Com a chegada do climatério e menopausa surgem diferentes manifestações e, apesar de serem assuntos muito comentados, ainda são um tabu na sociedade, em consequência disso, muitas mulheres desconhecem os sinais, sintomas e meios de melhorar a saúde. Sendo assim, o presente trabalho objetivou descrever as evidências científicas acerca dos desafios na atuação do enfermeiro frente ao climatério e menopausa na Atenção Primária à Saúde. Trata-se de um estudo bibliográfico, descritivo, do tipo revisão integrativa da literatura científica, por meio da busca sistemática nas bases LILACS, BDENF e EBSCO, durante setembro de 2022. Foram selecionados 9 artigos que evidenciaram as ações realizadas pelo enfermeiro direcionadas ao climatério e à menopausa, o conhecimento e percepções das mulheres sobre estes períodos e diferentes lacunas na assistência às demandas destas transições no âmbito da APS. Tendo em vista as evidências, a atuação do enfermeiro vai desde o acolhimento qualificado, atuando também como educador nesse processo. E, com base nas lacunas apontadas, a temática deve ser trabalhada desde a graduação até capacitações específicas, além de ser necessário modificações das políticas públicas de forma que incentivem ações que busquem qualificar a assistência à mulher no climatério e menopausa.
Background:The black caiman (Melanosuchus niger), belongs to the order Crocodylia, family Alligatoridae. More than a hundred species of helminths, mainly trematodes and nematodes, parasitize crocodilians around the world and a considerable number of species of ascaris have been described in crocodilians. There are few descriptions of hepatic and renal diseases affecting M. niger, and no articles related to the histopathological aspects of this species were found. The aim of this study was to evaluate gross and microscopically the liver and kidneys of 100 specimens of Melanosuchus niger slaughtered in Reserva de Desenvolvimento Sustentável Mamirauá, from natural populations. Materials, Methods & Results:The capture of the alligators was performed during the night, by members of the community itself in the channels and lagoons of the Reserve's lowland ecosystem. For the capture procedures, ties and harpoons were used and the animals were identified through the red glow of the eyes using the spot light lanterns. After being conducted to the slaughter area, the animals were submitted to the previous biometry to select which animals were appropriated for slaughter, they should measure between 2.10 m and 2.80 m. A total of 88 livers and 95 kidneys of M. niger of natural populations were analysed gross and microscopically, independently of gross lesions. The fragments collected for histopathological examination were approximately 0.5 cm thick and they were packed in appropriated identified containers with formalin 10% solution. The collection procedures were accompanied by field records for data recording. After fixation of the collected material, it were processes by habitual techniques for paraffin inclusion and hematoxylin-eosin staining. Grossly, none of the livers examined presented alterations and two kidneys presented parasitism. The hepatic microscopic analysis indicates in 3/88 cases, multiple foci of necrosis. In 7/88 cases, it was observed in the hepatic parenchyma, granulomas, mainly with epithelioid cells. In the histopathological examination of the kidney, the only alteration observe in 8/95 cases was the presence of granulomas. Discussion: The occurrence of Sebekia oxycephala nymphs, a pentastomid, in the liver of Alligator mississippiensis was reported in other researches. The parasite Sebekia mississippiensis was observed in liver and lungs of A. mississippiensis. similar alterations were also noticed in this research. The coccidiosis related to hepatic manifestations in crocodilians is related to the parasite that may belong to the genus Goussia. In the liver, under the oocysts form leads to a diffuse hydropic degeneration of hepatocytes. In this study it was also observed the hydronic degeneration, however, associated to the necrosis areas that had in the periphery epithelioid cells infiltrated, without parasitic participation. Two renal trematodes are known in crocodilians, Deurithrema gingae and Renivermis crocodyli both in Crocodylus porosus. Also it was found in the renal parenchyma few ...
Background: Ovarian cysts originate from mature follicles that do not ovulate within the predicted time according to the oestrous cycle. Dermoid cysts are structures lined by keratinized stratified squamous epithelium, without adjacent epidermal structures, filled by keratinic debris and amorphous proteinaceus material. They are small, located below the cortex, near the hilus. There is controversy regarding the teratogenicity of the dermoid cyst. Some authors use the nomenclature of benign cystic ovarian teratoma, others, reports that although the fibrous wall and histological features are similar to teratomas, it is not associated with this germ cell-derived neoplasia. Case: Ovaries and uterus were received from a female, adult bovine, Nelore, from a slaughterhouse. The left ovary measured 6.5x5.0x3.9 cm and weighed 80 g; the right ovary measured 5.7x3.7x3.0 cm and weighed 60 g. Grossly, the ovaries were similar, presenting floating consistency, multilobulated and pointed aspect, and at the cut surface, there was extravasation of mucopurulent content of whitish colour. Regarding to the uterus, macroscopically, the uterine horns were infantile and decrease in the diameter. Fragments of the tissues were collected and fixed in 10% buffered formalin for histopathological examination and the staining of the slides was done with hematoxylin and eosin. Microscopically, in the ovaries, it was observed rare vestigial elements of ovary identifying an atresic follicle. Polycystic formation with cysts exhibiting partial or total coating of a keratinized squamous epithelium was also observed. In the lumen abundant keratinous material was present. The uterine microscopy revealed compact endometrium with areas variably infiltrated by lymphocytes, plasmocytes and occasional neutrophils. Areas devoid of endometrial glands were observed, in addition to other areas with reduced quantity and size. Also, the myoepithelial layer was thin and enlargement of the endometrial vascular space was noted. Discussion: Only one study was found reporting three cases of unilateral dermoid cyst in bovine ovary, also from slaughterhouse. Dermoid cysts appear most often in Zebu cattle. Clinically, these cysts do not necessarily result in infertility and do not interfere in the ovarian functions, due to this, the ovaries are not referred for histopathology examination, which difficult its classification. However, in this study the histological examination showed the absence of follicular development, which characterizes infertility, including endocrine dysfunction. Macroscopically ovarian dermoid cysts are similar to abscesses. It has a viscous or milky content inside and, at the cut surface, usually the content project to the surface. Histologically, there are dilated cysts containing material in the lumen at various stages of keratinization conferring a lamellar aspect and a keratinized stratified squamous epithelium. In this study, we observed pseudostratified epithelial lining containing cilia in addition to lumen keratin content, without follic...
Background: Cryptococcosis is an opportunistic, systemic mycotic disease caused by a yeast of Cryptococcus neoformans. These pathogens cause serious public health problems, as they can be transmitted to humans, domestic and wild animals. In cats and dogs, the main site of infection is the upper lower respiratory tract, however, the infection can extend and affect other sites in the organism, however, the peritoneal manifestation of the disease is rare. Thus, the present work aims to report a case of cryptococcosis in a canine, mixed breed, female, adult, from the Metropolitan Region of Belém.Case: A mixed breed dog, female, adult was admitted in a veterinary hospital at Belém, presenting abdominal discomfort and, after the clinical examination, emergency exploratory laparotomy was indicated, and it were observed disseminated lesions in the abdominal cavity, with multiple nodules attached to the peritoneum and intestinal serosa and bladder, uterus, among other organs. Fragments from the surgical biopsy were fixed, and processed routinely according to the techniques for histological tissue processing. Histological examination revealed a predominance of granulomatous lesions in peritoneum and mesentery organs. It was observed a discrete inflammatory reaction of macrophages, epithelioid cells and giant cells, many in phagocytosis of spherical or ovoid organisms, with a thick capsule and a clear perinuclear halo. In the PAS staining, the Cryptococcus conidia presented eosinophilic characteristics and some of them had the capsule well demarcated, which was shown to be radiated. Also it was possible to see the budding yeast and in the Grocott stain, the Cryptococcus stained in black.Discussion: Cryptococcosis with peritoneal involvement in animals is rarely reported in the literature. Cryptococcus is an agent that presents tropism by the central nervous system and nasal cavity, however atypical presentations have been reported, especially at the level of the abdominal cavity (intestines and mesentery). It is believed that the gastrointestinal tract is the gateway for ascending contamination, or that the contamination can occur by fungal ingestion. The lesions presented a multiple distribution, with isolated and coalescent nodules adhered to the peritoneum and adjacent structures. The literature reports two cases of dogs with intra-abdominal cryptococcosis, in which, macroscopically, granulomatous formations were observed in the jejunum, with lymph nodes and mesentery. Microscopically, a discrete inflammatory infiltrate of macrophages and lymphocytes were observed. Some areas with granulomatous reaction, lymphocytes, epithelioid macrophages and giant cells and, in other areas, yeasts in the cytoplasm were observed. The yeasts were spherical or ovoid, surrounded by a thick capsule of polysaccharide. The periodic acid Schiff (PAS) and silver impregnation (Grocott) staining were used to highlight structures of the Cryptococcus wall which were presented by a strong stained polysaccharide capsule. It must be emphasized the zoonotic potential of cryptococcosis, a disease that can affect both animals and humans. Cryptococcosis in humans normally occurs when the fungus accesses the airways through inhalation and ranges from asymptomatic pulmonary colonization to compromised meninges, causing the human patient's life-threatening condition. In the present report, the diagnosis of cryptococcosis was established through histopathological and histochemical examination of the fungal structure, which were determinant in the etiological diagnosis of cryptococcosis.
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