RESUMO Objetivo: descrever o perfil epidemiológico das vítimas de trauma atendidas em um hospital de referência no município de Curitiba (PR), bem como investigar os mecanismos do trauma, além de avaliar os escores de gravidade. Métodos: estudo descritivo observacional transversal, cujos dados foram obtidos através da aplicação de questionário em vítimas atendidas na sala de emergência, entre dezembro de 2016 e fevereiro de 2018. Resultados: foram incluídos no estudo 1354 vítimas de trauma, das quais 60% tiveram como transporte pré-hospitalar o Serviço Integrado de Atendimento ao Trauma em Emergência (SIATE), e 40%, o Serviço de Atendimento Móvel de Urgência (SAMU). Quanto ao sexo, 70% dos pacientes eram do sexo masculino. A média de idade foi de 39,48 anos. Sobre o horário e dia dos atendimentos, a maior proporção se concentrou no período noturno na sexta-feira. Quanto ao mecanismo do trauma, nos pacientes atendidos pelo SIATE, o mais frequente em homens foi a colisão de motocicleta (34,3%), enquanto que em mulheres foi a queda de mesmo nível (21,42%). Já no SAMU, o mecanismo mais frequente independentemente do sexo foi queda de mesmo nível (20,06% e 40,66%, respectivamente). Analisando-se os escores de gravidade, observou-se que 95,5% dos pacientes eram classificados como leves pela escala de coma de Glasgow. Conclusões: o perfil das vítimas analisadas neste grande estudo muito se assemelha a outros estudos nacionais menores: homens, jovens, vítimas de acidentes de trânsito. A população economicamente ativa, portanto, é a mais afetada, refletindo em alto custo para a sociedade.

Introduction: twin-to-twin transfusion syndrome (TTTS), defined by combination of polyhydramnios-oligohydramnios, is the most prevalent (5%-35%) of the abnormalities due to placental vascular anastomoses and the most lethal (80%-100% mortality) if untreated. Fetoscopic laser ablation of abnormal vasculature using the Solomon technique is the gold standard approach. It consists of interrupting the intertwin blood flow. Objectives: to present our initial experience at the Fetal Surgery Service of the Hospital de Clinicas of the Federal University of Parana (HC-UFPR) and to compare our results with those reported in the literature. Methods: we conducted a retrospective analysis of pregnancies who had undergone laser ablation, assessing data on Quintero’s staging, gestational age at diagnosis and at the time of the procedure, placental position, immediate post-procedure survival, and survival after the neonatal period. We then compared these data with the most recent data available in the literature. Results: we analyzed ten TTTS cases. The diagnosis was performed before the 26th week of pregnancy (median 20.8 weeks) and treatment occurred in a median of 9.5 days later. The distribution by the Quintero’s staging was of three cases in stage II, five in stage III, and two in stage IV. In 50% of the gestations, at least one of the fetuses survived through the neonatal period. Conclusion: the treatment of TTTS in the HC-UFPR had a positive impact in the survival of the affected fetuses, although the results were worse than the ones reported in the literature, probably due to the delay in referencing the patients to our service, leading to a prolonged interval between diagnosis and treatment.

European Journal of Breast Health (Eur J Breast Health) is an international, scientific, open access periodical published by independent, unbiased, and double-blinded peer-review principles. It is the official publication of the Turkish Federation of Breast Diseases Societies, and Senologic International Society is the official supporter of the journal.

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Introduction: The current outbreak of the new coronavirus or SARS-CoV-2, which causes COVID-19, was first reported to the World Health Organization on December 31, 2019, being declared a pandemic on March 11, 2020. As for the clinical spectrum of SARS-CoV-2 infection, it is a broad one, ranging from asymptomatic, mild upper respiratory tract disease to severe viral pneumonia with respiratory failure and death. With a chance of severe clinical presentation close to 25%, SARS-CoV-2 infection can lead to health service overload and increase the demand for material and human resources. Aiming to increase the availability of health professionals directly involved in care during the pandemic, the Ministry of Education authorized the early graduation for students pursuing careers in health, including medicine. Objective: The aim of this article is to obtain preliminary results of the impact of early graduation for medical students during the COVID-19 pandemic. Method: Observational and cross-sectional study, carried out by applying a questionnaire with 13 questions, five of which used a Likert scale of assessment, six in multiple choice format and two descriptive, via Google Forms, applied to medical students from the universities of Curitiba-PR that graduated earlier in mid-year 2020, due to the COVID-19 pandemic. Results: 113 recently graduated students answered the questionnaire.101 participants reported that they are working as physicians and, among them, 63.36% stated that they are working directly in the treatment of COVID-19 cases. Regarding the importance of an early graduation, most participants fully agree or agree, while only three participants totally disagree. More than half of the interviewees do not feel harmed by the early graduation. However, 43.3% believe they have failed to acquire important information for their training. Finally, regarding their performance in the pandemic, 79.6% consider important their role in the fight against COVID-19 pandemic. Conclusion: The study shows that, at first, the efforts to give the Class of 2020 an early graduation were successful, since these new physicians are contributing to alleviate workforce shortages and provide better care for patients during the pandemic.

Hemophilia B is a recessive hereditary disease, and manifestations result from coagulation factor IX deficiency. Although improbable, as factor IX is produced exclusively in the liver, the possibility of developing the disease after transplantation represents an infrequent but potentially morbid complication. Standard laboratory tests may be insufficient to determine the probability of transmission of this pathology. This report describes the case of a patient who developed hemophilia B after liver transplantation whose donor had no prior knowledge of the disease.

O gene IFNG codifica o Interferon-γ (IFN-γ), molécula que exerce papel de destaque na defesa imunológica e atua como citocina, ativando células fagocíticas que destroem agentes invasores. Camundongos com a deleção do gene que codifica para o seu receptor, assim como a sua deficiência de IFN-γ, são muito mais susceptíveis a micobactérias e outros patógenos intracelulares. Sua expressão tem de ser estritamente regulada, para que a resposta proinflamatória não cause a destruição dos próprios tecidos. Esta regulação ocorre pela metilação do DNA na região promotora do gene, e por variantes alélicas, que modulam a afinidade por proteínas reguladoras. Dentre estas últimas, destaca-se uma variante intrônica, associada com a susceptibilidade à tuberculose e hanseníase, duas doenças que ainda representam, no Brasil, grave problema de saúde pública.

Examinar um paciente. Inspeção, palpação, percussão e ausculta. Quatro princípios básicos, aparentemente simples. Simples? Pode-se dizer que inicialmente, para nós, estudantes de medicina, não é nenhum um pouco simples.