Management of a Congenital Flexural Deformity in a Calf - Surgical and Pathological Aspects

Background: Flexural deformities are anatomical deviations, in varying degrees, of one or more joints, and may have a congenital or acquired origin. Congenital contracture of the deep digital flexor tendon (DDFT) affects newborn calves and results in hyperflexion of the metacarpal-phalangeal joint, which in severe cases means that the animal must support its own weight on its fetlock joints. The aim of this study is to report the rapid and successful result of applying bilateral total tenotomy technique on a newborn bovine that had been diagnosed with severe bilateral DDFT contracture in the thoracic limbs.Case: A 3-week-old male bovine with a history of difficulty in maintaining a quadrupedal position was attended at the Veterinary Hospital of the Federal University of Tocantins. The animal had severe bilateral locomotor alterations in the thoracic members to the point that he walked on his fetlock joints. The physical examination revealed clinical parameters within the normal range. However, the locomotor system examination showed severe flexor deformity in the bilateral metacarpal-phalangeal joints, and the limbs were being supported on the dorsal face of the fetlock joints, which presented ulcerations, and was suggestive of a shortening of the DDFT. Based on the patient's history and clinical examination, as well as the severity of the tendon contractures, surgical treatment using the DDFT bilateral total tenotomy technique was decided upon. Postoperative treatment consisted of 2.5 mg/kg of enrofloxacin intramuscularly (IM), SID, for 5 days and 0.5 mg/kg meloxicam via IM, SID, for 3 days; as well as a dressing (cotton, medical bandage and a PVC mold) on the thoracic limbs to provide support and allow the animal to walk, until its complete recovery. One day after the surgery, the animal was able to walk with difficulty and some trembling; however, on the third day after the surgical procedure, it could stand up by itself, walk and graze normally. The surgical stitches were removed seven days after the operation, as the surgical wounds had healed adequately. The animal was followed-up for a one-month period after the total tenotomy, with no recurrence of any of the clinical signs, and the thoracic limbs had regained normal biomechanics.Discussion: Congenital flexural deformities are common in newborn calves of different breeds and their incidence is mainly in the thoracic limbs, especially in the carpal, distal interphalangeal and metacarpal-phalangeal joints as was reported in the animal in this study. The history and anamnesis of the animal, along with a thorough physical examination, in order to rule out any other congenital alterations, was extremely important in the diagnosis, and the classification of the severity of the deformity along with the choice of appropriate treatment in the present study. Although total tenotomy is rarely reported in the literature, and there are controversial results with calves, the surgical treatment was chosen in the present case due to the severity of the case. The DDFT bilateral total tenotomy surgical technique gave satisfactory results for the correction of severe bilateral flexor deformity in the thoracic limbs of the newborn crossbred calf. Complete recovery of the limb biomechanics was rapid, and there was no post-surgical complications, thus ensuring the animal could have a good and healthy life. Total DDFT tenotomy is considered a viable surgical procedure for calves with severe congenital flexor deformities; however, post-operative care is also important to ensure good final results

Primary Urethral Carcinoma in a Bitch - Multimodal Treatment

Background: Urethral tumors are uncommon in canines, represented predominantly by transitional cell carcinoma, marked by aggressive behavior associated with short life expectancy. Definitive diagnosis is achieved by histopathological analysis. Surgery associated with chemotherapy is the main therapeutic alternative. The aim of this paper is to report a case of primary transitional cell carcinoma of the urethra in a bitch, submitted to surgical treatment associated with conventional adjuvant chemotherapy and metronomic chemotherapy, achieving survival of 21 months, to date. Case: A 12-year-old bitch mixed breed was admitted at the Veterinary Hospital of Federal Rural University of Rio de Janeiro (UFRRJ), manifesting hematuria and urinary incontinence for one month. Physical examination indicated that vital parameters were within normal limits. Laboratory tests of blood count and serum biochemistry, urinalysis, culture, urinary antibiogram, and abdominal ultrasound were performed. The ultrasound image suggested a neoplastic urethral process. Because of the suspicion of neoplasm, a thoracic X-ray was performed, showing no evidence of metastasis. Computed tomography (CT) of the abdominal region was performed, revealing an expansive lesion in the urethra with loss of definition of the walls and urethral lumen extending to the level of the pelvic floor, measuring about 2.9 x 1.4 x 1.2 cm. After pre-anesthetic exams, the animal underwent resection and surgical anastomosis of the affected urethral region. The sectioned tissue was sent for histopathological analysis, with diagnosis of transitional cell carcinoma. Adjuvant chemotherapy was performed using carboplatin at a dose of 250 mg/m², intravenously, every 21 days for 6 sessions. After completing the protocol, abdominal ultrasonography was performed again, which showed a cicatricial process in the urethral region of the surgical excision, with no sign of tumor recurrence. A metronomic chemotherapy protocol was then started with cyclophosphamide at a dose of 15 mg/m², daily for 6 months, with periodic oncological follow-up. At the end of the period, the animal remained under periodic follow-up with ultrasound exams performed at 2-month intervals, and has been free from recurrence for 21 months until now. Discussion: Urethral neoplasms account for 0.5 - 2% of all canine tumors, and are represented mostly by transitional cell carcinomas. Clinical signs of urinary obstruction and hematuria are the most common, as reported in the patient in question. The definitive diagnosis is by histopathological examination. However, imaging tests such as computed tomography are important in the initial investigation and surgical planning. The indicated treatment is surgical resection of the mass with subsequent adjuvant chemotherapy or radiotherapy. The chemotherapy protocol associating cisplatin and piroxicam can achieve remission rates of 70%, but this association has a high nephrotoxic effect. In the present case, cisplatin was replaced by carboplatin in order to reduce the nephrotoxic effects of chemotherapy. The metronomic protocol using cyclophosphamide was used as maintenance therapy, at the end of the conventional chemotherapy protocol. Survival achieved was longer than that described in the literature in cases of transitional cell carcinomas in the urethral region. Therefore, multimodal therapy using surgery associated with conventional and metronomic chemotherapy, is an option in canines with urethral carcinoma. Keywords: canine, urethral neoplasm, surgery, chemotherapy. Título: Carcinoma uretral primário em uma cadela - tratamento multimodal Descritores: canino, neoplasia uretral, cirurgia, quimioterapia

Atresia Ani (Imperforated Anus) in Calves: Clinical, Surgical and Pathological Aspects

Background: Anal atresia is a congenital malformation, which often affects calves, and is related to the imperforation of the membrane that separates the endoderm of the posterior intestine from the ectodermal anal membrane. It is commonly associated with other congenital malformations and skeletal anomalies. The clinical signs generally appear in the first days of the animal's life, due to a retention of feces. The diagnosis is clinical and is based on observation, anamnesis and a physical examination of the animal. The only viable treatment is surgical. This paper aims to report 6 cases of anal atresia in bovine calves, 4 males and 2 females that were successfully treated surgically. Cases: This work reports 6 cases of anal atresia in 4 male calves and 2 female calves. Three presented total atresia (type II), one partial (type I) and in both female calves, anal atresia and rectovaginal fistula (type IV) were observed. The animals were all of undefined race. Five of the cases were from northern Tocantins, 4 males and 1 female (anal atresia with rectovaginal fistula), and 1 female (anal atresia with rectovaginal fistula) was from Valença, RJ. All animals were born active, by eutocic/natural birth, and assumed a quadrupedal position followed by the first feeding as normal. They were aged between 2 days and 6 months, and had a clinical history of abdominal distention and difficulty or inability defecating, and the females both also had a rectovaginal fistula, all cases compatible with anal atresia. Based on the patient's history and clinical examination, surgical treatment for anal reconstruction was decided upon. Postoperative treatment consisted of enrofloxacin [2.5 mg/kg - intramuscularly (IM), once daily (SID), for 5 days] and fluxinin meglumine [1.1 mg/kg - IM, SID, for 3 days] ; as well as a healing ointment which was applied to the area of the surgical wound, every 12 h, for 7 days. There were no trans-surgical complications. The animals showed progressive recovery after anal reconstruction and the stitches were removed in all cases on the 10th postoperative day, with no postoperative complications and no recurrence of any clinical signs from that moment on.Discussion: The study of congenital and hereditary changes enables the identification of their origins, can help prevent new cases and, some of them, are open to economically viable treatment and/or correction that can improve the well-being of the animal and prevent economic losses due to death or animal sacrifice, as reported in the present study. Anal atresia is the most common congenital defect of the lower gastrointestinal tract in calves, being an isolated abnormality, or associated with other malformations, especially of the distal spinal column such as the absence of a tail (perosumus acaudato), as one of the animals in this study. The clinical signs and physical examination are sufficient to establish the diagnosis, as demonstrated in this report, which is usually made in newborn animals, due to the lack or difficulty in defecation associated with no anal orifice and/or swelling in the perineal region. The treatment of choice for anal atresia is surgical, in order to construct an anal neo-orifice and thus avoid endotoxemic shock as well as providing relief and well-being for the animals. As observed in this study, when anal atresia is diagnosed early, and surgical treatment is properly instituted, the prognosis is favorable. The surgery is considered of low complexity, quick and it can be carried out in the field. Thus, from a commercial point of view, considering the costs of the procedures and the value of the calf at the end of weaning, such treatments are beneficial to the owners. In addition, the surgical treatment is essential for animal health and welfare in cases of anal atresia.Keywords: cattle, congenital defects, hereditary pathology, perosomus acaudato, surgery

Primary Intestinal Fibrosarcoma in Cats

Background: Fibrosarcomas are malignant neoplasms of mesenchymal origin and can have different symptoms depending on the species, age, location and etiopathogenesis. Intestinal tumors in domestic cats are common and the small intestine is the most common site; however, fibrosarcomas are rare in the intestine of all animal species. This work reports intestinal fibrosarcoma in 2 domestic cats and aims to clarify and present information concerning this neoplastic type in the gastrointestinal tract of this species.Cases: We report 2 cases of intestinal fibrosarcoma in domestic felines (Felis catus). Cat 1. A 14-year-old female Persian breed, domestic cat, was taken to the Feline Sector of the Veterinary Hospital of Small Animals (HVPA) of the Federal Rural University of Rio de Janeiro (UFRRJ). The main complaint was chronic constipation and rectal prolapse. The clinical examination revealed an ulcerated mass, measuring 4.0 cm x 1.7 cm. Cat 2. A 10-year-old female undefined breed, domestic cat, was taken to the private clinic. The main complaint was diarrhea with bloody and rectal prolapse. The clinical examination revealed nodule measuring 2.5 cm in diameter. The surgical option decided upon was to use the rectal pull-through technique in both animals. The patients had no trans-surgical or postoperative complications. The material collected during the surgical interventions was analyzed macroscopically and fixed in 10% buffered formalin for 24 h and then sent to the Histopathology Laboratory of the Pathological Anatomy Sector (SAP) at UFRRJ for the cat 1 and in private laboratoryfor the cat 2. After fixation, it was cleaved for routine microscope exam using Hematoxylin and Eosin (HE) stains and for the histochemical method of Masson’s Trichrome staining technique. Complementary immunohistochemistry tests and electron microscopy were also performed. The patients were followed up clinically, showing complete remission of the clinical signs and survival for approximately 1 year after the neoplastic resection. Discussion: There are few reports of intestinal fibrosarcomas in veterinary medicine, therefore, little is known about racial predilection, age, sex or biological behavior. As far as these authors know, this is the 6th and 7th report of this neoplasm with a primary site in the large intestine in this species. The morphological diagnosis of fibrosarcoma is relatively simple, whereas, in some cases the differential diagnosis for tumors of the peripheral nerve sheath, leiomyosarcomas and gastrointestinal stromal tumor (GIST) can be extremely difficult. The immunohistochemistry technique in these cases may not be particularly useful. The fibrosarcoma diagnosis was also confirmed by electron microscopy since no evidence was found that could lead to a neuronal origin, thus excluding tumors such as neurofibrosarcoma and schawnoma, corroborating the immunohistochemical examination. The surgical management of tumor resection with wide safety margins (minimum 2 cm) remains the “gold standard” therapy for dealing with fibrosarcomas since they have a low response rate to chemotherapy and radiotherapy and the use of these therapies as an adjuvant is controversial. The advantages of thistechnique are related to the surgical time, simplicity, easy access and reduction in the risk of abdominal contamination. Histopathological, immunohistochemistry and electron microscopy evaluations were sufficient to enable the diagnosis of an intestinal fibrosarcoma in both cats. The occurrence of this neoplasm with intestinal involvement in the feline species is rare; therefore, this description is important as it provides information about epidemiology, associated signs, differential diagnoses, biological behavior, treatment and prognosis. Keywords: feline, intestine, mesenchymal, tumors, neoplasm, rectal pull-through

Evidências no Uso de Probióticos para Esteatose Hepática Não Alcoólica (NASH) / Evidence on the Use of Probiotics for Non Alcoholic Liver Steatosis (NASH)

INTRODUÇÃO: A doença hepática gordurosa não alcoólica (DHGNA) é uma comorbidade altamente prevalente no mundo, com terapêuticas estabelecidas, porém que necessita de alternativas que auxiliem no controle e na cura da doença, a exemplo dos probióticos. O objetivo do estudo é avaliar se o uso de probióticos pode contribuir para a prevenção e melhora da DHGNA. METODOLOGIA: Estudo caracterizado como revisão narrativa da literatura, realizado nas bases Pubmed e SciELO, utilizando 26 artigos encontrados através dos descritores “Non-alcoholic Fatty Liver Disease” e “Probiotics”, na série de 2013 a 2020. RESULTADOS: Foi encontrado o efeito geral do probiótico, que está relacionado à redução do impacto de bactérias no desenvolvimento da DHGNA por exclusão ou inibição destas, além do auxílio na melhora de parâmetros como: índice de massa corporal (IMC), função hepática, perfil lipídico, leptina, índice glicêmico, citocinas pró-inflamatórias, dentre outros capazes de influenciar diretamente na evolução da doença hepática gordurosa não alcoólica. CONCLUSÃO: Os probióticos são considerados uma terapia em potencial para auxílio no controle da evolução da DHGNA, sendo seguros e atuando, em especial, por mecanismos imunológicos inatos e adaptativos do intestino

A ACURÁCIA DIAGNÓSTICA DAS PATOLOGIAS CIRÚRGICAS NOS EXAMES POR CONGELAÇÃO.

Introduction: The frozen section is a quick way of histopathological evaluation of tissue fragments during the intraoperative period, being an important tool to help the surgeon in decision making. Objective: To assess the diagnostic accuracy of frozen section exams in different anatomical sites performed in the pathology service of a university hospital. Material and methods: Study of an exploratory nature, with a documentary-type quantitative approach. The sample comprises 803 medical reports of the freezing and definitive paraffin exams from January 1, 2015 to January 1, 2020, available at the Pathological Anatomy Laboratory of the Professor Alberto Antunes University Hospital (HUPAA), excluding 106 reports with data that has been unavailable for whatever reason. Results: It was observed that, of the 697 surgical specimens that make up this research, 540 (77.47%) were indicated for the diagnosis of the lesion and 157 (22.53%) for the assessment of margins. The most analyzed anatomical sites were the breast in 177 cases, lymph node in 120 and skin in 106 cases. Regarding the highest number of discordant results, globally, the breast comes first with 08 cases, followed by the ovary and annexes with 05 cases and, in relation to specific sites, the peritoneum presented 10.00% of its cases, while ovary and annexes 08.47%. The anatomopathological examinations by freezing presented a rate referring to the total accuracy of 91.10%, with the breast, specifically, 94.93%, intra-abdominal 93.75% and lymph node 93.33%. Conclusion: The observed accuracy rate is high and the numbers are in line with several similar studies, which reinforces the importance of the test and the quality of the procedures performed by the service in question.Introdução: O exame por congelação é uma forma rápida de avaliação histopatológica de fragmentos teciduais durante o intra-operatório, tratando-se de uma importante ferramenta no auxílio ao cirurgião à tomada de decisão. Objetivo: Aferir a acurácia diagnóstica dos exames por congelação em diferentes sítios anatômicos efetuados no serviço de patologia de um hospital universitário. Material e métodos: Estudo de natureza exploratória, com abordagem quantitativa do tipo documental. A amostra compreende 803 laudos médicos dos exames de congelação e os definitivos em parafina no período de primeiro de janeiro de 2015 a primeiro de janeiro de 2020, disponíveis no Laboratório de Anatomia Patológica do Hospital Universitário Professor Alberto Antunes (HUPAA), sendo excluídos 106 laudos com dados que estiveram indisponíveis por qualquer motivo. Resultados: Observou-se que, das 697 peças cirúrgicas que compõem esta pesquisa, 540 (77,47%) tiveram como indicação o diagnóstico da lesão e 157 (22,53%) a avaliação de margens. Os sítios anatômicos mais analisados foram a mama em 177 casos, linfonodo em 120 e pele em 106 casos. Em relação ao maior número de resultados discordantes, de modo global, a mama vem em primeiro lugar com 08 casos, seguida de ovário e anexos com 05 casos e, em relação aos sítios específicos, o peritônio apresentou 10,00% dos seus casos, enquanto que ovário e anexos 08,47%. Os exames anatomopatológicos por congelação apresentaram uma taxa referente a acurácia total de 91,10%, tendo a mama, de forma específica, 94,93%, intra-abdominal 93,75% e linfonodo 93,33%. Conclusão: É alta a taxa de acurácia observada e os números estão em consonância com diversos estudos similares, o que reforça a importância do exame e a qualidade dos procedimentos realizados pelo serviço em questão

Effect of Metabolic Syndrome on Parkinson’s Disease: A Systematic Review

Evidence shows that metabolic syndrome (MS) is associated with a greater risk of developing Parkinson’s disease (PD) because of the increase in oxidative stress levels along with other factors such as neuroinflammation and mitochondrial dysfunction. However, because some studies have reported that MS is associated with a lower risk of PD, the relationship between MS and PD should be investigated. This study aimed to investigate the effect of MS on PD. Two authors searched five electronic databases, namely, MEDLINE, PubMed, Scopus, PsycINFO, Web of Science, and Science Direct, for relevant articles between September and October 2020. After screening the title and abstract of all articles, 34 articles were selected for full-text review. Finally, 11 articles meeting the eligibility criteria were included in the study. The quality of articles was critically evaluated using the Joanna Briggs Institute. Overall, we evaluated data from 23,586,349 individuals (including healthy individuals, with MS and PD) aged 30 years or more. In cohort studies, the follow-up period varied between 2 and 30 years. MS contributed considerably to the increase in the incidence of PD. In addition, obesity, a component of MS, alone can increase the probability of developing neurodegenerative diseases. However, despite few studies on MS and PD, changes in cognitive function and more rapid progression of PD disease has been documented in patients with MS using methods commonly used in research

Doença diverticular do cólon: manifestações clínicas e conduta cirúrgica

Diverticular disease of the colon is a condition that affects the large intestine and can cause inflammation, infection or perforation. Treatment depends on the severity of symptoms and complications. In general, treatment includes antibiotics, painkillers, bowel rest and a low-residue diet. In more serious cases, surgery may be necessary to remove the affected part of the intestine. Surgery can be performed with primary intestinal resection or colostomy. Objective: to evaluate the clinical manifestations and surgical management of colonic diverticular disease, as well as the associated risk, prognosis and prevention factors. Methodology: followed the PRISMA checklist, the databases consulted were PubMed, Scielo, Web of Science, using the descriptors: diverticular disease, colon, clinical manifestations, surgical management and systematic review. Articles published in the last 10 years, in Portuguese or English, that addressed colon diverticular disease in adults were included. Articles that were not systematic reviews or meta-analyses, that dealt with other diseases of the large intestine or that did not present data on the clinical manifestations or surgical management of diverticular disease of the colon were excluded. Results: 15 studies were selected. The most common clinical manifestation of diverticular disease of the colon is abdominal pain in the left lower quadrant, which may be accompanied by fever, leukocytosis, changes in bowel habits and signs of peritoneal irritation. Surgery is indicated for cases refractory to conservative treatment, cases complicated by perforation, abscess, fistula or intestinal obstruction, or recurrent cases with disabling symptoms. Surgery can be performed open or laparoscopically, the latter being associated with lower morbidity and shorter hospital stays. The most commonly used surgical technique is primary intestinal resection with primary anastomosis, which consists of removing the affected part of the intestine and joining the remaining ends. In cases of diffuse peritonitis or hemodynamic instability, colostomy with deferred intestinal resection may be chosen. Conclusion: Diverticular disease of the colon is a common and potentially serious condition that requires an accurate diagnosis and appropriate treatment. Clinical manifestations range from mild symptoms to serious complications that can lead to death. Surgical management must be individualized according to the patient's clinical picture and conditions. Preventing diverticular disease of the colon involves adopting healthy lifestyle habits, such as a diet rich in fiber and practicing regular physical activity.A doença diverticular do cólon é uma condição que afeta o intestino grosso e pode causar inflamação, infecção ou perfuração. O tratamento depende da gravidade dos sintomas e das complicações. Em geral, o tratamento inclui antibióticos, analgésicos, repouso intestinal e dieta com pouco resíduo. Em casos mais graves, pode ser necessária uma cirurgia para remover a parte afetada do intestino. A cirurgia pode ser feita com ressecção intestinal primária ou com colostomia. Objetivo: avaliar as manifestações clínicas e a conduta cirúrgica da doença diverticular do cólon, bem como os fatores de risco, prognóstico e prevenção associados. Metodologia: seguiu o checklist PRISMA, as bases de dados consultadas foram PubMed, Scielo, Web of Science, utilizando os descritores: diverticular disease, colon, clinical manifestations, surgical management and systematic review. Foram incluídos artigos publicados nos últimos 10 anos, em português ou inglês, que abordassem a doença diverticular do cólon em adultos. Foram excluídos artigos que não fossem revisões sistemáticas ou meta-análises, que tratassem de outras doenças do intestino grosso ou que não apresentassem dados sobre as manifestações clínicas ou a conduta cirúrgica da doença diverticular do cólon. Resultados: Foram selecionados 15 estudos. A manifestação clínica mais comum da doença diverticular do cólon é a dor abdominal no quadrante inferior esquerdo, que pode ser acompanhada de febre, leucocitose, alteração do hábito intestinal e sinais de irritação peritoneal. A cirurgia é indicada para casos refratários ao tratamento conservador, casos complicados com perfuração, abscesso, fístula ou obstrução intestinal, ou casos recorrentes com sintomas incapacitantes. A cirurgia pode ser realizada por via aberta ou laparoscópica, sendo esta última associada a menor morbidade e menor tempo de internação. A técnica cirúrgica mais utilizada é a ressecção intestinal primária com anastomose primária, que consiste na retirada da parte afetada do intestino e na união das extremidades remanescentes. Em casos de peritonite difusa ou instabilidade hemodinâmica, pode-se optar pela colostomia com ressecção intestinal diferida. Conclusão: a doença diverticular do cólon é uma condição frequente e potencialmente grave, que requer um diagnóstico preciso e um tratamento adequado. As manifestações clínicas variam desde sintomas leves até complicações graves que podem levar à morte. A conduta cirúrgica deve ser individualizada de acordo com o quadro clínico e as condições do paciente. A prevenção da doença diverticular do cólon envolve a adoção de hábitos de vida saudáveis, como uma dieta rica em fibras e a prática de atividade física regular

Avaliação do painel de biomarcadores moleculares de bom prognóstico identificados em pacientes leucêmicos: uma revisão de literatura

A leucemia é caracterizada pelo acúmulo de células cancerígenas na medula óssea que substituem a celularidade sanguínea normal. Sua classificação depende da linhagem de células atingidas, sendo de origem mielóide ou linfóide, apresentam-se como leucemias agudas ou crônicas. Objetiva-se apresentar um painel de marcadores moleculares identificados nas leucemias linfóides e mielóides, através de uma revisão integrativa. Foram encontrados na base de dados Pubmed 512 artigos publicados em inglês entre os anos de 2015 e 2020. Após a submissão desses artigos aos critérios de inclusão e exclusão, foram eliminados 492 pesquisas, restando apenas 20. Os estudos demonstraram que os biomarcadores conseguem trazer uma melhor evolução do quadro do paciente, utilizando principalmente vias de sinalização para a inibição de alguns marcadores moleculares. Dessa forma, a utilização de biomarcadores no diagnóstico e prognóstico das leucemias, é de suma importância para o melhoramento do quadro clínico do paciente, diminuição da evolução da doença e menor recidivas de neoplasias hematológicas

Conceitos clínicos da crise hipertensiva: a classificação e o manejo hospitalar

The objective of this study is to expose the main concepts about hypertensive crises and indicate the best management. The present study is a narrative review of a critical and analytical nature, in research on the main concepts regarding hypertensive crises, in addition to management. A review of articles was carried out in the databases Medical Literature Analysis and Retrievel System Online (MEDLINE), Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Directory of Open Access Journals ( DOAJ) and PubMed, with the following Health Sciences Descriptors (DeCS): Cardiology; Hypertensive crisis; Management. Clinically, an abrupt increase in blood pressure may suggest a scenario of hypertensive crisis, which, if uncontrolled, may characterize a hypertensive emergency or urgency. Arbitrarily, a diastolic blood pressure greater than 120 millimeters of mercury (mmHG) associated with acute target organ damage is called a hypertensive emergency. Therefore, hypertensive urgency would be diastolic blood pressure greater than 120 mmHg, but without target organ damage. Therefore, early diagnosis and correct therapy affect the prognosis of patients, in addition, they limit sequelae that affect the outcomes of those affected. Therefore, it is necessary to further research on hypertensive crises, especially their classifications and management, so that protocols can be developed and used in hospital practice.El objetivo de este estudio es exponer los principales conceptos sobre las crisis hipertensivas e indicar el mejor manejo. El presente estudio es una revisión narrativa, de carácter crítico y analítico, en la investigación sobre los principales conceptos referentes a las crisis hipertensivas, además de su manejo. Se realizó una revisión de artículos en las bases de datos Medical Literature Analysis and Retrievel System Online (MEDLINE), Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Directory of Open Access Journals ( DOAJ) y PubMed, con los siguientes Descriptores de Ciencias de la Salud (DeCS): Cardiología; Crisis hipertensiva; Gestión. Clínicamente, un aumento abrupto de la presión arterial puede sugerir un escenario de crisis hipertensiva que, si no se controla, puede caracterizar una emergencia o urgencia hipertensiva. Arbitrariamente, una presión arterial diastólica superior a 120 milímetros de mercurio (mmHG) asociada con daño agudo a órganos diana se denomina emergencia hipertensiva. Por tanto, la urgencia hipertensiva sería una presión arterial diastólica superior a 120 mmHg, pero sin daño a órganos diana. Por tanto, el diagnóstico precoz y la terapia correcta inciden en el pronóstico de los pacientes, además, limitan las secuelas que afectan los desenlaces de los afectados. Por tanto, es necesario seguir investigando sobre las crisis hipertensivas, especialmente sobre su clasificación y manejo, de modo que se puedan desarrollar y utilizar protocolos en la práctica hospitalaria.O objetivo deste estudo é expor os principais conceitos acerca das crises hipertensivas e indicar o melhor manejo. O presente estudo trata-se de uma revisão narrativa de caráter crítico e analítico, na  pesquisa  sobre  os principais  conceitos  no  que tange às crises hipertensivas, além do manejo. Foi  realizada  uma  revisão  de  artigos  nas  bases  de  dados  Medical  Literature Analysis  and  Retrievel  System  Online  (MEDLINE),  Scientific  Electronic  Library  Online (SciELO), Literatura  Latino-Americana  e  do  Caribe  em  Ciências  da  Saúde  (LILACS), Directory of Open Access Journals (DOAJ) e PubMed, com os seguintes Descritores em Ciências  da  Saúde  (DeCS): Cardiologia; Crise hipertensiva; Manejo. Clinicamente, o aumento abrupto da pressão arterial, pode sugerir um cenário de crise hipertensiva, que, descontrolada, pode caracterizar emergência ou urgência hipertensiva. Arbitrariamente, uma pressão arterial diastólica  maior que 120 milímetros de mercúrio (mmHG) associada a lesão de órgão-alvo agudo, chama-se emergência hipertensiva. Logo, urgência hipertensiva seria pressão arterial diastólica maior que 120 mmHg, porém sem lesão de órgão-alvo. Logo, o diagnóstico precoce e a terapia correta afetam o prognóstico dos pacientes, ademais, limitam sequelas que afetam os desfechos dos afetados. Dessa forma, é necessário o aprofundamento de pesquisas acerca das crises hipertensivas, sobretudo, suas classificações e condutas, para que protocolos sejam desenvolvidos e utilizados na prática hospitalar.&nbsp