BACKGROUND: Malignant hyperfunctioning thyroid nodules are rare and more likely to occur in follicular cancer types rather than papillary variants. The authors present a case of a papillary thyroid carcinoma associated with a hyperfunctioning nodule. METHODS: A single adult patient submitted to total thyroidectomy with the presence of thyroid carcinoma within hyperfunctioning nodules was selected. Additionally, brief literature was conducted. RESULTS: An asymptomatic 58-year-old male was subjected to routine blood analysis and a TSH level of <0.003 mIU/L was found. Ultrasonography revealed a 21 mm solid, hypoechoic, and heterogenous nodule with microcalcifications in the right lobe. A fine needle aspiration guided by ultrasound resulted in a follicular lesion of undetermined significance. A 99mTc thyroid scintigram was followed and identified a right-sided hyperfunctioning nodule. Another cytology was performed and a papillary thyroid carcinoma was derived as a result. The patient underwent a total thyroidectomy. Postoperative histology confirmed the diagnosis and a tumor-free margin with no vascular or capsular invasions. CONCLUSION: Hyperfunctioning malignant nodules are a rare association, although a careful approach should be led since major clinical implications arise. Selective fine needle aspiration in all suspicious ≥1 cm nodules should be considered.
Carcinoma, Papillary , Thyroid Neoplasms , Thyroid Nodule , Male , Adult , Humans , Middle Aged , Thyroid Nodule/pathology , Thyroid Cancer, Papillary/surgery , Carcinoma, Papillary/diagnosis , Carcinoma, Papillary/surgery , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/surgery , Thyroid Neoplasms/pathology , Thyroidectomy , Ultrasonography
The purpose of this study is to evaluate the scientific evidence on the impact of photobiomodulation adjunct to non-surgical periodontal treatment on individuals with type 2 diabetes mellitus (T2DM). The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed. A protocol was registered in the International Prospective Registry of Systematic Reviews (PROSPERO #CRD42022310756). The research was carried out in seven databases, with no restrictions regarding the year of publication. Our work included studies that compared periodontal clinical parameters among individuals undergoing non-surgical periodontal therapy associated with photobiomodulation and a control group of individuals undergoing non-surgical periodontal treatment. Study selection, data extraction, and risk of bias assessment (RoB 2.0) were performed by two review authors. Meta-analysis was performed. Mean difference (MD) and a 95% confidence interval (CI) were provided. Three hundred forty-one studies were identified, of which eight studies were included. The meta-analysis demonstrated that photobiomodulation adjunctive to periodontal therapy in individuals with diabetes resulted in a greater reduction in probing depth and greater attachment gain in comparison to periodontal treatment alone (p < 0.05). The included studies exhibited a low risk of bias. Photobiomodulation adjunct to periodontal therapy contributes to the improvement of periodontal clinical parameters in individuals with T2DM.
Diabetes Mellitus, Type 2 , Low-Level Light Therapy , Periodontal Diseases , Humans , Diabetes Mellitus, Type 2/complications , Periodontal Diseases/therapy
Background: The objective of this systematic review and meta-analysis was to answer the questions ''Does lip repositioning surgery reduce the amount of gingiva exposed in the smile in individuals with excessive gingival display EGD (excessive gingival display)?'' and ''Is the reduction of the amount of gingiva exposed when smiling obtained with lip repositioning surgery stable over time?'' to evaluate the effectiveness of lip repositioning surgery for correcting EGD on smiling. Materials and Methods: A systematic structured search was carried out in five databases without data restriction. Studies reporting the degree of reduction in gingival ex-posure after lip repositioning surgery were included. Study selection, data extraction, and risk of bias assessment were performed in duplicate Results: One hundred sixty-four references were retrieved and eleven studies met the eligibility criteria. Meta-analysis demonstrated that lip repositioning surgery results in a significant reduction in the amount of exposed gingival tissue (mean difference = -3.03; confidence interval = -3.55; -2.52). In addition, the results remained stable in the evaluated follow-up periods (1, 3, 6 and 12 months). Included studies had a low risk of bias. Conclusions: Lip repositioning surgery is effective for the treatment of EGD on smiling and exhibits stable results in the evaluated periods. The study was registered (CRD42020184866) in the international prospective register of systematic reviews (PROSPERO)
Antecedentes: el objetivo de esta revisión sistemática y metanálisis fue responder a las preguntas "¿La cirugía de reposicionamiento de labios reduce la cantidad de encía expuesta en la sonrisa en personas con exposición gingival excesiva (EGE)?" y "¿La reducción de la cantidad de encía expuesto al sonreír obtenido con cirugía de reposicionamiento de labios estable en el tiempo?" para evaluar la efectividad de la cirugía de reposicionamiento de labios para corregir la EGE al sonreír. Materiales y Métodos: Se realizó una búsqueda sistemática estructurada en cinco bases de datos sin restricción de datos. Se incluyeron los estudios que informaron el grado de reducción de la exposición gingival después de la cirugía de reposición de labios. La selección de estudios, la extracción de datos y la evaluación del riesgo de sesgo se realizaron por duplicado. Resultados: Se recuperaron ciento sesenta y cuatro referencias y once estudios cumplieron con los criterios de elegibilidad. El metanálisis demostró que la cirugía de reposicionamiento de labios da como resultado una reducción significativa en la cantidad de tejido gingival expuesto (diferencia de medias = -3,03; intervalo de confianza = -3,55; -2,52). Además, los resultados se mantuvieron estables en los periodos de seguimiento evaluados (1, 3, 6 y 12 meses). Los estudios incluidos tenían un bajo riesgo de sesgo. Conclusión: La cirugía de reposicionamiento de labios es efectiva para el tratamiento de la EGE al sonreír y presenta resultados estables en los períodos evaluados. El estudio fue registrado (CRD42020184866) en el registro prospectivo internacional de revisiones sistemáticas (PROSPERO).
Humans , Gingiva/surgery , Gingivectomy , Lip/surgery , Smiling , Esthetics, Dental
BACKGROUND AND OBJECTIVE: To evaluate the retinal and vasculature changes in infants with congenital Zika syndrome (CZS) using fluorescein angiography (FA). PATIENTS AND METHODS: This consecutive case series included six infants with CZS. FA and color fundus imaging were performed under general anesthesia in both eyes of all infants using a contact widefield digital imaging system. All color fundus images were obtained using a 130° field of view lens, and the FA images were captured using either a 130° or 80° field of view lens. The immunoglobulin M antibody capture enzyme-linked immunosorbent assay was positive for Zika virus in the cerebrospinal fluid samples of all infants. Other congenital infections were ruled out. RESULTS: The mean ± standard deviation age of the infants at the time of examination was 1.4 years ± 0.1 years (range: 1.3 years to 1.5 years). Contact fundus photographs showed macular abnormalities in seven eyes (58%) and retinal vasculature changes in two eyes (17%). FA detected macular abnormalities in all 12 eyes (100%) and retinal vasculature changes in five eyes (42%). The main retinal vasculature changes were peripheral avascularity in five eyes (42%) and microvasculature abnormalities in three eyes (25%). CONCLUSION: FA may be an important tool for detecting subtle macular and retinal vasculature changes in CZS. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:702-708.].
Macula Lutea/blood supply , Retinal Vessels/pathology , Zika Virus Infection/pathology , Female , Fluorescein Angiography , Humans , Infant , Male
Abstract Herein we report a case of juvenile xantogranuloma, an inflammatory disease more commonly diagnosed during childhood and is characterized by cutaneous and ocular manifestations. Iris is the main target, presenting as local or diffuse yellowish lesions. Iris involvement may precipitate not only glaucoma but also amblyopia. Treatment is based on corticosteroids therapy, either local or systemic aiming disease control.
Resumo É relatado um caso raro de xantogranuloma juvenil, doença de natureza inflamatória diagnosticada mais frequentemente na infância, com manifestações cutâneas e oculares. A íris é o principal sítio extracutâneo da doença, apresentando-se como lesão amarelada, difusa ou localizada. O acometimento iriano pode acarretar surgimento de glaucoma, além de ambliopia. O manejo clínico da lesão ocular no presente caso foi baseado no necessidade no uso contínuo de corticoide tópico e sistêmico para estabilização da doença.
Humans , Female , Infant , Xanthogranuloma, Juvenile/complications , Iris Diseases/etiology , Iris Diseases/drug therapy , Iris Diseases/diagnostic imaging , Ophthalmoscopy , Scalp/pathology , Scalp Dermatoses/etiology , Dexamethasone/administration & dosage , Hyphema , Prednisolone/administration & dosage , Glaucoma , Ultrasonography , Facial Dermatoses/etiology , Slit Lamp Microscopy , Fundus Oculi
Com o intuito de obter uma alimentação mais prática, que não interfira no cumprimento da jornada de trabalho, grande parcela dos indivíduos tem recorrido a refeições provenientes de estabelecimentos de autosserviço, inclusive as saladas prontas para o consumo. Neste sentido, este estudo teve por finalidade a investigação dos perigos de natureza biológica em saladas cruas de restaurantes tipo self service localizados no município de Mossoró, Rio Grande do Norte. Foram realizadas análises parasitárias, pesquisa de coliformes e determinação de Escherichia coli e Salmonella sp., observando-se a conformidade das amostras com a legislação vigente. Sobre os micro-organismos, foi constatada a presença de coliformes a 45°C, mas com valores dentro do preconizado, bem como a ausência de E. coli e Salmonella sp. Apesar de não detectada a presença de parasitos, foram observadas sujidades em algumas das saladas avaliadas. Tais resultados ressaltam a necessidade de maiores cuidados quanto à manipulação do produto.
In order to obtain a more practical diet, which does not interfere with the work day, a large proportion of individuals have used meals from self-service establishments, including ready-to-eat salads. In this sense, the purpose of the study was to investigate biological hazards in raw salads of self-service restaurants located in the municipality of Mossoró, Rio Grande do Norte. Parasite analyzes, coliform research and determination of Escherichia coli and Salmonella sp. were realized, observing the compliance of the samples with the current legislation. On the microorganisms, the presence of coliforms at 45°C, but with values within the recommended, as well as the absence of E. coli and Salmonella sp. Although no parasites were detected, soils were observed in some of the evaluated salads. These results highlight the need for greater care in handling the product.
Parasites , Restaurants , Vegetables , Microbiological Techniques , Foodborne Diseases , Parasitology , Products Commerce , Food Handling
Frutos menos exigentes quanto ao seu crescimento, acabam por se tornar cultivos atraentes em regiões mais secas, como é o caso da região Nordeste. Com tal característica, merecem destaque os frutos de cajá e umbu-cajá, inseridos na categoria de tropicais, sendo estes de grande interesse dos consumidores e, consequentemente, das indústrias. O presente estudo teve por objetivo, avaliar as qualidades físico-químicas e microbiológicas das polpas de umbu-cajá e cajá comercializadas no município de Mossoró, RN. As amostras foram obtidas, de modo aleatório, em supermercados da cidade e transportadas ao Laboratório para realização das análises. Tomando como base a legislação vigente, constata-se que os valores obtidos às análises físico- -químicas e microbiológicas das polpas de cajá, apresentaram-se adequados. No entanto, as divergências para os dados do umbu-cajá mostram a necessidade de uma legislação para fixação de padrões do fruto.(AU)
Food Samples , Anacardiaceae , Fruit/microbiology , Food Quality Standards , Frozen Foods
Road mortality is the leading source of biodiversity loss in the world, especially due to fragmentation of natural habitats and loss of wildlife. The survey of the main species victims of roadkill is of fundamental importance for the better understanding of the problem, being necessary, for this, the correct species identification. The aim of this study was to verify if DNA barcodes can be applied to identify road-killed samples that often cannot be determined morphologically. For this purpose, 222 vertebrate samples were collected in a stretch of the BR-101 highway that crosses two Discovery Coast Atlantic Forest Natural Reserves, the Sooretama Biological Reserve and the Vale Natural Reserve, in Espírito Santo, Brazil. The mitochondrial COI gene was amplified, sequenced and confronted with the BOLD database. It was possible to identify 62.16% of samples, totaling 62 different species, including Pyrrhura cruentata, Chaetomys subspinosus, Puma yagouaroundi and Leopardus wiedii considered Vulnerable in the National Official List of Species of Endangered Wildlife. The most commonly identified animals were a bat (Molossus molossus), an opossum (Didelphis aurita) and a frog (Trachycephalus mesophaeus) species. Only one reptile was identified using the technique, probably due to lack of reference sequences in BOLD. These data may contribute to a better understanding of the impact of roads on species biodiversity loss and to introduce the DNA barcode technique to road ecology scenarios.
Animals, Wild/genetics , DNA Barcoding, Taxonomic/methods , Electron Transport Complex IV/genetics , Forests , Animals , Animals, Wild/classification , Brazil , Conservation of Natural Resources/methods , Geography , Molecular Sequence Data , Reproducibility of Results
