Clinical and computerized tomography findings in patients with miliary infestation of cysticerci in brain parenchyma are presented. Cysticercotic encephalitis produces a severe and frequently fatal neurological disorder. Although parenchymal cysticercosis is common in endemic areas, in the cases reported here, the pathology is induced by a severe inflammatory response in brain parenchyma rather than by the physical presence of multiple cysts. As a result of diffuse brain edema, all cases develop subacute severe intracranial hypertension and compromise of visual function. One important feature of this form of neurocysticercosis is that it particularly affects young women.

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RESUMOIntrodução: Em 2011, foi introduzido um novo rastreio para a diabetes gestacional que permitiu um diagnóstico mais precoce e de maior número de casos com o intuito de reduzir complicações maternas e perinatais. O objectivo deste estudo foi avaliar a prevalência da diabetes gestacional, comparar resultados obstétricos e perinatais do anterior e presente rastreio e os resultados e realização da prova de reclassificação pós-parto. Material e Métodos: Estudo retrospectivo em gestações simples e diabetes gestacional diagnosticados em 2009 (n = 223) e 2012 (n = 237), vigiadas na Maternidade Dr. Alfredo da Costa, Portugal. Após consulta de processos clínicos procedeu-se à análise de características demográficas, história médica e obstétrica, aumento ponderal durante a gravidez, idade gestacional do diagnóstico, terapêutica utilizada, resultados perinatais e reclassificação pós-parto, seguida de comparação destas variáveis entre os anos de 2009 e 2012. Resultados: Em 2012, houve maior prevalência de diabetes gestacional, ganho ponderal inferior (p < 0,001), maior recurso à terapêutica farmacológica (p < 0,001) e aumento dos casos diagnosticados no primeiro e segundo trimestres (p < 0,001). Relativamente aos resultados neonatais, o peso médio do recém-nascido ao nascer foi significativamente menor (p = 0,001) com diminuição dos recém-nascidos grandes para a idade gestacional (p = 0,002). A taxa de reclassificação pós-parto foi semelhante nos dois anos mas em 2012 houve um aumento dos resultados normais e diminuição das anomalias da glicémia em jejum. Discussão: Critérios mais apertados do actual rastreio permitiram a redução da maioria das complicações da diabetes gestacional levantando novas questões. Conclusão: A introdução do actual rastreio resultou num aumento de prevalência, diagnóstico mais precoce e redução da macrossomia. Palavras-chave: Diabetes Gestacional; Rastreio. Results: In 2012, there was an increased gestational diabetes prevalence, lower weight gain during pregnancy (p < 0.001), more frequent use of pharmacological therapy (p < 0.001) and more diagnosed cases during first and second trimester (p < 0.001). As for neonatal outcomes, in this group, the medium weight at birth was significantly lower (p = 0.001) with a decrease of newborns great for gestational age (p = 0.002). Postpartum screening rate was similar among both groups but in 2012 there was an increase of normal results and a decrease of impaired fasting glucose. Discussion: Tighter criteria of the current screening test resulted in reduction of the majority of gestational diabetes complications but raised new questions. Conclusion:The introduction of the current screening test resulted in an increased prevalence, earlier diagnosis and reduction of macrosomia. Keywords: Gestational Diabetes; Mass Screening. INTRODUÇÃOA diabetes gestacional (DG) é uma das complicações médicas mais frequentes da gravidez, cuja incidência tem vindo a crescer nos últimos anos. Definida como uma intolerância aos hidratos de carbono de intensidade variável que...

Bacillus anthracis is an uncommon cause of meniningitis. The characteristic hemorrhagic features in two patients who died despite antibiotic treatment are presented and discussed.

SUMMARY Two patients with the diagnosis of brain death were evaluated with computerized axial tomography (CAT). After intravenous infusion of 30% Conray there was no visualization of the intracranial vasculature (circle of Willis). The second patient also had an isoelectric EEC A third patient with an intracerebral lesion similar to the other cases but without diagnosis of brain death, showed good visualization of the circle of Willis. Therefore, contrast-enhanced CAT scans can be used as another diagnostic aid to confirm brain death.AN ISOELECTRIC electroencephalogram is one of the means by which brain death is confirmed. Lack of cerebral artery perfusion at arteriography has also been recognized as a neurodiagnostic sign of brain death. In the following 2 cases the lack of cerebral artery perfusion on contrast-enhanced computerized axial tomography (CAT) scan also confirmed brain death. Patient 1A 75-year-old hypertensive woman experienced a severe headache associated with vomiting 30 minutes prior to becoming unconscious. Blood pressure was 210/120, pulse 60/min. Brain stem reflexes were absent. The patient was flaccid and unresponsive to all stimuli. Supportive respiratory devices were used for 30 minutes after the patient went into respiratory arrest. An isoelectric electroencephalogram was recorded the following day and CAT scanning was performed after infusion of 300 ml of 30% Conray at the rate of 25 ml/min for the first 6 minutes and 12 ml/min for the next 12. The first horizontal cut, designed to transect the circle of Willis, was scanned after 150 cc had been infused. The preinfusion scan revealed an extensive thalamic hemorrhage with intraventricular extension.The contrast-enhanced scan confirmed this but failed to visualize the circle of Willis ( fig. 1). Patient 2A 47-year-old male complained of severe headache on the morning of hospital admission. BP was 170/90, pulse 80/min. He was semicomatose and responsive to painful stimuli only. Right hemiparesis was evident. There was nuchal rigidity. A spinal tap revealed CSF pressure of 450 mm of water and bloody spinal fluid.