The Journal of the Faculty of Medicine of Olinda (FMO) reflects the thougths and commitment to the production of knowledge based on social responsibility that we assume as protagonists, and as part of the Institutional Development Project of the Faculty of Medicine of Olinda-FMO. The Journal of FMO - Faculty of Medicine of Olinda was created to strengthen the inseparability of teaching, research and extension allowing the consolidation of quality education. The editorial line focused on medicine as a profession with a strong social and humanized component, committed with a sustainable world, a formation anchored in scientific bases and ethical values. Therefore, the Journal brings the presentation of original articles, case reports and reviews that will contribute to the advance of knowledge in the area. For both, it has a qualified and geographically diverse editorial board, with national and international insertion in the area.
Esta licença permite que outros distribuam, remixem, adaptem e desenvolvam seu trabalho, mesmo comercialmente, desde que creditem a revista pela criação original.
Gamma-linolenic acid interacts with human voltage-gated calcium channel
Objectives: To assess the correlation between gamma-linoleic acid (GLA) and the voltage-gated calcium channel CaV3.2 and compare it with pregabalin (PGB) to elucidate the potential analgesic mechanism of GLA in cases of mastalgia. Methods: This quantitative, experimental, in silico study employed GLA and PGB as ligand molecules and the CaV3.2 channel as the protein target. Molecular docking experiments were performed using the Dockthor platform and analyzed with the Chimera 1.14 software. The results of ligand simulations with CaV3.2 were organized based on binding affinity (BA) and compared using the t-test; p-values < 0.05 were considered statistically significant. Results and discussion: After one million simulations of GLA and PGB with CaV3.2, the three best docking poses were selected. No significant differences were observed between BA values of GLA and PGB (p = 0.15). Both ligands docked within the pore of the channel, forming hydrogen bonds with the same amino acid residues; PBG established one additional interaction. Conclusion: GLA binds to the CaV3.2 channel in a manner similar to the reference blocker PGB. The identified chemical interactions suggest a potential channel blockade, which may explain the analgesic effect of gamma-linolenic acid in the management of mastalgia.
Copyright (c) 2025 Gidelson José da Silva Júnior, Gisele Evelin de Jesus Arruda, Ana Carolina de Oliveira Aguiar, Lais Cristhinne Sabino Gondim, Lise Reis Melo, Joelmir Lucena Veiga da Silva https://creativecommons.org/licenses/by/4.0
Microbiological analysis of chitosan polymer membranes associated with Schinus terebinthifolius for treating skin wounds
Objective: To develop and evaluate chitosan membranes containing Schinus terebinthifolius bark extract for topical use in skin lesions. Methods: Chitosan membranes were prepared with different concentrations of Schinus terebinthifolius extract. The resistance to folding, the pH of the membranes, and the antimicrobial activity of the extract were evaluated using the disc diffusion technique on Mueller-Hinton agar. The bacterial inoculum used was Staphylococcus aureus ATCC® 25923. The diameters of the inhibition zones were measured with a caliper to determine the sensitivity of the bacteria. The interpretation of the results followed the cutoff points for minimum inhibitory concentration (MIC) and halo diameters from the Brazilian Committee on Antimicrobial Susceptibility Testing. Results: After incubation at 30°C for 24 hours, the Schinus terebinthifolius extract at concentrations of 43.0 µg and 21.5 µg showed the best inhibition zones for Staphylococcus aureus (16 mm and 14 mm, respectively). The membrane with 5% extract exhibited greater resistance to folding, supporting more than 300 folds before breaking. In contrast, the 10% membrane became very rigid and had low adhesion after only 12 folds. The pH of the membranes was 5.5 in both concentrations, without a significant difference. Conclusion: The best antimicrobial results from Schinus terebinthifolius extract were at concentrations of 43.0 µg and 21.5 µg. The membrane with 5% of the extract showed the best adaptation, while the one with 10% became excessively rigid. Further studies must explore lower concentrations of the extract.
Copyright (c) 2025 Sarah Maria Lucena Teles Cruz, Gislaine Simões Portela Barros, Leane de Fátima Matias do Nascimento, Camila Ananias Bezerra de Lima, Gabryella Garcia Guedes, Luciana Ramos Teixeira, Tharcia Kiara Beserra de Oliveira https://creativecommons.org/licenses/by/4.0
Relationship between depressive symptoms and functionality
Objective: To identify the presence of depressive symptoms in a sample of older adults and its relationship with functionality, in addition to protective factors against functional decline. Methods: A descriptive cross-sectional study was conducted with older adults attending a teaching clinic in Olinda (Pernambuco, Brazil) from August 2023 to April 2024. Depressive symptoms were assessed using the Simplified Geriatric Depression Scale (GDS-15). Activities of daily living were assessed using the Katz Index and the Lawton-Brody Instrumental Activities of Daily Living scale. Associations were verified using logistic regression with the generalized linear model and variable selection using the Stepwise method. All data was analyzed using R statistical software. Results: Most participants were between 60 and 70 years old (87.1%). Women accounted for 65% of partially dependent participant and the one completely dependent participant. A positive correlation was observed between depressive symptoms and functional decline in partially dependent participants (odds ratio [OR] = 6.05) and those with mild (OR = 4.62) or moderate dependence (OR = 4.94). Furthermore, employment was observed as a protective factor against functional decline in older adults with mild dependence. Conclusion: Depressive symptoms increased the likelihood of functional decline in older adults, while employment contributed to quality of life. Recognizing factors influencing functional decline is essential for strengthening strategies that improve functionality within this population.
Copyright (c) 2025 Ana Paula Rocha da Costa, Letícia Ferreira de Oliveira, Andressa Joyce Pereira Bispo, Kayo Matheus Rodrigues de Souza, Schirley Cristina Almeida Pereira, Danielle Machado Feitosa da Silva https://creativecommons.org/licenses/by/4.0
Assessment of female sexual function and the occurrence of its dysfunction
Objective: To assess and identify female sexual dysfunction (SD) using the Female Sexual Function Index (FSFI). Methods: A cross-sectional study was conducted in a Family Health Unit of Olinda, Pernambuco, from August 2023 to January 2024. A random sample of women aged ≥ 18 years and with active sexual life was included. SD was defined by a total FSFI score (sum of the scores of each domain) lower than 26. The phases of sexual intercourse were assessed using six domains and their possible types of dysfunction: disorders of desire, arousal, lubrication, orgasm, satisfaction with sexual life, and pain. Measures of central tendency, dispersion, and 95% confidence intervals (95% CI) were calculated for the occurrence of SD. Data were analyzed using the Microsoft Excel and Stata software, version 15. Results: Among the 105 women interviewed, 22 (20.9%; 95% CI: 14.1% to 29.9%) experienced SD. This condition was more prevalent among women aged > 35 years and those who were overweight or obese. The use of hormonal contraceptives was significantly associated with SD (p < 0.001). Conclusion: SD in women aged > 35 years and overweight or obese should be considered. The results highlight the need for an individualized assessment of female sexual health, particularly among users of hormonal contraceptives.
Copyright (c) 2025 Ana Beatriz de Melo Calado, Assíria de Holanda Gama, Yasmin Fausto de Oliveira, Maria Eduarda Dantas Medeiros, Petrus Augusto Dornelas Câmara , Érika Thienne Lopes da Silva, Carolline Araujo Mariz https://creativecommons.org/licenses/by/4.0
Analysis of the benefits and challenges faced by health professionals during the implementation of matrix support in Basic Health Units in Olinda, Pernambuco
Objective: To analyze the benefits and challenges of implementation of matrix support in Basic Health Units (BHU) in Olinda, Pernambuco, Brazil. Methods: An observational cross-sectional study was conducted using primary data collected through a questionnaire applied to health professionals in the BHU of Olinda. Results: The sample included 57 health professionals, comprising physicians, nurses, and dentists. A total of 80.7% of participants reported knowing matrix support, whereas 19.3% had no knowledge. In addition, 52.6% of participants declared that matrix support was implemented in their BHU, whereas 47.4% reported its absence. Conclusion: Although health professionals presented theoretical knowledge on matrix support, they faced practical challenges due to limited experience in its implementation. Thus, the urgency of investing in further training and strengthening of multidisciplinary teams to improve the implementation of matrix support was evidenced.
Copyright (c) 2025 Artur Areia Pereira Montenegro, Francyelle Maria Barbosa Fonseca, Jady Almeida de Melo Gusmão, Joelmir Lucena Veiga da Silva, Schirley Cristina Almeida Pereira https://creativecommons.org/licenses/by/4.0
Evaluation of visual acuity in young students at an education institution in Paulista, Pernambuco
Introduction: Vision is responsible for most of the information and sensory perception an individual receives from the environment, thus considered important for communication and learning. Ophthalmological screening is fundamental for evaluating visual acuity (VA) and early detection of diseases. The Snellen chart is a widely used tool for this evaluation. Objectives: To evaluate the VA of preschool and elementary students at an educational institution in Paulista, Pernambuco, using the Snellen chart, and refer those with reduced VA for specialized ophthalmological evaluation. Methods: This quantitative cross sectional study was conducted from May to September 2023 with 216 preschool and elementary students from Creche Escola Nossa Senhora do Ó in Paulista, Pernambuco. Results: A total of 123 students were included, with a mean age of 7.7 ± 3.4 years. Among them, 66.6% had decreased VA, which was significantly associated with educational level (p < 0.001) and age (p < 0.001). Conclusions: Although the Snellen chart does not replace a comprehensive ophthalmological examination, this valid and practical method is relevant to public health, as it may identify potential visual impairments related to VA.
Copyright (c) 2025 Dolly Brandão Lages, Andrezza Soares Souto , Larissa Ferreira Rodrigues Silva, Paula Tereza Fontes de Goes Vasconcelos, Thiago Henrique de Farias Carvalho, Danielle Machado Feitosa da Silva, Schirley Cristina Almeida Pereira https://creativecommons.org/licenses/by/4.0
Association between clinical factors and risk of obstructive sleep apnea syndrome evaluated by the Berlin Questionnaire
Objectives: to investigate the frequency of individuals at high risk for obstructive sleep apnea syndrome (OSAS) attending an ambulatory care of a teaching clinic in the metropolitan region of Recife/PE, and to verify the association of frequency of OSAS with clinical symptoms, such as snoring, sleepiness, fatigue, systemic arterial hypertension (SAH), and body mass index (BMI). Methods: This quantitative, cross-sectional, and observational study was conducted using a non-probabilistic convenience sample of 361 individuals. Results: Most individuals were classified as high risk for OSAS, with a higher prevalence among women. Furthermore, significant associations were identified between OSAS risk and snoring, sleepiness, fatigue, SAH, and increased BMI, highlighting the impact of these factors in identifying at-risk individuals. Conclusion: The findings reinforced the importance of the Berlin Questionnaire to stratify individuals at high risk for OSAS, allowing for the prioritization of diagnostic tests and proper interventions, and potentially optimizing clinical management and reducing examination costs.
Copyright (c) 2025 Mário Cruz Couto, Fernando Augusto Pacífico , Liliam de Souza Santos, Giovanna Sherly de Sá Guedes Marins, Michelle Alves de Farias, Dolly Brandão Lages, Eduardo Lins Paixão https://creativecommons.org/licenses/by/4.0
Epidemiological analysis of human papillomavirus infection in women at a Basic Health Unit in Olinda, Pernambuco
Objective: To outiline the epidemiological profile of women undergoing gynecological preventive examination at the USF Ilha do Maruim, in the municipality of Olinda-PE, from August 2023 to January 2024. Methods: This is a prospective, cross-sectional study in wich a questionnaire was administered to gather sociodemographic, socioeconomic data, and information related to epidemiological variables associated with HPV infection (Appendix 1) from women undergoing gynnecological preventive examination at the USF Ilha do Maruim, in the municipality of Olinda-PE. Results: Among the participants, there was a predominance of single women (60,71%), of mixed race (52,57%), with children (75%) and with income lower than one minimum wage (64,28%). Regarding HPV, 39,28% claimed to be vaccinated and 42,85% did not know what the vírus was. As for the descriptive diagnosis, the marjority (85,71%) indicated benign cellular alterations. In terms of microbiology, 57,14% presented cocci, 21,42% bacilli, 10,71% supracitoplasmatic (Gardnerella/Mobiluncus), 7,14% Lactobacillus sp., and 10,71% presented Trichomonas vaginalis, Candida albicans or Actinomyces sp. Conclusion: Early onset of sexual activity, multiple partners and socioeconomic vulnerability increase the risk of HPV infection. Most participants in this study had no basic knowledge about the vírus, however, none of them presented lesions or alterations related to HPV.
Copyright (c) 2025 Ana Carolina de Oliveira Câmara, Maria Luísa Nunes Siqueira, Rylia Pereira Rodrigues, Albert Eduardo Silva Martins https://creativecommons.org/licenses/by/4.0
Comparing covid-19 positivity rates and contextual factors across municipalities in a metropolitan area of Northeast Brazil
Objective: To compare covid-19 positivity and mortality rates and contextual factors across municipalities in a metropolitan area of Recife between 2020 and 2021. Methods: This ecological study examined covid-19 positivity (measured by reverse transcription polymerase chain reaction test) and mortality rates. Epidemiological data were extracted from the DataSUS system, while socioeconomic data were obtained from IBGE and the Pernambuco State Health Department databases, covering March 2020 to December 2020. Data were analyzed using Spearman’s correlation test and considering a 5% significance level. Results: Severe covid-19 cases were positively correlated with high household income per capita (U = 0.832; p < 0.001) but inversely correlated with illiteracy (U = -0.879, p < 0.001) rates. Conclusion: Contextual factors were correlated with increased covid-19 positivity and mortality rates during the study period.
Copyright (c) 2025 Pedro Pinto Ribeiro de Goes, Pedro Torban, Pedro Henrique de Lima Cavalcanti, Paulo Savio Angeiras de Goes https://creativecommons.org/licenses/by/4.0
The review analyzes the short film As Miçangas, directed by Rafaela Camelo and Emanuel Lavor, from a perspective that integrates cinematic aesthetics, public health, and reproductive rights. The film constructs an intimate and ritualized narrative about abortion, shifting the focus from the act itself to the experience of care, affection, and solidarity among women. The review examines the film’s visual and thematic proposal, highlighting its contribution to understanding feminine care practices that reframe women’s health experiences beyond traditional biomedical models. Through this approach, As Miçangas is analyzed as a significant example of how Brazilian cinema can articulate aesthetics and ethics in representing sensitive and urgent healthissues.
Copyright (c) 2025 Maria Vitória de Vasconcellos Marques https://creativecommons.org/licenses/by/4.0
Critical review about the book The Burnout Society.
Copyright (c) 2025 Fernando Augusto Pacífico, Paulo Savio Angeiras de Goes https://creativecommons.org/licenses/by/4.0
Histological properties of biological materials in the wound healing process
Introduction: Cutaneous wounds offer clinical challenges directly impacting the life of patients, as multiple aspects influence the healing process, including anatomical site, skin type, and the surgical techniques employed. In Brazil, chronic treatment of wounds imposes considerable economic impacts, accounting for 1% to 3% of healthcare costs. The development of effective and low-cost therapeutic alternatives have driven research toward the use of biomaterials (of natural or synthetic origin) to promote tissue regeneration. Objective: This study conducted an integrative review to evaluate the effects of biomaterials on wound healing, with a focus on histological properties. Methods: Twelve studies published in PubMed and MEDLINE databases between 2019 and 2024 meeting the inclusion criteria and addressing interventions with biomaterials were analyzed. Results: Biomaterials modulate the inflammatory response, promote angiogenesis, increase collagen production, and enhance re-epithelization. Despite the potential of biomaterials, the selection of the optimal material must consider the characteristics of the lesion and therapeutic goals. Additional studies are needed to validate the mechanisms of action and the durability of the observed effects. Conclusion: Anatomopathological analysis is essential to assess healing, evaluating the efficacy of interventions and guiding advances biomaterials application for cutaneous wounds, establishing biomaterials as innovative tools in clinical practice.
Copyright (c) 2025 Gislaine Simões Portela Barros, Sarah Maria Lucena Teles Cruz, Vitória Freire de Menezes Fonsêca, José Mário Ferreira da Rocha Junior, Said José Lucena Teles Cruz , Rhenan de Oliveira Cruz, Tharcia Kiara Beserra de Oliveira https://creativecommons.org/licenses/by/4.0
Extension activity for the awareness and prevention of viral hepatitis in the city of Olinda
Viral hepatitis, caused by hepatotropic viruses A, B, C, Delta, and E, presents a varied endemicity in the country, with high prevalence and infectivity. This experience report describes the experience of medical students from the Academic League of Gastroenterology in the Yellow July campaign outreach action. With the support of the Brazilian Society of Hepatology, the Olinda testing center, and the primary healthcare team from a Basic Health Unit, the students conducted vaccination, testing, and provided educational guidance on viral hepatitis. Moreover, they evaluated blood pressure and performed cardiopulmonary auscultation for the population. The action had a positive impact, achieving health promotion and raising awareness about the prevention of viral hepatitis.
Murillo Benicio da Silva de Carvalho Auto
Copyright (c) 2025 Lucas Lopes de Andrade Lima, Murillo Benicio da Silva de Carvalho Auto, Mariana Ribeiro Silva, José Tarso Gabriel de Oliveira e Sousa, Lavínia Silva Farias, Maria Clara Lopes Aguiar, João Manoel Neves Casa Nova https://creativecommons.org/licenses/by/4.0
Health education initiatives with pregnant women in Primary Care
This study aimed to describe the experience of medical students participating in conversation circles with pregnant women receiving prenatal care at a Basic Health Unit (BHU), as a space for the collective knowledge construction and learning. The study used a critical reflective approach, presented as an experience report of a theoretical-practical activity conducted in 2023 at BHU in Olinda, Pernambuco. Using health education initiatives and a welcoming approach, the need to establish conversation circles with healthcare professionals and students was identified, aiming to facilitate listening to pregnant women, expand access to knowledge among underserved populations, and contribute to the training of future healthcare professional.
Copyright (c) 2025 Andrezza Soares Souto, Ariana Conceição Couto de Almeida Souto, Évellyn Bezerra Cordeiro, João Marcelo de Arruda Casé, Lara Quintino de Macedo, Meiryellen Alves de Farias, Monique Fany de Oliveira Rocha https://creativecommons.org/licenses/by/4.0
University extension and prevention of anxiety and depression in high school
Anxiety and depression are psychological disorders that influence the well-being of adolescents with mood changes and specific symptoms. University extension programs contribute to mental health promotion and prevention, providing opportunities for dialogue and support. This experience report describes an extension project focused on mental health care in high school, conducted by medical students at a public school in Minas Gerais (Brazil), with 120 students. The project allowed a better understanding of the context of adolescents and identified suggestive cases of mental disorders. Thus, the initiative had a positive effect on promoting emotional well-being and creating a more supportive school environment.
Copyright (c) 2025 Wallace Adriel de Assis Maciel, Vitória Maria Sousa Ramos , Matheus Falcão da Silva Ornelas, Angélica Almeida Fernandes , Júlia Aguiar Macedo , Gabriela Carvalho Prado, Maria Flávia Ribeiro de Paula https://creativecommons.org/licenses/by/4.0
Introduction: Integrated educational interventions are important for addressing topics that remain taboo regarding the physical and mental health of women. Objective: To share knowledge and reinforce health-promoting behaviors among women, especially from gynecological and psychiatric perspectives. Methodology: This experience report described an educational intervention focused on the mental and gynecological health of women conducted by medical students from the Academic League of Psychiatry and Mental Health in partnership with the Academic League of Gynecology. Results: The initial perception of the participants was marked by beliefs and terminology related to women and mental health that were often associated with stigma. Conclusion: Combining academic expertise with community participation was effective in promoting health among women.
Letícia Maria de Albuquerque Fontes Costa
Copyright (c) 2025 Ana Beatriz de Melo Calado, Benjamin Araújo, Gabriel da Silva França, Gabriel Henrique Rodrigues de Medeiros, Letícia Maria de Albuquerque Fontes Costa, Rafaely da Silva Juvenal, Angela Cavalcanti Marcondes https://creativecommons.org/licenses/by/4.0
Practical guidelines and innovation in respiratory health
Inhalation therapy allows the administration of drugs directly into the airways. Thus, the devices used in this therapy are important for managing obstructive lung diseases (e.g., asthma and chronic obstructive pulmonary disease). Nowadays, different types of inhalers are used, such as nebulizers, dry powder inhalers, pressurized metered-dose inhalers, and soft-mist inhalers. Despite their particularities, they all require adequate use to ensure treatment effectiveness. From this perspective, a group of students identified the need to undertake initiatives in the city of Olinda, Pernambuco (Brazil) aimed at health education regarding the correct use of the pressurized metered-dose inhaler (commonly known as a pump), combined with the production of low-cost manual spacers.
Copyright (c) 2025 Larissa Souza Bezerra, Nelso Gabriel Lippo Turmina, Joyce Frutuoso Monteiro Lippo Turmina, Aline Silva Santos, Gabriel Camelo Freire, Adriana Velozo Gonçalves, Alina Farias França de Oliveira https://creativecommons.org/licenses/by/4.0
Problematization methodology and flipped classroom in teaching medical ethics to clinical cycle students
The Brazilian Code of Medical Ethics outlines the rights and responsibilities of physicians to protect medical professionals and their patients. However, the medical field is surrounded by ethical professional processes, evidencing the lack of knowledge among practitioners about medical ethics principles and guidelines. This study reports the experience of undergraduate medical students who participated in an extension course on medical ethics that addressed various topics using a problematization methodology and elements of the flipped classroom to promote active engagement. This activity aimed to reinforce the importance of medical ethics and its implications in medical practice. Students reported that the participation enhanced their autonomy in decision-making and encouraged a more critical posture towards ethical dilemmas in the medical profession.
Aparecida Aylara Isabella Souza Gonçalves
Copyright (c) 2025 Liz Camila Labrada Quevedo, Aparecida Aylara Isabella Souza Gonçalves, Isaac Vinicius Dantas Ribeiro, Larissa Souza Bezerra, Letícia Maria Silva Evangelista, Cecília Gomes de Sá https://creativecommons.org/licenses/by/4.0
Tertiary prevention action through the HIPERDIA program in a Basic Health Unit in the municipality of Olinda
Tertiary prevention of systemic arterial hypertension and diabetes mellitus is essential to promote comprehensive care for individuals with at least one of these comorbidities. This experience report described the experience of medical students in a tertiary prevention action of the HIPERDIA Program at a Basic Health Unit in the municipality of Olinda, Pernambuco, in May 2023, as part of the curricular unit “integration academy, service, and community.” The students successfully provided comprehensive care to the individuals, educating them about SAH and DM and their complications while emphasizing lifestyle modifications.
Thiago José Monteiro Borges da Silva Valente
Copyright (c) 2025 Thiago José Monteiro Borges da Silva Valente, Andressa Joyce Pereira Bispo, Sarah Oliveira Porto, Débora Henrique Bezerra https://creativecommons.org/licenses/by/4.0
Morphological analysis of complete metopism in a brachycephalic skull
The closure of the metopic suture (MS) is clinically relevant and widely debated in the field of neuroimaging. Identifying metopism is crucial to avoid misdiagnoses (e.g., cranial fractures or other pathological conditions). In this study, metopism occurred without signs of craniosynostosis in the major cranial sutures (e.g., coronal, parietal, and lambdoid sutures), indicating lifelong preservation of sutural characteristics. The analyzed skull was classified as brachycephalic, a finding relevant to associated morphological variations. Metopism identification is essential in clinical and imaging evaluations, as it impacts diagnosis and therapeutic approaches.
Copyright (c) 2025 Fernando Augusto Pacífico, Daniel Rodrigues Lemos Neto, Mariana Leandro Silva, Ismael Felipe Gonçalves Galvão, Renata Cristinny de Farias Campina https://creativecommons.org/licenses/by/4.0
Rare anatomical variation of the mastoid foramen and its clinical and surgical implications
The mastoid foramen is an osseous structure located on the posterior aspect of the mastoid process. This foramen may exhibit variations in size, diameter, laterality, number, location, and even sex and ancestry. Few studies investigate the anatomical variations in this bony structure. The present study reported a morphometric analysis of the increased diameter of the mastoid foramen in a 25-year-old male patient. In this context, our findings highlight the importance of describing the changes in the diameter of the mastoid foramen and their clinical and surgical implications.
Copyright (c) 2025 Fernando Augusto Pacífico, Jonatas Pinto Pinheiro de Sousa, Aparecida Aylara Isabella Souza Gonçalves, Marina de Freitas Andrade, Ismael Felipe Gonçalves Galvão, Renata Cristinny de Farias Campina https://creativecommons.org/licenses/by/4.0
High-grade squamous intraepithelial lesion of the vulva secondary to human papillomavirus in a 54-year-old patient
Vulvar high-grade squamous intraepithelial lesion (HSIL) is a premalignant condition often associated with human papillomavirus that may progress to carcinoma. This study reports the case of a 54-year-old asymptomatic woman diagnosed with vulvar HSIL during a routine gynecological examination. Histopathological analysis confirmed the diagnosis, revealing an usual and multifocal vulvar intraepithelial neoplasia grade 3 (VIN3). This case evidences the essential role of anamnesis and physical examination. The selected treatment was the loop electrosurgical excision of the affected area identified by vulvoscopy, ensuring adequate safety margins. To maintain vulvar aesthetics, the procedure was followed by vulvoplasty.
Copyright (c) 2025 Fernando Augusto Pacífico, Assíria de Holanda Gama, Pollyanna Alves da Silva, Rayra Luiza Araújo de Lira, Yasmin Iza Cotting, Angelina Farias Maia, Petrus Augusto Dornelas Câmara https://creativecommons.org/licenses/by/4.0
Male infertility and Klinefelter Syndrome
Klinefelter syndrome is determined by a male karyotype with an extra X chromosome. This syndrome leads to the degeneration of testicular tissue, characterized by fibrosis and hyalinization of the seminiferous tubules, as well as hyperplasia of Sertoli and Leydig cells, which regulate spermatogenesis and testosterone production, respectively. In adulthood, testosterone deficiency occurs due to an increase in luteinizing and follicle stimulating hormones, testicular atrophy, and infertility due to azoospermia. The study aims to report the case of a 32-year-old man undergoing infertility investigation with azoospermia. During a genetic study using karyotype analysis, the patient presented 47, XXY, inv per 9[20] and was diagnosed with Klinefelter syndrome. Therefore, a spermogram and a genetic study must be performed to investigate azoospermia. Furthermore, this syndrome needs to be more frequently diagnosed, as timely and appropriate treatment and follow-up may reduce the physical complications, as well as individual and social outcomes related to this syndrome.
Copyright (c) 2025 Fernando Augusto Pacífico, José Elimário Cardozo da Silveira, Thiago José Monteiro Borges da Silva Valente, Matheus Batista de Albuquerque, Mário Cruz Couto, Francisca de Alencar Antão, Gabriela Barbosa do Nascimento Macêdo https://creativecommons.org/licenses/by/4.0
Nutcracker Syndrome ultrasonography imaging features
The Nutcracker Syndrome (NCS), also known as left renal vein (LRV) entrapment syndrome, is caused by LRV stenosis due to the angle narrowing between the superior mesenteric artery (SMA) and the aorta. The stenosis leads to dilatation of the LRV distal portion. Patients may be asymptomatic or experience hematuria, proteinuria, flank pain, pelvic congestion in women, and varicocele in men. Doppler ultrasonography (US) is an excellent diagnostic tool for NCS as it facilitates assessing LRV anatomy and physiology. This case report aimed to describe the imaging features of NCS in Doppler US and to discuss the diverse features of NCS in various imaging studies.
Copyright (c) 2025 Yeda da Silva, Marianna Rafaelly Sforza Auerswald, Naiany Olivotto Martins, Alexia Victória Klassen, Isabelle Tomelin Rothenburg, Plauto Christopher Aranha Watanabe, Luciana Munhoz https://creativecommons.org/licenses/by/4.0
Migraine has the highest incidence among types of primary headaches, affecting approximately 16% of people worldwide, mostly women. This condition originates from multiple factors and significantly impairs quality of life. This case report presents an 81-year-old woman who had headache attacks since the age of 12 years. The patient was diagnosed with migraine in adulthood, with an alteration in the pain pattern after a stressful event. The initial treatment combined acupuncture, supervised by a specialized physician, and compounded medication. Sleep quality improved, and headache attacks reduced within initial sessions. After eight months of treatment, compounded medication was discontinued, acupuncture sessions were maintained, and the patient progressed without further episodes.
Copyright (c) 2025 Luciana Larissa Rodrigues dos Santos, Ismael Felipe Gonçalves Galvão, Fernando Augusto Pacífico https://creativecommons.org/licenses/by/4.0
Early diagnosis and management of congenital heart diseases with a focus on transposition of the great arteries
The transposition of the great arteries, characterized by exchange of the respective ventricles of origin between the aorta and pulmonary artery trunk, is responsible for approximately 5.7% of critical congenital heart diseases, with a high mortality rate in cases of late diagnosis and treatment. The objective of this study is to report a case of this heart disease, diagnosed by fetal echocardiography in the 27th week of gestation, to emphasize the importance of prenatal diagnosis for early management and reduction of the mortality rate of individuals with this heart disease.
Gabriella Priscila Pereira de Melo Napoleão
Copyright (c) 2025 Thiago José Monteiro Borges da Silva Valente, Ismael Felipe Gonçalves Galvão, Évellyn Bezerra Cordeiro, Antônia Victória Fernandes, Fernando Augusto Pacífico, Gabriella Priscila Pereira de Melo Napoleão https://creativecommons.org/licenses/by/4.0