Neonatal arterial hypertension in nephro-urological malformations in a tertiary care hospital

An increase in the survival of neonates with antenatal diagnosis of malformations was achieved by the recent technical advances in neonatal intensive care units. The aim of this article is to describe the experience with neonatal arterial hypertension, in newborns with nephro-urological malformations, in a tertiary care referral Nursery, in a period of 4 years. Newborn medical records from the Nursery Annex to the Maternity of Hospital das Clinicas, School of Medicine, University of Sao Paulo, with the diagnosis of nephro-urological malformations and systemic arterial hypertension (SAH) at hospital discharge, in a period from January 1999 to January 2003, were retrospectively analysed. Among 10.278 live newborns in the studied period, 15 (0.15%) newborns were compatible with our inclusion criteria. Of these 15 newborns, 12 (80%) were male and three were premature (20%). In relation to aetiology, 13 (87%) showed urological malformations, 1 (6%) chronic renal insufficiency secondary to kidney dysplasia and one (6%) autosomal recessive polycystic kidney disease. SAH control was achieved with monotherapy in eight patients (53%), five patients (33%) needed an association of two drugs (calcium-channel blocker and angiotensin converting enzyme (ACE) inhibitor), one child used three types of antihypertensive drugs (calcium-channel blocker, ACE inhibitor and hydrochlorothiazide) for pressoric control and one child's blood pressure (BP) was controlled exclusively by peritoneal dialysis. The incidence of nephro-urological malformations in our service during the studied period was 0.89%. SAH incidence among these newborns was 19%. Our data reinforce previous studies pointing to the necessity to consider children with nephro-urological malformations as a risk group for SAH, who should have the BP evaluated since the neonatal period.     

Acute post-traumatic optic nerve avulsion: case report

Optic nerve avulsion is a rare, but devastating complication. In this condition, the optic nerve is forcibly disinserted from the retina, choroid, and vitreous, and the lamina cribrosa is retracted from the scleral rim. If the media are clear, the avulsion is easily diagnosed. The appearance of the fundus is striking, with a hole or cavity where the optic disc has retracted into its dural sheath. The complementary examinations are not very accurate for the diagnosis of this pathology and with some residual vision, opaque media, that occur in partial avulsion, the diagnosis may be mistaken or delayed. In this article we report a case of complete optic nerve avulsion examined at the Retina and Vitreous Department of the "Hospital das Clínicas" of the Federal University of Uberlandia - MG - Brazil.     

Size and proliferative index correlation in acoustic neuromas

Acoustic neuromas are the most common tumors in the cerebellopontine angle. The molecular mechanisms involved in generation and growth of these tumors are not completely elucidated. Many radiological, clinic and immunohistochemistry data were correlated to tumor growth. We studied 11 acoustic neuromas surgically treated at Hospital S?o Paulo/Unifesp and correlated clinical and radiological data with proliferative index (Ki-67). The size of the tumors were positively correlationated with proliferative index. No other correlation had statistic significativity.     

Congenital and neonatal measles during an epidemic in São Paulo, Brazil in 1997

During a measles outbreak, 2 mothers with measles gave birth at University Hospital in S?o Paulo City, Brazil. Blood, saliva and urine were collected from the mothers and newborns. Measles virus genome and IgM antibodies against measles were detected. In 1 infant, measles virus genome persisted in peripheral blood mononuclear cells for 157 days after birth.     

Sigmoid sinus thrombosis in a child after closed head injury

Sigmoid sinus thrombosis in children following a closed head injury is rare. The authors report such a case with the clinical presentation, radiological findings and current literature.