Successful management of iatrogenic tear in vitrectomy for retinopathy of prematurity-related retinal detachment: a case report / Tratamento bem-sucedido de rotura iatrogênica em vitrectomia para descolamento de retina por retinopatia da prematuridade: relato de caso

ABSTRACT Retinal detachment related to retinopathy of prematurity is a surgical challenge, and vitrectomy can directly release transvitreal traction resulting from fibrous proliferation. The presence of iatrogenic breaks is a poor prognostic factor and has been considered a dismal prognosis. We report a case of premature female baby that underwent a 3-port 23-Gauge pars plana vitrectomy for stage 4A retinopathy of prematurity, with intraoperative progressive rhegmatogenous detachment complication. Lensectomy, extensive membrane dissection and vitreous shaving, followed by a posterior retinotomy, fluid air exchange, extensive peripheral photocoagulation and C3F8 15% injection were performed. Successful anatomical result was obtained.

RESUMO O descolamento de retina relacionado à retinopatia da prematuridade é um desafio cirúrgico, e a vitrectomia é um procedimento capaz de romper diretamente a tração vitreorretiniana resultante da proliferação fibrosa. A presença de roturas iatrogênicas é um fator prognóstico ruim e tem sido considerada como prognóstico sombrio. Relatamos um caso de bebê prematuro do sexo feminino que foi submetido à vitrectomia via pars plana (23 Gauge; três incisões), para retinopatia da prematuridade estágio 4A, complicada por descolamento regmatogênico progressivo intraoperatório. Foram realizadas lensectomia, dissecção extensa da membrana e aspiração vítrea, seguidas de retinotomia posterior, troca fluido-ar, fotocoagulação periférica extensa e injeção de C3F8 a 15%. O resultado anatômico bem-sucedido foi obtido.

Randomized trial of the efficacy of trial-based cognitive therapy for obsessive-compulsive disorder: preliminary findings.

INTRODUCTION: Obsessive-compulsive disorder (OCD) is the fourth most prevalent mental disorder and is a disabling condition. OCD is associated with anatomical and functional changes in the brain, in addition to dysfunctional cognitions. The treatments of choice are selective serotonin reuptake inhibitors, cognitive-behavioral therapy (CBT), and exposure and response prevention (ERP). Trial-based cognitive therapy (TBCT) is a recent and empirically validated psychotherapy with a focus on restructuring dysfunctional negative core beliefs (CBs). The objective of this study was to evaluate the efficacy of TBCT relative to ERP for treatment of OCD. METHOD: A randomized, single-blind clinical trial was conducted, randomizing 26 patients for individual treatment with TBCT (n = 12) or ERP (n = 14). The groups were evaluated at baseline, at the end of 3 months (12 sessions), and at 3, 6, and 12-month follow-ups. RESULTS: Both approaches reduced the severity of symptoms with large effect sizes. These results were maintained at the 12-month follow-up assessment. CONCLUSION: TBCT may be a valid and promising treatment for this disorder.

Brincar nas, com e apesar das telas / Playing with, on and in spite of the screens / Jugar con, en y a pesar de las pantallas / Jouer avec, dans et malgré les écrans

Este trabalho está inserido em uma pesquisa que buscou explorar as articulações forjadas entre crianças e telas durante o isolamento físico imposto pela pandemia da COVID-19. O objetivo aqui foi analisar como as brincadeiras se desenrolaram nesse momento tão especial, levando em conta a presença das telas. Nossos principais referenciais teóricos foram a psicanálise e a Teoria Ator-Rede e adotamos a cartografia como metodologia, a fim de explorar o campo em toda sua fluidez e complexidade. Utilizamos questionários online e entrevistas com responsáveis e crianças. Foi possível observar que as crianças não deixaram de brincar por causa das telas, mas puderam construir múltiplas e singulares articulações, brincaram nas, com e apesar das telas

This article is part of a piece of research that sought to explore the articulations forged between children and screens during the physical isolation imposed by the COVID-19 pandemic. The goal was to analyse how children's games developed in this particular moment, taking into account the presence of digital screens. In order to explore the research field in all its fluidity and complexity, our main theoretical references were psychoanalysis and Actor-Network Theory. Besides this, we adopted cartography as a methodology where online questionnaires and interviews with parents and children were carried out. It was possible to observe that the children didn't stop playing because of the screens but were able to build multiple and unique articulations, playing on, with and in spite of the screens

Este trabajo es parte de una investigación que buscó explorar las articulaciones entre los niños y las pantallas durante el aislamiento físico impuesto por la pandemia del COVID-19. El objetivo aquí fue analizar cómo se desarrollaron los juegos en este momento tan especial, teniendo en cuenta la presencia de las pantallas. Nuestros principales referentes teóricos fueron el psicoanálisis y la Teoría del Actor-Red y adoptamos la cartografía como metodología para explorar el campo en toda su fluidez y complejidad. Utilizamos encuestas virtuales y entrevistas con responsables y niños. Se pudo observar que los niños no dejaron de jugar por causa de las pantallas, sino que lograron construir múltiples y singulares articulaciones, jugaron en, com y a pesar de las pantallas

Ce travail s'inscrit dans une recherche qui visait à explorer les articulations forgées entre les enfants et les écrans lors de l'isolement physique imposé par la pandémie de COVID-19. L'objectif était d'analyser le déroulement des jeux dans ce moment particulier, en tenant compte de la présence des écrans. Nos principales références théoriques étaient la psychanalyse et la théorie de l'acteur-réseau et nous avons adopté la cartographie comme méthodologie afin d'explorer le domaine dans toute sa fluidité et complexité. Nous utilisons des questionnaires en ligne et des entretiens avec les parents et les enfants. Il a été possible de constater que les enfants n'ont pas arrêté de jouer à cause des écrans, mais ils ont su construire des articulations multiples et uniques, ils ont joué dans, avec et malgré les écrans

Randomized trial of the efficacy of trial-based cognitive therapy for obsessive-compulsive disorder: preliminary findings

Abstract Introduction Obsessive-compulsive disorder (OCD) is the fourth most prevalent mental disorder and is a disabling condition. OCD is associated with anatomical and functional changes in the brain, in addition to dysfunctional cognitions. The treatments of choice are selective serotonin reuptake inhibitors, cognitive-behavioral therapy (CBT), and exposure and response prevention (ERP). Trial-based cognitive therapy (TBCT) is a recent and empirically validated psychotherapy with a focus on restructuring dysfunctional negative core beliefs (CBs). The objective of this study was to evaluate the efficacy of TBCT relative to ERP for treatment of OCD. Methods A randomized, single-blind clinical trial was conducted, randomizing 26 patients for individual treatment with TBCT (n = 12) or ERP (n = 14). The groups were evaluated at baseline, at the end of 3 months (12 sessions), and at 3, 6, and 12-month follow-ups. Results Both approaches reduced the severity of symptoms with large effect sizes. These results were maintained at the 12-month follow-up assessment. Conclusion TBCT may be a valid and promising treatment for this disorder.

Política de Educação Permanente em Saúde de Pernambuco, Brasil: estratégias de implementação / Permanent Health Education Policy in Pernambuco, Brazil: implementation strategies

Objetivo: Analisar as estratégias de implementação da Política de Educação Permanente em Saúde no estado de Pernambuco. Métodos: Estudo descritivo de abordagem qualitativa. Realizou-se análise documental para produção dos dados. Foram analisados o Plano de Educação Permanente em Saúde de Pernambuco (2019 ­ 2022) e os relatórios das cinco oficinas regionais realizadas no período de junho a agosto de 2019. Utilizou-se a análise de conteúdo para exame e organização das discussões contidas nos relatórios, cuja categorização foi orientada pela descrição do eixo do plano: governança da Política Estadual de Educação Permanente em Saúde. Tomou-se como referência o modelo do ciclo de políticas públicas, voltando-se para a análise de implementação. Resultados: As oficinas contemplaram 548 participantes, 39,8% de segmento gestor, 15,0% de conselheiros de saúde, 4,6% de representantes de movimentos sociais, 25,0% de segmento trabalhador e 15,7% de instituições formadoras. Foi observada a necessidade de desenvolvimento de aspectos como a institucionalização da política no âmbito municipal, o financiamento tripartite e a participação efetiva do quadrilátero da formação. As residências em saúde se destacam como importante estratégia de formação de profissionais e desenvolvimento dos serviços e da regionalização. Conclusões: Os desdobramentos do Plano de Educação Permanente em Saúde nas regiões de saúde foram fundamentais para mobilizar os diversos atores no desenvolvimento das comissões de integração ensino-serviço regionais, no reconhecimento e incentivo à implantação das políticas municipais e na construção de estratégias coletivas para o desenvolvimento da política estadual.

Maintenance of venomous snakes in captivity for venom production at Butantan Institute from 1908 to the present: a scoping history.

Maintenance of snakes at Butantan Institute started in the last century, intending to produce a different antivenom serum to reduce death caused by snakebites. Through a successful campaign coordinated by Vital Brazil, farmers sent venomous snakes to Butantan Institute by the railway lines with no cost. From 1908 to 1962, the snakes were kept in an outdoor serpentarium, where venom extraction was performed every 15 days. During this period, the snake average survival was 15 days. In 1963, the snakes were transferred to an adapted building, currently called Laboratory of Herpetology (LH), to be maintained in an intensive system. Although the periodicity of venom extraction remained the same, animal average survival increased to two months. With the severe serum crisis in 1983, the Ministry of Health financed remodeling for the three public antivenom producers, and with this support, the LH could be improved. Air conditioning and exhausting systems were installed in the rooms, besides the settlement of critical hygienic-sanitary managements to increase the welfare of snakes. In the early 1990s, snake survival was ten months. Over the years to the present day, several improvements have been made in the intensive serpentarium, as the establishment of two quarantines, feeding with thawed rodents, an interval of two months between venom extraction routines, and monitoring of snake health through laboratory tests. With these new protocols, average snake survival increased significantly, being eight years for the genus Bothrops, ten years for genus Crotalus and Lachesis, and four years for the genus Micrurus. Aiming the production of venoms of good quality, respect for good management practices is essential for the maintenance of snakes in captivity. New techniques and efficient management must always be sought to improve animal welfare, the quality of the venom produced, and the safety of those working directly with the venomous snakes.

Maintenance of venomous snakes in captivity for venom production at Butantan Institute from 1908 to the present: a scoping history

Maintenance of snakes at Butantan Institute started in the last century, intending to produce a different antivenom serum to reduce death caused by snakebites. Through a successful campaign coordinated by Vital Brazil, farmers sent venomous snakes to Butantan Institute by the railway lines with no cost. From 1908 to 1962, the snakes were kept in an outdoor serpentarium, where venom extraction was performed every 15 days. During this period, the snake average survival was 15 days. In 1963, the snakes were transferred to an adapted building, currently called Laboratory of Herpetology (LH), to be maintained in an intensive system. Although the periodicity of venom extraction remained the same, animal average survival increased to two months. With the severe serum crisis in 1983, the Ministry of Health financed remodeling for the three public antivenom producers, and with this support, the LH could be improved. Air conditioning and exhausting systems were installed in the rooms, besides the settlement of critical hygienic-sanitary managements to increase the welfare of snakes. In the early 1990s, snake survival was ten months. Over the years to the present day, several improvements have been made in the intensive serpentarium, as the establishment of two quarantines, feeding with thawed rodents, an interval of two months between venom extraction routines, and monitoring of snake health through laboratory tests. With these new protocols, average snake survival increased significantly, being eight years for the genus Bothrops, ten years for genus Crotalus and Lachesis, and four years for the genus Micrurus. Aiming the production of venoms of good quality, respect for good management practices is essential for the maintenance of snakes in captivity. New techniques and efficient management must always be sought to improve animal welfare, the quality of the venom produced, and the safety of those working directly with the venomous snakes.(AU)

Maintenance of venomous snakes in captivity for venom production at Butantan Institute from 1908 to the present: a scoping history

Maintenance of snakes at Butantan Institute started in the last century, intending to produce a different antivenom serum to reduce death caused by snakebites. Through a successful campaign coordinated by Vital Brazil, farmers sent venomous snakes to Butantan Institute by the railway lines with no cost. From 1908 to 1962, the snakes were kept in an outdoor serpentarium, where venom extraction was performed every 15 days. During this period, the snake average survival was 15 days. In 1963, the snakes were transferred to an adapted building, currently called Laboratory of Herpetology (LH), to be maintained in an intensive system. Although the periodicity of venom extraction remained the same, animal average survival increased to two months. With the severe serum crisis in 1983, the Ministry of Health financed remodeling for the three public antivenom producers, and with this support, the LH could be improved. Air conditioning and exhausting systems were installed in the rooms, besides the settlement of critical hygienic-sanitary managements to increase the welfare of snakes. In the early 1990s, snake survival was ten months. Over the years to the present day, several improvements have been made in the intensive serpentarium, as the establishment of two quarantines, feeding with thawed rodents, an interval of two months between venom extraction routines, and monitoring of snake health through laboratory tests. With these new protocols, average snake survival increased significantly, being eight years for the genus Bothrops, ten years for genus Crotalus and Lachesis, and four years for the genus Micrurus. Aiming the production of venoms of good quality, respect for good management practices is essential for the maintenance of snakes in captivity. New techniques and efficient management must always be sought to improve animal welfare, the quality of the venom produced, and the safety of those working directly with the venomous snakes.(AU)

Perfil clínico dos portadores da síndrome congênita do zika vírus atendidos no centro especializado em reabilitação da cidade de Campina Grande- Pb / Clinical profile of patients with congenital syndrome of zika virus attended at the specialized center for rehabilitation in the city of Campina Grande-Pb

INTRODUÇÃO: No segundo semestre do ano de 2015 um surto de microcefalia foi registrado na região nordeste do Brasil. O presente artigo tem como objetivo traçar o perfil clínico dos portadores da síndrome congênita do zika vírus da cidade de Campina Grande. MÉTODOS: Tratou-se de um estudo documental com abordagem quantitativa. A coleta de dados deu-se no Centro Especializado em Reabilitação (CER), no município de Campina Grande no estado da Paraíba com análise de 66 prontuários. RESULTADOS: Maioria do sexo feminino (57,6%), com idade média de 3,36 anos. Houve predominância de infecção pelo vírus da Zika no 1º trimestre de gestação (69,7%), em mães com baixo grau de escolaridade em que apenas 28,8% completaram o ensino médio. A maioria das crianças, mesmo com a infecção, nasceram a termo (68,2%), porém, apresentaram baixo peso ao nascer, 2,697kg em média, perímetro cefálico médio de 29,97 cm, hipertonia, diminuição da amplitude de movimento, grande dependência nas atividades de vida diária e um importante atraso no desenvolvimento neuropsicomotor. CONSIDERAÇÕES FINAIS: Com isto é possível destacar que os distúrbios apresentados, contribuem de maneira negativa para o desenvolvimento motor das crianças gerando um impacto em sua qualidade de vida

INTRODUCTION: In the second half of 2015, an outbreak of microcephaly was recorded in the northeast of Brazil. This article aims to outline the clinical profile of patients with congenital Zika virus syndrome in the city of Campina Grande. METHODS: This was a documentary study with a quantitative approach. Data collection took place at the Specialized Center for Rehabilitation (CER), in the city of Campina Grande in the state of Paraíba, with the analysis of 66 medical records. RESULTS: Most of them were female (57.6%), with an average age of 3.36 years. There was a predominance of Zika virus infection in the first trimester of pregnancy (69.7%), in mothers with a low level of education, in which only 28.8% completed high school. Most of the children, even with the infection, were born at term (68.2%), however, they had low birth weight, 2.697 kg on average, average head circumference of 29.97 cm, hypertonia, decreased range of motion, great dependence on activities of daily living and an important delay in neuropsychomotor development. FINAL CONSIDERATIONS: With this it is possible to highlight that the disorders presented, contribute negatively to the motor development of children generating an impact on their quality of life

Characterization of amputees at a large hospital in Recife, PE, Brazil.

BACKGROUND: Limb amputation can be defined as a procedure that consists of separating a limb or a segment of a limb from the body. OBJECTIVES: To describe the profile of limb amputation procedures performed at a large hospital run by the state of Pernambuco (Brazil). METHODS: Cross-sectional descriptive and retrospective study conducted at a large hospital in the city of Recife, PE. Data were collected from the records of patients who underwent amputations during 2017. Records from patients who had had a limb amputation during 2017 were included, unless data were illegible or missing. RESULTS: A total of 328 procedures were performed on 274 patients, the majority of whom were male (57.7%). There was a predominance of lower limb amputations (64.2%), of non-traumatic causes (86.5%), and urgent treatment (96.4%). The majority of patients who underwent amputations remained in hospital for 11 to 25 days (32.1%). The study found that the majority of amputees were discharged (69.7%), although a proportion died. Deaths of lower limb amputees were primarily among elderly women in the age range of 60 to 90 years (76%), females (55%), and patients subjected to a single amputation (91%). CONCLUSIONS: The data observed in this study are alarming, particularly considering that many of these amputations could have been avoided, since they were caused by complications of diseases that can be prevented and controlled at healthcare services of a lower level of complexity and at a relatively low cost.

OSTEODENSITOMETRY AND TOMOGRAPHIC FINDINGS IN FOUR CAPTIVE GIANT SOUTH AMERICAN TURTLES (PODOCNEMIS EXPANSA) WITH METABOLIC BONE DISEASE.

Giant South American turtles (Podocnemis expansa) are at a risk of extinction because of the rapid decline in their population over the last few decades. Metabolic bone disease (MBD) is common in captive testudines, but is often not diagnosed until a later stage. The authors present the cases of four captive giant South American turtles with carapace deformity secondary to MBD that underwent computed tomography (CT) scans of the carapace bones and vertebral column. Findings indicative of changes in geometry were found in both. The cancellous bone pattern was characterized by varying degrees of increased trabecular spacing and cortical thinning of the pleural bones. Bone densitometry analysis of the pleural and neural bones and at the level of the body of the third, fourth, and fifth dorsal vertebrae showed mean density values much lower than those found in two adult specimens of the same species that were considered healthy. In conclusion, CT contributed important information on the degree of demineralization and possible structural changes due to MBD and should be considered a relevant tool for diagnosis of this condition.

Caracterização das pessoas amputadas de um hospital de grande porte em Recife (PE, Brasil) / Characterization of amputees at a large hospital in Recife, PE, Brazil

A amputação de membros pode ser definida como um procedimento que consiste em separar do corpo um membro ou segmento dele. Objetivos Descrever o perfil dos procedimentos de amputações de membros realizados em um hospital estadual de grande porte. Métodos Estudo transversal do tipo descritivo e retrospectivo realizado em um hospital de grande porte da cidade de Recife (PE). Os dados foram coletados em registros de pacientes que foram submetidos à amputação no ano de 2017. Foram incluídos pacientes que tiveram seu membro amputado em 2017 e excluídos aqueles com informações ilegíveis ou incompletas. Resultados Foram realizados 328 procedimentos em 274 pacientes, a maioria do gênero masculino (57,7%). Houve predominância de amputações em membros inferiores (64,2%), de causa não traumática (86,5%) e atendimentos de urgência (96,4%). A maioria dos pacientes submetidos a amputações ficaram internados por um período de 11 a 25 dias (32,1%). Este estudo mostrou que a maioria das pessoas amputadas recebeu alta (69,7%) e uma parte foi a óbito, sendo os óbitos, no caso das amputações de membros inferiores, principalmente de pessoas idosas na faixa etária de 60 a 90 anos (76%), do sexo feminino (55%), e submetidas a uma amputação (91%). Conclusões Os dados apresentados neste estudo são alarmantes, principalmente ao se considerar que muitas das amputações poderiam ter sido evitadas, visto que foram decorrentes de complicações de doenças cuja prevenção e controle podem ser realizados em outros níveis de complexidade do sistema e com custo relativamente baixo

Limb amputation can be defined as a procedure that consists of separating a limb or a segment of a limb from the body. Objectives To describe the profile of limb amputation procedures performed at a large hospital run by the state of Pernambuco (Brazil). Methods Cross-sectional descriptive and retrospective study conducted at a large hospital in the city of Recife, PE. Data were collected from the records of patients who underwent amputations during 2017. Records from patients who had had a limb amputation during 2017 were included, unless data were illegible or missing. Results A total of 328 procedures were performed on 274 patients, the majority of whom were male (57.7%). There was a predominance of lower limb amputations (64.2%), of non-traumatic causes (86.5%), and urgent treatment (96.4%). The majority of patients who underwent amputations remained in hospital for 11 to 25 days (32.1%). The study found that the majority of amputees were discharged (69.7%), although a proportion died. Deaths of lower limb amputees were primarily among elderly women in the age range of 60 to 90 years (76%), females (55%), and patients subjected to a single amputation (91%). Conclusions The data observed in this study are alarming, particularly considering that many of these amputations could have been avoided, since they were caused by complications of diseases that can be prevented and controlled at healthcare services of a lower level of complexity and at a relatively low cost

Configurações do processo de trabalho em núcleos de apoio à saúde da família e o cuidado integral / Work process configurations in family health support centers and comprehensive care / Configuraciones del proceso de trabajo en núcleos de apoyo a la salud de la familia y el cuidado integral

Resumo O estudo tem como objetivo sistematizar as configurações de Núcleos de Apoio à Saúde da Família. Trata-se de uma pesquisa qualitativa realizada em três municípios da Região Metropolitana do Recife, que utilizou dados coletados com grupos focais em três Núcleos de Apoio à Saúde da Família, analisados por meio da técnica de condensação de significados. Os resultados permitiram sistematizar três tipos de configurações: assistencial-curativista, que apresenta um distanciamento intenso do objetivo do Núcleo de Apoio à Saúde da Família; semimatricial, considerado uma configuração intermediária, e o matricial, que se aproxima mais do modelo ideal, preconizado pelo Ministério da Saúde. Conclui-se que existe, nos três municípios, uma proposta recente, frágil e que, apesar de ter potencialidades, é permeada por conflitos, contestações e incertezas. As informações obtidas podem subsidiar o planejamento e a execução de ações que busquem romper com vários conceitos hegemônicos norteadores da atuação dos profissionais de saúde na atenção básica.

Abstract The aim of this study was to systematize the configurations of Family Health Support Centers. A qualitative study was conducted in three municipalities of metropolitan Recife, in the state of Pernambuco, Brazil, and considered data collected from focus groups in three Family Health Support Centers and analyzed through the meaning condensation technique. The study's findings allowed the systematizing of three types of configurations: the assistive-curative, which shows great distancing from the family health support center's goals; the semi-matrical, considered to be an intermediary configuration, and the matrical, which stays closer to the ideal model, recommended by the Ministry of Health. In conclusion, there is, on all three municipalities, a recent and fragile family health proposal that, despite its potentialities, is permeated with conflicts, contestations and uncertainties. The findings of the present study can assist in the planning and execution of actions that seek to break from various hegemonic concepts regarding the work of primary healthcare professionals.

Resumen El estudio tiene como objetivo sistematizar las configuraciones de Núcleos de Apoyo a la Salud de la Familia. Se trata de una investigación cualitativa realizada en tres municipios de la Región Metropolitana de Recife, que utilizó datos recogidos con grupos focales en tres Núcleos de Apoyo a la Salud de la Familia, analizados por medio de la técnica de condensación de significados. Los resultados permitieron sistematizar tres tipos de configuraciones: asistencial-curativista, que presenta un gran distanciamiento del objetivo del Núcleo de Apoyo a la Salud de la Familia; semimatricial, considerada una configuración intermedia; y matricial, que se aproxima más al modelo ideal propuesto por el Ministerio de Salud. Se concluyó que en los tres municipios existe una propuesta reciente, frágil y que, a pesar de tener potencial, es atravesada por conflictos, discordancias e inseguridades. La información obtenida puede ayudar a la planificación y ejecución de acciones con el objetivo de romper varios conceptos hegemónicos que orientan la práctica de los profesionales de salud en la atención básica.

A strategy action from the Cievs/Pernambuco in response to the emergency on Congenital Syndrome associated to Zika virus infection: an integrative action / Estratégia de atuação do Cievs/Pernambuco na resposta à emergência da Síndrome Congênita associada à infecção pelo vírus Zika: uma ação integrativa

Abstract Objectives: to describe the strategy action from the Centro de Informações Estratégicas de Vigilância em Saúde (Cievs/PE) (Strategic Information on Health Surveillance Center) in response to the emergency on Congenital Syndrome associated to Zika virus infection (CSZ) in Pernambuco State between 2015 and 2016. Methods: description performed on the strategies and activities developed by Cievs/PE during the important international public health emergency related to CSZ. Results: participated in detecting suspected CSZ cases; participated in elaborating clinical epidemiological protocols; developed electronic forms to notify CSZ cases and pregnant women with exanthema rashes; prepared epidemiological reports; developed a website about the emergency on the Cievs/PE website; insert the occurrence in the Comitê de Avaliação e Monitoramento de Eventos (CAME) (Committee to Assess and Monitor Occurrence); resolution of demands during readiness; technical visits from National and International institutions. The actions developed by the Cievs/PE were fundamental in detecting and following-up on 2,073 CSZ cases. 390 cases were confirmed (18.1%) and 1,413 were discarded (65.6%), and 4,467 pregnant women had exanthema rash. Conclusions: the action from the Cievs/PE allowed to employ timely strategies on preparation and response in a qualified and cooperative way to face public health emergency on CSZ's

Resumo Objetivos: descrever a estratégia de atuação do Centro de Informações Estratégicas de Vigilância em Saúde (Cievs/PE) na resposta à emergência da Síndrome Congênita associada à infecção pelo vírus Zika (SCZ) no estado de Pernambuco, entre 2015 e 2016. Métodos: realizada descrição das estratégias e atividades desenvolvidas pelo Cievs/PE durante a emergência em saúde pública de importância internacional relacionada a SCZ. Resultados: participação na detecção dos casos suspeitos da SCZ; participação na elaboração dos protocolos clínico epidemiológicos; construção de formulários eletrônicos para notificação dos casos da SCZ e gestante com exantema; elaboração de informes epidemiológicos; construção de página eletrônica sobre a emergência no site do Cievs/PE; inserção do evento no Comitê de Avaliação e Monitoramento de Eventos (CAME); resolução de demandas durante a prontidão; visita técnica de instituições nacionais e internacionais. As ações desenvolvidas pelo Cievs/PE foram fundamentais para a detecção e acompanhamento de 2.073 casos da SCZ, com a confirmação 390 (18,1%) e descarte de 1.413 (65,6%) casos, e 4.467 gestantes com exantema. Conclusões: a atuação do Cievs/PE permitiu o emprego de estratégias de preparação e resposta em tempo oportuno, de forma qualificada e cooperativa no enfrentamento a emergência em saúde pública da SCZ.

Carcinoma mamário com metástase pulmonar em tatu-peba (Eupharactus sexcinctus) / Breast carcinoma with pulmonary metastasis in armadillo (Eupharactus sexcinctus)

Background: Breast neoplasms are among the most common neoplastic conditions affecting domestic animals and are considered the most common type of cancer affecting women, bitches, and cats. However, there are few reports on breast neoplasms in wild animals, and there is no record of their occurrence in armadillos worldwide. Breast neoplasms are hormone-dependent neoplasms that often cause lymph node and pulmonary metastases. The diagnosis is based on the patient’s history, complete physical examination, and complementary tests. Here we report a case of mammary neoplasia with pulmonary metastasis in an armadillo (Euphractus sexcinctus).Case: A senile female armadillo was referred to us for treatment with a history of hyporexia and nodules in both breasts. Ultrasonographic examination revealed a hypoechogenic nodular lesion with a cross-section of approximately 1.3 × 1.4 cm and well-defined borders. The lesion had a circumscribed aspect in the left mammary gland. In the right mammary gland, there was a heterogeneous lesion with cystic formations and anechoic content. Cytopathological examination of the nodules was performed by fine needle aspiration cytology and revealed the presence of epithelial cells with ovoid and aberrant nuclei, anisocariasis, binucleation, coarse chromatin, and a high nucleus to cytoplasm ratio suggestive of carcinoma. The animal had a lean body score due to hyporexia that had evolved to anorexia and was undergoing supportive treatment. Nevertheless, the animal died two months after the cytologic diagnosis. A necropsy was performed. Cutting of the breast nodules revealed a hardened pale yellow material. The animal had pronounced pleural effusion, hemorrhage, and numerous pale yellow nodules of various sizes with firm consistency throughout the lung parenchyma. It also had hepatomegaly and splenomegaly.[...]

Carcinoma mamário com metástase pulmonar em tatu-peba (Eupharactus sexcinctus) / Breast carcinoma with pulmonary metastasis in armadillo (Eupharactus sexcinctus)

Background: Breast neoplasms are among the most common neoplastic conditions affecting domestic animals and are considered the most common type of cancer affecting women, bitches, and cats. However, there are few reports on breast neoplasms in wild animals, and there is no record of their occurrence in armadillos worldwide. Breast neoplasms are hormone-dependent neoplasms that often cause lymph node and pulmonary metastases. The diagnosis is based on the patients history, complete physical examination, and complementary tests. Here we report a case of mammary neoplasia with pulmonary metastasis in an armadillo (Euphractus sexcinctus).Case: A senile female armadillo was referred to us for treatment with a history of hyporexia and nodules in both breasts. Ultrasonographic examination revealed a hypoechogenic nodular lesion with a cross-section of approximately 1.3 × 1.4 cm and well-defined borders. The lesion had a circumscribed aspect in the left mammary gland. In the right mammary gland, there was a heterogeneous lesion with cystic formations and anechoic content. Cytopathological examination of the nodules was performed by fine needle aspiration cytology and revealed the presence of epithelial cells with ovoid and aberrant nuclei, anisocariasis, binucleation, coarse chromatin, and a high nucleus to cytoplasm ratio suggestive of carcinoma. The animal had a lean body score due to hyporexia that had evolved to anorexia and was undergoing supportive treatment. Nevertheless, the animal died two months after the cytologic diagnosis. A necropsy was performed. Cutting of the breast nodules revealed a hardened pale yellow material. The animal had pronounced pleural effusion, hemorrhage, and numerous pale yellow nodules of various sizes with firm consistency throughout the lung parenchyma. It also had hepatomegaly and splenomegaly.[...](AU)

O papel do Núcleo de Apoio à Saúde da Família na coordenação assistencial da Atenção Básica: limites e possibilidades / The role of Family Health Support Center in assistance coordination of Primary Health Care: limits and possibilities

RESUMO O objetivo deste estudo foi o de analisar como o Núcleo de Apoio à Saúde da Família tem colaborado com as Equipes de Saúde da Família na sua função de coordenação assistencial. Realizou-se um estudo qualitativo do tipo estudo de caso no município de Camaragibe, Pernambuco. A coleta de dados cobriu o período de janeiro a maio de 2015 e aplicou grupos focais, análise documental e observação participante. Os resultados evidenciam que o Núcleo de Apoio à Saúde da Família, atuando segundo a lógica do apoio matricial, pode colaborar com o fortalecimento da função de coordenação assistencial da Atenção Básica.

ABSTRACT The aim of this study was to analyze how the Family Health Support Center has contributed to Family Health Teams in the fulfillment of its assistance coordination function. A qualitative case study was performed in the city of Camaragibe, State of Pernambuco. Data collection was held from January 2015 to May 2015 by means of focal groups, document analysis, and participatory observation. Results demonstrate that the Family Health Support Center, which acts following the logic of matrix support, is able to collaborate for the reinforcement of the Primary Health assistance coordination function.

Características dos primeiros casos de microcefalia possivelmente relacionados ao vírus Zika notificados na Região Metropolitana de Recife, Pernambuco / Características de los primeros casos de microcefalia, posiblemente relacionadas con el virus Zika reportados en la Región Metropolitana de Recife / Characteristics of the first cases of microcephaly possibly related to Zika virus reported in the Metropolitan Region of Recife, Pernambuco State, Brazil

OBJETIVO: descrever os primeiros casos de microcefalia possivelmente relacionados ao vírus Zika em nascidos vivos notificados na Região Metropolitana do Recife, Pernambuco, Brasil. MÉTODOS: estudo descritivo de tipo série de casos (notificados de 1º de agosto a 31 de outubro de 2015), com dados obtidos dos registros médicos e de questionário aplicado às mães. RESULTADOS: foram confirmados 40 casos com microcefalia, distribuídos em oito municípios da Região Metropolitana do Recife, com maior concentração no Recife (n=12); a mediana do perímetro cefálico foi de 29 cm, do perímetro torácico, 31 cm, e do peso, 2.628 gramas; 21/25 casos apresentaram calcificação cerebral, ventriculomegalia ou lisencefalia; entre as 40 mães, 27 referiram exantema na gestação, 20 no primeiro trimestre e sete no segundo, além de prurido, cefaleia, mialgia e ausência de febre. CONCLUSÃO: a maioria dos casos apresentou características de infecção congênita; a maioria das mães apresentou quadro sugestivo de infecção pelo vírus Zika na gestação.

OBJETIVO: describir los primeros casos de microcefalia en nacidos vivos reportados al Departamento de Salud del Estado de Pernambuco, en la región metropolitana de Recife, Pernambuco, 2015. MÉTODOS: estudio epidemiológico descriptivo de serie de casos (reportados de 1 de agosto a 31 de octubre de 2015), con datos obtenidos de registros médicos y cuestionarios aplicados a las madres. RESULTADOS: 40 casos fueron confirmados con microcefalia, en ocho municipios de la región metropolitana de Recife, con mayor concentración de casos en Recife (n=12); la circunferencia media de la cabeza fue 29 cm, perímetro torácico 31 cm y peso 2.628 gramos; exámenes revelaron que 21/25 casos mostraron calcificación, dilatación ventricular o lisencefalia; de las 40 madres, 27 (68%) informan exantema durante la gestación, 20 (74%) en el primer trimestre y siete (26%) en la segunda, además de prurito, dolor de cabeza, mialgia y ausencia de fiebre. CONCLUSIÓN: la mayoría de los casos presenta características de infección congénita; la mayoría de las madres mostró características que sugieren infección por el virus Zika en el embarazo.

OBJECTIVE: to describe the first cases of microcephaly possibly related to Zika virus in live born babies reported in the Metropolitan Region of Recife, Pernambuco State, Brazil. METHODS: this was a descriptive case series study (cases reported between August 1st and October 31st 2015), using medical record data and data from a questionnaire answered by the mothers of the babies. RESULTS: 40 microcephaly cases were confirmed, distributed in eight municipalities within the Metropolitan Region, with Recife itself having the highest concentration of cases (n=12); median head circumference was 29 cm, median chest girth was 31 cm and median weight was 2,628 grams; 21/25 cases had brain calcification, ventriculomegaly or lissencephaly; 27 of the 40 mothers reported rash during pregnancy, 20 in the first trimester and 7 in the second trimester, as well as itching, headache, myalgia and absence of fever. CONCLUSION: the majority of the cases bore the characteristics of congenital infection; the clinical condition of the majority of mothers suggested Zika virus infection during pregnancy.

Characteristics of the first cases of microcephaly possibly related to Zika virus reported in the Metropolitan Region of Recife, Pernambuco State, Brazil. / Características dos primeiros casos de microcefalia possivelmente relacionados ao vírus Zika notificados na Região Metropolitana de Recife, Pernambuco.

OBJECTIVE: to describe the first cases of microcephaly possibly related to Zika virus in live born babies reported in the Metropolitan Region of Recife, Pernambuco State, Brazil. METHODS: this was a descriptive case series study (cases reported between August 1st and October 31st 2015), using medical record data and data from a questionnaire answered by the mothers of the babies. RESULTS: 40 microcephaly cases were confirmed, distributed in eight municipalities within the Metropolitan Region, with Recife itself having the highest concentration of cases (n=12); median head circumference was 29 cm, median chest girth was 31 cm and median weight was 2,628 grams; 21/25 cases had brain calcification, ventriculomegaly or lissencephaly; 27 of the 40 mothers reported rash during pregnancy, 20 in the first trimester and 7 in the second trimester, as well as itching, headache, myalgia and absence of fever. CONCLUSION: the majority of the cases bore the characteristics of congenital infection; the clinical condition of the majority of mothers suggested Zika virus infection during pregnancy.

Ectopic testis in coati (Nasua nasua Linnaeus, 1766) / Testículo ectópico em quati (Nasua nasua Linnaeus, 1766)

This paper reports a case of unilateral extracorporeal ectopic testes in a captive coati (Nasua nasua) in the State Park of Dois Irmãos Zoo, Recife/PE, Brazil. The testicle was located in the subcutaneous tissue of the inguinal region not adhered to the surrounding tissues. After bilateral orchiectomy, both testes were measured, fixed with 10% formalin buffered and embedded in paraffin for histopathological evaluation. The left testis measured 1.2 cm width by 1.7cm length, and the right one measured 1.5 cm width by 2.0 cm length. The ectopic testes had seminiferous epithelium without post-meiotic germ cell lines. The non-ectopic testis had several changes in the seminiferous epithelium that indicated degeneration. In both epididymis, the lumen did not contain sperm and the major epithelial structural alterations were more distinct in the epididymis associated to the ectopic testicle. In conclusion, the ectopic testis and epididymis had lesions compatible with testicular exposition to body temperature. Non-ectopic epididymis and testis had minor lesions but could be related to the infertility of the coati.(AU)

O artigo relata um caso de testículo ectópico em quati de cativeiro (Nasua nasua) no Zoológico do Parque Estadual Dois Irmãos, Recife/PE. O testículo encontrava-se localizado no tecido subcutâneo da região inguinal, sem estar aderido aos tecidos circunvizinhos. Após orquiectomia bilateral, ambos os testículos foram mensurados, fixados em formol a 10% e embebidos em parafina para avaliação histopatológica. O testículo esquerdo mediu 1,2cm de largura por 1,7cm de movimento; e o testículo direito mediu 1,5cm de largura por 2,0cm de comprimento. O testículo ectópico apresentou epitélio sem linhagem de células germinativas pós-meióticas. O testículo não ectópico apresentou alterações no epitélio seminífero caracterizando degeneração. Em ambos os epidídimos, o lúmen não continha espermatozoides e as principais alterações estruturais do epitélio foram mais distintas no epidídimo associado ao testículo ectópico. Conclui-se que o testículo ectópico e epidídimo apresentaram lesões características de aumento de temperatura. O testículo e epidídimo não ectópico apesentaram lesões menores mas que puderam ser associadas à infertilidade do quati.(AU)