A severe case of sclerosing mesenteritis.

Sclerosing mesenteritis is a rare benign disease presenting with chronic inflammation of the mesenteric adipose tissue and variable degrees of fibrosis. A 47-year-old black man presented to the emergency department with symptoms of small bowel obstruction, requiring surgical treatment. The laparotomy revealed a stenosis of the distal ileum with mesenteric thickening and an enterectomy was performed. The postoperative period was complicated by the maintenance of bowel obstruction. The patient underwent a second laparotomy, in which the fibrosing process of the mesentery was much aggravated, and an ileo-colic resection was needed. After knowledge of the histological diagnosis, the patient was started on immunomodulators with clinical improvement. At 26 months of follow-up, patient is asymptomatic under medical treatment. This is the first report, to our knowledge, of a patient with progressive fibrosis in such short period of time requiring surgical re-intervention for bowel obstruction, owing to sclerosing mesenteritis.

Impact of vocal techniques on vocal improvement / Efecto de las técnicas vocales en la mejora voca

Introduction: Vocal techniques have shown to be important strategies to improve, promote and rehabilitate vocal health. Purpose: Verify the immediate impact of vocal techniques on the improvement of acoustic and aerodynamic parameters, vocal deviation and self-assessment. Methods: Descriptive, observational, comparative study including 40 women without vocal complaints, age range 18-45 years, equally divided into four groups according to the technique applied. The participants underwent voice assessment before and after performing the vocal technique. Each technique was performed for 1min and participants were re-evaluated in order to measure the immediate effects of the techniques on the parameters evaluated. For the analysis of the variables, the non-parametric Wilcoxon test was used. Results: Among the techniques studied, the high-pitched sound proved more effective in improving the acoustic and perceptual parameters, although in the other techniques was noticed a tendency to improvement in the result, but without statistical significance. In the self-assessment, the techniques to increase the maximum phonation time by softening the emission were more accepted by participants than those related to phonation resistance, which require more effort to be performed. Conclusion: The high-pitched sound technique favored an improved performance of participants in all parameters evaluated, although the other techniques studied showed a tendency to improvement in the evaluation measures

Introducción: Las técnicas vocales han demostrado ser importantes estrategias para mejorar, promover y rehabilitar la salud vocal. Objetivo: Determinar el efecto inmediato de técnicas vocales en la mejora de los parámetros acústicos y aerodinámicos de la voz, la desviación vocal y la autoevaluación. Metodología: Estudio descriptivo y observacional comparativo. El estudio incluyó a 40 mujeres sin quejas vocales, con edades comprendidas entre 18 y 45 años, igualmente divididas en 4 grupos, de acuerdo con la técnica dada. Las participantes fueron sometidas a evaluación vocal antes y después de la ejecución de la técnica vocal. Cada técnica fue dada por el tiempo de un minuto, y las participantes fueron re-evaluados con el fin de medir el impacto inmediato de las técnicas en los parámetros evaluados. Para el análisis de las variables de este estudio, se utilizó la prueba no paramétrica de Wilcoxon. Resultados: Entre las técnicas estudiadas la que produjo mejores resultados fue la del sonido agudo, aunque en las otras técnicas se observó una tendencia a la mejora del resultado, pero sin significación estadística. En la autoevaluación, las técnicas para aumentar el tiempo máximo de fonación mediante el ablandamiento de la emisión fueron más aceptadas por las participantes que las relacionadas con la resistencia a la fonación, que requieren más esfuerzo para ser realizadas. Conclusión: La técnica de sonido agudo favoreció un mejor rendimiento de las participantes en todos los parámetros, aunque las otras técnicas estudiadas han mostrado una tendencia a la mejora de las medidas de evaluación

[Leg ulcer: conservative treatment]. / Úlcera flebostática: estudo prospectivo de 202 doentes.

During 16 years 202 patients with leg ulcer have been studied prospectively. Whenever possible, cure has been obtained in ambulatory, which was the main objective. Surgery was preferentially made after the cure of the ulcer. From the 202 patients, 166 have made a prolonged follow-up. Cure in ambulatory has been obtained in 91% of the patients. We stress the importance of the direct control of all the treatment by the responsible doctor.