RESUMO

Purpose: This case report aims to present a rare instance of conjunctival melanoma in a 5-year-old patient and contribute to the limited body of knowledge on pediatric conjunctival melanoma. The purpose is to understand the characteristics, diagnosis, and management of this uncommon malignancy in young individuals. Observations: The case describes a 5-year-old female with a progressively growing pigmented conjunctival lesion. The lesion was observed to be located on the temporal conjunctiva of the right eye and displayed distinctive features, including feeder vessels. Imaging revealed specific dimensions of the lesion and ruled out deeper invasions. Histopathological examination revealed architectural and cytologic atypia, positive immunohistochemical staining for HMB-45, and a Ki67 proliferation index of 20 %, confirming the diagnosis of conjunctival melanoma. Conclusions: Conjunctival melanoma, an uncommon malignancy even more so in pediatric patients, typically presents with pigmented growths and feeder vessels. This case underscores the need for thorough diagnosis and early intervention, as conjunctival melanoma can lead to devastating outcomes. The rarity of such cases limits our understanding of their etiology and progression. This case contributes to the literature on pediatric conjunctival melanoma and reinforces the importance of vigilance in detecting and managing ocular pigmented lesions in children.

Assuntos

RESUMO

Resumen: Se desarrolló un sistema basado en árboles de decisión con factores de peso heurísticos orientados al diagnóstico mediante termografía mamaria. El sistema de apoyo a la toma de decisiones clínicas propuesto incluye árboles de decisión binarios para la clasificación estadística de algunas patologías de la glándula mamaria. Dentro de ellos, se incluyen factores de peso constantes encontrados a través de la correlación de las variables involucradas en el desarrollo de los padecimientos mamarios de acuerdo al apego estadístico de las características termográficas, así como de la información clínica complementaria (historial clínico, parámetros físicos, carga genética y hábitos, entre otros), con respecto a su incidencia diagnóstica. La certeza del sistema para los trastornos inflamatorios es de 96 %, para mastopatía fibroquística de 78 %, para necrosis grasa de 62 % y para cáncer de seno de 86 %. El 14 % de error se asocia a microcalcificaciones mismas que con la técnica termográfica reportada no es posible diferenciar. Por lo tanto, es posible catalogar el riesgo de una paciente a padecer alguna afección según los resultados arrojados después de llevar a cabo el examen térmico. Con este sistema de apoyo a la decisión se mejora la posibilidad de aplicación de pruebas de detección temprana en la población que sufre de contraindicaciones para realizarse los exámenes con otros métodos, además permite un diagnóstico integral para las demás pacientes.

Abstract: A decision tree based system with heuristic weight factors oriented to diagnosis by thermography was developed. The proposed clinical decision support system (CDSS) includes binary decision trees for statistical classification of some diseases of the mammary gland. These include weight constant factors found by the correlation of the variables involved in the development of breast disorders according to the statistical attachment of the thermal features, as well as complementary clinical information (medical history, physical parameters, genetic load and habits, among others), regarding its diagnostic incidence. The certainty of the system for inflammatory disorders is 96%, for fibrocystic mastopathy is 78 %, for fat necrosis is 62% and for breast cancer is 86%. The 14% error is associated to microcalcifications that with the reported thermographic technique it is not possible to differentiate. Thus, it is possible to catalog the risk of a patient having a condition according to the results obtained after conducting a thermal test. Then, with the CDSS the possibility of applying early detection tests in the population suffering from contraindications to perform the others is improved, in addition it allows a comprehensive diagnosis for other patients.

RESUMO

Genetic characterization of plasmids from bacterial strains provides insight about multidrug resistance. Ten wild type Escherichia coli (E. coli) strains isolated from cow fecal samples were characterized by their antibiotic resistance profile, plasmid patterns and three different identification methods. From one of the strains, a fertility factor-like plasmid was replicated using tandem shock wave-mediated transformation. Underwater shock waves with a positive pressure peak of up to approximately 40 MPa, followed by a pressure trough of approximately -19 MPa were generated using an experimental piezoelectric shock wave source. Three different shock wave energies and a fixed delay of 750 µs were used to study the relationship between energy and transformation efficiency (TE), as well as the influence of shock wave energy on the integrity of the plasmid. Our results showed that the mean shock wave-mediated TE and the integrity of the large plasmid (~70 kb) were reduced significantly at the energy levels tested. The sequencing analysis of the plasmid revealed a high identity to the pHK17a plasmid, including the replication system, which was similar to the plasmid incompatibility group FII. It also showed that it carried an extended spectrum beta-lactamase gene, ctx-m-14. Furthermore, diverse genes for the conjugative mechanism were identified. Our results may be helpful in improving methodologies for conjugative plasmid transfer and directly selecting the most interesting plasmids from environmental samples.

Assuntos

RESUMO

UNLABELLED: Due to an increasing number of skin diseases as a result of exposure to ultraviolet (UV) radiation, it is necessary to evaluate the effectiveness of new skin care formulations with broad-spectrum sunscreens. OBJECTIVES: This study aims to assess the status of nerve fibres in healthy human skin, to quantify effects of UV radiation on nerve endings, and to evaluate neuroprotective effects of new skin care formulations against UV exposure damage. METHODS: Samples were obtained from 34 female patients enrolled for plastic surgery and were immediately treated (10 min) with three emulsions: Cream 1, Cream 2 (placebo) and a sunscreen with sun protection factor 15 (SPF15). Control samples and those treated with the cream emulsions were exposed to UVA and UVB for 60 min. Nerve fibres were identified by immunofluorescence using a monoclonal antibody (anti-human CD56/NCAM). Cell damage was assessed by image analysis. RESULTS: Several cellular nervous structures were identified in the skin samples, including free nerve endings. UVA and UVB significantly decreased (40-60%) density of nerve endings in the control samples and those treated with placebo (Cream 2) or SPF15 (all P < 0.001). Cream 1 completely blocked effects of UV radiation on nerve endings (P > 0.05 vs. control). CONCLUSIONS: Quantification of cell damage induced by UV radiation provides useful information for identification of new skin care compounds with neuroprotective properties.

Assuntos

RESUMO

AIMS: To discuss our concern for some aspects of mathematics learning disorders related to the nomenclature employed and their diagnosis; these aspects refer to the term 'dyscalculia' and to its diagnosis (especially syndromatic diagnosis). We also intend to propose a classification that could help to define the terminology. Lastly we are going to consider the different aspects of diagnosis and to determine which of them are indispensable in the diagnosis of primary and secondary disorders. DEVELOPMENT: As far as the nomenclature is concerned, we refer to the term 'dyscalculia'. The origins of the term are analysed along with the reasons why it should not be used in children with difficulties in learning mathematics. We propose a classification and denominations for the different types that should undoubtedly be discussed. With respect to the diagnosis, several problems related to the syndromatic diagnosis are considered, since in our country there are no standardised tests with which to study performance in arithmetic and geometry. This means that criterion reference tests are conducted to try to establish current and potential performance. At this stage of the diagnosis pedagogical and psychological studies must be conducted. The important factors with regard to the topographical and aetiological diagnoses are prior knowledge, results from the studies that have been carried out and findings from imaging studies. The importance of a genetic study must be defined in the aetiological diagnosis. CONCLUSIONS: We propose a nomenclature to replace the term 'dyscalculia'. Standardised tests are needed for the diagnosis. The need to establish current and potential performance is hierarchized. With regard to the topographical diagnosis, we highlight the need for more information about geometry, and in aetiological studies the analyses must be conducted with greater numbers of children.

Assuntos

Assuntos