O coma mixedematoso (CM) é uma emergência endocrinológica rara, porém letal e consiste na expressão extrema do hipotireoidismo. Relatamos o caso de um paciente do sexo masculino, 51 anos, que abandonou tratamento do hipotireoidismo por 10 meses e evoluiu com sintomas de letargia, edema e intolerância ao frio que culminaram em insuficiência respiratória e coma. Apresentava também diagnóstico prévio de neurofibromatose. O diagnóstico precoce do coma mixedematoso aliado à instituição imediata do tratamento com levotiroxina e ao manejo adequado de complicações, como insuficiência respiratória, choque cardiogênico associado a swinging heart, insuficiências adrenal e renal agudas e sepse, permitiu a evolução favorável do quadro.

A 33-year-old male with right eye amaurosis and panhypopituitarism previously submitted to surgery and radiotherapy was admitted with a presumptive recurrence of a nonsecreting pituitary macroadenoma (the first diagnosis, in another service). Magnetic Resonance Imaging (MRI) confirmed an expansive solid isointense lesion in the posterior region of the sella with suprasellar component (Figure 1). After a new surgery, histological revealed granular cell tumor (GCT) (Figure 2).GCT of the CNS is rare 1.This report emphasizes the importance of this differential diagnosis in preoperatory for solid lesions with suprasellar component, homogeneous enhancement, and hyperattenuated on CT since they are more vascular and tend to bleed more than macroadenomas In the first surgical sample, the lesion showed morphological features essentially similar to those observed in the second specimen. Cells with cytoplasmic granules (A; Hematoxylin-eosin), which do not contain glycogen (B; Periodic Acid-Schiff with diastase digestion) and correspond to lysossomes (C: electron microscopy). In the first surgical sample, the lesion showed morphological features essentially similar to those observed in the second specimen.

Objectives:To evaluate aspects related to the psychiatric attendance in Campinas and population knowledge about mental disorders.Methods:Participants of a public event were invited to answer a questionnaire about sociodemographyc aspects and knowledge about mental health.Results:The 88 questionnaires showed that there was uniform distribution between sexes and that 50 % of subjects were between 41 and 65 years. The most people have concluded the primary and secondary school. About religion, 55,7 % were Catholics and 26,1% protestants. The study showed that 23% of the subjects have looked for a psychiatrist in last year, the most at primary care health, but only 4,35% said there was no psychiatrist for them. Beyond the psychiatrist, psychologists and spiritualists are looking to solve mental disorders. People consider suicide idea as a disorder that must be treated by psychiatrist more than the eating disorders. “Listen voices that do not exist” was considered as reason to look for psychiatrist, being an opinion more prevalent between Catholics than protestants (O.R = 1.67). The people with first or second grade think that spiritual works produce mental disorders more than those who are graduated. (OR=3.97). When the information about mental illness is TV the people have more chance to believe that spiritual works can produce mental disorders (OR=1.67).Conclusion:Psychiatric attendance is accessible for most people at primary health care in Campinas. The looking for psychiatrist comes with other professionals. The concept about mental disorders is influenced by level and source of information, sex and religion.