Congenital hepatic fibrosis leading to cirrhosis and hepatocellular carcinoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Congenital hepatic fibrosis is an uncommon cause of portal hypertension. Despite the presence of portal hypertension, hepatocellular and renal function are usually well preserved. Congenital hepatic fibrosis is included in the group of congenital diseases of fibropolycystic disorders. These include a broad spectrum of clinical diseases which are usually accompanied by hepatic involvement.</p> <p>Case presentation</p> <p>We report the case of a 27-year-old Iranian woman with congenital hepatic fibrosis leading to cirrhosis and subsequently hepatocellular carcinoma.</p> <p>Conclusion</p> <p>Advanced cirrhosis was diagnosed and our patient was scheduled for liver transplantation. During preparation for transplant, a hepatic mass was discovered which was found to be hepatocellular carcinoma. Radiofrequency ablation was performed and our patient was referred for transplantation.</p

Development of new town(s) : a bold and ambitious approach to the amelioration of populous Manila.

The City of Manila, despite the problems of overpopulation, grows and grows day by day. Two decades after recovering from the ruins of World War II, Manila has risen from rubble to a condition that the pre-war residents would not have conceived. Hand in hand with the city's phenomenal growth is its steady rise in construc— tion activities. Buildings have sprouted in every space available to provide for the demands of habitation, business and pleasure which are all heavy. It is estimated that the daytime population of Manila is more than three (3) million people,1 and thousands of public and private vehicles, maintain a steady flow to and from the city. From this daily convergence of millions of people together with the multitudes of vehicles and rapid growth of population con— centrated within a small area of nearly fifteen (15) square miles stem the most pressing problems confronting the premier city of Metropolitan Manila. Manila‘s growth could have been guided after the war, considering that most of its structures (about 80%) were wiped out. But because of the absence of a planning body, to guide and co—ordinate various land uses in the rebuilding of the city, the result is a haphazard mixture of residential, commercial and industrial establishments together with the growth of squatter and slum areas which are appalling and chaotic. With the proclamation of Quezon City in 1948 as the new capital and permanent seat of the national government, Manila was divested of the distinction of being the national capital. Despite this act of the Congress, the city has remained the country's nerve center, the central point from which the modern trends in every phase of life have radiited. The city has continued to draw people, especi— ally from the rural areas, to its fold. The mention of the place has held a certain illusion of a promise of a good job, business possibilities, educational opportunities and luxurious living. This condition excessively increases the volume of activities confined in a limited space, at the same time straining Manila's infrastructure. Naturally enough, the result is congestion accompanied by economical, political, social and moral ills. Dr. Jal Balsara, regarding the development plan for Greater Bombay, India, comments that: "Disproportionate growth and lack of neighborhood life leads to various social and moral evils which multiply in geometric ratio with every arithmetical addition of population beyond a certain size." likewise, lewis Mumford says that: "The very cost of doing business in the big city is magnified by high land values, by expensive delays in transportation, by the high expense of storage; all these costs increase in congestion, and eventually become prohibitive.

Impacto da pandemia de Covid-19 na incidência de sífilis gestacional no município de Juazeiro-BA

Introdução: A sífilis é uma infecção sexualmente transmissível (IST) ocasionada pela bactéria Treponema pallidum, a qual se propaga por via sexual, transfusão sanguínea e transmissão vertical. Mesmo sendo uma doença prevenível e tratável, a sua incidência persiste em níveis preocupantes, principalmente durante a gravidez. Objetivo: examinar de forma abrangente como a pandemia de COVID-19 impactou a notificação de sífilis gestacional na cidade de Juazeiro-BA. Métodos: trata-se de um estudo epidemiológico retrospectivo com abordagem descritiva e quantitativa. Com dados obtidos a partir do Sistema de Informação de Agravos de Notificação, do Ministério da Saúde, em que foi realizado o comparativo entre os casos de sífilis gestacional na Bahia e no município de Juazeiro entre os anos de 2018 a 2021. Resultados: observou-se que, na cidade de Juazeiro no ano de 2018, o número de casos foi de 24,11% e em 2021 foi de 9,37%. Discussão: Existem possíveis explicações para justificar a queda no número de notificações neste período, como o isolamento social, as dificuldades de acompanhamento médico pelas medidas de segurança impostas pela pandemia, as subnotificações e a necessidade de atender e tratar as pacientes vítimas da COVID-19 em detrimento de pacientes eletivos no sistema de saúde. Conclusão: Conclui-se que a redução no número de registros de casos de sífilis em Juazeiro-Ba de 2018 para 2021 possivelmente teve influência da pandemia de COVID-19