Urachal Cyst in a Bitch

Background: The urachus is a tubular structure continuous with the urinary bladder and the allantois in foetal mammals. It serves as a communication between these two structures. At birth, it loses its function and undergoes atrophy by fibrous proliferation within the lumen. When this atrophy process fails at some point, congenital anomalies of the urachus occur. These anomalies are rare in animals, and to our knowledge, the urachal cyst has not yet been described in dogs. The present work is unique in that it reports a case of this congenital defect in a dog. Our aim is to increase awareness and to discuss the clinical presentation, the imaging techniques used, and the final diagnosis of this anomaly.Case: A bitch Pit Bull, 3-year-old, was presented for veterinary assistance to investigate recurrent pseudopregnancy and an irregular estrous cycle. The animal presented in good bodily condition, and the white blood count and clinical biochemistry were normal. At ultrasound, 2 tubular structures, filled by an echogenic fluid mimicking uterine topography, were found extending through the umbilical and hypogastric regions. No alterations in structure, echogenicity or echotexture of the other organs were observed, including the ovaries and uterus. On exploratory laparotomy, a cystic structure was found, with 2 segments: the larger one was on the left side, attached to the apex of the bladder by its caudal portion; the other was on the right side, attached to the spleen by its cranial portion and to the apex of the bladder by its caudal portion in connection with the left segment. The ovaries, uterus and uterine horns showed no macroscopic alterations. The structure was removed, and after analysis (macroscopic morphology, wall histopathology and biochemistry of the contained fluid), it was determined to be a urachal cyst. The animal recovered uneventfully.Discussion: Ultrasound is an important tool for the evaluation of reproductive cycle physiology and its pathologies. At first, the owner’s complaint justified a fairly straightforward evaluation and clinical management of pseudopregnancy in a very healthy animal based on the history and clinical and complementary exams. However, ultrasound examination revealed two tubular structures filled with echogenic fluid in the lower abdomen. This made the case more complex, as these were interpreted as uterine horns by three different veterinarians, leading to the possibility of pyometra. The management of this condition must be cautious, since the animal's condition could rapidly deteriorate, necessitating an exploratory laparotomy. Based on the clinical presentation, macroscopic anatomy, fluid biochemistry and histological evaluations, the diagnosis of urachal cyst was proposed. Congenital anomalies occur when the urachus fails to obliterate. Four types can be found: patent urachus, urachal sinus, urachal diverticulum and urachal cyst. The urachal cyst occurs when the urachus encompasses a cyst-like structure that is closed to the umbilicus and the bladder lumen. The urachus becomes a cystic structure since its epithelium is still intact, active and accumulating fluid, like the one analysed in this report. Most urachal cysts in humans remain asymptomatic, but when infected, they can cause focal or diffuse peritonitis and an acute abdomen. Although rare, urachal cysts can develop malignant transformation. The combination of nonspecific symptoms and the infrequent occurrence of this anomaly make its diagnosis a difficult challenge. It is commonly an incidental finding like the case reported here. Therefore, diagnostic imaging techniques, especially ultrasound, are essential for the diagnosis. To our knowledge, this is the first case report of a urachal cyst in a dog. This rare anomaly of the urachus was an incidental finding in the investigation of the reproductive problems of a female dog

Pesquisa de marketing no setor dos cosméticos sergipano: o caso Ello Cosméticos

O presente artigo apresenta um estudo sobre a Ello Cosméticos sob a ótica do desenvolvimento das suas estratégias de marketing. O estudo é do tipo descritivo, que tem como objetivo tornar público as características da empresa sob as diversas variáveis do micro e macro ambiente. Para obter tais características foram feitos entrevista, observações e coleta de dados. Diante dessa pesquisa, notou-se que apesar de algumas deficiências da empresa, a Ello Cosméticos consegue atender todas as necessidades e os desejos dos consumidores de cosméticos de Aracaju.Macei

Assistência de enfermagem ao paciente com infarto agudo do miocárdio em uma urgência e emergência: relato de experiência / Nursing care for patients with acute myocardial infarction in an urgency and emergency: experience report

O infarto agudo do miocárdio (IAM), ou ataque cardíaco (AC), é a morte das células de uma região do músculo do coração por conta da formação de um coágulo que interrompe o fluxo sanguíneo de forma súbita e intensa. A principal causa do IAM é a aterosclerose, doença em que placas de gordura se acumulam no interior das artérias coronárias, chegando a obstrui-las. Na maioria dos casos o infarto ocorre quando há o rompimento de uma dessas placas, levando à formação do coágulo e interrupção do fluxo sanguíneo (MINISTÉRIO DA SAÚDE, 2018). Este estudo, é descritivo de natureza relato de experiência, elaborado a partir da vivência da equipe de enfermagem na atuação para com um paciente acometido por IAM em uma urgência e emergência de um hospital público do interior do Pará. Dentro desse contexto, faz parte da assistência de enfermagem ao indivíduo com IAM: instalação de oxigênio terapia, punção de acesso venoso periférico, monitorização de sinais, realização de ECG e administração de fármacos como nitratos.  Com isso, a equipe de enfermagem deve estar preparada para atender casos de IAM em uma unidade de urgência e emergência. Portanto, é fundamental que o enfermeiro tenha competências técnicas e conhecimento sobre a patologia evidenciada, tendo em vista que o tempo nessa situação imprescindíveis para o paciente

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

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 understanding 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,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 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 underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities 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 organism 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 neglected 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 lost