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Objective@#This study reported the demographic profile, clinical presentation, treatment, and outcomes of retinoblastoma (RB) patients seen at Jose R. Reyes Memorial Medical Center (JRRMMC) from January 2011 to December 2020.@*Methods@#This was a single-center, retrospective study. Medical records of patients diagnosed with RB at JRRMMC from January 2011 to December 2020 were reviewed. Descriptive statistics were used to summarize the characteristics of the participants.@*Results@#A total of 31 confirmed RB cases were seen, with almost half residing outside Metro Manila (52%). The median age at diagnosis was 2 years, with a slight male predominance (55%). Majority (81%) of patients had unilateral presentation, with leukocoria as the most common sign (19%) prompting consult. Nearly half (43%) of 37 eyes were diagnosed as Group E using the International Classification of Retinoblastoma (ICRB) system. Majority were in the advanced stage; 57% of eyes underwent enucleation and 29, 3 and 3% of patients required additional treatments such as chemotherapy, laser, and radiotherapy, respectively. RB was confirmed in 20 eyes (54%) through histopathology. Survival outcomes showed that 4 patients (13%) were alive, with either completed or ongoing treatment, and 19 (61%) did not complete prescribed management or were lost to follow-up. There were 8 (26%) known deaths.@*Conclusion@#Majority of cases were unilateral and at an advanced stage needing enucleation which may indicate low levels of awareness and screening efforts. Survival rates are difficult to ascertain due to patients abandoning treatment that may be attributed to limited social service support. The study reflects the 10-year data prior to the establishment of a collaborative, multispecialty RB team in the institution and exposes various areas that need to be addressed to improve clinical outcomes.
Subject(s)
Retinoblastoma , Drug Therapy , EpidemiologyABSTRACT
Unusual or prominent calcifications found on screening mammography may prompt additional radiologic and clinical work-up given the possible association with pre-malignant lesions, other high-risk lesions, or malignancies. Osseous metaplasia (OM) of the breast, also referred to as metaplastic ossification or heterotopic bone formation, is an uncommon finding that may present as radiographic calcification. There are isolated case reports of OM associated with benign or malignant tumors of the breast, as well as with a variety of nonneoplastic conditions. We report 2 cases of OM in the breast associated with a hemangioma and review the relevant literature. To the best of our knowledge, these are the first reported cases of this association in the breast.
ABSTRACT
Unusual or prominent calcifications found on screening mammography may prompt additional radiologic and clinical work-up given the possible association with pre-malignant lesions, other high-risk lesions, or malignancies. Osseous metaplasia (OM) of the breast, also referred to as metaplastic ossification or heterotopic bone formation, is an uncommon finding that may present as radiographic calcification. There are isolated case reports of OM associated with benign or malignant tumors of the breast, as well as with a variety of nonneoplastic conditions. We report 2 cases of OM in the breast associated with a hemangioma and review the relevant literature. To the best of our knowledge, these are the first reported cases of this association in the breast.
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BACKGROUND: Priapism is a rare complication seen in one to five percent of adult leukemic patients. The word 'Priapism' is related to Priapus, the Greek and Roman God of procreation whose symbol was an erect phallus. CLINICAL PRESENTATION: The patient is a 22-year-old male with no known co-morbidities presenting with one month intermittent, unstimulated, painful penile erection with no other associated symptoms which resolves spontaneously, until nine hours prior to admission when symptoms recurred and persisted. Patient had no history of trauma and no drug intake. PHYSICAL FINDINGS: Patient was awake, in pain and tachycardic. There was note of pallor and splenomegaly. The penis was erect, firm, swollen and tender with superficial venous engorgement. The rest of the physical examination was unremarkable. LABORATORY WORK UP: Complete blood count showed anemia and leukocystosis. Peripheral blood smear revealed markedly increased white blood cells with predominance of mature and immature cells belonging to granulocytic series. There was splenomegaly on ultrasound. Genetic testing showed an abnormal male karyotype of 46 chromosomes including translocation (9;22). TREATMENT: Corpora cavernosa aspiration was done. Terbutaline was given. Patient was started and maintained on hydroxyurea and presently enrolled in Imitanib study. OUTCOME: There was resolution of priapism after the corpus cavernosa aspiration and initiation of hydroxyurea and the white blood cell count had decreased after initiation of hydroxyurea.
Subject(s)
Humans , Male , Adult , Priapism , Hydroxyurea , Terbutaline , Pallor , Splenomegaly , Hyperemia , Penile Erection , Leukocyte Count , Penis , Blood Cell Count , Leukocytes , Anemia , PainABSTRACT
OBJETIVO: Revisar os principais artigos referentes ao tema desequilíbrio energético e obesidade, a fim de quantificar o excedente energético diário associado ao ganho de peso em crianças e adolescentes. FONTES DE DADOS: Artigos publicados nos últimos dez anos, indexados nas bases de dados eletrônicas Medline (Pubmed) e SciELO-Br. Na base de dados Medline, utilizou-se o descritor "energy gap", termo que descreve os valores energéticos associados às modificações no peso corporal em indivíduos ou populações. Na base de dados SciELO-Br, utilizaram-se os descritores "obesidade", "metabolismo energético", "balanço energético" e "desequilíbrio energético", devido ao fato de não terem sido encontrados artigos nacionais que discutissem o assunto "energy gap". SÍNTESE DOS DADOS: Na população infantil, quatro estudos foram realizados e indicam que crianças e adolescentes estão gradualmente ganhando peso devido a um pequeno, mas persistente, balanço energético positivo diário, 70 a 160kcal acima do total calórico adequado para o crescimento. Os valores encontrados sugerem que pequenas modificações nos hábitos diários de alimentação e de atividade física seriam suficientes para evitar futuros ganhos de peso nessa população. CONCLUSÕES: O ganho gradual de peso pode ser explicado por pequena média diária de balanço energético positivo, de 70 a 160kcal acima do total calórico adequado para o crescimento. O incentivo às pequenas modificações nos hábitos alimentares e de atividades físicas que promovam a redução de 160kcal diárias pode ser uma prática acessível, a fim de barrar o ganho de peso nessa população.
OBJECTIVE: To review the main articles on energy imbalance and obesity in order to quantify the daily energy surplus associated with weight gain in children and adolescents. DATA SOURCES: Articles published in the last ten years, indexed in electronic databases Medline (Pubmed) and SciELO-Br. In the Medline database, the descriptor "energy gap" was used and describes the energy values associated with changes in body weight in individuals or populations. In SciELO-Br database, the descriptors "obesity", "energy metabolism", "energy balance", and "energy imbalance" were used, once it was not possible to find national articles discussing the energy gap. DATA SYNTHESIS: In the pediatric population, four studies were performed and indicate that children and adolescents are gradually gaining weight due to a small, but persistent, daily positive energy balance of 70 to 160kcal above the total energy suitable for growth. The results suggest that small changes in daily eating behavior as well as physical activity would be enough to prevent future weight gain in this population. CONCLUSIONS: gradual weight gain can be explained by small daily average of positive energy balance, from 70 to 160kcal above the total energy suitable for growth. The incentive to small changes in eating behavior and physical activities that promotes daily reduction of 160kcal can be an accessible practice in order to block weight gain in this population.
OBJETIVO: Revisar los principales artículos referentes al tema desequilibrio energético y obesidad, a fin de cuantificar el excedente energético diario asociado a la ganancia de peso en niños y adolescentes. FUENTES DE DATOS: Revisión de artículos publicados en los últimos 10 años, indexados en las bases de datos electrónicas MEDLINE (Pubmed) y SciELO-BR. En la base de datos MEDLINE se utilizó el descriptor energy gap, término que describe los valores energéticos asociados a las modificaciones en el peso corporal en individuos o en poblaciones. En la base de datos SciELO-BR se utilizaron los descriptores obesidad, metabolismo energético, balance energético y desequilibrio energético, debido a no haberse encontrado artículos nacionales que discutieran el tema energy gap. SÍNTESIS DE LOS DATOS: En la población infantil, cuatro estudios fueron realizados e indican que niños y adolescentes están gradualmente ganando peso debido a un pequeño pero persistente balance energético positivo diario, 70 a 160kcal por encima del total calórico adecuado para el crecimiento. Los valores encontrados sugieren que pequeñas modificaciones en los hábitos diarios de alimentación y de actividad física serían suficientes para evitar futuras ganancias de peso en esta población. CONCLUSIÓN: La ganancia gradual de peso puede explicarse por pequeño promedio diario de balance energético positivo, de 70 a 160kcal por encima del total calórico adecuado para el crecimiento. El incentivo a las pequeñas modificaciones en los hábitos alimentares y de actividades físicas que promuevan la reducción de 160kcal diarias puede ser una práctica accesible a fin de parar la ganancia de peso en esta población.
Subject(s)
Adolescent , Child , Female , Humans , Male , Energy Intake , Obesity/etiology , Energy Metabolism , Obesity/metabolism , Weight GainABSTRACT
The patient is a 21-year old male, whose developmental history served as a fertile ground of predisposing factors for yielding a psychiatric diagnosis. He grew up without a mother in a dysfunctional home, without rules to follow or consequences for his disobedience. He did not receive clear instructions on what was right or wrong and did not have any good role models for an orderly life and stable relationship. Instead, he was given undeserved freedom at a very young age, and then at 21 years old, he became detached, anxious, distracted, and purposeless.
Subject(s)
Humans , Male , Young Adult , Methylphenidate , Valproic Acid , Anxiety , Apathy , Causality , Freedom , Life , Mental Disorders , Attention Deficit Disorder with Hyperactivity , Attention Deficit and Disruptive Behavior DisordersABSTRACT
Methanol extracts of the leaf & seed of Bixa orellana L. were studied for in vitro antimicrobial activity against MTCC strains of Staphylococcus aureus, Salmonella typhi, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus fecalis, Vibrio cholera, Moraxella catarrhalis, Acinetobacter sp., Brucella sp. along with fungal pathogens Candida albicans, Aspergillus niger and the dermatophytes Trichophyton mentagrophytes & Trichophyton rubrum. Leaf extract of B. orellana at 1000 μg/ml concentration showed significant inhibition against all the tested bacteria and fungus, with highest inhibition zone (18±0.3 mm) against S. typhi, Acinetobacter sp., T. mentagrophytes and T. rubrum. Seed extract of B. orellana was comparitively less efficacious in most of the tested pathogens, except Brucella sp. which was appreciably inhibited (15±0.1 mm). Minimum Inhibitory Concentration (MIC) of leaf extract was determined as 15.62 μg/ml against S. aureus and 31.25 μg/ml for K. pneumoniae, P. aeruginosa, E. fecalis & S. typhi, on average. Among the dermatophytes, 78.2% inhibition was seen in T. mentagrophytes & T. rubrum. Scanning Electron Microscopic (SEM) studies of the treated P. aeruginosa cells revealed disintegration & aggregation of cells after treatment with the leaf extract. Phytochemical analysis of leaf & seed extracts suggested the presence of flavonoids, tannins, saponins, steroids. Alkaloids were detected only in the leaf & anthroquinones, in the seeds.
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O estudo objetivou identificar/analisar a precepção dos enfermeiros em relação à assitência prestada pela enfermagem nos hospitais universitários - município do Rio de Janeiro. A análise qualitativa norteou a investigação. Os dados foram colhidos através de entrevistas abertas com enfermeiros que ocupavam cargo de enfermeiro-chefe ou supervisor. Os resultados revelaram que o déficit de recuross humanos/materiais interfere diretamente no atendimento à clientela e fica atrelado a aspectos subjetivos. A falta de recursos tecnológicos/qualidade do material utilizado vem causando prejuízos à assistência. O caráter humanitário perpassa o trabalho desses profissionais sendo indispensável à superação das dificuldades cotidianas.
Subject(s)
Humans , Nursing , Nursing Care , Hospitals, University , Perception , Health ResourcesABSTRACT
Trata-se de experiência, no laboratório de enfermagem Fundamental, com 22 graduandas de Enfermagem da UERJ, para a prática de "Banho no Leito". teve como objetivo registrar a estratégia de ensino deste procedimento, identificar representações e sentimentos dos alunos sobre seu próprio banho e caracterizar seus sentimentos após a dinãmica de sensibilidade desenvolvida no Projeto "VIVENDO VIVENCIAS". A pesquisa é exploratório-qualitativa e foi implementada em 1997. Entre os resultados encontram-se as categorias próprias da construção do conhecimento sobre "Banho no Leito": Estímulo de limpeza para o corpo sujo; Estímulo de prazer - o corpo relaxado; Estímulo ao conforto - o corpo livre; e Estímulo às sensações - corpo dinãmico. Conclui-se que os alunos trazem da sua realidade um conhecimento do senso comum sobre "sujo" e "limpo" quando representam seu próprio corpo. Ao experenciarem o "tocar" humores e sentirem os odores do cliente, mesmo simbolicamente, suas reações são diferentes e redimensionam um conhecimento cultural e científico.
Subject(s)
Humans , Baths/nursing , Baths/psychology , Education, NursingABSTRACT
Se presenta el caso de una mujer joven con un lupus eritematoso sistemico y titulo alto de anticuerpos anti-ribonucleoproteina que desarrollo el cuadro de una hipertension pulmonar primitiva grave en el breve curso de dos anos, a pesar de la completa remision de su enfermedad basica No hemos podido comprobar hallazgos similares en la literatura disponible