Multiple sclerosis (MS) is a demyelinating disease and is considered the most debilitating neurological disorder among young adults. Sudden deafness has been reported in MS patients. This article describes cases of sudden deafness related to acute bouts in MS patients. A survey was conducted using 405 records of MS patients attended to at a reference center in the city of Rio de Janeiro between 2011 and 2012 to identify cases of sudden deafness. Seven patients were identified, 6 with a relapsing-remitting course and 1 with progressive disease at onset. Five patients had unilateral deafness and 2 bilateral. The recovery was complete in 4 and partial in 1, and there was no recovery in 2 patients. It was not possible to establish a topographical correlation between deafness and brainstem lesions. Audiometric examinations revealed severe hearing loss during the bout and recovery of hearing in 5 cases after remission.
Investigar se a exposição a pacientes com COVID-19 poderia alterar o desempenho atencional de funcionários do Hospital Universitário Gaffrée & Guinle. Método: Um teste computadorizado de atenção visual foi aplicado em 161 funcionários. Após os critérios de exclusão (uso de medicação psicotrópica), 124 funcionários foram divididos em 2 grupos: Baixa ou nenhuma exposição semanal e alta exposição semanal a pacientes com COVID-19. Resultados: O grupo com alta exposição apresentou piora significativa na atenção sustentada (p<5%). Conclusão: O pior desempenho na atenção sustentada pode refletir lapsos atencionais, o que poderia aumentar o risco de acidentes de trabalho no grupo de funcionários que trabalham diretamente com pacientes infectados pelo SARS-CoV-2. Palavras-chave: atenção, variabilidade do tempo de reação, COVID-19.
Poster PresentationsP255 POSTERS recent clinical experience of patients with epistaxis and discussed important lessons for the management of cases of epistaxis.Method: Between 2005 and 2009, 1304 patients with epistaxis were treated at our department. There were 795 men and 509 women. Mean age was 57 years (range, 0-99 years). Clinical features: situations at the first visit; pathogenesis; bleeding points; methods of treatments; and clinical courses were retrospectively investigated.Results: The 700 patients (54%) first visited in the nighttime. The most common condition was hypertension in 388 patients (30%) followed by cardiovascular disease in 262 patients (20%). The 630 patients (48%) were on medication with hypotensors and/or antithrombotic drugs. Kiesselbach's plexus was the mostly observed, as it was observed in 679 patients (52%). In 225 patients (17%), bleeding point was not confirmed. The 424 patients (33%) were primarily treated by anterior packing, followed by electrocauterization in 365 patients (28%). Re-bleedings within 14 days after the primary treatments were found in 181 patients (14%). Hospitalized surgical treatments were required in 3% (6/181 patients).Conclusion: Outpatient therapy is usually enough to arrest hemorrhage in major cases. However, we have encountered patients with repeating arterial pulsing bleedings who require emergent hospitalized surgical therapy. Risk of re-bleeding within a day should be considered if patients had uncertain bleeding point and circulatory diseases.Objective: Nasolacrimal duct obstruction is a common change clinically manifested by the presence of epiphora and/or dacryocystitis. The objective is to analyze the technique and evaluate the success of endoscopic endonasal dacryocystorhinostomy to remove obstructions in the lacrimal ducts, using the same surgical technique for all cases.Method: This is a retrospective study. All 17 surgeries were performed from May 2006 to January 2011. Variables of interest were age, gender, duration, clinical presentation, etiology, surgical technique, use of silicone tubes, complications, and postoperative success. Successful surgery: absence of symptoms and tear flow after 7 months of follow-up.Results: Although drug therapy may resolve the symptoms, the definitive approach consists of surgical procedure to restore patency of the lacrimal drainage system. We noticed that females were predominant (70.59%). There were 11 women, 1 girl, and 5 boys ages 3 to 71 years (average age range, 40.11 years) submitted to surgery performed by unciform process incision and posterior flap of lacrimal sac. The most involved side was the right (n = 11). Etiology was idiopathic, and the most predominant clinic was dacryocystitis. Silicone tube was used in 2 cases. We obtained a primary success of 94.11%. Complication: major bleeding in 1 case (anterior tamponade).Conclusion: Primary success rate in most cases. Endoscopic surgery is a safe technique with excellent results for nasolacrimal duct obstruction. It is an excellent surgical option for...
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