Os aneurismas, assim como o Infarto Agudo do Miocárdio (IAM), se apresentam como evolução aguda da aterosclerose. A incidência do aneurisma de aorta abdominal é de 2% a 4 %, dentre ao quais 10% a 13% têm múltiplos aneurismas, em segmentos diferentes da artéria. Foi realizado exame anatomopatológico macroscópico e microscópico em cadáver do sexo masculino, idoso, não obeso, proveniente do acervo de Laboratório de Anatomia Humana de Faculdade de Medicina. Foi constatada aterosclerose disseminada na aorta e seus ramos, além de aneurisma fusiforme abdominal infrarrenal associado a outros menores em mesmo vaso e aneurisma sacular na artéria comunicante anterior. Foram encontradas alterações renais e miocárdicas correspondentes à isquemia, ainda que na ausência de infarto ou aneurisma roto. Ressaltamos que a ocorrência concomitante de numerosos aneurismas atingindo vasos em diferentes cavidades corporais em um único cadáver não foi reportada anteriormente.
Background A 73-year-old male patient who had a history of Human Immunodeficiency Virus (HIV) infection for over 20 years was diagnosed with SARS-CoV-2 infection. Case presentation The patient was admitted to the Intensive Care Unit (ICU), where he remained for 25 days, due to a severe condition. Intubation, hemodialysis, and tracheostomy were necessary to maintain homeostasis. In addition to regular treatment with etravirine, dolutegravir, darunavir, and ritonavir for highly active antiretroviral therapy, the patient received tocilizumab, which showed a great recovery in the patient’s condition. Conclusion The patient had several risk factors, such as male gender, age > 70 years, and arterial hypertension. The use of tocilizumab was of great importance in the patient’s recovery since the drug increased his immune response, which is deficient, due to HIV infection.
An 88-year-old woman diagnosed with COVID-19 in Brazil presented with recurrent pneumothorax. She was under mechanical ventilation for 20 days because of acute respiratory distress syndrome (ARDS). Chest x-ray revealed right lung pneumothorax, which was treated with a pigtail chest tube leading to successful lung reexpansion. After 48 hours the patient developed an ipsilateral pneumothorax and a new tube thoracostomy under conventional chest tube under suction was performed and kept in place for 14 days. This brief report highlights that the conventional chest tube under suction procedures might be a good choice in Covid-19 patients.
To relate omphalocele and biliary atresia and investigate possible embryological correlations that justify the simultaneous occurrence. A female preterm newborn diagnosed as omphalocele; cesarean delivery, weight 2,500g, 46 XX karyotype. Initially, the newborn remained fasting and on parenteral nutrition, and enteral diet was introduced later, with good acceptance. On the 12 th day of life, the newborn presented direct hyperbilirubinemia, increased levels of liver enzymes and fecal acholia, with a presumptive diagnosis of biliary atresia. However, the ultrasound was inconclusive, due to anatomical changes resulting from omphalocele. A surgical approach was chosen on the 37 th day of life aiming to confirm diagnosis of biliary atresia and to repair omphalocele. During the surgical procedure, structural alterations compatible with biliary atresia were observed, later confirmed by pathological examination; a hepatoportoenterostomy was performed and the omphalocele was corrected. She evolved well in the postoperative period, with a decrease in direct bilirubin and liver enzymes, as well as resolution of fecal acholia, and was discharged in good clinical condition. This is a bizarre and extremely rare association, but the prognosis may be good when an early diagnosis is made and surgery performed, besides support and clinical management to prevent complications in the perioperative period. Although the pathogenesis of the diseases has not been fully defined yet, there is, to date, no direct relation between them. The association between omphalocele and biliary atresia is extremely uncommon, with only two published cases.
Background: A 73-years-old-man patient who had a history of Human Immunodefiency Virus (HIV) infection for over 20 years was diagnosed with SARS-CoV-2 infection.Case presentation: The patient was admitted to the Intensive Care Unit (ICU), where he remained for 25 days, due to a severe condition. Intubation, hemodialysis and tracheostomy were necessary to maintain homeostasis. In addition to regular treatment with etravirine, dolutegravir, darunavir and ritonavir for highly active antiretroviral therapy, the patient received To-cilizumab, which showed a great recovery in the patient's condition.Conclusion : The patient had several risk factors, such as: male gender, age> 70 years and hypertension. The use of To-cilizumab was of great importance in the patient's recovery, since the drug increased his immune response, which is deficient, due to HIV infection.
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