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.

Comparison of the Role of Different Levels of Religiousness and Spirituality in Controversial Ethical Issues and Clinical Practice among Brazilian Resident Physicians: Results from the Multicenter SBRAMER Study.

This study compares clinical practice and objections to controversial ethical issues among 836 Brazilian resident physicians according to levels of religiousness/spirituality. Residents with low religiousness/spirituality (s/r) believed less in the influence of spirituality on clinical practice, were less comfortable addressing this issue, tended to listen less carefully and try to change the subject more than other groups. Residents with high spirituality and low religiousness (S/r) inquired more about religious/spiritual issues, while those with high religiousness/spirituality (S/R) were more supportive and reported fewer barriers to addressing these issues. Concerning ethical issues (e.g., physician-assisted suicide, withdrawal of life support, abortion), S/R had more objections than others.

Resilience and Mental Health Among Regularly and Intermittently Active Older Adults: Results From a Four-Year Longitudinal Study.

BACKGROUND: This study aims to investigate whether regularly active individuals have different levels of mental health and resilience compared to intermittently active individuals. METHODS: In this 4-year longitudinal study, 180 older people were included. General linear models were used to assess the level of physical activity, psychological resilience, and mental health among regularly and intermittently active older adults. RESULTS: Those who maintained regular physical activity were more resilient than those who did not. However, no differences were observed for mental health outcomes. Although those with higher levels of resilience had fewer mental health problems, there were no significant differences between the groups based on their level of physical activity. CONCLUSION: Differences in resilience levels favoring regularly active individuals were found. In both groups, resilience was inversely associated with mental health problems. These findings may help elucidate the underlying mechanisms in the relationship between physical activity and health outcomes.

Religiosity and Spirituality of Resident Physicians and Implications for Clinical Practice-the SBRAMER Multicenter Study.

OBJECTIVES: To assess the attitudes, knowledge, and experiences of Brazilian resident physicians regarding religiosity/spirituality (R/S), factors associated with addressing this issue, and its influence on clinical practice. METHODS: We report results of the multicenter "Spirituality in Brazilian Medical Residents" (SBRAMER) study involving 7 Brazilian university centers. The Network for Research Spirituality and Health (NERSH) scale (collecting sociodemographic data, opinions about the R/S-health interface, and respondents' R/S characteristics) and the Duke Religion Index were self-administered. Logistic regression models were constructed to determine those factors associated with residents' opinions on spirituality in clinical practice. RESULTS: The sample comprised 879 resident physicians (53.5% of total) from all years of residency with 71.6% from clinical specialties. In general, the residents considered themselves spiritual and religious, despite not regularly attending religious services. Most participants believed R/S had an important influence on patient health (75.2%) and that it was appropriate to discuss these beliefs in clinical encounters with patients (77.1%), although this was not done in routine clinical practice (14.4%). The main barriers to discussing R/S were maintaining professional neutrality (31.4%), concern about offending patients (29.1%), and insufficient time (26.2%). Factors including female gender, clinical specialty (e.g., internal medicine, family medicine, psychiatry) as opposed to surgical specialty (e.g., surgery, obstetrics/gynecology, orthopedics), having had formal training on R/S, and higher levels of R/S were associated with greater discussion of and more positive opinions about R/S. CONCLUSION: Brazilian resident physicians held that religious and spiritual beliefs can influence health, and deemed it appropriate for physicians to discuss this issue. However, lack of training was one of the main obstacles to addressing R/S issues in clinical practice. Educators should draw on these data to conduct interventions and produce content on the subject in residency programs.

Relative Rates of Metal-Free Azide-Alkyne Cycloadditions: Tunability over 3 Orders of Magnitude.

The thermal (3 + 2) dipolar azide-alkyne cycloaddition, proceeding without copper or strained alkynes, is an underutilized ligation with potential applications in materials, bioorganic, and synthetic chemistry. Herein, we investigate the effects of alkyne substitution on the rate of this reaction, both experimentally and computationally. Electron-withdrawing groups accelerate the reaction, providing a range of relative rates from 1.0 to 2100 between the slowest and fastest alkynes studied. Unexpectedly, aryl groups conjugated to the alkyne significantly retard the reaction rate. In contrast, a sulfonyl, ester-substituted alkyne is reactive enough that it couples with an azide at room temperature in a few hours. This reactivity scale should provide a guide to those who wish to use this ligation under mild conditions.

The Effect of Exercise Order in Circuit Training on Muscular Strength and Functional Fitness in Older Women.

The purpose of this study was to analyze the effect of different orders of exercises in circuit training on strength and functional fitness in older women over a 12-week period. After 10 repetition maximum (10-RM) and functional fitness baseline testing, thirty older women were randomly assigned into two groups. The exercise order for Group 1 was leg press, wide-grip lat pulldown, knee extension, pec deck fly, plantar flexion and triceps extension; Group 2 performed the same exercises, but in the opposite order: triceps extension, plantar flexion, pec deck fly, knee extension, wide-grip lat pulldown and leg press. Both groups performed the circuit three times with a load that permitted 8 to 10 repetitions per exercise set. Both groups exhibited gains in 10-RM strength and functional fitness test performance (p ≤ 0.05). In Comparing groups, the G1 presented greater strength gains for the wide-grip lat pulldown, while G2 showed higher values for the plantar flexion and triceps extension exercises (p ≤ 0.05). Both circuit exercise orders were effective and could be applied to promote strength and functional fitness gains. However, based on the results for the wide-grip lat pulldown, plantar flexion and triceps extension, it seems that exercise order should be considered when specific muscle weaknesses are a priority, so that these muscles are trained first within a circuit.

Quando Cada Quadrado Fala Sobre Si: escritos sobre os núcleos de residência multiprofissional em saúde / When Each Square Speaks About It: written on the cores of multiprofessional residence in health / Cuando Cada Cuadrado Discute Si: escrito sobre los núcleos de residencia multiprofesional de salud

Este artigo tem por objetivo revisar a literatura científica brasileira que versa sobreos núcleos profissionais de Residência Multiprofissional em Saúde, a partir das bases de dados da SCIELO e da LILACS, tendo como referência as publicações dos últimos 11 anos. Ao final, foram selecionados 39 artigos, que, após a leitura de seus resumos, se enquadravam nos critérios de in-clusão e exclusão escolhidos, que foram classificados em cinco eixos temáticos:Inserção e atuação do profissional de saúde-residente; Processo Formativo; Produções Científicas; Dimensão Política; e Processos de Adoecimento. Neste estudo, se considera a importância em se discutir às categorias profissionais envolvidas nos processos formativos da residência multiprofissional, no que concerne ao conteúdo destas publicações, compreendendo que precisamos discutir questões referentes à qua-lidade e quantidade de publicações, bem como sobre as perspectivas de campo e núcleo. (AU)

This article aims to review the Brazilian scientific literature that deals with the professional nuclei of Multiprofessional Residency in Health, from the SCIELO and the LILACS, referenced on the publications of the last 11 years. At the end, 39 articles were selected, which, after reading their summaries, fit the inclusion and exclusion criteria chosen, which were classified into five thematic axes: Insertion and actuation of the resident-health professional; Formative Process; Scientific Production; Political Dimension; And Sweetening Processes. In this study, it is considered the importance of discussing the professional categories involved in the multiprofessional residency training processes, regarding the content of these publications, understanding that we need to discuss issues related to the quality and quantity of publications, as well as field and core. (AU)

En este artículo se pretende revisar la literatura científica brasileña tratar con el nú-cleo profesional del Multidisciplinar Residencia en Salud, a partir de bases de datos SciELO y LI-LACS, tiendo como referencia las publicaciones de los últimos 11 años. Al final, se seleccionaron 39 artículos, los cuales, después de leer sus extractos, cumplieron con los criterios de inclusión y exclusión escogidos, que fueron clasificados en cinco temas: Inserción y el rendimiento del proceso salud-profesional residente; Proceso formativo; producciones científicas; Política dimensión; y el proceso de la enfermedad. En este estudio, teniendo en cuenta la importancia de discutir las cate-gorías profesionales que intervienen en el proceso formativo de multi-residencia, en relación con el contenido de estas publicaciones, la comprensión de que tenemos que discutir cuestiones relativas a la calidad y cantidad de publicaciones, así como las perspectivas del campo y núcleo. (AU)

Influência da frequência semanal do treinamento de força sobre o desempenho funcional em idosas / Influence of the weekly frequency of strength training on functional performance in older women

Introdução: No envelhecimento ocorrem declínios estruturais e funcionais que podem afetar a independência física. O treinamento de força (TF) é capaz de promover melhoras neste quesito, entretanto, poucos experimentos investigaram a influencia da frequência semanal. Objetivo: verificar a influência da frequência semanal do TF sobre o desempenho funcional em idosas. Métodos: 21 mulheres idosas foram divididas em dois grupos que treinavam em uma (G1: n=11) ou duas vezes por semana (G2: n=10). O TF aplicado foi no formato de circuito que consistiu de três passagens com intervalo de 30 segundos entre os exercícios e faixa de repetições entre oito a 10. Resultados: Os resultados demonstraram melhora em relação ao pré-treinamento em todos os testes em ambos os grupos (p<0,05). No entanto, não foram observadas diferenças significativas entre os grupos (p>0,05). Conclusão: O TF é capaz de promover melhoras no desempenho funcional independe da frequência de treinamento.

Introducion: Aging occur declines structural and functional that can to affect physical independence. Objective: Verify the influence of weekly frequency of Strength Training (ST) on functional performance in older women. Methods: 21 older women were divided in two groups that trained in one (G1: n=11) or two times a week (G2: n=10). The ST applied was in format of circuit that consisted of three turns with interval of 30 seconds in between exercises and repetitions between eight and 10. Results: Results showed improvement over pre-training in all tests in both groups (p <0.05). However, no significant differences were observed between groups (p> 0.05). Conclusion: ST is capable of promoting improvements in functional performance regardless of training frequency.

Prevalence of silent breast cancer in autopsy specimens, as studied by the disease being held by image-guided biopsies: The pilot study and literature review.

Breast cancer epidemiological patterns vary in European countries, which present different incidence rates. Data have suggested that the reduction in breast cancer mortality is not only due to the early detection of the disease, but is, in almost equal part, due to screening and to the advances that have been made in molecular medicine and the development of novel therapies. The aim of the present study is to quantify the actual number of cases of breast cancer present in both of the sexes by calculating the prevalence of silent breast cancer in corpses. To achieve this quantification, bilateral subcutaneous radical mastectomies are performed in corpses of either sex above 40 years of age that lacked any clinical manifestation of the disease, and where the breast cancer or its complications was not the cause of death. Only five publications exist in the international literature based on medico-legal autopsies that were designed to define the 'natural reservoir' of the disease. To the best of our knowledge, the present study is the first one to appraise breast tissue via imaging by means of orienting the biopsy incision. In conclusion, to the best of our knowledge, the design of the present study is the first of its type, where image-guided biopsies are used to define the prevalence of silent breast cancer. The study aims to demonstrate that the 'disease reservoir' is, in reality, higher than was originally considered to be so. Furthermore, the study aims to contribute towards an improved definition of the disease by determining which tumour profiles potentially do not benefit from aggressive treatments (for example, in case where a high prevalence of low-grade ductal carcinoma in situ is to be detected). According to our pilot study, this analysis represents a feasible protocol.

Comparison of the effect of different modalities of physical exercise on functionality and anthropometric measurements in community-dwelling older women.

The present study aims to assess the effect of different modalities of physical exercises ("Functional Gymnastics"-FG, "Resistance Training"-RT and "Pilates combined with Hydrogymnastics"-PCH) on functional capacity and anthropometric measurements of 148 older women (60 years old or more). A comparative observational study was conducted. Functional and anthropometric measurements were assessed at baseline and after 16 weeks. All groups assessed showed significant changes between baseline and post-training. On the comparison of pre and post-training, differences in anthropometric measurements but not in functional test performance were found. The PCH had greater weight loss compared to the FG and RT, reduction in BMI compared to the FG and RT; reduction in waist compared to the FG and RT, and in hip compared to the RT. Although all groups improved, Pilates/Hydrogymnastics combination was more strongly associated with reductions in weight, BMI, waist and hip measurements but not functionality, than other modalities. These results highlight the role of combination physical exercise training in older women.

Efeito do treinamento de força no formato de circuito nos níveis de força e desempenho funcional em mulheres idosas / Strength training effect in format circuit in levels of strength and functional performance in elderly women

Introdução: No envelhecimento são observadas alterações funcionais, bioquímicas e morfológicas. Objetivo: Verificar os efeitos de um período de treinamento de força (TF) nos níveis de força e desempenho funcional em mulheres idosas. Materiais e Métodos: Foram recrutadas 20 mulheres idosas (68,6 ± 6,6; anos; 69,7 ± 10,9 kg; 160,0 ± 0,10 cm) sem experiência prévia em TF. O protocolo de TF aplicado foi no formato de circuito com três séries, intervalo de 30 segundos entre cada exercício, faixa de repetições entre oito a dez com carga correspondente a percepção de esforço de cada participante. Os testes funcionais aplicados foram baseados no sênior fitness teste. Resultados: Após o período de intervenção foi observado diferença para o peso corporal, testes funcionais e níveis de força muscular (p<0,05). Conclusões: O TF com duração de apenas oito semanas já é eficaz para promover melhoras nos níveis de força e desempenho funcional em mulheres idosas.

Introduction: In the aging functional, biochemical and morphological changes are observed. Objective: To evaluate the effects of strength training period (ST) in the levels of strength and functional performance in elderly women. Materials and Methods: We recruited 20 elderly women (68.6 ± 6.6; years; 69.7 ± 10.9 kg, 160.0 ± 0.10 cm) without prior experience in ST. The ST protocol was applied in circuit format with three sets of 30 seconds between each exercise, rep range between eight to ten with load of perceived exertion of each participant. The functional tests were applied based on the senior fitness test. Results: After the intervention period was observed for body weight differences, functional tests and strength levels (p <0.05). Conclusions: The ST lasting just eight weeks is already effective to promote improvements in the levels of strength and functional performance in older women.

Doadores vivos no transplante hepático: panorama de publicações nacionais e internacionais / Living donors about liver transplantation: an overview of the national and the international publications / Donantes vivos acerca del trasplante hepático: un resumen de las publicaciones nacionales e internacionales

Objetivo: analisar estudos em periódicos online que abordaram doadores vivos no transplante hepático. Método: revisão integrativa, a partir da questão << Quais os temas e objetos de estudo que abordaram doadores vivos no transplante hepático? >> com coleta de dados nas bases de dados MEDLINE e LILACS, com os descritores liver transplantation and/or living donors. Foram incluídos artigos publicados na década 2001- 2011, na íntegra em Português, Inglês ou Espanhol. Resultados: a amostra foi constituída por 15 estudos. Foram construídas cinco categorias para a análise: avaliação clínica e cirúrgica do doador; técnica cirúrgica e procedimentos; aspectos psicossociais e qualidade de vida; assistência de enfermagem ao doador e sua família; aspectos éticos. Conclusão: em sua maioria, as pesquisas foram voltadas aos aspectos biológicos, clínicos e cirúrgicos do transplante hepático intervivos, com uma abordagem quantitativa em 94,4% dos estudos e publicações na área médica, predominantemente. (AU)

Objective: analyzing studies in online journals that addressed living donors in liver transplantation. Method: an integrative review, from the question << What are the subjects and objects of study that addressed live donors in liver transplantation? >> with data collection in the MEDLINE and LILACS databases, with the descriptors liver transplantation and/or living donors. There were included articles published in the decade 2001-2011 in full, in Portuguese, English or Spanish. Results: the sample consisted of 15 studies. There were built five categories for analysis: evaluation of clinical and surgical donor; surgical technique and procedures; psychosocial aspects and quality of life; nursing care to the donor and his family; ethical aspects. Conclusion: mostly, the searches were directed to biological, clinical and surgical aspects of liver transplantation, with a quantitative approach in 94,4% of the studies and publications in the medical field, predominantly. (AU)

Objetivo: analizar estudios en periodicos en línea que enfoquen los donantes vivos en el trasplante hepático. Método: revisión integradora, desde la pregunta << ¿Cuáles son las materias y objetos de estudio que abordan a los donantes vivos en trasplante de hígado? >> con la recopilación de datos en las bases de datos MEDLINE y LILACS, con los descriptores para el trasplante de hígado y/o donantes vivos. Se incluyeron los artículos publicados en la década 2001-2011, totalmente en portugués, inglés o español. Resultados: la muestra estuvo constituida por 15 estudios. Se construyeron cinco categorías de análisis: evaluación clínica y quirúrgica del donante; técnica quirúrgica y procedimientos; aspectos psicosociales y calidad de vida; atención de enfermería para el donante y su familia; aspectos éticos. Conclusión: en la mayoría de los casos, la investigación tuvo como objetivo aspectos biológicos, clinicos y quirúrgicos del trasplante de hígado de donante, con un enfoque cuantitativo en el 94,4% de los estudios y publicaciones en el campo de la medicina, en su mayor parte.(AU)

O cuidado das amas-de-leite e o protagonismo do negro na história da enfermagem: uma luta por equidade / The care of wet-nurses and the role of blacks in the history of nursing: a fight for fairness

Objetiva-se com esse estudo sistematizar referências relacionadas ao cuidado das amas-de-leite,ao racismo e ao legado deixado por grandes ícones negros da Enfermagem. Estudo descritivo com abordagem qualitativa, realizado a partir de uma pesquisa integrativa. A coleta de dados ocorreu nos meses de agosto e setembro de 2014. A técnica utilizada na pesquisa para obtenção dos dados foi por meio de um levantamento bibliográfico junto às bases de dados SciELO, Google Acadêmicoe EBSCO-HOST, que proporcionaram acesso aos periódicos e artigos científicos, a partir dos descritores: “aleitamento materno”, “cuidado da criança”, “história da enfermagem”. “racismo”,publicados em português, com recorte atemporal. Deve-se valorizar os diversos atores sociais que foram e constituem o conhecimento sobre o cuidado de Enfermagem, visando à emancipação do pensamento como forma de questionar o mundo, lutar contra preconceitos, iniquidades e injustiças.

Pais doadores no transplante hepático pediátrico / Parent donors in pediatric liver transplant

INTRODUÇÃO: No transplante de fígado intervivos os pais são considerados candidatos inatos a doar uma parte do seu fígado para salvar a vida do filho. Essa modalidade de transplante estabeleceu-se no Brasil como alternativa para suprir a escassez de órgãos cadavéricos no decorrer dos anos. É uma técnica onde o receptor infantil recebe de 20 a 25% do fígado de um doador adulto. Essa cirurgia é considerada de baixo risco, uma vez que a ressecção do segmento empregado como enxerto, conforme encontrado em estudos, implica em mortalidade de apenas 0,3% e não exige transfusão de sangue. OBJETIVO: Compreender a experiência dos pais-doadores na situação do transplante de fígado do seu filho. METODOLOGIA: Estudo de abordagem qualitativa teve como referencial metodológico a História Oral de Vida , utilizando como referencial teórico a Trajetória da Doença Crônica. O cenário deste estudo foi o ambulatório de Hepatologia Pediátrica do Hospital Universitário de Sergipe, onde participaram da pesquisa sete pais/mães que doaram parte do fígado para seus filhos. Através de uma entrevista aberta utilizaram-se as seguintes questões norteadoras: Qual é a sua vivência na trajetória do transplante de fígado de seu filho; O que significa ser um doador vivo. Os textos foram transcritos, textualizados e transcriados extraindo deles o tom vital. RESULTADOS: A caracterização dos colaboradores apresentou cinco mães e dois pais, variando entre 28 e 43 anos, onde o tempo de doação variou de oito meses a doze anos.O diagnóstico de Atresia de Vias Biliares em seis (85,7%) das sete crianças foi a principal causa do transplante hepático, seguida da Síndrome de Budal Chiari (14,3%). A modalidade de assistência ao binômio pai/filho foi majoritariamente subsidiada pelo Sistema Único de Saúde (SUS) ou através do modelo de Filantropia estabelecido pelo Hospital Sírio Libanês (HSL). DISCUSSÃO: A atitude motivacional para a doação é a expressão de laços emocionais autênticos e profundos como é o caso do pai para filho, estabelecendo uma relação muito íntima e delicada entre eles, na 10 qual o órgão transplantado se tornou um símbolo dessa ligação específica. Segundo o modelo de Bury (1997) a Ruptura Biográfica caracteriza-se a partir do início dos primeiros sintomas da doença hepática de seus filhos, manifestando-se pelo luto do filho ideal ao constatar a sua doença crônica. Na fase do Impacto do Tratamento e Cuidado à Saúde observou-se que o transplante hepático gerou um grande impacto na família devendo ser considerado por toda a equipe. Na fase de Adaptação e Manejo da Doença os pacientes com doença crônica buscam a melhor qualidade de vida possível adaptando-se às condições da sua doença. CONSIDERAÇÕES FINAIS: A doença hepática e o transplante representaram um desafio para os pais doadores e suas famílias, visto que durante a trajetória da doença passaram por uma série de dificuldades financeiras, rearranjos nos papéis familiares, afastamento físico do casal e dos outros filhos, vivenciando diversas situações de estresse por conta da doença.

INTRODUCTION: In a living donor liver transplant, parents are considered "innate" candidates to donate part of their liver to save the life of their child. This type of transplant established itself in Brazil as an alternative to address the shortage of cadaveric organs over the years. It is a technique whereby the child recipient receives 20-25% of the liver from an adult donor. This surgical procedure is considered low risk since resection of the segment to be used as a graft, as found in studies, suggests a mortality rate of only 0.3% and does not require a blood transfusion. OBJECTIVE: To understand the experience of parental donors during a liver transplant to their child. METHODS: A qualitative study with a methodological background in the oral history of life using the path of chronic illness as a theoretical framework. The setting for this study was the Liver Pediatrics outpatient clinic of the University Hospital of Sergipe where seven parents who donated a part of their livers to their children participated in the research. An open interview used the following guiding questions: What is your experience in the path of your childs liver transplant? What does it mean to be a living donor? The texts were transcribed with the vital tone removed. RESULTS: The group of participants consisted of five mothers and two fathers, between the ages of 28 and 43 years old, where the donation time ranged from eight months to twelve years. The diagnosis of Biliary Tract Atresia in six of the seven children (85.7%) was the leading cause of liver transplant, followed by the Budal Chiari syndrome (14.3%). The modality of assistance to the binomial parent / child was largely subsidized by the Unified Health System (SUS) or through the philanthropy model established by the Syrian-Lebanese Hospital (HSL).DISCUSSION: The motivation to donate is an expression of authentic and deep emotional ties such as those which exist between parent and child, establishing a very intimate and delicate relationship between them, in which the transplanted organ has become a symbol of that specific connection. Following the model of Bury (1997), Biographical Break characterizes 12 itself from the beginning of the first symptoms of liver disease in children, manifesting itself through the mourning of an ideal child when he becomes aware of his chronic disease. At the stage of the Impact of Treatment and Health Care, it was observed that the liver transplant had an enormous impact on the family which should not be discounted by anyone on the team. At the stage of Adaptation and Treatment of the Disease, patients with chronic disease seek the best quality of life possible while adapting themselves to the conditions of their disease. FINAL CONCLUSIONS: Liver disease and the transplant represented a challenge for parent donors and their families, since during the course of the disease they underwent a series of financial difficulties, rearrangements in family roles, physical distance from their spouses and other children, all while living through various stress related situations directly related to the illness.

[Pulmonary metastasis in a cardiac angiosarcoma - case report and discussion]. / Metastização pulmonar na apresentação de angiossarcoma cardíaco - Caso clínico e discussão.

We present a case report of a 35 year-old male without any relevant former pathology admitted to the emergency room with atypical chest pain, cough and sputum with ECG changes suggesting pericarditis. He was initially admitted to the cardiology ward and experienced clinical improvement after initiating anti- inflammatory treatment. As intercurrence he had bacterial origin pneumonia complicated by pleural effusion (PE). After discharge patient was referred to a pulmonology appointment where aetiological investigation of the PE was instigated. Investigation revealed changes in the cardiac cavities and multiple lung nodules, suggesting subacute endocarditis with septic pulmonary embolism. Admitted to the pulmonology unit patient underwent videothoracsopy which diagnosed cardiac angiosarcoma with pulmonary metastisation. Within a few days there was a rapid evolution of the clinical picture, with cardiac failure and death of the patient without radiotherapy or adjuvant chemotherapy being started.

Cirurgia guiada em função imediata: proposta de técnica sem incisão / This technique is possible with no one incision, less pos operative symptoms and low cost in comparison to other techniques

Neste trabalho, os autores descrevem uma técnica onde foi utilizado um sistema de implantes em forma de parafuso, assim como uma técnica cirúrgica guiada para confecção de próteses totais fixas provisórias implanto-suportadas e parafusadas, indicando para reabilitações do tipo protocolo maxilar e/ou mandibular, recebendo carga imediata. Para tal foi utilizado um software que permite o planejamento guiado em três dimensões partindo-se de uma tomografia. Este planejamento após ter sido concluído, fornece um guia prototipado, tornando possível uma cirurgia sem nenhum tipo de incisão e proporcionando ao cirurgião minimizar o trauma cirúrgico, por conseguinte um efeito pós-operatório mais favorável, e custo reduzido, fator primordial comparado às outras técnicas guiadas existentes

The aim of this study was purpose a clinical case in the author used a bicortical dental implants protocol immediate loading-Theo®, and a guide technique, used after tomography exam, to upper or lower provisional prosthesis, fixed with implants and with immediate loading. For this, one software is used to prepare in 3D a prototypal guide with gets a surgery without incision. This technique does to surgeons one way to minimize the pos-operative trauma for all patients and low cost, comparing to other techniques

A Importância da Educação Continuada sobre o Aleitamento Materno e o Impacto causado por ela para as Famílias da Unidade Básica de Saúde Dom Bosco ­ Nova Iguaçu, RJ

O presente estudo tem por finalidade demonstrar a importância da educação contínua sobre o aleitamento materno bem como o impacto que ela causa para as famílias da Unidade Básica de Saúde - Dom Bosco, Novo Iguaçu, RJ, através da constatação, pela análise descritiva, de que, com o devido suporte por parte dos profissionais desta Unidade possa haver uma maior conscientização sobre o planejamento familiar e tudo que o envolve, desde a concepção, passando pelo pré-natal e se estabelecendo no aleitamento materno. Espera-se com esta ação que as gestantes possam entender o real valor da amamentação e os benefícios que ela pode trazer ao bebê evitando assim uma vasta gama de doenças devido as suas características imunobiológicas, o que justifica essa prática de ação permanente, para os pacientes bem como para os funcionários desta Unidade. A fim de viabilizar o estudo começaremos, inicialmente, por uma revisão bibliográfica e documental sobre os processos de educação em família, pré-natal e aleitamento materno bem como as diretrizes instituídas pelo Ministério da Saúde a esse respeito. Em seguida, será realizada a comparação da analise descritiva sobre o impacto que as palestras têm causado sobre as gestantes da Unidade. Espera-se que com estas ações haja o fortalecimento do vinculo entre as gestantes/lactantes e a unidade, bem como a melhora na qualidade do atendimento prestado, fazendo com que haja maior esclarecimento sobre o assunto e maior rede de informações para elas.