Introduction:The treatment of leishmaniasis ischallenging, given the diffi culties in drug administration and resistance. Therefore, we chose to test the effi cacy of miltefosine combined with pentoxifylline. Methods: Twenty-seven isogenic C57Bl/6 mice were infected with Leishmania (Leishmania) amazonensis, and equally divided into three groups: miltefosine (200mg/ kg/day), miltefosine (200mg/kg/day) with pentoxifylline (8mg/kg/day), and untreated. Response to treatment was evaluated using paw diameter and parasitological criteria. Results: The number of viable Leishmania reduced signifi cantly within the miltefosine-pentoxifylline group (p < 0.05). Conclusions: There is hope that a viable treatment exists for Leishmania infection.
Objective: To describe the epidemiology of patients with thoracolumbar spine fracture submitted to surgery at Hospital Cristo Redentor and the related costs. Methods: Prospective epidemiological study between July 2014 and August 2015 of patients with thoracolumbar spine fracture with indication of surgery. The variables analyzed were sex, age, cost of hospitalization, fractured levels, levels of arthrodesis, surgical site infection, UTI or BCP, spinal cord injury, etiology, length of stay, procedure time, and visual analog scale (VAS). Results: Thirty-two patients were evaluated in the study period, with a mean age of 38.68 years. Male-female ratio was 4:1 and the most frequent causes were fall from height (46.87%) and traffic accidents (46.87%). The thoracolumbar transition was the most affected (40.62%), with L1 vertebra involved in 23.8% of the time. Neurological deficit was present in 40.62% of patients. Hospital stay had a median of 14 days and patients with neurological deficit were hospitalized for a longer period (p<0.001), with an increase in hospital costs (p= 0.015). The average cost of hospitalization was U$2,874.80. The presence of BCP increased the cost of hospitalization, and patients with spinal cord injury had more BCP (p= 0.014). Conclusion: Public policies with an emphasis on reducing traffic accidents and falls can help reduce the incidence of these injuries and studies focusing on hospital costs and rehabilitation need to be conducted in Brazil to determinate the burden of spinal trauma and spinal cord injury. os pacientes com déficit neurológico permaneceram internados por período mais prolongado (p <0,001), com aumento dos custos hospitalares (p= 0,015). O custo médio da internação foi de U$ 2.874,80. A presença de BCP aumentou o custo da internação e os pacientes com lesão medular tiveram mais BCP (p= 0,014). Conclusão: Políticas públicas com ênfase na redução de acidentes de trânsito e quedas podem ajudar a reduzir a incidência dessas lesões e estudos com foco nos gastos hospitalares e em reabilitação precisam ser realizados no
Introduction: Chordoma is a rare pathology in the pediatric age group, especially when located in the sacral region. Despite the local infiltrative character, some cases of metastasis are reported. The prognosis of these patients depends on early diagnosis and tumor resection. Case Report: 13 y-o girl transferred with a huge mass lesion in the lumbosacral area. In the primary hospital,she was submitted to a biopsy, whose anatomopathological report showed chordoma. The patient started with pain in the lumbosacral region a year ago, which rapidly evolved to a significant bulging in the area, pain in the posterior region of the left lower limb, urinary retention, and difficulty in walking. A surgical approach, both anterior and posterior, was performed en block resection of the tumor. During the procedures, there was evidence of metastatic dissemination to the ovary and peritoneum. The pathological examination confirmed the initial diagnosis. Due to the late recognition of the condition and the fast evolution of the disease, there was not enough time to perform adjuvant radiotherapy and the patient died. Discussion: From notochordal remnants, chordoma manifests in less than 5% of patients in the first two decades of life and is occasionally found in the sacral region, but rarely with metastatic dissemination at presentation. These patients open up with the manifestation of local pain and, when not diagnosed early, progress with bulging of the sacral region and tumor dissemination. Management is based on primary resection, for the complete removal of the lesion, followed by radiation therapy.
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