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PRES is a rare syndrome that must be suspected in every patient presenting neurologic symptoms in the course of immunosuppression. It can be induced by CSA and is totally reversible when the drug is rapidly withdrawn.

ObjectiveThe Hip Function Recovery Score questionnaire is an instrument that was developed for evaluating the functional recovery of patients over 60 years of age who undergo surgical treatment due to hip fractures. The objective of this study was to make a thorough transcultural translation of this questionnaire, with adaptation to the individual and cultural traits of the Brazilian population.MethodThis translation method consisted of initial translation, back translation, drafting of a consensual version and pretesting with comments invited. Subsequently, a final version was drawn up after making the necessary adjustments, without altering the semantics of the questions in the original text.ResultsThe consensual version was applied to thirty patients over the age of 60 years who had undergone surgical treatment due to hip fractures. However, some difficulties in understanding some words and expressions were observed, and these were then replaced with terms that were more easily understood. After the final version had been drawn up, this was applied to the same patients and full understanding was achieved among some of them, without altering the semantics of the questions of the original text.ConclusionThe transcultural translation of the Hip Function Recovery Score will have an immediate impact on functional evaluations on patients over 60 years of age who underwent surgery due to hip fracture. It will subsequently be possible for other Brazilian scientific studies to use this questionnaire, which has been standardized and adapted to Brazilian culture, in order to make comparisons between results, thereby enriching Brazilian scientific production.

Objectives: To evaluate PDE-5 inhibitors response in combination to hormonal replacement therapy in patients complaining of erectile dysfunction with low-normal serum testosterone and poor response to sildenafil citrate, vardenafil and tadalafil. Methods:We have been following 77 men with age between 28 to 88 (mean ± 59 years) years old with androgen deficiency and using hormonal replacement therapy since 2004. They were seen every month to check the Testosterone levels and see responses with PDE5 inhibitors answering the SHIM score. We decided to use Testosterone 1%, 2% and 3% gel and testosterone cypionate injections. All men had a clinical examination and blood drawn for hormonal profiles every month, the Prostate specific antigen level was included in males >40 years old with digital rectal examination. Results:The prevalence of men complaining with the symptoms of androgen deficiency was associated with erectile dysfunction and loss of libido. Most of these patients did not achieve a good erection before HRT with PDE5 inhibitors (sildenafil citrate, tadalafil or vardenafil). The libido changes dramatically after HRT and increases proportionally to testosterone level and response to PDE-5 inhibitors. Conclusions:We concluded that hormonal replacement therapy is necessary for achieving better erections, to improve the PDE-5 inhibitors response, sexual performance improvement, quality of life and even retarding the signals of elderly.