Sexual violence against children and adolescents in Paraná State: geospatial analysis and main socioeconomic indicators.

OBJECTIVE: Child sexual violence is a multidimensional problem of many contemporary societies, affecting people of all sexes, social stratum and age groups. Offenses involving children and adolescents are more serious, given their total or partial dependence on parents and caregivers. Information on child sexual violence in Brazil is found in raw form and without detail. The objective was to compare the information with social and economic data in the state of Paraná. METHODS: The authors conducted a retrospective study of secondary data from the Notifiable Diseases Information System (SINAN) on cases of sexual violence involving victims aged 0 to 19 years. Results are presented according to notification characteristics. The authors applied exploratory spatial data analysis to assess spatial autocorrelations and investigated relationships by the ordinary least squares regression model. RESULTS: Between 2017 and 2021, there were 13,403 reports of child sexual violence in Paraná State, Brazil. Most victims (82.8%) were female and aged between 10 and 14 years. The majority of sexual violence cases (67.8%) occurred in the home environment. The highest rates on a population basis were observed in the North Central and Greater Curitiba regions, mainly in cities with higher population density and with higher rates of other types of violence. CONCLUSION: The results provide data that can promote a broader understanding of the distribution of sexual violence and the state and associated variations. It is expected to improve the provision of care for victims of child sexual violence and assist in strategic planning to prevent future offenses.

Recurrent arterial thrombosis in a patient with Fabry disease: case report.

Fabry disease is a rare disease, defined as an X-linked lysosomal deposition disease that presents with multisystemic symptoms, including vascular impairment with thrombotic events. A 57-year-old female patient diagnosed with Fabry disease 11 years previously, presented with hyperhidrosis, hypoacusis, and angiokeratoma on the hands. Her previous pathological history included an episode of ischemic stroke before the age of 40 years and chronic acute thrombosis in the right lower limb, 1 year previously, which had been treated with stent angioplasty, with temporary improvement followed by recent relapse of the condition. Thrombotic events fit the typical symptoms of Fabry disease and are caused by deposition of globotriaosylceramide in the vascular endothelium, constituting a prothrombotic state and explaining the recurrence of symptoms and arterial thrombosis in the lower limb.

Trombose arterial recorrente em paciente com doença de Fabry: relato de caso / Recurrent arterial thrombosis in a patient with Fabry disease: case report

Resumo A doença de Fabry é definida como uma doença rara de depósito lisossomal ligada ao cromossomo X que apresenta sintomas multissistêmicos, incluindo comprometimento vascular com eventos trombóticos. Paciente do sexo feminino, 57 anos, com diagnóstico de doença de Fabry há 11 anos, apresentava hiperidrose, hipoacusia e angioqueratoma nas mãos. Na história patológica pregressa, relatou episódio de acidente vascular encefálico isquêmico prévio aos 40 anos de idade e trombose arterial crônica agudizada em membro inferior direito há 1 ano, a qual foi tratada por meio de angioplastia com uso de stent, apresentando melhora temporária e recente recidiva do quadro. Os eventos trombóticos se enquadram nos sintomas típicos da doença de Fabry, e são resultantes do depósito de globotriaosilceramida no endotélio vascular, implicando em um estado pró-trombótico, justificando a reincidência dos sintomas e da trombose arterial em membro inferior.

Abstract Fabry disease is a rare disease, defined as an X-linked lysosomal deposition disease that presents with multisystemic symptoms, including vascular impairment with thrombotic events. A 57-year-old female patient diagnosed with Fabry disease 11 years previously, presented with hyperhidrosis, hypoacusis, and angiokeratoma on the hands. Her previous pathological history included an episode of ischemic stroke before the age of 40 years and chronic acute thrombosis in the right lower limb, 1 year previously, which had been treated with stent angioplasty, with temporary improvement followed by recent relapse of the condition. Thrombotic events fit the typical symptoms of Fabry disease and are caused by deposition of globotriaosylceramide in the vascular endothelium, constituting a prothrombotic state and explaining the recurrence of symptoms and arterial thrombosis in the lower limb.

Transcatheter arterial chemoembolization of hepatocellular carcinoma in a patient with celiac trunk occlusion: a therapeutic challenge.

Transcatheter arterial chemoembolization is a technique for provoking ischemia and cytotoxic activity by selectively injecting microspheres containing chemotherapy drugs into vessels supplying a tumor. An 87-year-old female patient on palliative treatment for hepatocellular carcinoma and with indications for chemoembolization underwent preparatory angiography, which revealed celiac trunk occlusion. The treatment option chosen was selective catheterization of the hepatic artery proper to release the chemotherapy agent via an alternative route through the superior mesenteric artery with communication using the pancreaticoduodenal arcade. Studies have reported evidence showing increased survival after chemoembolization and also reduced tumor growth rate. However, difficulties with accessing and catheterizing the artery feeding the tumor via the alternative access make the procedure a challenge, because of the tortuosity of the pancreaticoduodenal arcade.

Evaluation of thromboprophylaxis in medium-sized general hospital / Avaliação de tromboprofilaxia em hospital geral de médio porte

CONTEXT: Deep vein thrombosis (DVT) is a serious, common disease whose complications include pulmonary thromboembolism (PTE) and postthrombotic syndrome. The importance and benefits of correct and effective pharmacological prophylaxis for DVT are well documented. OBJECTIVES: The aims of this study were to evaluate adequacy of prophylaxis for DVT and PTE at the Santa Casa de Misericórdia de Ponta Grossa (SCMPG), Paraná, Brazil, and determine risk stratification for patients hospitalized in this institution. METHODS: A cohort study was conducted to assess DVT prophylaxis of patients hospitalized on May 15th, 2009. The study population consisted of a sample of 104 patients, subdivided into clinical and surgical groups and stratified into different specialties. Correct use of DVT prophylaxis was evaluated according to recommendations published by The Brazilian Society for Angiology and Vascular Surgery and took into account prophylactic methods specified explicitly in information found in each patient's medical chart. RESULTS: Of the 104 patients interviewed, 51 (49.04%) were clinical patients and 53 (50.96%) surgical. Based on risk stratification, 17 (16.35%) were classified as low risk, 37 (35.58%) as moderate risk, 46 (44.23%) as high risk and 4 (3.85%) as extremely high risk for DVT/PTE. A total of 68 patients (65.38%) received prophylaxis, but of these only 56 (53.85%) received the correct prophylaxis, and 36 (34.62%) did not receive any prophylaxis. CONCLUSION: The rates of prophylaxis use for DVT and PTE in this service are higher than rates published in the literature. .

CONTEXTO: A trombose venosa profunda (TVP) é uma doença frequente e grave, tendo como complicações o tromboembolismo pulmonar (TEP) e a síndrome pós-trombótica. A importância e os benefícios de uma correta e efetiva profilaxia medicamentosa em relação à TVP estão bem documentados. OBJETIVOS: Este trabalho tem por objetivos avaliar a adequação das profilaxias de TVP e TEP na Santa Casa de Misericórdia de Ponta Grossa (SCMPG), Paraná, e estratificar o perfil de risco. MÉTODOS: Realizou-se um estudo de coorte, com a finalidade de avaliar a profilaxia da TVP nos pacientes internados no dia 15 de maio de 2009. Uma amostra de 104 pacientes foi dividida em grupos clínico e cirúrgico, e estratificada em diferentes especialidades. A correta utilização da profilaxia para TVP foi avaliada segundo recomendações da Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV), considerando-se métodos profiláticos presentes nas informações explícitas encontradas na prescrição médica de cada paciente. RESULTADOS: Dos 104 pacientes entrevistados, 51 (49,04%) eram pacientes clínicos e 53 (50,96%) eram cirúrgicos. De acordo com a estratificação do risco, 17 (16,35%) foram classificados como baixo risco, 37 (35,58%) como risco moderado, 46 (44,23%) como alto risco e 4 (3,85%) como altíssimo risco para TVP e TEP. Do total de pacientes, 68 (65,38%) receberam profilaxia, sendo que, deste número, apenas 56 (53,85%) receberam uma profilaxia correta e 36 (34,62%) não receberam nenhuma profilaxia. CONCLUSÕES: As profilaxias de TVP e TEP neste serviço apresentam uma aderência superior aos índices encontrados em trabalhos publicados na literatura. .