Melanoma primário de mama: relato de caso / Primary breast melanoma: case report

O melanoma primário de mama em sítio parenquimatoso é um tumor raro. Por sua baixa incidência, desconhece-se sua apresentação clínica usual, a evolução natural da doença, bem como resposta ao tratamento e seu prognóstico. É por esse motivo que se faz necessária uma boa investigação diagnóstica a fim de se obter precocemente o diagnóstico correto para se estabelecer a abordagem terapêutica adequada para cada paciente. Desse modo, relata-se o caso de paciente feminino, 61 anos, branca, encaminhada devido a nódulo palpável em mama direita e alteração mamográfica com BI-RADS 3, que teve diagnóstico de melanoma de parênquima mamário confirmado por exame anatomopatológico complementado por estudo imuno-histoquímico. Assim, com o objetivo desse trabalho de alcançar uma maior compreensão do assunto para que casos semelhantes a esse sejam futuramente abordados de maneira precoce e que garanta ao paciente o melhor cuidado, serão discutidos os aspectos relacionados à incidência do melanoma de mama, às dificuldades diagnósticas, ao prognóstico e às abordagens terapêuticas.

Primary melanoma in breast parenchyma is a rare tumor. Because of its low incidence, it is unknown its usual clinical presentation, the natural course of the disease and its response to treatment and prognosis. For this reason, a good diagnostic investigation is necessary in order to get the correct diagnosis as soon as possible to establish the appropriate therapeutic approach for each patient. Thus, we report a female patient case, 61 years-old, white, referred due to a palpable mass in the right breast and a mammographic alteration that shows BI-RADS 3, who had breast parenchyma melanoma diagnosed and confirmed by pathological examination complemented by immunohistochemical study. Under these circumstances, with the objective of this work to achieve a greater understanding of the subject so that such cases are identified as early as possible in the future and ensure the best patient care, aspects related to the incidence of breast melanoma, diagnostic difficulties, prognostic and therapeutic approaches will be discussed.

Surgical approach and the use of cryotherapy in a keratocystic odontogenic tumor after 12 months of decompression

Introduction: The Keratocystic Odontogenic Tumor (KOT) is a pathology classified as an odontogenic cyst and began to be considered an odontogenic tumor in 2005, because of the presence of intrinsic characteristics compatible with neoplasm, such as its high rate of recurrence and differentiated mechanism of growth. Although its etiology is still unknown, its origin is believed to be related to the remnants of the dental lamina. Clinically it presents aggressive behavior and high rates of recurrence. Various types of treatment have been related, ranging from more conservative methods to radical surgery. With the goal of diminishing the potential for recurrence of these lesions, some authors have recommended the use of adjunct therapies such as peripheral osteotomy with burs, treatment of the surgical site with Carnoy’s solution, electrocauterization, cryotherapy and resection. Objective:The aim of the present study is to report the case of a patient with a KOT of large proportions in the mandible. Case report: Treatment was taken to perform decompression of the lesion for 12 months, and after this treatment comprised curettage and cryotherapy. Conclusion: This procedure is considered useful and conservative, as it avoids traumatisms to the noble structures close to the lesion.

Automedicação entre acadêmicos de odontologia da Universidade Paulista Goiânia - Goiás / Self-medication in dentistry students at Paulista University, Goiânia - Goiás

Introduction: Self-medication is a procedure fundamentally characterized by the sick person, or person responsible for his/her care, taking the initiative to obtain or produce and use a product they believe will bring benefits in the treatment of diseases or relief of symptoms. Dentists, together with doctors and veterinarians, comprise the professional classes that may and must prescribe medications for their patients. Therefore, it is believed that these individuals, as a result of their duties, are professionals that know, understand and make an exhaustive study of medications. Objective and Methodology: Based on this, a research was conducted among the academic students of the dentistry course at Paulista University, Flamboyant campus, Goiânia, GO, Brazil, during which 209 questionnaires were applied among students from the 3rd to 8th periods. Results: The purpose of applying these questionnaires was to trace a profile with regard to the use of medications without medical prescription, and high incidence was found among academic students, both as regards the quantity of medica-tions and variety of substances used. Conclusions: The result was an alert that irrespective of the individual's knowledge, whether it involved a layperson or professional qualified for prescription, this habit repeated it. This is an alarming fact, because if the professional him/herself, who should educate patients and dissuade them from this practice, is a habitual user, it becomes more difficult to aspire to the future inhibition and reduction of this practice that is so harmful to health.

Study of infection by Rickettsiae of the spotted fever group in humans and ticks in an urban park located in the City of Londrina, State of Paraná, Brazil.

INTRODUCTION: Spotted fevers are emerging zoonoses caused by Rickettsia species in the spotted fever group (SFG). Rickettsia rickettsii is the main etiologic agent of Brazilian spotted fever (BSF)and it is transmitted by Amblyomma spp. ticks. METHODS: The study aimed to investigate SFG rickettsiae in the Arthur Thomas Municipal Park in Londrina, PR, by collecting free-living ticks and ticks from capybaras and blood samples from personnel working in these areas. Samples from A. dubitatum and A. cajennense were submitted for PCR in pools to analyze the Rickettsia spp. gltA (citrate synthase gene). RESULTS: All the pools analyzed were negative. Human sera were tested by indirect immunofluorescence assay with R. rickettsii and R. parkeri as antigens.Among the 34 sera analyzed, seven (20.6%) were reactive for R. rickettsii: four of these had endpoint titers equal to 64, 2 titers were 128 and 1 titer was 256. None of the samples were reactive for R. parkeri. An epidemiological questionnaire was applied to the park staff, but no statistically significant associations were identified. CONCLUSIONS: The serological studies suggest the presence of Rickettsiae related to SFG that could be infecting the human population studied; however, analysis of the ticks collected was unable to determine which species maybe involved in transmission to humans.

Study of infection by Rickettsiae of the spotted fever group in humans and ticks in an urban park located in the City of Londrina, State of Paraná, Brazil / Estudo da infecção por Rickettsias do grupo da febre maculosa em humanos e carrapatos de um parque urbano na Cidade de Londrina, Estado do Paraná

INTRODUCTION: Spotted fevers are emerging zoonoses caused by Rickettsia species in the spotted fever group (SFG). Rickettsia rickettsii is the main etiologic agent of Brazilian spotted fever (BSF) and it is transmitted by Amblyomma spp. ticks. METHODS: The study aimed to investigate SFG rickettsiae in the Arthur Thomas Municipal Park in Londrina, PR, by collecting free-living ticks and ticks from capybaras and blood samples from personnel working in these areas. Samples from A. dubitatum and A. cajennense were submitted for PCR in pools to analyze the Rickettsia spp. gltA (citrate synthase gene). RESULTS: All the pools analyzed were negative. Human sera were tested by indirect immunofluorescence assay with R. rickettsii and R. parkeri as antigens. Among the 34 sera analyzed, seven (20.6 percent) were reactive for R. rickettsii: four of these had endpoint titers equal to 64, 2 titers were 128 and 1 titer was 256. None of the samples were reactive for R. parkeri. An epidemiological questionnaire was applied to the park staff, but no statistically significant associations were identified. CONCLUSIONS: The serological studies suggest the presence of Rickettsiae related to SFG that could be infecting the human population studied; however, analysis of the ticks collected was unable to determine which species may be involved in transmission to humans.

INTRODUÇÃO: A febre maculosa é uma zoonose emergente causada por espécies de Rickettsia do grupo febre maculosa (GFM). Rickettsia rickettsii é o principal agente etiológico da febre maculosa brasileira (FMB) e é transmitida por Amblyomma spp. MÉTODOS: Com o objetivo de obter informações sobre GFM Rickettsiae no Parque Municipal Arthur Thomas em Londrina, PR, carrapatos de vida livre e de capivaras foram coletados, assim como amostras de sangue das pessoas que trabalham no parque. A. dubitatum e A. cajennense foram submetidos à PCR em pools para analises de Rickettsia spp. gltA (citrate synthase gene). RESULTADOS: Todos os pools de carrapatos analizados foram negativos. Soros de humanos foram testados pela imunofluorescência indireta com antigenos de R. rickettsii e R. parkeri. Entre os 34 soros analisados, 7 (20,6 por cento) foram positivos para R. rickettsii. Destes, quatro apresentaram títulos iguais a 64, dois iguais a 128 e um, igual a 256, mas nenhum soro reagiu com R. parkeri. Não houve nenhuma associação, estatisticamente significante, entre as variáveis analisadas no questionário epidemiológico fornecido às pessoas que participaram da pesquisa. CONCLUSÕES: Os estudos sorológicos sugerem a presença de alguma Rickettsiae relacionada ao GFM que poderiam estar infectando a população humana estudada. Entretanto, as análises dos carrapatos foram inconclusivas para determinar qual espécie poderia estar envolvida na transmissão para os humanos.

Serosurvey of antibodies against spotted fever group Rickettsia spp. in horse farms in Northern Paraná, Brazil.

Brazilian spotted fever (BSF) is an emerging disease most likely caused by Rickettsia rickettsii. The objective of the present study was to estimate the seroprevalence of BSF rickettsia infections in equines from six horse farms located in Londrina County, Paraná, Southern Brazil. Six owners of horse farms situated in Cambé, Santa Fé, Guaraci and Londrina municipalities participated in the study. All farms were located in areas where BSF has not been reported. A total of 273 horses were sampled and their sera were tested by indirect immunofluorescence assay (IFA) using R. rickettsii and R. parkeri antigens. Titers equal to and greater than 64 were considered positive. Of 273 sera tested, 15 (5.5%) reacted to R. rickettsii and 5 (1.8%) to R. parkeri. Five out of the six farms studied revealed seropositive animals and seropositivity rate ranged from 0 to 13%. The titers ranged from 64 to 512, and four samples had a titer of 512. Nine animals reacted to R. rickettsii with titers four-fold higher than those for R. parkeri. These results suggest that horses in Northern Paraná may have been exposed to rickettsiae identical or closely related to R. rickettsii.

Serosurvey of antibodies against spotted fever group Rickettsia spp. in horse farms in Northern Paraná, Brazil / Soroprevalência de anticorpos contra Rickettsia spp. do grupo febre maculosa em equinos de haras no Norte do Paraná, Brasil

Brazilian spotted fever (BSF) is an emerging disease most likely caused by Rickettsia rickettsii. The objective of the present study was to estimate the seroprevalence of BSF rickettsia infections in equines from six horse farms located in Londrina County, Paraná, Southern Brazil. Six owners of horse farms situated in Cambé, Santa Fé, Guaraci and Londrina municipalities participated in the study. All farms were located in areas where BSF has not been reported. A total of 273 horses were sampled and their sera were tested by indirect Immunofluorescence assay (IFA) using R. rickettsii and R. parkeri antigens. Titers equal to and greater than 64 were considered positive. Of 273 sera tested, 15 (5.5 percent) reacted to R. rickettsii and 5 (1.8 percent) to R. parkeri. Five out of the six farms studied revealed seropositive animals and seropositivity rate ranged from 0 to 13 percent. The titers ranged from 64 to 512, and four samples had a titer of 512. Nine animals reacted to R. rickettsii with titers four-fold higher than those for R. parkeri. These results suggest that horses in Northern Paraná may have been exposed to rickettsiae identical or closely related to R. rickettsii.

Febre Maculosa Brasileira (FMB) é uma doença emergente, sendo Rickettsia rickettsii o seu principal agente etiológico. O objetivo deste estudo foi determinar a soroprevalência de rickettsia do grupo da febre maculosa em equinos de seis haras localizados nos municípios de Cambé, Santa Fé, Guaraci e Londrina. As propriedades eram localizadas na região Norte do Paraná onde casos de FMB ainda não foram diagnosticados. Foram colhidas amostras de sangue de 273 equinos, e os soros foram testados pela RIFI, usando R. rickettsii e R. parkeri como antígenos, considerando-se como positivos títulos >64. Entre 273 soros, 15 (5,5 por cento) reagiram contra R. rickettsii e 5 (1,8 por cento) para R. parkeri. Cinco de seis haras estudados tinham animais reativos, e a taxa de sororreatividade variou de 0 a 13 por cento. Os títulos variaram de 64 para 512, e três amostras apresentaram título de 512. Nove animais reagiram para R. rickettsii com títulos quatro vezes maiores que para R. parkeri. Esses resultados sugerem que equinos no Norte do Estado do Paraná, Brasil, podem ter sido expostos a uma rickettsia idêntica ou muito próxima a R. rickettsii.

Degradabilidade ruminal da cana-de-açúcar integral tratada com diferentes níveis de hidróxido de sódio / Degradability of integral sugar cane treated with different sodium hidroxide levels

O experimento foi realizado utilizando-se quatro bovinos fistulados no rúmen. Durante o experimento, osanimais receberam uma dieta à base de silagem de milho e cana-de-açúcar picada e tratada com 2% deNaOH. Foram avaliados quatro tratamentos à base de cana-de-açúcar com diferentes níveis de NaOH (0,2, 4 e 6%) incubados no rúmen usando-se sacos de náilon. Determinou-se o desaparecimento da matériaseca (MS), matéria orgânica (MO), fibra em detergente neutro (FDN), fibra em detergente ácido (FDA),celulose (CEL) e hemicelulose (HEM) em 0; 6; 12; 24; 48; 72; 96 e 144 horas de incubações no rúmen. Asdegradabilidades potencial (DP) e efetiva (DE) foram determinadas segundo o modelo proposto porOrskov & McDonald (1979) a uma taxa de passagem de 5%/h. Dentro dos tempos de incubação, houvemaior desaparecimento de MS, MO, FDN, FDA, CEL e HEM. para o tratamento com 6% de NaOH.Observou-se maior (P<0,05) DP e DE, respectivamente, para MS (62,01% e 49,39%), MO (62,98% e49,10%), FDN (57,61% e 34,75%), FDA (55,67% e 35,25%), CEL (64,89% e 36,73%) e HEM (61,44% e35,72%), da cana-de-açúcar tratada com 6% de NaOH. Pode-se concluir que o tratamento químico dacana-de-açúcar com 6% de NaOH promoveu maior degradabilidade potencial e efetiva da MS, MO e dafração fibrosa. Os valores de DP e DE da fração fibrosa da cana de açúcar tratada com 6% de NaOH,justificam a utilização deste tratamento nas condições em que estas foram utilizadas.

The experiment was carried out being used four bovine cannulated at rumen. Corn silage and chopped sugar cane, treated with 2% NaOH were furnished to the animals during the experiment. Four treatments consisting of sugar cane treated with 0, 2, 4 and 6% NaOH were evaluated by ruminal incubation usingnylon bags. Dry matter (DM), organic matter (OM), neutral detergent fiber (NDF), acid detergent fiber (ADF), cellulose (CELL) and hemicellulose (HEM) disappearance were evaluated in 0, 6, 12, 24, 48, 72, 96 and 144 hours of ruminal incubation. Potencial degradability (PD) and effective degradability (ED) were determinated using the model suggested by Orskov & Mc Donald (1979), accepting a passage rate of potassium permanganate; conditioned fruits, in groups of 5, in carton boxes with cover, covered internally or no with low density polyethylene film addictived with potassium permanganate. The fruits were stored under storage room at 24,4 ¨¬C, 70 % RH. The evaluated variables were: loss of fresh mass, appearance, firmness of the pulp, soluble solids, titratable acidity and ascorbic acid. It were verified that the best treatments of modified atmosphere were individual packaging of the mango fruits in plastictrays, covered with plastic film of polivinila chloride (PVC) of 14 ¥ìm, without and with sachet of potassiumpermanganate. The potassium permanganate, in the form used in this study (sachet and impregnated inplastic film), did not interfere in the results obtained for the conservation of the fruits.