racial predisposition, where there is an increasing number of cases of pectus carinatum in brachycephalic canines. Respiratory symptoms are frequently reported in cases of pectus excavatum, which the evolution of the condition occurred in Case 1, that can be explained by the displacement of organs or the restriction to ventilation. Humans have shown that pectus excavatum reduces static lung function. Case 2 showed no clinical signs, despite this presented dextrocardia, which in the future may confer cardiac dysfunctions. The diagnosis for pectus is considered simple. Performed only by radiography, it can be complemented by echocardiography. In both cases, conservative treatment was the choice. However, in Case 1 there was no success due to the degree of patient involvement, unlike Case 2, which had a better development of the thoracic wall, ensuring better quality of life for the patient. Thus, it is possible to conclude that some differences were found in these two reported cases when compared to others described in the literature.  The radiographic diagnosis is confirmatory, and the therapy must be adequate to the degree of thoracic wall deformity. In addition, the prognosis is more reserved for pectus excavatum than pectus carinatum

Liga Acadêmica de Hematologia (HemoLiga): atuação no Ensino, Pesquisa e Extensão

Introduction: The Academic Leagues (ALs) are very present organizations in Medicine courses in Brazil. They are extracurricular and complementary activities which are based on tripod education, research, and extension, aiming to promote a more profound knowledge on a given topic. As a result, it stimulates creativity, self-learning, and critical thinking to provide better professional training. Objective: Report the history and performance of HemoLiga (HL), focusing on scientific production and compare it with other Brazilian Medicine ALs presented in the literature. Methods: Reading and analysis of HL meeting minutes for the league's historical documentation associated with the study of the Lattes Curriculum of current and former HL members to collect data on the league's scientific production. The information obtained was tabulated in spreadsheets according to the subtypes of work. Analysis and crossing of variables were performed to produce graphics. Results: HL has been functioning for 14 years and it is linked to three Medicine courses in Juiz de Fora. The aim of education is obtained through meetings and internships in the area of Hematology. Research is its main activity, including an international line of research. Since its foundation, HL has produced a list of 217 scientific works, including 32 scientific articles, 180 abstracts, three book chapters, and two books. Regarding the extension aspect, the league worked on the projects Unir para Cuidar, Doador do Futuro, Triagem Neonatal and Amigo de Sangue. Conclusion: Through its scope of action, as other ALs, HL contributes through its scientific initiation profile to the academic training of its members, in addition to benefiting society through its extension projects.Introdução: As Ligas Acadêmicas (LAs) são organizações universitárias muito presentes nos cursos de medicina no Brasil, são de caráter extracurricular e complementar, fundamentadas no tripé ensino, pesquisa e extensão (EPE). Suas atividades tendem a aprofundar os conhecimentos sobre determinado tema, estimular a criatividade, o autoaprendizado e o espírito crítico dos estudantes a fim de proporcionar uma melhor formação profissional. Objetivo: Relatar o histórico e a atuação da HemoLiga (HL) com foco na produção científica e compará-la com outras LAs de Medicina do Brasil descritas na literatura. Material e Métodos: Leitura e análise das atas de reuniões da HL para a documentação histórica da liga associada a busca dos Currículos Lattes dos atuais e ex-integrantes da HL para levantamento de dados sobre a produção científica da liga. As informações obtidas foram tabeladas em planilhas de acordo com os subtipos de trabalhos. Foram realizados análises e cruzamento de variáveis para confecção de gráficos. Resultados: A HL é uma liga vinculada a três faculdades de medicina e possui 14 anos de existência. Ela atua no ensino através de reuniões e estágios práticos na área de Hematologia. A pesquisa constitui sua principal atuação, integrando, inclusive, linha de pesquisa internacional. Assim, desde a sua fundação, a HL consta de uma lista de 217 trabalhos científicos produzidos, sendo 32 artigos científicos, 180 resumos, três capítulos de livros e dois livros. Na extensão, a liga agrega os projetos Unir para Cuidar, Doador do Futuro, Triagem Neonatal e Amigo de Sangue. Conclusão: A HL por meio do seu escopo de atuação, em consonância com outras LAs, contribui através de seu perfil de iniciação científica na formação acadêmica de seus membros, além de beneficiar a sociedade através de seus projetos de extensão

Diagnóstico e tratamento do câncer de colo de útero: uma revisão de literatura

This article aims to evaluate the clinical aspects of the diagnosis and treatment of cervical cancer carried out in the last five years. Integrative review in the VHL, LILACS, SciELO, PubMed database of works published between 2020 and 2024, combining the descriptors "cervical cancer", "diagnosis" and "treatment" with the Boolean descriptor "AND". The estimated incidence of cervical cancer in Brazil in 2023 was 16,340 cases, and there are large regional differences in the incidence of the disease. The most important risk factor for the development of this cancer is the presence of the HPV virus with its oncogenic subtypes, in addition to other factors. It is concluded that there are several ways to screen for cervical cancer, but the gold standard for diagnosing cervical cancer is histology, which can be performed through a direct biopsy of the lesion or, in cases of endocervical lesion, through cervical conization or curettage of the endocervical canal.Este artigo tem por objetivo avaliar os aspectos clínicos do diagnóstico e do tratamento do câncer de colo de útero realizada nos últimos cinco anos. Revisão integrativa no banco de dados da BVS, LILACS, SciELO, PubMed de trabalhos publicados entre 2020 e 2024, combinando os descritores "câncer de colo de útero", "diagnóstico" e "tratamento" ao descritor booleano "AND". A incidência estimada de câncer do colo do útero no Brasil no ano de 2023 foi de 16.340 casos, e existem grandes diferenças regionais na incidência da doença. O fator de risco mais importante para o desenvolvimento deste câncer é a presença do vírus HPV com seus subtipos oncogênicos, além de outros fatores. Conclui-se que existem várias maneiras de rastrear o câncer de colo, mas o método ouro de diagnóstico do câncer de colo uterino é dado pela histologia, que pode ser realizada através de uma biopsia direta da lesão ou, em casos de lesão endocervical, através da conização de colo uterino ou curetagem do canal endocervical. &nbsp

Convalescent plasma for COVID-19 in hospitalised patients : an open-label, randomised clinical trial

Background: The effects of convalescent plasma (CP) therapy in hospitalised patients with coronavirus disease 2019 (COVID-19) remain uncertain. This study investigates the effect of CP on clinical improvement in these patients. Methods: This is an investigator-initiated, randomised, parallel arm, open-label, superiority clinical trial. Patients were randomly (1:1) assigned to two infusions of CP plus standard of care (SOC) or SOC alone. The primary outcome was the proportion of patients with clinical improvement 28 days after enrolment. Results: A total of 160 (80 in each arm) patients (66.3% critically ill, 33.7% severely ill) completed the trial. The median (interquartile range (IQR)) age was 60.5 (48–68) years; 58.1% were male and the median (IQR) time from symptom onset to randomisation was 10 (8–12) days. Neutralising antibody titres >1:80 were present in 133 (83.1%) patients at baseline. The proportion of patients with clinical improvement on day 28 was 61.3% in the CP+SOC group and 65.0% in the SOC group (difference −3.7%, 95% CI −18.8–11.3%). The results were similar in the severe and critically ill subgroups. There was no significant difference between CP+SOC and SOC groups in pre-specified secondary outcomes, including 28-day mortality, days alive and free of respiratory support and duration of invasive ventilatory support. Inflammatory and other laboratory marker values on days 3, 7 and 14 were similar between groups. Conclusions: CP+SOC did not result in a higher proportion of clinical improvement on day 28 in hospitalised patients with COVID-19 compared to SOC alone

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