A school-based physical activity intervention in primary school: effects on physical activity, sleep, aerobic fitness, and motor competence.

Objective: The "Super Quinas" project evaluated the effectiveness of an intervention program to improve physical activity, aerobic fitness, sleep, and motor competence on children in primary school. Methods: The experimental group (n = 19) enrolled in a 12-week intervention program (one more extra-curricular activity class of 60 min per week) compared to the CG (n = 19), all aged 9-10 years. Physical activity (PA) and sleep were measured by accelerometry, and aerobic fitness was measured by Children's Yo-Yo test (YYIR1C) during the 1st week (PRE), the 6th week (DUR), and the 12th week (POST) of the intervention program. Motor Competence in PRE and POST intervention was also assessed by the Motor Competence Assessment (MCA) instrument. Heart rate (HR, assessed using HR monitors), and enjoyment level were recorded during all intervention program classes. A linear mixed model analysis (i.e., within-subject analyses) was performed. Results: Comparing the EG and CG in DUR and POST, the EG spent ~18 min and ~ 34 min more time in moderate to vigorous physical activity (MVPA) per day (p < 0.001); had ~44 min and ~ 203 min less sedentary time per day (p < 0.001); performed more 44 and 128 m in the Children's Yo-Yo test compared to CG (p < 0.001) and slept more 17 and 114 min per night (p < 0.001). In POST motor competence was significantly better (27%) in the EG compared to CG (p < 0.001). The %HRmax during the extra-curricular classes ranged between 65 and 81% (i.e., light to moderate intensities), and the enjoyment between fun and great fun. Conclusion: Our findings suggest that adding one more extra-curricular activity class of 60 min per week for 12 weeks effectively increased the levels of physical activity, aerobic fitness, sleep duration, and motor competence in children aged 9-10 years.

Primary gastric squamous cell carcinoma: case report.

Primary gastric squamous cell carcinoma is an extremely rare entity with an unknown etiopathology, and prognosis is generally poor. While diagnostic criteria are standardized, the optimal treatment strategy is not defined due to its rarity. In this article, we present a case of primary gastric squamous cell carcinoma, discussing its approach and treatment.

Spontaneous Rupture of a Urinary Bladder Diverticulum in Women: A Rare Cause of an Acute Abdomen.

A bladder diverticulum (BD) is an abnormal pouch protruding from the bladder wall, which can be congenital or acquired. Acquired diverticula are more common, usually secondary to outflow obstruction or neurogenic bladder. Spontaneous rupture of a BD is rare, particularly in women. This report is about a female patient who develops abdominal pain and dysuria, progressing to an acute abdomen. The diagnosis of spontaneous rupture of a BD was suspected in pelvic ultrasound and confirmed in computed tomography (CT) cystography. The patient was submitted to diverticulectomy and bladder wall reconstruction. Although rare, this entity should be considered in patients with acute abdomen with unclear etiology, even in women with no evident risk factors for a BD or its rupture.

Grynfeltt Hernia (GH): A Rare Case of Hernia.

Grynfeltt hernia (GH) is extremely rare among all abdominal wall hernias, so both diagnosis and treatment can be challenging. Surgery, open or laparoscopic, is the only definitive treatment. We present a case of a 71-year-old woman with GH (initially misdiagnosed as a lipoma), its approach, and treatment. We performed a hernioplasty with two meshes (preperitoneal and subaponeurotic position) by an open approach: Sandwich technique. This technique is safe, feasible, and associated with no short-term complications or relapses.

Prevalence of Imaging Detected Silent Male Breast Cancer in Autopsy Specimens: Study of the Disease Held by Image-Guided Biopsies.

Introduction: Regarding male breast cancer, a rare disease comprising ∼1% of breast cancers, data are generally scant. The present study aimed to quantify the imaging detected breast cancer in male gender corpses, determining in this way the prevalence of silent breast cancer in male gender. Methodology: The population target has been male corpses without clinical expression of breast cancer. Seventy-four male corpses have been submitted to bilateral subcutaneous radical mastectomy. Samples have been submitted to echography and mammography imaging and every lesion superior to BI-RADS 4a has been excised. Results: One excisional biopsy has been performed and no case of breast cancer has been identified. Discussion: Our findings suggest that screening of the general population for male breast cancer is not necessary.

Effects of home-based exercise programs on physical fitness in cancer patients undergoing active treatment: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVES: This systematic review and meta-analysis aimed to investigate the effects of home-based exercise on physical fitness (cardiorespiratory fitness, muscle strength, and body composition) in cancer patients undergoing active treatment. DESIGN: Systematic review with meta-analysis and Grading Recommendations Assessment, Development, and Evaluation of the evidence. METHODS: A comprehensive search of existing literature was carried out in four electronic databases: PubMed, Web of Science, Scopus, and PEDro. All databases were searched for randomized controlled trials assessing the effects of home-based exercise on physical fitness outcomes in cancer patients during active treatment. Multicomponent interventions (i.e., exercise plus diet/behavioral therapy) were excluded. The methodological quality of each study was assessed using the Revised Cochrane risk-of-bias tool for randomized trials. Meta-analytical procedures were performed when appropriate and standardized mean differences (SMD) were calculated. RESULTS: Twenty-eight randomized controlled trials (n = 2424 cancer patients) were included. Most of the interventions were conducted in breast cancer patients (n = 13) during the adjuvant treatment period (n = 17); 18 studies included a walking component in their home-based protocol. Home-based exercise was effective at improving the distance of the 6-minute walk test (k = 6; SMD = 0.321, p = 0.010). However, the results were no longer significant when performing sensitivity analysis based on exclusively walking (k = 1) and non-exclusively walking interventions (k = 5; SMD = 0.258; p = 0.072). No effects were found for muscle strength and body composition outcomes (p > 0.05). CONCLUSIONS: Regular home-based exercise programs are an effective strategy to improve 6-minutes walk test in cancer patients undergoing active treatment. Conversely, no alterations were found in muscle strength and body composition.

Prevalence of Imaging-Detected Silent Female Breast Cancer in Autopsy Specimens: A Study Using Image-Guided Biopsies.

Background This study was conducted to evaluate the prevalence of imaging-detected silent breast cancer in females, with the hypothesis that the incidence of imaging-detected silent breast cancer in females is greater than the true disease incidence. The main purpose of this study is the attempt to prove whether breast imaging can identify silent breast cancers that apparently are common in serial histology analysis. Methodology A series of 217 consecutive medicolegal autopsies on fresh Portuguese cadavers were performed from July 2016 to December 2019 at the National Institute of Legal Medicine and Forensic Science, Lisbon, Portugal. The criteria for exclusion were age younger than 40 years, the autopsy performed in less than 48 hours after death, any major injury to one or both breasts, and known or clinically evident breast cancer. Once the eligibility criteria were met, and the sample collection authorization was obtained, a bilateral subcutaneous modi-fied radical mastectomy was performed in each fresh cadaver at the National Institute of Legal Medicine and Forensic Science. Mammography, ecography, and excisional biopsies of suspect areas were conducted on the collected samples. Results The indication for excisional biopsy by imaging was assigned in eight cases, and no breast cancer was discovered in the excised specimens. Conclusions In light of the findings, it cannot be concluded that the imaging-detected silent breast cancer prevalence is higher than the actual incidence of the disease, so the author's initial hypothesis was rejected. Mammography does not overdiagnose breast cancer. Benign breast alterations are common, accounting for 43.6% of the corpses collected, while low-suspicion alterations were discovered in 1.84% of breast samples. The objective examination, which included inspection and palpation, missed 37.5% of the biopsied breast changes. This finding indicated that an objective examination leads to a significant number of false-negative results which cannot be used as a screening method.

Laparoscopic Repair of an Acute Traumatic Diaphragmatic Hernia: Clinical Case.

Traumatic diaphragmatic rupture is uncommon, life threatening and remains a diagnostic and radiographic challenge. Diagnosis is frequently delayed, which may result in a late intervention with a potential catastrophic outcome. We report a case of an acute diaphragmatic laceration in a 40-year-old woman, with a personal history of bipolar disease, admitted on the emergency department after falling from a nine-meter building. During initial evaluation, the plain chest radiograph showed multiple rib fractures associated with a significant left pneumothorax. It also showed an elevated left diaphragm with a suspicious gastric shadow in the left hemithorax. Computed tomography confirmed the diagnosis of a left-sided diaphragmatic laceration and the patient was advised surgical intervention. During laparoscopy, a 7 cm rupture of the left hemi-diaphragm with herniation of the stomach was identified. The hernia was reduced laparoscopically and the defect repaired with interrupted, non-absorbable, sutures. The patient had an uneventful recovery and remained well at a 3-month follow-up visit. Emergency repair of the diaphragm is usually performed via a thoracotomy or/and laparotomy. However, if the patient is hemodynamically stable and major organ injuries have been excluded, a laparoscopic approach can be considered safe and effective.

Estudo prospectivo utilizando material coletado por bioptycut para realização de exame de congelação em pacientes com tumores de mama / Prospective study using bioptycut specimens for frozen section in patients with breast tumors

Estudo conduzido com o objetivo de avaliar a confiabilidade, acurácia e dificuldades do exame de congelação, utilizando-se pequenos fragmentos de tumores mamários obtidos com a biópsia histológica por agulha grossa (bioptycut). Durante 13 meses, 37 pacientes foram submetidas ao Bioptycut (pistola BIP 2.2 ou Promag 1.2, agulhas 14G), sendo que, de cada uma delas, foram retirados no mínimo dois fragmentos, um a fresco para congelação e outro submerso em formol para inclusão posterior em parafina. O estudo de congelação constituiu-se de exame citológico do "imprimir" da peça e de exame histológico usando cortes através de congelação. Os cortes foram feitos usando criostato e micrótomo, com cortes de 8µ. O tamanho do tumor puncionado variou de 1cm a 12cm (média 4,8cm). A congelação foi conclusiva em 33 casos (89 por cento), sendo trinta carcinomas e três benignos, e inconclusiva em quatro casos (11 por cento). A obtenção deste diagnóstico se deu pelo "imprint" e corte em 29 casos (78 por cento), só pelo "imprint" em quatro casos (11 por cento), em dois casos tanto o corte quanto o "imprint" foram inadequados e dois não foram descritos. Posteriormente foram obtidas peças por exérese da lesão (até a análise) em 28 casos, dos quais 25 carcinomas e três tumores benignos (11 por cento). Houve um caso de congelação conclusiva de benignidade, em que a exérese posterior revelou se tratar de carcinoma (falso-negativo). Não houve falsos-positivos. A sensibilidade foi de 96 por cento e a especificidade de 100 por cento. Assim, conclui-se que o exame por congelação, usando-se peças obtidas com bioptycut se mostrou confiável, evitando biópsias abertas em 81 por cento dos casos, garantindo rapidez e melhor preparo das pacientes para terapêutica definitiva

Influência de corticóide, na Doença de Chagas crônica, administrado em virtude de afecçöes associadas / Corticosteroid influence on chronic Trypanosoma cruzi infected patients, administered by virtue of associated diseases

Individuos acometidos de doença de Chagas em fase crônica foram tratados com corticóide, em virtude de afecçöes concomitantes. A fim de avaliar repercussöes sobre a infecçäo devida ao Trypanosoma cruzi, houve adoçäo de procedimentos de várias ordens, representados por métodos referentes à parasitose, exames inespecíficos e subsídios clínico, eletrocardiográfico e radiológico, tendo também sido mantido, para comparaçäo, grupo controle. Através do xenodiagnóstico ficou constatada a acentuaçäo da parasitemia, diretamente relacionada com a dose de corticóide, sem influência na evoluçäo da enfermidade parasitária, pelo menos durante o período no qual ocorreu a investigaçäo

AvaliaçÝo da dissecçäo axilar na mastectomia radical modificada a Madden para o tratamento do câncer mamário / Evaluation of axillary dissection in Madden modified radical mastectomy for treatment of breast cancer

Com o objetivo de analisar o número de linfonodos dissecados, foram estudados 229 pacientes portadoras de câncer de mama, tratadas no Hospital Araújo Jorge entre 1979 e 1988. Destas, 175 foram submetidas à mastectomia radical clássica (MRC) e 54 à mastectomia radical modificada com preservaçäo de ambos os músculos peitorais (MRM). NÝo houve influência do estádio clínico nem do tratamento prévio sobre o procedimento cirúrgico, porém pacientes mais jovens foram submetidas mais freqüentemente à MRC. O número médio de linfonodos disecados foi maior na MRC que na MRM, 23 e 18 respectivamente. Ressecçäo de mais de 30 gânglios só foi obtida com a MRC, sendo esta diferença significativa (p < 0,001). Concluiu-se que a MRC possibilita uma melhor dissecaçäo axilar com retirada de maior número de linfonodos quando comparado à MRM com preservaçäo de ambos os peitorais.

Tumor de células granulosas (mioblastoma) da mama / Granular tumor (myoblastoma) of the breast

O tumor de células granulosas (TCG) é uma neoplasia que raramente se localiza no tecido mamario, onde geralmente simula um carcinoma. Acredita-se que sua origem seja neurogênica, porém ela nao esta completamente elucidada. É relatado um caso de TCG em uma paciente de 44 anos, na qual o exame físico, a mamografia e a ecografia mamaria foram sugestivos de malignidade, sendo o diagnóstico definido apenas pela histologia. Foram realizados testes imuno-histoquímicos que reforçaram o diagnóstico histológico. Com base na literatura sao discutidos aspectos da origem do tumor, sua divisao histológica e tratamento.

Nódulos tiroidianos e câncer da tiróide: 1975-1983 / Thyroid nodules and thyroid cancer 1975-1983

Os autores analisaram 298 pacientes portadores de patologia tiroidiana atendidos no Hospital Araújo Jorge da ACCG. A cintilografia tiroidiana mostrou hipocaptaçäo em 55% dos casos. O carcinoma folicular foi a neoplasia mais freqüente (55%). A tiroidectomia total foi o tratamento preconizado em 72,6%. A complicaçäo pós-operatória mais comum foi a disfonia em 4,8%

Osteossarcoma de pequenas células simulando sarcoma de Ewing: apresentaçäo de um caso / Small cell osteosarcoma simulating Ewing's sarcoma: report of a case

Apresenta-se um caso de osteossarcoma de pequenas células que ocorreu em paciente do sexo masculino de 17 anos de idade. O quadro histológico pode realmente ser confundido com o de sarcoma de Ewing e a imagem radiológica näo mostrou calcificaçäo que sugerisse o diagnóstico de um tumor osteoformador. A evoluçäo foi rápida, o paciente falecendo 6 meses depois da amputaçäo

Tumor ósseo de comportamento biológico benigno apesar da malignidade histológica / Bone tumor of benign biological behavior in spite of histological malignancy

Apresenta-se um caso de tumor ósseo histologicamente maligno, mas de comportamento biológico benigno, avaliado do ponto de vista clínico e radiológico, que ocorreu em paciente do sexo feminino de 18 anos de idade. Em funçäo do diagnóstico anatômico da lesäo, optou-se pela ressecçäo em bloco, com resultado satisfatório observado durante 10 anos

Correlaçäo citologia-colposcopia-conizaçäo nas displasias cervicais uterinas / Cytology colposcopy-conization correlation in uterine cervical dysplasias

Foram estudados 101 casos de conizaçäo do colo uterino no período de 1979 a 1981. Os exames citológico e colposcópico foram correlacionados com o exame histopatológico. Encontraram-se 11,8% de resultados falsos negativos e 4,9% de falsos positivos para a citologia vaginal. A colposcopia evidenciou concordância total com o exame histopatológico em 75,1% dos casos, sendo as lesöes leucoqueratóticas as mais freqüentes (58%) A complicaçäo mais freqüente da conizaçäo foi o sangramento vaginal (8,9%)

Reaçäo de células gigantes do osso: apresentaçäo de um caso e revisäo da literatura / Bone giant cells reaction: report of a case and literature review

Os autores apresentam um caso de reaçäo de células gigantes do osso que ocorreu em falange de dedo da mäo de uma criança de 5 anos de idade. Na revisäo da literatura, encontramos apenas 11 casos descritos

A radiologia nas lesöes ósseas solitárias: metodologia de análise / The radiology in the solitary bone lesions: analysis methodology

Três métodos de análise radiológica das lesöes solitárias foram revisados: 1) O que analisa radiologicamente as lesöes com o objetivo de presumir o tipo histológico; 2) O que tem por finalidade avaliar a velocidade de crescimento e agressividade das lesöes; 3) O que tem por objetivo avaliar o comportamento biológico das lesöes ósseas, fazendo o diagnóstico necessário à conduta do caso. Fazem ainda, os autores, o estudo crítico desses três métodos e concluem ser o objetivo final da radiologia contribuir com dados para a conduta e näo apenas servir de instrumento de presunçäo de tipo histológico