Adult respiratory distress syndrome in newborns: 5 cases.

Aiming to set out the occurrence of the Adult Respiratory Distress Syndrome (ARDS) in the neonatal period, and according to recent descriptions in literature, we prospectively analyzed 5 cases. The criterion adopted to characterize ARDS was the expanded definition of the syndrome suggested by Murray & Matthay, (10), conjointly with non-invasive cardiac monitoring, to exclude pulmonary edema resulting from myocardial dysfunction. For each case, evolution was briefly described, as well as the predisposing conditions associated to the clinical score punctuation for diagnosis, stressing the importance of adequate identification and fastest possible management of such source of systemic effects. Upon admission at the intensive care unit (Ped. ICU), the five cases were either related to sepsis or to the syndrome of multiple organ failure, or to both. Both syndromes were essentially triggered by severe anoxia neonatorum, respiratory distress of the newborn and/or previous hospitalization with hypoxemia and use of a higher inspired fraction of oxygen. The primary causes of death were related to uncontrolled infection or shock, and not directly related to pulmonary failure.

[Intrauterine adhesion: analysis of 28 cases]. / Sinequia intra-uterina: analise de 28 casos.

PIP: Intrauterine adhesions are frequent in women with puerperal or post-abortion curettages. In rare cases there are adhesions due to inflammatory processes, particularly due to endometrial tuberculosis. The adhesions occur in patients in the menacme, without any endocrinological complaints. The disease affects women of different ethnic backgrounds; however this study is comprised of white females. A histopathological exam of the endometrial material revealed different histological varieties of the uterine wall including fibrous leukocytic exudate. In 89 cases studied, an increase was noted in the vascularity of fragments of the miometrium and fibrosis as well as changes of the miometrium in accordance with the cycle. These findings indicate that there are no endocrinological changes in women with intrauterine adhesions. Regarding treatment carried out by means of curettages, IUD insertion and estrogen treatment, good results were obtained in the normalization of the menstrual cycle in more than 60.8% cases. However, only 3 women were able to get pregnant, 2 had spontaneous abortions, and only 1 achieved a full term gestation.^ieng