An Unusual Coexistence: Right-Sided Colon Cancer and Intestinal Malrotation in an Adult.

Intestinal malrotation (IM), a rare congenital anomaly disrupting typical embryonic rotation around the superior mesenteric artery, is exceptionally uncommon in adults, with its link to colon cancer being even rarer. This article presents a case of colonic cancer in conjunction with IM in a 63-year-old male. Image studies and intraoperative findings show signs of IM. Open resection was performed due to concerns about vascular anomalies and abnormal lymphatic drainage. The case underscores the rarity of colon cancer in a malrotated gut, highlighting the necessity of preoperative identification for precise surgical planning and emphasizing the importance of careful dissection to prevent inadvertent vascular injury.

Fournier Gangrene Management: Is a Stoma Mandatory?

Fournier gangrene is a rare life-threatening surgical emergency mainly due to a polymicrobial infection of the perineal, genital, or perianal region. It is characterized by rapid tissue destruction and systemic signs of toxicity. It is more frequent in males and immunocompromised patients, such as patients with poorly controlled diabetes, alcoholism, or human immunodeficiency virus (HIV) infection. Treatment often involves surgical intervention, broad-spectrum antibiotic therapy, fecal diversion surgery, and negative pressure wound therapy (NPWT). Delays in diagnosis are associated with high mortality due to rapid progression to septic shock.

Breast cancer in young women: a rising threat: A 5-year follow-up comparative study.

Introduction: Breast cancer in young women is usually considered as breast cancer occurring in women younger than 40 years and is the most frequent cancer-related cause of death in these patients. In the past few years, there seems to be an increasing trend in the prevalence of breast cancer in young women, which, associated with poorer prognosis, more aggressive histologic features, and more frequent recurrence rates, makes it a rising threat to young women. This study aimed to evaluate the biological behavior of breast cancer in young women in our institution. Material and methods: A retrospective, unicentric, cohort study was conducted between 2012 and 2016. All consecutive patients with breast cancer were enrolled in the study. Cases were divided into two groups: case group, those younger than 40 years, and control group, those 40 years or older. The exclusion criterion was nonoperative treatment. Several clinical and pathologic parameters were evaluated, as well as were overall survival time and disease-free survival time. Results: The incidence of breast cancer in young women presented a rising tendency over the study period. Significant differences were observed in the comparison of the groups according to body mass index, age at menarche, age at birth of the first child, and proliferation rate. There were no differences in overall survival and disease-free survival rates between the groups. Conclusions: Young women had a more symptomatic presentation, a greater tumor proliferation rate, but similar outcomes compared with older patients. Greater multicentric studies are needed to confirm or refute these results.

Root dentin translucency and age at death estimation in adults using single rooted teeth: Update of the Forensic International Dental Database.

Since the publication of Lamendin's age estimation technique, the root dentin translucency has received increasing attention as an important indicator of age. Recently, Parra and colleagues presented the Forensic International Dental Database (FIDB), a proposal to estimate age at death in adults based on Bayes theorem by applying the criteria of Lamendin's technique. The present study aims to update the procedure and to evaluate a new version of the method (named FIDBv2) using two control samples from Colombia and Greece. The performance of this new version was acceptable and suggests that the method is suitable for age at death estimation in adult individuals from different forensic contexts. The best approximations to chronological age were obtained for individuals between 30 and 60 years old, with errors less than 10 years. The age estimations calculated on control samples suggest the adequate performance of FIDBv2 on individuals from varied populations. It can be stated that the FIDBv2 constitutes a solid alternative to be used in contexts where no additional data are available. Here we reinforce the initial idea that this model for estimating age at death in adults may be generalizable to any forensic context in the world.

Atenção ao parto e puerpério durante a pandemia de COVID-19: implicações na humanização do cuidado / Care during childbirth and the puerperal period during the COVID-19 pandemic: implications for the humanization of care / Atención al parto y puerperio durante la pandemia de COVID-19: implicaciones para la humanización de la asistencia

Introdução: conhecer as implicações da pandemia COVID-19 na humanização do cuidado em duas maternidades públicas no Sul do Brasil na perspectiva da equipe multiprofissional em saúde. Métodos: pesquisa qualitativa realizada com 16 profissionais de saúde que atuavam em maternidades públicas durante a pandemia da COVID-19. A coleta de dados foi realizada de abril a junho de 2021 por meio de entrevista semiestruturada. As entrevistas foram gravadas, transcritas e analisadas tematicamente. Resultados: os profissionais de saúde apresentaram preocupação em se adaptar ao contexto da pandemia, sem perder o foco na humanização da assistência. Foram necessárias mudanças nas maternidades que comprometeram a implementação das boas práticas, como a restrição à presença do acompanhante e a separação entre mãe-bebê no caso de pacientes com COVID-19. Conclusão: as restrições impostas pela pandemia foram necessárias naquele contexto, pois existiam muitas dúvidas sobre como intervir na atenção ao parto e puerpério, entretanto afetaram diversas conquistas em relação à humanização do cuidado, limitando os direitos individuais em prol de interesses coletivos.

Introduction: to know the implications of the COVID -19 pandemic in the humanization of care in two public maternity hospitals in Southern Brazil from the perspective of the multidisciplinary health team. Methods: qualitative study conducted with 16 health professionals who worked in public maternity hospitals during the COVID-19 pandemic. Data collection was performed from April to June 2021 through a semi-structured interview. The interviews were recorded, transcribed and analyzed thematically. Results: health professionals were concerned about adapting to the context of the pandemic without losing focus on the humanization of care. Changes were needed in maternity hospitals, which compromised the implementation of good practices, such as restricting the presence of a companion and separation of mother and baby in the case of patients with COVID-19. Conclusion: the restrictions imposed by the pandemic were necessary in that context, as there were many doubts about how to intervene in childbirth and postpartum period care. However, they affected several achievements in relation to the humanization of care, limiting individual rights in favor of collective interests.

Introducción: conocer las implicaciones de la pandemia COVID-19 en la humanización de los cuidados en dos maternidades públicas del sur de Brasil desde la perspectiva del equipo multiprofesional de salud. Métodos: investigación cualitativa realizada con 16 profesionales de salud que trabajaron en maternidades públicas durante la pandemia de COVID-19. Los datos se recogieron entre abril y junio de 2021 mediante entrevistas semiestructuradas. Las entrevistas se grabaron, transcribieron y analizaron temáticamente. Resultados: los profesionales de salud mostraron preocupación por adaptarse al contexto pandémico, sin perder de vista la humanización de la atención. Fueron necesarios cambios en las maternidades que comprometían la aplicación de buenas prácticas, como la restricción a la presencia de un acompañante y la separación entre madre y bebé en el caso de pacientes con COVID-19. Conclusión: las restricciones impuestas por la pandemia eran necesarias en ese contexto, ya que había muchas dudas sobre cómo intervenir en la atención al parto y al puerperio, sin embargo afectaron a varios logros en relación con la humanización de la atención al limitar los derechos individuales en favor de intereses colectivos.

Handlebar hernia-unusual complication from blunt trauma.

Handlebar hernia is a rare entity, mainly resulting from blunt abdominal trauma with a sudden deceleration mechanism. Diagnosis of handlebar at admission may be difficult because the rupture of abdominal wall layers often is not clinically recognized in the emergency department, which requires a high degree of suspicion to identify theses lesions. It is very important to rule out the presence of intra-abdominal injuries, and in adults, surgical repair is needed. Herein, the case of an adult man who presented to the emergency department with blunt abdominal trauma caused by a motorcycle handlebar is described.

Uncertainty in climate change impact studies for irrigated maize cropping systems in southern Spain.

This study investigates the main drivers of uncertainties in simulated irrigated maize yield under historical conditions as well as scenarios of increased temperatures and altered irrigation water availability. Using APSIM, MONICA, and SIMPLACE crop models, we quantified the relative contributions of three irrigation water allocation strategies, three sowing dates, and three maize cultivars to the uncertainty in simulated yields. The water allocation strategies were derived from historical records of farmer's allocation patterns in drip-irrigation scheme of the Genil-Cabra region, Spain (2014-2017). By considering combinations of allocation strategies, the adjusted R2 values (showing the degree of agreement between simulated and observed yields) increased by 29% compared to unrealistic assumptions of considering only near optimal or deficit irrigation scheduling. The factor decomposition analysis based on historic climate showed that irrigation strategies was the main driver of uncertainty in simulated yields (66%). However, under temperature increase scenarios, the contribution of crop model and cultivar choice to uncertainty in simulated yields were as important as irrigation strategy. This was partially due to different model structure in processes related to the temperature responses. Our study calls for including information on irrigation strategies conducted by farmers to reduce the uncertainty in simulated yields at field scale.

Primary cutaneous B-cell lymphoma arising from an inguinal hernioplasty scar.

The primary cutaneous B-cell lymphoma (PCBCL) is a rare neoplasm. It is believed that antigenic stimulation and chronic inflammation can be the basis of pathogenesis. Here, we report a case that to our knowledge is the first patient with a presentation of a PCBCL arising from a surgical scar, in particular, an inguinal hernioplasty. The case reminds us of the importance of raising clinical suspicion for malignant neoplasms in surgical scars, in particular, after mesh placement. MeSH terms: 'lymphoma, large b-cell, diffuse', 'skin' and 'cicatrix'.

Age-at-death estimation in adults using three forensic methodologies: A Lamendin's technique approach for Latin American context and the extension of a forensic international dental database.

In forensic science, the information that teeth provide to the age estimation process is very important. In adults, one of the most widely used indicators of skeletal age is the Root Dentin Translucency (RDT), mainly through the Lamendin technique, which is used in various Latin American contexts. Recently, Parra et al. (2020) have developed a Bayesian regression model using the Lamendin technique to establish standardized criteria for estimating age-at-death in adults in various forensic contexts. In this study, we evaluate the applicability of this proposal together with the proposal by Lamendin et al. (1992) and Prince and Ubelaker (2002) in Latin American contexts. A sample of single-rooted teeth belonging to 805 individuals from six Latin American countries was used. The results of the three proposals considered were analyzed taking into account factors such as age, sex, origin, and the tooth surface on which the variables were surveyed. Of the factors that would affect the estimates, it was found that the age of the individuals had the greatest influence. However, it was confirmed that the sex and surface of the teeth on which the measurements were taken did not influence the final result. On the other hand, as we expected, the application of the analyzed proposals would also be possible in other forensic contexts, as shown by the results obtained according to the origin. This research expands the FIDB with more information on Latino contexts.

Diverging importance of drought stress for maize and winter wheat in Europe.

Understanding the drivers of yield levels under climate change is required to support adaptation planning and respond to changing production risks. This study uses an ensemble of crop models applied on a spatial grid to quantify the contributions of various climatic drivers to past yield variability in grain maize and winter wheat of European cropping systems (1984-2009) and drivers of climate change impacts to 2050. Results reveal that for the current genotypes and mix of irrigated and rainfed production, climate change would lead to yield losses for grain maize and gains for winter wheat. Across Europe, on average heat stress does not increase for either crop in rainfed systems, while drought stress intensifies for maize only. In low-yielding years, drought stress persists as the main driver of losses for both crops, with elevated CO2 offering no yield benefit in these years.

[Institutional violence: routine experiences of the nursing team]. / Violência institucional: vivências no cotidiano da equipe de enfermagem.

The purpose of this qualitative study was to describe the experience of a professional nursing team exposed to institutional violence, to discuss how these experiences influence their routine lives and their service organization as well as learn about the events which provoke these violent attitudes. The subjects of this study were eleven professionals of the nursing team. Data was collected through interviews and analyzed by using thematic analysis, organized in categories: violent situations involving the nursing staff, the influence of violence in the workplace and service organization and contributing causes of violent attitudes against the nursing team. The results show that professionals are more prone to violent behavior in the workplace due to longer permanence and greater interaction with patients and caregivers.

Violência institucional: vivências no cotidiano da equipe de enfermagem / Institutional violence: routine experiences of the nursing team / Violencia institucional: vivencias en el cotidiano del equipo de enfermería

Estudo qualitativo que objetivou descrever a vivência dos profissionais da equipe de enfermagem expostos à violência institucional, discutir como essas vivências influem no cotidiano e na organização do serviço e conhecer os eventos causadores dessas atitudes violentas. Os sujeitos foram onze profissionais da equipe de enfermagem. Os dados foram produzidos por meio de entrevista, analisados utilizando técnica de análise temática, organizados nas categorias: vivências de violência na equipe de enfermagem, influência da violência no cotidiano de trabalho e na organização do serviço e fatores causadores de atitudes violentas contra a equipe de enfermagem. Os resultados demonstram que os profissionais encontram-se susceptíveis a atitudes violentas no ambiente de trabalho por permanecerem mais tempo e em maior interação com pacientes e acompanhantes.

The purpose of this qualitative study was to describe the experience of a professional nursing team exposed to institutional violence, to discuss how these experiences influence their routine lives and their service organization as well as learn about the events which provoke these violent attitudes. The subjects of this study were eleven professionals of the nursing team. Data was collected through interviews and analyzed by using thematic analysis, organized in categories: violent situations involving the nursing staff, the influence of violence in the workplace and service organization and contributing causes of violent attitudes against the nursing team. The results show that professionals are more prone to violent behavior in the workplace due to longer permanence and greater interaction with patients and caregivers.

Estudio cualitativo que objetivó describir la vivencia de los profesionales del equipo de enfermería expuestos a la violencia institucional, discutir como esas vivencias influyen en el cotidiano y en la organización del servicio y conocer los eventos causadores de esas actitudes violentas. Los sujetos fueron once profesionales del equipo de enfermería. Los datos fueron producidos por medio de encuesta, analizados utilizando técnica de análisis temática, organizados en las categorías: vivencia de violencia en el equipo de enfermería, influencia de la violencia en el cotidiano de trabajo y en la organización del servicio y factores causadores de actitudes violentas contra el equipo de enfermería. Los resultados demonstran que los profesionales se encuentran susceptibles a actitudes violentas en el ambiente de trabajo por permanecieren más tiempo y en mayor interacción con pacientes y acompañantes.

[Profile of motorcycle accident victims treated at a public hospital emergency department]. / Perfil das vítimas de trauma por acidente de moto atendidas em um serviço público de emergência.

The number of accidents involving motorcycles has increased in Brazil. The objective of this study was to identify the type of victims of these accidents who were treated at an emergency department in Piauí State, Brazil. The sample included 430 such victims in this quantitative study. Most were male, 15-24 years of age, and from the State of Piauí itself. 301 of the victims were drivers of the motorcycles, 81 were passengers, and 48 were struck or run over by the motorcycles. 76.05% of the accidents occurred from Thursday to Sunday. 80.75% had temporary sequelae, and 53.33% of the accidents occurred at night. In 69.3% of the cases, victims suffered lacerations; 51.4% fractures; 27.44% hematomas; and 20.7% head trauma. Among the accident victims, motorcycle drivers, and those suspected of alcohol consumption, 52.07% were not wearing a helmet at the time of the accident. Most of the victims were discharged from hospital, while 14 died. In conclusion, injuries from motorcycle accidents deserve attention, especially to plan preventive measures to help control their occurrence in the State.

Perfil das vítimas de trauma por acidente de moto atendidas em um serviço público de emergência / Profile of motorcycle accident victims treated at a public hospital emergency department

No Brasil, observa-se um aumento dos acidentes envolvendo motocicletas. Este estudo objetivou caracterizar as vítimas desse tipo de acidente atendidas em um serviço de emergência no Piauí. Pesquisa quantitativa com amostra de 430 vítimas. A análise mostrou predominância do sexo masculino, na faixa etária de 15 a 24 anos e procedentes do próprio estado. Observou-se que 301 dessas vítimas eram condutores da motocicleta, 81 passageiros e 48 foram atropelados por moto. Verificou-se que 76,05 por cento das vítimas sofreram acidente de quinta-feira a domingo, 80,75 por cento apresentaram seqüelas temporárias e 52,33 por cento dos acidentes ocorreram no período noturno. Os tipos de lesão corresponderam em 69,3 por cento dos casos a ferimentos; 51,4 por cento a fraturas; 27,44 por cento a hematomas; e 20,7 por cento a traumatismos cranioencefálicos. Entre as vítimas de acidente, condutores da moto e suspeitos de ingestão de álcool, 52,07 por cento não utilizavam capacete no momento do acidente. A maioria das vítimas recebeu alta hospitalar e 14 foram a óbito. Conclui-se que o trauma provocado pelos acidentes envolvendo motocicletas merece atenção, especialmente em relação ao planejamento de ações preventivas, assim como controle de sua ocorrência no estado.

The number of accidents involving motorcycles has increased in Brazil. The objective of this study was to identify the type of victims of these accidents who were treated at an emergency department in Piauí State, Brazil. The sample included 430 such victims in this quantitative study. Most were male, 15-24 years of age, and from the State of Piauí itself. 301 of the victims were drivers of the motorcycles, 81 were passengers, and 48 were struck or run over by the motorcycles. 76.05 percent of the accidents occurred from Thursday to Sunday. 80.75 percent had temporary sequelae, and 53.33 percent of the accidents occurred at night. In 69.3 percent of the cases, victims suffered lacerations; 51.4 percent fractures; 27.44 percent hematomas; and 20.7 percent head trauma. Among the accident victims, motorcycle drivers, and those suspected of alcohol consumption, 52.07 percent were not wearing a helmet at the time of the accident. Most of the victims were discharged from hospital, while 14 died. In conclusion, injuries from motorcycle accidents deserve attention, especially to plan preventive measures to help control their occurrence in the State.