Outcomes of patients with invasive fusariosis who undergo further immunosuppressive treatments, is there a role for secondary prophylaxis?

Background: Patients treated for invasive aspergillosis may relapse during subsequent periods of immunosuppression and should receive secondary prophylaxis. Little is known about the frequency of relapse and practices of secondary prophylaxis for invasive fusariosis (IF).

Objectives: Evaluate practices of secondary prophylaxis and the frequency of relapse in patients who survived IF and were exposed to subsequent periods of immunosuppression.

Sexual Function Under Adequate Estrogen Therapy in Women After Oophorectomy Versus Natural Menopause.

There is scarce evidence regarding endogenous postmenopausal ovarian testosterone (T) production and estrogen replacement roles in different sexual domains. This study aimed to determine whether lower endogenous T in oophorectomized women that were estradiol (E2)-treated influenced global or specific domains of sexual function. Depressive and cognitive symptoms were evaluated to exclude potential confounders.

CASE STUDY OF CONGENITAL ANOMALIES OF THE UPPER LIMB IN REFERENCE AMBULATORY CARE FACILITY.

Objective: The epidemiological profile of congenital anomalies of the upper limbs (CAULs) is of major relevance to monitoring and planning. A study of this profile may reveal if there is prevalence of some specific type of malformation in comparison to a more comprehensive epidemiological sample. The Latin American Collaborative Study of Congenital Malformations (ECLAMC) has an extensive database, providing an excellent source of comparison.

Evaluation of the use of tranexamic acid in total knee arthroplasty.

Objective: Evaluate the efficacy of tranexamic acid in reducing bleeding in patients undergoing total knee arthroplasty.

Methods: 101 patients were randomized into two groups: the tranexamic acid group ( = 51) and the placebo group ( = 50). Patients were compared regarding the following parameters: reduction of hemoglobin, total estimated blood loss, drain output, and postoperative blood transfusion rate.

Case Report: Acute Transverse Myelitis after Zika Virus Infection.

We report here one case of Zika virus (ZIKV) infection associated with auto-immunity directed against the central nervous system in a Brazilian woman who developed acute transverse myelitis 9 days after recovery from an acute episode of fever with generalized erythema. Imaging of the spinal cord showed an elongated area on the T1-T10 level with gadolinium uptake. The diagnostic of the ZIKV infection was confirmed by cerebrospinal fluid and serum analysis.

Lower frequency of antibodies to MOG in Brazilian patients with demyelinating diseases: An ethnicity influence?

Objective: Antibodies against Myelin Oligodendrocyte glycoprotein (MOG-Ab) have been investigated as potential biological marker for neuromyelitis optica (NMO) and high-risk syndromes (HR) negative for AQP4-Ab in populations with different ethnic background. We tested AQP4 and MOG antibodies in a Brazilian population with high African ethnic background.

Method: The study population was composed of adult patients from Rio de Janeiro with inflammatory demyelinating diseases (new and old cases).

Intraoperative neurophysiological monitoring in neuroanesthesia.

Purpose Of Review: The purpose of this review is to highlight the importance of making informed choices of anesthetics and evaluating the impact of depth of anesthesia, hemodynamic status and other factors capable of interfering with signal capture during intraoperative neurophysiological monitoring (IONM).

Recent Findings: Over the last decades, neuromonitoring has advanced considerably, allowing for insights into neurological function during anesthesia and making it possible to assess intraoperative consciousness and neural integrity in real time. IONM is indicated in surgeries posing risk to targeted neural tissues and adjacent structures.

Penile refracture: a preliminary report.

Objective: To report our institutional experience with penile refracture, including demographic data, recurrence time, etiology and operative findings in the first and second episodes.

Materials And Methods: Between January 1982 and September 2017, 281 patients underwent surgical treatment for penile fracture (PF) at our institution. Demographic data, clinical presentation, besides operative findings and follow-up of patients with relapsed PF were retrospectively assessed by reviewing medical records.

Sexual complications of penile frature in men who have sex with men.

Objectives: Evaluate the demographic data, etiology, operative findings and results of surgical treatment of penile fracture (PF) in men who have sex with men(MSM) with emphasis on sexual complications.

Materials And Methods: We studied 216 patients underwent surgical correction of PF at our hospital. Patients self-identified as MSM were followed for at least 6 months.

WRIST ARTHROSCOPY: BASIC TIPS FOR DRY ARTHROSCOPIC EXPLORATION.

Objective: This article provides details and tips on the dry arthroscopic technique, based on our experience and its clinical applications.

Method: The technique was applied to 65 patients (33 men and 32 women) aged between 20 and 62 years (average of 35.4 years) for treating: synovial cyst resection, scapholunate ligament injury repair, ulnocarpal impact correction, triangular fibrocartilage injury repair, and assisted reduction of distal radius fractures.

Tinnitus and sound intolerance: evidence and experience of a Brazilian group.

Introduction: Tinnitus and sound intolerance are frequent and subjective complaints that may have an impact on a patient's quality of life.

Objective: To present a review of the salient points including concepts, pathophysiology, diagnosis and approach of the patient with tinnitus and sensitivity to sounds.

Methods: Literature review with bibliographic survey in LILACS, SciELO, Pubmed and MEDLINE database.

Can renal stone size and the use of the nephrolithometric system increase the efficacy of predicting the risk of failure of percutaneous nephrolithotripsy?

Objective: to verify the association of success rate of percutaneous lithotripsy, Guy score and size of the stone.

Methods: one hundred patients submitted to percutaneous nephrolithotripsy were evaluated. All stones were classified according to Guy Score.

Angiolymphoid hyperplasia with eosinophilia versus Kimura's disease: a case report and a clinical and histopathological comparison.

Angiolymphoid hyperplasia with eosinophilia is a rare and benign vascular tumor whose etiology remains uncertain. It clinically presents itself by angiomatous papules or nodules located on the head and neck. Many controversies in the literature are found in relation to angiolymphoid hyperplasia with eosinophilia and Kimura's disease - its main differential diagnosis - due to their clinical and histopathological similarities.

Double inlay plus ventral onlay buccal mucosa graft for simultaneous penile and bulbar urethral stricture.

Objectives: Buccal mucosa grafts and fascio-cutaneous flaps are frequently used in long anterior urethral strictures (1). The inlay and onlay buccal mucosa grafts are easier to perform, do not need urethral mobilization and generally have good long-term results (2-4). In the present video, we present a case where we used a double buccal mucosa graft technique in a simultaneous penile and bulbar urethral stricture.

Epidemiology of neuromyelitis optica in Latin America.

A major development over the past two decades was the recognition of recurrent neuromyelitis optica (NMO) as a particular central nervous system disorder different from multiple sclerosis (MS). Here we reviewed the epidemiology of NMO in Latin America (LATAM). A predominance of a mixed population is found in this region.

Etanercept in erythema nodosum leprosum.

One of the biggest challenges in treating leprosy is the control of reaction events. Patients with lepromatous leprosy may present reaction type II, or erythema nodosum leprosum, during treatment, and this reaction can remain in a recurrent form after being released from the hospital, requiring the use of thalidomide and/or prednisone for long periods of time, in turn increasing the risk of side effects. Two reports of the use of antiTNF to treat erythema nodosum leprosum were found in the literature.

The HLA DRB1*03:01 allele is associated with NMO regardless of the NMO-IgG status in Brazilian patients from Rio de Janeiro.

The aim of this study was to analyze the HLA class II alleles in neuromyelitis optica (NMO) and MS patients from Rio de Janeiro to clarify whether the pattern of genetic predisposition in NMO is different from the one seen in MS or whether it is possible to determine specific alleles of susceptibility or resistance. The DR3 haplotype was over represented in NMO while the DR15 was over represented in MS. The HLA-DRB1*03:01 allele was associated with NMO regardless the NMO-IgG status but did not influence the long term disability.

Treatment of vascular lesions located in the lip and in the oral cavity with Nd:YAG laser.

Vascular lesions such as hemangiomas can be found in the oral cavity. Some therapeutic modalities can be used in the treatment of these lesions and Nd:YAG 1064 nm long pulse laser shows good results with easy application, fewer complications and satisfactory results. This study describes the technique and outcome of a case of hemangioma located on the tongue treated with Nd:YAG laser.

Malignant multiple sclerosis: clinical and demographic prognostic factors.

Patients with malignant multiple sclerosis (MMS) reach a significant level of disability within a short period of time (Expanded Disability Status Scale score of 6 within five years). The clinical profile and progression of the disease were analyzed in a Brazilian cohort of 293 patients. Twenty-five (8,53%) patients were found to have MMS and were compared with the remaining 268 (91,47%).

Eosinophilic fasciitis.

Eosinophilic fasciitis is a rare sclerodermiform syndrome of unknown etiology. It is characterized by the thickening of the muscular fascia and subcutaneous tissue, with a variable infiltration of eosinophils. Peripheral eosinophilia, poly or monoclonal hypergammaglobulinemia and increased erythrocyte sedimentation rate can be seen.

Pituitary Hyperplasia in a Female Patient with a Severe Childhood Abuse History.

A 24-year-old Caucasian female patient was referred to our endocrinology service to investigate a structural magnetic resonance imaging (sMRI) finding of "pituitary mass". The first two sMRI were identified as pituitary adenoma but the following two examinations suggested the possibility of pituitary hyperplasia (PH). The patient was referred to our service for diagnostic clarification and therapy due to the divergence in sMRI reports and the surgical procedure indicated by the neurosurgical team of the other institution.