Cytological and Histopathological Correlation of Feline Giant Cell-Rich Osteosarcoma

Background: Primary bone tumours are uncommon and poorly reported in cats but osteosarcoma (OSA) is the most frequent, mostly in elderly animals. Giant cell-rich OSA is considered rare in the literature representing 3% of all OSA in humans. The mitotic index seems to have a significant effect on the survival time of cats affected by this neoplasm as well as the tumour histopathological grade. The objective of this study was to report the cytological and histopathological findings of a giant cell rich OSA in a 4-year old cat with persistent feline leukemia virus (FeLV) antigenaemia.Case: A 4-year-old male neutered cat was referred with a history of persistent FeLV viraemia and pelvic limb lameness with a firm swelling. Previous radiographs of the affected limb revealed bone lysis in the third and fourth metatarsals and increased soft tissue radiopacity in the tarsal region. The referral veterinary assumed it to be osteomyelitis and initiated clinical treatment with antibiotic and anti-inflammatory. The cat was referred after there was no response to medical treatment. The cat was presented with a 5cm diameter ulcerated mass, with putrid odor in the pelvic limb. Complementary exams were performed, and abnormalities were found, including increased urea, creatinine, calcium and potassium, and decreased sodium and phosphorus. A new radiograph showed exuberant bone proliferation, with increased radiopacity involving tarsal, metatarsal, distal third of tarsal I and II, and distal diaphysis of metatarsal V, without compromising the metaphyseal region of distal diaphysis of metatarsal IV. Chest radiographs and abdominal ultrasound were unremarkable. Fine-needle aspiration was performed for cytological analysis, which reavealed a moderate amount of pleomorphic mesenchymal cells with moderate adhesion, cytoplasm with a format ranging from fusiform to stellate, pronounced anisocytosis and cellular pleomorphism, and elevated nucleus:cytoplasm ratio. Nucleus was oval and presented loose chromatin, single to double large and evident nucleolus, frequent karyomegaly, along with marked anisocariosis and nuclear pleomorphism. Multinucleated giant cells were and there was a single mitotic figure in 12 high power fields (0.196 mm2 FN20/400x). Therefore, it was suggestive of malignant mesenchymal neoplasia with possibility of OSA, fibrosarcoma oe undifferentiated sarcoma. Limb amputation with femoral disarticulation was performed uneventfully. The material was conserved in 10% formalin, submitted to macroscopic and microscopic evaluation, which showed a large number of fusiform and stellate cells, with indistinct edges, scarce eosinophilic cytoplasm, high nucleus:cytoplasm ratio and oval nucleus, presenting moderate to marked anisocariosis, loose chromatin, with unique and evident nucleoli, besides of bone trabeculae. Nuclear pleomorphism was moderate and there was four mitotic figures in three random high-power fields (400x). It was observed areas of vascular ectasia, and neoplastic embolization in lymphatic and blood vessels. Among the cells, collagenous stroma was predominant but in some areas there was an eosinophilic amorphous material with the possibility of osteoid matrix or collagen. There was also a large numbers of multinucleated giant cells. The histopathological result was compatible with a grade III giant cell rich OSA.Discussion: Although bone tumours are uncommon in cats, OSA is the most frequent, affecting maingly middle-aged to elderly cats, with a mean age of 10 years, which is different from the present report in a 4-year old cat, with FeLV persistent viraemia. Retroviral status may have influenced the development of the disease at na early onset. FeLV induces uncontrolled cell proliferation through insertional mutagenesis (usually near myc) inducing malignant neoplasias, mainly lymphoma, but also multiple cartilaginous exostosis, which, along with osteomyelitis and bone cyst were included in this patient´s list of differential diagnoses. Despite the macroscopic and radiographical andagressiveness there was no metastasis identified through chest radiographs or abdominal ultrasound, and feline OSA is associated with a lower metastatic rate, if compared to canine OSA. Cytological analysis was compatible with malignant mesenchymal neoplasia, being suggestive of giant cell rich OSA. There is no cytological classification for OSA, however cytological findings of malignancy may be correlated with the patient's clinical course. Cytological features were in agreement with the histopathological findings, compatible with a grade III giant cell rich OSA. Therefore, it is concluded that the characteristics of malignancy presented by cytology were sufficient for the recommendation of amputation of the affected limb, once there was no imaging sign of metastases in the chest or abdomen

Sporotrichosis Outburst after Cancer Chemotherapy in a Dog

Background: Sporotrichosis is a dermatozoonosis that affects mammals in general, with the domestic feline (Felis catus) being the most epidemiologically important species. However, diagnosis of this disease in dogs is important considering the proximity with people and with other communicants. The epidemiology of sporotrichosis is already known in some states of Brazil, especially in the southeast region, but to the best of our knowledge there are no reports of sporotrichosis in non-human species in the state of Espírito Santo. This paper aimed at describing the first case of canine sporotrichosis in Espírito Santo, Brazil.Case: A 10 year-old Bull Terrier male dog was presented with nodular non-ulcerated lesions on the head and nodular ulcerated lesion on the nasal planum. The dog had a previous diagnosis of a low-grade mast cell tumour and palpebral melanoma. Mast cell tumour was treated with scrotum ablation (and orchiectomy) and bilateral inguinal lymph node removal, followed by chemotherapy with twelve intravenous infusion of vinblastine, along with prednisolone. Cutaneous lesions in the head and nasal planum appeared two months after finishing chemotherapy. At further anamnesis, the pet´s responsible reported that the dog had the habit of hunting cats that entered the residence, which raised the hypothesis of sporotrichosis. An undiagnostic cytology was performed, followed by a fungal culture, positive for Sporothrix schenckii. Treatment was then initiated with itraconazol (Oficial generic drug), at a dose of 10mg/kg/SID, until clinical remission, obtained after 60 days, maintaining it for 60 more days. Patient showed completed recovery, with no further complatints after a follow-up of more than 220 days.Discussion: Sporotrichosis is considered a rare disease in dogs, with isolated cases in the literature. The dog of the present report was diagnosed with sporotrichosis two months after the end of a chemotherapy treatment for a mast cell tumour. Therefore, it is suggested that the patient in this study was infected during an immunosuppressive phase. The same can occur with other immunosuppressive treatments, such as glucocorticoid, also included in the chemotherapy treatment of this patient, calcineurin inhibitors (cyclosporine) and mercaptopurine derivatives (azathioprine). Cytology is usually unconclusive for such lesions in dogs, once only a few yeast might be present. Nevertheless, the definitive diagnosis was obtained through fungal microculture. Treatment with itraconazol was successful but dogs might also present favorable responses to ioidine. Itraconazole is a fungistatic drug, fungicidal only in high doses. For this reason, if the fungistatic dose is not administered for sufficient time, recurrences may occur. In the last three years, Espirito Santo has become a new epidemiological scenario for sporotrichosis, and it is placed in the route of transmission, closely to Rio de Janeiro. Cats are the most affected animals and are commonly responsible for transmission to other species, including humans. The increase in cases of canine sporotrichosis requires its inclusion in the differential diagnosis of nodular-ulcerative lesions, along with cutaneous neoplasias and immune-mediated diseases

Avaliação do indicador de qualidade do Sistema de Triagem de Manchester: tempo de atendimento

Objetivo: Verificar a conformidade do intervalo de tempo entre o término da classificação de risco e o início do atendimento médico com o recomendado pelo protocolo de Manchester e relacionar os tempos de atendimento e as categorias de risco com o desfecho. Método: Estudo transversal, retrospectivo e analítico. Foram utilizados o teste t, a análise de variância e o modelo linear generalizado. Resultados: O tempo médio para atendimento médico nas categorias vermelha e laranja foi de 3 e 39,5 minutos, respectivamente. Desfecho óbito associou-se à categoria vermelha, com tempo médio para início da classificação de 5,5 minutos e tempo médio de permanência de 2,3 horas. Conclusão: O tempo de espera para atendimento médico nas categorias de alta prioridade foi maior que recomendado, o que sugere a necessidade de monitorar continuamente o sistema. Menores tempos de espera para a classificação e de permanência relacionaram-se à categoria vermelha e ao desfecho óbito.Palavras-chave: Triagem. Serviços médicos de emergência. Tempo de internação. Aglomeração. Enfermagem em emergência. Protocolos

Socioeconomic inequality shaping the dietary patterns of children and teens

OBJETIVO: Identificar e quantificar a influência dos fatores socioeconômicos sobre os padrões alimentares. \ud MÉTODOS: Estudo transversal de base populacional com amostra de 1.136 crianças e adolescentes de 7 a 14 anos de idade, de ambos os sexos, matriculados na rede pública de Salvador (BA), Brasil. O consumo alimentar foi medido por meio do questionário qualitativo de frequência alimentar. Os padrões de consumo foram identificados por meio de análise de componentes principais. Para o estudo da influência dos indicadores socioeconômicos na conformação dos padrões alimentares, foram utilizados modelos de regressão quantílica. \ud RESULTADOS: Os padrões alimentares extraídos foram classificados em padrão obesogênico e padrão tradicional. Nos modelos de regressão quantílica, ajustados por faixa etária e por sexo, o menor grau de instrução materna esteve associado negativamente, em níveis significantes, na maioria dos percentis, ao consumo de alimentos que integram o padrão obesogênico. A baixa renda associou-se negativamente aos maiores percentis (p>95). Os dados indicam não haver influência dos indicadores socioeconômicos sobre o consumo de alimentos que integram o padrão tradicional. \ud CONCLUSÃO: Conclui-se que há influência dos fatores socioeconômicos na adesão ao padrão obesogênico de consumo. Esse conjunto de resultados requer a atenção dos gestores públicos para a identificação de um padrão de consumo ocidental, visualizado amplamente nos estudos em que se avaliam padrões de consumo adotados na atualidade pela população brasileira - sobretudo por crianças e adolescentes -, caracterizados por englobar componentes alimentares de risco para as doenças crônicas não transmissíveis.Objective The present study identified and quantified the influence of socioeconomic factors on dietary patterns. Methods This cross-sectional, population-based study investigated the food habits of 1136 children and adolescents of both genders, aged 7 to 14 years, enrolled in public schools of Salvador (BA), Brazil, using the qualitative food frequency questionnaire. Intake patterns were identified by principal component analysis. Quantile regression models were used to study the influence of socioeconomic indicators on dietary patterns. Results The sample's eating patterns were classified into obesogenic or traditional. Quantile regression models adjusted for age and gender showed that, for most percentiles, low maternal education level was significantly negatively associated with consumption of foods included in the obesogenic pattern. Low income was negatively associated with the highest percentiles (p >= 95). The data showed that socioeconomic indicators do not influence the consumption of foods included in the traditional pattern. Conclusion Socioeconomic factors promote adherence to obesogenic eating patterns. These results indicate that public authorities need to identify the Western consumption pattern, commonly observed in studies that assess the current consumption patterns of the Brazilian population, especially of children and adolescents, characterized by foods that promote non-communicable chronic diseases

Secretory carcinoma of the canine mammary gland with nodal and bone metastases: Case report

Background: Secretory carcinoma is a rare histological type of breast neoplasm in humans and dogs that is characterized by the presence of intracellular and extracellular eosinophilic secretions.Case Description: In this case report, we describe the cytological, histological, and immunohistochemical characteristics of secretory mammary carcinoma in a 10-year-old mixed-breed female dog with nodal and bone metastases. The bitch had a history of claudication and a mass in the left humeral scapular region, which revealed osteolysis of the proximal humerus on radiography. Fine-needle aspiration cytology revealed numerous neoplastic cells arranged mostly in cohesive groups but sometimes isolated, that contained cytoplasmic vacuoles and had a moderate-to-high nucleus: cytoplasm ratio with frequent karyomegaly and evident nucleoli. Histologically, the neoplasm was organized in solid, tubular structures with luminal spaces filled with eosinophilic secretions and was composed of cells with clear cytoplasm and prominent vacuoles that pushed the nuclei to the periphery, resembling signet ring cells. The extracellular and intracytoplasmic material of the epithelial cells was positive for periodic acid-Schiff staining and immunoreactive for alpha-lactalbumin. Two chemotherapy sessions were performed, but 1 month after surgery, the clinical condition worsened, and euthanasia was elected, accounting for 133 days of survival after surgical removal of the tumor.Conclusion: The bitch presented with secretory mammary carcinoma with nodal and bone metastases, and histological and immunohistochemical characteristics were important for diagnosis. The morphological and immunohistochemical characteristics of this carcinoma were similar to those observed in humans. Mammary gland secretory carcinoma with bone metastasis must be included as a differential diagnosis among canine mammary gland carcinomas showing cellular morphological characteristics of intracytoplasmic vacuolization and eosinophilic secretion

Sistema de triagem de Manchester: caracterização dos atendimentos por meio dos discriminadores

Objetivo: Caracterizar os atendimentos em um serviço de emergência, por meio dos discriminadores do Sistema de Triagem de Manchester, e associar os principais discriminadores com as categorias de risco. Método: Estudo transversal, com 3.213 adultos atendidos no serviço de emergência no ano de 2015. As variáveis: idade sexo cor da pele escolaridade discriminador e categoria da Classificação de Risco, avaliados por meio do Sistema de Triagem de Manchester foram coletadas de prontuários e analisadas estatisticamente, pelo teste da razão de verossimilhança. Resultados: A média de idade foi 48,2±18,7 anos, predomínio de mulheres (52,3%), pardas (94,4%), classificadas na categoria amarela (33,9%), com dor moderada (21,9%) seguida de dor leve recente (14,4%). Pacientes classificados nas categorias vermelha e laranja apresentaram maior percentual de dor intensa e aqueles da categoria amarela maior percentual de dor moderada. Pacientes das categorias verde e azul apresentaram maior percentual de evento recente quando comparados aos classificados em outras categorias (p<0,0001). Conclusão: Os discriminadores mais prevalentes neste estudo foram relacionados a queixa de dor, que pode, muitas vezes, relacionar-se a gravidade. Este estudo fornece informações que podem nortear a tomada de decisão do enfermeiro no estabelecimento de prioridades clínicas e subsidiar a implantação de estratégias que organizem o fluxo de atendimento no serviço de emergência

Geographic patterns of tree dispersal modes in Amazonia and their ecological correlates

Unidad de excelencia María de Maeztu CEX2019-000940-MAim: To investigate the geographic patterns and ecological correlates in the geographic distribution of the most common tree dispersal modes in Amazonia (endozoochory, synzoochory, anemochory and hydrochory). We examined if the proportional abundance of these dispersal modes could be explained by the availability of dispersal agents (disperser-availability hypothesis) and/or the availability of resources for constructing zoochorous fruits (resource-availability hypothesis). Time period: Tree-inventory plots established between 1934 and 2019. Major taxa studied: Trees with a diameter at breast height (DBH) ≥ 9.55 cm. Location: Amazonia, here defined as the lowland rain forests of the Amazon River basin and the Guiana Shield. Methods: We assigned dispersal modes to a total of 5433 species and morphospecies within 1877 tree-inventory plots across terra-firme, seasonally flooded, and permanently flooded forests. We investigated geographic patterns in the proportional abundance of dispersal modes. We performed an abundance-weighted mean pairwise distance (MPD) test and fit generalized linear models (GLMs) to explain the geographic distribution of dispersal modes. Results: Anemochory was significantly, positively associated with mean annual wind speed, and hydrochory was significantly higher in flooded forests. Dispersal modes did not consistently show significant associations with the availability of resources for constructing zoochorous fruits. A lower dissimilarity in dispersal modes, resulting from a higher dominance of endozoochory, occurred in terra-firme forests (excluding podzols) compared to flooded forests. Main conclusions: The disperser-availability hypothesis was well supported for abiotic dispersal modes (anemochory and hydrochory). The availability of resources for constructing zoochorous fruits seems an unlikely explanation for the distribution of dispersal modes in Amazonia. The association between frugivores and the proportional abundance of zoochory requires further research, as tree recruitment not only depends on dispersal vectors but also on conditions that favour or limit seedling recruitment across forest types

Transtorno bipolar em crianças: análise de relato de caso 2018-2023

O transtorno bipolar em crianças é uma realidade clínica que demanda atenção especializada. A compreensão dos sintomas, fatores de risco, prevalência e desafios diagnósticos é fundamental para proporcionar intervenções precoces e adequadas, visando melhorar a qualidade de vida desses jovens e reduzir o impacto a longo prazo dessa condição psiquiátrica. Trata-se de um estudo cujo objetivo foi objetivo revisar relatos de caso publicados entre 2018 e 2023 sobre transtorno bipolar em crianças, identificando o estado da arte desses estudos. Para isso, se realizou uma revisão sistemática de literatura utilizando as bases de dados Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Scientific Electronic Library Online (SCIELO). Com a análise e interpretação qualitativa dos resultados, a principal conclusão deste estudo é que o transtorno bipolar na infância é uma condição complexa, manifestando-se com comportamentos consistentes com o Transtorno de Conduta e sendo influenciado por fatores ambientais, familiares e genéticos. O tratamento eficaz requer uma abordagem multidisciplinar, integrando intervenções farmacológicas e não farmacológicas, personalizadas conforme as necessidades individuais. A supervisão familiar é crucial para a adesão ao tratamento, mas reconhece-se a necessidade contínua de pesquisa para aprimorar as estratégias terapêuticas diante da diversidade de casos

Geography and ecology shape the phylogenetic composition of Amazonian tree communities

Aim: Amazonia hosts more tree species from numerous evolutionary lineages, both young and ancient, than any other biogeographic region. Previous studies have shown that tree lineages colonized multiple edaphic environments and dispersed widely across Amazonia, leading to a hypothesis, which we test, that lineages should not be strongly associated with either geographic regions or edaphic forest types. Location: Amazonia. Taxon: Angiosperms (Magnoliids; Monocots; Eudicots). Methods: Data for the abundance of 5082 tree species in 1989 plots were combined with a mega-phylogeny. We applied evolutionary ordination to assess how phylogenetic composition varies across Amazonia. We used variation partitioning and Moran\u27s eigenvector maps (MEM) to test and quantify the separate and joint contributions of spatial and environmental variables to explain the phylogenetic composition of plots. We tested the indicator value of lineages for geographic regions and edaphic forest types and mapped associations onto the phylogeny. Results: In the terra firme and várzea forest types, the phylogenetic composition varies by geographic region, but the igapó and white-sand forest types retain a unique evolutionary signature regardless of region. Overall, we find that soil chemistry, climate and topography explain 24% of the variation in phylogenetic composition, with 79% of that variation being spatially structured (R$^{2}$ = 19% overall for combined spatial/environmental effects). The phylogenetic composition also shows substantial spatial patterns not related to the environmental variables we quantified (R$^{2}$ = 28%). A greater number of lineages were significant indicators of geographic regions than forest types. Main Conclusion: Numerous tree lineages, including some ancient ones (>66 Ma), show strong associations with geographic regions and edaphic forest types of Amazonia. This shows that specialization in specific edaphic environments has played a long-standing role in the evolutionary assembly of Amazonian forests. Furthermore, many lineages, even those that have dispersed across Amazonia, dominate within a specific region, likely because of phylogenetically conserved niches for environmental conditions that are prevalent within regions

Geography and ecology shape the phylogenetic composition of Amazonian tree communities

AimAmazonia hosts more tree species from numerous evolutionary lineages, both young and ancient, than any other biogeographic region. Previous studies have shown that tree lineages colonized multiple edaphic environments and dispersed widely across Amazonia, leading to a hypothesis, which we test, that lineages should not be strongly associated with either geographic regions or edaphic forest types.LocationAmazonia.TaxonAngiosperms (Magnoliids; Monocots; Eudicots).MethodsData for the abundance of 5082 tree species in 1989 plots were combined with a mega-phylogeny. We applied evolutionary ordination to assess how phylogenetic composition varies across Amazonia. We used variation partitioning and Moran's eigenvector maps (MEM) to test and quantify the separate and joint contributions of spatial and environmental variables to explain the phylogenetic composition of plots. We tested the indicator value of lineages for geographic regions and edaphic forest types and mapped associations onto the phylogeny.ResultsIn the terra firme and várzea forest types, the phylogenetic composition varies by geographic region, but the igapó and white-sand forest types retain a unique evolutionary signature regardless of region. Overall, we find that soil chemistry, climate and topography explain 24% of the variation in phylogenetic composition, with 79% of that variation being spatially structured (R2 = 19% overall for combined spatial/environmental effects). The phylogenetic composition also shows substantial spatial patterns not related to the environmental variables we quantified (R2 = 28%). A greater number of lineages were significant indicators of geographic regions than forest types.Main ConclusionNumerous tree lineages, including some ancient ones (>66 Ma), show strong associations with geographic regions and edaphic forest types of Amazonia. This shows that specialization in specific edaphic environments has played a long-standing role in the evolutionary assembly of Amazonian forests. Furthermore, many lineages, even those that have dispersed across Amazonia, dominate within a specific region, likely because of phylogenetically conserved niches for environmental conditions that are prevalent within regions