RESUMO
Different environmental and biological factors can originate and support different alternative life histories in different taxonomic groups. Likewise, these factors are important for the processes that assemble and structure communities. Amphibians, besides being highly susceptible to environmental conditions, have various reproductive strategies, such as the direct development of individuals. Several hypotheses have been raised about possible selective pressures related to the emergence of direct development in anurans, as well as the relationship between environmental characteristics and the occurrence of these species. Such investigations, however, have mainly focused on specific clades and/or regions. Here, we use structural equation modelling to investigate the relationships between different abiotic (temperature, precipitation, humidity, and terrain slope) and biotic (phylogenetic composition and functional diversity) factors and the proportion of species with direct development in 766 anuran communities of the Atlantic Forest, a biome with a vast diversity of anuran species and high environmental complexity. Anuran communities with higher proportions of direct developing species were found to be mainly influenced by low potential evapotranspiration, low temperature seasonality, and high functional diversity. Phylogenetic composition and terrain slope were also found to be important in determining the occurrence of these species in Atlantic Forest communities. These results show the importance of these factors in the structuring of these communities and provide important contributions to the knowledge of direct development in anurans.
Assuntos
Anuros , Florestas , Humanos , Animais , Filogenia , Ecossistema , BiodiversidadeRESUMO
OBJECTIVE: To analyze the perioperatory and short-oncological outcomes in 5 cases with CRPC M0 developed after pRT that underwent salvage laparoscopic RP (sLRP) and review the current evidence. MATERIAL AND METHODS: Perioperatory and oncological outcomes were prospectively analyzed. Inclusion criteria were patients that had received pRT and posteriorly presented with CRPC M0 in standard imagines and positron emission tomography MRI coline. Evidence was reviewed in PUBMED database. RESULTS: No surgical complications and blood transfusion were reported. Two patients required an endoscopic urethrotomy due to bladder neck contracture (Clavien IIIb). Final pathological findings were T3 or more, multifocal with 3 positive surgical margins. Four patients reach undetectable PSA after surgery except one that continuous under ADT without disease progression. After 12 months follow-up, 4 patients persist with undetectable PSA and one with stable disease under ADT. Current evidence demonstrated that CRPC M0 treated with open, laparoscopic or robotic RP a biochemical recurrence of 68.7% as a hormone-sensitive PC; however, 17.4% were disease-free after 4 years of follow-up. CONCLUSION: Our serie, 4 cases are disease free after 12 months follow-up. Current evidence is a retrospective and multicenter experience with few cases and intermediate oncological follow-up. More cases with longer follow-up and better evidence are required to opt for this treatment as a first line.
Assuntos
Neoplasias de Próstata Resistentes à Castração , Neoplasias da Próstata , Hormônios , Humanos , Masculino , Recidiva Local de Neoplasia , Antígeno Prostático Específico , Prostatectomia/métodos , Neoplasias da Próstata/patologia , Neoplasias de Próstata Resistentes à Castração/cirurgia , Estudos Retrospectivos , Terapia de Salvação , Resultado do TratamentoRESUMO
OBJECTIVE: To report 2 cases of an extremely rare bladder tumor such as Cystitis Glandularis (CG) that were management by different strategies and review the current evidence. MATERIAL AND METHODS: Both cases of 43 and 48 years reported the same lower urinary tract symptoms that simulated a malignant bladder tumor. Case 1 presented with an extensive tumor affecting the trigone and the left upper urinary tract; the second case presented a less extensive tumor also at the bladder trigone. RESULTS: The first patient required two bladder tumor resection and a laparoscopic uretero-vesical reimplantation with adyuvant steroids. The other patient only required one bladder tumor resection without adyuvant treatment. Finally, after 7 and 6 months, both patients do not present tumor recurrence; respectively. CONCLUSION: Cystitis Glandularis (CG) represent an extremely rare tumor. Usually presentation is in young people with predilection at the bladder trigone. Current evidence ruled out being preneoplastic without standardized treatment. Two cases were analyzed with completely different characteristics, but with satisfactory treatment.
Assuntos
Cistite , Neoplasias da Bexiga Urinária , Sistema Urinário , Adolescente , Cistite/diagnóstico , Humanos , Recidiva Local de Neoplasia , Bexiga Urinária , Neoplasias da Bexiga Urinária/patologiaRESUMO
Objetivos: El objetivo del estudio fue evaluar nuestra experiencia inicial en cirugía intrarrenal retrógrada para el tratamiento de litiasis renales y determinar si es una cirugía eficaz y segura para realizarse en un centro ambulatorio. Materiales y métodos: Se evaluó a todos los pacientes sometidos a ureterorrenoscopia flexible con láser Holmium en la Clínica Andina de Urología luego de un año de procedimientos. Se determinaron datos demográficos, características de las litiasis operadas, porcentaje libre de litiasis y complicaciones según escala modificada de Clavien. Resultados: Un total de 63 pacientes fueron intervenidos desde marzo de 2017 a marzo de 2018. El tamaño medio de las litiasis urinarias fue de 11,6 mm. En un 93,6% de los pacientes la cirugía se pudo completar sin inconvenientes con un tiempo medio de 44 minutos. El porcentaje global libre de litiasis fue del 76,19%. Un 17,4% tuvo complicaciones generales, sin embargo, solo 2 pacientes requirieron reinternación. Conclusiones: La ureterorrenoscopia flexible es una cirugía mínimamente invasiva, eficaz y segura, con un bajo índice de complicaciones (AU)
Objectives: The aim of this study was to evaluate our initial experience in retrograde intrarenal surgery for the treatment of renal lithiasis and determinate if the surgery is effective and safe to be practice in an ambulatory center. Materials and methods: We recorded all patients who underwent flexible ureterorenoscopy and laser Holmium at Clínica Andina de Urología after one year of surgeries. Demographic information, stones characteristics, stone free rate and complication using Clavien system were gathered. Results: A total of 63 patients underwent flexible ureterorenoscopy from March 2017 to March 2018. Mean stone diameter was 11.6 mm. Surgery was complete in 93.6% of patients with a mean operative time of 44 minutes. Stone free rate was 76.19%. The overall complication rate was 17.4%, nevertheless, only 2 patients were readmitted. Conclusions: IFlexible ureterorenoscopy is a minimally invasive procedure, effective and safe, with a low rate of complications. (AU)
Assuntos
Adulto , Lasers de Estado Sólido/uso terapêutico , Procedimentos Cirúrgicos Minimamente Invasivos , Nefrolitíase/cirurgia , Resultado do Tratamento , Ureteroscopia/métodos , Assistência AmbulatorialRESUMO
INTRODUÇÃO: Lipomas são os tumores benignos mesenquimais mais comuns. Entretanto, são pouco frequentes na face, principalmente o tipo considerado gigante, derivado do coxim adiposo bucal. A literatura é escassa e provavelmente a sua incidência é subestimada. MÉTODO: Relato do caso de tratamento cirúrgico de lipoma gigante bucal e temporal recidivado, e revisão da literatura no Pubmed na língua inglesa e na Revista Brasileira de Cirurgia Plástica. RESULTADOS: O tumor, anatômica e morfologicamente, corresponde ao coxim adiposo bucal, foi totalmente retirado pelo acesso facial e temporal, sem sequelas ao nervo facial. Foram encontrados 31 casos relatados de lipoma de origem do coxim adiposo bucal, entretanto, vários casos foram encontrados e relatados sob outras denominações. DISCUSSÃO: O coxim adiposo bucal é maior e mais complexo que se conhecia, e várias patologias se derivam deste, sendo importante o diagnóstico diferencial do lipoma simples com o de células fusiformes e com o lipossarcoma, devido a sua extrema semelhança. CONCLUSÃO:Nas lesões lipomatosas da face, a possível origem no coxim adiposo bucal deve ser considerada. Um estudo amplo dessas lesões com a finalidade de uniformizar a terminologia e de determinar a sua real incidência deve ser realizado.
INTRODUCTION: Lipomas are the most common benign mesenchymal tumors. Nevertheless, they are infrequent in the face, particularly giant lipomas, which are derived from the buccal fat pad. The literature regarding these tumors is scarce and their incidence is likely underestimated. METHODS: We present a case report of surgical treatment of a relapsed giant buccal and temporal lipoma and review the related English literature in Pubmed and that in the Brazilian Journal of Plastic Surgery. RESULTS: The tumor, which anatomically and morphologically corresponded to the buccal fat pad, was completely excised by facial and temporal access without sequelae to the facial nerve. A total of 31 reported cases of lipoma originating from the buccal fat pad were found; however, several were found and reported under other names. DISCUSSION: The buccal fat pad is larger and more complex than assumed, and several pathologies are derived thereof, making the differential diagnosis of simple lipoma with fusiform cell lipoma and liposarcoma difficult due to their extreme similarities. CONCLUSION: In lipomatous lesions of the face, the possible origin in the buccal fat pad must be considered. An extensive study of these lesions with the purpose of standardizing the terminology and determining its real incidence must be performed.
Assuntos
Humanos , Masculino , Adulto , História do Século XXI , Ferimentos e Lesões , Lipomatose Simétrica Múltipla , Relatos de Casos , Tecido Adiposo , Revisão , Procedimentos Cirúrgicos Bucais , Face , Lipoma , Lipomatose , Boca , Recidiva Local de Neoplasia , Neoplasias , Ferimentos e Lesões/cirurgia , Ferimentos e Lesões/complicações , Lipomatose Simétrica Múltipla/cirurgia , Lipomatose Simétrica Múltipla/patologia , Tecido Adiposo/cirurgia , Tecido Adiposo/crescimento & desenvolvimento , Procedimentos Cirúrgicos Bucais/métodos , Face/cirurgia , Face/patologia , Lipoma/cirurgia , Lipoma/patologia , Lipomatose/cirurgia , Lipomatose/patologia , Boca/anatomia & histologia , Boca/cirurgia , Boca/crescimento & desenvolvimento , Boca/fisiopatologia , Recidiva Local de Neoplasia/cirurgia , Recidiva Local de Neoplasia/patologia , Neoplasias/cirurgiaRESUMO
Hombre de 47 años de edad, diabético tipo 2, que consulta por cefalea holocraneana de 12 horas de evolución, intensa, que se acompaña de fotofobia. Al examen físico no hay presencia de rigidez de nuca y los signos de Kernig y Brudzinsky son negativos. Se re a l i z óTAC de cráneo sin arrojar resultados positivos. Finalmente, se realizó punción lumbar diagnosticándose meningitisaguda bacteriana.
Assuntos
Infecções Bacterianas , Meningites BacterianasRESUMO
OBJETIVO: buscando identificar e comparar características familiares e maternas entre portadores de fendas faciais e recém-nascidos isentos de morbidade, realizou-se um estudo com delineamento de caso e controle nos hospitais da cidade de Pelotas-RS. MÉTODOS: os dados foram obtidos através de entrevista com mães de 56 casos e 232 controles, nascidos nas cinco maternidades da cidade de Pelotas no período de 1990 a 2002. Os controles foram os quatro recém-nascidos que nasceram após o caso. Foram obtidas informações sobre o tipo de lábio leporino, sexo e peso do recém-nascido, gemelaridade, consangüinidade, etnia, história familiar de fissuras e de outras malformações. O planejamento de análise de dados incluiu o uso do teste t-Student, qui-quadrado e "odds ratio". RESULTADOS: obteve-se uma incidência de fenda labial com ou sem fenda palatina de 0,78 por 1.000 nascidos vivos. Diferenças significativas foram observadas em relação ao grau de instrução materna e história familiar positiva de malformações, com riscos relativos estimados em 6,0 e 2,3, respectivamente. CONCLUSÕES: em Pelotas, RS, foram encontrados 56 recém-nascidos portadores de lábio leporino com ou sem palato fendido no período do estudo. Os fatores de risco para esse tipo de anomalia foram: baixo grau de instrução materna, o qual pode estar relacionado ao conseqüente baixo nível socioeconômico, e história familiar positiva de presença de malformação de vários tipos.