RESUMO
INTRODUCTION: Surveillance is necessary for bloodstream infection control. Daily monitoring of the central venous catheter (CVC) use, a time-demanding process, is the standard denominator to calculate the infection rate; surveillance of only one day per week has been proposed as alternative. OBJECTIVE: To determine whether surveillance of one day per week is similar to daily monitoring in a second-level hospital. MATERIAL AND METHODS: Daily monitoring of CVC utilization ratio was done during nine weeks in four locations of a second-level hospital. For each day, proportional differences respect to the global CVC utilization ratio was estimated. An ANOVA test was done to find differences between each weekday. RESULTS: CVC usage surveillance was performed for 9 weeks, so nine determinations were obtained for each weekday. No significant differences were found between each day (F = 2.20, p = 0.056). The lowest sampling discrepancy was found on Wednesdays. CONCLUSIONS: According to previous studies, and our own data, monitoring the CVC use one day per week is a reasonable alternative to the daily surveillance.
Assuntos
Infecções Relacionadas a Cateter/diagnóstico , Cateterismo Venoso Central/efeitos adversos , Infecção Hospitalar/diagnóstico , Sepse/diagnóstico , Análise de Variância , Infecções Relacionadas a Cateter/prevenção & controle , Infecção Hospitalar/prevenção & controle , Hospitalização , Humanos , Estudos Longitudinais , Estudos Prospectivos , Sepse/etiologia , Fatores de TempoRESUMO
A 40-year-old woman presented with a rapidly enlarging palpable thyroid mass. The patient underwent a total thyroidectomy. The tumor fulfilled the criteria of primary solitary extramedullary plasmacytoma (SEP), including cellular expression of the CD138 and lambda light chain antibodies. Solitary extramedullary plasmacytoma of the thyroid occurs most commonly in patients with Hashimoto thyroiditis and must be distinguished from involvement of thyroid in multiple myeloma, inflammatory pseudotumor plasma cell variant, mucosa-associated lymphoid tissue lymphoma, and medullary carcinoma. The distinction is determined on the basis of histologic findings, immunohistochemical analysis, and other laboratory tests. Currently, no standard treatment exists for this entity. In this report, we discuss the differential diagnosis of SEP of the thyroid and the clinical features observed in this case.
Assuntos
Plasmocitoma/patologia , Neoplasias da Glândula Tireoide/patologia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Cadeias lambda de Imunoglobulina/biossíntese , Imuno-Histoquímica , Linfoma/patologia , Mieloma Múltiplo/patologia , Plasmocitoma/metabolismo , Sindecana-1/biossíntese , Neoplasias da Glândula Tireoide/metabolismoRESUMO
We report the case of a 47-year-old woman who experienced multiple recurrences of acinic cell carcinoma, lung metastasis, and intracranial extension of the tumor during a 32-year period. In this report, the clinical, microscopic, histochemical, and electron microscopy features of this acinic cell carcinoma are described, and a review of published information about this neoplasm is presented.
Assuntos
Neoplasias Encefálicas/secundário , Carcinoma de Células Acinares/secundário , Recidiva Local de Neoplasia/patologia , Neoplasias Parotídeas/patologia , Biópsia por Agulha Fina , Carcinoma de Células Acinares/química , Carcinoma de Células Acinares/terapia , Citoplasma/ultraestrutura , Grânulos Citoplasmáticos/química , Grânulos Citoplasmáticos/ultraestrutura , Feminino , Humanos , Neoplasias Pulmonares/secundário , Pessoa de Meia-Idade , Neoplasias Parotídeas/química , Neoplasias Parotídeas/terapia , Reação do Ácido Periódico de SchiffRESUMO
We report the clinicopathologic findings of four cases of laryngeal osteosarcoma and one of carcinosarcoma with osteosarcoma components. The tumors occurred in men ranging in age from 50 to 69 years within a median age of 63.3 years. The most common symptoms were hoarseness, dyspnea, and obstruction, or a combination of these. Biopsy material and intraoperative frozen sections usually showed a high-grade sarcoma, but the diagnosis of osteosarcoma was quite apparent on microscopic examination of the surgical specimen. The primary differential diagnosis is spindle cell carcinoma with osteoid formation. Pulmonary metastases and local recurrences were common. Surgery is the treatment of choice, followed by adjuvant chemotherapy. Whether to use radiotherapy or not should be decided on an individual basis.
Assuntos
Carcinossarcoma/patologia , Neoplasias Laríngeas/patologia , Osteossarcoma/patologia , Idoso , Biópsia , Carcinossarcoma/diagnóstico , Diagnóstico Diferencial , Humanos , Neoplasias Laríngeas/diagnóstico , Masculino , Pessoa de Meia-Idade , Osteossarcoma/diagnósticoAssuntos
Humanos , Masculino , Feminino , Adenocarcinoma/patologia , Adenoma Pleomorfo , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Carcinoma Ductal de Mama , Carcinoma de Células Pequenas , Carcinossarcoma , Diagnóstico Diferencial , Imuno-Histoquímica , Prognóstico , Radioterapia , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/patologia , Neoplasias das Glândulas Salivares/fisiopatologia , Neoplasias das Glândulas Salivares/terapiaRESUMO
El adenocarcinoma de células basales de las glándulas salivales es una neoplasia infrecuente y con bajo potencial maligno. Desde el punto de vista histológico, es similar al adenoma de células basales; sin embargo, el patrón infiltrativo, el aumento de actividad mitósica anormal, la afección perineural y la permeación vascular permiten definir el comportamineto maligno. La localización más frecuente del adenocarcinoma de células basales tiene lugar en las glándulas salivales mayores, pero también se ha observado en las glándulas salivales menores. En el 66.6 por ciento de nuestros casos se localizó en las glándulas salivales mayores. Esta neoplasia afecta predominantemente a sujetos en la sexta década de la vida, en quienes la enfermedad puede tener un largo tiempo de evolución. En la presente serie, el tiempo de evolución del tumor antes del diagnóstico tuvo una medida de 4.3 años. El tratamiento de elección es la cirugía y como opción adyuvante se utiliza radioterapia. Al igual que otros tumores de la glándula salival, la recurrencia del carcinoma de células basales es común con una frecuencia observada del 66.6 por ciento. Los sitios de metástasis más frecuente son ganglios linfáticos cervicales y pulmonares. Los estudios de inmunohistoquímica y microscopia electrónica han demostrado que en esta neoplasia participan células mioepiteliales y epiteliales ductales con diferenciación epidermoide. El diagnóstico diferencial del adenocarcinoma de células basales debe establecerse con adenoma de células basale, carcinoma adenoideo quístico, adenocarcinoma polimorfo de bajo grado y con carcinoma mucoepidermoide