BackgroundSubmucosal hematoma has never been associated with caustic injuries. Long-term follow-up of patients who ingested ammonia is not well known and ammonia ingestion is rare.MethodsIn a Single-center observational study, prospective data were collected from 2009 to 2013, in patients over the age of 14 years old referred for ammonia ingestion. The emergency and follow-up endoscopic data and the outcome were reported.ResultsAmmonia ingestion occurred in 43 patients. Submucosal hematoma of the gastric wall was a distinctive endoscopic sign observed in 15 (34.8%) cases. Oropharyngeal lesions were present in 30 (69.8%) patients, which was associated with ingestion with suicidal intent in 18 cases. Mild and severe endoscopic lesions (grade IIB to IIIB) were found in 16 (37.2%) cases with 10 (23.3%) cases presenting submucosal hematoma at initial endoscopy. A complete spontaneous gastric healing was frequently observed in 36 (83.7%) cases. In 11 cases with submucosal hematoma, a favourable outcome was observed with a medical treatment, however 6 of these patients had severe endoscopic lesions initially.ConclusionsSubmucosal hematoma of the gastric wall is an endoscopic sign occurring frequently in ammonia ingestion. Submucosal hematoma should be distinguished from necrosis in order to avoid false misclassification in favour of more severe lesions, which would lead to an abusive surgery.Electronic supplementary materialThe online version of this article (10.1186/s12876-018-0809-8) contains supplementary material, which is available to authorized users.

Background: In Brazil, myocardial infarction affects approximately 300 thousand individuals per year, with mortality rate of 30%, and 80% of deaths occur in the first 24 hours. The telemedicine systems, such as Latin America Telemedicine Infarct Network, aim to optimize the stages from triage to treatment. Communication among the emergency care units and tertiary care services is known to be difficult, and the system aims to interconnect triage, physician and transport, facilitating transfer of patients to the cath lab. Therefore, implementing a telemedicine system for myocardial infarction and assessment of cardiovascular outcomes is justified. The objective of this study was to analyze the implementation of a telemedicine program, the characteristics of the population and the time intervals for treatment and transfer, in addition to in-hospital mortality. Methods: A cohort study with 110 individuals diagnosed as ST-segment elevation myocardial infarction in five emergency care units in the city of Aparecida de Goiânia, from November 2015 to August 2018. Results: In the period described, 110 patients were treated, mean age of 58±11 years, 72.2% were male, 53.6% hypertensive, 23.6% diabetic, 27.3% active smokers and 6.4% had a history of previous infarction. Of the patients admitted, 90.9% were submitted to primary percutaneous coronary intervention, and 8.2% of total number of patients died within the first 30 days. Conclusion: Implementing a telemedicine system resulted in reduced mortality as compared to the public health system. Despite better care, we observed longer transfer time, which justifies the need to implement fibrinolytic therapy in secondary care units. RESUMO -Introdução:No Brasil, o infarto agudo do miocárdio acomete aproximadamente 300 mil pessoas ao ano, com mortalidade de 30%, sendo 80% destas nas primeiras 24 horas. Os sistemas de telemedicina, a exemplo do Latin America Telemedicine Infarct Network, objetivam otimizar as etapas, desde a triagem ao tratamento. Sabendo da dificuldade de comunicação entre unidades de pronto atendimento e serviço terciário, o sistema busca interligar triagem, médico e transporte, facilitando a transferência do paciente à hemodinâmica. Desse modo, justifica-se a implementação de sistema de telemedicina voltado ao infarto agudo do miocárdio e à avaliação de desfechos cardiovasculares. O objetivo do presente trabalho foi analisar a implementação de um programa de telemedicina, bem como as características da população e os tempos envolvidos no tratamento e na transferência, além da mortalidade hospitalar. Métodos: Estudo de coorte com 110 indivíduos diagnosticados com infarto agudo do miocárdio com supradesnivelamento do segmento ST em cinco unidades de pronto atendimento do município de Aparecida de Goiânia, no período entre novembro de 2015 e agosto de 2018. Resultados: No período descrito, foram tratados 110 pacientes, com média de idade de 58±11 anos, sendo 72,2% do sexo masculino, 53,6% hipertensos, 23,6% diabéticos, 27,3% tabagistas ativos e 6,4% com história...

Prinzmetal angina is described as episodes of chest pain that occur at rest, associated with electrocardiographic changes in the ST-segment, which may or may not evolve to ischemia, and are not caused by coronary artery disease, having more recently been related to a coronary vasospasm. This diagnosis becomes especially challenging in patients who have already undergone previous percutaneous coronary procedures. We report a case of a patient diagnosed with Prinzmetal angina with a recent percutaneous coronary intervention due to coronary artery disease.

The journal will accept original material for publication in the field related to ultrasound. The journal will publish: 1. Full original articles, whether prospective, experimental or retrospective. 2. Case reports of great interest as long as they are well documented clinically and laboratory. 3. Special issues with annals, collections of works presented at Scientific Journal CEREM-GO and supplements with works on a topic of great interest. 4. Review articles, including meta-analyzes and editorial comments, upon invitation, when requested to members of the editorial board.

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