Pancreatite Aguda Necrosante — Caso Clínico

Os autores apresentam um caso clínico de Pancreatite Aguda Hemorrágica, de provável etiologia idiopática, numa criança de 10 meses, que se manifestou inicialmente por vómitos, e alteração do estado de consciência e posteriormente por abdómen agudo. O diagnóstico foi feito durante a laparotomia. Houve boa evolução clínica. Como complicações, refere-se o aparecimento de dois pseudoquistos pancreáticos que regrediram progressiva e espontaneamente

Endobronchial Ultrasound under Moderate Sedation versus General Anesthesia

BACKGROUND: Different anesthetic protocols may influence endobronchial ultrasound-guided needle aspiration (EBUS-TBNA) outcomes, patient comfort, and even safety. In this study, two anesthesia techniques were assessed and compared for EBUS-TBNA. METHODS: A prospective, multicenter study was carried out. Patients were allocated to Group 1 (general anesthesia with neuromuscular blockade and controlled ventilation) and Group 2 (intravenous sedation). EBUS-TBNA accuracy was the primary outcome. Safety, patient comfort and satisfaction, and operators' difficulties were defined as secondary outcomes. RESULTS: Of the 115 patients enrolled (Group 1 = 59, Group 2 = 56), EBUS-TBNA was performed for hilar or mediastinal lesion diagnosis and lung cancer staging in, respectively, 77 (67%) and 38 (33%) patients. The numbers of lymph nodes stations (1.8 ± 1.0 vs. 1.7 ± 1.0, p = 0.472) and punctures per station (6.9 ± 3.1 vs. 6.0 ± 2.5, p = 0.084) were similar between groups. Adequate samples were obtained from 109 patients (97.3%) with similar diagnostic accuracy. Procedure duration was not significantly different (p = 0.348). Hemodynamic parameters and systolic and diastolic blood pressures were higher in Group 1 at the beginning and at the end of the procedure. Adverse events were equally distributed, and no significant differences were found regarding patient satisfaction and bronchoscopist/anesthesiologist difficulties. CONCLUSIONS: The type of anesthesia used did not influence EBUS-TBNA outcomes. EBUS-TBNA performed under sedation or general anesthesia did not affect the diagnostic yield, complication rate, and patients' comfort and satisfaction.info:eu-repo/semantics/publishedVersio

Hypercalcemic crisis associated with primary hyperparathyroidism during pregnancy

Primary hyperparathyroidism is a rare occurrence in pregnancy with significant risks to the mother and the foetus, witch is related to the level of serum calcium. A 41-year-old women, gravida 2, para 1, presented at 22 weeks gestation with nausea, vomiting and mild cognitive dysfunction associated with hypercalcemic crisis. The hypercalcemia was observed to be related to parathyroid hyperplasia that was surgically removed. Complete resolution of her symptomatology and hypercalcemia occurred postoperatively. The pregnancy was complicated with transient hypertension. A small for gestational age healthy male infant was delivered at term with no neonatal complications related with this pathology

Anomalia de Ebstein: um caso com uma evolução inesperada

A anomalia de Ebstein da válvula tricúspide é uma cardiopatia congénita complexa rara. A etiologia é desconhecida e, na maioria dos casos parece ser multifactorial. A mortalidade no período neonatal é alta. Os autores apresentam um caso clínico de anomalia de Ebstein grave com diagnóstico pré-natal. No período perinatal efectuou-se um shunt de Blalock-Taussig modificado à esquerda e aos cinco meses de vida foi submetida a valvuloplastia pulmonar percutânea com sucesso. A evolução clínica tem sido favorável tendo-se optado por não efectuar operação de Glenn. Actualmente com 18 meses de vida encontra-se assintomática. Ebstein’s anomaly of the tricuspid valve is a rare and complex congenital heart defect. Its etiology is unknown and in the majority of cases it is multifactorial. Mortality in the neonatal period is high. The authors present a case of severe Ebstein’s anomaly diagnosed antenatally. In the perinatal period a Blalock-Taussig shunt was performed and at the age of five months the infant underwent successful percutaneous pulmonary valvuloplasty. The clinical outcome has been favorable and we decided to postpone a Glenn procedure. At 18 months the child is asymptomatic

Monoclonal antibody-conjugated dendritic nanostructures for siRNA delivery

Small interfering RNA (siRNA) is a promising tool for gene therapy-based disease treatments. However, delivery of siRNA to the target cells requires a specific and reliable carrier system. Herein we describe a targeted carrier system that can deliver siRNA to cancer cells overexpressing the human epidermal growth factor 2 (HER2) receptor. Trastuzumab-conjugated poly(amido)amine dendrimers can be synthesized using the protocols described here

The influence of textile materials on flame resistance ratings of professional uniforms

This study compares the flame speed of different textile materials employed in professional uniforms. Five different garments of aeronauts’ uniforms were analyzed (totaling 200 specimens submitted to flammability tests). Plain weaves and twill weaves composed by 100% CO; 100% PES; 67% PES/33% CO; 50% PES/50% WO; and 55% PES/45%WO were analyzed in the warp and filling directions. The flame speed of each material was determined, and differences in the flame propagation of the fabrics were identified. The lowest flame speed occurred for the material 50% PES/50% WO plain weave and weft direction (0.742 ± 0.140 m/s). The highest flame speed was 3.698 ± 1.806 cm/s for the material 67%PES/33%CO, plain weave and filling direction. Future experiments for reducing the fabric flammability of the uniforms could be related to more closed fabric constructions; mixtures with synthetic fibers to add functionality; changing the direction of the fabric; and changing the weight and torsion of its constituent yarns.São Paulo Research Foundation—FAPESP (“Fundação de Amparo à Pesquisa do Estado de São Paulo”) Grant Number 2016/01331-