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BACKGROUND: Salivary gland cystadenoma (SGCA) is a rare benign tumor that predominantly occurs in the parotid gland. SGCAs affecting the minor salivary glands are uncommon and often resemble, clinically and histopathologically, other salivary gland lesions. METHODS: This study aimed to describe a series of four cases of SGCA affecting intraoral sites and performed a literature review of well-reported SGCA published in the English-language literature. RESULTS: SGCA cases included in this series were diagnosed in the buccal mucosa, lip, and hard palate of female patients aged between 19 and 78 years. All cases underwent excisional biopsy and were histologically characterized by a multicystic growth with variable degrees of capsule formation and were lined by several types of epithelium, including some cell types that are infrequently reported in SGCA. In some cases, a small collection of lymphocytes was observed adjacent to cystic formations. All SGCA were positive for periodic acid-Schiff, and immunohistochemical reactions were positive for CK7 and p63. The follow-up time ranged widely from 3 to 53 months, and to date, no recurrence has been observed. CONCLUSION: The literature review revealed a total of 33 published studies accounting for 55 SGCA cases.
Assuntos
Cistadenoma , Neoplasias das Glândulas Salivares , Humanos , Feminino , Neoplasias das Glândulas Salivares/patologia , Adulto , Pessoa de Meia-Idade , Cistadenoma/patologia , Idoso , Adulto JovemRESUMO
BACKGROUND: Neural tumors are difficult to distinguish based solely on cellularity and often require immunohistochemical staining to aid in identifying the cell lineage. This article investigates the potential of a Convolutional Neural Network for the histopathological classification of the three most prevalent benign neural tumor types: neurofibroma, perineurioma, and schwannoma. METHODS: A model was developed, trained, and evaluated for classification using the ResNet-50 architecture, with a database of 30 whole-slide images stained in hematoxylin and eosin (106, 782 patches were generated from and divided among the training, validation, and testing subsets, with strategies to avoid data leakage). RESULTS: The model achieved an accuracy of 70% (64% normalized), and showed satisfactory results for differentiating two of the three classes, reaching approximately 97% and 77% as true positives for neurofibroma and schwannoma classes, respectively, and only 7% for perineurioma class. The AUROC curves for neurofibroma and schwannoma classes was 0.83%, and 0.74% for perineurioma. However, the specificity rate for the perineurioma class was greater (83%) than in the other two classes (neurofibroma with 61%, and schwannoma with 60%). CONCLUSION: This investigation demonstrated significant potential for proficient performance with a limitation regarding the perineurioma class (the limited feature variability observed contributed to a lower performance).
Assuntos
Estudos de Viabilidade , Neoplasias Bucais , Neoplasias de Bainha Neural , Redes Neurais de Computação , Neurilemoma , Neurofibroma , Humanos , Neurofibroma/patologia , Neurilemoma/patologia , Neoplasias de Bainha Neural/patologia , Neoplasias Bucais/patologia , Diagnóstico DiferencialRESUMO
BACKGROUND: The purpose of this systematic review (SR) is to gather evidence on the use of machine learning (ML) models in the diagnosis of intraosseous lesions in gnathic bones and to analyze the reliability, impact, and usefulness of such models. This SR was performed in accordance with the PRISMA 2022 guidelines and was registered in the PROSPERO database (CRD42022379298). METHODS: The acronym PICOS was used to structure the inquiry-focused review question "Is Artificial Intelligence reliable for the diagnosis of intraosseous lesions in gnathic bones?" The literature search was conducted in various electronic databases, including PubMed, Embase, Scopus, Cochrane Library, Web of Science, Lilacs, IEEE Xplore, and Gray Literature (Google Scholar and ProQuest). Risk of bias assessment was performed using PROBAST, and the results were synthesized by considering the task and sampling strategy of the dataset. RESULTS: Twenty-six studies were included (21 146 radiographic images). Ameloblastomas, odontogenic keratocysts, dentigerous cysts, and periapical cysts were the most frequently investigated lesions. According to TRIPOD, most studies were classified as type 2 (randomly divided). The F1 score was presented in only 13 studies, which provided the metrics for 20 trials, with a mean of 0.71 (±0.25). CONCLUSION: There is no conclusive evidence to support the usefulness of ML-based models in the detection, segmentation, and classification of intraosseous lesions in gnathic bones for routine clinical application. The lack of detail about data sampling, the lack of a comprehensive set of metrics for training and validation, and the absence of external testing limit experiments and hinder proper evaluation of model performance.
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Inteligência Artificial , Radiômica , Humanos , Ameloblastoma/diagnóstico por imagem , Ameloblastoma/patologia , Cisto Dentígero/diagnóstico por imagem , Doenças Maxilomandibulares/diagnóstico por imagem , Aprendizado de Máquina , Cistos Odontogênicos/diagnóstico por imagem , Cistos Odontogênicos/patologia , Reprodutibilidade dos TestesRESUMO
INTRODUCCIÓN La anemia es un problema de salud pública en los países de bajos y medianos ingresos. Al no existir consenso sobre cómo evaluar el nivel de hierro en las poblaciones, la prevalencia de la deficiencia de hierro suele inferirse a partir de la concentración de hemoglobina. El HemoCue es un método recomendado por la OMS para realizar la cuantificación de la hemoglobina a nivel poblacional. OBJETIVO Describir la experiencia inédita de haber utilizado el HemoCue en la red de atención pública de la ciudad de Rosario. MÉTODOS Se realizó un estudio retrospectivo, de corte transversal, en niños de 6 a 42 meses de edad. Las variables de interés fueron el registro del HemoCue en la historia clínica del niño y la toma de conducta (diagnóstica, preventiva o terapéutica) durante la consulta pediátrica. Además se recolectó información (edad, sexo, antecedentes de desnutrición y/o anemia, peso, talla, etc.) con el fin de describir la muestra del estudio. Los datos se analizaron de forma global y según diagnóstico de anemia. Se utilizó el programa R. RESULTADOS Se incluyó un total de 500 niños provenientes de cinco centros de salud. La mediana de la edad fue de 17 meses. A nivel global se registró el HemoCue en un 42% y en alrededor de la mitad de estos casos se tomó algún tipo conducta clínica. En el grupo de niños con anemia (n=242), la toma de conducta basada en el resultado del HemoCue fue mayor (75%, 1C 95%: 660/0-820/0) en comparación con los niños sin anemia (n=258) que contaban con registro del HemoCue (33 0 0). La solicitud de un hemograma de rutina fue la intervención diagnóstica más frecuente y la ìnvestigación para suplementación con hierro por vía oral fue la intervención más utilizada para prevención y/o tratamiento de la anemia. DISCUSIÓN Nuestros hallazgos sugieren que el HemoCue es un método potencialmente útil para el control de la anemia infantil en el sistema público. La evidencia generada a partir de este estudio debería ser considerada en futuras investigaciones
Assuntos
Pediatria , Estudos Retrospectivos , Hemoglobinometria , AnemiaRESUMO
RESUMEN Antecedentes: determinar el estado nutricional y los síntomas depresivos en personas adultas, son factores importantes a tener en cuenta para el diseño de estrategias que contribuyan a mejorar las condiciones de vida. Objetivo: describir la relación entre factores sociodemográficos, nutricionales y síntomas depresivos en adultos de 50 o más años. Materiales y métodos: estudio descriptivo transversal, en el cual se determinaron variables sociodemográficas, antropométricas, nutricionales y de salud mental en 168 adultos de 50 o más años, pertenecientes al Programa Adulto Mayor (PAM) de Sabaneta (Antioquia). Resultados: se encontraron diferencias significativas entre las variables Índice de Masa Corporal (IMC), sexo y estado civil, al igual que en el puntaje de la Minivaloración Nutricional (MNA) en relación con el estado civil (p<0,05); en cuanto al puntaje de depresión de Beck no se determinaron relaciones significativas con las variables sociodemográficas (p>0,05), pero sí con el MNA (p<0,001). Conclusiones: los hallazgos permiten establecer según el IMC y el MNA, que los participantes en general presentan una situación socioeconómica favorable y un estado nutricional adecuado; además la frecuencia de síntomas depresivos que se encontró fue mínima, lo cual contribuye al estado de salud y bienestar de los adultos pertenecientes al PAM.
ABSTRACT Background: To determine nutritional status and symptoms of depression in adults, factors which are importantto consider in the design of strategies that contribute to increasing quality of life. Objetive: To describe the relationbetween sociodomographic, nutritional, and depression factors in adults 50 years of age and older. Materials and methods: Descriptive cross-sectional study, in which sociodemographic, anthropometric, nutritional and mental healthvariables were determined in 168 adults aged 50 years and over, who belong to the Older Adult Program (PAM) of thecity of Sabaneta, Antioquia. Results: We found significant differences between the variables body mass index (BMI),sex, and marital status, as well as in the nutritional minivaloration score (MNA) in relation to marital status (p <0.05).With the Beck depression score no significant relationships were found with sociodeomograhpic variables (P> 0.05),but significance was found with with MNA score (p <0.001). Conclusions: The findings make it possible to establishaccording to BMI and MNA, that participants generally have a favorable socioeconomic situation and an adequatenutritional status; In addition, the frequency was low of depression symptoms, contributing to the health status andwell-being of adults belonging to the PAM.
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Las infecciones de piel y partes blandas son una causa frecuente de consulta en los centros de atención primaria de la salud. Los datos de la epidemiología local de estas infecciones son escasos; el Staphylococcus aureus y el Streptococcus pyogenes son los principales agentes etiológicos. La emergencia, en los últimos años, de cepas de S. aureus meticilino resistentes provenientes de la comunidad y S. pyogenes resistentes a eritromicina plantea controversia en la elección del tratamiento empírico inicial. Este consenso nacional está dirigido a médicos pediatras, de familia, dermatólogos, infectólogos y otros profesionales de la salud. Trata el manejo clínico, especialmente el diagnóstico y tratamiento, de las infecciones de piel y partes blandas de origen bacteriano provenientes de la comunidad en pacientes inmunocompetentes menores de 19 años de edad.
Skin and soft tissue infections are a common reason for consultation in primary health care centers. Data from the local epidemiology of these infections are rare, but Staphylococcus aureus and Streptococcus pyogenes are known to be the major etiologic agents. The appearance in recent years of community-originated strains of methicillin-resistant S. aureus and erythromycin-resistant pyogenes raises controversy in the choice of initial empirical treatment. This national consensus is for pediatricians, dermatologists, infectologists and other health professionals. It is about clinical management, especially the diagnosis and treatment of community-originated skin and soft tissue infections in immunocompetent patients under the age of 19.
Assuntos
Humanos , Criança , Dermatopatias Infecciosas/diagnóstico , Dermatopatias Infecciosas/terapia , Infecções dos Tecidos Moles/diagnóstico , Infecções dos Tecidos Moles/terapiaRESUMO
Skin and soft tissue infections are a common reason for consultation in primary health care centers. Data from the local epidemiology of these infections are rare, but Staphylococcus aureus and Streptococcus pyogenes are known to be the major etiologic agents. The appearance in recent years of community-originated strains of methicillin-resistant S. aureus and erythromycin-resistant pyogenes raises controversy in the choice of initial empirical treatment. This national consensus is for pediatricians, dermatologists, infectologists and other health professionals. It is about clinical management, especially the diagnosis and treatment of community-originated skin and soft tissue infections in immunocompetent patients under the age of 19.
RESUMO
El priapismo es una erección peneana prolongada, desencadenada o no por estímulo sexual. Es poco frecuente en pediatría, pero importa su conocimiento pues su presencia puede trasuntar enfermedades graves, como la leucemia, y también puede complicarse con la disfunción sexual eréctil irreversible, si no se establece el tratamiento oportuno. Se informa el caso de un niño de 16 años, que debuta con priapismo como presentación de una leucemia mieloide crónica. El conocimiento del cuadro de priapismo permite realizar un enfoque adecuado, aplicar de forma sistemática las exploraciones y establecer un tratamiento para prevenir sus complicaciones.
Priapism is a prolonged penis erection, triggered by sexual stimulation or not; it is uncommon in children, but its knowledge is of great importance since it may lead to suspect serious diseases, such as leukemia, and it can lead to permanent erectile dysfunction if appropriate treatment is not timely done. We present the case of a 16-year-old boy with priapism which lead to a diagnosis of chronic myeloid leukemia. Knowledge of an uncommon pathology in children, like priapism, it is very important in order to establish the suitable and timely treatment, to prevent the irreversible sequelaes and complications of this disease.