ABSTRACT
Mycotic aortic aneurysm is a rare entity, manifesting with nonspecific symptoms of abdominal pain, fever, general malaise. We present a case of an 83-years-old-man, with hematemesis, generalized abdominal pain, and a six-month history of constipation, anorexia, and involuntary weight loss. Upper endoscopy revealed an erosion with oozing hemorrhage and hemostasis was performed. Later he developed a hemorrhagic shock. Abdominal computed tomography disclosed a 3,7x2,5x- 2,5cm aneurysm of the abdominal aorta with an aortoduodenal fistula, inducing an inflammatory plastron that encompassed the descending colon and duodenum. The inflammatory plastron prompted partial duodenal and colonic obstruction and led to an atypical presentation of an aortic aneurysm. Mycotic aneurysms complicated with aorto-enteric fistulas are potentially life-threatening conditions. We highlight the rarity of this case, as the clinical manifestations were prolonged and atypical. The goal is to drive awareness to maintain a high clinical suspicion, as early detection is critical to avoid a tragic outcome.
Subject(s)
Aneurysm, Infected , Aortic Aneurysm , Male , Humans , Aged, 80 and over , Aneurysm, Infected/complications , Abdominal Pain/diagnosis , Constipation/etiology , Weight LossSubject(s)
Gallbladder , Stents , Drainage , Endosonography , Gallbladder/diagnostic imaging , Gallbladder/surgery , HumansABSTRACT
This article analyses the use of facial recognition technology (FRT) in (semi-)public spaces with a focus in the Brazilian context. Therefore, the operation of the FRT processing chain is addressed, as well as the juridical nature of the facial signature, focusing mainly in the Brazilian data protection framework. FRT has been used in everyday life for several purposes, such as security, digital ranking, targeted marketing and health protection. However, the indiscriminate use of FRT poses high risks to privacy and data protection. In this perspective, to avoid harms such as inaccuracy, normalisation of cyber-surveillance and lack of transparency, safeguards were identified to guarantee individual rights, such as soft law, oversight, international standards and regulatory sandboxes.
Subject(s)
Duodenal Obstruction/diagnostic imaging , Gallstones/diagnostic imaging , Gastric Outlet Obstruction/diagnostic imaging , Intestinal Fistula/diagnostic imaging , Duodenal Obstruction/etiology , Duodenal Obstruction/surgery , Endoscopy, Digestive System , Female , Gallstones/complications , Gallstones/surgery , Gastric Outlet Obstruction/etiology , Gastric Outlet Obstruction/surgery , Humans , Intestinal Fistula/complications , Intestinal Fistula/surgery , Middle Aged , Syndrome , Tomography, X-Ray ComputedSubject(s)
Drainage/methods , Endoscopy, Digestive System , Pancreatic Pseudocyst , Stents , Surgery, Computer-Assisted , Endoscopy, Digestive System/instrumentation , Endoscopy, Digestive System/methods , Endosonography/methods , Humans , Male , Middle Aged , Pancreatic Pseudocyst/diagnosis , Pancreatic Pseudocyst/diagnostic imaging , Pancreatic Pseudocyst/surgery , Surgery, Computer-Assisted/instrumentation , Surgery, Computer-Assisted/methods , Treatment OutcomeABSTRACT
Actinomycosis is a rare disorder caused by an anaerobic gram-positive bacillus (Actinomyces), predominantly by the Actinomyces israelii species. Only 20% of cases show an abdominal manifestation, the appendix and ileocecal valve being the most frequent locations. Definitive diagnosis is based on microbiological cultures, microscopy or macroscopy examination. Nevertheless, histological examination of the percutaneous biopsy and blood microbiological cultures are rarely positives. Preoperative diagnosis is hampered by the lack of specific clinical and imaging manifestations, which often mimic malignancy. The rate of preoperative diagnosis is less than 10%, however, the outcome is excellent, with a low mortality rate. The authors describe the case of a patient who was diagnosed with primary hepatic actinomycosis only by a histological examination of the surgical specimen of left hepatectomy extended to segments V and VIII, for suspected malignant lesion. This case demonstrates the difficulties in diagnosing hepatic actinomycosis.
A actinomicose é uma entidade clínica rara, causada por uma bactéria anaeróbia gram-positiva (Actinomyces), predominantemente da espécie Actinomyces israelii. Apenas em 20% dos casos apresenta manifestação abdominal, sendo o apêndice e a válvula ileocecal as localizações mais frequentes. Os autores descrevem o caso de um doente em que foi feito o diagnóstico de actinomicose hepática primária apenas pelo exame histológico da peça cirúrgica de hepatectomia esquerda alargada aos segmentos V e VIII, por suspeita de lesão maligna. Este caso demonstra a dificuldade diagnóstica da actinomicose hepática. O diagnóstico pré-operatório é dificultado pela falta de manifestações clínicas e imagiológicas específicas, muitas vezes simulando doença maligna. Para além disso, as culturas e o exame histológico de biópsia percutânea raramente são positivos. A taxa de diagnóstico pré-operatório é inferior a 10%, contudo o prognóstico é bom, apresentando uma taxa de mortalidade de cerca de 7,6%.
ABSTRACT
Necessitando encontrar mecanismos que atuassem em nível da microbiota oral, tem-se na atualidade que o flúor exerce um papel importante na prevençäo da cárie, pois atua näo só em nível da microbiota oral, mas também na formaçäo de uma camada protetora do esmalte. Assim, materiais odontológicos restauradores, que liberam certa quantidade de flúor estäo sendo desenvolvidos e aprimorados para que funcionem de maneira efetiva nos mecanismos de prevençäo da cárie. Esta revisäo literária explanará o estado atual destes materiais
