Microbial trace based on PCR-DGGE to evaluate the ripening stage of minas artisanal cheeses from the Canastra microregion produced by different dairies.

The Minas artisanal cheese from the Serra da Canastra (MAC-CM) microregion is a traditional product due to its production and ripening process. Artisanal chesses manufactured with raw cow's milk and endogenous dairy starters ("also known as pingo") have distinctive flavors and other sensory characteristics because of the unknown microbiota. The aim of this study was to evaluate the microbiota during 30 days of ripening, the physicochemical changes, and their relation in MACs produced in two different microregions located in the Serra da Canastra microregion through culture-dependent and culture-independent methods. The MACs were collected in the cities of Bambuí (MAC-CMB) and Tapiraí (MAC-CMT) in the Canastra microregion (n = 21). Cheeses uniqueness was demonstrated with the multivariate analysis that joined the microbiota and physicochemical characteristics, mainly to the proteolysis process, in which the MAC-CMT showed deeper proteolysis (DI -T0:14.18; T30: 13.95), while the MAC-CMB reached only a primary level (EI -T0:24.23; T30: 31.10). Abiotic factors were responsible for the differences in microbial diversity between the cheese farms. Different microbial groups: the prokaryotes, like Corynebacterium variabile, Lactococcus lactis, and Staphylococcus saprophyticus; and the eukaryotes, like Kluyveromyces lactis and Diutina catenulata dominated ripening over time. The microbial community and proteolysis were responsible for the predominance of volatile groups, with alcohols predominating in MAC-CMB and free fatty acids/acids and esters in MAC-CMT.

Overexpression of Fibroblast Activation Protein (FAP) in stroma of proliferative inflammatory atrophy (PIA) and primary adenocarcinoma of the prostate.

Fibroblast activation protein (FAP) is a serine protease upregulated at sites of tissue remodeling and cancer that represents a promising therapeutic and molecular imaging target. In prostate cancer, studies of FAP expression using tissue microarrays are conflicting, such that its clinical potential is unclear. Furthermore, little is known regarding FAP expression in benign prostatic tissues. Here we demonstrated, using a novel iterative multiplex IHC assay in standard tissue sections, that FAP was nearly absent in normal regions, but was increased consistently in regions of proliferative inflammatory atrophy (PIA). In carcinoma, FAP was expressed in all cases, but was highly heterogeneous. High FAP levels were associated with increased pathological stage and cribriform morphology. We verified that FAP levels in cancer correlated with CD163+ M2 macrophage density. In this first report to quantify FAP protein in benign prostate and primary tumors, using standard large tissue sections, we clarify that FAP is present in all primary prostatic carcinomas, supporting its potential clinical relevance. The finding of high levels of FAP within PIA supports the injury/regeneration model for its pathogenesis and suggests that it harbors a protumorigenic stroma. Yet, high levels of FAP in benign regions could lead to false positive FAP-based molecular imaging results in clinically localized prostate cancer.

Eutrichophilus cordiceps Mjöberg, 1910 (Ischnocera: Trichodectidae) in Spiny Tree Porcupines (Coendou villosus): New locality records and the first molecular evidence of association with Bartonella sp.

The chewing louse genus Eutrichophilus Mjöberg has 19 species only associated with porcupines (Rodentia: Erethizontidae). Of these species, E. cercolabes, E. cordiceps, E. emersoni, E. minor, E. moojeni, and E. paraguayensis have been recorded in Brazil. In the present study, we report E. cordiceps for the first time in the São Paulo State (Bauru Municipality) and for the second time in the Santa Catarina State (Lages Municipality), providing scanning electron images and light microscopy for the eggs, as well as the first molecular data (18S rRNA) for the genus. Additionally, Bartonella sp. was detected for the first time in this chewing lice species.

Divergent immune microenvironments in two tumor nodules from a patient with mismatch repair-deficient prostate cancer.

Patients with prostate cancer (PC) generally do not respond favorably to immune checkpoint inhibitors, which may be due to a low abundance of tumor-infiltrating lymphocytes even when mutational load is high. Here, we identified a patient who presented with high-grade primary prostate cancer with two adjacent tumor nodules. While both nodules were mismatch repair-deficient (MMRd), exhibited pathogenic MSH2 and MSH6 alterations, had a high tumor mutational burden (TMB), and demonstrated high microsatellite instability (MSI), they had markedly distinct immune phenotypes. The first displayed a dense infiltrate of lymphocytes ("hot nodule"), while the second displayed significantly fewer infiltrating lymphocytes ("cold nodule"). Whole-exome DNA analysis found that both nodules shared many identical mutations, indicating that they were derived from a single clone. However, the cold nodule appeared to be sub-clonal relative to the hot nodule, suggesting divergent evolution of the cold nodule from the hot nodule. Whole-transcriptome RNA analysis found that the cold nodule demonstrated lower expression of genes related to antigen presentation (HLA) and, paradoxically, classical tumor immune tolerance markers such as PD-L1 (CD274) and CTLA-4. Immune cell deconvolution suggested that the hot nodule was enriched not only in CD8+ and CD4 + T lymphocytes, but also in M1 macrophages, activated NK cells, and γδ T cells compared to the cold nodule. This case highlights that MMRd/TMB-high PC can evolve to minimize an anti-tumor immune response, and nominates downregulation of antigen presentation machinery (HLA loss) as a potential mechanism of adaptive immune evasion in PC.

Induction of double-strand breaks with the non-steroidal androgen receptor ligand flutamide in patients on androgen suppression: a study protocol for a randomized, double-blind prospective trial.

BACKGROUND: Prostate cancer remains the most prevalent malignancy and the second-leading cause of cancer-related death in men in the USA. Radiation therapy, typically with androgen suppression, remains a mainstay in the treatment of intermediate- and high-risk, potentially lethal prostate cancers. However, local recurrence and treatment failure remain common. Basic and translational research has determined the potential for using androgen receptor (AR) ligands (e.g., dihydrotestosterone and flutamide) in the context of androgen-deprived prostate cancer to induce AR- and TOP2B-mediated DNA double-strand breaks (DSBs) and thereby synergistically enhance the effect of radiation therapy (RT). The primary aim of this study is to carry out pharmacodynamic translation of these findings to humans. METHODS: Patients with newly diagnosed, biopsy-confirmed localized prostatic adenocarcinoma will be recruited. Flutamide, an oral non-steroidal androgen receptor ligand, will be administered orally 6-12 h prior to prostate biopsy (performed under anesthesia prior to brachytherapy seed implantation). Key study parameters will include the assessment of DNA double-strand breaks by γH2A.x foci and AR localization to the nucleus. The initial 6 patients will be treated in a single-arm run-in phase to assess futility by establishing whether at least 2 subjects from this group develop γH2A.x foci in prostate cancer cells. If this criterion is met, the study will advance to a two-arm, randomized controlled phase in which 24 participants will be randomized 2:1 to either flutamide intervention or placebo standard-of-care (with all patients receiving definitive brachytherapy). The key pharmacodynamic endpoint will be to assess whether the extent of γH2A.x foci (proportion of cancer cells positive and number of foci per cancer cell) is greater in patients receiving flutamide versus placebo. Secondary outcomes of this study include an optional, exploratory analysis that will (a) describe cancer-specific methylation patterns of cell-free DNA in plasma and urine and (b) assess the utility of serum and urine samples as a DNA-based biomarker for tracking therapeutic response. DISCUSSION: This study will confirm in humans the pharmacodynamic effect of AR ligands to induce transient double-strand breaks when administered in the context of androgen deprivation as a novel therapy for prostate cancer. The findings of this study will permit the development of a larger trial evaluating flutamide pulsed-dose sequencing in association with fractionated external beam RT (+/- brachytherapy). The study is ongoing, and preliminary data collection and recruitment are underway; analysis has yet to be performed. TRIAL REGISTRATION: ClinicalTrials.gov NCT03507608. Prospectively registered on 25 April 2018.

The Role of MRI in Differentiating Demyelinating and Inflammatory (not Infectious) Myelopathies.

Demyelinating and inflammatory myelopathies represent a group of diseases with characteristic patterns in neuroimaging and several differential diagnoses. The main imaging patterns of demyelinating myelopathies (multiple sclerosis, neuromyelitis optica spectrum disorder, acute disseminated encephalomyelitis, and myelin oligodendrocyte glycoprotein antibody-related disorder) and inflammatory myelopathies (systemic lupus erythematosus-myelitis, sarcoidosis-myelitis, Sjögren-myelitis, and Behçet's-myelitis) will be discussed in this article, highlighting key points to the differential diagnosis.

Infectious Myelitis.

Myelitis is an extensive group of pathologies, including inflammatory, demyelinating, and infectious disorders, sometimes mimicking tumors. This article will discuss infectious myelitis, mainly the patterns of spinal cord involvement caused by each infectious agent and the contribution of magnetic resonance imaging as a major tool to establish the specific diagnosis.

The Role of MRI in the Diagnosis of Spinal Cord Tumors.

Spinal cord tumors are uncommon, and its multiple representatives not always have pathognomonic characteristics, which poses a challenge for both patients and caring physicians. The radiologist performs an important role in recognizing these tumors, as well as in differentiating between neoplastic and non-neoplastic processes, supporting clinical and surgical decision-making in patients with spinal cord injury. Magnetic Resonance Imaging (MRI) assessment, paired with a deep understanding of the various patterns of cord involvement allied to detailed clinical data can provide a diagnosis or significantly limit the differential diagnosis in most cases. In this article, we aim to review the most common and noteworthy intramedullary and extramedullary spinal tumors, as well as some other tumoral mimics, with an emphasis on their MRI morphologic characteristics.

Fertility Life Table, Thermal Requirements, and Ecological Zoning of Anthonomus grandis grandis Boheman (Coleoptera: Curculionidae) in Brazil.

The boll weevil, Anthonomus grandis grandis Boh., is the most important cotton pest in Central and South America. The biological characteristics and thermal requirements of boll weevils reared on an artificial diet were assessed at seven constant temperatures (18, 20, 22, 25, 28, 30, and 32 ± 1 °C) under laboratory conditions. These data were used to determine the ecological zoning for the pest in Brazil. The development time; oviposition period; the number of eggs produced; survival of eggs, larvae, and pupae; adult longevity; and sex ratio were recorded, and additional life table parameters were calculated. The total development duration ranged from 16.1 (32 °C) to 46.2 (18 °C) days. Temperature significantly affected the number of eggs laid per female (fecundity), with the highest number of eggs observed at 25 °C (251 ± 15.8). The parameters from the fertility life table indicated the greatest population growth at 25 °C and 28 °C. The net reproductive rate (R0) at these temperatures was 22.25 times higher than at 18 °C. Based on R0 and temperature, an ecological zoning of the pest was developed for Brazil. Brazilian regions with mean temperatures above 20 °C and below 30 °C are most favorable for the population growth of the boll weevil. The most suitable crop areas were found to be the north, midwest, and part of the northeast region, although the weevil can occur throughout Brazil if the host plants are available.

Tracheal stenosis in a yellow-crowned parrot (Amazona ochrocephala) due to diffuse ossification and osteopetrosis of tracheal rings.

Tracheal luminal stenosis can cause clinical respiratory distress in wild birds. We describe a case of tracheal stenosis due to diffuse ossification with osteopetrosis of tracheal rings in a yellow-crowned parrot (Amazona ochrocephala) with a history of chronic respiratory distress and death after development of marked dyspnoea. An ante-mortem radiographic examination revealed that the tracheal rings were radiopaque and that there were multiple areas of osteopenic change in long bones. At necropsy, there was stenosis of the tracheal rings characterized by complete replacement of cartilage by thickened compact bone with osteopetrosis and bone necrosis. The clinical respiratory distress and death of the parrot were associated with tracheal luminal stenosis due to thickening of the tracheal rings by diffuse ossification with osteopetrosis.

Metastatic Sertoli cell tumour in a captive giant anteater (Myrmecophaga tridactyla).

There are a few studies on diseases of anteaters, but reports on reproductive lesions and neoplasms of these animals are scarce. This is the first report of a case of metastatic Sertoli cell tumour in a giant anteater (Myrmecophaga tridactyla). The animal had renal lesions associated with impaired renal function as indicated by serum biochemistry. Histopathological and immunohistochemical examinations provided a conclusive diagnosis of Sertoli cell tumour with metastasis to the liver, kidneys and lymph nodes.

Analysis of the antifungal potential of Macrocybe titans extract against Candida albicans.

Aim: To investigate the antifungal potential of Macrocybe titans extracts against Candida albicans. Material & methods: Extracts were obtained as aqueous (EfraMat-22 and EfraMat-45) and methanolic/ethyl acetate fractions. Results: Broth microdilution and disk diffusion assays showed that EfraMat-45 provided the best results in terms of minimum inhibitory concentration. Scanning electron microscopy analysis revealed morphological changes and slight damage on the surfaces of cells exposed to EfraMat-45 at the MIC. Fluorescence microscopy analysis of the yeasts showed cell elongation. EfraMat-45 presented high levels of phenolic compounds and flavonoids, high antioxidant activity and absence of in vitro cytotoxicity. Conclusion: The results indicated that the aqueous extract of M. titans is highly promising as an antifungal agent.

Mesenchymal stromal cell-derived membrane particles: A novel cell-free therapy for inflammatory bowel diseases.

Inflammatory bowel diseases (IBD), including ulcerative colitis, are chronic and idiopathic inflammations of the gastrointestinal tract. A disruption of the epithelial barrier and an imbalance between Th1 and Th2 subsets are associated with the onset and progression of these diseases. Mesenchymal stromal cells (MSC) are a promising therapy for IBD. However, cell-tracking studies have shown that intravenously infused MSC localize to the lungs and present short-term survival. To reduce practical complexities arising from living cells, we generated membrane particles (MP) from MSC membranes, which possess some of the immunomodulatory properties of MSC. This study investigated the effect of MSC-derived MP and conditioned media (CM) as cell-free therapies in the dextran sulfate sodium (DSS)-induced colitis model. Acute colitis was induced in C57BL/6 mice by oral administration of 2% DSS in drinking water ad libitum from days 0 to 7. Mice were treated with MP, CM, or living MSC on days 2 and 5. Our findings revealed that MP, CM, and living MSC ameliorated DSS-induced colitis by reducing colonic inflammation, the loss of colonic goblet cells, and intestinal mucosa permeability, preventing apoptosis of damaged colonic cells and balancing Th1 and Th2 activity. Therefore, MSC-derived MP have high therapeutic potential for treating IBD, overcoming the deficiencies of living MSC therapy, and opening novel frontiers in inflammatory diseases medicine.

Intoxicação cutânea grave por Paraquat / Serious skin poisoning by Paraquat

O Paraquat é um herbicida não seletivo altamente tóxico, sendo responsável por altas taxas de letalidade acidentais ou provocadas, devido, principalmente, à insuficiência respiratória. Apesar de a intoxicação por via oral ser a principal e mais grave, o contato prolongado com a substância em uma grande área corporal pode gerar uma toxicidade similar e levar ao óbito ­ fato pouco elucidado na literatura. Este é o relato de caso de um homem de 22 anos, que foi admitido em um hospital devido a queixas de mal-estar, náuseas, febre, cefaleia, dor abdominal, diarreia, queimaduras e dispneia. A suspeita diagnóstica inicial foi de hantavirose, leptospirose, dengue e tromboembolismo pulmonar e, posteriormente, foi comprovado intoxicação exógena com agrotóxico por via inalatória e cutânea. Exames de imagem revelaram fibrose pulmonar difusa e ele também apresentou alterações renais, hepáticas e coagulatórias. Como não há antídoto específico, foi empregado tratamento sintomático e suportivo, com uso de carvão ativado, antibióticos, corticoides, antioxidantes e hemodiálise. No entanto, o paciente teve uma piora progressiva do quadro, vindo a óbito devido à síndrome da angústia respiratória aguda e fibrose pulmonar. O Paraquat, embora proibido no Brasil em 2020, continua sendo utilizado de forma ilegal. Além disso, seu substituto, o Diquat, possui toxicidade semelhante. Assim, é fundamental que os profissionais da saúde reconheçam o diagnóstico da intoxicação por tais substâncias e suas diferentes vias de exposição. Também são necessárias novas medidas de fiscalização das substâncias e maior investimento em educação em saúde para evitar exposições acidentais, assim como relatado (AU).

Paraquat is a highly toxic non-selective herbicide and is responsible for high accidental or provoked lethality rates, mainly due to respiratory failure. Although oral poisoning is the primary and most severe, prolonged contact with the substance in a large body area can lead to similar toxicity and death ­ a fact that is little elucidated in the literature. This is the case report of a 22-year-old man admitted to a hospital due to complaints of malaise, nausea, fever, headache, abdominal pain, diarrhea, burns and dyspnea. The initial diagnostic suspicion was hantaviruses, leptospirosis, dengue and pulmonary thromboembolism, and there was subsequently proven exogenous intoxication with pesticides by inhalation and cutaneous route. Imaging tests revealed diffuse pulmonary fibrosis and he also had renal, hepatic and coagulation alterations. As there is no specific antidote, symptomatic and supportive treatment was performed using activated charcoal, antibiotics, corticosteroids, antioxidants and hemodialysis. However, the patient had a progressive worsening of the condition and died due to acute respiratory distress syndrome and pulmonary fibrosis. Paraquat, although banned in Brazil in 2020, continues to be used illegally. In addition, its substitute, the Diquat, has similar toxicity. Thus, it is essential that health professionals recognize the diagnosis of intoxication by such substances and their different exposure routes. New control measures for these substances and greater investment in health education are also needed to prevent accidental exposure, as reported (AU).

Avaliação dos repelentes: efeitos na saúde humana / Evaluation of repellents: effects on human health / Evaluación de repelentes: efectos sobre la salud humana

Este artigo teve como objetivo avaliar os efeitos do uso de repelentes na população brasileira. Para alcançar o objetivo proposto, foram utilizadas as metodologias da revisão de literatura e a pesquisa documental junto à ANVISA referentes aos repelentes registrados e comercializados no Brasil. De acordo com a RDC nº 7 de 2015 da ANVISA, os repelentes são classificados como produtos de Grau 2, compostos por Produtos de Higiene Pessoal, Cosméticos e Perfumes. Nessa categoria, constatou-se a existência de 113 produtos registrados para comercialização no Brasil. Verificou-se que, apesar do aumento do consumo devido às doenças causadas por picada dos mosquitos Aedes aegypti, a maioria dos repelentes comercializados possuem como princípio ativo as substâncias DEET, Icaridina ou IR3535, não resultando em reações tóxicas relevantes para a população, visto que, essas substâncias são de baixa toxicidade ou atóxicas, como é o caso do IR3535. Faz-se necessário considerar que o uso desses produtos deve seguir rigorosamente as orientações dos fabricantes disponíveis nos rótulos das embalagens no que tange à aplicação, reaplicação, frequência e uso específico para crianças, gestantes e lactantes. No que se refere à eficácia, a Icaridina apresenta-se como mais eficaz que o IR3535 quando considerados os fatores tempo de proteção versus concentração do princípio ativo. Entretanto, a Icaridina, em alguns casos, pode apresentar moderada toxicidade, enquanto que, o IR3535 é atóxico. Observa-se ainda, que mesmo diante desse cenário, o DEET é o mais comercializado e amplamente estudado no país.

This article aimed to evaluate the effects of the use of repellents in the Brazilian population. To achieve the proposed objective, the methodologies of literature review and documentary research with ANVISA regarding repellents registered and marketed in Brazil were used. According to ANVISA's RDC No. 7 of 2015, repellents are classified as Grade 2 products, composed of Personal Hygiene Products, Cosmetics and Perfumes. In this category, it was found the existence of 113 products registered for commercialization in Brazil. It was found that, despite the increased consumption due to diseases caused by bites from Aedes aegypti mosquitoes, most repellents marketed have as active ingredients the substances DEET, Icaridin or IR3535, not resulting in toxic reactions relevant to the population, since these substances are of low toxicity or non- toxic, as is the case of IR3535. It is necessary to consider that the use of these products should strictly follow the manufacturers' guidelines available on the packaging labels regarding application, reapplication, frequency and specific use for children, pregnant and lactating women. With regard to efficacy, Icaridin is more effective than IR3535 when considering the factors protection time versus concentration of the active ingredient. However, Icaridin, in some cases, may present moderate toxicity, while IR3535 is non- toxic. It is also observed that, even in this scenario, DEET is the most marketed and widely studied in the country.

artículo tuvo como objetivo evaluar los efectos del uso de repelentes en la población brasileña. Para alcanzar el objetivo propuesto, se utilizaron las metodologías de revisión bibliográfica e investigación documental con ANVISA sobre repelentes registrados y comercializados en Brasil. De acuerdo con el CDR nº 7 de 2015 de ANVISA, los repelentes se clasifican como productos de Grado 2, compuesto por Productos de Higiene Personal, Cosméticos y Perfumes. En esta categoría, se constató la existencia de 113 productos registrados para comercialización en Brasil. Se constató que, a pesar del aumento del consumo debido a las enfermedades causadas por picaduras de mosquitos Aedes aegypti, la mayoría de los repelentes comercializados tienen como principios activos las sustancias DEET, Icaridina o IR3535, no resultando en reacciones tóxicas relevantes para la población, ya que estas sustancias son de baja toxicidad o no tóxicas, como es el caso del IR3535. Es necesario considerar que el uso de estos productos debe seguir estrictamente las directrices de los fabricantes disponibles en las etiquetas de los envases en cuanto a aplicación, reaplicación, frecuencia y uso específico para niños, mujeres embarazadas y lactantes. En cuanto a la eficacia, la Icaridina es más eficaz que el IR3535 si se consideran los factores tiempo de protección frente a concentración del principio activo. Sin embargo, la Icaridina, en algunos casos, puede presentar una toxicidad moderada, mientras que el IR3535 no es tóxico. También se observa que, incluso en este escenario, el DEET es el más comercializado y ampliamente estudiado en el país.

Identifying patient safety competences among anesthesiology residents: systematic review

Abstract Introduction and objective Patient safety is a concept of great importance to managers, health professionals, and patients and their families, given patient safety promotes more effective care and reduces costs. Moreover, while analyzing the area of anesthesiology, one can realize the epidemiological changes, increased complexity and number of procedures, and the adoption of a new matrix of essential skills mandatory for residents of anesthesiology in Brazil. Thus, it is relevant to identify current patient safety competences among anesthesiology residents. Methods A systematic review was elaborated using PubMed, SciELO, BVS, Cochrane Library, LILACS and CAPES databases with the descriptors "anesthesiology", "patient safety", "residency" and "competence". Results and conclusions Thirteen articles published in the past 10 years were analyzed. The articles depicted competences grouped into three categories: knowledge (identification, prevention and management of adverse events; use of correct and up-to-date information; understanding of human factors; and continuous learning), skills (efficient communication; teamwork; leadership; decision-making; and self-confidence), and attitude (management of stress and fatigue; and infection control). All these skills can be developed and assessed through simulation and active learning methods, profiting from a multidisciplinary approach. Studies also reveal that residents perform poorly in certain patient safety domains due to lack of effective in-depth understanding, appreciation of the topic and ineffective teaching. As a result, greater investment in the topic is needed by teaching and health institutions and researchers.

Rabies in a Captive Lowland Tapir (Tapirus terrestris).

Rabies is a severe viral zoonosis of mammals and causes irreversible neurological damage. We describe the clinical presentation and anatomopathological lesions of rabies in a captive lowland tapir (Tapirus terrestris) in Bauru, São Paulo State, Brazil. The clinical course of the disease lasted 6 days and was characterized by progressive neurological deterioration and death. The main anatomopathological findings were non-suppurative encephalitis and presence of Negri bodies within neurons. Direct immunofluorescence and mouse inoculation tests were positive for rabies virus. This is the first report of rabies in a lowland tapir and highlights the importance of disease prevention under managed care and continuous control measures in urbanized environments.

Treatment of acquired perforant dermatoses with allopurinol / Tratamento de dermatose perfurante adquirida com alopurinol

Perforating dermatoses are papulonodular cutaneous pathologies characterized by transepithelial extrusion of components of the extracellular matrix of the dermis, by inflammation or degeneration. When secondary, the systemic diseases are called Acquired Perforating Diseases. Our letter aims to report a case of acquired perforating dermatoses secondary to chronic renal dialysis. The treatment with Allopurinol proved to be effective in this case. Allopurinol would act as an antioxidant, reducing the inflammatory reaction in tissues and consequent damage to the collagen fibers (AU)

Dermatoses perfurantes são patologias cutâneas papulonodulares que se caracterizam pela extrusão transepitelial de componentes da matriz extracelular da derme, por inflamação ou degeneração. Quando são secundárias as doenças sistêmicas são chamadas Doenças Perfurantes Adquiridas. Nossa carta tem como objetivo relatar caso de dermatose perfurante adquirida secundária a insuficiência renal crônica dialítica. O tratamento com Alopurinol se mostrou eficaz neste caso. O Alopurinol atuaria como antioxidante, reduzindo a reação inflamatória nos tecidos e consequentes danos nas fibras colágenas (AU)

Common and uncommon neuroimaging manifestations of ataxia: an illustrated guide for the trainee radiologist. Part 1 - acquired diseases.

Ataxia is defined as a lack of coordination of voluntary movement, caused by a variety of factors. Ataxia can be classified by the age at onset and type (chronic or acute). The causative lesions involve the cerebellum and cerebellar connections. The correct, appropriate use of neuroimaging, particularly magnetic resonance imaging, can make the diagnosis relatively accurate and facilitate implementation of the appropriate clinical management. The purpose of this pictorial essay is to describe the imaging findings of ataxia, based on cases obtained from the archives of a tertiary care hospital, with a review of the most important findings. We also review and discuss the imaging aspects of infectious, toxic, vascular, and inflammatory diseases.

Ataxia é definida como uma síndrome de falta de coordenação dos músculos de movimentação voluntária. Vários fatores podem causar ataxias, os quais podem ser classificados de acordo com a idade, tipo de evolução (crônica ou aguda), cujas lesões envolvem o cerebelo e as conexões cerebelares. Com o uso correto e apropriado da neuroimagem, particularmente da ressonância magnética, o diagnóstico pode ser relativamente preciso e o manejo clínico pode ser implementado de maneira correta. O objetivo deste artigo é descrever os achados de imagem na síndrome atáxica com base em casos recuperados do arquivo digital de um hospital terciário, com a revisão dos principais achados de imagem. Neste ensaio revisamos e discutimos os aspectos imagem de doenças infecciosas, tóxicas, vasculares e inflamatórias.

Common and uncommon neuroimaging manifestations of ataxia: an illustrated guide for the trainee radiologist. Part 2 - neoplastic, congenital, degenerative, and hereditary diseases.

Ataxia is defined as a lack of coordination of voluntary movement, caused by a variety of factors. Ataxia can be classified by the age at onset and type (chronic or acute). The causative lesions involve the cerebellum and cerebellar connections. The correct, appropriate use of neuroimaging, particularly magnetic resonance imaging, can make the diagnosis relatively straightforward and facilitate implementation of the appropriate clinical management. The purpose of this pictorial essay is to describe the imaging findings of ataxia, based on cases obtained from the archives of a tertiary care hospital, with a review of the most important findings. We also discuss and review the imaging aspects of neoplastic diseases, malformations, degenerative diseases, and hereditary diseases related to ataxia.

Ataxia é definida como uma síndrome de falta de coordenação dos músculos de movimentação voluntária. Vários fatores podem causar ataxias, as quais podem ser classificadas de acordo com a idade, tipo de evolução (crônica ou aguda), cujas lesões envolvem o cerebelo e as conexões cerebelares. Com o uso correto e apropriado da neuroimagem, particularmente da ressonância magnética, o diagnóstico pode ser relativamente direito e o manejo clínico pode ser implementado de maneira correta. O objetivo deste artigo é descrever os achados de imagem na síndrome atáxica a partir de casos recuperados do arquivo digital de um hospital terciário, com a revisão dos principais achados de imagem. Neste ensaio revisamos e discutimos os aspectos de imagem de doenças neoplásicas, malformações, doenças degenerativas e doenças hereditárias relacionadas à ataxia.