A ALTERIDADE COMO INSTRUMENTO PARA REDUÇÃO DA ASSIMETRIA DA RELAÇÃO MÉDICO-PACIENTE: UMA ANÁLISE À LUZ DA PERSPECTIVA DAS VULNERABILIDADES

O presente artigo destinado a analisar a relevância da alteridade na relação médico-paciente, como um instrumento capaz de promover a redução da assimetria entre os sujeitos. Como premissa, buscou-se compreender os conceitos e sentidos de alteridade e vulnerabilidade, para que, posteriormente, fosse estabelecida a suas respectivas medidas de contribuição na solução de conflitos biojurídicos concernentes à relação. Buscou-se analisar as perspectivas histórica e principiológica da relação médico-paciente, a partir da deontologia e das categorias da vulnerabilidade. O caminho metodológico adotado perpassou pela abordagem hipotético-dedutiva, a partir da escolha de referencial teórico capaz de evidenciar os pressupostos necessários ao objeto investigado

Toad venom intoxication in a dog

O sapo do gênero Bufo possui nas suas glândulas paratóides uma secreção mucóide contendo toxinas como bufaginas e bufotoxinas, que são esteróides cardiogênicos. Os cães podem atacar os sapos, entrando em contato com o veneno por meio das mucosas. Um canino, da raça Bulldog Francês, foi encaminhado ao Setor de Patologia Veterinária da Universidade Federal do Rio Grande do Sul (UFRGS) para a necropsia com histórico de provável intoxicação por veneno de sapo. Na necropsia o canino apresentava pulmões aumentados de volume, avermelhados e com edema, e rins de coloração vermelho-escura. As alterações microscópicas indicaram congestão, hemorragia e edema pulmonar. Nos rins, no baço e nos linfonodos foi observada congestão. As análises toxicológicas para os venenos de rotina foram negativas. Porém, a investigação do veneno de sapo a partir de cromatografia por camada delgada e gasosa demonstrou resultado positivo, revelando ser esta a causa da morte do canino. ____________________________________________________________________________ ABSTRACTThe toads of the genus Bufo produce, in their parotoid glands, a mucoid secretion containing toxins such as bufagins and bufotoxins, which are cardiogenic steroids. The mucous membranes of dogs can absorb this venom when they attack the toads. A French bulldog with a history of probable toad venom intoxication was referred to Veterinary Pathology Section of Federal University of Rio Grande do Sul (UFRGS) for necropsy. The necropsy revealed enlarged, reddish, edematous lungs, and kidneys displaying a dark red color. The microscopic alterations indicated the presence of congestion, hemorrhage, and pulmonary edema. Congestion was observed in the kidneys, spleen and lymph nodes. The routine toxicological analyses for venom detection were negative. Nevertheless, the toad venom test result was positive as assessed by thin layer and gas chromatography, indicating that toad venom intoxication was the cause of death

Are histological alterations observed in the gallbladder precancerous lesions?

INTRODUCTION: Gallbladder cancer, which is characterized by rapid progression and a poor prognosis, is a complex disease to treat. Unfortunately, little is known currently about its etiology or pathogenesis. A better understanding of its carcinogenesis and determining risk factors that lead to its development could help improve the available treatment options. METHOD: Based on this better understanding, the histological alterations (such as acute cholecystitis, adenomyomatosis, xanthogranulomatous cholecystitis, polyps, pyloric metaplasia, intestinal metaplasia, dysplasia, cancer and others) in gallbladders from 1,689 patients who underwent laparoscopic cholecystectomy for cholecystolithiasis were analyzed. The association of these gallbladder histological alterations with clinical data was studied. RESULTS: Gender analysis revealed a greater incidence of inflammatory changes in males, while dysplasia and cancer were only found in women. The incidence of cholesterolosis was greater in the patients 60 years of age and under, and the incidence of adenomyomatosis and gangrene was greater in the elderly patients. A progressive increase in the average age was observed as alterations progressed through pyloric metaplasia, intestinal metaplasia, dysplasia and then cancer, suggesting that the metaplasia-dysplasia-carcinoma sequence may occur in gallbladder cancer. Gallbladder histological alterations were also observed in asymptomatic patients. CONCLUSION: The results of this study suggest that there could be an association between some histological alterations of gallbladder and cancer, and they also suggest that the metaplasia-dysplasia-carcinoma sequence could in fact be true in the case of gallbladder cancer. Nevertheless, further studies directed towards a perfect understanding of gallbladder carcinogenesis are required

Prevalence of cutaneous neoplasms in dogs from the metropolitan area of Porto Alegre, RS, Brazil : 1,017 cases (2002-2007)

O objetivo deste trabalho foi realizar um estudo retrospectivo sobre neoplasias cutâneas diagnosticadas em cães. A avaliação foi realizada pela análise dos arquivos diagnósticos do Setor de Patologia Veterinária (SPV) da Universidade Federal do Rio Grande do Sul (UFRGS), Brasil, considerando-se um intervalo de seis anos (2002 a 2007). Neste intervalo, um total de 1.869 (37,3%) amostras de pele canina foram obtidas de 5.016 amostras variadas de tecidos de cães encaminhadas ao SPV. Dentre as amostras cutâneas, 1.002 pertenciam a cães diagnosticados com um tipo de neoplasia cutânea e 15 animais apresentaram mais de uma neoplasia de pele, totalizando 1.017 (20,3%) amostras. Os resultados revelaram que 50,5% (514/1017) das neoplasias cutâneas apresentaram origem mesenquimal, 45,1% (459/1017) para epitelial e 3,9% (40/1017) para melanocítica. Mastocitoma foi o tipo neoplásico cutâneo mais frequente, diagnosticado em 228 casos (22,4%), seguido por carcinoma de células escamosas (7,5%), lipoma (7,3%), adenoma de glândula perianal (7,1%) e tricoblastoma (5,8%). Cocker Spaniel, Boxer, Poodle e Pastor Alemão foram as raças mais representadas em diversos neoplasmas. Os dados obtidos, comparados aos estudos prévios, ressaltam as variáveis raças, idade e sexo, relacionadas a alguns tumores cutâneos e salientam a importância e prevalência dos diferentes tipos de neoplasia cutânea em cães. __________________________________________________________________________________________ ABSTRACTThe aim of this study was to perform a retrospective study of cutaneous neoplasms diagnosed in dogs. The evaluation was established by analyzing the diagnostic files at the Veterinary Pathology Sector, UFRGS, Brazil, over a 6-year period (2002 to 2007). During this period a total of 1869 (37.3%) skin samples were obtained from 5016 different tissue samples of dogs submitted for examination. Among the referred skin samples, 1002 were from dogs with the diagnosis of cutaneous neoplasia and 15 dogs exhibited more than one type of skin tumor, what amounted to a total of 1017 (20.3%) cutaneous tumor samples. Results confirmed 50.5% (514/1017), 45.1% (459/1017), and 3.9% (40/1017) of respectively mesenquimal, epithelial, and melanocytic origin. Mast cell tumor was the most frequent neoplasia, diagnosed in 228 cases (22.4%), and was followed by squamous cell carcinoma (7.5%), lipoma (7.3%), perianal gland adenoma (7.1%), and trichoblastoma (5.8%). Purebred dogs such as Cocker Spaniel, Boxer, Poodle and German Sheepdog were the most representative breeds affected by various neoplasms. The data obtained, compared to data from previous studies, emphasize the variables breed, age and sex related to some skin tumors, and reinforce the importance and prevalence of different types of skin tumors in dogs

O DISCURSO DOS FRAGMENTOS: SÓCIO-COSMOLOGIA E ALTERIDADE NA CERÂMICA GUARANI PRÉ-COLONIAL

According to the 16th century ethno historical documents, Guarani pottery decoration and formal variability were related to distinct kinds of vessel's use and painted pottery was used mainly in ritual situations. We analyze archaeological pottery collections from Rio Grande do Sul North shore and Norwest region, seeking to explore the relationship between graphic patterns and distinct functional types of vessels, as well the regional and/or chronological stylistic variation of the sample. In the case study here presented, we suggest that painted pottery has high potential for the analysis of issues related to pre-colonial Guarani alterity and their social cosmological universe.De acuerdo a las fuentes etnohistóricas del siglo XVII, la decoración y la variabilidad formal de la cerámica Guarani estaban relacionadas a los diferentes tipos de uso de los recipientes, siendo la cerámica pintada usada principalmente en situaciones rituales. Con el objetivo de investigar la relación entre los grafismos y las categorías funcionales de vasijas, así como las variaciones estilísticas regionales y/o cronológicas presentadas por las muestras, analizamos colecciones de cerámicas arqueológicas del litoral norte y de la región noroeste de Rio Grande do Sul. En el estudio de caso aquí presentado, sugerimos que la cerámica pintada presenta alto potencial para análisis de problemáticas relacionadas a la alteridad y al universo socio-cosmológico Guarani precolonial.De acordo com as fontes etnohistóricas do século XVII, a decoração e a variabilidade formal da cerâmica Guarani estavam relacionadas aos diferentes tipos de uso dos vasilhames, sendo a cerâmica pintada usada principalmente em situações rituais. Com o objetivo de explorar a relação entre os grafismos e as categorias funcionais de vasilhas, bem como as variações estilísticas regionais e/ou cronológicas apresentadas pelas amostras, analisamos coleções de cerâmicas arqueológicas do litoral norte e da região noroeste do Rio Grande do Sul. No estudo de caso aqui apresentado, sugerimos que a cerâmica pintada apresenta alto potencial para análise de problemáticas relativas à alteridade e ao universo sócio-cosmológico Guarani pré-colonial

MicroRNA and protein profiles in invasive versus non-invasive oral tongue squamous cell carcinoma cells in vitro

Complex molecular pathways regulate cancer invasion. This study overviewed proteins and microRNAs (miRNAs) involved in oral tongue squamous cell carcinoma (OTSCC) invasion. The human highly aggressive OTSCC cell line HSC-3 was examined in a 3D organotypic human leiomyoma model. Non-invasive and invasive cells were laser-captured and protein expression was analyzed using mass spectrometry-based proteomics and miRNA expression by microarray. In functional studies the 3D invasion assay was replicated after silencing candidate miRNAs, miR-498 and miR-940, in invasive OTSCC cell lines (HSC-3 and SCC-15). Cell migration, proliferation and viability were also studied in the silenced cells. In HSC-3 cells, 67 proteins and 53 miRNAs showed significant fold-changes between non-invasive vs. invasive cells. Pathway enrichment analyses allocated "Focal adhesion" and "ECM-receptor interaction" as most important for invasion. Significantly, in HSC-3 cells, miR-498 silencing decreased the invasion area and miR-940 silencing reduced invasion area and depth. Viability, proliferation and migration weren't significantly affected. In SCC-15 cells, down-regulation of miR-498 significantly reduced invasion and migration. This study shows HSC-3 specific miRNA and protein expression in invasion, and suggests that miR-498 and miR-940 affect invasion in vitro, the process being more influenced by mir-940 silencing in aggressive HSC-3 cells than in the less invasive SCC-15.Peer reviewe

ESTUDO SOBRE A TERMINALIDADE DA VIDA NO CURSO DE MEDICINA: UMA REVISÃO DA LITERATURA

Introduction: Terminality is a process that covers distinct psychic manifestations, with effects in the patient in this situation, the family and the health team. In that meaning, this study aims to make a bibliographic survey about the terminality and its reflections in the patient, the medicine student and the doctor. Methodology: Thereunto, a search was made in the Biblioteca Virtual em Saúde (BVS), with descriptors “terminally ill” and “medical students”. Firstly, 42 works were found, from which, according to inclusion and exclusion criteria, 12 texts were selected. Results: Moreover, these topics were discussed: Communication between terminally ill patients and medicine students; Palliative care as an alternative to terminality; Student’s, professional’s and patient’s preparedness to deal with the matter of death. Discussion: The learning related to terminal illness and palliative care is essential for the future physician, because it provides security, empathetic attendance in the patients and their families care, that is a fact that strengthens the doctor-patient relationship. Therefore, it is known that this bond is extremely important regarding the process of death, as it enables both for the student and the physician, as well as for the patient and their family, a fruitful communication between them. In addition, it ensures trust between these people and helps with ways to deal with terminal illness, through empathy. Conclusion: Therefore, it is necessary to expand the reflexion and teaching of topics referring to the question of death, to capacitate medical staff to deal with the terminality of life.Introdução: A terminalidade é um processo que engloba manifestações psíquicas, com efeitos no paciente, na família e na equipe de saúde. Nesse esteio, este estudo objetiva fazer um levantamento bibliográfico sobre a terminalidade e os reflexos desta no paciente, no estudante de medicina e no médico. Metodologia: Para isso, fez-se uma busca na Biblioteca Virtual em Saúde (BVS), utilizando os descritores “paciente terminal” e “estudantes de medicina”. A princípio, encontraram-se 42 trabalhos, dos quais, segundo critérios de inclusão e exclusão, selecionaram-se 12 textos. Resultados: Dentre os assuntos englobados na discussão sobre o término da vida, destacam-se as seguintes temáticas: Comunicação entre pacientes terminais e estudantes de medicina; Cuidados paliativos como alternativa à terminalidade; Preparo do estudante, do profissional e do paciente para lidar com a questão da morte. Discussão: O aprendizado relacionado à terminalidade e aos cuidados paliativos é essencial ao futuro médico, pois propicia segurança, atendimento empático nos cuidados com o paciente e seus familiares, fato que fortalece a relação médico-paciente. Diante disso, sabe-se que esse vínculo é extremamente importante no que se refere ao processo da morte, visto que possibilita, tanto para o estudante e o médico quanto para o paciente e sua família, uma comunicação profícua entre os indivíduos. Além disso, assegura a confiança entre essas pessoas e contribui com o auxílio às formas de lidar com a terminalidade, pela empatia. Conclusão: Assim, é preciso ampliar a reflexão e ensino dos assuntos referentes ao término da vida, para capacitar o corpo médico a lidar com a morte