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Clinical Outcomes of Positive Newborns for COVID-19 in Rio de Janeiro, Brazil

Open Journal of Obstetrics and Gynecology 2021年第12期11卷 1851-1861页

作者： Karina Martins-Cardoso Luana Ferreira Martins de Toledo Juliana Aparecida Souza Paz Andressa Rangel de Oliveira Lima Thaís Chrispim de Souza Giangiarulo Jéssica da Silva Oliveira IPB COVID Workgroup Carla Carolina Teixeira Jones Zitenfeld Cardia Neto Giovanna Geórgia Pires Carrilho Vallim Shana Priscila Coutinho Barroso Laboratório de Biologia Molecular Instituto de Pesquisas Biomédicas Hospital Naval Marcílio Dias Rio de Janeiro Brasil Instituto de Bioquímica Médica Leopoldo de Meis Universidade Federal do Rio de Janeiro Rio de Janeiro Brasil UTI neonatal Clínica de Pediatria Hospital Naval Marcílio Dias Rio de Janeiro Brasil Serviç o de Patologia Hospital Naval Marcílio Dias Rio de Janeiro Brasil

The disease caused by the SARS-CoV-2 virus has spread very rapidly throughout the world, causing various clinical manifestations and affecting several organs and systems. However, the possibility of vertical transmission of COVID-19 in symptomatic pregnant women has been questioned. The aim of this work was to report cases of possible vertical transmission in pregnant women affected by the SARS-CoV-2 virus, as well as its clinical repercussions on the newborn. In this paper, we conducted a cross-sectional retrospective study by analyzing medical records of pregnant women admitted at the military hospital, in Rio de Janeiro, Brazil, diagnosed with COVID-19 and who had positive newborns. To evaluate epidemiological data, clinical manifestations, laboratorial and histopathological changes were related to such vertical transmission. Only six tested newborns were positive for COVID-19. The mothers had no respiratory symptoms, and the gestational age was at term, except for one newborn born prematurely due to detection of pericadial effusion. Three neonates had respiratory symptoms, requiring ventilatory support. None of the mothers or newborns died. During the pandemic, possible vertical transmission cases of infected pregnant women in the third trimester of pregnancy were observed. According to the case reports published in the literature, they illustrate phenotypes of neonatal involvement with varied clinical manifestations and severity;however, further scientific studies are needed to prove the effective vertical transmission of SARS-CoV-2 in positive pregnant women.

关键词： SARS-CoV-2 Infection Neonatal Outcomes Vertical Transmission

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An Unusual Case of Herpes Simplex Meningitis after Inadvertent Puncture of the Subarachnoid Space

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Case Reports in Clinical Medicine 2021年第9期10卷 232-239页

作者： Richell Bastos Vale Bruno Vítor Martins Santiago José Abel de Almeida Neto Luiz Otávio Ribeiro de Lemos Felgueiras Karine Grillo de Freitas Thiago dos Santos Ferreira Department of Anesthesiology Piedade Municipal Hospital Rio de Janeiro Brazil Department of Anesthesiology Marcílio Dias Naval Hospital Rio de Janeiro Brazil Interleague Association of Anesthesiology of the State of Rio de Janeiro Rio de Janeiro Brazil

The study seeks to report the clinical evolution of a patient who suffered an inadvertent subarachnoid puncture and evolved with a herpetic viral meningitis, confirmed by cerebrospinal fluid (CSF) analysis. Female, 48 years old, submitted to epidural anesthesia, for surgery, with median puncture, between L2-L3 and inadvertently accessed the subarachnoid space, with clear cerebrospinal fluid. The same puncture was used and the solution with 15 mg hyperbaric bupivacaine and 80 mcg morphine was administered. There was no complication during the entire surgical procedure. On the first postoperative day, she started complaining of headache and nausea, being treated with dipyrone, non-steroidal anti-inflammatory drugs (NSAIDs) and ondansetron. On the third day, she presented two episodes of seizure that ceased with the use of diazepam 10 mg. On the fifth day, the patient presented fever and seizures, which did not stop with medication, requiring sedation, orotracheal intubation and transfer to the intensive care unit. Lumbar puncture was performed for CSF analysis, which was positive for Herpes simplex type I. The patient was extubated, on the second day of hospitalization, maintained with a maintenance dose of phenytoin, sumatriptan, dipyrone, metoclopramide and acyclovir 500 mg, remaining intravenous, without presenting new seizures for 45 days, when she was discharged. After 30 days, he returned for a review consultation without making a complaint.

关键词： Headache Opioids Herpes Simplex Dural Puncture

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Mandibular Reconstruction with Autogenous Fragment of Previous Iliac Crest Associated to Hyperbaric Oxygen Therapy： Case Report

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Journal of Pharmacy and Pharmacology 2017年第9期5卷 688-696页

作者： Joao Femando Veiga Pires Claudio Lessa Renata Pittella Cancado Filipe Barcellos Caldas Andre Alberto Camara Puppin Department of Oral and Maxillofacial Surgery Hospital Naval Mareilio Dias Rio dejaneiro 20725-090 Brazil Department of Oral and Maxillofacial Surgery Universidade Federal do Espirito Santo Vit6ria 29043-900 Brazil

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Preemptive endoluminal vacuum therapy after pancreaticoduodenectomy: A case report

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World Journal of Gastrointestinal Endoscopy 2020年第11期12卷 493-499页

作者： Flaubert Sena de Medeiros Epifanio Silvino do Monte Junior Romero de Lima França Heli Clóvis de Medeiros Neto Juliany Medeiros Santos Eligio Alves Almeida Júnior Samuel Oliveira da Silva Júnior Mario Herman Santos Moura Pedreira Tavares Eduardo Guimarães Hourneaux de Moura Department of Surgery Federal University of Rio Grande do NorteNatal 59012-300Rio Grande do NorteBrazil Gastrointestinal Endoscopy Unit Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão Paulo 05403-000Brazil Department of Surgery Hospital do CoraçãoNatal 59075-050Rio Grande do NorteBrazil Gastrointestinal Endoscopy Unit Faculty of Medicine of ABCSão Paulo 09190-615Brazil Department of Surgery Instituto Juarez AlmeidaBacabal 65700-000MaranhãoBrazil Department of Surgery Hospital Naval Marcílio DiasRio de Janeiro 20725-090Rio de JaneiroBrazil

BACKGROUND Pancreaticoduodenectomy is a technically demanding operation,with reported morbidity rates of approximately 40%-50%.A novel idea is to use endoscopic vacuum therapy(EVT)in a preemptive setting to prevent anastomotic leakage and pancreatic fistulas.In a recent case series,EVT was proven to be effective in preventing leaks in patients with anastomotic ischemia.There have been no previous reports on preemptive EVT after pancreaticoduodenectomy.CASE SUMMARY We describe the case of a 71-year-old woman with hypertension and diabetes who was admitted to the emergency room with jaundice,choluria,fecal acholia,abdominal pain,and fever.Admission examinations revealed leukocytosis and hyperbilirubinemia(total:13 mg/dL;conjugated:12.1 mg/dL).Abdominal ultrasound showed cholelithiasis and dilation of the common bile duct.Magnetic resonance imaging demonstrated a stenotic area,and a biopsy confirmed cholangiocarcinoma. Considering the high risk of leaks after pancreaticoduodenectomy,preemptive endoluminal vacuum therapy was performed.The system comprised a nasogastric tube,gauze,and an antimicrobial incise drape.The negative pressure was 125 mmHg,and no adverse events occurred.The patient was discharged on postoperative day 5 without any symptoms.CONCLUSION Preemptive endoluminal vacuum therapy may be a safe and feasible technique to reduce leaks after pancreaticoduodenectomy.

关键词： Preemptive Endoluminal Vacuum Pancreaticoduodenectomy Case report

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A Proof-of-Concept Assessment of the Safety and Efficacy of Intralesional Diclofenac in the Treatment of Cutaneous Neurofibromas

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International Journal of Clinical Medicine 2015年第12期6卷 975-983页

作者： Mauro Geller Aguinaldo Bonalumi Filho Lisa Oliveira Allan ERubenstein Luiz Guilherme Darrigo Jr David Azulay Allan Bernacchi Marcia Goncalves Ribeiro Karin Soares Goncalves Cunha Immunology Department Fundacao Educacional Serra dos Orgaos(UNIFESO)TeresopolisBrazil Clinical Immunology Instituto de Pos-Graduacao Medica Carlos Chagas(IPGMCC)Rio de JaneiroBrazil Medical Genetics Service IPPMG-Universidade Federal Rio de JaneiroRio de JaneiroBrazil hospital naval marcilio dias Rio de JaneiroBrazil Sociedade Evangelica Beneficiente de Curitiba Outpatient Unit CuritibaBrazil NYU Langone Medical Center New YorkNYUSA Bone Marrow Transplant Unit Hospital das Clinicas da Faculdade de Medicina de Ribeirao PretoUniversidade de Sao Paulo(USP)Ribeirao PretoBrazil Pontifica Universidade Catolica do Rio de Janeiro(PUC-RJ) Rio de JaneiroRJBrazil Plastic Surgery Post-Graduation PUC-RJRio de JaneiroBrazil 1 Universidade Federal Fluminense(UFF) Rio de JaneiroBrazil

The objectives of this study were to assess the safety and efficacy of intralesionally administered diclofenac in the treatment of cutaneous neurofibromas in patients with NF1. This was a proof-of-concept, prospective, safety and efficacy study of the effect of intralesionally administered diclofenac 25 mg/ml given once a week to 3 target cutaneous neurofibromas for 4 consecutive weeks. Overall, there was no significant change in neurofibroma size. During the study, some treated lesions developed signs of necrosis and fell off after a few weeks, but none of the control neurofibromas fell off. There were no significant changes in patient’s vital signs. A few adverse events occurred, mostly at the injection sites. During the study, some neurofibromas developed necrosis after the diclofenac injections and eventually detached from the patient. Overall, diclofenac was well tolerated, suggesting minimal systemic exposure, which required confirmation and further studies, including bioavailability analysis.

关键词： Neurofibromatosis Type 1 Cutaneous Neurofibromas Diclofenac Sodium

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