Aspectos electroclínicos de la epilepsia temporal mesial / Neuropsychological risk in temporal lobe epilepsy

Introducción: La epilepsia del lóbulo temporal mesial se considera la más frecuente de las epilepsias focales, con signos y síntomas característicos que ayudan a definir su diagnóstico. Contenidos: Dentro de su historia natural, las crisis pueden iniciar en los primeros años de vida, usualmente como episodios febriles con un periodo de remisión, para reaparecer en la adolescencia o en el adulto joven. La presentación electroencefalográfica tiene un patrón característico, con aparición de puntas y ondas agudas interictales en la región temporal anterior, por lo general unilaterales, y con actividad ictal generalmente theta en la misma localización. La causa más frecuente es la esclerosis del hipocampo. El tratamiento con medicamentos anticrisis puede controlar la epilepsia, aunque algunos casos pueden evolucionar a la farmacorresistencia, en la cual la cirugía de epilepsia está indicada, y tiene buenos resultados. Conclusiones: Esta revisión se centra en la descripción de las características electroclínicas de la epilepsia temporal mesial, para hacer un diagnóstico temprano e iniciar un tratamiento adecuado, a efectos de lograr un mejor pronóstico y una mejor calidad de vida para los pacientes con epilepsia y sus familiares.

Introduction: Mesial temporal lobe epilepsy is considered the most common of the focal epilepsies, with characteristic signs and symptoms that help define its diagnosis. Contents: In the natural history of the disease, seizures can begin in the first years of life, usually as febrile seizures with a period of remission, to reappear in adolescence or in the young adult. The electroencephalographic presentation has a characteristic pattern with the appearance of interictal sharp waves and spikes in the anterior temporal region, usually unilateral, and with generally theta ictal activity in the same location. The most common cause is hippocampal sclerosis. Treatment with antiseizure medication can control epilepsy. However, in some cases evolution of drug resistance can occur, leading to epilepsy surgery as the most appropriate treatment, based on its good results. Conclusions: This review focuses on the description of the electroclinical characteristics of temporal mesial epilepsy, in order to make an early diagnosis and adequate treatment, thus providing a better prognosis and quality of life for patients with epilepsy and their families.

O Gabinete de Curiosidades da Universidade de Coimbra: uma proposta museológica e científica / The Cabinet of Curiosities at the University of Coimbra: a museological and scientific initiative

Resumo Os gabinetes de curiosidades constituem a origem do museu moderno. Na utopia da Wunderkammer existe a aspiração à convivência entre arte e ciência. Como docente do novo Curso de Philosofia Natural da Universidade de Coimbra (1772), Portugal contratou o naturalista italiano Domingos Vandelli, que transportou consigo uma coleção, com objetos do seu gabinete em Pádua, à qual anexou uma outra coleção, recolhida em Portugal (1764-1768), repositório ainda não tributário do paradigma naturalista de Lineu. É com fundamento na descrição dessas duas coleções que defendemos a relevante proposta - para a ciência e para a museologia - do Gabinete de Curiosidades do Museu da Ciência da Universidade de Coimbra, inaugurado em maio de 2022.

Abstract Cabinets of curiosities are the origin of modern museums. The utopia these Wunderkammer contain also includes aspirations for art and science to coexist. The Italian naturalist Domingos Vandelli was contracted as an instructor for the new course in natural philosophy at the University of Coimbra (1772), and brought objects from his own cabinet in Padua; he combined these with another collection mounted in Portugal (1764-1768), which did not yet conform to Linneus's naturalistic paradigm. Based on descriptions of these two collections, we defend the important initiative underway at the Cabinet of Curiosities at the University of Coimbra's Museum of Science, which was inaugurated in May 2022.

Erasing the extinct: the hunt for Caribbean monk seals and museum collection practices / O desaparecimento do que está extinto: a caça às focas-monge-do-caribe e as práticas de acervos museológicos

Abstract The Caribbean monk seal (Monachus tropicalis), the only seal species native to Central America, was declared extinct in 2008, with the last confirmed sighting in 1952. This species historically had a broad range throughout the gulf of Mexico. This article discusses the history of Western science on the monk seal, from its first recorded sighting by a Western colonizer in 1492 to scientific collection in the 1800s and 1900s, as a history of the erasure of this species. Museum practices of collecting and displaying Caribbean monk seals have directly contributed to this erasure, and ways of writing a new history by giving the Caribbean monk seal the capacity to refuse erasure are suggested.

Resumo A foca-monge-do-caribe (Monachus tropicalis), a única espécie de focas nativa da América Central, foi declarada extinta em 2008, tendo o último registro de avistamento confirmado em 1952. Historicamente, essa espécie ocupou vastas áreas do golfo do México. Este artigo discute a história da ciência ocidental sobre a foca-monge, desde o primeiro registro de seu avistamento por um colonizador ocidental, em 1492, até a coleção científica nos anos 1800 e 1900, como uma história de desaparecimento da espécie. As práticas museológicas de coleta e exposição de focas-monge-do-caribe contribuíram diretamente para tal desaparecimento, e aqui são sugeridas maneiras de escrever uma nova história concedendo à foca-monge-do-caribe a possibilidade de recusa ao desaparecimento.

A flora da antiga capitania de Porto Seguro na viagem de Wied-Neuwied, 1815-1817: prática científica, inventário naturalista e colaboração indígena / The flora of the former Captaincy of Porto Seguro in the journey of Wied-Neuwied, 1815-1817: scientific practice, naturalistic inventory, and indigenous collaboration

Resumo O artigo revisita o relato da Viagem ao Brasil (1815-1817) de Maximiliano de Wied na perspectiva de valorizar as contribuições dos registros da expedição do príncipe naturalista para a história natural, especialmente no levantamento da flora do atual extremo sul da Bahia. A abordagem perpassa a análise das características gerais da produção científica no campo da história natural e dos relatos de viagens do século XIX, bem como do perfil biobibliográfico do viajante. O objetivo central é demonstrar como se deu a relação do naturalista com as populações indígenas na produção do seu inventário florístico, destacando a importância dos saberes e fazeres dos índios para o trabalho do naturalista europeu.

Abstract This article revisits Maximilian zu Wied's Viagem ao Brasil (1815-1817) in terms of the value of this naturalist prince's expedition records for natural history, especially the survey of flora in what is currently south Bahia. The general characteristics of scientific production in the field of natural history and nineteenth-century travel reports are analyzed, as well as the bibliographic profile of the traveler. The main objective is to demonstrate how the naturalist's relationship with indigenous peoples emerged in producing the flora inventory, highlighting the importance of indigenous knowledge and practices to the European naturalist's work.

Epistemología del cáncer de mama: comprendiendo su origen para anticipar su desenlace / Epistemology of breast cancer: understanding its origin to anticipate its outcome

Resumen El cáncer de mama es uno de los de mayor incidencia y mortalidad a nivel mundial. Es necesario comprender su historia natural a través de una mirada epistemológica, integrando modelos clínicos, filosóficos y matemáticos para poder abordar una visión general del mismo, cómo se ha interpretado a lo largo de la historia, y el aporte que los estudios de detección y ensayos clínicos han dado a los tratamientos que reciben los pacientes, mostrando evidencia científica e histórica que pueda ser empleada como bitácora por parte de clínicos, salubristas y público en general.

Abstract Breast cancer has one of the highest incidence and mortality rates worldwide. It is necessary to examine its natural history through an epistemological framework, by integrating clinical, philosophical, and mathematical models, in order to have an overview of it, as well as to understand how it has been interpreted throughout history, and the contribution of screening and clinical trials to treatments received by patients, based on scientific and historical evidence that can be used as a guide by clinicians, health professionals, and the general public.

Amphibians in a transition region between the Cerrado and the Atlantic Forest, west-central region of the state of São Paulo, Brazil / Anfíbios em uma região de transição entre o Cerrado e a Mata Atlântica, Região Centro-Oeste do estado de São Paulo, Brasil

Studies of the diversity and natural history of amphibians are extremely important and contribute with the knowledge about the patterns of geographical distribution and biology of the species, outlining the factors that influence this distribution, and contributing to the development of conservation projects of them. This study aimed to identify the richness, abundance, spatial and temporal distribution of amphibians in the Bauru region, state of São Paulo, Brazil, and compare the species composition with others regions in the São Paulo state located in the Cerrado and Atlantic Forest. Eight locations were sampled between the years 2009 and 2012. Thirty-seven amphibian species were recorded, which represents 15.61% of the species in the state of São Paulo. In comparison to other regions of the state, Bauru resemble with the north-western region of the state and with the Assis Ecological Station in species composition. The community of amphibians in the studied region is regulated to morphoclimatic conditions, environmental heterogeneity and the conservation of natural resources, which directly reflect on the composition, abundance and species' spatial and temporal distribution of the amphibians in this region. The richness of amphibians of the Bauru region is significant for the state of São Paulo and contributes with the maintenance of environments with conditions for the occurrence of Proceratophrys moratoi, which is considered in threat of extinction. This study contributed with the filling gap on the amphibian knowledge of the state of São Paulo.

Estudos sobre diversidade e história natural de anfíbios são de extrema importância para o conhecimento sobre os padrões de distribuição geográfica e biologia das espécies delineando os fatores que influenciam nessa distribuição, o que contribui para a elaboração de projetos de conservação mais realistas e efetivos. Este estudo visou identificar a riqueza, abundância, distribuição espacial e temporal das espécies de anfíbios da região de Bauru, estado de São Paulo, Brasil, e comparar a composição de espécies com outras regiões de Cerrado e Mata Atlântica do estado de São Paulo. Oito localidades foram amostradas entre os anos de 2009 e 2012. Foram registradas 37 espécies de anfíbios, as quais representam 15,61% das espécies do estado de São Paulo. Em comparação com outras regiões do estado, Bauru se assemelha à Região Noroeste do estado e à Estação Ecológica de Assis na composição de espécies. A comunidade de anfíbios da região estudada é regulada pelas condições morfoclimáticas, heterogeneidade ambiental e estado de conservação dos recursos naturais, que refletem diretamente na composição, na abundância e nos padrões de distribuição espacial e temporal das espécies de anfíbios presentes na região. A riqueza de anfíbios da região de Bauru é significativa para o estado de São Paulo e contribui com a manutenção de ambientes com condições para a ocorrência de Proceratophrys moratoi, considerada em risco de extinção. Este estudo contribui com o preenchimento de lacunas no conhecimento de anfíbios do estado de São Paulo.

Covid-19: fisiopatología, historia natural y diagnóstico / Covid-19: pathophysiology, natural history, and diagnosi

SARS CoV-2 se transmite principalmente a través de la vía aérea. La media del tiempo desde la exposición hasta la presentación de la sintomatología es de 5 días. Los pacientes infectados pueden permanecer asintomáticos o tener un amplio espectro de manifestaciones como: fiebre, tos seca y malestar general. Aproximadamente, el 20% de pacientes con la COVID-19 requiere hospitalización (10% en área general, el 5% requiere cuidados intermedios y el 5% restante ingresa a cuidados intensivos debido a su estado de gravedad). Los exámenes de laboratorio y radiológicos muestran anomalías de común presentación, pero inespecíficas. El diagnóstico es a través de la prueba de reacción en cadena de polimerasa de transcripción inversa cuando detecta SARS CoV-2. El objetivo de la revisión que se presenta es sintetizar elementos importantes relacionados con la fisiolopatología, manifestaciones clínicas y diagnóstico de la COVID-19.

SARS CoV-2 is transmitted primarily through the airway. The mean time from exposure to presentation of symptoms is 5 days. Infected patients can remain asymptomatic or have a wide spectrum of manifestations such as: fever, dry cough, and general malaise. Approximately 20% of patients with COVID-19 require hospitalization (10% in the general area, 5% require inter-mediate care, and the remaining 5% enter intensive care due to their serious condition). Labora-tory and radiological examinations show common but nonspecific abnormalities. Diagnosis is through the reverse transcription polymerase chain reaction test when it detects SARS CoV-2. This systematic review aimed to synthesize important elements related to the physiopathology, clinical manifestations, and diagnosis of COVID-19.

Dos aldeamentos ao horto botânico: a apropriação de plantas de uso indígena na capitania de Guayases, 1772-1806 / From settlements to the botanical garden: the appropriation of plants used by indigenous peoples in the captaincy of Guayases, 1772-1806

Resumo O artigo pretende contribuir com a história das ciências, a história indígena e a história da América portuguesa. Parte-se dos pressupostos metodológicos de Dominique Pestre e da historiografia sobre a América portuguesa para interrogar a existência de uma rede de aldeamentos indígenas, a atuação de funcionários com saberes naturalistas, o envio de espécies botânicas para análise em Portugal e, por fim, a fundação de um horto botânico na capitania de Guayases (Goiás) entre 1772 e 1806. Apresenta-se a contribuição indígena na construção dos conhecimentos da história natural e discutem-se as influências de concepções da Ilustração na reforma do sistema colonial português na capitania a partir de documentação administrativa portuguesa, cartas e do estudo da aplicação de leis e instruções.

Abstract The article intends to contribute to the history of science, indigenous history and the history of Portuguese America. We begin with the methodological assumptions of Dominique Pestre and the historiography on Portuguese America to investigate a network of indigenous settlements, the work of civil servants with naturalist knowledge, the shipment of botanical species for analysis in Portugal and, finally, the foundation of a botanical garden in the captaincy of Guayases (Goiás) from 1772 to 1806. We describe the indigenous contribution to the construction of natural history knowledge, and discuss the influence of Enlightenment concepts on the reform of the Portuguese colonial system in the captaincy based on Portuguese administrative documentation, letters and study of the application of laws and instructions.

Natural history study of an understudied sea catfish species from Panama (Siluriformes: Ariidae)

The semi-anadromous sea catfish species Cathorops tuyra (Ariidae, Besudo sea catfish) from the Tropical Eastern Pacific has been found reproductively active in the freshwater rivers and lakes of the Panama Canal. Despite growing concerns for biodiversity, reports on natural history are lacking for many Neotropical sea catfishes. We aimed to provide data on the diet and seasonal timing of spawning of C. tuyra for an autochthonous, semi-anadromous, brackish water population from Rio Santa Maria and an allochthonous freshwater non-migrating population from Rio Chagres, an affluent to the Panama Canal, to understand how changing from semi-anadromous to residential lifestyle affects the natural history of a species. Fish from both sampling sites were dissected and information on stomach content, size, weight, parasitic load, sex, maturity, and number of eggs were recorded. In Rio Chagres, there was a female bias and individuals were larger and in pre-spawning mode compared to Rio Santa Maria. Parasite prevalence was low in Rio Chagres and zero in Rio Santa Maria. The diets were very similar between populations: gastropods, bivalves, and insects were the most important prey items in both rivers representing a diverse omnivorous diet that is similar to that of other catfishes.(AU)

El bagre de mar semi-anádromo Cathorops tuyra (Ariidae, Bagre besudo) del Pacífico Oriental Tropical se encuentra reproductivamente activa en los ríos y lagos del Canal de Panamá. A pesar de la creciente preocupación por la biodiversidad, faltan informes sobre la historia natural de muchos de los bagres Neotropicales. Nuestro objetivo es proporcionar datos básicos sobre la dieta y el momento del desove estacional de C. tuyra para una población autóctona semi-anádroma de agua salobre de Río Santa María y una población alóctona residente de agua dulce de Río Chagres para comprender cómo el cambio de un estilo de vida semi-anádromo a residencial afecta la historia natural de una especie. Se disecaron peces de ambos sitios de muestreo y se registró la información de contenido del estómago, tamaño, peso, carga parasitaria, sexo, madurez y número de huevos. En Río Chagres hubo un sesgo femenino y los individuos eran más grandes y estaban en modo pre-desove que en Río Santa María. La prevalencia de parásitos fue baja en el Río Chagres y cero en Río Santa María. Las dietas fueron muy similares entre poblaciones: gasterópodos, bivalvos e insectos fueron las presas más importantes en ambos ríos, lo que representa una dieta omnívora diversa, que es similar a la de otros bagres.(AU)

King Cobra and snakebite envenomation: on the natural history, human-snake relationship and medical importance of Ophiophagus hannah

King Cobra (Ophiophagus hannah) has a significant place in many cultures, and is a medically important venomous snake in the world. Envenomation by this snake is highly lethal, manifested mainly by neurotoxicity and local tissue damage. King Cobra may be part of a larger species complex, and is widely distributed across Southeast Asia, southern China, northern and eastern regions as well as the Western Ghats of India, indicating potential geographical variation in venom composition. There is, however, only one species-specific King Cobra antivenom available worldwide that is produced in Thailand, using venom from the snake of Thai origin. Issues relating to the management of King Cobra envenomation (e.g., variation in the composition and toxicity of the venom, limited availability and efficacy of antivenom), and challenges faced in the research of venom (in particular proteomics), are rarely addressed. This article reviews the natural history and sociocultural importance of King Cobra, cases of snakebite envenomation caused by this species, current practice of management (preclinical and clinical), and major toxinological studies of the venom with a focus on venom proteomics, toxicity and neutralization. Unfortunately, epidemiological data of King Cobra bite is scarce, and venom proteomes reported in various studies revealed marked discrepancies in details. Challenges, such as inconsistency in snake venom sampling, varying methodology of proteomic analysis, lack of mechanistic and antivenomic studies, and controversy surrounding antivenom use in treating King Cobra envenomation are herein discussed. Future directions are proposed, including the effort to establish a standard, comprehensive Pan-Asian proteomic database of King Cobra venom, from which the venom variation can be determined. Research should be undertaken to characterize the toxin antigenicity, and to develop an antivenom with improved efficacy and wider geographical utility. The endeavors are aligned with the WHO´s roadmap that aims to reduce the disease burden of snakebite by 50% before 2030.(AU)

De curandis hominum morbis: una receta médica del siglo XVIII para el sarampión y las viruelas en el Nuevo Reino de Granada / De curandis hominum morbis: An 18th century medical prescription for measles and smallpox in the Nuevo Reino de Granada

En el Archivo Histórico de la Biblioteca "Octavio Arizmendi Posada" de la Universidad de La Sabana, se encuentra una colección de más de un centenar de recetas médicas de finales del siglo XVIII donadas por el presbítero Cipriano Rodríguez Santa María, epónimo institucional del archivo. Estos textos son un legado histórico médico y un fundamento para comprender la terapéutica colonial y tradicional de diversas enfermedades. En este artículo, se describen algunas recetas para el tratamiento de la viruela y el sarampión, como aporte a la historia de la medicina en Colombia.

A collection of more than one hundred medical recipes from the late 18th century was donated by Presbyter Cipriano Rodríguez Santa María, institutional eponym of the collection at the Historical Archive "Octavio Arizmendi Posada" of the library of the Universidad de La Sabana in Colombia. These texts represent an important historical and medical legacy and they constitute an important basis for understanding the colonial and traditional therapeutics related to various diseases. In this article, we describe one of these recipes for the treatment of smallpox and measles as a contribution to the history of medicine in Colombia.

The natural history of patients with acute disc herniation: a series of 150 cases / A história natural de pacientes com herniação discal aguda: uma série de 150 casos / La historia natural de pacientes con herniación discal aguda: una serie de 150 casos

ABSTRACT Objective This study aims to analyze the characteristics of patients with acute lumbar/sciatic disc herniation who underwent conservative, pain block procedures and surgical treatment, in order to better understand the natural history of herniations and their surgical indications, as well as the impact of hernia volume. Methods We analyzed 150 patients with a diagnosis of acute lumbar disc herniation. The treatments considered were: conservative, infiltration/pain block procedures and microdiscectomy. For seven patients who were surgically treated, the lumbar sequestrectomy volume was submitted to pathological analysis. Results Of the 150 patients, 80% were treated conservatively; 15.31% were treated with pain block procedures and 4.66% underwent microdiscectomy. The mean age of the surgical group was 42.5 years, and 57.1% of the patients were men. Most of the hernias were at L5-S1 (55.5%), and 77.7% were on the left side. All patients had presented significant lumbar pain or sciatica for a long period prior to the surgery. The Lasègue sign was present in all patients. Of the total number of patients, 85.7% presented hypoesthesia and 42.8% presented focal motor deficits, among other findings. The mean hernia volume was 9.6 cm3. Conclusions Unresponsiveness to conservative treatment is an important indication for surgery. The clinical manifestations in patients with a lumbar/sciatic hernia can be very diverse, as can the disc herniation volume, so these are not good indicators for surgery. Level of evidence IV; Case series

RESUMO Objetivo O presente estudo tem como objetivo analisar as características dos pacientes com hérnia de disco lombar/ciática aguda que passaram por procedimentos conservadores, procedimentos de bloqueio de dor e tratamento cirúrgico, a fim de melhor entender a história natural das hérnias e suas indicações cirúrgicas, assim como o impacto do volume da hérnia. Métodos Analisamos 150 pacientes diagnosticados com hérnia de disco lombar aguda. Os tratamentos considerados foram: tratamento conservador, procedimentos para bloqueio da dor/infiltração e microdiscectomia. Para sete pacientes tratados cirurgicamente, o volume de sequestrectomia lombar foi enviado para análise patológica. Resultados Dos 150 pacientes analisados, 80% foram tratados de modo conservador, 15,31% com procedimentos de bloqueio da dor e 4,66% com microdiscectomia. A idade média do grupo submetido à cirurgia foi 42,5 anos, sendo que 57,1% dos pacientes eram homens. A maior parte das hérnias estavam localizadas em L5-S1 (55,5%) e 77,7% das hérnias estavam no lado esquerdo. Todos os pacientes apresentaram significativa dor lombar ou ciática por um longo período antes da cirurgia. O sinal de Lasègue estava presente em todos pacientes. Do número total de pacientes, 85,7% apresentaram hipoestesia e 42,8% apresentaram déficits motores focais, entre outros achados. O volume médio das hérnias foi 9,6 cm3. Conclusões A falta de resposta ao tratamento conservador é uma importante indicação para cirurgia. As manifestações clínicas dos pacientes com hérnia lombar/ciática podem ser muito diversas, assim como o volume da hérnia de disco, portanto, esses não são bons indicadores para cirurgia. Nível de evidência IV; Série de casos.

RESUMEN Objetivo El presente estudio tiene como objetivo analizar las características de los pacientes con hernia de disco lumbar/ciática aguda que pasaron por procedimientos conservadores, procedimientos de bloqueo de dolor y tratamiento quirúrgico, a fin de entender mejor la historia natural de las hernias y sus indicaciones quirúrgicas, así como el impacto del volumen de la hernia. Métodos Analizamos a 150 pacientes diagnosticados con hernia de disco lumbar aguda. Los tratamientos considerados fueron: conservador, procedimientos para bloqueo de dolor/infiltraci ón y microdiscectom ía . Para siete pacientes tratados quirúrgicamente, el volumen de secuestrectomía lumbar fue enviado para análisis patológico. Resultados De los 150 pacientes analizados, 80% fue tratado de modo conservador, 15,31% con procedimientos de bloqueo de dolor y 4,66% con microdiscectomía. La edad promedio del grupo sometido a cirugía fue de 42,5 años, siendo que 57,1% de los pacientes eran hombres. La mayor parte de las hernias estaban localizadas en L5-S1 (55,5%) y 77,7% de las hernias estaban en el lado izquierdo. Todos los pacientes presentaron dolor lumbar o ciático significativo por un largo período antes de la cirugía. La señal de Lasègue estaba presente en todos los pacientes. Del número total de pacientes, 85,7% de los pacientes present ó hipostesia y 42,8% present ó déficit s motores focales, entre otros hallazgos. El volumen promedio de las hernias fue de 9,6 cm3. Conclusiones La falta de respuesta al tratamiento conservador es una importante indicación para la cirugía. Las manifestaciones clínicas de los pacientes con hernia lumbar/ciática pueden ser muy diversas, así como el volumen de la hernia de disco, por lo tanto, é stos no son buenos indicadores para cirugía. Nivel de evidencia IV; Serie de casos.

Instrumentos, objetos e coleções como fontes para a história do ensino das ciências / Instruments, objects, and collections as sources for the history of science education

Resumo Um elevado número de escolas secundárias portuguesas possui coleções científicas, elementos centrais para a memória e identidade das instituições que as preservam, concorrendo para a compreensão das características que foram definindo a instrução pública de nível secundário em Portugal ao longo do tempo. Porém, esse património é ainda largamente desconhecido. O artigo chama a atenção para o debate historiográfico que envolve o uso de fontes materiais na história do ensino das ciências, dando a conhecer a relevância das coleções de história natural dos liceus de Portugal, bem como sua vulnerabilidade, dada a ausência de uma política geral ou diretrizes orientando sua conservação.

Abstract A large number of Portuguese secondary schools have scientific collections, which are central elements for the memory and identity of the institutions that maintain them, and contribute to understanding the characteristics that over time have defined public secondary education in Portugal. However, this heritage is still largely unknown. This article draws attention to the historiographic debate surrounding the use of material sources in the history of science education, describing the relevance of natural history collections in Portuguese secondary schools as well as their vulnerability, considering the lack of a general policy or guidelines related to conservation.

Natural history of lumbar canal stenosis: clinical aspects and sagittal balance / História natural da estenose do canal lombar: aspectos clínicos e do equilíbrio sagital / Historia natural de la estenosis del canal lumbar: aspectos clínicos y del equilibrio sagital

ABSTRACT Objective To compare the sagittal alignment (SA) parameters in individuals with LCS and surgical indication with a control group and to study the correlations between SA parameters and ODI, VAS and EQ-5D in individuals with LCS and surgical indication. Methods In this multicenter cross-sectional case-control study, the individuals were allocated as follows. A stenosis group (SG) composed by patients with LCS confirmed by magnetic resonance imaging with surgical indication, treated between July 2010 and August 2016 and a control group (CG), without LCS. All subjects underwent anamnesis, completed the Health-related Quality of Life (HRQoL) and total spine radiographs were taken. Clinical data, HRQoL and radiographic parameters were correlated. Results Sixty-four individuals formed the SG and 14 the CG. The SG had higher values of mean age, coronal imbalance, sagittal vertical axis (SVA), pelvic tilt (PT), sacrofemoral distance (SFD), overhang (OH), PI-LL mismatch, Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) for pain and smaller thoracic kyphosis (TK), total (TLPL) and regional lumbopelvic lordosis (RLPL) in all vertebrae, sagittal offset (SO) in all evaluated vertebrae and EuroQol-5D (EQ-5D) with p <0.05. In the SG, the only significant correlations (p <0.05) were between TK and ODI and EQ-5D; all the other sagittal parameters did not correlated with VAS, ODI or EQ-5D. Conclusion SG had SA parameters altered in relation to CG. There was a direct correlation between decrease in TK and worsening of ODI and EQ-5D in SG. Level of evidence: III; Case Control Study.

RESUMO Objetivo Comparar parâmetros do AS em indivíduos portadores de EDL com indicação cirúrgica aos de uma população controle; estudar a correlação entre os questionários ODI, VAS e EQ-5D a parâmetros do AS nos portadores de EDL com indicação cirúrgica. Métodos Estudo transversal multicêntrico tipo caso-controle. Grupo estenose (GE) composto por portadores de EDL, confirmada por Ressonância Nuclear Magnética, com indicação cirúrgica, atendidos entre Julho de 2010 a agosto de 2016. Grupo controle (GC) sem EDL. Todos os indivíduos realizaram anamnese, responderam questionários de qualidade de vida e realizaram radiografias de coluna total. Dados clínicos, questionários e parâmetros radiográficos foram correlacionados. Resultados 64 indivíduos formaram o GE e 14 o GC. GE apresentou valores maiores de idade média, desequilíbrio coronal, sagital vertical index (SVA), pelvic tilt (PT), sacrofemoral distance (SFD), overhang (OH), missmatch PI - LL, Owestry Disability Index (ODI), Visual Analogic Scale (VAS) e valores menores de cifose torácica, lordose lombopélvica total e regional em todas as vértebras, offset sagital em todas as vértebras avaliadas e EuroQol-5D (EQ-5D), com p < 0,05. No GE, houve correlações significativas (p < 0,05) apenas entre TK e ODI e EQ-5D, sendo que todos os outros parâmetros sagitais não apresentaram correlação significativa com os questionários de qualidade de vida. Conclusão GE apresentou perda dos parâmetros de AS em relação ao GC. Houve correlação direta entre diminuição da TK e piora do ODI e EQ-5D no GE. Nível de Evidência III; Estudo de Caso Controle.

RESUMEN Objetivo Comparar los parámetros del alineamiento sagital (AS) en individuos con ECL e indicación quirúrgica con un grupo control y estudiar las correlaciones entre los parámetros de SA y ODI, EVA y EQ-5D en pacientes con ECL e indicación quirúrgica. Métodos En este estudio multicéntrico de casos y controles, los individuos fueron asignados como sigue. Un grupo estenosis (GE) compuesto por pacientes con ECL confirmada por imágenes de resonancia magnética con indicación quirúrgica, tratados entre julio de 2010 y agosto de 2016 y un grupo control (GC) sin ECL. Todos los individuos se sometieron a una anamnesis, respondieron el cuestionario de Calidad de Vida Relacionada con la Salud (HRQoL) y se tomaran radiografías totales de la columna. Se relacionaron datos clínicos, HRQoL y parámetros radiográficos. Resultados Sesenta y cuatro individuos formaron el GE y 14 el GC. El GE tenía valores más altos de edad promedio, desequilibrio coronal, eje sagital vertical (ESV), inclinación pélvica (IP), distancia sacrofemoral (DSF), protuberancia (P), falta de emparejamiento IP -LL, Índice de Discapacidad de Oswestry (ODI), Escala Visual Analógica (VAS) para el dolor y menos cifosis torácica (CT), lordosis lumbopélvica total (LLPT) y regional (LLPR) en todas las vértebras, offset sagital (OS) en todas las vértebras evaluadas y EuroQol-5D (EQ-5D), con p < 0,05. En el GE, las únicas correlaciones significativas (p < 0,05) fueron entre TC y ODI y EQ-5D; todos los demás parámetros sagitales no se correlacionaron con EVA, ODI o EQ-5D. Conclusión El GE tuvo parámetros de AS alterados en relación con el GC. Hubo correlación directa entre la disminución de TC y el agravamiento del ODI y EQ-5D en el GE. Nivel de evidencia III; Estudio de Caso Controle.

Reproductive and feeding biology of the common lancehead Bothrops atrox (Serpentes, Viperidae) from central and southwestern Brazilian Amazonia

The pitviper Bothrops atrox is a widely distributed and medically important snake in Amazonia. Given that the reproductive and feeding biology of snakes varies geographically, we aimed to characterize the natural history of individuals from the central and southwestern portions of the biome. We analyzed museum-preserved specimens collected in the region between the metropolitan areas of the Brazilian cities of Manaus and Porto Velho. We took morphometric measurements and performed the analysis of gonads and digestive tracts of 109 individuals. Females attain sexual maturity with larger body sizes. Adults of the species show pronounced sexual dimorphism in body size, with females being larger. The reproductive cycle, especially in males, appears to be synchronized with regional rainfall, which markedly differed across the biome. The pitvipers had a generalist diet, consuming a wide range of prey such as centipedes, frogs, lizards, snakes and mammals. We provide the first record of predation of the snake Imantodes cenchoa (Dipsadidae) by B. atrox. There was an ontogenetic shift in the diet: smaller individuals fed mainly on ectothermic prey (centipedes, frogs, lizards and snakes), while adults tended to incorporate endothermic prey (mammals) to their food repertoire. (AU)

A Case of Asymptomatic Multiple Endocrine Neoplasia Type I with Thymic Carcinoid

Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominant hereditary disorder caused by germline mutation of the MEN1 gene. It is characterized by tumors of the anterior pituitary gland, parathyroid glands, and endocrine pancreas. Thymic carcinoid tumor is uncommon and associated with a high mortality, but its natural history has not been investigated yet. We report a case of asymptomatic MEN 1 with a thymic carcinoid tumor. A 37-year-old man underwent a routine medical checkup and upper gastrointestinal endoscopy revealed a duodenal neuroendocrine tumor (NET). Further studies showed the coexistence of pancreatic tumor, parathyroid hyperplasia, pituitary adenoma, and thymoma. The patient underwent duodenal endoscopic mucosal resection, distal pancreatectomy, subtotal parathyroidectomy, and thymectomy. The pathological test revealed a duodenal NET, pancreatic NET, parathyroid hyperplasia, and thymic carcinoid tumor. He was treated for MEN 1. We report this asymptomatic case of MEN 1 with a literature review.

Growth Pattern and Prognostic Factors of Untreated Nonfunctioning Pituitary Adenomas

OBJECTIVE: Pituitary adenomas (PAs) are often detected as incidental findings. However, the natural history remains unclear. The objective of this study was to evaluate the natural history and growth pattern of untreated PAs.METHODS: Between 2003 and 2014, 59 PAs were managed with clinico-radiological follow up for longer than 12 months without any kind of therapeutic intervention. Tumor volumes were calculated at initial and last follow-up visit, and tumor growth during the observation period was determined. Data were analyzed according to clinical and imaging characteristics.RESULTS: The mean initial and last tumor volume and diameter were 1.83±2.97 mL and 13.77±6.45 mm, 2.85±4.47 mL and 15.75±8.08 mm, respectively. The mean annual tumor growth rate was 0.33±0.68 mL/year during a mean observation period of 46.8±32.1 months. Sixteen (27%) PAs showed tumor growth. The initial tumor size (HR, 1.140; 95% confidence interval, 1.003–1.295; p=0.045) was the independent predictive factor that determined the tumor growth. Six patients (11%) of 56 conservatively managed non-symptomatic PAs underwent resection for aggravating visual symptoms with mean interval of 34.5 months from diagnosis. By Cox regression analysis, PAs of last longest diameter over 21.75 mm were a significant prognostic factor for eventual treatment.CONCLUSION: The initial tumor size of PAs was independently associated with the tumor growth. Six patients (11%) of conservatively managed PAs were likely to be treated eventually. PAs of last follow-up longest diameter over 21.75 mm were a significant prognostic factor for treatment. Further studies with a large series are required to determine treatment strategy.

Characteristics and Clinical Course of Fusiform Middle Cerebral Artery Aneurysms According to Location, Size, and Configuration

OBJECTIVE: To analyze the angiographic features and clinical course, including treatment outcomes and the natural course, of fusiform middle cerebral artery aneurysms (FMCAAs) according to their location, size, and configuration.METHODS: We reviewed the literature on adult cases of FMCAAs published from 1980 to 2018; from 25 papers, 112 FMCAA cases, for which the location, size, and configuration could be identified, were included in this study. Additionally, 33 FMCAA cases in our hospital were included, from which 16 were assigned to the observation group. Thus, a total of 145 adult FMCAA cases were included. We classified the FMCAAs according to their location (l-type 1, beginning from prebifurcation; l-type 2, beginning from bifurcation; l-type 3, beginning from postbifurcation), size (small, <10 mm; large, ≥10 mm; giant, ≥25 mm), and configuration (c-type 1, classic dissecting aneurysm; c-type 2, segmental ectasia; c-type 3, dolichoectatic dissecting aneurysm).RESULTS: The c-type 3 was more commonly diagnosed with ischemic symptoms (31.8%) than hemorrhage (13.6%), while 40.9% were found accidentally. In contrast, c-type 2 was more commonly diagnosed with hemorrhagic symptoms (14.9%) than ischemic symptoms (10.6%), and 72.3% were accidentally discovered. According to location, ischemic symptoms and hemorrhage were the most frequent symptoms in l-type 1 (28.6%) and l-type 3 (34.6%), respectively. Most of l-type 2 FMCAAs were found incidentally (68.4%). Based on the size of FMCAAs, only 11.1% of small aneurysms were found to be hemorrhagic, while 18.9% and 26.0% of large and giant aneurysms were hemorrhagic, respectively. Although four aneurysms of the 16 FMCAAs in the observation group increased in size and one aneurysm decreased in size during the observation period, no rupture was seen in any case and there were no significant predictors of aneurysm enlargement. Of 104 FMCAAs treated, 14 cases (13.5%) were aggravated than before surgery and all the aggravated cases were l-type 1.CONCLUSION: While ischemic symptoms occurred more frequently in l-type 1 and c-type 3, hemorrhagic rather than ischemic symptoms occurred more frequently in l-type 3 and c-type 2. In case of l-type 1 FMCAAs, more caution is required in determining the treatment due to the relatively high complication rate.

Natural History Data in Symptomatic Severe Aortic Stenosis Alerts Cardiologists to the Dangers of No Action

No abstract available.

Long Term Efficacy of Antiviral Therapy: Mortality and Incidence of Hepatocellular Carcinoma / 대한소화기학회지

Multiple studies have shown that oral antiviral therapies reduced the incidence of hepatocellular carcinoma (HCC) and improved the survival of patients with chronic hepatitis B when compared with that of untreated patients. In particular, entecavir and tenofovir share the qualities of high efficacy in reducing the HBV DNA levels, and they have excellent tolerability and safety. These drugs modified the natural history of liver fibrosis, improve liver function, decrease the incidence of HCC, decrease the need for liver transplantation, and improve survival. Many studies have suggested that long-term antiviral therapy reduces the risk of HCC and liver cirrhosis in patients with chronic hepatitis. The mechanism of these drugs in reducing the risk of HCC is not clear. This article reviews the mechanisms of carcinogenic HBV by conducting a review of the literature on the efficacy of therapy for reducing the risk of HCC. A few recent articles have suggested that tenofovir offers advantages over entecavir in terms of HCC prevention, but these articles have the inherent limitations of observational data. No other head-to-head randomized trials exist. Further randomized studies would help provide stronger evidence of the association between the type of antiviral agent and the HCC outcomes. Only achieving complete viral eradication from the liver will truly decrease the mortality and incidence of HCC.