TROMBOEMBOLISMO PULMONAR EM PACIENTE COM SÍNDROME DE KLIPPEL-TRENAUNAY-WEBER: RELATO DE CASO

Klippel-Trenaunay-Weber syndrome (KTW) is a rare disease characterized by vascular disorder with capillary, venous and lymphatic malformation, large hemangiomas and bone or soft tissue hypertrophy. Herein we report the case of a 24-years-old women, obese, with previous history of unilateral lymphedema and hemangioma in right leg witch evolves to pulmonar tromboembolism. She had clinical and ultrasonographic diagnosis of Klippel-Trenaunay-Weber Syndrome five years before. After anticoagulation, the patient evolves assymptomatic and without new tromboembolic events.RESUMO A síndrome de Klippel-Trenaunay-Weber (KTW) é uma doença rara caracterizada por distúrbio vascular com malformação capilar, venosa e linfática, grandes hemangiomas e hipertrofia óssea ou de tecidos moles. Relatamos o caso de uma mulher de 24 anos de idade, obesa, com história prévia de linfedema e hemangioma unilateral da perna direita que evoluiu com tromboembolismo pulmonar. Ela possuia diagnóstico clínico e ultrassonográfico de síndrome de Klippel-Trenaunay-Weber há 5 anos. Após a anticoagulação, a paciente evoluiu assintomática e sem novos eventos tromboembólicos.   Palavras-chave: Síndrome de Klippel-Trenaunay-Weber; Embolia Pulmonar; Tromboembolia; Tromboembolia Venosa. ABSTRACT Klippel-Trenaunay-Weber syndrome (KTW) is a rare disease characterized by vascular disorder with capillary, venous and lymphatic malformation, large hemangiomas and bone or soft tissue hypertrophy. Herein we report the case of a 24-years-old women, obese, with previous history of unilateral lymphedema and hemangioma in right leg witch evolves to pulmonar tromboembolism. She had clinical and ultrasonographic diagnosis of Klippel-Trenaunay-Weber Syndrome five years before. After anticoagulation, the patient evolves assymptomatic and without new tromboembolic events. Keywords: Klippel-Trenaunay-Weber Syndrome; Pulmonary Embolism; Thromboembolism; Venous Thromboembolism

Self-Limited Cytomegalovirus Infection During Natalizumab Treatment for Multiple Sclerosis

Natalizumab is indicated as monotherapy for the treatment of relapsing-remitting multiple sclerosis; it prevents outbreaks and delays the progression of physical disability. Here, we report the case of a 30-year-old patient with multiple sclerosis receiving natalizumab as monotherapy who subsequently developed self-limited cytomegalovirus disease. Cytomegalovirus infection has been reported during treatment with natalizumab, and in this study, we use new techniques to analyze the possible association of cytomegalovirus infection with natalizumab

Construction of a competence-based curriculum for internship in obstetrics and gynecology within the medical course at the Federal University of Ceará (Sobral campus)

CONTEXT AND OBJECTIVE: This research project arose from a proposal made to the teachers by the students of a medical course at a federal university in Brazil, from their personal experiences regarding the skills and competencies that should be developed during the obstetrics and gynecology (OBG) stage of the internship. The objective here was to develop the matrix of skills necessary for training good general physicians in the medical course.DESIGN AND SETTING: Exploratory qualitative study conducted in a federal university in Brazil.METHODS: The basis for developing these competencies among OBG interns was "The Competency Matrix for Medical Internship" developed by Bollela and Machado. The instrument was presented to, analyzed by and modified by a set of OBG specialists, at two sessions.RESULTS: The specific competencies expected from students over the internship in OBG were framed within overall topics that had previously been determined and listed: healthcare, decision-making, communication and interpersonal relationships, management and organization of the Brazilian National Health System (Sistema Único de Saúde, SUS) and professionalism.CONCLUSIONS: A competency matrix that standardizes the minimum requirements that interns should be capable of putting into practice after concluding the OBG stage is a valuable tool for ensuring student performance and a fair and rigorous assessment for them, thereby seeking to train good general physicians who meet the community's needs