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Clinicopathologic along with immunohistochemical examine regarding breast angiosarcoma.
The approach chosen by the surgeon should be based on factors other than the biomechanical strength of the screw orientation.OBJECTIVE To verify the association of obesity and infertility related to anovulatory issues. METHODS This case-control study was carried out with 52 women, aged 20 to 38 years, divided into two groups (infertile - cases - and fertile - control), seen at outpatient clinics, in the period from April to December, 2017. RESULTS We found significant evidence that obesity negatively affects women's fertility (p=0.017). The group of infertile women was 7.5-fold more likely to be obese than fertile women. CONCLUSION Strategies that encourage weight control are indicated for women with chronic anovulation, due to hight metabolic activity of adipose tissue.OBJECTIVE To develop a computational algorithm applied to magnetic resonance imaging for automatic segmentation of brain tumors. METHODS A total of 130 magnetic resonance images were used in the T1c, T2 and FSPRG T1C sequences and in the axial, sagittal and coronal planes of patients with brain cancer. The algorithms employed contrast correction, histogram normalization and binarization techniques to disconnect adjacent structures from the brain and enhance the region of interest. Automatic segmentation was performed through detection by coordinates and arithmetic mean of the area. Morphological operators were used to eliminate undesirable elements and reconstruct the shape and texture of the tumor. The results were compared with manual segmentations by two radiologists to determine the efficacy of the algorithms implemented. RESULTS The correlated correspondence between the segmentation obtained and the gold standard was 89.23%. CONCLUSION It is possible to locate and define the tumor region automatically with no the need for user interaction, based on two innovative methods to detect brain extreme sites and exclude non-tumor tissues on magnetic resonance images.BACKGROUND Nowadays, there is an ethical and moral necessity to establish rules that govern professional attitudes and conduct. In the medical field, these rules are multifaceted, given the health consequences inherent to medical procedures. Ethics is an even more delicate subject when it comes to plastic surgery, since one of the aims of this particular medical specialty is esthetic improvement of the body. OBJECTIVE To survey and classify São Paulo State Medical Board investigations of plastic-surgery complaints that were treated as professional-misconduct cases between 2007 and 2016. DESIGN AND SETTING Cross-sectional study conducted in a medical council. METHODS A total of 360 cases were reviewed. Among these, 8 (2.23%) were dismissed, 1 (0.27%) became an administrative lawsuit and 351 (97.50%) were treated as professional-misconduct cases. RESULTS A breakdown of the complaints filed over the nine-year period showed that complaints concerning malpractice were the most common (28.43%), followed by those regarding medical advertising (24.19%) and poor doctor-patient relationships (10.39%). CONCLUSION Overall, the number of complaints lodged decreased over the last two years reviewed, although complaints regarding malpractice and poor doctor-patient relationships increased by 10% over the same period. In order to further reduce the number of medical board investigations, the medical establishment needs to carefully review the medical training of students and doctors at every stage of their careers.BACKGROUND Fatigue is a frequent symptom in patients with primary Sjögren's syndrome (pSS) and can be a cause of or be associated with sleep disorders. OBJECTIVE To assess the sleep quality of pSS patients and its relationship with fatigue and disease activity. DESIGN AND SETTING Analytical observational study conducted at an exercise psychobiology laboratory. METHODS Sleep quality was evaluated using the Pittsburg sleep quality index (PSQI) and actigraphy. Fatigue was evaluated through the Profile of Fatigue and Discomfort - Sicca Symptoms Inventory (PROFAD-SSI-SF) and a visual analogue scale for fatigue (VAS-fatigue). Disease activity was evaluated using a visual analogue scale for pain (VAS-pain), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) and Disease Activity Index (ESSDAI). We summarized the data through descriptive statistics. RESULTS A total of 50 female patients with pSS, of average age 56.4 years, were included in the study; 80% presented low disease activity. The total PSQI score showed that 74% had poor sleep. The actigraphy showed mean sleep latency of 26.2 minutes and mean nightly awakening of 48.2 minutes (duration of wakings after sleep onset, WASO). There were correlations between PSQI and VAS-pain, VAS-fatigue, PROFAD-SSI and ESSPRI. Actigraphy showed a correlation between the duration of WASO and ESSDAI. CONCLUSION The present study provides important information regarding correlations between sleep disorders and disease activity. There is a need for proper control over disease activity and for development of strategies to help patients to sleep better in order to diminish their fatigue. TRIAL REGISTRATION ClinicalTrials.gov NCT03130062.in English, Portuguese OBJETIVO Correlacionar a prevalência e o prognóstico de cada padrão de TCAR de pneumonia intersticial usual (PIU) típica, provável e indeterminada com o diagnóstico clínico multidisciplinar de doença pulmonar intersticial (DPI). MÉTODOS Incluímos todos os pacientes com diagnóstico multidisciplinar de DPI com padrão de TCAR de PIU típica, PIU provável ou indeterminada para PIU. Dados clínicos e histopatológicos, teste de função pulmonar e status de sobrevida foram obtidos retrospectivamente. Selleck compound 3k O diagnóstico final foi validado por uma equipe multidisciplinar. RESULTADOS Foram incluídos no estudo 244 pacientes, com média de idade de 68 ± 13 anos sendo 52,5% do sexo masculino. Em um total de 106 pacientes com padrão típico de PIU, 62% tiveram o diagnóstico multidisciplinar de FPI, 20% de pneumonia por hipersensibilidade crônica (PHC) e 10% de DPI relacionada à doença do tecido conjuntivo (DPI-DTC). Dos 114 casos com provável PIU, DPI-DTC correspondeu a 39%, FPI a 31%, pneumonia intersticial descamativa a 11%, doença pulmonar relacionada a medicamentos a 9% e PHC a 8%.
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