Isoniazid-Induced Acute Liver Failure Requiring Liver Transplantation.

Tuberculosis (TB) is a contagious disease caused by the bacilli Mycobacterium tuberculosis complex. Currently, about a quarter of the world's population is infected with Mycobacterium tuberculosis. According to the World Health Organization, in 2018, Portugal had a TB incidence rate of about 24 cases per 100,000 inhabitants. It is estimated that 5-15% of individuals with latent TB infection progress to active TB. Isoniazid is one of the most widely used drugs for the treatment of active and latent TB. However, care must be taken with the possible development of toxicity, particularly hepatic. The authors report a case of a 60-year-old woman diagnosed with latent TB who started therapy with isoniazid. Five months later, she developed acute liver failure secondary to the drug, requiring liver transplantation, with a favorable clinical outcome. Thus, we intend to alert to the potential toxicities of isoniazid, establishing follow-up strategies in patients on this therapy.

Neurological manifestations of adult-onset Still's disease-case-based review.

Adult-onset Still's disease (AOSD) is a rare inflammatory disorder in which pathophysiology is yet to be fully understood. We report the case of a 66-year-old male that presents with fever, arthralgia, and laboratory abnormalities suggestive of a systemic inflammatory disease. During a diagnostic workout, the patient developed neurological symptoms, namely a sudden confounding syndrome and hearing loss that improved with corticosteroid therapy. After exclusion of malignancy, infection-namely nervous system infection-and other rheumatic diseases, AOSD diagnosis was made using the Yamaguchi criteria. In some rare cases, neurological symptoms are present and the diagnosis may become even more challenging if the clinicians are not aware of these rare manifestations of AOSD. Therefore, the authors present the case of a patient with neurological manifestations of AOSD.

Dangerous mistake: an accidental caffeine overdose.

Caffeine (1,3,7-trimethylxanthine) is a natural product commonly presented in food's composition, beverages and medicinal products. Generally, it is thought to be safe under normal dosage, yet it can be fatal in case of severe intoxication. We report a case of a healthy 32-year-old woman who went to the local emergency department (ED) 30 min after ingesting, accidentally, 5000 mg of anhydrous caffeine for a preworkout supplement. At the ED, she presented an episode of presyncope followed by agitation. ECG showed polymorphic broad complex QRS tachycardia and arterial blood gas revealed metabolic acidaemia with severe hypokalemia. The dysrhythmia was successfully treated with intravenous propranolol. Acid-base and hydroelectrolytic disorders were also corrected. A persistent sinus tachycardia was observed in the first 2 days in the ward and 5 days later she was discharged asymptomatic with internal medicine follow-up.

Utilização da tecnica de Moire para detectar alterações posturais / Utilization of Moire topography to detect postural deformities

O aparecimento de desvios na coluna ocorre em criancas e adolescentes durante a fase de crescimento, podendo levar a deformidades graves e comprometer a postura. Existem varias...

Analise dos casos de paralisia braquial obstetrica nos prontuarios do Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto - USP / Survey based on medical records about the cases of obstetric brachial paralysis of Ribeirao Preto Medicine University Clinic Hospital - USP

A paralisia braquial obstetrica e uma lesao do plexo braquial que ocorre durante o parto. O tratamento e conservador na maioria dos casos e o acompanhamento fisioterapico e essencial. O objetivo deste trabalho foi realizar uma analise dos casos acompanhados...