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Main Author:	Antonio Carlos Nogueira
Format:	Artículo científico
Language:	pt
Published:	Hospital Universitário da Universidade de São Paulo 2011
Subjects:	Medicina esofágica Fístula traqueo Próteses e implantes Paracoccidioidomicose
Online Access:	https://www.redalyc.org/articulo.oa?id=576060811006
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Fístula traqueoesofágica associada a paracoccidioidomicose Antonio Carlos Nogueira Daniel Soares de Sousa Dantas Francisco Garcia Soriano Simone Peres Pilli João Epalanga Júnior Vidro Edmar Tafner Lincoln Tavares de Andrade Luis Masuo Maruta Hélio Minamoto José Pinhata Otoch João Augusto dos Santos Martines Medicina esofágica Fístula traqueo Próteses e implantes Paracoccidioidomicose A paracoccidioidomicose é uma micose sistêmica causada pelo Paracoccidioides brasiliensis, que é encontrado em regiões da América do Sul e Central, com casos relatados do norte do México ao sul da Argentina. As infecções causadas pelo P. brasiliensis frequentemente mimetizam outras doenças. A paracoccidioidomicose pulmonar crônica é frequentemente confundida com neoplasia ou tuberculose. Os autores apresentam o caso de um homem de 57 anos internado com quadro de tosse crônica, fraqueza, disfagia, mal estar e síndrome consumptiva. Fora submetido a tratamento para tuberculose com rifampicina, pirazinamida e isoniazida há 1 ano sem melhora dos sintomas. Durante a investigação clínica foi diagnosticada paracoccidioidomicose pulmonar com fistula traqueo-esofágica. A infecção foi tratada com anfotericina B deoxicolato e posteriormente com sulfametoxazol e trimetoprim devido a desenvolvimento de insuficiência renal aguda. A fístula foi tratada endoscopicamente com implante de prótese traqueal para proteger o brônquio esquerdo, seguido de clipagem do óstio esofágico da fístula. 2011 artículo científico 2236-1960 https://www.redalyc.org/articulo.oa?id=576060811006 pt http://www.redalyc.org/revista.oa?id=5760 Autopsy and Case Reports application/pdf Hospital Universitário da Universidade de São Paulo Autopsy and Case Reports (Brasil) Num.3 Vol.1

if (filemtime($filename) + $maxlifetime < time()) { unlink($filename); $count++; } } return $count; } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ protected function saveSession($sessId, $data): bool { $sessFile = $this->path . '/sess_' . $sessId; if ($handle = fopen($sessFile, 'w')) { $return = false; // Lock the file for exclusive access to avoid issues with multiple // processes writing session simultaneously: if (flock($handle, LOCK_EX)) { $return = fwrite($handle, $data); // Make sure that there's no trailing data by truncating the file to // the correct length: ftruncate($handle, strlen($data)); fflush($handle); flock($handle, LOCK_UN); } fclose($handle); if ($return !== false) { return true; } } // If we got this far, something went wrong with the file output... // It is tempting to throw an exception here, but this code is called // outside of the context of exception handling, so all we can do is // echo a message.

// Anecdotal testing Today and Yesterday seems to indicate destroy() // is called by the garbage collector and everything is good. // Something to keep in mind though. return 0; } /** * Write function that is called when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ public function write($sessId, $data): bool { if ($this->writesDisabled) { return true; } return $this->saveSession($sessId, $data); } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ abstract protected function saveSession($sessId, $data): bool; }

* * @return void */ public function writeClose() { // The assumption is that we're using PHP's ext/session. // session_write_close() will actually overwrite $_SESSION with an // empty array on completion -- which leads to a mismatch between what // is in the storage object and $_SESSION. To get around this, we // temporarily reset $_SESSION to an array, and then re-link it to // the storage object. // // Additionally, while you _can_ write to $_SESSION following a // session_write_close() operation, no changes made to it will be // flushed to the session handler. As such, we now mark the storage // object isImmutable. $storage = $this->getStorage(); if (! $storage->isImmutable()) { $_SESSION = $storage->toArray(true); session_write_close(); $storage->fromArray($_SESSION); $storage->markImmutable(); } } /** * Attempt to set the session name * * If the session has already been started, or if the name provided fails * validation, an exception will be raised. * * @param string $name * @return SessionManager * @throws Exception\InvalidArgumentException */ public function setName($name) { if ($this->sessionExists()) { throw new Exception\InvalidArgumentException( 'Cannot set session name after a session has already started'

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