ABSTRACT Epiphrenic diverticulum is a rare disease associated with esophageal motor disorders that is usually asymptomatic and has a well-established surgical indication. We report a case of giant epiphrenic diverticulum in a 59-year-old symptomatic woman who was diagnosed after underwent complementary exams. Because of her symptoms, the surgical treatment was chosen, and esophageal diverticulectomy was performed along with laparoscopic cardiomyotomy and anterior partial fundoplication.

ABSTRACT Duchenne muscular dystrophy is the most common muscle disease found in male children. Currently, there is no effective therapy available for Duchenne muscular dystrophy patients. Therefore, it is essential to make a prenatal diagnosis and provide genetic counseling to reduce the birth of such boys. We report a case of preimplantation genetic diagnosis associated with Duchenne muscular dystrophy. The couple E.P.R., 38-year-old, symptomatic patient heterozygous for a 2 to 47 exon deletion mutation in DMD gene and G.T.S., 39-year-old, […]

ABSTRACT Hereditary hyperferritinemia-cataract syndrome is an autosomal dominant genetic disorder associated with mutations in the 5’UTR region of the ferritin light chain gene. These mutations cause the ferritin levels to increase even in the absence of iron overload. Patients also develop bilateral cataract early due to accumulation of ferritin in the lens, and many are misdiagnosed as having hemochromatosis and thus not properly treated. The first cases were described in 1995 and several mutations have already been identified. However, this […]

ABSTRACT Germ cell tumors are rare neoplasms that mostly occur in the gonads, although they can also affect other body sites, especially the anterior mediastinum (50 to 70% of all extragonadal germ cell tumors). We report a case of a primary mediastinal yolk sac tumor, a rare and aggressive germ cell tumors subtype. This was a 38-year-old man who was admitted to Hospital do Servidor Público Estadual “Francisco Morato de Oliveira”, complaining about dyspnea and dry cough for 1 year. […]

A 13-year-old patient was referred for surgical treatment of scoliosis. Her neurological examination revealed the complete loss of horizontal eye movements with normal vertical gaze, suggesting diagnosis of horizontal gaze palsy and progressive scoliosis. The magnetic resonance imaging revealed a hypoplastic pons and medulla with a prominent midline cleft, therefore resulting in characteristic “butterfly” configuration.() The tractography showed absence of major crossing pathways within the pons and midbrain, and normal interhemispheric connections in the corpus callosum (). Surgical treatment for […]

A 45-year-old woman sought ophthalmologic care complaining about a sudden visual acuity on her right eye and anisocoria. She denied previous comorbidities and traumas. Upon examination, her ocular motility was normal and no ptosis was seen. Slit-lamp biomicroscopy and fundoscopy exams were normal. The mydriasis of the right eye, with consensual light reflex of the left eye, did not show changes ( ). The patient, when questioned about the use of medication, reported the use on her face, in the […]

Patients are the same all over the world. Evidence is the same in the entire world. However, care policies are not the same. This is impossible to understand and unacceptable, since there is no different evidence for public and private care; it is not a matter of being capitalist or socialist, of presence or distribution of money; it is the fight against consumerist, untruthful and voracious capitalism, encouraging licit “robbery”; it is an issue of equity and ethics; of assured […]

By and large, Medicine and sciences only advance due to new ideas, which should be tested according to academic standards to be accepted. It is estimated that out of every 100 new and creative ideas, few will effectively give some contribution and lead to improvement. However, remembering Thomas Alva Edison “There’s a way to do it better – find it!”() Therefore, new ideas should not be despised, a priori, as long as they are logic and consistent. The article under […]

ABSTRACT Objective: To describe our initial experience with a novel approach to follow-up and treat gastroschisis in “zero minute” using the EXITlike procedure. Methods: Eleven fetuses with prenatal diagnosis of gastroschisis were evaluated. The Svetliza Reductibility Index was used to prospectively evaluate five cases, and six cases were used as historical controls. The Svetliza Reductibility Index consisted in dividing the real abdominal wall defect diameter by the larger intestinal loop to be fitted in such space. The EXIT-like procedure consists […]

ABSTRACT Objective: To evaluate the frequency of polymorphisms in the vascular endothelial growth factor (VEGF) gene, as well as to identify a potential risk haplotype among the polymorphic regions in this gene in patients with disc degeneration and in the Control Group. Methods: This study analyzed a total of 217 individuals distributed into the Disc Degeneration and Control Groups. Peripheral blood was collected from all patients to detect VEGF gene polymorphisms identified by qPCR (rs699947, rs1570360, rs2010963, rs833061 and rs3025039). […]

ABSTRACT Objective: To identify factors associated with not attempting resuscitation. Methods: A cross-sectional study conducted at the emergency department of a teaching hospital. The sample consisted of 285 patients; in that, 216 were submitted to cardiopulmonary resuscitation and 69 were not. The data were collected by means of the in-hospital Utstein Style. To compare resuscitation attempts with variables of interest we used the χ2 test, likelihood ratio, Fisher exact test, and analysis of variance (p

ABSTRACT Objective: To analyze the association between active commuting and blood pressure in adolescents. Methods: This is a cross-sectional study with high school students from public education network in the state of Pernambuco, Brazil. Data from 6039 students (14 to 19 years) were collected using a questionnaire. “Physically inactive” were considered those who reported not to walk or ride a bicycle to and from school on any day of the past week, and/or those who, regardless of the weekly frequency […]

ABSTRACT Objective: To verify agreement between estimative of predicted resources using the adapted Emergency Severity Index and the real amount of resources used by patients. To analyze the variables number of years since graduation, years of work experience and years of experience in emergency services especially with accurate anticipation of resources need. Methods: This retrospective analytical study with a quantitative approach included 538 medical records of patients assisted by 11 triage nurses. Data collected were related to assistances carried out […]

ABSTRACT Objective: To verify the profile of elderly followed up by Family Health Strategy teams and the influence of self-reported chronic diseases on demographic variables, describing self-perception and satisfaction with quality of health. Methods: This is a cross-sectional population- based study carried out with 301 elderly residents in two areas of a city in southern Brazil. Data were collected through a questionnaire based on the Health, Well-Being, and Aging Study adapted by researchers, and a playful scale to assess satisfaction […]

ABSTRACT Objective: To analyze which abnormalities in body composition (obesity, sarcopenia or sarcopenic obesity) are related to reduced mobility in older people aged 80 years and older. Methods: The sample included 116 subjects aged 80 years and older. The body composition was measured using dual-energy X-ray absorptiometry (DXA) and mobility was assessed by motor tests. The χ2 test was used to analyze the proportion of older people with sarcopenia, obesity and sarcopenic obesity based on sex as well as to […]

ABSTRACT Objective: To evaluate the gene expression of beta-trace protein in urine of diabetic patients, with no reduction in glomerular filtration rate, which was defined as below 60mL/min/1.73m2. Methods: Type 2 diabetes mellitus patients were recruited, and a group of non-diabetic individuals served as control. Beta-trace protein gene expression was analyzed by quantitative PCR. Blood samples were collected to establish glucose levels and baseline kidney function. Accuracy was analyzed using ROC curves. Results: Ninety type 2 diabetes mellitus patients and […]

ABSTRACT Objective: To evaluate the clinical response of patients with symptoms of genitourinary syndrome of menopause after application of microablative fractional radiofrequency in the vagina and vaginal introitus. Methods: Fourteen patients with symptoms of genitourinary syndrome of menopause underwent three applications of microablative fractional radiofrequency with a 30-day interval, using the Wavetronic 6000HF-FRAXX device and a fractional vaginal electrode. The questionnaires World Health Organization Quality of Life (for quality of life evaluation), Female Sexual Function Index and Quality of Life […]

ABSTRACT Objective: To analyze the quality and quantity of data in the questionnaires and in request forms for magnetic resonance imaging. Methods: This retrospective study was conducted with data from 300 medical records. The research used the following data from the questionnaires: patient age, reason for the magnetic resonance imaging, reason for placing the breast implant, report of any signs or symptoms, time elapsed since surgery to place the current breast implant, replacement implant surgery, chemotherapy, and/or radiation therapy treatments. […]

ABSTRACT Objective: This article presents the first series of robotic single-port hysterectomy cases performed at a hospital in Brazil. Methods: From November 2014 to October 2016, 11 patients were indicated to undergo, and nine of them were submitted to single-port hysterectomy using da Vinci Single-Site® platform. However, in two patients, due to multiple previous abdominal surgeries, large uterine volume, and/or a uterus with no mobility, a pneumoperitoneum was performed with a Verres needle, and the pelvic cavity was assessed using […]

ABSTRACT Anaphylaxis is a severe, life-threatening generalized or systemic hypersensitivity reaction that requires rapid and adequate care. This study aimed to obtain an integrated view of the level of physicians’ knowledge related with treatment of anaphylaxis in studies published within the last 5 years. Sixteen studies were found and four points were identified as of the great interest to the authors: (1) emergency pharmacological treatment, (2) epinephrine auto-injectors prescription, (3) knowledge of the main signs of anaphylaxis, and (4) admission […]