Hydrocephalus associated to congenital Zika syndrome: does shunting improve clinical features?

PURPOSE: Congenital Zika syndrome (CZS) is a new entity with little information about its course and natural history. It is known that prenatal infection by Zika virus is associated to disrupted nervous system development, leading to typical neurological disabilities and deformities. Some children present progressive ventriculomegaly and hydrocephalus associated to aggravation of seizures and neurological impairment. The aim of this study is to evaluate the development of hydrocephalus and the impact of ventriculoperitoneal shunt insertion in the clinical condition of these children. METHODS: Data was obtained from chart review, direct interviews with patients' parents, direct neurological examination, and analysis of pre- and postoperative neuroimages. RESULTS: A group of 115 patients had CZS diagnosis from November 2015 to July 2017. Among them, 21 (18.3%) patients had ventricular enlargement noted on follow-up CT scans. Six children (28.6%) underwent a ventriculoperitoneal shunt and all had some improvement after surgery concerning either waking time during the day and better interaction. Overall improvement was also noted in seizures. Spasticity decrease and more cervical control were also achieved. In two out of six cases, a slight increase in parenchymal length could be noted on the CT scans. CONCLUSION: This series points out the possibility of hypertensive hydrocephalus development in CZS patients. Affected children may benefit from VP shunt insertion. These findings suggest a dual pathology association: fetal brain disruption and primary cortical malformation by the virus itself and hypertensive hydrocephalus. This is already seen in some cases of congenital rubella, toxoplasmosis, or cytomegalovirus-associated hydrocephalus.

Extensive Melanotic Neuroectodermal Tumor of Infancy.

The melanotic neuroectodermal tumor of infancy (MNTI) is a rare childhood neoplasm with an alarming but classical clinical presentation. We present the case of a 2-month-old male infant treated with surgery for an aggressive MNTI on the alveolar process of the maxilla. Radiographic examination showed a diffuse osteolytic radiolucent lesion in the right maxilla, and displacement and dysmorphic changes in the developing primary tooth buds. The patient remained well without evidence of recurrence for 6 months after surgery. We discussed clinicopathological features, management alternatives, and outcome.

Tetralogy of Fallot and hypertrophic cardiomyopathy: a rare association.

Tetralogy of Fallot is known as the most common cyanotic congenital heart disease and has a prevalence of 10% of all congenital heart diseases. Although many other heart anomalies may coexist, the association of tetralogy of Fallot and hypertrophic cardiomyopathy is extremely rare. We report this association in a 15-month-old female, cyanotic since birth, in her first hospital admission for diagnosis and treatment of recurring cyanotic crises. In addition, a review of the literature and of the problems related to the treatment is provided.

Comportamento das próteses biológicas em crianças abaixo de 15 anos / Behavior of biological prosthesis in children under 15

Foi feita a análise de 26 operados menores de 15 anos, que receberam prótese valvular cardíaca entre janeiro de 1975 e dezembro de 1983. O comportamento das próteses biológicas, nesta faxia etária, näo foi satisfatório, com mortalidade 54,5% em um período máximo de seguimento de 58 meses. O tempo médio entre a implantaçäo e a explantaçäo ou óbito foi de 39,8% (+ ou - 17) meses. O grupo que recebeu prótese mecênica teve um seguimento mais favorável

Comunicaçäo direta entre a artéria pulmonar direita e o átrio esquerdo: relato de caso / Direct communication of the right pulmonary artery and the left atrium: a case report

Uma criança de 7 anos de idade portadora de comunicaçäo direta da artéria pulmonar direita com o átrio esquerdo, com cianose intensa, foi operada com sucesso. Foi feita revisäo dos 20 casos até agora publicados, com especial atençäo no diagnóstico, tipos anatômicos e resultado cirúrgico

Associaçäo rara entre tetralogia de Fallot e miocardiopatia hipertrófica / Tetralogy of Fallot and hypertrophic cardiomyopathy. A rare association

Tetralogy of Fallot is known as the most common cyanotic congenital heart disease and has a prevalence of 10 percent of all congenital heart diseases. Although many other heart anomalies may coexist, the association of tetralogy of Fallot and hypertrophic cardiomyopathy is extremely rare. We report this association in a 15-month-old female, cyanotic since birth, in her first hospital admission for diagnosis and treatment of recurring cyanotic crises. In addition, a review of the literature and of the problems related to the treatment is provided

Cardiac tumours: clinical, echocardiographic and pathological features

OBJETIVO: Caracterizaçäo clínica e ecocardiográfica dos pacientes com tumores cardíacos, avaliaçäo da terapêutica cirúrgica e da recidiva dos tumores. MÉTODO: Na primeira parte da pesquisa, o delineamento metodológico foi do tipo retrospectivo, através da identificaçäo de tumores cardíacos e coleta de dados dos prontuários do Hospital Universitário Walter Cantídio (UFCE) e Hospital de Messejana, no período de 1981 a 2001, onde foram encontrados 19 casos de tumores cardíacos. Os pacientes foram submetidos a uma reavaliaçäo clínica, eletro e ecocardiográfica durante o período de março a julho de 2002. RESULTADOS: Sintomas congestivos e dor torácica foram os sintomas mais freqüentes em nossa série. A localizaçäo preferencial dos tumores cardíacos em nossa série foi no átrio esquerdo. Entre os pacientes submetidos a operaçäo, todos tiveram o tumor ressecado dos átrios, predominando a localizaçäo em átrio esquerdo (79 por cento). O tipo histopatológico mais encontrado em nossa série foi o mixoma (78 por cento). A mortalidade cirúrgica foi de 14 por cento. Detectamos recidiva de tumor em um paciente. CONCLUSÕES: Tumores cardíacos foram mais encontrados no átrio esquerdo. Os tumores benignos foram mais freqüentes que os malignos. O tipo histopatológico mais encontrado foi o mixoma.

Causas de óbito em cirurgia de revascularizaçäo do miocárdio / Causes of death in surgery of myocardial revascularization

É relatada a mortalidade cirúrgica na revascularizaçäo do miocárdio em diferentes etapas, entre outubro de 1972 e dezembro de 1984. A partir de 1980 esteve sempre igual ou inferior a 3%, sendo que em um dos Serviços chegou a 0,9% em 1983 e 1984. Säo analisados os fatores incrementadores do risco cirúrgico nesta experiência