Forequarter amputation in a patient with locally advanced recurrent breast carcinoma

Forequarter amputation (FQA) involves the removal of the upper limb, clavicle, and scapula and is indicated for the resection of primary or metastatic tumors invading the axillary neurovascular bundle. Reports on breast cancer have associated FQA with the primary resection of a locally advanced tumor, resection of recurrent disease, brachial plexus injury, Stewart-Treves syndrome, or sarcoma secondary to breast cancer irradiation. We described a case of recurrent breast carcinoma with curative-intent surgery. The surgery aimed at locoregional control and improvement in the quality of life. The literature is scarce on the topic, discussing the multiple aspects related to the indication of FQA for breast cancer patients. This report presents the first case described in Latin American literature.

A novel body mass index reference range - an observational study

OBJECTIVE: To generate a new body mass index curve of reference values and ranges for body mass index and weight gain during pregnancy and to compare the new curve and weight gain ranges with the currently used references. METHODS: A prospective observational study was conducted with a total of 5,656 weight and body mass index measurements in 641 women with single pregnancy who attended their first prenatal visit before 12 weeks. All the women were over 18 years old and had no medical conditions that would influence body mass index. Data were collected using prenatal charts and medical records during hospitalization for childbirth. A linear regression method was used for standard curve smoothing in the general population and for specific curves according to the baseline body mass index classification. Curves were obtained for the 5th, 10th, 50th, 85th, 90th and 95th percentiles. Concordance between the classification of women using the newly generated and currently used curves was evaluated by percentages and kappa coefficients. The weight gain was compared with the reference values of the Institute of Medicine using Student's T test. The data were analyzed using SAS software version 9.2, and the significance level was set at 5%. RESULTS: A general reference curve of percentiles of body mass index by gestational age was established. Additionally, four specific curves were generated according to the four baseline body mass index categories. The new general curve offered percentile limits for women according to their initial body mass index and according to the Centers for Disease Control and Prevention limits, showing poor agreement with the currently used curve (48.3%). Women who were overweight or obese when starting prenatal care had higher weight gain than the Institute of Medicine recommendation. CONCLUSIONS: The new proposed curve for body mass index during pregnancy showed weak agreement with the currently used curve. The new curve provided more information regarding body mass index increase using percentiles for general and specific groups of body mass index. Overweight pregnant women showed an upward body mass index trend throughout pregnancy that increased more dramatically than those of other groups of pregnant women, and they also presented a major mean difference between weight gain and the Institute of Medicine recommendation.

A propósito de Ling, da ginástica sueca e da circulação de impressos em língua portuguesa / About the proposal of Ling, Swedish gymnastics and the movement of prints in Portuguese language / A propósito de Ling, de la gimnasia sueca y de la circulación de impresos en lenguaportuguesa

Este artigo analisa o sistema sueco de ginástica criado por P. H. Ling e retoma a trajetória de seu precursor e a vocação do Instituto Central de Ginástica de Estocolmo no papel de preservação e divulgação dos preceitos lingianos. Especificamente, atentamo-nos para a vulgarização e a circulação do método por meio de manuais em língua portuguesa produzidos entre fins do século XIX e início do XX. Tem como fontes os manuais escolares escritos por Pedro Borges, Antonio M. Ferreira, Paulo Lauret e Arthur Higgins. Percebemos neles forte inspiração na ginástica sueca, revelada nas lições sistematizadas e na valorização de aspectos como retidão, racionalidade, simetria, correção, educação da vontade e aperfeiçoamento físico.

This article analyzes the Swedish gymnastic system created by P. H. Ling. It resumes the trajectory of its precursor and the vocation of the Stockholm Gymnastic Central Institute for the preservation and divulgation of the "lingian" precepts. The focus is, specifically, on the vulgarization and circulation of the method through Portuguese textbooks that were published in late nineteenth-century and early twentieth-century. The main sources were the textbooks written by Pedro Borges, Antonio M. Ferreira, Paulo Lauret e Arthur Higgins. It was observed in these textbooks a strong inspiration on the Swedish gymnastic, revealed in their systematic lessons, and in the value put on the rectitude, rationality, symmetry, accuracy, education of the will and physical improvement.

El siguiente artículo analiza el sistema sueco de gimnasia creado por P. H. Ling, retomando la trayectoria de su precursor y la vocación del Instituto Central de Gimnasia de Estocolmo en el papel de preservación y difusión de los preceptos y supuestos "lingianos". Específicamente, nos centramos en la popularización y la circulación del método sueco a través de manuales en lengua portuguesa producidos entre fines del siglo XIX y principios del XX, tomando como fuentes primarias los manuales escolares escritos por Pedro Borges, Antonio M. Ferreira, Paulo Lauret y Arthur Higgins. Identificamos en ellos una fuerte inspiración en la gimnasia sueca, revelados en las lecciones sistematizadas y en la valorización de aspectos tales como la rectitud, la racionalidad, la simetría, la corrección, la educación de la voluntad y el perfeccioamiento físico.

Efeitos da continuidade do treinamento da hidrocinesioterapia sobre o perfil lipídico, a composição corporal e o VO2máx de mulheres ativas na pós-menopausa / Effects of the continuation of hydrotherapy training on the lipids profile, body composition and VO2max in active and post-menopausal women

O presente estudo teve por objetivo avaliar o efeito da continuidade do treinamento de hidrocinesioterapia sobre o perfil lipídico, a composição corporal e o consumo de oxigênio (VO2máx) de mulheres ativas, pós-menopausa. Para este estudo longitudinal, a amostra foi composta de 13 mulheres praticantes de hidrocinesioterapia (idade = 54 ± 7 anos). As variáveis foram comparadas em um intervalo de 18 meses: índice de massa corporal (IMC), percentual de gordura (%G), coeficiente cintura-quadril (CQ), VO2máx, perfil lipídico e glicose. Os testes t dependente e de Wilcoxon não apresentaram diferença significativa (p < 0,05). Na correlação de Spearman, foi observada correlação significativa entre: IMC e %G (r = 0,657; p = 0,0001); IMC e CQ (r = 0,587; p = 0,002); IMC e VO2máx (r = -0,497; p = 0,010); %G e CQ (r = 0,450; p = 0,021); %G e VO2máx (r = -0,417; p = 0,034); CQ e VO2máx (r = -0,448; p = 0,022); CQ e HDL (r = -0,417; p = 0,034); glicose e IMC (r = 0,427; p = 0,029); glicose e %G (r = 0,445; p = 0,023) e CT e LDL (r = 0,705; p = 0,0001). O presente estudo observou na amostra analisada, que mulheres ativas, pós-menopausa, apesar da obesidade moderada (pelo %G), apresentaram, ao longo do tempo, uma estabilidade da composição corporal, do perfil lipídico, da glicose e do VO2máx, tendo revelado estes valores dentro dos parâmetros de normalidade.

This study aimed to assess the effect of the continuity of hydrotherapy training on the lipid profile, body composition and consumption of oxygen (VO2max) of active women, post-menopause. In this longitudinal study, the sample was composed of 13 women practitioners of hydrotherapy (age = 54 ± 7 years). The variables were compared in a range of 18 months: body mass index (BMI), percentage of fat (%G), waist-hip coefficient (WH), VO2max, lipid profile and glucose. The dependent t tests and Wilcoxon showed no significant difference (p < 0.05). In a Spearman correlation was observed significant correlation between: BMI and %fat (r = 0.657; p = 0.0001); BMI and WH (r = 0.587; p = 0.002); BMI and VO2max (r = -0.497; p = 0.010); %G and WH (r = 0.450; p = 0.021); %fat and VO2max (r = -0,417; p = 0.034); WH and VO2max (r = -0.448; p = 0.022); WH and HDL (r = -0.417; p = 0.034); glucose and BMI (r = 0.427; p = 0.029); glucose and %fat (r = 0.445; p = 0.023) e TC and LDL (r = 0.705; p = 0.0001). This study noted, in this sample, that active and post-menopausal women, despite the moderate obesity, had, over time, a stable body composition, lipid profile, glucose and VO2max, having disclosed these values within the parameters of normality.