RESUMEN
Primary central nervous system vasculitis (PCNSV) is a rare cause of ischemic stroke and is considered idiopathic in most cases. PCNSV can present with a wide variety of neurological manifestations and should be considered in the differential diagnosis of ischemic stroke, particularly if the neurological deficit cannot be explained by the affected vascular area or when it is multifocal. The diagnosis of PCNSV is relevant because the required therapy differs from the treatments commonly used for frequent ischemic strokes. We report the case of a 64-year-old woman admitted for an ischemic stroke with a right frontal cortico-subcortical ischemic lesion. The etiological investigation documented multiple intracranial arterial stenoses. Secondary causes of central nervous system vasculitis were excluded. The patient refused a brain biopsy, and corticosteroid therapy was initiated due to high suspicion of PCNSV, supported by findings from transcranial Doppler ultrasound and brain magnetic resonance angiography. The patient had a positive clinical outcome and did not have any recurrences while under therapy. This case raises awareness of the importance of considering PCNSV in the differential diagnosis of ischemic stroke. It emphasizes the importance of promptly initiating therapy to minimize PCNSV-associated complications.
RESUMEN
Wolff-Chaikoff effect (WCE) is an acute physiologic response of the thyroid gland to high levels of iodine. The WCE is usually temporary, and the thyroid gland adjusts to high iodine levels within days or weeks. It is a protective mechanism and a failure to escape from it can result in thyroid dysfunction. Hypothyroidism is rare but more likely in patients who have had thyroid disease, are under stress, or are exposed to high iodine concentrations for a long time. The use of iodinated contrast media in radiologic studies or invasive medical procedures is a common source of excessive iodine exposure and can lead to thyroid disfunction. Despite the frequent use of contrast media in health care, the thyroid dysfunction associated with their use is poorly recognized. We report a patient who developed iodine-induced hypothyroidism after chemoembolization of recurrent chylothorax with ethiodized oil (Lipiodol®, Villepinte, France). This case report raises awareness of the importance of the physiologic WCE as well as the relevance of monitoring thyroid function when using iodinated contrast media in patients with specific risk factors.
RESUMEN
Objetivo: verificar se a intervenção fisioterapêutica no puerpério imediato contribui para a redução da diástase. Métodos: estudo de intervenção com randomização de dois grupos de 25 puérperas recrutadas em uma maternidade de Vitória-ES. Ambos foram submetidos à avaliação e mensuração da diástase através de um paquímetro, e no grupo de tratamento além da avaliação foi aplicado um protocolo de tratamento fisioterápico às 06 e 18 horas após o parto. Os dados foram analisados através dos testes de Wilcoxon, Mann-Whitney e teste t pareado. Resultados: houve diminuição da diástase abdominal entre a primeira e a última avaliação em ambos os grupos, no entanto, a análise entre grupos identificou uma redução mais acentuada no grupo de tratamento (p<0,001). Conclusão: os achados deste estudo mostram que o atendimento fisioterápico no puerpério imediato é capaz de influenciar positivamente na redução da diástase abdominal, proporcionando às puérperas uma recuperação mais rápida
Objective: to verify if the physiotherapeutic intervention in the immediate puerperium contributes to the reduction of the diastasis. Methods: randomized intervention study of two groups of 25 mothers recruited at a maternity hospital in Vitória-ES. Both were submitted to diastasis evaluation and measurement using a caliper, and in the treatment group, in addition to the evaluation, a physical therapy protocol was applied at 06 and 18 hours after delivery. Data were analyzed by Wilcoxon, Mann-Whitney and paired t-tests. Results: there was a decrease in the abdominal diastasis between the first and last evaluation in both groups and the variables studied, however, the analysis between groups identified a sharper decline in the treatment group (p <0.001). Conclusion: the findings of this study show that the physiotherapeutic care in the immediate puerperium is able to positively influence the reduction of the abdominal diastasis, providing a faster recovery to the puerperal women
Objetivo: verificar si la intervención de fisioterapia en el período posparto inmediato contribuye a la reducción de la diástasis. Métodos: estudio de intervención aleatorizado de dos grupos de 25 madres reclutadas en un hospital de maternidad en Vitória-ES. Ambos fueron sometidos a evaluación y medición de la diástasis utilizando un calibrador, y en el grupo de tratamiento, además de la evaluación, se aplicó un protocolo de fisioterapia a las 06 y 18 horas después del parto. Los datos fueron analizados por Wilcoxon, Mann-Whitney y pruebas t pareadas. Resultados: hubo una disminución en la diástasis abdominal entre la primera y la última evaluación en ambos grupos y las variables estudiadas, sin embargo, el análisis entre los grupos identificó una reducción más marcada en el grupo de tratamiento (p <0.001). Conclusión: los resultados de este estudio muestran que la atención de fisioterapia en el período posparto inmediato puede influir positivamente en la reducción de la diástasis abdominal, proporcionando a las mujeres puerperales una recuperación más rápida
