RESUMO
PHACE(S) syndrome is a neurocutaneous syndrome with a wide array of presentations. The most known and present trait is facial hemangioma > 5 cm. The name is an acronym for Posterior fossa malformations, infantile Hemangiomas, Arterial anomalies, aortic Coarctation, Eye abnormalities, and middle-line malformations of the Sternum. The exact etiopathogenic mechanism of this syndrome is not fully understood, and its treatment depends on detailed and individualized assessment. The aim of this paper is to describe a child with a throat hemangioma, vascular malformations, cognitive delay, and other anomalies to illustrate the neuroimaging found in this syndrome.
Assuntos
Anormalidades Múltiplas/diagnóstico por imagem , Coartação Aórtica , Fossa Craniana Posterior/diagnóstico por imagem , Anormalidades do Olho , Hemangioma/diagnóstico por imagem , Síndromes Neurocutâneas , Anormalidades Múltiplas/patologia , Angiografia Cerebral , Pré-Escolar , Disfunção Cognitiva/etiologia , Fossa Craniana Posterior/patologia , Feminino , Hemangioma/patologia , Humanos , Faringe , Malformações Vasculares/diagnóstico por imagem , Transtornos da Visão/etiologiaRESUMO
The life and death of Henrique Dumont (1832-1892) is little known, being usually remembered as Alberto Santos-Dumont's father. This report describes the history of this Brazilian engineer, also known as the King of Coffee, who achieved enormous business success and fortune in the late nineteenth century. In 1890, during the inspection of his farm, the world's largest coffee plantation at that time, he fell from a carriage, which left him a hemiplegic. This forced him to sell the farm and move to France for treatment. Before his death two years later, he gave his 18-year-old son bits of advice, and distributed his inheritance, which allowed Alberto to study in Paris and finance his experiments that would culminate in the development of the airplane. The diagnostic and therapeutic possibilities are also discussed.
Assuntos
Aeronaves/história , Lesões Encefálicas Traumáticas/história , Brasil , França , História do Século XIX , ParisRESUMO
Carotid artery dissection is a significant cause of stroke in young patients. It may be asymptomatic and go undiagnosed, or minimal transient manifestations may follow, commanding a higher index of suspicion than ordinarily exists to avoid misdiagnosis. Reported herein is a 27-year-old man who suffered extracranial internal carotid artery dissection while practicing a Brazilian Jiu-Jitsu submission maneuver. The patient's condition suddenly deteriorated one week later due to distal embolization and stroke. Despite endovascular treatment, with stenting of the cervical carotid artery, neurologic deficits remained. Of note, the objective in martial arts, which is to kill or incapacitate, has yet to be fully tempered in transitioning to sport. Brazilian Jiu-jitsu, a relatively new and fast-growing form of martial art, places emphasis on submission maneuvers. Related injuries are not common knowledge and are poorly described in the literature. This account is intended to shed light on the risk of this discipline. Through education and improved supervision, vascular injuries of this nature and the potentially lethal or disabling consequences may thus be prevented in young athletes.
RESUMO
ABSTRACT The life and death of Henrique Dumont (1832-1892) is little known, being usually remembered as Alberto Santos-Dumont's father. This report describes the history of this Brazilian engineer, also known as the King of Coffee, who achieved enormous business success and fortune in the late nineteenth century. In 1890, during the inspection of his farm, the world's largest coffee plantation at that time, he fell from a carriage, which left him a hemiplegic. This forced him to sell the farm and move to France for treatment. Before his death two years later, he gave his 18-year-old son bits of advice, and distributed his inheritance, which allowed Alberto to study in Paris and finance his experiments that would culminate in the development of the airplane. The diagnostic and therapeutic possibilities are also discussed.
RESUMO A vida e especialmente a morte do brasileiro Henrique Dumont (1832-1892) são pouco conhecidas, sendo geralmente lembrado como pai de Alberto Santos Dumont. Relatamos a história deste engenheiro que obteve enorme sucesso empresarial no final do século XIX, sendo denominado Rei do Café. Em 1890, durante a inspeção da sua fazenda, maior cafeicultura do mundo na época, caiu da charrete e ficou hemiplégico. Isso o fez vender a fazenda e buscar tratamento na França, trazendo o primeiro automóvel do Brasil ao retornar. Antes de morrer dois anos após o acidente, deu valorosos conselhos e distribuiu sua herança ao filho Alberto, então com dezoito anos de idade, que pôde assim estudar em Paris e financiar seus experimentos que culminariam no desenvolvimento do avião. São discutidas e contemporizadas as possibilidades diagnósticas e terapêuticas relacionadas ao déficit neurológico.
Assuntos
História do Século XIX , Aeronaves/história , Lesões Encefálicas Traumáticas/história , Paris , Brasil , FrançaRESUMO
BACKGROUND: Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic noninflammatory disease characterized by ossification of the entheses. METHODS: This paper reviews the etiopathogenesis, epidemiology, clinical features, differential diagnosis, and treatment of DISH, based on current available literature. RESULTS: Exact prevalence and incidence of DISH remains undetermined. Many external and genetic factors have been reported as being contributors to the pathogenesis of DISH. Current theories focus on the pathologic calcification of the anterior longitudinal ligament of the spine as the main physiopathological mechanism of disease. Clinical features are variable from monoarticular sinovitis to airway obstruction, and can be associated to systemic conditions. Comorbidities include obesity, hypertension, diabetes mellitus, hyperinsulinemia, dyslipidemia, and hyperuricemia according to a number of reports. CONCLUSIONS: DISH is a disease which involves the calcification of the anterior longitudinal ligament of the spine and can be associated with numerous clinical presentations and comorbidities.
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OBJECTIVE: To evaluate the forms of treatment employed to heart injuries and the main aspects related to their morbidity and mortality. METHODS: A retrospective study of 102 patients with cardiac injuries treated in the two emergency rooms in Manaus (Dr. John Lucio Pereira Machado Emergency Hospital and August 28 County Emergency Hospital) from January 1998 to June 2006. RESULTS: Of the 102 patients, 95.1% were men; mean age was 27 years; stab wounds accounted for 81.4% of cases and gunshot wounds for 18.6%; cardiorrhaphy was performed in 98.1% of cases. The heart chambers affected were: Right Ventricle (RV): 43.9% (36.2% isolated and 7.7% associated with other chambers); Left Ventricle (LV): 37.2%; Right Atrium (RA): 8.5%; and Left Atrium (LA): 10.4%; specific mortalities were of 21%, 23%, 22% and 45%, respectively. The mortality injuries to two associated chambers was 37.5%, 20% being for RA + RV, 100% for RV + LV, and zero for RV + LA. The lung accounted for 33.7% of the 89 associated lesions. Mean time of surgery and hospital stay were 121 minutes and 8.2 days, respectively. About 22.5% of patients displayed 41 complications. The mortality rate was 28.4%. Lesions grade IV and V corresponded to 55% and 41% of cases, with specific mortality of 26% and 15%, respectively. All patients with grade injuries VI died. CONCLUSION: Cardiac stab wounds were associated with lower mortality, cardiac lesions grade IV were associated with higher mortality and a shorter operative time was associated with greater severity and mortality.
Assuntos
Traumatismos Cardíacos/terapia , Adolescente , Adulto , Idoso , Brasil , Feminino , Traumatismos Cardíacos/complicações , Traumatismos Cardíacos/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
OBJETIVO: Avaliar as formas de tratamento empregadas e os principais aspectos relacionados à morbidade e à mortalidade dos ferimentos cardíacos.. MÉTODOS: Estudo retrospectivo de 102 doentes com lesão cardíaca, atendidos nos dois prontos socorros de Manaus (Pronto Socorro Municipal 28 de Agosto e Hospital Pronto Socorro Dr. João Lúcio P. Machado) no período de janeiro de 1998 a junho de 2006. RESULTADOS: Dos 102 doentes, 95,1% eram homens; a média de idade foi 27 anos; ferimentos por arma branca representaram 81,4% dos casos, contra 18,6% por arma de fogo; cardiorrafia foi realizada em 98,1% dos casos. As câmaras cardíacas atingidas foram: VD: 43,9% (36,2% isoladamente e 7,7% associada a outras câmaras); VE: 37,2%; AD: 8,5% e AE: 10,4%, com mortalidades específicas de 21%, 23%, 22% e 45%, respectivamente. Lesões de duas câmaras associadas alcançaram mortalidade de 37,5%, sendo 20% para VD+AD, 100% para VD+VE e zero para VD+AE. O pulmão correspondeu a 33,7% de 89 lesões associadas. Os tempos médios de cirurgia e de internação foram de 121 minutos e 8,2 dias, respectivamente. Cerca de 22,5% complicaram representando 41 complicações. A mortalidade foi 28,4%. Lesões grau IV e V corresponderam a 55% e 41% dos casos, com mortalidade específica de 26% e 15%, respectivamente. Todos os doentes com lesão grau VI morreram. CONCLUSÃO: O ferimentos cardíacos por arma branca estiveram associados a menor mortalidade, as lesões cardíacas grau IV estiveram associadas à maior mortalidade e um menor tempo operatório esteve associado à maior gravidade e mortalidade.
OBJECTIVE: To evaluate the forms of treatment employed to heart injuries and the main aspects related to their morbidity and mortality. METHODS: A retrospective study of 102 patients with cardiac injuries treated in the two emergency rooms in Manaus (Dr. John Lucio Pereira Machado Emergency Hospital and August 28 County Emergency Hospital) from January 1998 to June 2006. RESULTS: Of the 102 patients, 95.1% were men; mean age was 27 years; stab wounds accounted for 81.4% of cases and gunshot wounds for 18.6%; cardiorrhaphy was performed in 98.1% of cases. The heart chambers affected were: Right Ventricle (RV): 43.9% (36.2% isolated and 7.7% associated with other chambers); Left Ventricle (LV): 37.2%; Right Atrium (RA): 8.5%; and Left Atrium (LA): 10.4%; specific mortalities were of 21%, 23%, 22% and 45%, respectively. The mortality injuries to two associated chambers was 37.5%, 20% being for RA + RV, 100% for RV + LV, and zero for RV + LA. The lung accounted for 33.7% of the 89 associated lesions. Mean time of surgery and hospital stay were 121 minutes and 8.2 days, respectively. About 22.5% of patients displayed 41 complications. The mortality rate was 28.4%. Lesions grade IV and V corresponded to 55% and 41% of cases, with specific mortality of 26% and 15%, respectively. All patients with grade injuries VI died. CONCLUSION: Cardiac stab wounds were associated with lower mortality, cardiac lesions grade IV were associated with higher mortality and a shorter operative time was associated with greater severity and mortality.