Distúrbios na secreção e ação do hormônio antidiurético

Acute cardiovascular responses to a session of Manual Lymphatic Drainage

Introduction Manual Lymphatic Drainage (MLD) creates pressure differentials to promote the movement of lymph and interstitial fluid, for their relocation into the bloodstream and can thus act on the variables responsible for determining blood pressure (BP). Objective To investigate the behavior of hemodynamic parameters, such as BP and Heart Rate (HR) during and immediately after a session of MLD. Materials and methods 23 healthy young volunteers with a mean age of 22 ± 2.97 years (18-29), underwent a session of MLD and evaluation of systolic BP, diastolic BP and HR after 10 minutes of initial rest, at the end of the implementation of the protocol in SP, PP and after 15 minutes of final rest. Results No changes were found in systolic BP or diastolic BP before, during and immediately after the MLD session (p = 0.57, p = 0.20, respectively). There was increased heart rate after the final 15 minute rest when compared to the HR after MLD in SP (72 ± 1.9 vs. 76 ± 1.9, p = 0.002), however, without clinical relevance. Conclusion During a session of MLD with healthy young women, no significant hemodynamic changes occurred, demonstrating that this technique is safe from the cardiovascular point of view.

Avaliação de estratégias no manejo da sede na sala de recuperação pós-anestésica

OBJETIVO: Avaliar estratégias simples e seguras para mitigar a sede no pós-operatório imediato (POI). MÉTODOS: Estudo quantitativo, experimental, de corte transversal, com amostra de 90 pacientes. Aqueles que apresentaram sede foram divididos aleatoriamente em dois grupos, Água ou Gelo. RESULTADOS: 96 (75%) relataram sede. O jejum pré-operatório variou de 8 a 37 horas e não houve associação entre o tipo de anestesia, sangramento, tempo de jejum e sede. A intensidade média inicial de sede foi de 5,1 para o grupo Água e 6,1, ao grupo Gelo. Os métodos experimentados mostraram-se eficazes em aliviar a sede no POI. O grupo Gelo teve intensidade final de 1,51 contra os 2,33 de grupo Água. Dois (2,2%) pacientes apresentaram vômitos durante a pesquisa. CONCLUSÃO: A sede é um desconforto real e gera grande sofrimento ao paciente. Este estudo indicou estratégias viáveis e seguras no manejo da sede no POI.

[Cutaneous non-Langerhans cells histiocytoses as cause of central diabetes insipidus]

The histiocytoses are rare diseases caused by alterations in the monocyte-histiocytic series with several clinical findings. Among the cutaneous syndromes of non-Langerhans cells, xanthoma disseminatum is the only disease of this group that has been classically associated to the central diabetes insipidus (CDI). The case reported describes a 30-year-old man that two years after presenting with CDI developed non confluent disseminated cutaneous brown papular lesions throughout the body. The histopathology, immunohistochemistry, and electronic microscopy were compatible with the diagnosis of non-Langerhans histiocytoses, suggesting the diagnosis of juvenile xanthogranuloma. The endocrine-metabolic evaluation did not show other alterations besides CDI in a 10-year follow up. The magnetic resonance of hypophysis showed absence of the pituitary hyperintense sign (bright spot). The radiologic and scinthigraphic evaluation of the bones did not show the presence of osteolytic lesions. This case prints out the importance of skin examination in cases of CDI and its association with cutaneous non-Langerhans histiocytoses in a broader spectrum, rather then restricted to the cases of xanthoma disseminatum.