Myeloid Sarcomas Causing Unilateral Cranial Nerve Palsies in a Patient with Relapsed Acute Myeloblastic Leukemia.

Myeloid sarcomas (MS) are a rare manifestation of myeloid malignancies and can often be misdiagnosed, leading to a delay in treatment. The objective of this clinical case is to highlight the challenges of the clinical presentation and to emphasize the importance of this manifestation ensuring timely diagnosis and therapy. Here, we present a 43-year-old man who was diagnosed with acute myeloblastic leukemia (AML) after being evaluated for unintentional weight loss, subcutaneous nodules, thrombocytopenia, and anemia. The patient underwent chemotherapy with complete remission and presented 4 months later with dysphagia and cranial nerve palsies. Appropriate imaging and biopsy led to a diagnosis of myeloid sarcoma, and a decision was made to begin reinduction chemotherapy for AML achieving a second complete remission although his neurological deficits did not improve. Our case illustrates the protean presentation of myeloid sarcomas; clinicians should have a high suspicion for MS and remain vigilant when unexplained signs and symptoms arise in the background of a myeloid malignancy although challenges still remain when presentation is de novo. Advancements in understanding the pathophysiology of MS have been performed but remain not completely understood. High clinical suspicion, appropriate imaging, biopsy techniques, and expertise are paramount for timely diagnosis and treatment.

Thermal and optical behavior dataset of surfaces coated with high reflectance and common materials under different conditions, used in Brazil.

External and internal surface temperatures values of coated steel plates and the interior air temperature of a box-like model were collected throughout the time under different conditions: an artificial infrared radiation source was placed facing the external side of the plate to promote the temperature change, the energy power was variated by changing the distance from the plate and simultaneously different airflow conditions were inputted, data was collected by making experiments using the combination of distance and airflow changes. Reflectance raw data, of the materials, was also acquired by measuring the reflectance index of the samples according to ASTM E903 "Standard Test Method for Solar Absorptance, Reflectance, and Transmittance of Materials Using Integrating Spheres". Amplified optical images and infrared images of the samples were taken (using a "Flir e4" infrared camera) while they were under the influence of the source in the three chosen distances (60 cm, 40 cm and 20 cm). Considering that researches at this particular field lack of more direct comparisons of temperature, reflectance and heat flux behaviours; between special high reflectance coatings and common ones when the substrate is steel, when the direction of airflow is changed and when the source is an infrared one; measurements intending to give faster insights and directions were done. These insights can be used by anyone who intends to develop new coating materials and compare them with already existing ones to streamline their researches in this area. Finally, the buying costs of these coatings, similar to commercially used ones, are showed.

Effects of prolonged treatment with Syzygium cumini on the salivary glands of spontaneously diabetic mice

It is estimated that 190 million people worldwide have diabetes mellitus. Several attempts have been made to elucidate the deleterious effects of diabetes on various organ systems, as well as the reversal of these effects by treatment and/or diet. Thus, the objective of the present study was to analyze the effects of prolonged treatment with Syzygium cumini (Jambolan) sheet aqueous extract on the structure of cells responsible for secretory processes in the parotid and submandibular salivary glands of spontaneously diabetic mice. Ten female mice, including five diabetic Nod mice (group I) and five BALB/c mice (group II), were used. After characterization of the diabetic state, animals of group I received Syzygium cumini extract and group II animals received water ad libitum. After the experimental period, the salivary glands were collected from the animals for stereological analysis. The results showed structural alterations in the salivary glands of diabetic animals characterized by nuclear and cytoplasmic atrophy and the occurrence of inflammatory cells, as well as elevated glycemia levels. We conclude that no recovery of normal glycemia levels or glandular tissue structure occurs in diabetic animals even when treated with Syzygium cumini extract, a fact that might result in changes in the functional mechanisms of these organs.

Prostatic stromal microenvironment and experimental diabetes.

The diabetes causes alterations in various organ systems, including the male accessory sex glands. The prostate is very important in the reproductive process and it is a frequent target of malignant changes. The aim of this work was to demonstrate the histochemical and ultrastructural alterations in the prostate of diabetic animals. Two groups of animals were utilized: control and non-obese diabetic mice (NOD). Twelve days after the characterization of diabetic status the ventral prostate was collected, fixed in Karnovsky and paraformaldehyde, processed for histochemistry and TEM associated to stereology. The results showed reduction of the epithelial area and increasing of the stromal area with muscular and collagen hypertrophy in the prostatic gland. It was characterized the development of prostatic intraepithelial neoplasia, inflammatory processes and dilation of the organelles involved in the secretory process. It was concluded that diabetes besides damaging the reproductive process, affects the glandular homeostasis favoring the development of prostatic pathologies.

HIV and AIDS surveillance among inmates in Maryland prisons.

The prevalence of those with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) is higher among inmates of correctional facilities than among the general population. This raises the need to identify inmates living with or at risk of HIV/AIDS and to provide counseling and appropriate services for HIV treatment and prevention. The Maryland Division of Corrections (DOC) offers voluntary testing to all inmates on entry and tests inmates when clinically indicated. We reviewed all 1998 HIV antibody tests and confirmed AIDS cases in the Maryland DOC. Inmate demographics, testing acceptance, rates of seropositivity, and AIDS cases and comparisons based on gender, race/ethnicity, and age were examined. Comparisons were also made to HIV testing and AIDS cases from the nonincarcerated Maryland population. Trends in DOC AIDS diagnoses and AIDS-related deaths over time were also examined. Of the inmates, 39% were voluntarily tested for HIV on entry to the Maryland DOC in 1998 (38% of males and 49% of females). Overall, HIV seropositivity was 3.3% (5% for females and 3% for males). The 888 cumulative AIDS cases diagnosed in the DOC inmate population were concentrated among males (90% vs. 77% statewide), African Americans (91% vs. 75% statewide), and among IDUs (84% vs. 39% statewide). Due to high rates of HIV and AIDS, inmate populations are a crucial audience for HIV/AIDS testing, treatment, and prevention efforts, especially women. Prison-based programs can identify significant numbers of HIV and AIDS cases and bring HIV prevention interventions to a population characterized by frequent high-risk behavior.

Evaluation of a statewide non-name-based HIV surveillance system.

Recent advances in AIDS-related therapies have delayed the onset of AIDS-defining illnesses and reduced the usefulness of AIDS surveillance in assessing the incidence of early HIV disease and estimating future needs of the HIV-infected population. These changes have prompted renewed interest in expanding surveillance to include HIV and have engendered national debate on whether an HIV surveillance system should be based on reports of the names of infected individuals or employ non-name-based data codes. In 1994, the state of Maryland implemented a program to require HIV surveillance by unique identifier (UI) patient code. This evaluation of Maryland's program found that when complete, the 12-digit UI number provided a virtually unduplicated count 99.8% unique, was 99.9% unique with only the last four digits of the U.S. government Social Security Number (SSN), date of birth (DOB), and race, and 77.7% unique if the last four digits of the SSN were missing. Health care providers were willing to create the UI, with DOB and gender present 98.3% and 98.8% of the time, race was complete 84.1% and last four digits of SSN were complete 72.4%. The overall completeness of reporting for HIV tests was 87.8%.and 84.8%, respectively, using different methodologies. Evidence from the Maryland UI evaluation demonstrates that a non-name-based system can provide accurate, timely and valid data concerning the scope of the HIV epidemic, without the creation of state-wide name-based registry.

II Fórum Nacional da SBACV recentes avanços em cirurgia de varizes tronculares primárias dos MMII: uma nova visäo / Recent advances in the surgical treatment of primary varicose veins

No presente artigo säo apresentados os resultados do II Fórum Nacional da Sociedade Brasileira de Angiologia e Cirurgia Vascular, que versou sobre: "Recentes avanços em cirurgia de varizes tronculares primárias do MMII", compilados por uma Comissäo de Síntese, a partir de discussöes realizadas em 8 Regionais da SBACV. As principais conclusöes foram: 1. Existe, atualmente, um consenso sobre o valor de se preservar a veia safena magna, sem prejuízo do resultado cirúrgico funcional e estético, devendoe avaliar a capacidade de recuperaçäo da sefena em direçäo à normalidade, informando o paciente sobre a técnica utilizada. 2. Que talvez a técnica CHIVA seja muito complicada para tal preservaçäo e que ainda necessite de melhores estudos para justificar seu emprego, podendo ser substituídas por outras técnicas, sendo sugerida como uma alteranativa a técnica de Hammarsten et al. 3. Foi considerado de grande importância o uso de Duplex Scan pré e pós operatório na cirurgia de varizes, sendo entretanto umatcnica observador e aparelho dependente, podendo ainda, encarecer o custo do tratamento. 4. A cirurgia ambulatorial dentro de critérios aprovados no I Fórum Nacional da SBACV pode ter um melhor custo/benefício no tratamento das varizes e tem melhor aceitaçäo por parte do doente. 5. Näo existe ainda um consenso sobre a melhor técnica para tratamento da veia safena parva insuficiente, (com ou sem fleboextraçäo) e no tratamento das varizes relacionadas às veias pudendas. 6. Existe a necessidade de um maiornúero de publicaçöes e divulgaçäo dos trabalhos que estäo sendo realizados no Brasil sobre o assunto.

Complicacoes vasculares nos transplantes renais. / Vascular complications in renal transplantation

Os autores apresentam analise de 115 casos de transplantes renais realizados pelo Grupo de Transplantes Renais do Hospital Felicio Rocho e Hospital das Clinicas da Faculdade de Medicina da Universidade Federal de Minas Gerais, com enfase as complicacoes vasculares. Dos 115 casos operados, tivemos 7 complicacoes vasculares.Dos valentes a uma percentagem de 6,0%. De maneira geral, os problemas vasculares quando aparecem no pos-operatorio imediato ou tardio, simulam um quadro de rejeicao. Encontramos frequentemente queda do volume urinario associado ou nao a elevacao ou estabelecimento de niveis tensionais altos A complicacao mais frequente em nosso estudo foi exatamente a oclusao da arteria renal (tres casos), seguida por ruptura renal (um caso), estenose de arteria renal (um caso), ruptura espontanea da arteria iliaca (um caso) e hemorragia hilar (um caso). As complicacoes vasculares estao en intima relacao a problemas tecnicos peroperatorios tais como a manipulacao renal durante a sua retirada, a perfusao renal e a confeccao das anastomoses. A atencao a estes detalhes nos proporcionara um numero reduzido de problemas pos-operatorios

Adesão ao tratamento medicamentoso pelos hipertensos acompanhados pela saúde da família Montes Claros/MG

O presente trabalho tem por objetivo problematizar e contextualizar a hipertensão arterial na cidade de Montes Claros na ESF do bairro Nova Morada. Ressalta-se a melhoria da adesão ao tratamento desses pacientes como elemento modificador de morbidade e mortalidade populacional. Tal intento se dá a partir da construção de três principais eixos delineadores. O primeiro a identificação do problema de maior gravidade, impacto e resolutividade através do método de estimativa rápida, que se tornou base para diagnóstico situacional. O segundo uma revisão de literatura na SCIELO, BVS, Bireme em que a avaliação comparativa dos autores reforça a importância do tema e instrumentaliza as propostas do terceiro eixo em que o projeto de intervenção, seguindo o PES, é apresentado como algo dinâmico e passível de modificação, inclusive durante sua própria aplicação em virtude dos aspectos regionais e sociais previamente apresentados com mensuração de resultados a partir de entrevistas semi-estruturadas. Desta maneira, a presente proposta apresenta potencial de transformação da realidade local em saúde para práticas mais propositivas de trabalho da equipe

Implantação do acolhimento na Unidade Básica Estrada da Cocisa no município de Salvador no estado da Bahia

Acolhimento na unidade básica de saúde como condição da melhoria de acesso dos usuários aos serviços de saúde. Proposta do plano de ação para implantação do acolhimento sistemático e priorização dos atendimentos na Unidade de Saúde da Família Estrada da Cocisa no município de Salvador no Estado da Bahia. Serão realizadas reuniões com o propósito de humanizar as relações entre comunidade e profissionais de saúde, além de visitas em serviços que já têm essa experiência. Dessa forma, pretende-se contribuir para a reorganização do serviço e garantir acesso universal, com resolutividade e atendimento humanizado.