Tratamento de tuberculose pulmonar em paciente com esclerose múltipla: relato de caso / Pulmonary tuberculosis treatment in a patient with multiple sclerosis: case report

A esclerosemúltipla (EM) é uma doença crônica, autoimune, que compromete a bainha de mielina do sistema nervoso central (SNC), no caso clínico apresentado cursa com tuberculose (TB), doença infectocontagiosa grave, transmitida pelo ar e causada pela bactéria Mycobacterium tuberculosis ou Bacilo de Koch (BK).A identificação prévia da doença, assim como da etiologia e fatores de risco faz-se necessária, pois tal medida influenciará diretamente no curso do tratamento, podendo atingir um prognóstico de forma mais precisa e inclusive, ampliar a sobrevida do paciente. 

Infecção relacionada a cateter venoso central: comparação entre duas técnicas de fixação

Estudo realizado com objetivo de avaliar diferença na taxa de infecção relacionada a cateter venoso central (IRCVC) entre os dois métodos de fixação com sutura mais comuns. Foram avaliados 40 indivíduos (20 do grupo ALETA e 20 do grupo BAILARINA) internados em enfermarias ou unidades de terapia intensiva do Hospital Universitários Walter Cantídio, unidade terciária localizada em Fortaleza/Ce. Não foram considerados na pesquisa pacientes em uso de antibióticos, portadores de traqueostomia, com sítio de punção em veia femoral ou cuja indicação seja troca por suspeita de IRCVC prévia. Os dados foram analisados por meio do programa Jamovi®.  Foi considerada como infecção associada ao cateter, hiperemia regional, saída de secreção purulenta pelo óstio de punção ou infecção de corrente sanguínea sem fonte determinada. O tempo médio de permanência foi de 13,7 dias para o grupo ALETA e 12,8 dias para o grupo BAILARINA. A taxa de IRCVC foi de 27,5%, não havendo diferença estatisticamente significativa entre os grupos estudados

Ampulectomia transduodenal e a adaptação cirúrgica focada no paciente: Um relato de caso

Tumores da Ampola de Vater são entidades clínicas raras, em sua maioria adenocarcinomas, e em menor frequência do tipo neuroendócrino. O tratamento inclui ressecções endoscópicas e cirúrgicas, que podem ser extensas ou locais. Objetivo: Relatar um caso de Tumor Neuroendócrino de ampola em uma paciente idosa, que foi submetida a uma Ampulectomia Transduodenal. Relato: Paciente do sexo feminino, 83 anos, apresentou quadro de anorexia, icterícia progressiva, colúria e acolia fecal. Ecoendoscopia evidenciou lesão de 2,2 cm na ampola. Indicado o tratamento cirúrgico, no qual optou-se pela Ampulectomia Transduodenal. Após biópsia da peça cirúrgica, o estudo imunohistoquímico indicou Tumor Neuroendócrino grau III (Ki67 > 80%) Paciente evoluiu bem e foi seguida por 8 meses com relativa estabilidade clínica e sem complicações relativas ao tratamento cirúrgico ou a doença de base. Discussão: Os tumores neuroendócrinos correspondem a menos de 2% dos tumores da ampola. O tratamento mais indicado é a Duodenopancreatectomia, que promove um melhor controle locorregional e possibilita a obtenção de margens oncológicas, apesar de estar associado a complicações graves. Ressecções mais conservadoras como a endoscópica e a ampulectomia transduodenal estão associadas a menor morbimortalidade mas possuem a desvantagem do menor controle oncológico. Em pacientes bem selecionados, a Ampulectomia Transduodenal demonstrou taxas de sobrevida semelhantes à duodenopancreatectomia e com menor morbidade. Fatores associados à ausência de metástase linfonodal e obtenção de margem livre, incluindo tamanho, grau e diferenciação histológica, devem ser avaliados como preditores de sucesso terapêutico. Além disso, deve se considerar o status clínico na escolha. Conclusão: a ampulectomia transduodenal é uma opção que deve ser considerada no tratamento dos tumores da ampola, sendo particularmente eficaz em casos selecionados e em pacientes sem performance para duodenopancreatectomia

Cervical Vertebral Stenotic Myelopathy in a Nelore Calf

This paper aims to report clinical, laboratory, radiographic, and pathological features in a case of cervical vertebral stenotic myelopathy (CVSM) affecting a 4-month-old Nelore calf for the first time. During physical examination, the calf could stand if assisted when lifting by the tail but fallen to the ground when trying to walk. Attempts to flex and extend the neck to the right side failed. Radiographs findings consisted of reduced intervertebral spaces, and misalignments between the endplates, more evident between the C3 and C4 vertebrae, resulting in narrowing of the spinal canal and compression of the spinal cord. Grossly, C4 showed cranial articular surface malformation, abnormal metaphyseal growth plate development, reduced vertebral body size and deformity. Histologically, C4 showed an abnormal vertebral bone development characterized by moderate replacement of trabecular bone by fibrous tissues, multifocal areas of dystrophic hyaline cartilage development, and cartilaginous growth failure along the metaphyseal growth plate. Cervical spinal cord within the stenotic vertebral canal showed swollen neurons with central chromatolysis, areas of Wallerian degeneration, and necrotic debris. In contrast with the well-known Wobbler syndrome in horses, the etiology of CVSM in cattle remains undetermined, and further genetic and pathological studies must be conducted to elucidate it

Chondrosarcoma metastasis simulating a primary stomach tumor: a case report

Gastric tumors are an important cause of cancer deaths. The main type is the primary gastric adenocarcinoma, and rarely secondary metastatic implants can be present. A 79-years-old woman sought medical attention due to a complaint of epigastralgia, unintentional weight loss, two cases of melena in the past two months, and a prior history of a chondrosarcoma of the thigh treated 13 years before. A neoplastic lesion was detected at the stomach during evaluation, and a gastrectomy was opted as a treatment. The immunohistochemical evaluation was compatible with a chondrosarcoma metastatic implant on the stomach. The patient obtained a survival superior to 5 years after surgery. Only one case of gastric metastasis from chondrosarcoma was described in the literature. We observed a great benefit in the use of surgical resection of the gastric lesion, showing that surgery may be considered in selected individuals with chondrosarcoma metastasis

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data

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