HEMANGIOMA MAMÁRIO: UMA FORMA BENIGNA DE NEOPLASIA VASCULAR DA MAMA.

Vascular neoplasms of the breast are defined by vascular lesions that can be located in the extraparenchymal region (in the subcutaneous adipose tissue), usually benign or intraparenchymal (to the superficial fascia), most of which are malignant. 2 They are classified according to the histopathological examination that defines the malignant characteristic, such as: angiosarcomas, epithelioid hemangioendothelioma, or benign, such as: hemangiomas, lymphangioma, angiolipoma.5 The diagnosis is challenging because the pathology is extremely rare and the radiological findings are not very specific.2 A core needle biopsy can be used to confirm the diagnosis.5 However, excision should be considered to exclude possible angiosarcoma, which is a malignant tumor that originates from vascular lining endothelial cells.Hemangiomas are benign vascular tumors. They are common in early and middle childhood, but are extremely rare when they appear in the breast, representing approximately 0.4% of breast tumors.9,10 The aim of this case report is a retrospective, cross-sectional study, analyzing the medical records of a patient with a vascular neoplasm of the breast with atypia in the initial analysis, defined as a breast hemangioma without atypia after complete excision and immunohistochemical complementation. The data reported was obtained by accessing the patient's medical records. A bibliographic review was carried out on the PubMed, Scielo, Google Scholar, Sociedade Brasileira De Mastologia Regional São Paulo and FEBRASGO - Federação Brasileira das Associações de Ginecologia e Obstetrícia research platforms. The clinical case describes a vascular neoplasm in the left breast in a 49-year-old female patient who, after investigation, underwent complete excision of the lesion with a safety margin. This is a rare and unusual case with a final diagnosis of breast hemangioma. The patient's post-operative evolution was favorable and without any complications, and she was discharged from hospital and re-evaluated at the mastology outpatient clinic. Breast hemangioma is a rare, benign and uncommon vascular neoplasm of the breast that can mimic malignant tumors. It is extremely important to carry out a detailed investigation in the event of any alteration, both in the physical examination and in breast screening and diagnosis tests, always with the aim of excluding malignancy, since among vascular neoplasms of the breast we have, for example, angiosarcoma, which has a worse prognosis.As neoplasias vasculares da mama são definidas por lesões vasculares que podem ser localizadas na região extraparenquimatosa (no tecido adiposo subcutâneo), geralmente benignos, ou intraparenquimatoso (à fáscia superficial), o qual a maioria é de caráter maligno.2 São classificadas de acordo com o exame histopatológico que define a característica maligna, como exemplos: angiosarcomas, hemangioendotelioma epitelióide ou, benigna como: hemangiomas, linfangioma, angiolipoma.5 Possui diagnóstico desafiador tendo em vista a patologia ser extremamente rara e seus achados radiológicos serem poucos específicos.2 A biópsia por agulha grossa pode ser utilizada como exame para confirmação do diagnóstico.5 Contudo a excisão deve ser ponderada para exclusão de possível angiossarcoma, o qual, é um tumor maligno, que tem origem em células endoteliais de revestimento vascular. Os hemangiomas são tumorações vasculares benignas. Eles são comuns na primeira e segunda infância, todavia são extremamente raros quando aparecem na mama, representando aproximadamente 0,4% das tumorações mamárias.9,10 O relato de caso tem como objetivo um estudo retrospectivo e transversal, com análise do prontuário do paciente com neoplasia vascular da mama com atipia em análise inicial definida como hemangioma mamário sem atipias após exérese completa e complementação imuno-histoquímica. Os dados relatados foram obtidos por meio do acesso ao prontuário médico do paciente. Fora realizada revisão bibliográfica nas plataformas de pesquisa PubMed, Scielo, Google Acadêmico, Sociedade Brasileira De Mastologia Regional São Paulo, FEBRASGO – Federação Brasileira das Associações de Ginecologia e Obstetrícia. O caso clínico descreve neoplasia vascular na mama esquerda em paciente do sexo feminino de 49 anos, submetida após investigação, à exérese completa da lesão com margem de segurança. Ressalta-se um caso raro e incomum com diagnóstico final de hemangioma mamário. A evolução da paciente no pós-operatório foi favorável e sem qualquer intercorrência, com alta hospitalar e reavaliação médica no ambulatório de mastologia. O hemangioma mamário é uma neoplasia vascular da mama rara, benigna e incomum que pode simular tumores malignos. É de extrema importância a investigação detalhada diante de qualquer alteração tanto no exame físico quanto em exames de rastreio e diagnóstico mamário, sempre com o objetivo de excluir malignidade, uma vez que, dentre as neoplasias vasculares da mama temos por exemplo, o angiosarcoma que possui um pior prognóstico

POLITRAUMA PEDIÁTRICO: RELATO DE CASO

Polytrauma is characterized as multiple injuries to at least two organs or two distinct parts of the body caused by an external force of a physical or chemical nature.2 It is considered the leading cause of death in the first four decades of life.3 Thus, Pediatric Advanced Life Support (PALS) assists in care by standardizing initial care for pediatric polytrauma and defines priorities in the approach.1 The aim of this case report is a retrospective, cross-sectional study, with an analysis of the polytrauma patient's medical records, highlighting the importance of adequate initial care standardized by PALS and its prevention, contributing to a positive prognosis. The data reported was obtained by accessing the patient's medical records and interviewing the patient's mother. A bibliographic review was carried out on the Scielo, Google Scholar, Brazilian Society of Pediatrics periodicals and Pediatric advanced life support (PALS) research platforms. The clinical case describes a pediatric polytrauma victim of a pedestrian-car accident, with pulmonary contusion, right pneumothorax, right rib fracture and right clavicle fracture, in a male patient aged 4 years and 11 months. The initial care was based on the PALS, consisting of a systemic approach to the seriously ill child. Based on this approach, with laboratory tests and imaging exams, the treatment was conservative, with the use of a sling, asymptomatic and oxygen therapy. The outcome was favorable, and the patient was discharged after 5 days in the Intensive Care Unit, with a referral to the attending pediatrician.The case report evaluates pediatric polytrauma, demonstrating the need for a systemic approach, so that it is possible to quickly recognize signs of respiratory distress, respiratory failure and shock, and immediately carry out interventions. In addition, it is necessary to emphasize the need for preventive measures since the majority of pediatric traumas in Brazil are avoidable.O politraumatizado é caracterizado como múltiplas lesões, de ao menos dois órgãos ou duas partes distintas do corpo causadas por força externa de natureza física ou química.2 Sendo o mesmo considerado a principal causa de morte nas primeiras quatro décadas de vida.3 Assim, o Pediatric Advanced Life Support (PALS) auxilia na assistência através da padronização do atendimento inicial ao politraumatizado pediátrico e define prioridades na abordagem. 1O relato de caso tem como objetivo um estudo retrospectivo e transversal, com análise do prontuário do paciente de politrauma; evidenciando a importância do atendimento inicial adequado padronizado pelo PALS e sua prevenção, contribuindo com prognóstico positivo. Os dados relatados foram obtidos por meio do acesso ao prontuário médico do paciente e entrevista à progenitora do mesmo. Fora realizada revisão bibliográfica nas plataformas de pesquisa Scielo, Google Acadêmico, Revistas Periódicas da Sociedade Brasileira de Pediatria e Pediatric advanced life support (PALS). O caso clínico descreve o politraumatizado pediátrico, vítima de atropelamento de carro x pedestre, com presença de: contusão pulmonar; pneumotórax a direita; fratura de costelas a direita e fratura de clavícula a direita, em paciente do sexo masculino, com 4 anos e 11 meses. Ressaltando-se o atendimento inicial fundamentado no PALS, consistindo numa abordagem sistêmica da criança gravemente enferma. A partir desta abordagem, com a realização de exames laboratoriais e exames de imagem, o tratamento realizado foi conservador, instituindo-se uso de tipóia, assintomáticos e oxigenioterapia. A evolução foi favorável, com alta médica após 5 dias de hospitalização em Unidade de Terapia Intensiva, com encaminhamento ao pediatra assistente. Logo, o relato de caso avalia o politraumatizado pediátrico, demonstrando a necessidade de uma abordagem sistêmica, de forma que seja possível reconhecer rapidamente sinais de desconforto respiratório, insuficiência respiratória, choque e realizar, imediatamente, intervenções. Além disso, é necessário ressaltar a necessidade de medidas preventivas uma vez que a maioria dos traumas pediátricos no Brasil são evitáveis

Severe form of lymphocutaneous sporotrichosis: a case report

Sporotrichosis is the most frequent subcutaneous mycosis in Latin America. It is caused by species of the genus Sporothrix. Infection in humans occurs through the entry of the fungus into the skin. Zoonotic outbreaks involving cats in the transmission of the disease have been frequently reported. The lymphocutaneous form is the most commonly observed and the upper limbs are the most affected sites. We report a case of a 64-year-old healthy female patient with a lymphocutaneous form with rapid progression of lesions, which was refractory to initial treatment with itraconazole. Treatment with liposomal amphotericin B was performed with a satisfactory resolution, but aesthetic and functional sequelae in the left upper limb were installed

Incidência de internações por transtornos menstruais e seu impacto na saúde da mulher

Os transtornos da menstruação constituem um conjunto de condições que podem afetar significativamente a regularidade, duração e intensidade do ciclo menstrual feminino. Desde o início da menarca até a transição para a menopausa, o ciclo menstrual é uma parte fundamental da saúde reprodutiva e geral da mulher. Ao quantificar o número de internações relacionadas a esses transtornos, podemos identificar tendências, grupos populacionais mais vulneráveis e lacunas nos serviços de saúde, subsidiando assim políticas e programas direcionados à prevenção, diagnóstico precoce e tratamento adequado. Nesse sentindo, o principal objetivo desse trabalho foi descrever um panorama epidemiológico das internações causadas por transtornos da menstruação no Brasil, no período de 2019 a 2023. Este é um estudo ecológico de séries temporais, que usou dados do Sistema de Informações Hospitalares (SIH) do DATASUS. Essa fonte abrangente oferece uma visão detalhada das internações no Brasil. Através desse estudo demostramos uma redução de 7% nas internações causadas por transtornos da menstruação no Brasil, com o Sudeste sendo responsável pela maioria das internações e custos hospitalares. Além disso, identificamos que mulheres brancas com idade entre 40 a 49 anos foram as mais acometidas. A redução das internações hospitalares causadas por transtornos da menstruação é um indicador importante do progresso na saúde feminina e na eficácia dos sistemas de saúde. Isso não só alivia o ônus sobre os recursos hospitalares, mas também melhora a qualidade de vida das mulheres, permitindo-lhes gerenciar melhor sua saúde menstrual e prevenir complicações graves. Mesmo sendo resultados animadores, é importante continuar investindo em estratégias de prevenção, capacitação de profissionais de saúde e promoção de cuidados de saúde equitativos para garantir que todas as mulheres tenham acesso a cuidados de saúde, seguros e de qualidade

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others

Abstracts from the 20th International Symposium on Signal Transduction at the Blood-Brain Barriers

https://deepblue.lib.umich.edu/bitstream/2027.42/138963/1/12987_2017_Article_71.pd

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men