Choristoma: a very rare cause of thyroid nodule. Case report and literature review.

BACKGROUND: Choristoma is a well-defined benign lesion formed by histologically normal tissue in an unusual location. Diagnosis is confirmed after surgical removal of the mass. To our knowledge, to date there has been only one case of thyroid choristoma described in the literature. PATIENT FINDINGS: A 70-year-old man with a history of non-Hodgkin lymphoma presented with sudden cervical enlargement. Cervical CT scan showed a 47mm hypodense nodule on the right thyroid lobe. Fine-needle aspiration revealed follicular lesion of undetermined significance. During the following weeks there was noticeable thyroid enlargement. Reassessment with thyroid ultrasound showed a 73mm nodule. The patient underwent total thyroidectomy. Histopathological examination revealed a choristoma composed of squamous epithelium lined cysts, smooth muscle, adipose tissue, connective tissue, foci of ossification and extramedullary hematopoiesis. No cytological atypia or tumoral necrosis were found. Thyroid choristomas are an exceedingly rare cause of a thyroid nodule.

Two Novel Betarhabdovirins Infecting Ornamental Plants and the Peculiar Intracellular Behavior of the Cytorhabdovirus in the Liana Aristolochia gibertii.

Two novel members of the subfamily Betarhabdovirinae, family Rhabdoviridae, were identified in Brazil. Overall, their genomes have the typical organization 3'-N-P-P3-M-G-L-5' observed in mono-segmented plant-infecting rhabdoviruses. In aristolochia-associated cytorhabdovirus (AaCV), found in the liana aristolochia (Aristolochia gibertii Hook), an additional short orphan ORF encoding a transmembrane helix was detected between P3 and M. The AaCV genome and inferred encoded proteins share the highest identity values, consistently < 60%, with their counterparts of the yerba mate chlorosis-associated virus (Cytorhabdovirus flaviyerbamate). The second virus, false jalap virus (FaJV), was detected in the herbaceous plant false jalap (Mirabilis jalapa L.) and represents together with tomato betanucleorhabdovirus 2, originally found in tomato plants in Slovenia, a tentative new species of the genus Betanucleorhabdovirus. FaJV particles accumulate in the perinuclear space, and electron-lucent viroplasms were observed in the nuclei of the infected cells. Notably, distinct from typical rhabdoviruses, most virions of AaCV were observed to be non-enclosed within membrane-bounded cavities. Instead, they were frequently seen in close association with surfaces of mitochondria or peroxisomes. Unlike FaJV, AaCV was successfully graft-transmitted to healthy plants of three species of the genus Aristolochia, while mechanical and seed transmission proved unsuccessful for both viruses. Data suggest that these viruses belong to two new tentative species within the subfamily Betarhabdovirinae.

Long-term clinical sequelae and socio-professional performance in craniopharyngioma patients.

BACKGROUND: Craniopharyngioma (CP) is a rare tumor, leading to several post-treatment sequelae which may have significant clinical and social implications, including impaired academic performance or employability. METHODS: We conducted a retrospective study involving CP patients followed at our center between 1986 and 2020. Data on demographics, clinical, imaging, and treatment characteristics were collected from the clinical records. RESULTS: There were 33 patients (current mean age of 49.8±18.7 years), being 22 diagnosed in adulthood. The average follow-up duration was 16.03±9.3 years. Twelve patients were treated with surgery alone, while 21 underwent surgery and radiotherapy. Pituitary and hypothalamic deficits were more frequent in treated with surgery, whereas visual defects and metabolic diseases were more frequent in treated with surgery and radiotherapy. There were no differences between age of onset groups and type of sequelae. After diagnosis, nine patients concluded their academic training. In childhood-onset group, after diagnosis, one patient was retired, three continue studying and the others concluded schooling. In the other group, six patients were retired and two concluded schooling. There was no association between academic performance or employability and the type of treatment. CP patients academic performance was not worse comparing with general Portuguese population. CONCLUSIONS: Long-term sequelae may not be related with the age of CP onset, but may vary according to the type of treatment. There was a wide variety of clinical sequelae with extended follow-up, however academic performance and employability seemed not affected. CP diagnosis in an early period of life may not compromise the academic success of patients.

Usefulness of a clinicopathological classification in predicting treatment-related outcomes and multimodal therapeutic approaches in pituitary adenoma patients: retrospective analysis on a Portuguese cohort of 129 patients from a tertiary pituitary center.

PURPOSE: A clinicopathological classification has been designed to predict recurrence/progression in patients with pituitary adenomas (PAs). We aimed to study its usefulness in predicting PAs that will have a challenging disease course and may require more often complex multimodal and multiple therapeutic approaches. METHODS: Retrospective analysis of 129 patients with PAs operated in our institution between 2001 and 2020 (84 non-clinically functioning PAs, 32 acromegaly, 9 Cushing's disease, 2 prolactinomas and 2 thyrotropinomas). Grading was based on invasion and proliferation: 1a (non-invasive, non-proliferative; n = 59), 1b (non-invasive, proliferative; n = 17), 2a (invasive, non-proliferative; n = 38), and 2b (invasive, proliferative; n = 15). RESULTS: Of the 129 patients, 68 (52.7%) were females, and the mean age at diagnosis was 53.7 ± 15.4 years. The mean follow-up duration was 93.1 ± 61.8 months. Grade 2b PAs when compared to other grades (2b-2a-1b-1a) had significantly higher rates of persistent tumor remnant within 1-year after operation (93-78-18-30%; p < 0.001), active disease at last follow-up (40-27-12-10%; p = 0.004), re-operation (27-16-0-5%; p = 0.023), irradiation (53-38-12-7%; p < 0.001), multimodal treatment (67-49-18-25%; p = 0.003), multiple treatment (33-27-6-9%; p = 0.017). Patients with grade 2b PAs also required a higher mean number of treatments (2.6-2.1-1.2-1.4; p < 0.001). CONCLUSIONS: This clinicopathological classification appears to be a useful grading system to identify PAs that may be more refractory and more often require complex multimodal and multiple therapeutic approaches. Invasive PAs, especially grade 2b tumors, may be more likely to need complex treatment approach, including radiotherapy, and may display higher rates of active disease at last follow-up, despite receiving higher number of treatments.

Pediatric growth hormone and prolactin-secreting tumor associated with an AIP mutation and a MEN1 variant of uncertain significance.

OBJECTIVES: Pituitary gigantism is a rare condition and it often has an identifiable genetic cause. In this article we report a case of a young girl with pituitary gigantism and two genetic changes. CASE PRESENTATION: A 15-year-old girl with primary amenorrhea was diagnosed with a growth hormone (GH) and prolactin (PRL)-producing tumor, needing surgery and medical treatment with octreotide in order to achieve disease control. The co-occurrence of an AIP mutation and a MEN1 variant of uncertain significance was demonstrated in this patient. The germline mutation involving AIP was inherited from her father who at the age of 55 was unaffected and the MEN1 variant was a de novo duplication of the region 11q13.1. The latter variant, not previously reported, is unlikely to be pathogenic. Nonetheless, screening for other components of multiple endocrine neoplasia type 1 (MEN1) was performed and proved negative. CONCLUSIONS: The rare co-occurrence of an AIP mutation and a MEN 1 variant of uncertain significance was demonstrated in this patient.

Delayed Presentation of Functioning Metastasis in a Patient with Follicular Thyroid Carcinoma.

Functioning metastases from differentiated thyroid carcinoma are rare and present a great therapeutic challenge. Here, we present an unusual case of a patient with metastatic thyroid carcinoma who developed a hyperthyroid state a few years after the diagnosis due to functioning metastases. Radioiodine treatment was effective in controlling the hyperthyroidism; however, it had no effect on tumor burden. By sharing our experience with this case, we hope to raise awareness for this rare condition and the ways to manage it.

Construction and validation of the Scale of Attitudes towards lynching / Construção e validação da Escala de Atitudes frente ao linchamento / Construcción y validación de la Escala de Actitudes hacia el linchamiento

The present study aimed to develop and validate the Scale of Attitudes towards Lynching (Escala de Atitudes frente ao Linchamento - EAL). For this purpose, 2 studies were conducted. Study 1 aimed to test the measure's structure-based validity and internal consistency and included 428 undergraduate and graduate students from the 5 Brazilian regions, with a mean age of 26.86 (SD =7.92). The results of the first study showed adequate psychometric indexes, indicating the bifactorial structure of the construct: crimes against property (α = 0.97) and heinous crimes (α = 0.97). Study 2 aimed to test the replicability of the bifactorial structure obtained in study 1 and included 481 college students from all Brazilian regions with an average age of 27.47 (SD = 9.23). The results supported the adequacy of the bifactorial solution (GFI = 92, CFI = 97, TLI = 97, RMSEA = 0.08). Overall, the EAL presented satisfactory psychometric characteristics that can support future studies. (AU)

A presente pesquisa teve como objetivo desenvolver e validar a Escala de Atitudes frente ao Linchamento (EAL). Para tanto, foram realizados dois estudos. O Estudo 1 teve por objetivo testar a validade baseada na estrutura e consistência interna da medida e participaram 428 estudantes de graduação e pós-graduação, residentes nas cinco regiões brasileiras, com média de idade de 26,86 (DP = 7,92). Os resultados desse estudo evidenciaram índices psicométricos adequados, que indicam a estrutura bifatorial do construto: crimes contra a propriedade (α = 0,97) e crimes hediondos (α = 0,97). Já o Estudo 2 objetivou testar a replicabilidade da estrutura bifatorial obtida no Estudo 1 e contou com a participação de 481 estudantes universitários, de todas as regiões brasileiras, com média de idade de 27,47 (DP = 9,23). Os resultados deram suporte para a adequação da solução bifatorial (GFI = 92, CFI = 97, TLI = 97, RMSEA = 0,08). Em linhas gerais, a EAL apresentou características psicométricas satisfatórias, podendo subsidiar estudos futuros. (AU)

Esta investigación buscó desarrollar y validar la Escala de Actitudes hacia el Linchamiento (EAL). Con este fin, se llevaron a cabo dos estudios. El estudio 1, tuvo como objetivo probar la validez a partir de la estructura y consistencia interna de la medida. Participaron 428 estudiantes de grado y posgrado, residentes en las 5 regiones brasileñas, con edad media de 26.86 (DS 7.92). Los resultados mostraron índices psicométricos adecuados, indicando la estructura bifactorial del constructo: delitos contra la propiedad (α= 0.97) y delitos atroces (α= 0.97). El estudio 2, por otro lado, buscó evaluar la replicabilidad de la estructura bifactorial obtenida en el estudio 1 y contó con la participación de 481 estudiantes universitarios de todas las regiones brasileñas, con una edad media de 27.47 (DS= 9.23). Los resultados respaldaron la adecuación de la solución bifactorial (GFI= 92, CFI= 97, TLI= 97, RMSEA= 0.08). En términos generales, la EAL presentó características psicométricas satisfactorias, pudiendo ser utilizada para futuros estudios. (AU)

Long-term administration of soft drink causes memory impairment and oxidative damage in adult and middle-aged rats.

INTRODUCTION: The consumption of soft drinks has increased considerably in recent decades, mainly cola soft drinks. Excessive consumption of cola-based soft drinks is associated with several diseases and cognitive decline, particularly memory impairment. Furthermore, diets with high sugar can promote insulin resistance, metabolic syndrome, and dyslipidemia. AIM: Thus, the present study aimed to evaluate the effect of cola soft drink intake on behavioral alterations and oxidative damage in 2-, 8- and 14- month-old male Wistar rats. METHODS: The soft drink groups drank soft drink and/or water ad libitum during 67 days, the control groups ingested only water. Radial-arm maze and Y-maze were used to evaluate spatial memory, open-field to evaluate the habituation memory, and inhibitory avoidance to evaluate aversive memory. The behavioral tests started at the day 57 and finished at day 67 of treatment. At 68th day, the rats were killed; frontal cortex and hippocampus were dissected to the analysis of antioxidants enzymes catalase (CAT) and superoxide dismutase (SOD); and the oxidative markers thiobarbituric acid reactive substances (TBARS) and dichloro-dihydro-fluorescein diacetate (DCFH) were measured in the hippocampus. RESULTS AND DISCUSSION: The cola-based soft drink intake caused memory impairment in the radial-arm maze, Y-maze task, and open-field in the 2- and 8-month-old rat, but not in the 14-month-old. There were no difference among groups in the inhibitory avoidance test. In the frontal cortex, soft drink intake reduced CAT activity in the 8-month-old rats and SOD activity in the 8- and 14-month-old rats. In the hippocampus, the soft drink increased CAT activity in 2- and 8-month-old rats, increased DCFH levels at all ages, and increased TBARS levels in 2-month-rats. Therefore, the results show that long-term soft drink intake leads to memory impairment and oxidative stress. The younger seems to be more susceptible to the soft drink alterations on behavior; however, soft drink caused alterations in the oxidative system at all ages evaluated.

Neuroticism, stress, and rumination in anxiety and depression of people with Vitiligo: An explanatory model.

Psychological impacts of Vitiligo have been demonstrated, and associations of the skin disease with anxiety and depression disorders have already been shown. However, it is still unclear the role of individuals' personality factors, such as neuroticism, stress, and rumination, as well as sociodemographic characteristics of people with Vitiligo in such disorders. We conducted a study in a community sample of individuals with Vitiligo (N = 324) aiming to test the hypothesis that neuroticism, stress, and rumination are subjacent to these individuals' anxiety and depression symptomatology. We also explored whether individuals' gender might favor the onset or worsening of the psychological consequences of such disorders. Results showed that the relationship between neuroticism, anxiety and depression was mediated by stress and rumination (brooding), being this effect moderated by the participants' gender. Specifically, women's reflection and stress seemed to be important mechanisms to predict their anxiety and depression symptoms, whereas brooding predicts such disorders' symptomatology in men with Vitiligo. These findings may guide future research and clinical interventions for this population, for which it is necessary to consider the psychological consequences of the disease and not just its physiological aspects.

Perceived vulnerability to disease: adaptation and validation of the PVD-br.

Perceived vulnerability to disease is characterized by the extent to which individuals perceive themselves to be susceptible to contracting infectious diseases, as well as by the emotional discomfort that results from assessing the risk of getting contaminated by pathogens. The PVD self-report scale, which measures this construct, is widely used internationally. However, it has not yet been adapted for Brazil. To address this gap, we adapted and validated the PVD scale for the Brazilian context (PVD-br) in four studies. Study 1 (N = 39) addressed translation, expert validation, and assessment of the comprehensibility of the scale's items. Study 2 (N = 200) showed that the items were organized into two correlated factors and tested the scale's items quality using the Item Response Theory. Study 3 (N = 201) confirmed the bifactorial structure and examined the invariance of PVD-br for men and women, while Study 4 analyzed the convergent (N = 432) and discriminant (N = 181) validity of the instrument. Results indicate strong evidence of content, factorial, and criterion validity.

Absence of severe COVID-19 in patients with clonal mast cells activation disorders: effective anti-SARS-CoV-2 immune response.

Mast cells are key actors of innate immunity and Th2 adaptive immune response which counterbalance Th1 response, critical for anti-viral immunity. Clonal Mast Cells Activation Disorders (cMCADs) such as mastocytosis and clonal mast cells activation syndrome are characterized by an abnormal mast cells accumulation and/or activation. No data have been published on the anti-viral immune response of patients with cMCADs. The aims of the study were to collected, in a comprehensive way, outcomes of cMCADs patients who experienced a biologically-proven COVID-19 and to characterize both anti-endemic coronaviruses and specific anti-SARS-CoV-2 immune responses in these patients. Clinical follow-up and outcome data were collected prospectively for one year within the French rare disease network CEREMAST encompassing patients from all over the country. Anti-SARS-CoV-2 and anti-endemic coronaviruses specific T-cells were assessed with an enzyme-linked immunospot assay (EliSpot) and anti-SARS-CoV-2 humoral response with dosage of circulating levels of specific IgG, IgA and neutralizing antibodies. Overall, 32 cMCADs patients were identified. None of them required non-invasive or mechanical ventilation; two patients were hospitalized to receive oxygen and steroid therapy. In 21 patients, a characterization of the SARS-CoV-2-specific immune response has been performed. A majority of patients showed a high proportion of circulating SARS-CoV-2-specific interferon (IFN)-{gamma} producing T-cells and high levels of anti-Spike IgG antibodies with neutralizing activity. In addition, no defects in anti-endemic coronaviruses responses were found in patients with cMCADs compared to non-cMCADs controls. Patients with cMCADs frequently showed a spontaneous IFN-{gamma} T-cell production in absence of any stimulation that correlated with circulating basal tryptase levels, a marker of mast cells burden. These findings underscore that patients with cMCADs might be not at risk of severe COVID-19 and the spontaneous IFN-{gamma} production might explain this observation. Author SummaryMast cells are immune cells involved in many biological processes including the anti-microbial response. However, previous studies suggest that mast cells may have a detrimental role in the response against viruses such as SARS-CoV-2, responsible for COVID-19. When a mutation occurs in mast cells, it can lead to a group of diseases called clonal mast cells activation disorders (cMCADs), characterized by deregulated activation of these cells. Hence, patients with cMCADs might be more susceptible to severe COVID-19 than general population. We therefore conducted a 1-year study in France to collect data from all cMCADs patients included in the CEREMAST rare disease French network and who experienced COVID-19. Interestingly, we did not find any severe COVID-19 (i.e. requiring non-invasive or mechanical ventilation) in spite of well-known risk factors for severe COVID-19 in a part of cMCADs patients. We then have studied the immune response against SARS-CoV-2 and other endemic coronaviruses in these patients. We did not observe any abnormalities in the immune response either at the level of T and B lymphocytes. These findings underscore that these patients might not be at risk of severe COVID-19 as one might have feared.

Estrutura representacional da microcefalia e autoimagem de mães de crianças com tal condição neurológica / Representational structure of microcephaly and self-image from mothers of children with the neurological affliction

Objetivou-se no presente estudo analisar a estrutura representacional da microcefalia, bem como da autoimagem que mães de crianças com tal condição neurológica possuem. Participaram da pesquisa 105 brasileiras com idades entre 20 e 50 anos (M=31; DP=7,32), que moram, maioritariamente, na região Sudeste do Brasil (39,0%). Para recolha de dados, em 2018, foi utilizado a Técnica de Associação Livre de Palavras. Análises prototípicas do material coletado demonstraram que as participantes constroem suas representações sobre a microcefalia com base no conhecimento científico, a descrevendo, ainda, através de signos que se referem à espiritualidade e ao amor. No que diz respeito à autoimagem dos participantes, foi possível perceber elementos que remetem-se a resiliência, além de outros fatores associados a características auto-transcendentes. As representações identificadas revelam processos adaptativos, a partir da alocação de recursos resilientes que permitem com que as participantes deste estudo ressignifiquem sua condição de mães de crianças com microcefalia.

This study aimed to analyze the representational structure of microcephaly, as well as the self-image that mothers of children with the illness possess. There were 105 Brazilian women, aged between 20 and 50 (M=31; SD=7.32), who live, mostly, in the south-eastern region of Brazil (39.0%). For data acquisition, in 2018, it was used the Free Word Association Technique. Prototypical analyses of the collected material demonstrated that the participants build their representations upon microcephaly based on scientific knowledge, also describing it using signs that refer to spirituality and love. When it comes to the participants' self-image, it was possible to notice elements that support the feature resilience and other factors that are associated with self transcending characteristics. The identified representations reveal adaptive processes, based on the allocation of resilient resources that allow the participants from this study to give a different meaning of being a mother of a child with microcephaly.

Posicionamento Atitudinal, Percepção de Vulnerabilidade e Preocupação em contrair a COVID-19 / Attitudinal Positioning, Perception of Vulnerability and Concern on getting COVID-19 / Posicionamiento Actitudinal, percepción de vulnerabilidad y preocupación por contraer la COVID-19

Este programa de pesquisa objetivou testar um conjunto de hipóteses de modo a evidenciar como Posicionamentos Atitudinais e Políticos, Atitudes em face das Doenças, Traços de Personalidade e a Religiosidade de brasileiros relacionam-se com sua Percepção de Vulnerabilidade e Preocupação em contrair a COVID-19. Para tanto, realizaram-se dois estudos. No primeiro, identificou-se o Posicionamento Atitudinal de internautas em 2.000 comentários sobre um pronunciamento do Presidente do Brasil acerca do novo coronavírus e da COVID-19. Já o estudo 2 resultou na proposição de um modelo explicativo com bons índices de ajustes [x² = 67,72; g = 24; x²/gl = 2,6; CFI = 0,94; TLI = 0,9; RMSEA = 0,06 (IC90%: 0,04-0,08)], demonstrando que Posicionamentos Políticos, Atitudes em face das Doenças e Consienciosidade predizem a Percepção de Vulnerabilidade e a Preocupação em contrair a COVID-19. Em suma, tais achados podem subsidiar estudos futuros e modelos interventivos na dinâmica social para contenção da atual pandemia

This research program aimed to test a set of hypotheses in order to show how Attitudinal and Political Positions, Attitudes towards Diseases, Personality Traits and the religiosity of Brazilians are related to their perception of vulnerability and concern in contracting COVID-19. To do this, two studies were carried out. In the first, the Attitude Positioning of internet users was identified in 2.000 comments on a statement made by the President of Brazil about the new coronavirus and COVID-19. Study 2, on the other hand, resulted in the proposition of an explanatory model with good adjustment rates [x² = 67.72; g = 24; x²/gl = 2.6; CFI = 0.94; TLI = 0.9; RMSEA = 0.06 (CI90%: 0.04-0.08)], demonstrating that Political Positions, Attitudes towards Diseases and Conscientiousness predict the perception of vulnerability and the concern to get COVID-19. In short, such findings may support future studies and interventional models in social dynamics to contain the current pandemic

Esta investigación buscó probar un conjunto de hipótesis sobre cómo las posiciones actitudinales y políticas, las actitudes hacia las enfermedades, los rasgos de personalidad y la religiosidad de los brasileños están relacionadas con su percepción de vulnerabilidad y preocupación en contraer la COVID-19. Para esto, se realizaron dos estudios. En el primero, se identificó el posicionamiento actitudinal de los usuarios de Internet en 2.000 comentarios en una declaración del presidente de Brasil sobre el nuevo coronavirus y la COVID-19. El estudio 2, resultó en un modelo explicativo con buenas tasas de ajuste [x² = 67,72; g = 24; x²/gl = 2,6; CFI = 0,94; TLI = 0,9; RMSEA = 0,06], demostrando que las Posiciones políticas, las actitudes hacia las enfermedades y la conciencia predicen la percepción de vulnerabilidad y la preocupación en contraer la COVID-19. En resumen, tales hallazgos pueden respaldar futuros estudios y modelos de intervención en la dinámica social para contener esta pandemia