OBJETIVO: Analisar o cumprimento do calendário de vacinação de crianças pelos usuários da Unidade de Saúde da Família Água Cristal bem como possíveis razões para o seu eventual não cumprimento.
MÉTODO: O estudo foi prospectivo, transversal e qualitativo, realizado a partir de visitas às residências das crianças pesquisadas, sendo a casuística constituída por 108 pessoas, número obtido através do registro presente nas fichas da família observadas. Incluíram-se crianças de ambos os sexos, analisando-se a faixa etária de 0 a 2 anos de idade, cadastradas na Unidade no ano de 2007.
RESULTADOS: Verificou-se que 87,97% das crianças estão com a vacinação atualizada, sendo que 13,89% dessas têm histórico de atrasos. Um fator fortemente atribuído a estes bons índices foi a atuação constante dos agentes comunitários de saúde. Entre aquelas que apresentaram atraso ou não receberam as vacinas, a falta da vacina contra rotavírus foi a mais observada, em 22,46% dos casos. Foram analisados fatores que poderiam contribuir para o índice de atraso, como escolaridade e ocupação dos pais. Nenhum desses foi estatisticamente significante.
CONCLUSÃO: Os resultados encontrados são comparáveis a ambulatórios de centros de referência latino-americanos, o que indica a efetividade da atuação do Programa Saúde da Família naquela comunidade. Contudo, a vacinação tem forte apelo na saúde da população e merece iniciativas de fortalecimento das ações, a fim de diminuir e evitar reaparecimento de doenças.
Paragangliomas can be found from the skull base to the sacrum. Sinonasal paragangliomas are infrequent. A 16-year-old female reported spontaneous discrete bilateral epistaxis once a month beginning when she was 3 years of age. Computed tomography showed an expansive hypervascular mass occupying the right nasal cavity and nasopharynx. Sinonasal paragangliomas usually occur in middle-aged women. Radiologic investigation is essential for the diagnosis of sinonasal paragangliomas and evaluating extension of the lesion. Endoscopic and conventional approaches are effective, and preoperative embolization is paramount for reducing bleeding risk. Histopathological features cannot differentiate benign from malignant paragangliomas, and since metastasis may eventually occur, follow-up must be carried out for a long period of time.
Objective: As spontaneous pneumomediastinum (PMS) is a rare and idiopathic entity, the present report proposes to record one of the few cases of a patient who presented PMS after intense cries induced by psychiatric illness. Case details: A 50-year-old male patient who was admitted to emergency department with agitation, cold sweating, tachycardia and echolalia, associated with screams. Symptoms lasted for about 15 hours and they have started after the patient witnessed a first-degree relative (father) dying at home due to COVID-19. A thorax computed tomography scan found a Pneumomediastinum that involved the upper mediastinum with mild extension to lower neck, near the Thyroid gland. After acute stress reaction diagnosis, accordingly with DSM-IV criteria, patient followed observation for two days and punctual benzodiazepines use, having no clinical complications during hospital stay. Pneumomediastinum was completely resolved. Final considerations: Screams motivated by psychiatric condition can be added to SPM causes list and should motivate phisician awareness, since it may bare life-threatening complications associated.
Desde os primórdios da medicina, as doenças que acometem a região da cabeça e pescoço foram preocupação de médicos de diversas áreas. No INCA, a criação da Seção de Cirurgia de Cabeça e Pescoço ocorreu em janeiro de 1952, por iniciativa conjunta do então diretor Dr. Mario Kröeff e do Dr. Jorge Sampaio de Marsillac Motta3. Desde então, cresceu e vem contribuindo de maneira relevante para o desenvolvimento da especialidade no país.
Merkel cell carcinoma is an uncommon neuroendocrine carcinoma with a rising
incidence and an aggressive behavior. It predominantly occurs in older patients,
with onset occurring at a mean age of 75-80 years. Recognized risk factors are
ultraviolet sunlight exposure, immunosuppression, and, more recently,
Merkel cell polyomavirus. We report a case of Merkel cell
carcinoma in a young HIV positive patient with Merkel Cell polyomavirus detected
in the tumor.
Concomitant occurrence of two different carcinomas in the same organ is rare. Also, it is quite uncommon in thyroid. In this case, three histological types were diagnosed in the same specimen. A 57-year-old patient with a thyroid nodule history, diagnosed 2 years ago. After a suspicious fine needle aspiration cytological result, total thyroidectomy was performed and the histopathological analysis presented three divergent thyroid tumors. There are few thyroid collision tumors cases described, no one with three different histologic types. The lack of clinical information about it, compelled a judicious management, that guided to a satisfatory outcome.
Introduction: Leiomyosarcoma (LMS) is rare, although commonly described in oral cavity. It can appear anywhere smooth muscle is present and there are reports of this type of neoplasm in many subsites in head and neck. Case Report: 44-year-old male patient with 2-year-history of cervical nodule, progressively growing, causing pain and neck movement limitation. Patient underwent en bloc resection of the tumor along with right ECM muscle, cervical levels II, III, IV and V. Discussion: Primary resection with wide margins is the treatment of choice for localized lesions. The present case originating in ECM may be unique until now, but it was handled based on the available literature and presented a satisfactory outcome.
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