Bologna - Estudo Retrospectivo na MAC

Estudo retrospectivo para a avaliação de resultados em doentes com incontinência urinária de esforço e prolapso da parede vaginal anterior submetidas a cirurgia de Bologna, num follow-up de 20 meses.

Localized Abdominal Idiopathic Lipodystrophy

Localized loss of subcutaneous tissue can occur after panniculitis, injections of corticosteroids and other drugs, or associated with infectious, autoimmune or neurologic diseases. The "idiopathic lipoatrophies" are a group of poorly characterized diseases, with focal disappearance of subcutaneous fat, and usually the thighs, abdomen or the ankles are affected. Three subtypes have been described based on clinical presentation: lipoatrophia semicircularis, annular lipoatrophy of the ankles and centrifugal lipodystrophy. We describe a 52-year-old female patient who developed a localized atrophy of the abdominal areas over a period of 3 months without any inflammatory signs over the evolution of the disease. The patient denied any previous local trauma or medication of any type. The atrophy stabilized, showing no progression over the last 6 years. The histopathological examination was normal except for the absence of subcutaneous fat, although the biopsy was taken down to the fascia. There was no clinical or serologic evidence of autoimmune diseases and laboratory testing for Borrelia burgdorferi infection was negative. Other causes of localized lipoatrophies were excluded and the final diagnosis was localized idiopathic lipodystrophy. Our patient is the second report on an abdominal lipodystrophy, with no previous inflammatory signs, absence of subcutaneous fat and no associated pathogenic factor. There is no established treatment for idiopathic lipodystrophy, and the lesions do not tend to resolve spontaneously.

Annular Lichen Planus in Association with Crohn Disease

BACKGROUND: Lichen planus is an idiopathic inflammatory disease of the skin and mucous membranes. Although the etiology is not established, it has been associated with autoimmune diseases, viral infections, drugs and dental restoration materials. However, the association with inflammatory bowel disease has been very rarely reported in the literature. CASE REPORT: A 19-year-old female patient presented with annular lesions on her upper body and limbs, with a sharply defined border and non-atrophic skin in the center. The lesions were hyperpigmented and had been stable for over one year. The histopathology confirmed the diagnosis of annular lichen planus. She had weight loss, occasional diarrhea, and a severe anemia. The investigation of these symptoms led to the diagnosis of Crohn disease and a sickle cell trait. Therapy with systemic corticosteroids and mesalazine controlled the intestinal disease, with concomitant improvement of the skin lesions. CONCLUSIONS: As lichen planus can be associated with other immunological disorders, the association with inflammatory bowel disease should be considered in the evaluation of the patient.

Gravidez Não Vigiada. A Experiência da MAC em 2004

A gravidez não vigiada é ainda uma realidade da prática obstétrica. A compreensão da não vigilância médica da gravidez, suas condicionantes e consequências, é essencial para o combate a esta problemática. O presente trabalho, cujo conteúdo foi apresentado no 5º Encontro da Unidade Coordenadora Funcional da Maternidade Dr. Alfredo da Costa a 1 de Junho de 2005, pretende caracterizar os aspectos demográficos, sociais e médicos desta população que recorre aos cuidados de saúde apenas no desfecho da gravidez.

Drepanocitose e Gravidez: Estado da Arte

Os autores apresentam uma revisão teórica da Drepanocitose (SS), focando os aspectos mais pertinentes da fisiopatologia, clínica, diagnóstico e principais medidas terapêuticas. Alertam para as complicações mais frequentes na gravidez e salientam a importância do Aconselhamento Genético e do Diagnóstico Pré-Natal no modelo de prevenção da doença.