Técnica Alternativa Para A Remoção De Stent Duplo J Em Doentes Pediátricos: Série De 3 Casos

Introduction: Double-J (DJ) ureteral stents are widely used in urological practice for the management of ureteral obstructions. As traditional techniques for ureteral stent removal, such as cystoscopy, may have limitations and associated risks, the development of more cost-effective alternative methods is relevant. In this study, we describe a novel technique for the removal of ureteral stents in three pediatric patients with the diagnosis of ureteropelvic junction (UPJ) stenosis. Case presentation: The surgical technique involves using a Nelaton urethral catheter with a polypropylene 3.0 wire attached. After bladder catheterization, the wire is fixed with two loops, and the bladder catheter is gently rotated and removed, enabling the extraction of the stent connected to the wire loop. Discussion: The described technique was successfully employed in all cases. The surgical procedure was quick, easy to perform, and required minimal sedation. Although other cost-effective methods have been described, there is a lack of larger studies comparing these techniques. Conclusions: Among the different modalities described, the decision regarding the best DJ removal procedure is still controversial and should be individualized, and further comparison between techniques is warranted.  Introdução: Os stents ureterais Duplo-J (DJ) são amplamente utilizados na prática urológica para o tratamento de obstruções ureterais. Como as técnicas tradicionais de remoção de stents ureterais, como a cistoscopia, podem ter limitações e riscos associados, o desenvolvimento de métodos alternativos mais económicos é relevante. Neste estudo, descrevemos uma nova técnica para a remoção de stents ureterais em três doentes pediátricos com diagnóstico de estenose da junção ureteropélvica (JUP). Apresentação dos casos: A técnica cirúrgica envolve o uso de um cateter uretral de Nelaton com um fio de polipropileno 3.0 anexado. Após a cateterização da bexiga, o fio é fixado com dois laços, e o cateter vesical é suavemente rodado e removido, permitindo a extração do stent conectado ao laço do fio. Discussão: A técnica descrita foi utilizada com sucesso em todos os casos. O procedimento cirúrgico foi rápido, fácil de realizar e exigiu sedação mínima. Embora outros métodos económicos tenham sido descritos, há uma falta de estudos mais amplos comparando essas técnicas. Conclusões: Entre as diferentes modalidades descritas, a decisão sobre o melhor procedimento de remoção de DJ ainda é controversa e deve ser individualizada, sendo necessária uma comparação adicional entre as técnicas

Congenital herpes simplex with ophthalmic and multisystem features: a case report

Abstract Background Neonatal herpes simplex virus (HSV) infection is rare and has significant morbimortality rates. Approximately 85% of newborns are infected intrapartum, and risk factors for mother-to-child transmission include vaginal delivery, primary maternal infection, and prolonged rupture of membranes. Neonatal HSV can manifest with isolated mucocutaneous lesions, neurological involvement, or disseminated disease. In general, herpetic infection can cause blepharoconjunctivitis or keratitis. We report a rare case of congenital herpes with ophthalmologic manifestations and multisystemic involvement. Case presentation A preterm infant, born at 32 weeks and 2 days, with presumed neonatal infection developed intestinal and respiratory complications, as well as hyperemic lesions on the left nostril and oral mucosa. An ophthalmological assessment was requested and brought up the suspicion of HSV infection, indicating empirical treatment with endovenous acyclovir. Later, a new ocular examination was suggestive of panuveitis. Afterward, serum IgM antibodies to HSV-1 and HSV-2 were positive. Proper antiviral therapy led to an improvement in the condition. Discussion Neonatal herpes is associated with a high risk of persistent skin lesions, long-term neurological disability and other lasting sequelae. It is essential to consider HSV infection in cases of neonatal conjunctivitis, especially in patients with an epithelial defect and no improvement after initial treatment with topical or systemic antibiotics. Conclusions In the management of neonatal HSV, early diagnosis is essential for the timely initiation of antiviral therapy. Our report highlights that ocular assessment can be crucial in the correct diagnostic investigation of this condition