Adnexal mass in pregnancy

Adnexal masses in pregnancy are a rare finding. The majority of these masses are discovered incidentally during routine follow-up. The differential diagnosis of adnexal masses discovered during pregnancy is broad and the management of such lesions has been a subject of debate for years with no consensus regarding the best management plan. We report a case of a 38 year-old pregnant woman who was diagnosed at the time of the first trimester ultrasound with a multilocular solid arising form the right ovary. A laparoscopy followed by left oophorectomy was performed at 22 weeks and the definitive histology revealed a borderline ovarian cyst/proliferative mucinous atypical cyst. The patient delivered via vaginal at 38 weeks of gestation. This case was discussed and a secondary staging surgery (peritoneal washing, total abdominal hysterectomy, salpingo-oophorectomy, omentectomy, appendectomy, and peritoneal biopsies) was performed with no evidence of disease found. The surgical approach is controversial due to the increased risk of complications. In the absence of large prospective randomized trials it is difficult to know which are the best management practices and especially to determine the right moment during pregnancy to perform surgery in these patients.

Avaliação e perspectivas da abordagem à conservação do patrimônio organístico no Brasil

Órgãos de tubos são construídos no Brasil, ou importados do exterior, desde as primeiras décadas do período colonial. Estes instrumentos, apesar de constituírem um conjunto relativamente exíguo, representam um testemunho histórico e musical de valor inestimável. No entanto, de um modo geral, encontram-se em condições precárias de funcionamento e, em parte, mais ou menos descaracterizados profundamente, quanto à sua estrutura e configuração original, às vezes em estado de abandono e, por incrível que pareça, ainda sujeitos ao risco de intervenções arbitrárias e desprovidas de bases técnicas e de preocupação histórica e musicológica. Neste artigo, busca-se percorrer o caminho que levou à atual situação e discutem-se os princípios e os critérios de processos de recuperação, manutenção e conservação preventiva desse patrimônio, partindo dos pressupostos do respeito à sua originalidade e do direito a restauros segundo os rigorosos cânones já definidos para objetos com plena condição de bem cultural, cujo reconhecimento para os órgãos de qualquer época deve ser urgentemente garantido.Pipe organs have been built in Brazil or imported from elsewhere since the very first decades of the colonial period. Albeit relatively small in number, such instruments have inestimable historical and musical value. Notwithstanding, they are generally in very poor working condition and some have lost much of their original structure and configuration; they are often found in a state of abandonment and, incredible as it may seem, still under the threat of arbitrary interventions performed with no technical expertise or any concern for their historical and musicological significance. This article is an effort to understand how this state of affairs came to be, and discusses principles and criteria for the restoration, maintenance and preventive conservation of this legacy, based on assumptions regarding its original conditions and entitlement to restoration in accordance with the stringent standards already set for artifacts that enjoy the full status of cultural assets, which should also be urgently granted to pipe organs of any time and age