Trastorno grave del medio interno por fístula enterovesical, a propósito de un caso clínico / Severe metabolic disorder associated with an enterovesical fistula: report of one case

Enterovesical fistula (EVF) is a fistulous communication between the intestine and the bladder. It is uncommon and its classic clinical manifestations are the presence of pneumaturia, fecaluria, suprapubic pain and recurrent urinary infections. Surgical repair of EVF leads to rapid correction of both diarrhea and metabolic abnormalities. We report a 73-year-old diabetic woman with a neurogenic bladder secondary to a spine meningioma. She presented with diarrhea, vomiting, impaired consciousness and metabolic acidosis. She developed hypernatremia, hypokalemia, hypocalcemia, and hypophosphatemia, which were successfully corrected.

Nefropatía aguda por fosfatos secundaria al uso de laxantes con fosfato de sodio: caso clínico-patológico / Acute phosphate nephropathy secondary to the use of oral sodium phosphate laxatives: report of one case

Acute phosphate nephropathy (APN) is an acute renal failure secondary to the use of oral sodium phosphate (OSP) laxatives, with a high risk of progression to chronicity. We report a 60-year-old woman with mixed connective tissue disease whose serum creatinine increased up to 2.0 mg/dL in her regular control tests, without an evident causative factor. Kidney biopsy showed numerous intratubular calcium phosphate deposits, consistent with APN. She had a history of OSP laxative intake, and a sodium phosphate enema was used before a colonoscopy performed six months earlier. The temporal association between the use of OSP laxatives and acute kidney injury, should lead to the suspicion of APN. The urine sediment is generally normal or with mild to moderate proteinuria. The diagnosis is confirmed with a kidney biopsy. Until now, there is no specific treatment for APN, thus prevention is essential. In high-risk patients for developing APN, the administration of these laxatives should be avoided.

Monitoramento por radiotelemetria da área de uso de onça parda reintroduzida no entorno do Parque Estadual da Serra do Brigadeiro - MG, Brasil / Radiotelemetry monitoring of the home range of cougar reintroduced at the surroundings of the State Park of Serra do Brigadeiro - MG, Brazil

Um exemplar macho, subadulto de onça parda reintroduzido foi monitorado por técnica de radiotelemetria. O monitoramento foi de 110 dias, realizado de forma aleatória, com intervalos descontínuos. Os dados do acompanhamento sugerem que a área utilizada por este espécime seja de, aproximadamente, 26km². Esta configura o menor índice já descrito para a espécie, porém, deve-se ressaltar a importância deste monitoramento básico, visto a incipiência do comportamento de um felino de grande porte reintroduzido em habitat natural após período em cativeiro.

One subadult male specimen of a reintroduced mountain lion was monitored using the radio telemetry technique. The monitoring lasted 110 days, being randomly distributed. Data of the monitoring through radiotelemetry suggested that the home range of this specimen was of approximately 26km². This sets as the smallest home range described for this species. However, the importance of this basic monitoring should be emphasized, since information of the behavior of a large feline reintroduced in its natural habitat after a period in captivity is incipient.