MATERNAL DRUG USE DURING PREGNANCY AND INFANCY-THE IMPORTANCE OF A MULTIDISCIPLINARY APPROACH Introduction: Drug use in pregnancy and infancy is a serious problem. In particular, the use of marijuana by the mother is not harmless. It may be associated with a withdrawal syndrome in the newborn and may affect the development of older children. This article describes a multidisciplinary approach to maternal drug use, providing advice to the family physician in dealing with affected children and increasing interest in the effects of drug addiction on the mother-child relationship. Description: We present the case of a pregnant woman affected by marijuana use and the human immune deficiency virus (HIV). The pregnancy was unplanned, but desired and monitored. The child presented with a delay in psychomotor development of 3 to 6 months. The case was managed by a family physician together with a pediatrician and a social worker. Comment: A multidisciplinary approach is recommended in these cases through timely referral. Provision of support for the mother is always appropriate and should be given early. Promotion of a functional family environment along with the surveillance of the child protection services, educational interventions during pregnancy and in the first months of life of the child are of value in aiding child development. This type of care is possible by the family doctor.

Marfan syndrome is an autosomal dominant illness of the connective tissue, with typical skeletal, ocular and cardiovascular manifestations. Less frequently, pulmonary involvement occurs, namely spontaneous pneumothorax, which generally is recurrent and occurs in 4 -11% of cases. The authors describe a 14 -year -old boy, previously healthy, admitted with a unilateral spontaneous pneumothorax, and clinical phenotype of Marfan syndrome. The subsequent investigation led to the diagnosis of mitral valve prolapse and dilatation of the root of aorta. Pneumothorax resolved through active drainage and a computerised tomography scan excluded subpleural blebs. The patient was readmitted two months later with a new spontaneous pneumothorax, with an identical localization. Surgical resection of a newly identified enfisematous bleb and pleurodesis were performed. Two years later he is asymptomatic. We highlight the importance of an early diagnosis of and a multidisciplinary approach to these patients. Monitoring illness progression and prevention of serious complications, namely cardiovascular, are essential.

Caso Clínico Clinical Case Resumo A síndroma de Marfan é uma doença do tecido conjuntivo de transmissão autossómica dominante, com manifestações esqueléticas, oculares e cardiovasculares típicas. Com menor frequência, verifica-se envolvimento pulmonar, nomeadamente pneumotórax espontâneo. Este é habitualmente recorrente, surgindo em 4-11% dos casos. Descreve-se um adolescente de 14 anos, sem diagnóstico anterior de doença, internado por pneumotórax espontâneo unilateral, com fenótipo de síndroma de Marfan. A investigação subsequente conduziu ao diagnóstico de prolapso da válvula mitral e dilatação da raiz da aorta. Houve resolução do pneumotórax através de drenagem activa e excluíram-se, por tomografia computorizada, lesões bolhosas subpleurais. O doente foi reinternado, dois meses depois, por novo pneumotórax espontâneo, com idêntica localização, procedendo-se a ressecção cirúrgica de bolha Abstract Marfan syndrome is an autosomal dominant illness of the connective tissue, with typical skeletal, ocular and cardiovascular manifestations. Less frequently, pulmonary involvement occurs, namely spontaneous pneumothorax, which generally is recurrent and occurs in 4-11% of cases. The authors describe a 14-year-old boy, previously healthy, admitted with a unilateral spontaneous pneumothorax, and clinical phenotype of Marfan syndrome. The subsequent investigation led to the diagnosis of mitral valve prolapse and dilatation of the root of aorta. Pneumothorax resolved through active drainage and a computerised tomography scan excluded subpleural blebs. The patient was readmitted two months later with a new spontaneous pneumothorax, with an identical localization. Surgical resection of a newly identified enfisematous bleb and Pneumotórax espontâneo-A pista para outro diagnóstico Spontaneous pneumothorax-a clue to another diagnosis Recebido para publicação/received for publication: 08.04.01 Aceite para publicação/accepted for publication: 08.05.12

Desmistificando a visão da arte latino-americana como uma arte menor, dependente de apropriações e reformulações de conceitos vindos de universosCada época histórica e cada espaço geográfico, com o seu contexto social e político, despertam nos artistas reacções e estímulos que são frequentemente canalizados para a produção artística. É assim natural que as suas obras se tornem relatos e evidências dos problemas de um lugar e de uma época, e simultaneamente o seu legado.

No abstract