Conservatively Treated Mesenteric Vein Thrombosis in a 48-Year-Old Obese Female: A Case Report.

Mesenteric vein thrombosis (MVT) is a rare pathological entity that results in compromised venous return from the intestine due to involvement, in most cases, of the superior mesenteric vein. Its diagnosis is not straightforward, since the findings on physical examination are often disproportionate to the patient's pain complaints, leading to it being undervalued by clinicians. The patient is a 48-year-old female with a medical history of essential arterial hypertension, dyslipidemia, class II obesity, and Hashimoto's thyroiditis. She also had a family history of gastric and colon cancer, with an age at diagnosis of over 70 years. She went to an appointment at a primary care facility for abdominal pain located in the left hypochondrium and flank, with ipsilateral lumbar irradiation and no other accompanying symptoms. Physical examination revealed a globose, depressible abdomen, painful on palpation of the left quadrants, with no other associated signs of peritoneal irritation. Due to suspicion of acute diverticulitis, the patient was referred to the emergency department (ED) for assessment by general surgery. In the emergency department, given the patient's body type and the fact that the physical examination findings were disproportionate to her symptoms, an abdominal and pelvic computed tomography (CT) scan was ordered, which revealed complete thrombosis of the entire length of the inferior mesenteric vein, with a focal extension of the thrombus, partially obstructing the confluence with the superior mesenteric and portal veins. Various complementary diagnostic tests were requested, which revealed no clinically significant findings, and obesity was therefore identified as the only risk factor. In this context, the patient started anticoagulation with warfarin, with the indication that it should be ad aeternum. To date, the patient remains asymptomatic, and there have been no new thrombotic events. Given the high morbidity and mortality rates of this pathological entity, it is imperative that clinicians are trained to recognize the typical signs of mesenteric venous thrombosis, in the characteristic epidemiological context, in order to establish a timely diagnosis and carry out early targeted therapeutic intervention.

Evaluation of extra-narrow diameter implants in the oral rehabilitation of young patients after oral trauma: A prospective study.

BACKGROUND/AIM: Oral trauma is a common event in young patients and can lead to tooth loss, especially after avulsion of a tooth. The aim of this study was to evaluate the survival, esthetic outcomes, ridge preservation, and patient satisfaction of extra-narrow diameter implants (NDIs) as a temporary rehabilitation treatment for young patients who had lost permanent maxillary incisors after an avulsion. MATERIALS AND METHODS: This study comprised a prospective clinical and experimental study on a case series of 13 patients (age: 10-14 years) with a history of avulsion of one or more maxillary incisors. The patients received 19 mini-drive locks implants (Intralock) with acrylic resin crowns, divided into two evaluation arms: immediate implant placement (n = 10) and delayed implant placement (n = 9). The cases were followed up every 3 months with an initial tomography (T0) before implant placement and after 1 year (T1). The clinical stability of the implant in the bone and the retention of the provisional implant crown were evaluated, and the esthetic index was calculated at each follow-up. Intragroup and intergroup differences in alveolar ridge height and thickness were compared at T0 and T1, and a questionnaire was administered to assess the patient's perception of the treatment. RESULTS: The implant survival rate after 1 year was 78.9%. Alveolar ridge height and thickness increased in all cases at T1 (p < .05). Patients who received immediate implants had greater initial and final alveolar ridge thickness. The esthetic index progressively increased over the investigated time period (p = .001). Only one female patient presented with crown infraocclusion after 1 year. The patients' esthetic perceptions of their smiles significantly improved after treatment (p = .001). CONCLUSIONS: Extra-NDI had good survival rates, were effective at maintaining alveolar bone, and promoted aesthetic recovery and patient satisfaction with treatment during the period studied.

Lesão por pressão relacionada a dispositivos médicos: prevenção e fatores de risco associados / Lesión por presión relacionada con dispositivos médicos: prevención y factores de riesgo asociados / Pressure injury related to medical devices: prevention and associated risk factors

Introdução: A lesão por pressão é encontrada na pele ou tecido subjacente, geralmente sobre uma proeminênciaóssea, resultante da exposição à pressão ou forças de cisalhamento, possuindo fatores intrínsecos e extrínsecos: imobilidade, inconsciência, perda da continência urinária e fecal, deficiência nutricional, doenças crônico degenerativas, peso e relacionados a dispositivos médicos. Objetivo: Descrever a prevenção e fatores de risco para Lesão por pressão relacionadas à dispositivos médicos. Método: Revisão integrativa de literatura, entre 201 O a 2020 nas bases de dados LILACS, PubMed, Bdenf e site de busca Scielo. Resultados: Foram incluídos nove estudos, sendo: quatro (44,4%) publicações que descrevem os principais dispositivos relacionados a estas lesões. Conclusão: Foi descrito os fatores associados ao desenvolvimento de Lesões por Pressão Relacionadas a Dispositivos Médicos e como preveni-las, identificando quais os dispositivos de risco, e medidas de prevenção e tratamento, cuidados específicos e eficazes por meio dos profissionais de enfermagem na prevenção e tratamento(AU)

lntroduction: Pressure injury is found in the skin or underlying tissue, usually over a bony prominence, resulting fromexposure to pressure or shear forces, having intrinsic and extrinsic factors: immobility, unconsciousness, loss of urinary and fecal continence, nutritional deficiency, chronic degenerative diseases, weight and related to medical devices. Objective: To describe the prevention and risk factors for Pressure lnjury related to medical devices. Method: lntegrative literature review, between 201 O and 2020 in LILACS, PubMed, Bdenf and Scielo search engine databases. Results: Nine studies were included: four (44,4%) publications describing the main devices related to these injuries. Conclusion: The factors associated with the development of Pressure Injuries Related to Medical Devices and how to prevent them were described, identifying which are the risk devices, and prevention and treatment measures, specific and effective care through nursing professionals in prevention and treatment.(AU)

lntroducción: La lesión por presión se encuentra en la piei o tejido subyacente, generalmente sobre una prominenciaósea, como resultado de la exposición a fuerzas de presión o cizallamiento, teniendo factores intrínsecos y extrínsecos: inmovilidad, inconsciencia, pérdida de continencia urinaria y fecal, deficiencia nutricional, crónico degenerativo. enfermedades, peso y relacionados con dispositivos médicos. Objetivo: Describir la prevención y los factores de riesgo de las lesiones por presión relacionadas con los dispositivos médicos. Método: Revisión integrativa de la literatura, entre 201 O y 2020 en las bases de datos de los motores de búsqueda LILACS, PubMed, Bdenf y Scielo. Resultados: Se incluyeron nueve estudios: cuatro (44,4%) publicaciones que describen los principales dispositivos relacionados con estas lesiones. Conclusión: Se describieron los factores asociados ai desarrollo de Lesiones por Presión Relacionadas con Dispositivos Médicos y cómo prevenirias, identificando cuáles son los dispositivos de riesgo, y las medidas de prevención y tratamiento, atención específica y efectiva a través de profesionales de enfermería en prevención y tratamiento.(AU)

Diagnóstico e tratamento de úlcera hipertensiva de Martorell: artigo de revisão / Diagnóstico y tratamiento de la úlcera hipertensiva de Martorell: artículo de revisión / Diagnosis and treatment of Martorell's hypertensive ulcer: review article

Introdução: A úlcera hipertensiva de Martorell é uma ferida crônica, associada a hipertensão arterial sistêmica, dedifícil manejo clínico e subdiagnosticada. Objetivo: Investigar os métodos de diagnóstico e os tratamentos existentes para a UHM. Método: Estudo descritivo e qualitativo de revisão integrativa com a análise sistemática de referências bibliográficas nas bases de dados PubMed, SciELO, MEDLINE e LILACS no período de 2016 e 2021, e periódicos da CAPES. Resultados: Clinicamente o paciente apresenta uma ferida pequena, de forma arredondada, superficial, com margens necróticas e cianóticas e eritema perilesional eventual. Os pulsos distais usualmente estão presentes e há ausência de edema e varizes locais. De todos os sinais e sintomas relatados, destaca-se a dor, descrita como intensa e desproporcional à sua dimensão. Conclusão: O cerne ao diagnóstico é avaliação clínica e o tratamento é a normalização da pressão arterial sistêmica e curativos regulares e, uso de analgésicos, antibióticos e vasodilatadores periféricos.(AU)

lntroduction: Martorell's hypertensive ulcer is a chronic wound, associated with systemic hypertension withdifficult clinicai management and it is often underdiagnosed. Goal: To investigate the diagnostic method and current treatments for Martorell's hypertensive ulcer disease. Method: A descriptive and qualitative study of integrative literature review with a systematic analysis of bibliographic references from PubMed, SciELO, MEDLINE and LILACS databases, ranging from 2016 to 2021, as well as selected articles from CAPES journals. Results: patients usually present with a small, rounded and superficial wound with cyanotic and necrotic edges and occasional perilesional erythema. Distal pulses are usually present and there is an absence of edema and local varicose veins. From all the signs and symptoms reported by patients with this type of injury, it is possible to point out that the pain is intense and disproportionate to its dimension. Conclusion: The core of diagnosis is the clinicai evaluation and the treatment is controlled systemic blood pressure, regular bandages and, if needed, analgesics, antibiotics and peripheral vasodilators. (AU)

lntrodución: La úlcera hipertensiva de Martorell es una herida crónica, asociada a la hipertensión arterial sistémica,de difícil manejo clínico y muchas veces subdiagnosticada. Objetivo: Investigar los métodos de diagnóstico y tratamientos existentes para este tipo de lesión. Método: Se realizá un análisis sistemático de referencias bibliográficas en las bases de datas PubMed, SciELO, MEDLINE y LILACS en el período de publicación entre 2016 y 2021, además de artículos seleccionados de revistas CAPES. Resultados: Clínicamente el paciente suele presentarse con una pequena herida, redondeada, superficial, con márgenes necróticos y cianóticos con eritema perilesional ocasional. Los pulsos distales suelen estar presentes y hay ausencia de edema y venas varicosas locales. De todos los signos y síntomas reportados por los pacientes con este tipo de lesiones, se destaca el dolor, que se describe como intenso y desproporcionado con la zona de la herida y su tamafio. Conclusión: La base dei tratamiento es la normalización de la presión arterial sistémica y los apósitos regulares y, si necesario, analgésicos, antibióticos y vaso dilatadores periféricos(AU)

Enfermeiro: ator no empreendedorismo social / Nurse: actor in social entrepreneurships

Introdução: O empreendedor social é um agente de mudanças que inspira outras pessoas a se engajarem em torno de uma causa comum e corrobora com a melhoria de ambientes onde os recursos são escassos. O enfermeiro realiza o empreendedorismo social, uma vez que busca soluções inovadoras e busca a sustentabilidade social. Objetivo: discutir o papel do Enfermeiro como ator no empreendorismo social. Método: Estudo descritivo e qualitativo de revisão integrativa de literatura nas bases de dados Pubmed, Lilacs, Scielo e indexador Spell, entre 2010 a 2020 sobre empreendedorismo social e enfermagem. Resultados: Foram encontradas vinte pesquisas, do qual 25% retrata as características empreendedoras de acadêmicos, docentes e enfermeiros; 25% aborda o empreendedorismo na formação dos enfermeiros; 15% dos estudos trazem informações nacionais e internacionais sobre a temática. Conclusão: É essencial discutir sobre o papel do enfermeiro enquanto empreendedor social, sua formação e atuação para seu empoderamento na assistência de saúde.(AU)

Introduction: The social entrepreneur is an agent of change that inspires others to engage around a common cause and supports the improvement of environments where resources are scarce. Nurses carry out social entrepreneurship, as they seek innovative solutions and seek social sustainability. Objective: to discuss the role of the nurse as an actor in social entrepreneurship. Method: Descriptive and qualitative study of an integrative literature review in Pubmed, Lilacs, Scielo and Spell indexer databases, between 2010 and 2020 on social entrepreneurship and nursing. Results: Twenty researches were found, of which 25% portray the entrepreneurial characteristics of academics, teachers and nurses; 25% addresses entrepreneurship in the training of nurses; 15% of the studies bring national and international information on the subject. Conclusion: It is essential to discuss the role of nurses as social entrepreneurs, their training and performance for their empowerment in health care.(AU)

El emprendedor social es un agente de cambio que inspira a otras personas a involucrarse en una causa común. El enfermero realiza emprendimiento social al buscar soluciones innovadoras y la sostenibilidad social. Objetivo: discutir el rol del enfermero como actor en el emprendimiento social. Método: Estudio descriptivo y cualitativo de revisión integradora de literatura sobre emprendimiento social y enfermería en las bases de datos Pubmed, Lilacs, Scielo y Spell index, entre 2010 y 2020. Resultados: Se encontraron veinte encuestas, de las cuales el 25% retrata las características emprendedoras de académicos, docentes y enfermeros; El 25% aborda el espíritu empresarial en la formación de enfermeros; El 15% de los estudios aportan información nacional e internacional sobre el tema. Conclusión: Discutir sobre el rol del enfermero como emprendedor social, su formación y desempeño para que estos profesionales se empoderen en el cuidado de la salud.(AU)

High rates of undiagnosed vascular cognitive impairment among American Indian veterans.

As data on prevalence and etiology of dementia in American Indians are limited, we sought to determine rates and patterns of memory loss among American Indian veterans with vascular risk factors. Sixty consecutive outpatient American Indian veterans with a mean age of 64 years (range 50-86), without prior dementia or mild cognitive impairment (MCI), and with ≥ 2 vascular risk factors were enrolled. The Montreal Cognitive Assessment (MoCA) and the Beck Depression Inventory-II were used to screen for cognitive impairment and depression. Patients with MoCA scores < 26 were referred for additional evaluation, including imaging, serology, and neuropsychological testing. Overall rates, types, and distribution of cognitive impairment were determined. Most prevalent vascular risk factors included hypertension (92%), hyperlipidemia (88%), diabetes (47%), and smoking (78%). Eight patients (13%) with severe depression were excluded, leaving 23/52 with abnormal MoCA scores (44%, 95%CI 30%-59%). Fifteen completed additional evaluation for memory loss, including four with normal MoCA scores who requested evaluation based on symptoms. Results were adjudicated as normal (4), non-amnestic MCI (4), vascular MCI (5), and vascular dementia (2). These results show that rates of undiagnosed cognitive impairment among American Indian veterans with vascular risk factors exceed rates previously published in non-American Indian cohorts. The most common etiology is vascular. Our findings support the need to improve vascular risk reduction in this understudied population.

Mulheres com câncer de mama: adesão ao tratamento com tamoxifeno / Mujeres con cáncer de mama: adhesión al tratamiento con tamoxifeno / Women with breast cancer: adherence to tamoxifen treatment

RESUMO O objetivo foi identificar a adesão ao tratamento com tamoxifeno em mulheres com câncer de mama e avaliar os fatores que podem estar relacionados à sua aderência. Este estudo foi transversal e quantitativo. Foram entrevistadas 67 mulheres com câncer de mama, atendidas em um ambulatório de mastologia de um Hospital Universitário de Recife, entre abril e julho de 2017. Para obtenção das variáveis independentes foi utilizado um questionário estruturado, elaborado pela própria equipe. Para investigar a adesão ao tamoxifeno optou-se pelo Teste de Morisky e Green e para verificar potenciais fatores influentes na adesão ao tratamento, foi escolhido o questionário "Fatores que podem influenciar a adesão ao tratamento". Os efeitos colaterais do tamoxifeno e as relações afetivas se mostraram pontos sensíveis para adesão, conforme apresentado nos resultados. A taxa de adesão foi de 55,2% e 85,1% das mulheres fazem o tratamento há menos de um ano. O tempo longo da terapia com o tamoxifeno é um preditivo que pode tolher a adesão. A avaliação de potenciais fatores influentes na adesão destaca a relevância das equipes multiprofissionais nesse contexto, pois sua variedade de enfoques torna possível elucidar a efetividade do papel ativo dos indivíduos no processo de reabilitação da saúde.

RESUMEN El objetivo fue identificar la adhesión al tratamiento con tamoxifeno en mujeres con cáncer de mama y evaluar los factores que pueden estar relacionados a su adhesión. Este estudio fue transversal y cuantitativo. Fueron entrevistadas 67 mujeres con cáncer de mama, atendidas en un ambulatorio de mastología de un Hospital Universitario de Recife-Brasil, entre abril y julio de 2017. Para recolección de las variables independientes fue utilizado un cuestionario estructurado, elaborado por el propio equipo. Para investigar la adhesión al tamoxifeno se optó por el Test de Morisky-Green y para verificar potenciales factores influyentes en la adhesión al tratamiento, fue elegido el cuestionario "Factores que pueden influir la adhesión al tratamiento". Los efectos colaterales del tamoxifeno y las relaciones afectivas se mostraron puntos sensibles para la adhesión, conforme presentado en los resultados. La tasa de adhesión fue de 55,2% y 85,1% de las mujeres hacen el tratamiento a menos de un año. El largo tiempo de la terapia con el tamoxifeno es un predictivo que puede perjudicar la adhesión. La evaluación de potenciales factores influyentes en la adhesión destaca la relevancia de los equipos multiprofesionales en este contexto, pues su variedad de enfoques vuelve posible dilucidar la efectividad del papel activo de los individuos en el proceso de rehabilitación de la salud.

ABSTRACT The objective was to identify adherence to tamoxifen treatment in women with breast cancer and to evaluate the factors that may be related to their adherence. This study was transversal and quantitative. Were interviewed 67 women with breast cancer, attended in a mastology outpatient clinic of a University Hospital of Recife, between April and July 2017.To obtain the independent variables, a structured questionnaire was used, elaborated by the team itself. To investigate tamoxifen adherence, the Morisky and Green test was chosen and the questionnaire "Factors that may influence adherence to treatment" was chosen to check potential influencing factors in adherence to treatment. The side effects of tamoxifen and the affective relationships proved to be sensitive points for adherence, as presented in the results. The rate of adherence was 55.2% and 85.1% of women were on treatment for less than a year. The longtime of therapy with tamoxifen is a predictor that may hinder adherence. The evaluation of potential factors influencing adherence highlights the relevance of multiprofessional teams in this context, since its variety of approaches makes it possible to elucidate the effectiveness of the active role of individuals in the process of health rehabilitation.

Effects of low-level laser therapy on bone regeneration of the midpalatal suture after rapid maxillary expansion.

This study evaluated the effect of low-level laser therapy (LLLT) on bone regeneration at the midpalatal suture (MPS) after rapid maxillary expansion (RME), using cone beam computed tomography. Fourteen 8-14-year-old patients with transverse maxillary deficiency underwent RME with a Hyrax-type expander activated with one full turn after installation and two half turn daily activations until achieving overcorrection. Patients were randomly assigned to either a control group (RME alone, n = 4) or an experimental group (n = 10) in which RME was followed by 12 LLLT sessions (GaAlAs, p = 70 mW, λ = 780 nm, Ø = 0.04 cm(2)). Two tomographic images of the MPS were obtained-T0, after disjunction and T1, after 4 months. Bone regeneration was evaluated by measuring the optical density (OD) on the tomographic images using InVivo Dental 5.0 software. Data were analyzed by the paired Student's t test (α = 0.05 %). A statistically significant difference between T0 and T1 OD values was observed in the laser-treated group (p = 0.00), but this difference was not significant in the control group (p = 0.20). Intergroup comparison of OD values at T1 revealed higher OD in the laser-treated group (p = 0.05). In conclusion, LLLT had a positive influence on bone regeneration of the midpalatal suture by accelerating the repair process.

In vitro evaluation of anti-adherence activity of the Ocimum basilicum l. ( basil) extract and of the Coriandrum sativum l. ( coriander) in acrylic surface of removable orthodontic appliances

AIM: The aim of this study is evaluate the antimicrobial activity of the Ocimum basilicum L. (basil) extract and of the Coriandrum sativum L. (coriander) extract in biofilm of Streptococcus mutans colonized in specimens confectioned in acrylic used to confection removable orthodontic appliances. MATERIAL AND METHODS: To perform this work, specimens were confectioned (spherical discs in sterile acrylic) which were immersed in extracts pure and in series dilutions (1:2 a 1:128) by 24, 48 and 72 hours. For each time of exposition, the disintegration of bacterial films was performed by sonication in saline solution. RESULTS: The results obtained were satisfactory for the extracts studied on the inhibition of biofilm formation. CONCLUSION: We conclude that polyphenols present in the extracts interfered on the glucan synthesis engine, possibly inhibiting the enzymes (glucosyl- and fructosyl transferase) which synthesize the extracellular polymers, also acting as antioxidant, and therewith they presented antimicrobial activity.

An unusual case of an isolated capitellar fracture of the right elbow in a child: a case report.

INTRODUCTION: Although elbow fractures have a high incidence in the pediatric population, fractures of the capitellum are almost exclusively observed in individuals older than 12 years of age. Due to their rarity in children, reports with large numbers of cases are lacking in the literature and the surgical treatment options are poorly defined. CASE PRESENTATION: We present the case of an 11-year-old Portuguese girl with a displaced fracture of the capitellum of the right elbow, a typical Hahn-Steinthal or Type 1 fracture, which was followed for one year. The treatment and outcome of this fracture are described. Our patient underwent an open reduction and internal fixation with two cannulated screws. There were no complications and normal elbow function was recovered. CONCLUSION: The authors believe that cannulated screw fixation is a reliable method of treatment for Type 1 capitellar fracture in children because it enables good interfragmentary compression, early mobilization, faster functional elbow recovery and implant removal is rarely necessary.

Tumor miofibroblástico inflamatório peritonial: revisão da literatura / Peritoneal inflammatory myofibroblastic tumor: a literature review

Introdução: o tumor miofibroblástico inflamatório (tmi) ao longo das últimas duas décadas saiu de dentro da grande categoria de pseudotumor inflamatório, devido as suas distintas características clínicas, patológicas e moleculares, o pseudotumor é um termo genérico aplicado a uma variedade de entidades neoplásicas e não neoplásicas que compartilham uma aparência histológica em comum, ou seja, uma proliferação de células citologicamente parecida, geralmente com infiltrado inflamatório crônico...

Tumor miofibroblástico inflamatório peritonial: revisão da literatura

Introdução: o tumor miofibroblástico inflamatório (tmi) ao longo das últimas duas décadas saiu de dentro da grande categoria de pseudotumor inflamatório, devido as suas distintas características clínicas, patológicas e moleculares, o pseudotumor é um termo genérico aplicado a uma variedade de entidades neoplásicas e não neoplásicas que compartilham uma aparência histológica em comum, ou seja, uma proliferação de células citologicamente parecida, geralmente com infiltrado inflamatório crônico. (...)

Tumor miofibroblástico inflamatório peritonial: revisão da literatura / Peritoneal inflammatory myofibroblastic tumor: a literature review

Introdução: o tumor miofibroblástico inflamatório (tmi) ao longo das últimas duas décadas saiu de dentro da grande categoria de pseudotumor inflamatório, devido as suas distintas características clínicas, patológicas e moleculares, o pseudotumor é um termo genérico aplicado a uma variedade de entidades neoplásicas e não neoplásicas que compartilham uma aparência histológica em comum, ou seja, uma proliferação de células citologicamente parecida, geralmente com infiltrado inflamatório crônico. (...) (AU)

Composição físico-química da merenda escolar municipal de Imperatriz, MA / Physico-chemical composition of school feeding city of Imperatriz, MA

O Programa Nacional de Alimentação Escolar (PNAE) é o mais antigo programa social do Governo Federal Brasileiro e atende milhões de crianças e adolescentes por dia. A merenda escolar representa um atrativo para a freqüência dos alunos matriculados nas escolas públicas, consistindo numa atividade integrada ao ensino, daí sua importância. O presente estudo investiga os parâmetros físico-químicos no que se referem à umidade, cinzas, sais minerais (cálcio, magnésio, ferro, fósforo e potássio), acidez titulável e lipídeos de alguns produtos (arroz, bolacha salgada, achocolatado, canjica de milho, macarrão e leite em pó), que compõem e merenda servida em escolas do município de Imperatriz-MA.