Revista Científica do Hospital e Maternidade José Martiniano Alencar

Cryptorchid and orchidopexy in a young adult: a case report

Wed, 22 May 2024 00:00:00 +0000

Cryptorchidism is the absence of testicles in the scrotum that may be related to histopathological and functional changes that impair fertility or promote an increased risk of malignancy. They are more common in childhood and current guidelines are based on studies with the pediatric population establishing the diagnosis and management of these cases. However, there are cases of late diagnosis, the management of which is controversial. This article reports the case of a 22-year-old patient with an intraoperative diagnosis of cryptorchidism.

Incarcerated umbilical Littre's hernia: A case report

Wed, 22 May 2024 00:00:00 +0000

Littre's hernia is a rare presentation characterized by a Meckel's diverticulum within a hernia, which can be umbilical, femoral or inguinal. The case presented reveals an 83-year-old patient with stopped elimination of feces and bulging in the umbilical region, and during an abdominal tomography an incarcerated hernia was identified. She underwent enterectomy and Littre's hernia was identified during the intraoperative period. Resection of Meckel's diverticulum is important to prevent complications such as intestinal obstruction, hemorrhage and perforation and this potentially serious presentation must be taken into account for patients with hernias.

Richter's Hernia: case report and surgical description

Wed, 22 May 2024 00:00:00 +0000

Richter's hernia is a rare condition in which a portion of the antimesenteric border of the intestine protrudes through the hernial defect, potentially leading to intestinal obstruction and severe complications if not appropriately treated. It is a condition of varying severity that can result in strangulation or incarceration, necessitating immediate surgical intervention. Although patients typically experience abdominal pain, symptoms can be vague, and the differential diagnosis should consider other conditions. In this context, computed tomography and/or ultrasonography are usually the preferred diagnostic modalities. The purpose of this study is to report and describe a successful case of Richter's hernia correction in a 66-year-old woman treated in our facility. During surgery, incarceration and signs of necrosis were identified in the hernial sac, requiring subsequent laparotomy for a more detailed evaluation of the incarceration.

Post-cholecystectomy biliary ileus: case report

Wed, 22 May 2024 00:00:00 +0000

Gallstone ileus, an unusual complication associated with cholelithiasis and also chronic cholecystitis, predominantly affects women and elderly people over 60 years of age. Its incidence is low, representing 0.5% of biliary complications and intestinal obstructions, and its occurrence is rare in patients with past cholecystectomy surgery and there are only 49 case reports validated and published in the period from 1939 to 2019 in the world according to a database review including PubMed and MEDLINE. This article reports the case of a young patient, 48 years old, with intestinal obstruction caused by gallstone ileus and a medical past history of cholecystectomy.

Isolated rectal Kaposi's Sarcoma in an HIV-positive patient with human Herpesvirus type 8 infection: a case report

Robert William de Azevedo Bringel, Eric Arcanjo Bringel, Júlia Oliveira de Assis — Wed, 22 May 2024 00:00:00 +0000

The authors aim to describe a case of extensive isolated Rectal Kaposi's Sarcoma (KS) in a homosexual patient with HIV and Human Herpesvirus Type 8 (HHV-8) infection, presenting with complaints of rectal pain and bleeding. The study highlights endoscopic findings and diagnostic challenges. Data were obtained from the patient's medical records, including clinical history, physical examination, access to endoscopic and imaging tests, laboratory results, and pathology findings. This is one of the rare reports of isolated rectal KS in an AIDS patient with HHV-8 coinfection, emphasizing the importance of suspicion and active screening in HIV-positive individuals with relevant endoscopic findings.

Sheehan Syndrome: about a clinical case

Wed, 22 May 2024 00:00:00 +0000

Postpartum hypopituitarism, commonly referred to as Sheehan’s syndrome, arises from pituitary gland necrosis, a consequence of severe hypotension or significant uterine bleeding during or immediately after childbirth. The ensuing spectrum of manifestations stems from diminished secretion of one or more crucial hormones originating in the pituitary gland, ranging from mild clinical presentations to life-threatening outcomes.
While the complete pathophysiological understanding remains elusive, postpartum hemorrhage, still the leading cause of Sheehan’s Syndrome. However, it is postulated that genetic and autoimmune factors play contributory roles, given the frequently observed gradual progression, often necessitating years after the initial insult for discernible effects to manifest.
In this report, we show a case of Sheehan’s Syndrome diagnosed in an outpatient medical setting, over a decade after the last pregnancy. The patient received treatment involving thyroid hormone and corticosteroid therapy, resulting in a notable enhancement of her overall condition.

Oral and maxillofacial surgery performance at Hospital José Martiniano de Alencar: treating faces, changing lives

Raimundo Thompson Gonçalves Filho — Wed, 22 May 2024 00:00:00 +0000

Awareness event about bariatric surgery for patients: an experience report in a large digestive surgery center

Wed, 22 May 2024 00:00:00 +0000

Obesity, a global health issue, is characterized by excess body fat, with multifactorial etiological influence. With progressive stages, it can lead to various comorbidities, requiring multidisciplinary interventions, including lifestyle changes, medication treatments, and bariatric surgery in severe cases. Diseases with high prevalence in the general population are strongly associated with obesity, comorbidities that bariatric surgery aims to resolve after its completion. We can highlight some comorbidities with higher incidence, such as Type 2 Diabetes Mellitus (DM2), cardiovascular diseases, dyslipidemia, and hepatic steatosis. Preoperative multidisciplinary approach is crucial to reduce surgical risks and improve outcomes. A major digestive surgery center aimed to implement a program targeting patients desiring bariatric surgery. The program, led by a multiprofessional team, provided comprehensive guidance on obesity, treatment, and inclusion criteria. Screening based on BMI and comorbidities directed patients for evaluation and interventions, highlighting the multidisciplinary approach. Given the strong association of comorbidities in the obese population, bariatric surgery emerges as a treatment option aimed not only at sustained weight reduction but also at the long-term resolution of comorbidities.

Surveillance of notifiable diseases in a hospital in Fortaleza: an experience report

Wed, 22 May 2024 00:00:00 +0000

This is an experience report that aims to evaluate the national information system of the most recurrent diseases and/or conditions of compulsory notification at the José Martiniano de Alencar Hospital and Maternity, located in the municipality of Fortaleza-CE. This maternity hospital is a state reference and offers, at the time of admission of pregnant women, rapid serological testing for the detection of Sexually Transmitted Infections (STIs) in order to control the diseases and prevent vertical transmission. For the elaboration of this product, a survey of the disease that was most reported in the HMJMA was initiated, in the period from 2018 to 2022, with congenital syphilis being the selected disease. Thus, this product was developed in June 2023, based on this survey, the analysis and evaluation of the Notifiable Diseases Information System (Sinan) was followed. The results of this experiment were: verification of the good completeness of the variables pertinent to the Congenital Syphilis form, notification by the epidemiological surveillance of all naciturnal patients admitted to the service, active search for cases, but in relation to the opportunity of typing, it is necessary to devise strategies for entering the data into the system in the shortest possible time, although it is a weekly notifiable disease and it is an epidemiological orientation to wait for the results of the re-evaluated tests for better reliability of the case definition, mainly about Neurosyphilis. Thus, the following is a suggestion that the physician responsible for the hospitalization fill out the notification, as well as the typing of these forms in the same place of occurrence as a way to provide opportunities for the planning and decision-making process.

Epidemiological analysis of Inflammatory Bowel Disease in Brazil over the last 10 years

Wed, 22 May 2024 00:00:00 +0000

Inflammatory Bowel Disease, represented mainly by Crohn's Disease and Ulcerative Colitis, is characterized by a multifactorial and immune-mediated process in individuals with a genetic predisposition for the development and evolution of this condition. There is a global trend towards an increase in cases, both in developed and developing countries, whose explanatory hypotheses are based on the influence of lifestyle and globalization. In Brazil, despite the low incidence, there has been an increase in the number of cases in recent years. The study was carried out by analyzing data from the Hospital Morbidity Declaration system provided by SUS. The prevalence of females in both diseases and, in the age group, in young adults was analyzed. Regarding Brazilian regions, there was a prevalence in the South and Southeast. The North region had the highest mortality rate. This scenario may be a consequence of socioeconomic disparities and underreporting.

Epidemiological analysis of oral and maxillofacial biopsies at Hospital José Martiniano de Alencar

Wed, 22 May 2024 00:00:00 +0000

Introduction: A nearly and consistent diagnosis for oral and maxillofacial pathologies, as well as the poor epidemiological data on the oral disorders diagnosed in the city of Fortaleza, Ceara, a great comprehension concerning such entities is needed. Aim: The current article described an epidemiological survey for medical patients records undergoing their biopsies performed at the Service of Oral and Maxillo facial Surgery and Traumatology of the José Martiniano de Alencar Hospital in Fortaleza, Ceará. Medical records were analyzed from May 5, 2015 to December 31, 2020, in 72 (seventy-two) months. Data related to patient’s identification were examined: age, sex, birthplace, type of lesion and biopsy, early diagnosis, references to clinical, final and histopathological diagnoses. Histopathological reports, as well as clinical hypotheses, were categorized into thirteen groups of lesions. The gathered data were organized and imported into the Statistical Package for The Social Sciences program to prompt the statistical analysis. The level of significance adopted will be 95%. In Brazil, there are several studies that emphasize the incidence and prevalence of lesionsthat affect the stomatognathic system, based on the high diversity of diseases that affect the oral and maxillo facial complex. The study reflects the importance of oral and maxillo facial epidemiological research in health services.