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Navegando por Palavras-chave "Case reports"

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Allergic proctocolitis: the clinical evolution of a transitory disease with a familial trend. Case reports
(Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2013-06-01) Fagundes-neto, Ulysses [UNIFESP]; Ganc, Arnaldo José [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital Israelita Albert Einstein
Allergic colitis is a clinical manifestation of food allergy during the first months of life. It is estimated that genetic factors play a role in the expression of this allergic disease. This case report described the clinical progress of infants who were cousins from two distinct family groups with allergic colitis. Five infants under six months of age and of both sexes were studied, with a diagnosis of allergic colitis characterized clinically and histologically by (1) rectal bleeding; (2) exclusion of infectious causes of colitis; (3) disappearance of symptoms after elimination of cow's milk and dairy products from the child's and/or the mother's diet. Patients were submitted to the following diagnostic investigation: complete blood count; stool culture; parasitologic examination of stools; rectoscopy or colonoscopy; and rectal biopsy. Patient age varied from 40 days to six months; three were males. All patients presented with complaints of intense colic and rectal bleeding. The colonoscopy showed presence of hyperemia of the mucosa with microerosions and spontaneous bleeding upon the procedure. Microscopy revealed the existence of colitis with eosinophilia >20 e/HPF. Patients were treated with a hypoallergenic formula and showed remission of symptoms. After one year of age, all were submitted to an oral challenge with a milk formula and presented food tolerance. Allergic colitis is a disease with evident genetic inheritance and a temporary character.
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Anestesia congênita de córnea: relatos de casos
(Conselho Brasileiro de Oftalmologia, 2012-06-01) Lana, Flávia Pelinsari [UNIFESP]; Oliveira, Renato Correa Souza De [UNIFESP]; Vieira, Ana Carolina Cabreira [UNIFESP]; Araújo, Maria Emília Xavier Santos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Case series of nine patients with congenital corneal anesthesia, six of them showed systemic changes in association with the ocular status. Three patients were submitted to electromyography, two showed isolated bilateral ophthalmic ramus alteration. Two patients had initial visual acuity better than 20/60 and six had final best corrected visual acuity better than 20/60 at the last visit. All of them were treated surgically and developed cornea opacities of variable sizes. Treatment of corneal congenital anesthesia must be performed as soon as possible to avoid corneal opacification. Systemic investigation, close follow-up and preparing the family for longterm and multidisciplinary approach are crucial to maintain the ocular health.
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Apophyseal ring fracture associated with two levels extruded disc herniation: case report and review of the literature
(Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2014-04-01) Alvarenga, José Alexandre Lopes da Silva; Ueta, Fernando Tadashi Salvioni; Del Curto, David [UNIFESP]; Ueta, Renato Hiroshi Salvioni; Martins, Delio Eulalio; Wajchenberg, Marcelo [UNIFESP]; Puertas, Eduardo Barros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Apophyseal ring fractures are rare injuries that may be associated with lumbar disc herniation in young patients. We report a unique case in the literature of a 15-year-old male patient who played football and was admitted at our service complaining of sciatica radiating into the left leg. An apophysial ring injury of L5 vertebral body was observed. This injury caused two extruded disc herniation in adjacent levels. Surgical procedure was indicated after failure of conservative treatment.
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Avaliação dinâmica e interdisciplinar na deficiência auditiva em ambulatório público: relato de caso
(Sociedade Brasileira de Fonoaudiologia, 2009-01-01) Gomes-Machado, Maria Luiza [UNIFESP]; Soares, Alexandra Dezani [UNIFESP]; Chiari, Brasilia Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Associação de Pais e Amigos dos Excepcionais; Fundação para o Estudo e Tratamento das Deformidades Crânio Faciais
The aim of this study was to describe the effects of the interdisciplinar dynamic clinical assessment in a case attended at the Research Ambulatory of Language in Hearing Disorders of the São Paulo Hospital - Federal University of São Paulo. It is describe the case of a 26-year-old woman who presented sudden bilateral deafness, as a result of Cogan's syndrome - which also affects the vision. When the intervention process began, the patient had restricted orofacial reading, difficulty to communicate with her family, social isolation and depressive symptoms. The dynamic assessment based on interactivity and humanistic listening provided conditions for the patient to improve her communication, self-concept and social interaction. From this perspective, it was noticed that, with only ten sessions of intervention, therapeutic effects were operated, therefore breaking the classic assessment/intervention dichotomy at different moments.
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Biomicroscopia ultra-sônica em esclerectomia profunda: relato de caso
(Conselho Brasileiro de Oftalmologia, 2008-06-01) Villas-bôas, Flávia; Allemann, Norma [UNIFESP]; Morales, Maira Saad Avila; Omi, Carlos Akira [UNIFESP]; Instituto Brasileiro de Oftalmologia e Prevenção à Cegueira; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
Case report of a woman with the diagnosis of primary open-angle glaucoma who was submitted to a successful surgical procedure of deep sclerectomy in the right eye. In the postoperative period, at month 3, the surgical procedure was evaluated with ultrasound biomicroscopy (UBM) utilizing two distinct equipments (UBM 840-Zeiss; UBM-VUMAX-Sonomed), with 50-MHz transducers. The diagnostic method of ultrasound biomicroscopy can be utilized as a non invasive method to evaluate the internal architecture of the eye at the topography of deep sclerectomy. It allows to identify the anterior segment structures, their anatomical relationship, and also the intact trabecular-Descemet membrane and the intrascleral space. Ultrasound biomicroscopy showed to be useful in evaluating postoperative status of the surgical procedure.
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Canaliculite: relato de caso e conduta
(Sociedade Brasileira de Oftalmologia, 2011-12-01) Lorena, Silvia Helena Tavares [UNIFESP]; Silva, João Amaro Ferrari [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The canaliculitis is a rare infection and chronicle lachrymal pathology, whose commoner etiology is Actinomyces israelli ( bacteria anaeroby positive gram). This pathology does not present cure espontany The diagnosis differential with is done: Recurring chronic conjunctivitis, blefarity and hordeoly. The definitive treatment is the surgical (canaliculotomy)), being accomplished under location anesthetizes.
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A case of anterior internal ophthalmomyiasis: case report
(Conselho Brasileiro de Oftalmologia, 2006-10-01) Saraiva, Vinicius da Silveira; Amaro, Miguel Hage [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Burnier Júnior, Miguel Noel Nascente [UNIFESP]; McGill University Health Centre The Henry C. Witelson Ophthalmic Pathology Laboratory and Registry; Universidade Federal de São Paulo (UNIFESP)
A case of anterior internal ophthalmomyiasis is described. A 27-year-old female from Northern Brazil presenting with anterior uveitis and vitritis had a fly larva surgically removed from the anterior chamber of the left eye. The species was Cochliomyia hominivorax. The larva was covered by macrophages and foreign body giant cells characterizing a foreign body granulomatous reaction.
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Congenital dacryocystocele: diagnosis using ante and post-natal ultrasonography
(Conselho Brasileiro de Oftalmologia, 2014-08-01) Machado, Marco Antonio de Campos [UNIFESP]; Abreu Junior, Luiz de; Silva, João Amaro Ferrari [UNIFESP]; Allemann, Norma [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Grupo Fleury Setor de Radiologia
Congenital dacryocystocele is an unusual type of nasolacrimal obstruction. Treatment with antibiotics or surgical removal is practiced to reduce the risks of infection (acute dacryocystitis) and potentially lethal septicemia. Here, we report a case of congenital dacryocystocele, antenatal ultrasonographic diagnosis (intrauterine), and postnatal reassessment.
Acesso aberto (Open Access)
Conservative treatment in isolated penetrating cervical esophageal injury: case report
(Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2012-12-01) Epstein, Marina Gabrielle; Costa, Sara Venoso; Carvalho, Filipe Gusmão; Pasquetti, Aline Fioravanti; Arsie Neto, Herico; Pedroso, Pamella Tung; Simões, Cesar Augusto; Pinus, Jaques [UNIFESP]; Ribeiro Junior, Marcelo Augusto Fontenelle [UNIFESP]; Universidade de Santo Amaro General Surgery Residency Program; Hospital Municipal Dr. Moyses Deutsch Emergency Service; Universidade de Santo Amaro; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Hospital Municipal Dr. Moyses Deutsch; Hospital Municipal Dr. Moyses Deutsch General Surgery Service
Non-iatrogenic traumatic cervical esophageal perforations are usually hard to manage in the clinical setting, and often require a careful and individualized approach. The low incidence of this particular problem leads to a restricted clinical experience among most centers and justify the lack of a standardized surgical approach. Conservative treatment of esophageal perforation remains a controversial topic, although early and sporadic reports have registered the efficacy of non-operative care, especially following perforation in patients that do not sustain any other kind of injuries, and who are hemodynamically stable and non-septic. We report a case of a patient sustaining a single cervical gunshot wound compromising the cervical esophagus and who was treated exclusively with cervical drainage, enteral support and antibiotics.
Acesso aberto (Open Access)
Dacriocistite aguda: relato de 2 casos
(Sociedade Brasileira de Oftalmologia, 2011-02-01) Lorena, Silvia Helena Tavares [UNIFESP]; Silva, João Amaro Ferrari [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The adult lacrimal obstruction can be congenital or acquired. In the case of the acquired form, the etiology classifies in not-specific (it involves the coating epithelium and/or the vascular plexus submucosae of the lacrimal duct) and specific (infections, inflammations, tumours and iatrogenies). The diagnosis is established by means of the anamnesis and clinical evaluation based on semiology of the lacrimal sack. The patients with lacrimal obstruction present epiphora, acute pains and swelling, mostly in the region of the lacrimal sack causing ectasye of various degrees whichn culminate with cutaneous fistulization. The image exams routinely proposed for dacryocysto-graphy, which represent a great help in showing the best surgical technique for dacryocystorhinostomy, will be indicated as soon as the acute inflammatory state is treated.
Acesso aberto (Open Access)
Dacriocistocele congênita: relato de caso e conduta
(Sociedade Brasileira de Oftalmologia, 2014-08-01) Lorena, Silvia Helena Tavares; Gonçalves, Eliana Domingues; Silva, João Amaro Ferrari; Universidade Federal de São Paulo (UNIFESP)
A dacriocistocele representa uma rara anomalia congênita da região medial da órbita, causada pela obstrução distal (ao nível da válvula de Hasner) e proximal (ao nível da válvula de Rosenmüller) da via lacrimal, com subsequente dilatação do saco lacrimal. Recebe o nome de mucocele, quando seu conteúdo representa muco, ou amniocele, quando o seu conteúdo é preenchido por fluido amniótico. Acomete somente 0.1% das crianças, com obstrução do ducto lácrimonasal, sendo comumente unilateral e mais frequente no sexo feminino e com predisposição familiar. O diagnóstico é realizado pelas características clínicas: lesão cística tensa, abaixo do tendão cantal medial, de coloração azulacinzentada, rósea ou vermelha acompanhada por epífora desde o nascimento. No entanto podemos utilizar exames de imagem para diagnosticar esta anomalia congênita tais como: tomografia computadorizada, ressonância magnética e ultrassonografia.
Acesso aberto (Open Access)
Danish type gelsolin-related amyloidosis in a Brazilian family: case reports
(Conselho Brasileiro de Oftalmologia, 2011-08-01) Solari, Helena Parente; Ventura, Marcelo Palis; Antecka, Emilia; Belfort, Rubens Junior [UNIFESP]; Burnier Júnior, Miguel Noel Nascente [UNIFESP]; Universidade Federal Fluminense; McGill University The Henry C. Witelson Ocular Pathology Laboratory; Universidade Federal de São Paulo (UNIFESP)
Familial amyloidosis of the Finnish type (FAF) is an autosomal dominant form of systemic amyloidosis showing marked geographic clustering in Finland. The disease is caused by a point mutation, 654G-A, in the gelsolin gene. The Danish-subtype of FAF has been previously described in three families, the patients present clinical findings similar to FAF, and the mutation 654G-T in the gelsolin gene. Three members from two generations of the same family, with familial amyloidosis, were screened for mutations in the GSN gene. Genomic DNA was extracted from peripheral blood lymphocytes and the polymerase chain reaction (PCR) was carried out under standard conditions, using appropriate primers. Sequence analysis showed the presence of a G to T transition at nucleotide 654 of the gelsolin gene. This is the first report of gelsolin-related familial amyloidosis in a Brazilian family, and the result is particularly significant as this pedigree presents an unusual mutation, described previously in three families, with no known Finnish ancestors (Danish type).
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Direct cyclopexy surgery for post-traumatic cyclodialysis with persistent hypotony: ultrasound biomicroscopic evaluation
(Conselho Brasileiro de Oftalmologia, 2014-01-01) Murta, Fabiola [UNIFESP]; Mitne, Somaia [UNIFESP]; Allemann, Norma [UNIFESP]; Paranhos Junior, Augusto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Cyclodialysis is a relatively rare condition usually caused by ocular injury; however, it can also be caused iatrogenically during intraocular surgery. Hypotony maculopathy is the most important complication and the primary reason for visual loss. Clinical diagnosis using gonioscopy may be difficult, and ultrasound biomicroscopy (UBM) can be an alternative. There are different kinds of treatments, and the optimal one remains controversial. Here we describe a case of traumatic cyclodialysis with persistent ocular hypotony treated by direct cyclopexy, as illustrated by UBM performed before and after surgery.
Acesso aberto (Open Access)
Enfisema orbitário compressivo após asseio nasal: relato de caso
(Conselho Brasileiro de Oftalmologia, 2009-04-01) Furlani, Bruno de Albuquerque [UNIFESP]; Diniz, Bruno [UNIFESP]; Bitelli, Luis Gustavo; Martins, Elisabeth Nogueira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Orbital emphysema is the abnormal presence of air in the orbit. Occurrence in the absence of orbital fracture is rare. We report a case of a 40-year-old female presenting unilateral orbital emphysema after vigorous nose blowing. She developed sudden visual loss as a result of elevated intraocular pressure and urgent treatment was required. She underwent an orbital decompression, performed using a 24-gauge needle puncture adjacent to the supraorbital notch. After treatment, she reported considerable decrease of symptoms.
Acesso aberto (Open Access)
Ensaio clínico de medicamento para controle da fissura em usuários de crack sob cuidados na RAPS: um estudo de caso
(Universidade Federal de São Paulo (UNIFESP), 2019) Jezierski, Marta Ana [UNIFESP]; Rios, Ademar Arthur Chioro dos [UNIFESP]; http://lattes.cnpq.br/9454572596499303; http://lattes.cnpq.br/4844930507147288; Universidade Federal de São Paulo (UNIFESP)
Introduction: According to data from the Fundação Oswaldo Cruz (Fiocruz) on crack use in Brazil, only 0.5% of the Brazilian population use crack cocaine regularly. The motivation to start using reported by 29.2% of the interviewees was related to family problems, important affective losses and social pressure. As scientific studies on the subject can be carried out through different types of research, in 2016, a randomized clinical trial (RCT) was proposed among crack users under Mental Health Services (MHS) care to investigate the efficacy of a drug designed to relieve fissure (abstinence crisis) by crack. However, in the course of its development, the study encountered barriers and faced so many biases that it became completely unfeasible. Objectives: The objective of this doctoral was to carry out a case report on the RCT from the identification and discussion of the critical nodes of the originally research design, the challenges related to care with crack users, as well as the problems and challenges related to MHS as a space to produce scientific research. Methods: The Consolidated Standards of Reporting Trials (Consort, 2010) was used for the critical analysis of the RCT. A Bibliographic Review was performed for the analysis on the subjects to whom the potential benefits of the drug’s use were destined and the MHS structure for the care of these subjects. Results: The critical analysis carried out with Consort, showed that the proposed RCT failed to fulfill 17 of the 25 evidence-based requirements set out in the guideline. The RCT sample should have 150 patients allocated in 2 groups (control and experimental), but only 5 participants concluded the protocol, and it is not possible to validate the RCT. The methodological biases were basically derived from the choice and vulnerability of the study population. Conclusion: This critical analysis invites a reflection on the difficulties and limits involved in conducting an RCT in the MHS with population samples under high vulnerability. The development and analysis of research should consider mapping the imperceptible networks developed by drug users and other street individuals beyond the formal points of the MHS and taking as a starting point the user in their life context, relationships and treatment, having as guiding the Individual Therapeutic Project.
Acesso aberto (Open Access)
Essential trichomegaly: case report
(Conselho Brasileiro de Oftalmologia, 2013-02-01) Rossetto, Julia Dutra [UNIFESP]; Nascimento, Heloisa Moraes do [UNIFESP]; Muccioli, Cristina [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The present study reports two cases of symptomatic essential trichomegaly. Trichomegaly may develop in various diseases, including anorexia nervosa, hypothyroidism, pregnancy, pretibial myxedema, systemic lupus erythematosus, vernal keratoconjunctivitis, and uveitis. The exact incidence trichomegaly is unknown, and the condition remains sporadically reported. Two cases of symptomatic trichomegaly without any associated systemic disorder are presented in this paper.
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Fundus flavimaculatus e neovascularização subretiniana: relato de caso
(Conselho Brasileiro de Oftalmologia, 2005-04-01) Aragão, Ricardo Evangelista Marrocos De; Barreira, Ieda Maria Alexandre [UNIFESP]; Holanda Filha, Joana Gurgel; Universidade de Regensburg; Universidade Federal do Ceará Hospital Universitário Walter Cantídeo; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Ceará Hospital Universitário Walter Cantídeo Serviço de Oftalmologia
Fundus flavimaculatus is a progressive, bilateral, hereditary retinal dystrophy characterized by ill-defined, yellowish, pisciform flecks at the level of the retinal pigment epithelium. Since the disease process is at level of the retinal pigment epithelium, it is not surprising that subretinal macular neovascularizations might occur. Nevertheless, they have been rarely reported as complications of the disease. The following report describes a case of fundus flavimaculatus that progressed with blurred vision by a subretinal macular neovascularization.
Acesso aberto (Open Access)
Hepatotoxicidade induzida por Hypericum perforatum com possível associação a copaíba (Copaifera langsdorffii Desf): relato de caso
(Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2014-09-01) Agollo, Marjorie Costa; Miszputen, Sender Jankiel; Diament, Jayme; Universidade Federal de São Paulo (UNIFESP); Hospital Israelita Albert Einstein
We report a case of liver damage in an elderly patient after the use of herbal products of Hypericum perforatum and copaiba (Copaifera langsdorffii Desf). Hepatotoxicity related to Hypericum perforatum is anecdotally known, but for copaiba, widely used as anti-inflammatory, there is just experimental data in the national literature. This report aimed to draw attention to the possible toxic effects of this association as well as to the clinical recovery of the patient after discontinuing their use. There is a tendency to suspect of the action of drugs to justify a non-viral acute liver injury, because of the large number of drugs responsible for hepatotoxicity. There are experiments and clinical reports in the literature describing some herbal products, including Hypericum perforatum, as the causative agents of this aggression, and are considered innocuous and used with no restrictions. We must remember that adverse reactions also occur with these substances; hence, they should be investigated when collecting the patient´s history, for leading to severe liver failure.
Acesso aberto (Open Access)
Hipertensão intracraniana com manifestações oculares associada ao uso de tetraciclina: relato de caso
(Conselho Brasileiro de Oftalmologia, 2005-10-01) Santos, Frederico Xavier Dos; Parolin, André [UNIFESP]; Lindoso, Elissandro Márcio Silva; Santos, Fernando Henrique Xavier; Sousa, Luciene Barbosa De [UNIFESP]; Hospital oftalmológico de Sorocaba; Universidade Federal de São Paulo (UNIFESP); Pontifícia Universidade Católica de Sorocaba
The authors describe a young female patient with intracranial hypertension associated with ocular manifestations, during treatment with tetracycline. This is a rare adverse effect described in the medication warnings, and in a few reported cases in the scientific literature.
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Importância do exame oftalmológico na doença de von Hippel-Lindau
(Sociedade Brasileira de Oftalmologia, 2009-08-01) Aragão, Ricardo Evangelista Marrocos de; Barreira, Iêda Maria Alexandre [UNIFESP]; Bezerra, Andreya Ferreira Rodrigues; Ramos, Régia Maria Gondim; Pereira, Felipe Bezerra Alves; Universidade de Regensburg; Universidade Federal do Ceará Hospital Universitário Walter Cantídio Departamento de Oftalmologia; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Ceará Hospital Universitário Walter Cantídio Serviço de Oftalmologia
Von Hippel-Lindau (VHL) disease is an autossomical, dominant inherited tumour syndrom. These tumours may include haemangioblastoma in the retina and central nervous system (CNS), renal cell carcinoma, phaeochromocytoma, islet cell tumours of the pancreas, cystadenoma in the kidney, pancreas, and epididymis. The most common symptoms include: loss of vision, raised intracranial pressure, neurological deficits, paroxysmal raised blood pressure and local pain. We report herein a 29-year-old man with visual loss and cerebellar haemangioblastoma that despite neurological manifestations the diagnosis of VHL was established after the ophthalmological examanination.