Objective: The purpose of this case-control study was to evaluate risk factors associated with death in children with severe dengue. Methods: The clinical condition of hospitalized patients with severe dengue who died (cases, n = 18) was compared with that of hospitalized patients with severe dengue who survived (controls, n = 77). The inclusion criteria for this study were age under 13 years; hospital admission in São Luis, northeastern Brazil; and laboratory-confirmed diagnosis of dengue. Results: Severe bleeding (hemoptysis), a defining criterion for dengue severity, was the factor most strongly associated with death in our study. We also found that epistaxis and persistent vomiting, both included as warning signs in the World Health Organization (WHO) classification of dengue, were strongly associated with death. No significant association was observed between any of the laboratory findings and death. Conclusions: The finding that epistaxis and persistent vomiting were also associated with death in children with severe dengue was unexpected and deserves to be explored in future studies. Because intensive care units are often limited in resource-poor settings, any information that can help to distinguish patients with severe dengue with a higher risk to progress to death may be crucial.

Os lipomas espinhais são raros, respondendo por 1% de todos os tumores espinhais, estando associados ao disrafismo espinhal oculto em mais de 99% dos casos. Estão divididos em três tipos principais: lipomielomeningocele, lipoma intradural e fibrolipoma do filo terminal. Este relato descreve um caso de lipoma lombossacral congênito associado a estigma cutâneo do tipo seio dérmico lombar congênito.

Spinal lipomas are rare, accounting for 1% of all spinal tumors and being associated with occult spinal dysraphism in more than 99% of cases. Such lesions are divided into three main types, namely, lipomyelomeningoceles, intradural lipomas, and filum terminale fibrolipomas. The present report describes a case of congenital lumbosacral lipoma associated with cutaneous stigmata of the lumbar dermal sinus type.

O dengue é doença endêmica em regiões tropicais e subtropicais. Quando sintomática, classifica-se em febre do dengue e febre hemorrágica do dengue, com tendência a síndrome do choque do dengue. A febre hemorrágica do dengue é marcada por manifestações hemorrágicas, trombocitopenia e aumento da permeabilidade capilar. A síndrome do choque do dengue apresenta os achados de febre hemorrágica do dengue com hipotensão. Muitos achados ultrassonográficos têm sido descritos, incluindo derrame pleural, ascite, espessamento da parede da vesícula biliar e derrame pericárdico. O objetivo desta revisão da literatura é descrever os achados ultrassonográficos e demonstrar o papel da ultrassonografia em crianças com suspeita de febre hemorrágica do dengue

Dengue virus infection is endemic in tropical and subtropical areas. Symptomatic dengue infection is classified into dengue fever or dengue hemorrhagic fever with a tendency to develop shock syndrome. Dengue hemorrhagic fever is characterized by hemorrhagic manifestations, thrombocytopenia and increased capillary permeability. Dengue shock syndrome presents findings of dengue hemorrhagic fever with hypotension. Many sonographic findings have been described, including pleural effusion, ascites, gallbladder wall thickening and pericardial effusion. The aim of the present review is to describe sonographic findings and to demonstrate the role of ultrasonography in the assessment of children with suspected dengue hemorrhagic fever

As anormalidades do primeiro trimestre da gravidez são detectadas pela ultrassonografia transvaginal em exame de rotina ou em caso de sangramento vaginal anormal. A ameaça de abortamento é uma afecção comum no primeiro trimestre da gestação, ocorrendo em mais de um terço dos casos. O advento de sondas vaginais de alta resolução vem revolucionando nossa compreensão da fisiopatologia e o manejo da gestação inicial. Trata-se de ferramenta essencial para determinar a viabilidade da gestação nos casos de ameaça de abortamento. Uma conduta expectante no abortamento poderia reduzir significativamente o número de esvaziamentos desnecessários de produtos retidos, dependendo dos critérios utilizados.

First trimester pregnancy abnormalities may be detected by transvaginal ultrasonography at routine examinations or in cases where abnormal vaginal bleeding is present. Threatened miscarriage is frequently observed in the first trimester, occurring in more than one-third of pregnancies. The advent of high-resolution transvaginal ultrasonography has revolutionized the understanding of the pathophysiology and the management of early pregnancy. This method represents an essential tool for determining the pregnancy viability in cases of threatened miscarriage. An expectant approach in the management of miscarriage could significantly reduce the number of unnecessary evacuations of retained products of conception, depending on the adopted criteria.

A utilização de plantas medicinais é uma prática comumente observada nos países em desenvolvimento. Desta forma objetivou-se verificar os efeitos microscópicos do óleo de copaíba no fígado de ratos. Para tal foram utilizados 50 Rattus norvegicus albinus, machos, distribuídos em cinco grupos: Grupo Copaíba 0,63 (GC0,63 ml/Kg de óleo de copaíba), Grupo copaíba 0,06 (GC0,06 ml/Kg de óleo de copaíba), Grupo Água (GA0,63 ml/kg de água), Grupo milho (GM0,63 ml/Kg de óleo de milho) e grupo Padrão (GP). As substâncias foram administradas diariamente por 14 dias, quando os animais foram submetidos à eutanásia. Os resultados obtidos demonstraram que microscopicamente, não foram encontradas alterações hepatocelulares, porém, foi verificado congestão vascular nas veias portais e centrolobulares, maior no grupo GC0,63 em relação aos grupos GC0,06, GM, GA e GP (p< 0,05). Já no grupo GC0,06, apesar de não haver diferença estatística, foi observado congestão em maior intensidade que nos grupos GM, GA e GP (p>0,05) o que sugere haver uma relação dose dependente. Os autores concluem que, de acordo com a metodologia empregada, o óleo de copaíba tanto na dose de 0,06 ml/kg como de 0,63 ml/kg foi capaz de promover congestão vascular no fígado de ratos, sugerindo ação dose dependente.

The use of medicinal plants is a commonly practice observed at developing countries. Then, this paper aim to verify the effect of the copaiba oil in the liver of rats. Fifty male Wistar rats were used distributed into five groups: Group Copaiba 0.63 (GC0.63 ml/kg of copaiba oil), Group Copaiba 0.06 (GC0.06 ml/kg of copaiba oil), Group Water (GA0.63 ml/kg of water), Group Corn Oil (GM0.63 ml/kg of corn oil) and Standard group (GP). The substances were administered daily by 14 days. The animals were submitted to euthanasia in the 14th day, being withdraw the liver and realized histologic study. The results demonstrated that microscopically, in the hepatocity cells no alterations were found; however, vascular congestion was verified in the portal and mid-lobular veins. A larger congestion was observed in the group GC0.63 in relation to the groups GC0.06, GM, GA and GP (p <0.05). Although, the group GC0.06 has presented larger vascular congestion in relation to the groups GM, GA and GP but without significance statistical (p> 0.05), suggesting a dose-effect relationship. Then, the authors conclude that in agreement with methodology used, the copaiba oil promote vascular congestion in the liver of rats, suggesting dose-dependent action.