Nonimmune fetal ascites: identification of ultrasound findings predictive of perinatal death.

AIM: To determine the ultrasonographic findings that predict death in fetal ascites. METHODS: This was a retrospective cohort study involving pregnancies with ultrasonographic findings related to fetal ascites. The inclusion criteria were as follows: single pregnancy with a live fetus; ultrasound findings of ascites; ascites unrelated to maternal fetal alloimmunization; and pregnancy follow-up at our institution. The χ2-test was used to evaluate the association of ultrasound findings and death. Multiple logistic regression analysis was performed to determine the ultrasound findings that are predictive of death prior to hospital discharge. RESULTS: A total of 154 pregnancies were included in the study. In 8 (5.19%) cases, ascites was an isolated finding, and in 146 cases, other alterations were observed during the ultrasound evaluation. Death before hospital discharge occurred in 117 cases (76.00%). The following ultrasonographic findings were significantly associated with death: gestational age at diagnosis <24 weeks (P<0.0001); stable/progressive ascites evolution (P=0.004); the presence of hydrops (P<0.0001); and the presence of cystic hygroma (P<0.0001). The presence of hydrops, the presence of respiratory tract malformations, and stable/progressive ascites evolution were significantly associated with the prediction of death. CONCLUSIONS: Based on ultrasound examination, the presence of hydrops, malformation of the respiratory tract, and stable/progressive evolution of ascites increase the chances of death in cases of fetal ascites.

O uso de enxerto e retalho de periósteo em Oftalmologia / The periosteal graft and flap use in Ophthalmology

Resumo Objetivo: Os autores revisaram o uso de periósteo em cirurgias oftalmológicas e seus resultados. Métodos: Uma revisão de literatura usando os bancos de dados do Google Scholar, PubMed e SciElo com todos os artigos sobre o uso de periósteo em Oftalmologia publicados de 1977 até 2018. Resultados: Um total de 21 estudos cumpriram o objetivo do estudo: 9 relatos de caso, 9 séries de casos, 1 coorte retrospective e 2 coortes prospectivas. 206 pacientes foram submetidos aos procedimentos cirúrgicos com uso de periósteo nas duas formas principais: enxerto e retalho. Os principais motivos para uso do periósteo foram: recobrimento de implante orbitário e reconstrução palpebral. Resultados cirúrgicos foram satisfatórios com baixas taxas de complicação de 10.67% e mínima necessidade de nova intervenção cirúrgica de 2.42%. Conclusão: O uso de periósteo em Oftalmologia é uma técnica promissora com bons resultados até o momento e deve sempre ser uma opção terapêutica para o Oftalmologista. Todavia, mais estudos com poder estatístico para sedimentação do conhecimento sobre o tema são recomendados.

Abstract Purpose: The authors reviewed the periosteum use in ophthalmic surgery and its results. Methods: A comprehensive review of the literature using Google Scholar, PubMed and SciElo databases with all articles about the periosteum use in Ophthalmology published from 1977 to 2018. Results: A total of 21 studies followed the review's purpose: 9 case reports, 9 case series, 1 retrospective cohort and 2 prospective cohorts. 206 patients were submitted to the procedures with the periosteum use in the two main forms: graft and flap. The principal reasons for periosteal use were: orbital implant covering and eyelid reconstruction. Surgical outcomes were very satisfactory with low complication rates of 10.67% and minimal necessity of new surgical intervention of 2.42%. Conclusion: The periosteum use in Ophtalmology is a promising technique with good results so far and should always be a therapeutic option for the ophthalmologist. However, based on available data in the literature, more studies with statistical power for knowledge sedimentation in this subject are recommended.