Fast growth rate of a right atrial myxoma.

Primary cardiac tumors are rare, with an incidence between 0.0017 and 0.19%, and are asymptomatic in up to 72% of cases. Approximately 75% of tumors are benign, and nearly 50% of these are myxomas. Concerning location, 75% of myxomas are in the left atrium, 15 to 20% in the right atrium, and more rarely in the ventricles. The finding of cardiac myxomas usually implies immediate surgical excision to prevent embolic events and sudden cardiac death. Reports with documented growth rate are rare, and the actual growth rate remains a controversial issue. We report the rapid growth rate of a right atrial myxoma in an oligosymptomatic 69-year-old patient, with negative previous echocardiographic history in the last two years, who refused surgery upon diagnosis, enabling monitoring of myxoma growth.

Fast growth rate of a right atrial myxoma

ABSTRACT Primary cardiac tumors are rare, with an incidence between 0.0017 and 0.19%, and are asymptomatic in up to 72% of cases. Approximately 75% of tumors are benign, and nearly 50% of these are myxomas. Concerning location, 75% of myxomas are in the left atrium, 15 to 20% in the right atrium, and more rarely in the ventricles. The finding of cardiac myxomas usually implies immediate surgical excision to prevent embolic events and sudden cardiac death. Reports with documented growth rate are rare, and the actual growth rate remains a controversial issue. We report the rapid growth rate of a right atrial myxoma in an oligosymptomatic 69-year-old patient, with negative previous echocardiographic history in the last two years, who refused surgery upon diagnosis, enabling monitoring of myxoma growth.

Sepsis in Burned Adult Patients: Study of Serie of Cases in Brazil.

Sepsis is currently the leading cause of death in burned patients. There are few studies on sepsis in burned patients at intensive care unit (ICU). To determine demographic profile, clinical presentation, evolution, procedures, and treatments used for burned patients affected by sepsis. Retrospective study in medical records of severe burned adult patients who developed sepsis between November 2015 and May 2018 in a university hospital in Curitiba, Brazil. Patients' details about hospitalization and sepsis were collected. Were included 44 patients, 75% men, and mean age of 42.1±16.88 years. The median TBSA was 50% that was significantly associated with mortality (P = .013). Outcome of death was observed in 50% of the patients. The median duration of hospitalization was 35 days, and in the ICU was 21.5 days. Orotracheal intubation and tracheostomy were the most prevalent aggravating procedures conducted during the hospitalization (77.2% and 56.8%, respectively). The median time to the first sepsis episode was 7 days, and the average total time in sepsis was 13.2 days. The median length of hospital stay among patients with septic shock who died was significantly lower than that of patients who did not die (P = .031). Blood culture was positive in 79.5% of cases, with the majority being typical ICU bacteria. Sepsis occurs more frequently in patients with higher TBSA and long hospitalization time accompanied by aggravating procedures and complications. Infections were caused by typical ICU bacteria, resulting in 50% patient mortality primarily due to septic shock.

Apresentação atípica de um Divertículo de Meckel: relato de caso e revisão de literatura / Atypical presentation of a Meckel Diverticulum: case report and literature review

O divertículo de Meckel (DM) é um vestígio remanescente do ducto vitelino que se forma entre a oitava e nona semanas de gestação. É uma manifestação relativamente comum na população geral (2%), no entanto, raramente desenvolve sintomas. Quando desenvolve sintomas a hematoquezia indolor é o sintoma mais prevalente. A investigação da hematoquezia dolorosa requer a exclusão de diversas patologias gastrointestinais. No presente artigo relatamos o caso de um paciente com DM de apresentação clínica e epidemiologia atípicas e sua investigação, assim como uma revisão de literatura sobre os métodos diagnósticos para se chegar ao DM.

Meckel's diverticulum (DM) is a remnant of the vitelline duct that forms between the eighth and ninth weeks of gestation. It is a relatively common manifestation in the general population (2%), however, it rarely develops symptoms. When symptoms develop, painless hematochezia is the most prevalent symptom. The investigation of painful hematoquezia requires the exclusion of several gastrointestinal pathologies. In the present article we report the case of a patient with atypical clinical and epidemiology DM presentation and it´s investigation, as well as a literature review on the diagnostic methods to arrive at DM.