Strong OLIG2 expression in supratentorial ependymoma, ZFTA fusion-positive: A potential diagnostic pitfall.

Ependymomas (EPN) are central nervous system neoplasms that exhibit an ependymal phenotype. In particular, supratentorial EPN (ST-EPN) must be differentiated from more aggressive entities such as glioblastoma, IDH-wildtype. This task is frequently addressed with the use of immunohistochemistry coupled with clinical presentation and morphological features. Here we describe the case of a young adult presenting with migraine-like symptoms and a temporoinsular-based expansile mass that was first diagnosed as a GBM, mostly based on strong and diffuse oligodendrocyte transcription factor 2 (OLIG2) expression. Molecular characterization revealed a ZFTA::RELA fusion, supporting the diagnosis of ST-EPN, ZFTA fusion-positive. OLIG2 expression is rarely reported in tumors other than GBM and oligodendrocyte-lineage committed neoplasms. The patient was treated with radiotherapy and temozolomide after surgery and was alive and well at follow-up. This report illustrates the need to assess immunostains within a broader clinical, morphological and molecular context to avoid premature exclusion of important differential diagnoses.

Vascular Myelopathies.

There are many vascular disorders that can affect the spinal cord, and their prevalence and etiology are highly influenced by age, sex, and risk factors. This article reviews the embryology and anatomy of the spinal cord, as well as several vascular conditions, describing their clinical and imaging presentation, emphasizing the different imaging modalities' contributions to increasing specificity and better defining the most appropriate therapy strategy for improving the patient's prognosis.

Environmental pollution and deaths due to stroke in a city with low levels of air pollution: ecological time series study / Poluição ambiental e óbitos devido a acidente vásculo-encefálico em uma cidade com baixos níveis de poluentes: estudo ecológico de séries temporais

CONTEXT AND OBJECTIVE: Little has been discussed about the increased risk of stroke after exposure to air pollutants, particularly in Brazil. The mechanisms through which air pollution can influence occurrences of vascular events such as stroke are still poorly understood. The aim of this study was to estimate the association between exposure to some air pollutants and risk of death due to stroke. DESIGN AND SETTING: Ecological time series study with data from São José dos Campos, Brazil. METHODS: Data on deaths due to stroke among individuals of all ages living in São José dos Campos and on particulate matter, sulfur dioxide and ozone were used. Statistical analysis was performed using a generalized additive model of Poisson regression with the Statistica software, in unipollutant and multipollutant models. The percentage increase in the risk of increased interquartile difference was calculated. RESULTS: There were 1,032 deaths due to stroke, ranging from 0 to 5 per day. The statistical significance of the exposure to particulate matter was ascertained in the unipollutant model and the importance of particulate matter and sulfur dioxide, in the multipollutant model. The increases in risk were 10% and 7%, for particulate matter and sulfur dioxide, respectively. CONCLUSION: It was possible to identify exposure to air pollutants as a risk factor for death due to stroke, even in a city with low levels of air pollution. .

CONTEXTO E OBJETIVO: Pouco se tem discutido sobre o aumento do risco de acidente vascular cerebral após exposição a poluentes do ar, principalmente no Brasil. Os mecanismos pelos quais a poluição pode influenciar a ocorrência de eventos vasculares, tais como acidente vascular cerebral, ainda são pouco compreendidos. O objetivo deste estudo foi estimar a associação entre exposição a alguns poluentes do ar e risco de morte por acidente vascular cerebral. TIPO DE ESTUDO E LOCAL: Estudo ecológico de séries temporais com dados de São José dos Campos, Brasil. MÉTODOS: Dados sobre mortes por acidente vascular cerebral em indivíduos de todas as idades que vivem em São José dos Campos e sobre material particulado, dióxido de enxofre e ozônio foram utilizados. A análise estatística utilizou modelo aditivo generalizado de regressão de Poisson com o software Statistica, em modelos "unipollutant" e "multipollutant". Foi calculado o percentual de aumento no risco para o aumento da diferença interquartil. RESULTADOS: Houve 1.032 mortes por acidente vascular cerebral, que variou de 0 a 5 por dia. A significância estatística da exposição ao material particulado em modelo "unipoluente" e a importância do material particulado e dióxido de enxofre no modelo "multipoluente" foram verificadas. O aumento do risco foi de 10% e 7%, respectivamente para material particulado e dióxido de enxofre. CONCLUSÃO: Foi possível identificar exposição a poluentes do ar como um fator de risco para morte por acidente vascular cerebral, mesmo em uma cidade com baixos níveis de poluição do ar. .

Environmental pollution and deaths due to stroke in a city with low levels of air pollution: ecological time series study.

CONTEXT AND OBJECTIVE: Little has been discussed about the increased risk of stroke after exposure to air pollutants, particularly in Brazil. The mechanisms through which air pollution can influence occurrences of vascular events such as stroke are still poorly understood. The aim of this study was to estimate the association between exposure to some air pollutants and risk of death due to stroke. DESIGN AND SETTING: Ecological time series study with data from São José dos Campos, Brazil. METHODS: Data on deaths due to stroke among individuals of all ages living in São José dos Campos and on particulate matter, sulfur dioxide and ozone were used. Statistical analysis was performed using a generalized additive model of Poisson regression with the Statistica software, in unipollutant and multipollutant models. The percentage increase in the risk of increased interquartile difference was calculated. RESULTS: There were 1,032 deaths due to stroke, ranging from 0 to 5 per day. The statistical significance of the exposure to particulate matter was ascertained in the unipollutant model and the importance of particulate matter and sulfur dioxide, in the multipollutant model. The increases in risk were 10% and 7%, for particulate matter and sulfur dioxide, respectively. CONCLUSION: It was possible to identify exposure to air pollutants as a risk factor for death due to stroke, even in a city with low levels of air pollution.

Cutaneous melanoma in the State of São Paulo: a spatial approach.

BACKGROUND: Cutaneous melanoma is a skin cancer with low incidence but high mortality rates. Several factors are associated with increased risk of melanoma, such as excessive sun exposure, fair skin, and family history, among others. Little is known about the spatial distribution of this cancer in Brazil. OBJECTIVE: To identify, through the use of geostatistical tools, spatial clusters of municipalities in the state of São Paulo based on their incidence of cutaneous melanoma. METHODS: This was an ecological and exploratory study of data on new cases obtained from Fundação Oncocentro for the period 1 January 2006-31 December 2011. Cases were separated by gender and rates per 100,000 inhabitants were calculated and used to compile thematic maps, Moran maps and kernel maps, using TerraView software. RESULTS: There were 3,172 new cases of cutaneous melanoma in the study period. High rates were identified in the North, Northwest, Southwest, and Southeast regions of São Paulo state. Global Moran's I values were statistically significant (p<0.05) at 0.12, 0.08, and 0.16, respectively, for males, females, and all cases. Areas such as the Southeast, North, and Northwest of São Paulo were identified as being of high priority for intervention. CONCLUSION: Spatial clusters of municipalities with high incidence rates of cutaneous melanoma in the state of São Paulo were identified. These data can serve as an important input for public health agencies.

Cutaneous melanoma in the State of São Paulo: a spatial approach

BACKGROUND: Cutaneous melanoma is a skin cancer with low incidence but high mortality rates. Several factors are associated with increased risk of melanoma, such as excessive sun exposure, fair skin, and family history, among others. Little is known about the spatial distribution of this cancer in Brazil. OBJECTIVE: To identify, through the use of geostatistical tools, spatial clusters of municipalities in the state of São Paulo based on their incidence of cutaneous melanoma. METHODS: This was an ecological and exploratory study of data on new cases obtained from Fundação Oncocentro for the period 1 January 2006-31 December 2011. Cases were separated by gender and rates per 100,000 inhabitants were calculated and used to compile thematic maps, Moran maps and kernel maps, using TerraView software. RESULTS: There were 3,172 new cases of cutaneous melanoma in the study period. High rates were identified in the North, Northwest, Southwest, and Southeast regions of São Paulo state. Global Moran's I values were statistically significant (p<0.05) at 0.12, 0.08, and 0.16, respectively, for males, females, and all cases. Areas such as the Southeast, North, and Northwest of São Paulo were identified as being of high priority for intervention. CONCLUSION: Spatial clusters of municipalities with high incidence rates of cutaneous melanoma in the state of São Paulo were identified. These data can serve as an important input for public health agencies. .

Asthma and ambient pollutants: a time series study.

OBJECTIVE: To estimate the risk of hospitalization for asthma in children after exposure to air pollutants in a medium-sized city in Southeast Brazil. METHODS: An ecological time series study was carried out with hospitalization data for asthma in children under 10 years of age living in São José dos Campos, SP, Brazil, and concentrations of particulate matter with aerodynamic diameter < 10 microns, sulfur dioxide, and ozone; data were also obtained on relative humidity and temperatures. Pearson's coefficient correlation was used for the study variables. To estimate the association between hospitalizations due to asthma and air pollutants, Poisson regression generalized additive models were built, according to lags of up to seven days. RESULTS: There was a strong correlation between hospitalizations and the pollutants particulate matter and sulfur dioxide. Exposure to particulate matter and sulfur dioxide were associated with significant relative risks of 1.01 to 1.04 of hospitalization due to asthma on the same day and within three days after exposure. Increases in the concentrations of these pollutants increase the risk of hospitalization between 8% and 19%. CONCLUSION: There is evidence of the effect of air pollutants on asthma hospitalization in a medium-sized city in Southeast Brazil.

Asma e poluentes ambientais: um estudo de séries temporais / Asthma and ambient pollutants: a time series study

OBJETIVO: O objetivo deste estudo foi estimar o risco para internação por asma em crianças após exposição a poluentes do ar em uma cidade de porte médio do Sudeste do Brasil. MÉTODOS: Foi realizado um estudo ecológico de séries temporais com dados de internação por asma em crianças com até 10 anos de idade residentes em São José dos Campos, SP, e concentrações de material particulado com diâmetro aerodinâmico inferior a 10 micra, dióxido de enxofre e ozônio; foram obtidos dados sobre umidade relativa do ar e temperaturas. Foram estimados os coeficientes de correlação de Pearson para as variáveis do estudo. Para estimar a associação entre as internações por asma e os poluentes do ar, foram construídos modelos aditivos generalizados de regressão de Poisson, segundo defasagens de até sete dias. RESULTADOS: Houve forte correlação entre as internações e os poluentes material particulado e dióxido de enxofre. Exposições a material particulado e dióxido de enxofre estiveram associadas a riscos relativos significativos de 1,01 a 1,04 para internação por asma no mesmo dia e em até três dias após a exposição. Aumentos nas concentrações destes poluentes elevam o risco de internação entre 8% e 19%. CONCLUSÃO: Assim, apresentaram-se evidências da ação de poluentes do ar na internação por asma em uma cidade de porte médio do Sudeste do Brasil.

OBJECTIVE: To estimate the risk of hospitalization for asthma in children after exposure to air pollutants in a medium-sized city in Southeast Brazil. METHODS: An ecological time series study was carried out with hospitalization data for asthma in children under 10 years of age living in São José dos Campos, SP, Brazil, and concentrations of particulate matter with aerodynamic diameter < 10 microns, sulfur dioxide, and ozone; data were also obtained on relative humidity and temperatures. Pearson's coefficient correlation was used for the study variables. To estimate the association between hospitalizations due to asthma and air pollutants, Poisson regression generalized additive models were built, according to lags of up to seven days. RESULTS: There was a strong correlation between hospitalizations and the pollutants particulate matter and sulfur dioxide. Exposure to particulate matter and sulfur dioxide were associated with significant relative risks of 1.01 to 1.04 of hospitalization due to asthma on the same day and within three days after exposure. Increases in the concentrations of these pollutants increase the risk of hospitalization between 8% and 19%. CONCLUSION: There is evidence of the effect of air pollutants on asthma hospitalization in a medium-sized city in Southeast Brazil.

Poluentes ambientais e chance de internações por asma em crianças - São José dos Campos, Brasil, nos anos 2004-2005 / Environmental pollutants and odds of hospitalization for asthma in children - São José dos Campos, Brazil, in the years 2004-2005

OBJETIVO: estimar a associação entre exposição a poluentes atmosféricos e internações por asma brônquica MÉTODO: trata-se de um estudo ecológico de séries temporais, que incluiu indivíduos de 0 a 10 anos residentes de São José dos Campos, para o período de 2004 e 2005. Os dados das internações por asma foram obtidos do DATASUS. Os dados de níveis ambientais de material particulado, dióxido de enxofre e ozônio foram obtidos da Companhia de Tecnologia de Saneamento Ambiental (CETESB) e de temperatura e umidade da Fundação de Ciência, Aplicações e Tecnologia Espaciais (FUNCATE). Foram feitos modelos de defasagem de 0 a 7 dias e analisados por regressão logística binária, obtendo-se as odds ratio e seus respectivos intervalos de confiança de 95 por cento, pelo SPSS 15.0. RESULTADOS: houve 809 internações com variações diárias de 0 a 7. Foi possível identificar associação do material particulado tanto no mesmo dia da exposição quanto nos próximos três, quinto e sexto dias com as internações; o dióxido de enxofre esteve associado às internações no primeiro, segundo e terceiro dias após a exposição e o ozônio no terceiro dia após a exposição ao gás. Dessa maneira, esse estudo mostrou associação entre poluentes atmosféricos e internações por asma numa cidade de porte médio.