Sinusite recorrente de causa incomum

The authors present a case of chronic recurrent sinusitis of rare etiology in a man submitted previously to a facial peeling. The computed tomography and the sinusal endoscopy revealed periorbital fat in the maxilary sinus. There was a history of old orbital floor fracture.

Leiomiossarcoma de jejuno

We describe a case of leiomyosarcoma of the jejunum in which abdominal computed tomography showed an intestinal tumor with a "sui generis" metalic artefact inside, which made us think of a benign disease (foreign body granuloma), because the patient lived in the rural area and he had a manioc flour mill, which is one the basic foods of the majority of the population of the north in Brazil. Because of the aspect of the tumor, we decided on a large scale resection, considering the possibility of a malignant tumor since we don't have frozen sections. This assured us of an adequate treatment for the tumor. This type of pathology should be remembered even though it only accounts for 0,2-2% of the intestinal tract tumors.

Tricobezoar gástrico

Bezoar is a foreign body in the digestive tract originated from ingestion of varied substances, mainly vegetal hair or coats, staple fibers among others. We present a case of a 16-year-old female with trichotillomania history of approximately 5 months, diagnosed through clinical evidence of traumatic alopecia made by her dermatologist. Though asymptomatic the presence of tricobezoar was suspected and confirmed through digestive seriography and high digestive endoscopy. The patient was operated on for gastrotomy and removal of bezoar, with good postoperative follow-up, except for surgical wound infection.

Abscesso hepático piogênico por corpo estranho

Pyogenic hepatic abscess by a foreign body is a rare disease and its diagnosis is habitually made during necropsy. The authors present a case of a woman operated because of a pyogenic hepatic abscess, in the interior of which bristle made of material of vegetable origin were encountered and identified in the laboratory as the principal rib of a leaf, known in Brazil as piaçava. The hepatic abscess was drained and the patient was discharged. The probable mechanism for the formation of the hepatic abscess consisted of the accidental ingestion, perforation of the intestines and penetration in the liver.

Hemoptise maciça 14 anos após ferimento por projétil de arma de fogo

A 54 - year-old male returned 14 years after a gunshot wound to the chest with intermitent hemoptysis that progressed to frank pulmonary hemorrhage. The complications of retained intrapulmonary foreign body are briefly reviewed.

Corpo estranho retido na cavidade abdominal durante onze anos

A retained foreign body in the abdominal cavity following surgery is a continuing problem. Despite precautions, the incidence is grossly underestimated. Presentation is possible as a pseudotumour, occlusive, or septic syndrome. We describe a case of retained surgical sponge that remained asymptomatic for eleven years.

Arma branca retida em aorta abdominal superior

Abdominal aorta wounds carries a high immediate mortality. Few patients reach hospital care alive. There are no reports on Medline (1969-2002) about aortic wounds of foreign body with retention. A case with upper abdominal aortic wound with an inlaid blade is reported. The retained blade fixed the stomach to the surgical field, difficulting the vascular control, leading to an unconventional approach and allowing extensive contamination. The patient developed multiple organ dysfunction and died at fifth postoperative day. Singularities of an inlaid knife in upper abdominal aorta and changes in traditional approach are discussed. The authors assumed that the inlaid knife decreased the bleeding, allowing the patient arrival to the hospital, but worsened the approach to the aorta wound.

Corpos estranhos provenientes de acessos cirúrgicos à cavidade abdominal: aspectos fisiopatológicos e implicações médico legais

There is no large series about retained foreign bodies in abdominal cavity. In fact data are underestimated because of the lack of reports considering its serious medicolegal implications. An inflammatory fibrotic process inside the peritoneal cavity, a virtual discharge of inorganic material through the surgical incision and also a slow process of transmural migration into the intestinal lumen are the most frequent pathophysiologic situations. It is not uncommon the incidental diagnosis of foreign body and radiographic studies may be particularly helpful to elucidate the etiology. An early recognition minimizes the surgical risks and contributes to avoid severe complications. The best approach is to adopt preventive measures. Careful peroperative materials vigilance and instrumentation and also a meticulous check at the end of operations are essential to avoid such legal responsibility.

Oclusão intestinal por compressas cirúrgicas intraluminais: experiência de cinco casos

Despite being unusual, retained foreign bodies after surgical procedures is a matter of great concern for surgeons. The main purpose of this article is to describe five cases of intestinal obstruction due to intraluminal surgical sponges. The average time between the first operation and the intestinal obstruction was eight months. All patients referred abdominal pain and change of intestinal habit prior to the intestinal obstruction. In two cases bowel perforation was also observed, in addition to the intestinal obstruction. Four patients had no postoperative complications. One patient died due to an intra-abdominal abscess and sepsis.

Tricobezoar gástrico: relato de caso

Bezoars are foreign bodies impacted in the digestive tract resulting of their ingestion and accumulation, involving mainly the stomach. The most common types are phytobezoars, contaning vegetables, fiber and seed and the trichobezoar, made of hair. The present case is the description of a 25-year-old female with nonspecific dyspeptic symptoms associated to intestinal habit change. The diagnosis was suggested by Computerized Tomography in association with clinical history - initially omitted by the pacient - of trichophagia for 10 years. Treatment consisted of Anterior Gastrotomy and remotion of the bezoar.

Celiotomy by plastrotomy in a yellow-footed tortoise (Geochelone denticulata)

One herein reports a successful case of celiotomy by plastrotomy for removal of foreign bodies in yellow-footed tortoise (Geochelone denticulata). The animal was treated at the Veterinary Hospital of the Federal University of Piaui, with appetite loss, regurgitation, constipation, lethargy, reluctance to walk and slightly reddish ocular mucous membranes. Radiographic examination was performed, confirming the presence of foreign bodies in the stomach. The tortoise underwent celiotomy by plastrotomy for the removal of the foreign bodies. The opening of the plastron was performed through the abdominal shields, with the aid of a circular mini grinding saw. One performed an incision in the midline between the two abdominal veins to access the abdominal cavity. A gastrotomy for removal of the foreign bodies (nails, toothpicks, stones, pieces of plastic, glass and crockery pieces) was performed after the location of the stomach. The surgery was successful and confirmed with radiographic evaluation in the immediate postoperative period. The celiotomy by plastrotomy for removal of foreign bodies in that animal proved to be a viable, very important and safe technique to the survival of chelonians.

Use of sodC versus ctrA for real-time polymerase chain reaction-based detection of Neisseria meningitidis in sterile body fluids

We evaluated the use of a newly described sodC-based real-time-polymerase chain reaction (RT-PCR) assay for detecting Neisseria meningitidis in normally sterile sites, such as cerebrospinal fluid and serum. The sodC-based RT-PCR assay has an advantage over ctrA for detecting nongroupable N. meningitidis isolates, which are commonly present in asymptomatic pharyngeal carriage. However, in our study, sodC-based RT-PCR was 7.5% less sensitive than ctrA. Given the public health impact of possible false-negative results due to the use of the sodC target gene alone, sodC-based RT-PCR for the diagnosis of meningococcal meningitis should be used with caution.

Recent brazilian experience on farmer reaction and crop response to fertilizer use

(1) In the period 1965/77 fertilizer consumption in Brazil increased nearly fifteen foild from circa 200,000 tons of N + P2O5 + K2O to 3 million tons. During the fifteen years extending from 1950 to 1964 usage of the primary macronutrients was raised by a factor of 2 only. (2) Several explanations are given for the remarkable increase, namely: an experimental background which supplied data for recommendations of rates, time and type of application; a convenient governmental policy for minimum prices and rural credit; capacity of the industry to meet the demand of the fertilizer market; an adequate mechanism for the diffusion of the practice of fertilizer use to the farmer. (3) The extension work, which has caused a permanent change in the aptitude towards fertilization, was carried out in the traditional way by salesmen supported by a technical staff, as well as by agronomists of the official services. (4) Two new programs were started and conducted in a rather short time, both putting emphasis on the relatively new technology of fertilizer use. (5) The first program, conducted in the Southern part of the country, extended lab and green house work supplemented by a few field trials to small land owners - the so called "operação tatú" (operation armadillo). (6) The seconde program, covering a larger problem area in the Northeast and in Central Brazil, began directly in field as thousands of demonstrations and simple experiments with the participation of local people whose involvement was essential for the success of the initiative; in this case the official extension services, both foreign and national sources of funds, and universities did participate under the leadership of the Brazilian Association for the Diffusion of Fertilizers (ANDA). (7) It is felt that the Brazilian experience gained thereof could be useful to other countries under similar conditions.

Colony polymerase chain reaction of stably transfected Trypanosoma cruzi grown on solid medium

Tools for the genetic manipulation of Trypanosoma cruzi are largely unavailable, although several vectors for transfection of epimastigotes and expression of foreign or recombinant genes have been developed. We have previously constructed several plasmid vectors in which recombinant genes are expressed in T. cruzi using the rRNA promoter. In this report, we demonstrate that one of these vectors can simultaneously mediate expression of neomycin phosphotransferase and green fluorescent protein when used to stably transfect cultured epimastigotes. These stably transfected epimastigotes can be selected and cloned as unique colonies on solid medium. We describe a simple colony PCR approach to the screening of these T. cruzi colonies for relevant genes. Thus, the methodologies outlined herein provide important new tools for the genetic dissection of this important parasite.