BRSET: A Brazilian Multilabel Ophthalmological Dataset of Retina Fundus Photos.

INTRODUCTION: The Brazilian Multilabel Ophthalmological Dataset (BRSET) addresses the scarcity of publicly available ophthalmological datasets in Latin America. BRSET comprises 16,266 color fundus retinal photos from 8,524 Brazilian patients, aiming to enhance data representativeness, serving as a research and teaching tool. It contains sociodemographic information, enabling investigations into differential model performance across demographic groups. METHODS: Data from three São Paulo outpatient centers yielded demographic and medical information from electronic records, including nationality, age, sex, clinical history, insulin use, and duration of diabetes diagnosis. A retinal specialist labeled images for anatomical features (optic disc, blood vessels, macula), quality control (focus, illumination, image field, artifacts), and pathologies (e.g., diabetic retinopathy). Diabetic retinopathy was graded using International Clinic Diabetic Retinopathy and Scottish Diabetic Retinopathy Grading. Validation used a ConvNext model trained during 50 epochs using a weighted cross entropy loss to avoid overfitting, with 70% training (20% validation), and 30% testing subsets. Performance metrics included area under the receiver operating curve (AUC) and Macro F1-score. Saliency maps were calculated for interpretability. RESULTS: BRSET comprises 65.1% Canon CR2 and 34.9% Nikon NF5050 images. 61.8% of the patients are female, and the average age is 57.6 (± 18.26) years. Diabetic retinopathy affected 15.8% of patients, across a spectrum of disease severity. Anatomically, 20.2% showed abnormal optic discs, 4.9% abnormal blood vessels, and 28.8% abnormal macula. A ConvNext V2 model was trained and evaluated BRSET in four prediction tasks: "binary diabetic retinopathy diagnosis (Normal vs Diabetic Retinopathy)" (AUC: 97, F1: 89); "3 class diabetic retinopathy diagnosis (Normal, Proliferative, Non-Proliferative)" (AUC: 97, F1: 82); "diabetes diagnosis" (AUC: 91, F1: 83); "sex classification" (AUC: 87, F1: 70). DISCUSSION: BRSET is the first multilabel ophthalmological dataset in Brazil and Latin America. It provides an opportunity for investigating model biases by evaluating performance across demographic groups. The model performance of three prediction tasks demonstrates the value of the dataset for external validation and for teaching medical computer vision to learners in Latin America using locally relevant data sources.

BRSET: A Brazilian Multilabel Ophthalmological Dataset of Retina Fundus Photos.

Introduction: The Brazilian Multilabel Ophthalmological Dataset (BRSET) addresses the scarcity of publicly available ophthalmological datasets in Latin America. BRSET comprises 16,266 color fundus retinal photos from 8,524 Brazilian patients, aiming to enhance data representativeness, serving as a research and teaching tool. It contains sociodemographic information, enabling investigations into differential model performance across demographic groups. Methods: Data from three São Paulo outpatient centers yielded demographic and medical information from electronic records, including nationality, age, sex, clinical history, insulin use, and duration of diabetes diagnosis. A retinal specialist labeled images for anatomical features (optic disc, blood vessels, macula), quality control (focus, illumination, image field, artifacts), and pathologies (e.g., diabetic retinopathy). Diabetic retinopathy was graded using International Clinic Diabetic Retinopathy and Scottish Diabetic Retinopathy Grading. Validation used Dino V2 Base for feature extraction, with 70% training and 30% testing subsets. Support Vector Machines (SVM) and Logistic Regression (LR) were employed with weighted training. Performance metrics included area under the receiver operating curve (AUC) and Macro F1-score. Results: BRSET comprises 65.1% Canon CR2 and 34.9% Nikon NF5050 images. 61.8% of the patients are female, and the average age is 57.6 years. Diabetic retinopathy affected 15.8% of patients, across a spectrum of disease severity. Anatomically, 20.2% showed abnormal optic discs, 4.9% abnormal blood vessels, and 28.8% abnormal macula. Models were trained on BRSET in three prediction tasks: "diabetes diagnosis"; "sex classification"; and "diabetic retinopathy diagnosis". Discussion: BRSET is the first multilabel ophthalmological dataset in Brazil and Latin America. It provides an opportunity for investigating model biases by evaluating performance across demographic groups. The model performance of three prediction tasks demonstrates the value of the dataset for external validation and for teaching medical computer vision to learners in Latin America using locally relevant data sources.

Effect of preservation solution and distension pressure on saphenous vein's endothelium.

OBJECTIVES: Approaches to improve saphenous vein (SV) patency in coronary artery bypass graft (CABG) surgery remain relevant. This study aimed to evaluate the effects of different preservation solutions and different pressures of intraluminal distention on the endothelium of SV segments in CABG. METHODS: Forty-two SV segments obtained from 12 patients undergoing CABG were divided into 7 groups. Group 1 (control) was prepared without preservation or intraluminal distension, while the other 6 groups were preserved in autologous heparinized autologous arterial blood or normal saline (NS), with distention pressures 30, 100 and 300 mmHg. To assess the effects of using these solutions and pressures on the endothelium, the grafts were analysed by scanning electron microscopy, with the measurement of endothelial damage degree. RESULTS: Segments in group 1 showed minimal endothelial damage. SV grafts preserved with NS had significantly greater endothelial damage both compared to the control group and compared to groups preserved with autologous arterial blood (P < 0.001). Segments distended with pressures up to 100 mmHg showed less damage when compared to those distended at 300 mmHg, with the ones subjected to higher pressures presenting a maximum degree of damage, with considerable loss and separation of endothelial cells, extensive foci of exposure of the basement membrane and numerous fractures of the intimate layer, without differences regarding the solution used. CONCLUSIONS: Preparation of SV using NS and with intraluminal distension pressures above 100 mmHg is factors related to increased damage to the venous endothelium.

Like Parents, Like Offspring? Susceptibility to Bt Toxins, Development on Dual-Gene Bt Cotton, and Parental Effect of Cry1Ac on a Nontarget Lepidopteran Pest.

An important step to devise appropriate pest management strategies for armyworms (Lepidoptera: Noctuidae) in Bacillus thuringiensis Berliner (Bt) crops is to determine the lethal, sublethal, and parental effects of Bt toxins on target and nontarget pest species. Here we documented the susceptibility of black armyworm, Spodoptera cosmioides (Walker), to three Cry toxins and its life-history traits feeding on dual-toxin Bt cotton and an artificial diet containing sublethal concentrations of Cry1Ac. In concentration-response bioassays, black armyworm larvae showed low susceptibility to Cry toxins, with 853 ng/cm2 as the lowest value estimated for the median lethal concentration (LC50). The decreasing rank of toxicity was Cry1F, Cry2Aa, and Cry1Ac. Foliage of dual-toxin Bt cotton varieties (Cry1Ac + Cry1F and Cry1Ab + Cry2Ae) caused higher larval mortality than Cry1Ac-expressing cotton. Black armyworms showed reduced larval weight when growing on the Cry1Ac-treated diet, yet they reached adulthood and produced offspring. Interestingly, these larvae were grown on the control diet and showed reduced weight gain associated with the toxin exposure of the previous generation, indicating a parental effect of the exposure to Cy1Ac. The reduced larval weight was recovered in later instars, and there was no significant change in the population fitness of the parental armyworms or their offspring. To our knowledge, this is the first study documenting the parental effects of Bt toxins in insects. These results advance our understanding of potential responses of nontarget species when exposed to Bt toxins and contribute to design pest management programs for armyworms and other nontarget lepidopteran species exposed to Bt crops.

Abordagem clínico e cirúrgico da fixação dorsal de patela em equinos - relato de caso

A fixação dorsal de patela (FDP) é uma das afecções que mais acometem a articulação femoro tíbio patelar dos equinos, esta é caracterizada pela hiperextensão do membro pélvico, podendo acometer uni ou bilateral, tem diversas etiologias e pré-disposições, sendo as mais comuns a falta de tônus muscular e aprumos irregulares, os tratamentos são escolhidos de acordo com o grau da lesão, podendo ser estes com fisioterapia, contrairritantes e desmotomia associados ou não. Relata-se neste trabalho um animal atendido pelo hospital veterinário de grandes animais da FAEF, sendo necessário o uso de diferentes tratamentos para a solução do caso.

Dorsal patellar fixation (PDF) is one of the affections that most affect the patellofemoral articulation of horses, which is characterized by hyperextension of the pelvic limb, which can be uni or bilateral, has several etiologies and pre-dispositions, being the most common lack of muscle tone and irregular, the treatments are chosen according to the degree of the injury, being these with physiotherapy, contrairritantes and desmotomy associated or not. This work reports an animal attended by the veterinary hospital of large animals of the FAEF, where it was necessary to use different treatments for the solution of the case.

Abordagem clínico e cirúrgico da fixação dorsal de patela em equinos - relato de caso

A fixação dorsal de patela (FDP) é uma das afecções que mais acometem a articulação femoro tíbio patelar dos equinos, esta é caracterizada pela hiperextensão do membro pélvico, podendo acometer uni ou bilateral, tem diversas etiologias e pré-disposições, sendo as mais comuns a falta de tônus muscular e aprumos irregulares, os tratamentos são escolhidos de acordo com o grau da lesão, podendo ser estes com fisioterapia, contrairritantes e desmotomia associados ou não. Relata-se neste trabalho um animal atendido pelo hospital veterinário de grandes animais da FAEF, sendo necessário o uso de diferentes tratamentos para a solução do caso.(AU)

Dorsal patellar fixation (PDF) is one of the affections that most affect the patellofemoral articulation of horses, which is characterized by hyperextension of the pelvic limb, which can be uni or bilateral, has several etiologies and pre-dispositions, being the most common lack of muscle tone and irregular, the treatments are chosen according to the degree of the injury, being these with physiotherapy, contrairritantes and desmotomy associated or not. This work reports an animal attended by the veterinary hospital of large animals of the FAEF, where it was necessary to use different treatments for the solution of the case.(AU)

Citronellol, a monoterpene alcohol with promising pharmacological activities - A systematic review.

Many diseases, such as inflammatory and central nervous system disorders, currently have a limited number of effective side-effect free treatments. Citronellol (CT) is a monoterpene alcohol present in the essential oil of several plants used in cooking and traditional medicine, such as those of the genus Cymbopogon and Citrus, with pharmacological activities already described in the literature. The aim of this review was to summarize the pharmacological activities already attributed to CT that could be used in treatments for humans. The databases PubMed, MedLine, Scopus, Lilacs and Scielo were searched using the terms "Citronellol" and "Drug effect". 32 articles were identified and used in the study. Twenty-one articles demonstrated CT activities, including antibiotic and antifungal effects in vitro, and 11 properties including analgesic and anticonvulsant effects in vivo, besides presenting low toxicity. In view of the need to discover new drugs and the activities reported for CT, it can be stated that CT is a promising molecule to target in future pharmacological studies.

Coloanal intussusception in adults due to lipoma / Intussuscepção colo-anal decorrente de lipoma em adulto

ABSTRACT Adult intussusception is a rare condition. But coloanal intussusception is an exception. Malignant lesions are the most common cause of colonic intussusception, and in this aspect, differ from childhood intussusception. We present a case wherein the patient had a lipoma of the sigmoid colon that caused an immense prolapse through the anus. Very few cases of coloanal intussusception are reported in adults, and we discuss the diagnostic tools and the management of this rare surgical entity.

RESUMO A intussuscepção no adulto é uma entidade rara. Mas a intussuscepção colo-anal é uma exceção. Lesões malignas são a causa mais comum de intussuscepção colônica e, neste aspecto, difere da intussuscepção infantil. Apresentamos um caso de lipoma do cólon sigmoide que causou um prolapso imenso através do ânus. Muito poucos casos de intussuscepção colo-anal foram relatados em adultos e discutimos as ferramentas diagnósticas e o tratamento dessa entidade cirúrgica rara.

Fos Protein as a Marker of Neuronal Activity: a Useful Tool in the Study of the Mechanism of Action of Natural Products with Analgesic Activity.

Pain treatment is still ineffective in many conditions and remains one of the greatest challenges of modern medicine. Historically, due to the incredible variety of pharmacologically promising natural products (NPs) and the chemical complexity of their compounds, scientists have explored their use as a source of treatment for diseases or symptomatology. Fos protein and its precursor, the gene c-Fos, have been the subject of study in relation to the pathophysiology of pain as a possible tool to aid in its understanding. More recently, it has become a useful tool in the study of NPs with analgesic profile. Thus, this systematic review aimed to investigate the analgesic effect of NPs and derivatives through changes in Fos protein or c-Fos expression in nervous system central. The search terms "analgesics," "Fos," and "drug effects" were used in the databases PubMed, MEDLINE, Scopus, and Embase. Forty-six articles were identified. Twenty-five articles investigated Fos expression in the spinal cord, 1 in dorsal root ganglion, 11 in brain areas, and 9 investigated the association between the spinal cord and brain areas. Although Fos protein expression has been used as a tool in the studies of the mechanism of action of pain in relation to NPs with analgesic activity, the associations between brain areas and the spinal cord-and the possible pathways involved-have not yet been fully elucidated and deserve further study.

Structural signatures of water-soluble organic aerosols in contrasting environments in South America and Western Europe.

This study describes and compares the key structural units present in water-soluble organic carbon (WSOC) fraction of atmospheric aerosols collected in different South American (Colombia - Medellín and Bogotá, Peru - Lima, Argentina - Buenos Aires, and Brazil - Rio de Janeiro, São Paulo, and Porto Velho, during moderate (MBB) and intense (IBB) biomass burning) and Western European (Portugal - Aveiro and Lisbon) locations. Proton nuclear magnetic resonance (1H NMR) spectroscopy was employed to assess the relative distribution of non-exchangeable proton functional groups in aerosol WSOC of diverse origin, for the first time to the authors' knowledge in South America. The relative contribution of the proton functional groups was in the order H-C > H-C-C= > H-C-O > Ar-H, except in Porto Velho during MBB, Medellín, Bogotá, and Buenos Aires, for which the relative contribution of H-C-O was higher than that of H-C-C=. The 1H NMR source attribution confirmed differences in aging processes or regional sources between the two geographic regions, allowing the differentiation between urban combustion-related aerosol and biological particles. The aerosol WSOC in Aveiro, Lisbon, and Rio de Janeiro during summer are more oxidized than those from the remaining locations, indicating the predominance of secondary organic aerosols. Fresh emissions, namely of smoke particles, becomes important during winter in Aveiro and São Paulo, and in Porto Velho during IBB. The biosphere is an important source altering the chemical composition of aerosol WSOC in South America locations. The source attribution in Medellín, Bogotá, Buenos Aires, and Lima confirmed the mixed contributions of biological material, secondary formation, as well as urban and biomass burning emissions. Overall, the information and knowledge acquired in this study provide important diagnostic tools for future studies aiming at understanding the water-soluble organic aerosol problem, their sources and impact at a wider geographic scale.

Prevención y control de la infección en la formación del enfermero: estudio descriptivo / Prevenção e controle de infecção na formação do enfermeiro: estudo descritivo / Prevention and control of infection in professional nursing training: a descriptive study

Aim: to offer subsidies to broaden the discussion regarding the teaching of practices in the prevention and control of infection in the training of nurses. Material and Methods: an exploratory, descriptive, qualitative approach, based on the Collective Subject Discourse method. The participants were 42 nursing students from a Brazilian higher education institution. Data were processed and analyzed by the Descending Hierarchical Classification. Results: four classes of nursing care were obtained in the prevention and control of infection, the conceptual bases, responsibilities and the acquisition of knowledge for safe care. Conclusion: the training of human resources in nursing with the emphasis on infection prevention and control is challenging, especially due to the constant evolution of the theme. In this dynamic scenario, nursing education requires, among other aspects, to overcome conceptual weaknesses and misconceptions for the development of safe and harmless health care.(AU)

Objetivo: oferecer subsídios para ampliar a discussão do ensino das práticas de prevenção e controle de infecção na formação do profissional de enfermagem. Material e Métodos: pesquisa exploratória, descritiva, de abordagem qualitativa, fundamentada no método do Discurso do Sujeito Coletivo. Participaram 42 discentes de enfermagem, de uma instituição de ensino superior brasileira. Os dados foram processados e analisados pela Classificação Hierárquica Descendente. Resultados: obteve-se quatro classes relacionadas ao cuidado de enfermagem na prevenção e controle da infecção, as bases conceituais, responsabilidades e aquisição de conhecimentos para uma assistência segura. Conclusão: a formação de recursos humanos na área de enfermagem com ênfase na prevenção e controle da infecção representa um desafio especialmente pela constante evolução da temática. Neste cenário dinâmico, o ensino de enfermagem exige, entre outros aspectos, superar fragilidades e equívocos conceituais para o desenvolvimento de uma assistência à saúde segura e livre de danos.(AU)

Incubation Temperature during Fetal Development Influences Morphophysiological Characteristics and Preferred Ambient Temperature of Chicken Hatchlings.

Skin and feather characteristics, which play a critical role in body temperature maintenance, can be affected by incubation circumstances, such as incubation temperature. However, no study to date has assessed the influence of incubation temperature during the fetal stage on morphometric characteristics and vascular development of the skin, feather characteristics, and their relationship to hormone levels and preferred temperature in later life in chickens. Broiler breeder eggs were exposed to low (36°C), control (37.5°C), or high (39°C) temperatures (treatments LT, CK, and HT, respectively) from day 13 of incubation onward, because it is known that the endocrine axes are already established at this time. During this period, eggshell temperature of HT eggs (38.8±0.33°C) was higher than of LT (37.4±0.08°C) and CK eggs (37.8 ±0.15°C). The difference between eggshell and incubator air temperature diminished with the increasing incubation temperature, and was approximately zero for HT. HT hatchlings had higher surface temperature on the head, neck, and back, and thinner and more vascularized skin than did CK and LT hatchlings. No differences were found among treatments for body weight, total feather weight, number and length of barbs, barbule length, and plasma T4 concentration. LT hatchlings showed lower plasma T3 and GH, as well as lower T3/T4 ratio and decreased vascularity in the neck, back, and thigh skin compared to CK hatchlings. On the other hand, HT hatchlings had decreased skin thickness and increased vascularity, and preferred a higher ambient temperature compared to CK and HT hatchlings. In addition, for all treatments, surface temperature on the head was higher than of the other body regions. We conclude that changes in skin thickness and vascularity, as well as changes in thyroid and growth hormone levels, are the result of embryonic strategies to cope with higher or lower than normal incubation temperatures. Additionally exposure to increased temperature during incubation is an environmental factor that can exert early-life influence on ambient temperature preference of broiler hatchlings in later life.

Phylogeny of Gracilariaceae (Rhodophyta): evidence from plastid and mitochondrial nucleotide sequences.

Gracilariaceae are mostly pantropical red algae and include ~230 species in seven genera. Infrafamilial classification of the group has long been based on reproductive characters, but previous phylogenies have shown that traditionally circumscribed groups are not monophyletic. We performed phylogenetic analyses using two plastid (universal plastid amplicon and rbcL) and one mitochondrial (cox1) loci from a greatly expanded number of taxa to better assess generic relationships and understand patterns of character distributions. Our analyses produce the most well-supported phylogeny of the family to date, and indicate that key characteristics of spermatangia and cystocarp type do not delineate genera as commonly suggested. Our results further indicate that Hydropuntia is not monophyletic. Given their morphological overlap with closely related members of Gracilaria, we propose that Hydropuntia be synonymized with the former. Our results additionally expand the known ranges of several Gracilariaceae species to include Brazil. Lastly, we demonstrate that the recently described Gracilaria yoneshigueana should be synonymized as G. domingensis based on morphological and molecular characters. These results demonstrate the utility of DNA barcoding for understanding poorly known and fragmentary materials of cryptic red algae.

As transformações da regulação em saúde suplementar no contexto das crises e mudanças do papel do estado / The changes in health insurance regulation in the context of crises and changes in the role of the state

Esta tese analisa a trajetória, os desafios e as perspectivas da regulação em saúde suplementar, contextualizados num ambiente de grandes transformações do papel dos Estados nacionais e das relações entre a Economia e a Política no âmbito mundial e no Brasil. As interrelações entre economia e política são a base para importantes mudanças no papel doEstado brasileiro, do arcabouço regulatório e da regulação da saúde suplementar em particular. A tese tem início com o desenvolvimento de uma análise sobre o panorama político e econômico mundial, de modo a identificar suas influências sobre o Brasil e o setor de saúde brasileiro. À luz deste arcabouço analítico, é desenvolvido um detalhamento retrospectivo dos principais normativos que compuseram a regulação em saúde suplementar, editados por intermédio da Agência Nacional de Saúde Suplementar – ANS. Para tanto, foi construído um banco de dados que servirá não apenas para a pesquisa da tese, mas para outros trabalhos aserem desenvolvidos posteriormente. O estudo desse material permitiu identificar uma trajetória da saúde suplementar marcada por três diferentes tônicas, que tem se desdobrado a partir da cena das grandes transformações mundiais. As conclusões aqui obtidas sobre a trajetória da regulação foram ainda apreciadas, por meio de pesquisa com todos os atuais eantigos dirigentes da ANS. Adiante, foi realizada uma breve análise dos efeitos produzidos por cada uma das tônicas anteriormente descritas, bem como discutidos os principais desafiosque se colocam na ordem do dia na agenda da saúde suplementar no Brasil...

Comorbidade asma e rinite alérgica: inter-relações entre as vias aéreas superiores e inferiores / Asthma and allergic rhinitis comorbidity: interactions between upper and lower airways

Objetivo: revisar a literatura sobre as inter-relações entre as vias aéreas superiores e inferiores, com enfoque na asma e na rinite alérgica. Métodos: pesquisa não sistemática realizada nas bases Medline e LILACS nos últimos 20 anos, usando os descritores "asthma" "allergic rhinitis" "interaction" "united airways". Resultados: vários estudos clínicos, epidemiológicos, experimentais sugerem a hipótese de que asma e rinite alérgica são a expressão de uma única doença que acomete as vias aéreas. Pacientes com asma frequentemente apresentam rinite alérgica e a rinite alérgica não tratada dificulta o controle da asma. Do ponto de vista histológico, as mucosas nasais e brônquicas compartilham várias semelhanças. Alterações da mucosa nasal causam alterações mediadas por respostas fisiológicas na mucosa brônquica, e vice-versa. Esse corpo de evidências culminou com a iniciativa ARIA (Allergic Rhinitis and its Impact on Asthma), que enfatiza a necessidade de tratar a rinite alérgica no paciente com asma. Conclusões: a hipótese de que asma e rinite alérgica são a expressão de uma única doença que acomete o trato respiratório tem se consolidado e reforça a importância da busca por tratamentos que contemplem de forma integrada a comorbidade. (AU)

Objective: To review the literature about interactions between upper and lower airways with emphasis in asthma and allergic rhinitis. Methods: A non systematic review was conducted using Medline and LILACS in the last twenty years, using "asthma" "allergic rhinitis" "interaction" "united airways" as descriptors. Results: Several clinical, epidemiological, experimental studies suggest the hypothesis that asthma and allergic rhinitis are the expression of a single disease that affects the airways. Patients with Asthma often have allergic rhinitis, and untreated allergic rhinitis make asthma control difficult. From the histological point of view, the nasal and bronchial mucosa share many similarities. Changes in the nasal mucosa cause changes in bronchial mucosa, mediated by physiological responses and vice-versa. These findings led to the initiative (ARIA) Allergic Rhinitis and its Impact on Asthma, that emphasizes the need to treat allergic rhinitis in patients with asthma. Conclusions: The hypothesis that allergic rhinitis and asthma are the expression of a single disease that affects the respiratory tract has been strengthened and reinforced the importance of searching for integrated treatments that aim the seamless comorbidity (AU)

Isolated low grade pilocytic astrocytoma of the optic nerve in the elderly: case report.

A 68-year-old man presented with a history of a right optic glioma. Eighteen months ago he underwent a lateral orbitotomy at another institution for removal of an optic nerve mass. At that time histology revealed that the tumor was an optic nerve glioma with a pilocytic pattern. No further treatment was instituted and one year after surgery he noticed that his right eye was proptotic again. Magnetic resonance imaging of the orbit showed that his right orbit was almost completely filled with a mass which extended through the optic canal to the chiasma. The tumor was excised by a combined neurosurgical and orbital approach. Histology proved that the neoplasm was a low grade pilocytic astrocytoma of the optic nerve.

Isolated low grade pilocytic astrocytoma of the optic nerve in the elderly: case report

A 68-year-old man presented with a history of a right optic glioma. Eighteen months ago he underwent a lateral orbitotomy at another institution for removal of an optic nerve mass. At that time histology revealed that the tumor was an optic nerve glioma with a pilocytic pattern. No further treatment was instituted and one year after surgery he noticed that his right eye was proptotic again. Magnetic resonance imaging of the orbit showed that his right orbit was almost completely filled with a mass which extended through the optic canal to the chiasma. The tumor was excised by a combined neurosurgical and orbital approach. Histology proved that the neoplasm was a low grade pilocytic astrocytoma of the optic nerve.

Paciente masculino de 68 anos com história de orbitotomia lateral para exérese de tumor no nervo óptico 18 meses antes em outro serviço. O exame histológico demonstrou glioma do nervo óptico com padrão pilocítico. Um ano após, observou-se novo episódio de proptose no olho direito. Ressonância nuclear magnética das órbitas mostrou massa preenchendo quase toda a cavidade orbitária direita com extensão pelo canal óptico até o quiasma. Foi realizada exenteração da órbita direita com excisão da porção posterior do tumor via transcraniana pela neurocirurgia e reconstrução orbitária. A histologia confirmou astrocitoma pilocítico de baixo grau do nervo óptico.

Elective appendicovesicostomy in association with monfort abdominoplasty in the treatment of prune belly syndrome

OBJECTIVE: To evaluate the role of elective appendicovesicostomy in association with Monfort abdominoplasty to avoid urinary tract infection (UTI) and renal damage in the post-operative follow-up of patients with prune belly syndrome. MATERIALS AND METHODS: We followed 4 patients operated in our institution (UNIFESP) (Monfort, orchidopexy and Mitrofanoff) and compared them to 2 patients treated similarly, but without an appendicovesicostomy, in a second institution (UFBA). We evaluated postoperative clinical complications, UTI and preservation of renal parenchyma. Patients were followed as outpatients with urinalysis, ultrasonography (US) and occasionally with renal scintigraphy. RESULTS: Mean follow-up was 23.5 months. Immediate post-operative course was uneventful. We observed that only one patient with the Mitrofanoff channel persisted with UTI, while the 2 patients used as controls persisted with recurrent pyelonephritis (> 2 UTI year). CONCLUSION: Our data suggest that no morbidity was added by the appendicovesicostomy to immediate postoperative surgical recovery and that this procedure may have a beneficial effect in reducing postoperative UTI events and their consequences by reducing the postvoid residuals in the early abdominoplasty follow-up. However, we recognize that the series is small and only a longer follow-up with a larger number of patients will allow us to confirm our suppositions. We could not make any statistically significant assumptions regarding differences in renal preservation due to the same limitations.

Elective appendicovesicostomy in association with Monfort abdominoplasty in the treatment of prune belly syndrome.

OBJECTIVE: To evaluate the role of elective appendicovesicostomy in association with Monfort abdominoplasty to avoid urinary tract infection (UTI) and renal damage in the post-operative follow-up of patients with prune belly syndrome. MATERIALS AND METHODS: We followed 4 patients operated in our institution (UNIFESP) (Monfort, orchidopexy and Mitrofanoff) and compared them to 2 patients treated similarly, but without an appendicovesicostomy, in a second institution (UFBA). We evaluated postoperative clinical complications, UTI and preservation of renal parenchyma. Patients were followed as outpatients with urinalysis, ultrasonography (US) and occasionally with renal scintigraphy. RESULTS: Mean follow-up was 23.5 months. Immediate post-operative course was uneventful. We observed that only one patient with the Mitrofanoff channel persisted with UTI, while the 2 patients used as controls persisted with recurrent pyelonephritis (> 2 UTI year). CONCLUSION: Our data suggest that no morbidity was added by the appendicovesicostomy to immediate postoperative surgical recovery and that this procedure may have a beneficial effect in reducing postoperative UTI events and their consequences by reducing the postvoid residuals in the early abdominoplasty follow-up. However, we recognize that the series is small and only a longer follow-up with a larger number of patients will allow us to confirm our suppositions. We could not make any statistically significant assumptions regarding differences in renal preservation due to the same limitations.