Double-lumen Aortic Arch: Persistence of the Fifth Aortic Arch?

Abstract Double-lumen aortic arch is a rare congenital anomaly related to persistence of the fifth aortic arch. It may be found alone or in association with other anatomical changes of the heart. We report a case of double-lumen aortic arch associated with coarctation of the aorta and patent ductus arteriosus in a child with a congenital malformation known as the VACTERL association (vertebral defects, imperforate anus, cardiopathy, tracheoesophageal fistula, renal abnormalities and limb anomalies).

Fibroadenoma in axillary accessory breast: a case report

The mass are among the possible alterations observed in the axilla. When found, the most frequent differential diagnosis are lymphadenopathy, metastatic lymphadenomegaly, lymphoma, lipoma or tumors in the apocrine glands. Besides that, the presence of accessory breast tissue must also be considered and, as the topical breast tissue, can be the target of breast diseases, either benign or malignant. Female patient, 23 years old, with the presence of hardened palpable node in the right axilla. At the ultrasound, it presented characteristics that classified it as Bi-Rads® 4. An aspiration biopsy of the node was performed with fine-needle, which resulted in unsatisfying material. After the explanation of the therapeutic choices, the patient opted for the excision of the axillary node. The anatomical pathological result showed a nodular formation compatible with fibroadenoma. The occurrence of a node in the axillary region is common. However, in the vast majority of times, it is merely an inflammatory response, manifested as a lymphadenomegaly. In case of chronic mass with suspicious characteristics, it is convenient to suspect the presence of lymphoid neoplasms, locoregional metastasis of breast cancer or melanoma and alterations in accessory breast tissue. In young patients, it is important to evaluate the existence of accessory breast tissue with the presence of suspicious axillary node, because, although controversial, some authors believe that such alterations occur more frequently in these patients. Additionally, in cases of inconclusive imaging, an excision of the lesion must be performed for a definite diagnosis.

Routine mammography: an opportunity for the diagnosis of chronic degenerative diseases? A cross-sectional study / Mamografia de rotina: oportunidade para o diagnóstico de doenças crônicas degenerativas? Um estudo transversal

Abstract Objective: The aim of this study was to evaluate breast arterial calcification (BAC) detected on routine mammography, analyzing its association with chronic degenerative disease. Materials and Methods: This was a cross-sectional study involving women treated at a specialized outpatient clinic for high-risk hypertension, diabetes, or chronic kidney disease, as well as volunteers who participated in a study to validate a method of screening for occult renal disease. A total of 312 patients between 40 and 69 years of age, with no history of breast cancer, all of whom had undergone routine mammography in the last two years, were included. The mammograms were analyzed by researchers who were unaware of the risk factors for BAC in each case. Results: The mean age was 55.9 ± 7.4 years, and 64.3% of the patients were white. The mean glomerular filtration rate was 41.87 ± 6.23 mL/min/1.73 m2. Seventy-one patients (22.8%) had BAC. We found that BAC was associated with advanced age, hypertension, diabetes, chronic kidney disease, and low glomerular filtration rate. In the multivariate analysis, advanced age and diabetes continued to be associated with BAC. The odds ratio for BAC was higher for all chronic diseases. Conclusion: The association of BAC with advanced age, hypertension, diabetes, chronic kidney disease, and low glomerular filtration rate should call the attention of radiologists. Therefore, the presence of BAC should be reported, and patients with BAC should be screened for those diseases.

Resumo Objetivo: O objetivo deste estudo foi avaliar calcificações arteriais mamárias (CAMs) detectadas em mamografia de rotina e analisar sua associação com doenças crônicas degenerativas. Materiais e Métodos: Estudo transversal com mulheres atendidas em um ambulatório especializado para tratamento de hipertensão de alto risco, diabetes ou doença renal crônica, bem como as voluntárias que participaram de um estudo para validar um escore para triagem de doença renal crônica oculta. Trezentas e doze pacientes entre 40 e 69 anos de idade, sem histórico de câncer de mama, com mamografia realizada nos últimos dois anos foram incluídas. Os pesquisadores, que desconheciam os fatores de risco para CAMs, analisaram as mamografias de rotina. Resultados: A média de idade foi 55,9 ± 7,4 anos, 64,3% brancas. A média da taxa de filtração glomerular foi 41,87 ± 6,23 mL/min/ 1,73 m2. Setenta e uma participantes (22,8%) apresentavam CAMs. Houve associação entre CAMs e idade, hipertensão, diabetes, doença renal crônica e taxa de filtração glomerular. Na análise multivariada, idade e diabetes persistiram associadas a CAMs. O odds ratio entre CAMs versus doenças crônicas foi elevado. Conclusão: Houve associação entre CAMs com a idade, hipertensão, diabetes, doença renal crônica e taxa de filtração glomerular. Esta associação chama a atenção do radiologista/clínico, para que a presença dessas alterações deva ser relatada, e essas doenças devam ser triadas nestes pacientes.

Perfil das usuárias de um banco de leite humano, em Juiz de Fora, MG / Characteristics of mothers attended at a human milk bank, in Juiz de Fora, MG

Com objetivo de conhecer o perfil socioeconômico das mães usuárias do Banco de Leite Humano (BLH) de Juiz de Fora, MG, assim como suas motivações e demandas, quando na busca pelos serviços oferecidos pela institui- ção, realizou-se uma pesquisa transversal, aplicada, de objetivo exploratório, realizada no BLH, na qual foram avaliados 47 binômios mãe-filhos que buscaram o serviço. A maioria das mães era casada, possuía nível médio ou superior, emprego com direitos trabalhistas e realizou o pré- -natal, em serviço de saúde privado. O aleitamento materno exclusivo foi adotado pela maioria dos binômios (62%) e orientado por profissionais de saúde em 66%. Houve baixa prevalência de procura pelo BLH por usuárias de serviço público (23%). A procura ao BLH foi motivada por problemas associados ao aleitamento, em sua maioria (85,1%). Assim, o estudo indica como ação importante para as equipes das unidades de Atenção Primária intensificar a orientação à população de gestantes e puérperas em direção à busca aos serviços do BLH, tanto como forma de promoção do aleitamento materno e apoio ao mesmo nessa população, quanto para possível captação de doadoras.

To identify the socioeconomic profile of the mothers who sought care at the Human Milk Bank, in Juiz de Fora, MG, as well as their motivations and needs when seeking the services offered by the institution. A cross-sectional, applied, exploratory study was conducted at the milk bank, where 47 mother-child pairs who sought the Milk bank services were assessed. It was noted that the majority of the mothers were married, had a secondary or higher level of education, had a job with labor rights, and had done prenatal care in a private health service. Exclusive breastfeeding was adopted by most of the motherchild pairs analyzed (62%), mostly guided by health care professionals (66%). There was a low prevalence of mothers seeking milk bank care by users of the public service (23%). The demand for the milk bank was mostly motivated by problems associated with breastfeeding (85.1%). Thus the study shows that teams of primary care units should intensify their guidance to expectant and post-partum mothers to seek out the milk bank services, both to promote breastfeeding in this population and to identify potential human milk donors.