ABSTRACT Snakebites from the genus Bothrops account for up to 90% of venomous snakebites in Brazil. Among these species, Bothrops taeniatus is considered rare in Brazil, with only one reported case in the literature. Its venom has a strong hemorrhagic effect but lacks procoagulant activity, which can lead to significant variations in the neutralizing efficacy of anti-Bothrops serum. We describe the first case of severe envenomation by B. taeniatus with rapid recovery following the administration of anti-Bothrops serum in Brazil, […]

ABSTRACT This report presents a case of a 59-year-old male diagnosed with metastatic esophagogastric junction adenocarcinoma, who presented with mild dysphagia and vertigo. Brain magnetic resonance imaging initially showed no abnormalities. Upper gastrointestinal endoscopy revealed a vegetative lesion in the distal esophagus, and concurrent colonoscopy identified a laterally-spreading tumor in the transverse colon. Immunohistochemistry confirmed a poorly differentiated adenocarcinoma, suggesting an upper gastrointestinal origin. Further investigation of the worsening neurological symptoms led to the identification of leptomeningeal carcinomatosis via cerebrospinal […]

ABSTRACT Intestinal worm infections, referred to as helminthiases, represent a significant global health challenge, particularly in low- and middle-income countries. These infections affect millions of people and contribute to malnutrition, anemia, and impaired cognitive development, particularly in children. Nitazoxanide, first described in 1975, was initially developed as a veterinary anthelmintic. It has shown efficacy against various pathogens including Giardia lamblia, Entamoeba histolytica, and Cryptosporidium parvum. Recently, its use has expanded due to its observed in vitro activity against viruses, including […]

ABSTRACT Groove pancreatitis is a rare form of chronic pancreatitis that affects the anatomical area between the head of the pancreas, medial wall of the second part of the duodenum, and common bile duct, known as the groove area. We present the case of a 40-year-old female patient with recurrent acute abdominal pain, vomiting, inappetence, and weight loss over several months. Diagnostic imaging revealed obliteration of fat in the pancreaticoduodenal groove and densification of the adjacent adipose planes, along with […]

ABSTRACT Vulvar cancer, a rare gynecological malignancy, accounts for 3-5% of cases and is most commonly squamous cell carcinoma. Prognosis is poorer in cancers unrelated to human papillomavirus (HPV), often associated with chronic inflammation. We report the case of a 42-year-old woman from São Paulo, Brazil, who presented with a vulvar lesion initially misdiagnosed as an ingrown hair. Despite treatment, the lesion progressed, and subsequent evaluation revealed invasive squamous cell carcinoma. Biopsy confirmed HPV-independent disease, with immunohistochemistry demonstrating aberrant p53 […]

ABSTRACT Lower back pain and sciatica account for approximately 40% of work-related absences, with management options ranging from conservative measures, such as rest and analgesia, to surgical intervention. Lumbar epidural steroid injections and facet joint blocks are frequently used for both diagnostic and therapeutic purposes. While most complications are minor (2.4%-9.6%), severe events, including infection, hematoma formation, and spinal cord infarction, have been reported. This case presents a perineural hematoma manifesting as acute radiculopathy, necessitating urgent surgical decompression. The patient […]

ABSTRACT Lisdexamfetamine, a prodrug used to treat Attention Deficit/Hyperactivity Disorder in children, adolescents, and adults, is an inactive substance that is converted into its active form (dextroamphetamine) after being metabolized. This conversion primarily occurs in the bloodstream through enzymatic cleavage following active absorption from the gastrointestinal lumen. The active metabolite then stimulates the central nervous system by increasing the levels of dopamine and norepinephrine in the brain. It was discovered in 1996 by New River Pharmaceuticals and approved by the […]

ABSTRACT Lymphatic leakage after pelvic lymphadenectomy is a rare complication. Furthermore, in some cases, drainage is not possible or proves insufficient to resolve this complication. Therefore, more effective and minimally invasive interventional treatments are necessary. Accordingly, this case report presents a case of transafferent nodal embolization in a 50-year-old woman who underwent videolaparoscopic total hysterectomy with pelvic lymphadenectomy. The patient developed high post-surgery vaginal flow due to a lymphatic fistula, which was identified after intranodal lymphangiography and treated successfully via […]

ABSTRACT Platypnea-orthodeoxia syndrome, first described in 1949, is a rare clinical condition characterized by positional dyspnea and oxygen desaturation in the upright position that improves when lying down. Herein, we report the case of an 86-year-old patient who experienced episodes of dyspnea on assuming an upright position, which limited her daily activities. The patient’s oxygen saturation was 82% in the standing position and 91% in the supine position. During diagnostic investigation, a patent foramen ovale was identified using transesophageal echocardiography. […]

ABSTRACT Mammoplasty is commonly performed under epidural anesthesia combined with intravenous sedation; however, this carries a risk of dural puncture and post-dural puncture headache. Successful treatment is often achieved with opioids, non-steroidal anti-inflammatory drugs, and caffeine. When conservative treatment fails, an epidural blood patch should be performed; this procedure has a high resolution rate. We report the case of a patient who developed a post-dural puncture headache 25 days after elective breast implant replacement performed under thoracic epidural anesthesia combined […]