Acute pulmonary embolism (APE) is a major cause of pulmonary hypertension and death. We examined the effects of sildenafil on the hemodynamic changes caused by APE in anesthetized dogs. Sham-operated dogs (n = 3) received only saline. APE was induced by stepwise IV injections of 300 mum microspheres in amounts adjusted to increase mean pulmonary artery pressures by 20 mm Hg. Hemodynamic evaluation was performed at baseline, after APE was induced, and then after sildenafil 0.25 mg/kg (n = 8), or sildenafil 1 mg/kg + 0.3 mg . kg(-1) . h(-1) (n = 8) or saline (n = 9) infusions were started. Similar experiments were conducted to examine the effects of sildenafil in rat isolated perfused lung preparation. Plasma thiobarbituric acid reactive species were also determined in both studies to measure oxidative stress. Both doses of sildenafil reduced mean pulmonary artery pressures in dogs by approximately 8 to 16 mm Hg (both P < 0.05) and attenuated the increase in oxidative stress after APE. Mean arterial blood pressure remained unaltered after both doses of sildenafil. Sildenafil produced similar effects after APE in rat isolated perfused lung preparation. These findings indicate that IV sildenafil can selectively attenuate the increases in mean pulmonary artery pressures after APE, possibly through antioxidant mechanisms.

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OBJECTIVE:The aim of the present work is to analyze the differences and similarities between the elements of a conventional autopsy and images obtained from postmortem computed tomography in a case of a homicide stab wound.METHOD:Comparison between the findings of different methods: autopsy and postmortem computed tomography.RESULTS:In some aspects, autopsy is still superior to imaging, especially in relation to external examination and the description of lesion vitality. However, the findings of gas embolism, pneumothorax and pulmonary emphysema and the relationship between the internal path of the instrument of aggression and the entry wound are better demonstrated by postmortem computed tomography.CONCLUSIONS:Although multislice computed tomography has greater accuracy than autopsy, we believe that the conventional autopsy method is fundamental for providing evidence in criminal investigations.

Benign tumors of the esophagus are rare but can lead be fatal when aspirated into the upper airway. Here, we describe a sudden death due to aspiration of a fibrovascular polyp supported by a review of 11 cases from the literature.

Zerbini TZ, Araki MMP. Benefício de aposentadoria por invalidez previdenciária em portadores de doença renal crônica submetidos a transplante renal. Saúde, Ética & Justiça. 2014;19(2):86-9. RESUMO:A doença renal crônica é uma síndrome clínica causada pela perda progressiva e irreversível das funções renais. No Brasil, a Previdência Social utiliza a taxa de filtração glomerular da creatinina como um dos critérios para estabelecer o grau de capacidade laboral do segurado. Entretanto, com o transplante renal, há a possibilidade de melhora da qualidade de vida do segurado, existindo a possibilidade de reintegrá-lo no meio socioeconômico. Após o período inicial de transplante, o segurado pode estar capaz para retornar ao trabalho. Sendo assim, o presente trabalho aborda os aspectos que devem ser pesquisados pelo médico perito em uma perícia previdenciária oficial de um segurado submetido a transplante renal, tais como taxa de filtração e avaliação das consequências da terapia imunossupressora instituída.

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