RESUMO
Infectious disease is the most significant cause of morbidity and mortality in allotransplantation because of heavy immunosuppression. Brain abscesses caused by melanized fungi have been found occasionally and are an example of this complication. In this paper, we describe a case in a 61-year-old black man, who received a cadaveric kidney transplantation in December 1993, followed by triple therapy with cyclosporine, azathioprine, and prednisone. The patient developed right hemiparesis at the beginning of April 1998. A computed tomography scan showed a mass in the left parieto-temporal region of the brain. The patient underwent surgery and a brown-colored encapsulated brain abscess was resected. Histology of the tissue revealed a large number of pigmented fungal hyphae. Culture in a Sabouraud dextrose medium with cyclohexamide and chloramphenicol at 25 degrees C resulted in the growth of dark-green colonies. The fungus identified was Cladophialophora bantiana, based on characteristic microscopic features and on growth at 40 degrees C. The abscess recurred in spite of treatment with fluconazole. The patient was submitted to a second brain surgical procedure and was treated with amphotericin B in addition to fluconazole. Ten days later the patient's blood cultures became positive for Escherichia coli. After 3 days the patient died due to septic shock.
Assuntos
Ascomicetos/isolamento & purificação , Abscesso Encefálico/microbiologia , Infecções Fúngicas do Sistema Nervoso Central/microbiologia , Transplante de Rim/efeitos adversos , Encéfalo/diagnóstico por imagem , Abscesso Encefálico/diagnóstico por imagem , Infecções Fúngicas do Sistema Nervoso Central/diagnóstico por imagem , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
We conducted a retrospective study on 201 conizations for CIN III done over the last 14 years. Of these, 53 (26.4%) had involvement of the margins, 114 (56.7%) had margins free of neoplasia, and 34 (16.9%) were not evaluated. Of the 53 cases with margin involvement, 28 (52.8%) had complementary surgery and 25 (47.2%) cytological follow-up. Residual CIN was identified in the surgical specimen in 15 cases (53.6%) and microinvasion was present in 2 cases (7.1%). Of the 114 patients with margins free of neoplasia in the cone, 12 had a hysterectomy during follow-up for CIN III diagnosed by cytology and biopsy. Seven of these 12 patients (58.3%) had CIN in the surgical specimen and none had microinvasive cancer.
Assuntos
Conização , Displasia do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/cirurgia , Adulto , Idoso , Biópsia , Colo do Útero/patologia , Conização/métodos , Feminino , Humanos , Histerectomia/métodos , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias do Colo do Útero/patologia , Displasia do Colo do Útero/patologiaRESUMO
PIP: The authors observed the changes produced in the endometrium of 20 women who took a daily dose of 350 mcg of norethindrone uninterruptedly, starting on the 1st day of the menstrual cycle. It was found that this dose of norethindrone prevents endometrial development and the endometrium does not reach the stage of full secretion.^ieng