We are all on fire [...]’: os primórdios da canonização da literatura medieval inglesa

Tomando como ponto de partida a célebre confissão do Bispo Hurd em Letters on Chivalry and Romance (1762), o nosso texto procurará reflectir, enquadrando-os culturalmente, sobre os processos de (re)descoberta, reavaliação e revalorização setecentistas da literatura medieval, mercê das histórias literárias pioneiras de Hugh Blair (1718-1800), Thomas Warton (1728-1790) e do próprio Richard Hurd (1720-1808).

The Environmental History of Cetaceans in Portugal: Ten Centuries of Whale and Dolphin Records

The history between cetaceans and humans is documented throughout time not only in reports, descriptions, and tales but also in legal documents, laws and regulations, and tithes. This wealth of information comes from the easy spotting and identification of individuals due to their large size, surface breathing, and conspicuous above water behaviour. This work is based on historical sources and accounts accounting for cetacean presence for the period between the 12th and 17th centuries, as well as scientific articles, newspapers, illustrations, maps, non-published scientific reports, and other grey literature from the 18th century onwards. Information on whale use in Portugal's mainland has been found since as early as the 12th century and has continued to be created throughout time. No certainty can be given for medieval and earlier events, but both scavenging of stranded whales or use of captured ones may have happened. There is an increasing number of accounts of sighted, stranded, used, or captured cetaceans throughout centuries which is clearly associated with a growing effort towards the study of these animals. Scientific Latin species denominations only started to be registered from the 18th century onwards, as a consequence of the evolution of natural sciences in Portugal and increasing interest from zoologists. After the 19th century, a larger number of observations were recorded, and from the 20th century to the present day, regular scientific records have been collected. Research on the environmental history of cetaceans in Portugal shows a several-centuries-old exploitation of whales and dolphins, as resources mainly for human consumption, followed in later centuries by descriptions of natural history documenting strandings and at sea encounters. Most cetaceans species currently thought to be present in Portuguese mainland waters were at some point historically recorded.

Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literature

We report 2 cases of patients with immune reconstitution inflammatory syndrome (IRIS) associated with cutaneous disseminated sporotrichosis and human immunodeficiency virus (HIV) coinfection. The patients received specific treatment for sporotrichosis. However, after 4 and 5 weeks from the beginning of antiretroviral therapy, both patients experienced clinical exacerbation of skin lesions despite increased T CD4+ cells (T cells cluster of differentiation 4 positive) count and decreased viral load. Despite this exacerbation, subsequent mycological examination after systemic corticosteroid administration did not reveal fungal growth. Accordingly, they were diagnosed with IRIS. However, the sudden withdrawal of the corticosteroids resulted in the recurrence of IRIS symptoms. No serious adverse effects could be attributed to prednisone. We recommend corticosteroid treatment for mild-to-moderate cases of IRIS in sporotrichosis and HIV coinfection with close follow-up.

Integrative literature review of the reported uses of serological tests in leprosy management

Abstract: An integrative literature review was conducted to synthesize available publications regarding the potential use of serological tests in leprosy programs. We searched the databases Literatura Latino-Americana e do Caribe em Ciências da Saúde, Índice Bibliográfico Espanhol em Ciências da Saúde, Acervo da Biblioteca da Organização Pan-Americana da Saúde, Medical Literature Analysis and Retrieval System Online, Hanseníase, National Library of Medicine, Scopus, Ovid, Cinahl, and Web of Science for articles investigating the use of serological tests for antibodies against phenolic glycolipid-I (PGL-I), ML0405, ML2331, leprosy IDRI diagnostic-1 (LID-1), and natural disaccharide octyl-leprosy IDRI diagnostic-1 (NDO-LID). From an initial pool of 3.514 articles, 40 full-length articles fulfilled our inclusion criteria. Based on these papers, we concluded that these antibodies can be used to assist in diagnosing leprosy, detecting neuritis, monitoring therapeutic efficacy, and monitoring household contacts or at-risk populations in leprosy-endemic areas. Thus, available data suggest that serological tests could contribute substantially to leprosy management.

Double pylorus: case report and review of the literature

Double pylorus is an unusual condition in which a double communication between the gastric antrum and the duodenal bulb occurs. It may be congenital, or it may be acquired complication of peptic ulcer disease. We present a case of double pylorus in a gentleman with epigastric pain and previous history of peptic ulcer disease. The relationship between Helicobacter pylori and this disease was assessed. A review of the literature, the role of associated diseases and the role of H. pylori are discussed.

Laparoscopic treatment of retroperitoneal fibrosis: report of two cases and review of the literature

OBJECTIVES: We present the results of treatment by laparoscopy of two patients with retroperitoneal fibrosis and review the literature since 1992, when the first case of this disease that was treated using laparoscopy was published. We also discuss the contemporary alternatives of clinical treatment with corticosteroids and tamoxifen. CASE REPORT: Two female patients, one with idiopathic retroperitoneal fibrosis, and other with retroperitoneal fibrosis associated with Riedel's thyroiditis, were treated using laparoscopic surgery. Both cases had bilateral pelvic ureteral obstruction and were treated using the same technique: transperitoneal laparoscopy, medial mobilization of both colons, liberation of both ureters from the fibrosis, and intraperitonealisation of the ureters. Double-J catheters were inserted before the operations and removed 3 weeks after the procedures. The first patient underwent intraperitonealisation of both ureters in a single procedure. The other had 2 different surgical procedures because of technical difficulties during the first operation. Both patients were followed for more than 1 year and recovered completely from the renal insufficiency. One of them still has occasional vague lumbar pain. There were no abnormalities in the intravenous pyelography in either case. CONCLUSIONS: Surgical correction of retroperitoneal fibrosis, when indicated, should be attempted using laparoscopy. If possible, bilateral ureterolysis and intraperitonealisation of both ureters should be performed in the same operation.

Microlaparoscopy in gynecology: analysis of 16 cases and review of literature

Microlaparoscopy represents the development of endoscopic surgery towards a minimally invasive surgical procedure. The advantages include fewer surgical complications, faster return to daily activities, more comfortable postoperative recovery, and satisfactory aesthetic results. The possibility of performing surgery under sedation may result in shorter hospitalization, lower hospital costs, and easier anesthetic procedures. The authors report their preliminary experience with the use of microlaparoscopy, using optics and 2mm instruments, as well as a review of the literature since the introduction of this new technique. The report of these 16 cases demonstrates that microlaparoscopy is a feasible technique with satisfactory results. On the other hand, this new technique requires precise indications and a training period for the development of the skills necessary for performing these surgeries.

Acute renal failure due to abdominal compartment syndrome: report on four cases and literature review

We report on 4 cases of abdominal compartment syndrome complicated by acute renal failure that were promptly reversed by different abdominal decompression methods. Case 1: A 57-year-old obese woman in the post-operative period after giant incisional hernia correction with an intra-abdominal pressure of 24 mm Hg. She was sedated and curarized, and the intra-abdominal pressure fell to 15 mm Hg. Case 2: A 73-year-old woman with acute inflammatory abdomen was undergoing exploratory laparotomy when a hypertensive pneumoperitoneum was noticed. During the surgery, enhancement of urinary output was observed. Case 3: An 18-year-old man who underwent hepatectomy and developed coagulopathy and hepatic bleeding that required abdominal packing, developed oliguria with a transvesical intra-abdominal pressure of 22 mm Hg. During reoperation, the compresses were removed with a prompt improvement in urinary flow. Case 4: A 46-year-old man with hepatic cirrhosis was admitted after incisional hernia repair with intra-abdominal pressure of 16 mm Hg. After paracentesis, the intra-abdominal pressure fell to 11 mm Hg.

Prostate carcinoma with neuroendocrine differentiation: case report and literature review

Neuroendocrine differentiation in prostatic carcinomas generally confers a more aggressive clinical behavior and less favorable prognosis than usual prostatic carcinomas. In this manuscript, we report a case of a 58-year-old man with prostatic carcinoma who died 1 year after initial diagnosis. Autopsy showed a disseminated prostatic carcinoma with neuroendocrine differentiation. There were metastasis to the spleen, an organ infrequently involved by disseminated epithelial neoplasms. Neuroendocrine differentiation was demonstrated by immunohistochemical studies in the biopsy and autopsy material.

Recurrent spontaneous breast hematoma: report of a case and review of the literature

BACKGROUND: Breast hematomas are common after traumas, surgeries, or contusions. They are rarely spontaneous, but they can occur spontaneously in patients with hematologic disease or with coagulation disorders. MATERIAL AND METHODS: The authors report a clinical case of a 48-year-old female with a 27-year history of paroxysmal nocturnal hemoglobinuria who underwent mammography screening because of a painless palpable moveable node in the upper inner quadrant of the right breast. RESULTS: Mammography showed a partially defined heterogeneous node of 35 mm without microcalcifications in the upper inner quadrant of the right breast which, associated with the clinical features, seemed to be an hematoma. Further mammography and ultrasound after 45 days showed retrocession of the lesion, and another mammography obtained after 60 days was normal. Seventy-five days after the first episode, the patient complained of another node with a skin bruise in the upper outer quadrant of the same breast, which seemed to be a recurrent hematoma. Two months later the mammography obtained was normal. CONCLUSION: Breast hematoma must be thought of as a differential diagnosis for a breast node, regardless of previous trauma or hematologic disorders.

Primary rhabdomyosarcoma of the diaphragm: case report and literature review

The authors report a case of primary rhabdomyosarcoma of the diaphragm, an extremely rare presentation with only 14 cases reported in the literature. An 18-year-old male presented 2 spontaneous occurrences of pneumothorax. Computed tomography and magnetic resonance showed a tumoral mass on the right diaphragmatic surface, and after biopsy, the diagnosis was compatible with spindle cell rhabdomyosarcoma. Because the visceral pleura was invaded by the tumoral mass, a right pleuropneumonectomy was performed. The patient received adjuvant chemotherapy, and there was no evidence of disease 15 months after the operation. Based on the Intergroup Rhabdomyosarcoma Study Group (IRSG) criteria, which consider the extent of the disease and its surgical resectability, rhabdomyosarcomas can be classified into 4 groups. In clinical group I, which was the classification of our patient, the tumor is localized and completely resectable, which implies a good prognosis. Rhabdomyosarcoma is a rare tumor, and a good outcome may result if it is completely resected.

Complications of tracheobronchial foreign body aspiration in children: report of 5 cases and review of the literature

Foreign body aspiration (FBA) is one of leading causes of death in children, especially among those younger than 3 years of age. The inhalation of a foreign body may cause a wide variety of symptoms, and early diagnosis is highly associated with the successful removal of the inhaled foreign material. Despite the great advances in endoscopic procedures and anesthesia, a large number of difficulties and complications still result from foreign body aspiration. We describe 5 cases of serious acute complications following aspiration of foreign bodies that became lodged in the tracheobronchial tree, including pneumomediastinum, pneumothorax, total atelectasis, foreign body dislodgment, and need for thoracotomy in children admitted into our intensive care unit in 1999 and 2000; these were all situations that could have been prevented with early recognition and prompt therapeutic intervention.

Incisional hernia at the insertion site of the laparoscopic trocar: case report and review of the literature

Laparoscopic operations offer a myriad of advantages resulting in a rapid postoperative recovery. Incisional hernia is an uncommon cause of morbidity in operative procedures performed by laparoscopic access, and the diagnosis may not be easily made. In our service we identified 2 patients with incisional hernia the site of trocar insertion. The records of these 2 cases were reviewed. We report on these 2 cases and present a review of the literature.

Pulmonary artery catheter complications: report on a case of a knot accident and literature review

A particular event concerning a Swan-Ganz catheter complication is reported. A 41-year-old woman was admitted at the emergency room of our hospital with massive gastrointestinal bleeding. A total gastrectomy was performed. During the postoperative period in the intensive care unit , the patient maintained hemodynamic instability. Invasive hemodynamic monitoring with a pulmonary artery catheter was then indicated. During the maneuvers to insert the catheter, a true knot formation was identified at the level of the superior vena cava. Several maneuvers by radiological endovascular invasive techniques allowed removal of the catheter. The authors describe the details of this procedure and provide comments regarding the various techniques that were employed in overcoming this event. A comprehensive review of evidence regarding the benefits and risks of pulmonary artery catheterization was performed. The consensus statement regarding the indications, utilization, and management of the pulmonary artery catheterization that were issued by a consensus conference held in 1996 are also discussed in detail.

Recensão: Joana Ramôa, Christus Patiens. Representações do calvário na escultura tumular medieval portuguesa (século XIV)"

Recensão de: Joana Ramôa. 2008. Christus Patiens. Representações do calvário na escultura tumular medieval portuguesa (século XIV). Lisboa: Instituto de História da Arte - Faculdade de Ciências Sociais e Humanas da Universidade Nova de Lisboa