Raimunda Violante Campos de Assis

Parinaud's oculoglandular syndrome associated with paracoccidioidomycosis

The authors report one case of Parinauds oculoglandular syndrome associated with Paracoccidioides brasiliensis infection. No other medical report of this condition was found in the medical literature available at Index Medicus and Medline. The eye involvement has been rather uncommon in paracoccidioidomycosis and this report emphasizes the possibility of this kind of presentation making it also necessary to include paracoccidioidomycosis among the several known causes of Parinauds oculoglandular syndrome.

Perioperative acute myocardial infarction after valve replacement

The incidence of fatal acute myocardial infarction (AMI) after valve replacement has decreased with use of cold potassium-induced cardioplegia. Despite this method of myocardial preservation, 12 of 662 consecutive patients submitted to valve replacement had this complication. This study retrospectively analyzes, in those 12 patients, the etiologic profile of fatal perioperative AMI, together with its morphologic aspects. The clinical picture in 11 patients was a refractory low cardiac output state. In only 3 cases was AMI diagnosis confirmed during life. Six patients either had a technical complication or a coronary embolus; in these patients AMI was localized in the vascular bed of a single occluded coronary artery, and its morphologic picture resembled that of usual AMI. The 6 other patients did not have a defined cause for AMI and coronary occlusion was not present. In 4 such patients, there was massive circumferential necrosis, mainly in the subendocardium; comparatively, there was a greater prevalence of hemorrhage, contraction bands and necrosis of the layer of subendocardial cells adjacent to the left ventricular cavity. The findings for this group suggest myocardial necrosis due to cell damage during cardiopulmonary bypass; no predisposing factor for perioperative AMI was identified.

Cardiac involvement in human rabies: case report

A case of human rabies with cardiac involvement and viral inclusion bodies in the heart is presented. The Negri bodies were found in the Schwann cells of the right epicardial atrium, with secondary mononuclear cells inflammation. In the myocardium, an interstitial edema, proliferation of Anitschkov and rare mononuclear inflammatory cells were seen. There was no relevant cardiovascular signs or symptoms. The rarity of histological descriptions of Negri bodies in the heart is stressed, as well as the importance of cardiac involvement as a potential complication for cases with life prolonged by intensive care units, or in the end-stages of the disease.

Raiva humana: estudo neuropatológico de trinta casos

O estudo epidemiologico e neuropatologico concernente a trinta autopsias de encefalite rabica foi realizado, tendo sido os dados obtidos comparados com aqueles da literatura. Nao houve relacao estatistica entre a topografia lesional e o local da mordida, entre o periodo de incubacao ou a duracao da doenca e a presenca ou ausencia de inclusoes virais (IV) assim como entre a intensidade do processo inflamatorio (PI) e a presenca de IV. A dispersao do PI e das IV atraves o SNC foi diretamente proporcional a sua intensidade. A estrutura mais frequentemente comprometida pelo PI foi o mesencefalo, seguido pelo bulbo, ponte e medula espinhal. A estrutura mais intensamente afetada foi o bulbo. As IV foram particularmente proeminentes no hipocampo e cerebelo.Thirty autopsies of human rabies encephalitis were carried out and the results of some epidemiological data and neuropathological studies were compared with those previously reported. There was no statistical relation between the topography of the lesions and the site of bite, between the incubation period or disease duration and the presence or absence of viral inclusion bodies (VIB), and between the intensity of the inflammatory process (IP) and the presence of VIB. The dispersion of the IP and of the VIB throughout the CNS was in direct proportion to their intensity. The most frequently affected structure by the IP was the midbrain, followed by the medulla oblongata, pons and spinal cord. The most intensively injured structure was the medulla oblangata. The VIB had striking predominance in the hippocampus and cerebellum.

Leiomiossarcoma epitelióide mediastinal em paciente portador de insuficiência coronária: tratamento cirúrgico simultâneo

The authors describe a case of a 64 year-old woman with a four-year history of angina. The patient was operated upon under standart cardiopulmonary bypass and had received two saphenous vein grafts and an internal mamary artery graft, concomitant with a mediastinal mass resection. The histological tumor diagnosis was epithelial leiomyosarcoma. The patient had first presented, 13 years ago, an uterine fibrosis, that had been resected. The radiograph diagnosis of the tumor was difficulted by several pleural opacities secondary to a previous pulmonary tuberculosis and a left thoracotomy. This rare association and the validity of the simultaneous surgical procedure are here emphasided.