Carcinoma espinocelular da base do chifre, bilateral e simétrico, em vaca com distúrbio hormonal ˗ relato de caso / [Horn-based squamous cell carcinoma, bilateral and symmetrical in cow with hormonal disorder ˗ case report]

Este trabalho tem por objetivo descrever um caso de carcinoma espinocelular da base do chifre, bilateral e simétrico, em uma vaca e discutir a questão hormonal, possivelmente envolvida na patogênese da doença. Tratava-se de uma fêmea bovina, 11 anos, com histórico de emagrecimento progressivo, presença de massas exofíticas na base de ambos os chifres e em anestro por muitos anos. Foi realizada biopsia incisional de ambas as lesões para exame histopatológico e dosagens hormonais. Devido à progressão do quadro clínico, optou-se pela eutanásia, seguida dos exames necroscópico e histopatológico. O exame histopatológico revelou tratar-se de um carcinoma espinocelular infiltrativo bem diferenciado, e as dosagens hormonais apresentaram alterações nos níveis do hormônio luteinizante, folículo estimulante e estrógenos totais. Apesar de existirem descrições de carcinomas espinocelulares da base do chifre, ainda não havia relatos da ocorrência do mesmo bilateral e em uma vaca com distúrbios hormonais.(AU)

The objective of this study was to describe a case of bilateral and symmetrical squamous cell carcinoma from the horn base in a cow and to discuss the hormonal question, possibly involved in its pathogenesis. A 11-year-old beef cow presenting a history of progressive thinning, presence of exophytic masses at the base of both horns and anestrous for many years was assisted. An incisional biopsy of both lesions was performed for histopathological examination and hormonal dosages. Due to the clinical progression, euthanasia followed by necroscopic and histopathological examination was carried out. Histopathological examination revealed a well differentiated infiltrative squamous cell carcinoma and the hormonal dosages presented changes in luteinizing hormone, follicle stimulating and total estrogen levels. Although there are descriptions of basal squamous cell carcinoma of the horn, there were still no reports of the occurrence of the same bilateral in a cow with hormonal disorders.(AU)

Promoção dos direitos da criança e prevenção de maus tratos infantis / Promotion of children's rights and prevention of child abuse

Resumo A violência praticada contra crianças é tema complexo e polissêmico. Estudo de coorte retrospectiva buscou caracterizar o perfil das crianças vítimas de violência doméstica e de seus agressores e avaliar a eficácia das intervenções judiciais. Analisou-se 98 processos da Vara da Infância e Juventude, envolvendo 179 crianças e 121 agressores. Negligência/abandono e violência física foram as violações mais frequentes. Revelou-se a mãe como principal agressora; renda mensal de até um salário mínimo e história de uso de álcool mostraram-se associados à violência. Encontrou-se 71% das vítimas matriculadas em instituições de ensino. Em 25% a gravidade da situação determinou o afastamento da família. Um terço das crianças foram incluídas em programas de apoio, orientação e acompanhamento à família. A intervenção judicial garantiu 93% de interrupção da violência em até dois anos, tempo ainda longo, pelo risco da criança ser revitimizada. Ações efetivas pressupõem o envolvimento da família, da sociedade, das instituições escolares e de saúde. A garantia de direitos tem na execução das políticas públicas, e não na judicialização, o lócus privilegiado de efetivação.

Abstract Child abuse is a complex, multi-faceted and controversial topic. A retrospective cohort study aimed to characterize the profile of children victims of domestic violence and their aggressors and to evaluate the efficiency of judicial interventions. Ninety-eight cases lodged with the Infancy and Childhood Court involving 179 children and 121 perpetrators were analyzed. Negligence/abandonment (62%) and physical violence (30%) were the most frequent violations. Mothers were identified as the most frequent aggressor; monthly income of up to one minimum wage and history of alcohol use have been associated with violence. Seventy-one percent of victims were enrolled in educational institutions. In 25% of the cases the severity of the abuse required the removal of the child from the family. A third of the children were enrolled in official programs designed to provide the family with support, orientation and follow-up. This protective judicial intervention was successful in reducing abuse in 93% of the cases within 2 years. Prevention of child abuse requires the involvement of professionals of multiple fields at an early stage. The promotion and safeguarding of children's rights must come primarily from the implementation of public policy not judicial intervention.

[Promotion of children's rights and prevention of child abuse]. / Promoção dos direitos da criança e prevenção de maus tratos infantis.

Child abuse is a complex, multi-faceted and controversial topic. A retrospective cohort study aimed to characterize the profile of children victims of domestic violence and their aggressors and to evaluate the efficiency of judicial interventions. Ninety-eight cases lodged with the Infancy and Childhood Court involving 179 children and 121 perpetrators were analyzed. Negligence/abandonment (62%) and physical violence (30%) were the most frequent violations. Mothers were identified as the most frequent aggressor; monthly income of up to one minimum wage and history of alcohol use have been associated with violence. Seventy-one percent of victims were enrolled in educational institutions. In 25% of the cases the severity of the abuse required the removal of the child from the family. A third of the children were enrolled in official programs designed to provide the family with support, orientation and follow-up. This protective judicial intervention was successful in reducing abuse in 93% of the cases within 2 years. Prevention of child abuse requires the involvement of professionals of multiple fields at an early stage. The promotion and safeguarding of children's rights must come primarily from the implementation of public policy not judicial intervention.

A violência praticada contra crianças é tema complexo e polissêmico. Estudo de coorte retrospectiva buscou caracterizar o perfil das crianças vítimas de violência doméstica e de seus agressores e avaliar a eficácia das intervenções judiciais. Analisou-se 98 processos da Vara da Infância e Juventude, envolvendo 179 crianças e 121 agressores. Negligência/abandono e violência física foram as violações mais frequentes. Revelou-se a mãe como principal agressora; renda mensal de até um salário mínimo e história de uso de álcool mostraram-se associados à violência. Encontrou-se 71% das vítimas matriculadas em instituições de ensino. Em 25% a gravidade da situação determinou o afastamento da família. Um terço das crianças foram incluídas em programas de apoio, orientação e acompanhamento à família. A intervenção judicial garantiu 93% de interrupção da violência em até dois anos, tempo ainda longo, pelo risco da criança ser revitimizada. Ações efetivas pressupõem o envolvimento da família, da sociedade, das instituições escolares e de saúde. A garantia de direitos tem na execução das políticas públicas, e não na judicialização, o lócus privilegiado de efetivação.

Fluoride gel supplemented with sodium hexametaphosphate reduces enamel erosive wear in situ.

OBJECTIVE: This study evaluated the effect of fluoride gels, supplemented or not with sodium hexametaphosphate (HMP), on enamel erosive wear in situ. METHODS: Twelve healthy volunteers wore palatal appliances containing four bovine enamel discs. Subjects were randomly allocated into four experimental phases (double-blind, crossover protocol) according to the gels: Placebo (no fluoride or HMP), 1% NaF, 2% NaF, and 1% NaF+9% HMP. Enamel discs were selected after polishing and surface hardness analysis, and treated only once with the respective gels prior to each experimental phase. Erosion (ERO) was performed by extra-oral immersion of the appliance in 0.05M citric acid, pH 3.2 (four times/day, five minutes each, 5 days). Additional abrasion (ERO+ABR) was produced on only two discs by toothbrushing with fluoridated dentifrice after ERO (four times/day, 30s, 5 days). The specimens were submitted to profilometry and hardness analysis. The results were analyzed by two-way ANOVA and the Student-Newman-Keuls test (p<0.05). RESULTS: The 1% NaF+9% HMP gel promoted significantly lower enamel wear for ERO compared to the other groups, being statistically lower than 1% NaF and Placebo for ERO+ABR. Similarly, the lowest values of integrated lesion area were found for 1% NaF+9% HMP and 2% NaF, respectively, for ERO and ERO+ABR. CONCLUSION: The addition of HMP to the 1% NaF gel promoted greater protective effect against ERO and ERO+ABR compared to the 1% NaF gel, achieving similar protective levels to those seen for the 2% NaF gel. CLINICAL SIGNIFICANCE: Gel containing 1% NaF+9% HMP showed a high anti-erosive potential, being a safer alternative when compared to a conventional 2% NaF gel.

A direct action for GH in improvement of oocyte quality in poor-responder patients.

Declining female fecundity at later age and the increasing tendency for women to delay childbirth have lead to a drastic rise in the number of women seeking assisted reproductive technology. Many women fail to respond adequately to standard ovarian stimulation regimens, raising a significant therapeutic challenge. Recently, we have demonstrated that the administration of GH, as an adjunct to ovarian stimulation, has improved the clinical outcomes by enhancing the oocyte quality. However, the mechanism(s) by which GH facilitated this improvement is yet to be understood. This study aimed to determine these potential mechanism(s) through the use of immunofluorescent localisation of GH receptors (GHRs) on the human oocyte and unbiased computer-based quantification to assess and compare oocyte quality between women of varying ages, with or without GH treatment. This study demonstrates for the first time, the presence of GHRs on the human oocyte. The oocytes retrieved from older women showed significant decrease in the expression of GHRs and amount of functional mitochondria when compared with those from younger patients. More interestingly, when older patients were treated with GH, a significant increase in functional mitochondria was observed in their oocytes. We conclude that GH exerts a direct mode of action, enabling the improvement of oocyte quality observed in our previous study, via the upregulation of its own receptors and enhancement of mitochondrial activity. This result, together with recent observations, provides scientific evidence in support of the use of GH supplementation for the clinical management of poor ovarian response.

Characterization, sensorial evaluation and moisturizing efficacy of nanolipidgel formulations.

BACKGROUND: Nanostructured lipid carriers (NLC) have been widely studied for cosmetic and dermatological applications due to their favourable properties that include the formation of an occlusive film on the skin surface that reduces the transepidermal water loss (TEWL) and increase in water content in the skin which improves the appearance on healthy human skin and reduces symptoms of some skin disorders like eczema. OBJECTIVE: The main objective of this study was the development of semisolid formulations based NLC with argan oil or jojoba oil as liquid lipids, by addition of Carbopol®934 or Carbopol®980 as gelling agents, followed by comparison between instrumental analysis and sensorial evaluation and in vivo efficacy evaluation. METHODS: Nanostructured lipid carriers dispersions were produced by the ultrasound technique, and to obtain a semisolid formulation, gelling agents were dispersed in the aqueous dispersion. Particle size, polydispersity index and zeta potential were determined. Instrumental characterization was performed by rheological and textural analysis; the sensorial evaluation was also performed. Finally, skin hydration and TEWL were studied by capacitance and evaporimetry evaluation, respectively. RESULTS: Particles showed a nanometric size in all the analysed formulations. All the gels present pseudoplastic behaviour. There is a correspondence between the properties firmness and adhesiveness as determined by textural analysis and the sensory evaluation. The formulations that showed a greater increase in skin hydration also presented appropriate technological and sensorial attributes for skin application. CONCLUSIONS: Nanolipidgel formulations with the addition of humectants are promising systems for cosmetic application with good sensory and instrumental attributes and moisturizing efficacy.

Cattle tick-associated bacteria exert anti-biofilm and anti-Tritrichomonas foetus activities.

Research on microbiota in cattle tick and the evaluation of its activity against other microorganisms can contribute to identify new molecules potentially useful to control infections caused by bacteria and protozoa. Biofilms pose increasing problems worldwide, mainly due to their resistance to antimicrobial therapies and host immune response. In this study we investigate the ability Rhipicephalus (Boophilus) microplus-associated bacteria may exhibit to produce anti-biofilm and trichomonicidal compounds. Gut, ovary, salivary glands, and Gené organ were collected from engorged R. microplus female. Homogenates of each tissue were inoculated onto 15 distinct culture media. Anti-biofilm and trichomonicidal activities were analyzed by culturing each bacterium isolated in a liquid medium. Results showed that R. microplus cattle tick microflora varies for different tissues. Bacteria belonging to different genera (Aeromonas, Bacillus, Brevibacillus, Castelaniella, Comamonas, Kocuria, and Microbacterium) were identified. Interestingly, all bacterial species found displayed pronounced activity against Staphylococcus epidermidis and Pseudomonas aeruginosa biofilms, and also against the cattle pathogen Tritrichomonas foetus, confirming the hypothesis that cattle tick could be a source of bacteria active against pathogens. This is the first study showing that bacteria isolated from a tick exert anti-biofilm and trichomonicidal activities.

Center-by-center results of a multicenter prospective trial to determine the inter-observer correlation of the simplified POP-Q in describing pelvic organ prolapse.

INTRODUCTION AND HYPOTHESIS: This study was conducted to determine the differences in the inter-observer agreement of the simplified Pelvic Organ Prolapse Quantification (POP-Q) system from center to center in a large international multicenter study. METHODS: This is a secondary analysis of the results of a large prospective single blind multicenter trial studying the inter-observer agreement of a simplified POP-Q exam. Twelve centers from four continents with a total of 511 subjects were included in this study. The number of subjects recruited per center ranged from 20 to 81. Each patient was independently examined by two investigators, with examination order randomly assigned and investigators blinded to each other's result. The weighted kappa statistic was used to evaluate the inter-observer agreement. RESULTS: Good and significant associations were observed on the anterior, posterior, and apical segments. Six out of 11 sites did not provide adequate number of subjects with prior hysterectomy for weighted kappa statistics or achieve significance regarding vaginal cuff measurement. CONCLUSIONS: The simplified POP-Q demonstrated good inter-examiner agreement across multiple centers.

Schistosoma mansoni: a rare cause of tubal infection.

S. haematobium is an important cause of urinary schistosomiasis, and symptomatic female genital infection is a common gynecological finding in areas where S. haematobium is prevalent. On the other hand, genital manifestations of intestinal schistosomas as S. mansoni are not frequent or are misdiagnosed. A case of a 40-year-old woman with abnormal uterine bleeding and asymptomatic tubal infection by S. mansoni identified in histological examination is presented.

Schistosoma mansoni: a rare cause of tubal infection

S. haematobium is an important cause of urinary schistosomiasis, and symptomatic female genital infection is a common gynecological finding in areas where S. haematobium is prevalent. On the other hand, genital manifestations of intestinal schistosomas as S. mansoni are not frequent or are misdiagnosed. A case of a 40-year-old woman with abnormal uterine bleeding and asymptomatic tubal infection by S. mansoni identified in histological examination is presented.

[A rare case of hyperandrogenism: bilateral Leydig cell tumor of the ovary]. / Um caso raro de hiperandrogenismo tumor ovárico bilateral de células de Leydig.

BACKGROUND: The androgen-secreting tumors constitute fewer than 1% of ovarian tumors. Leydig cell tumor is one of the most common of this type of lesion and it is usually benign, small and unilateral. CASE REPORT: A 67 year old woman was referred to the Endocrine clinic due to hirsutism (score 22 Ferriman-Gallwey) and male type alopecia with 3 years of evolution and progressive worsening. Biochemically she had high levels of serum testosterone - 662 ng/dl (N < 62 ng/dl). Transvaginal ultrasonography and abdomen-pelvic CT scan didn't show any signs of adrenal or ovarian tumors. Bilateral oophorectomy was performed and histopathologic exam revealed bilateral Leydig cell tumors, measuring 1cm each. Four months after surgery, the patient had a marked improvement of the signs (score 3 Ferriman-Gallwey) and normalized testosterone levels (35.9 ng/dl). DISCUSSION: Androgen-secreting tumors are rare, but they should be excluded in cases of rapid onset of virilization and elevated androgen levels. Tumors are frequently undetectable by imaging techniques because of their small dimensions, exploratory surgery by a skilled team is frequently necessary and is often the best treatment for the majority of these cases. In this case report we present a rare case of bilateral Leydig cell tumor. Only five cases have been reported in the literature.The clinical history and the elevated levels of testosterone had suggested the presence of an androgen-producing tumor, despite the difficulty of the diagnosis on imaging techniques. Due to the fact that our patient was in a post-menopausal stage, we decided that the appropriate treatment would be bilateral oophorectomy. The histopathologic disclosed the diagnosis and allowed the patient's cure.

Vitrification in assisted reproduction: myths, mistakes, disbeliefs and confusion.

The purpose of this work is to update embryologists and clinicians on different approaches in human oocyte and embryo cryopreservation, by clarifying some misunderstandings and explaining the underlying reasons for controversial opinions. The work is based on literature review and critical analysis of published papers or conference abstracts during the last 24 years, with special focus on the last 3 years. Due to the latest advancements in techniques, cryopreservation now offers new perspectives along with solutions to many demanding problems, and has developed from a backup procedure to a successful alternative that is an indispensable constituent of assisted reproductive techniques. However, this progress is not free from controversies, at some points is rather serendipitous, and many factors, including human ones, hamper the selection and widespread application of the most efficient technique for the given task. A better understanding of the basic features of the two rival approaches (slow-rate freezing and vitrification), a clarification of terms and technical details, and a balanced, pragmatic evaluation of possible risks and potential, or definite, gains are required to accelerate advancement. Alternatively, the increasing flow of patients to the few assisted reproduction clinics and countries that are highly successful in this field will enforce the required changes in methodology and mentality worldwide.

[Superior vena cava syndrome and intrathoracic goiter: an unusual presentation in the 21st century]. / Bócio mergulhante e síndroma da veia cava superior: uma apresentação rara no século XXI.

We present a rare case of retrosternal goiter complicated with superior vena cava síndrome (SVCS) with impressive clinical signs. After clinical and imagiologic confirmation, total thyroidectomy was performed with complete remission of compressive signs.