Oroantral Communication After Segmental Le Fort I Osteotomy.

Segmental Le Fort I osteotomy is a very versatile technique for correcting mainly transverse discrepancies of the maxilla. However, there are possibilities of intraoperative and intraoperative complications. This article reports a case of oral-antral communication after maxillary segmentation with intraoperative identification and correction using the rotation of the palatal flap. The surgeon needs to know such possible complications when performing the technique to identify and correct them promptly to avoid further sequelae to the patient.

Health Digital Twins in Life Science and Health Care Innovation.

Health digital twins (HDTs) are virtual representations of real individuals that can be used to simulate human physiology, disease, and drug effects. HDTs can be used to improve drug discovery and development by providing a data-driven approach to inform target selection, drug delivery, and design of clinical trials. HDTs also offer new applications into precision therapies and clinical decision making. The deployment of HDTs at scale could bring a precision approach to public health monitoring and intervention. Next steps include challenges such as addressing socioeconomic barriers and ensuring the representativeness of the technology based on the training and validation data sets. Governance and regulation of HDT technology are still in the early stages.

Prevalence of HIV-1 infection and associated characteristics in a Brazilian indigenous population: a cross-sectional study.

Background: Despite significant progress in the areas of prevention, diagnosis, and treatment, HIV continues to result in a substantial number of fatalities on a global scale each year. Gaining insights from epidemiological data can prove instrumental in the development of health promotion strategies, particularly within vulnerable populations, such as indigenous groups. Consequently, our study aimed to investigate the prevalence of HIV infection within the indigenous population residing in the second-largest region of Brazil. Additionally, we sought to explore the subtypes of HIV-1 and detect any drug-resistance mutations present within this population. Methods: In this cross-sectional study, we aimed to evaluate the prevalence of HIV-1 infection and explore its associated characteristics within the indigenous population residing in the villages of Jaguapiru and Bororó, located in the Dourados area of Mato Grosso do Sul (MS), Brazil. Blood samples were collected for rapid HIV screening, serological tests, nucleic acid amplification, and HIV subtyping. Additionally, the HIV-1 viral load and CD4+ T lymphocyte count of the people living with HIV (PLHIV) were assessed at the time of recruitment and 24 weeks later. Findings: Out of the 2190 invited individuals, 1927 (88%) were included in this study. The average age of the participants was 34.2 (±13.8) years, with a majority of 74% being female. Moreover, 68.44% of the participants identified themselves as belonging to the Guarani-Kaiowa ethnic group. HIV seroprevalence was 0.93% (18/1927), and 73.22% (1411/1927) were unaware of their serological status. The prevalence of HIV-1 was higher in single indigenous people [10/617 (1.62%)], who received government benefits [14/1021 (1.37%)], had less than five years of formal education [11/685 (1.61%)], had sexual intercourse with users of injectable drugs [2/21 (9.52%)], with history of sexually transmitted infections (STIs) [10/62 (16.2%)] and incarceration [3/62 (4.84%)]. Of 18 positive samples, 44.4% (8/18) were successfully amplified, and HIV-1 subtype C was prevalent. Furthermore, we identified HIV-1 drug resistance mutations in four patients, specifically from the classes of Protease Inhibitor, Nucleoside Reverse Transcriptase Inhibitor, and Non-Nucleoside Reverse Transcriptase Inhibitor. Notably, three of these patients exhibited a high viral load even after 24 weeks of undergoing antiretroviral therapy. Out of the 18 PLHIV, 66.66% (12/18) had a viral load below 1000 copies/mL, while 50% (9/18) had a CD4+ T lymphocytes count greater than 350 cells/mL after 24 weeks of treatment. Interpretation: Despite the concerted efforts to control HIV infection, the prevalence observed in the indigenous population under study surpassed that reported in other Brazilian indigenous groups. This disparity highlights the disproportionate impact of the disease on this particular group. The detection of drug-resistance mutations further emphasizes the critical need to expand diagnostic coverage, closely monitor treatment strategies, and maintain ongoing molecular surveillance. These measures are imperative for enhancing HIV management within this vulnerable population. Funding: This study was partially funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Fundação de Apoio ao Desenvolvimento do Ensino, Ciência e Tecnologia do Estado de Mato Grosso do Sul (FUNDECT), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Secretaria do Estado de Saúde (SES) of Governo do Estado de Mato Grosso do Sul, and Universidade Federal da Grande Dourados (UFGD).

Retirada de projetil de arma de fogo alojado em assoalho infraorbitário com preservação do globo ocular: relato de caso / Removal of a firearm projectile lodged in the infraorbital floor with preservation of the eyeball: case report

Objetivo: relatar um caso de ferimento por arma de fogo (FAF), com projétil balístico alojado em região infraorbitária à esquerda, relatando tratamento cirúrgico de urgência para exérese do projetil por acesso subciliar. Relato do caso: Paciente do gênero masculino, 18 anos, foi encaminhado ao pronto socorro do Hospital Universitário por conta de ferimento por arma de fogo. Ao exame clínico, foi verificado discreto aumento de volume em região cervical e hemiface à esquerda, ausência de sangramento em face; presença de limitação para infraversão de olho esquerdo. O orifício de entrada do projetil foi identificado em região de tórax superior posterior à esquerda; após realização de tomografia de face, confirmou-se fratura de assoalho orbitário esquerdo, assim como projétil alojado abaixo do globo ocular. O ato cirúrgico foi realizado com caráter de urgência pela equipe de Cirurgia e Traumatologia Bucomaxilofacial. Discussão: estudos descrevem a importância da realização do adequado manejo de lesões traumáticas decorrentes de FAF seguido de remoção do projetil com urgência, visto que as complicações ao postergar o tempo cirúrgico só agravam o quadro clínico do paciente, além das afecções futuras que podem surgir com o decorrer da resolução do caso clínico. Conclusão: ratifica-se a importância da multidisciplinariedade entres as clínicas médicas, assim como, o correto manejo do paciente traumatizado, baseado nos critérios que conduzem o plano de tratamento.(AU)

Aim: to report a case of gunshot wound, with ballistic projectile lodged in the left infraorbital region, reporting emergency surgical treatment for projectile exeresis by subciliary access. Case Report: An 18-year-old male patient was referred to the emergency department of the University Hospital due to a gunshot wound. On clinical examination, it was found slight increase in volume in the cervical region and left hemiface, absence of bleeding in the face; presence of limitation to infraversion of the left eye. The entrance hole of the projectile was identified in the posterior left upper thorax region; after a tomography of the face, a fracture of the left orbital floor was confirmed, as well as the projectile lodged below the eyeball. The surgery was urgently performed by the Oral and Maxillofacial Surgery team. Discussion: Studies describe the importance of performing the proper management of traumatic injuries resulting from FAF followed by removal of the projectile with urgency, since the complications to postpone the surgical time only aggravate the clinical picture of the patient, in addition to future problems that may arise with the resolution of the clinical case. Conclusion: the importance of multidisciplinarity among medical clinics is ratified, as well as the correct management of the traumatized patient, based on the criteria that lead to the treatment plan.(AU)

Nontraditional Healing Utilization and Disclosure Among Dermatology Patients: A National Cross-Sectional Survey Study.

Nontraditional healing (NTH) consists of spiritual and religious healing (SRH) and complementary and alternative medicine (CAM). SRH includes faith healing, prayer, and meditation. CAM includes use of nonprescribed medications or behaviors such as supplements, plant-based remedies, and behavioral changes.

Fluência de leitura, reconhecimento de palavras e compreensão leitora em alunos do 4º ao 9º ano do ensino fundamental: revisão sistemática / Fluidez lectora, reconocimiento de palabras y comprensión lectora en estudiantes de 4° a 9° año de educación primaria: revisión sistemática / Reading Fluency, Word Recognition and Reading Comprehension of Students From the 4th to the 9th Grade of Elementary School: Systematic Review

O processamento da leitura é resultado da interação de distintos processos cognitivos, como reconhecimento de palavras, compreensão oral e fluência. Há evidências sobre a importância da fluência para predizer a com-preensão de leitura, mas ainda não é claro seu papel ao longo do desenvolvimento. Essa revisão sistemática analisou estudos nacionais e internacionais sobre a re-lação das habilidades de reconhecimento de palavras e fluência de leitura com a compreensão de leitura em alunos do 4º ao 9º ano. A revisão foi conduzida de acordo com a metodologia prisma e utilizou a base de dados PubMed, de 2000 a setembro de 2019. Foram incluídos artigos que respondiam à pergunta norteadora e atendiam à temática estabelecida pelos descritores e palavras-chave. Foram encontrados 992 artigos, dos quais 904 foram excluídos pelo título e resumo e 56 pela leitura do texto completo. Isto possibilitou a análise de 32 artigos. Os resultados sugerem que, diferentemente do reconhecimento de palavras, a habilidade de fluência de leitura tende a manter relação significativa com a compreensão de leitura no decorrer do segundo ciclo do Ensino Fundamental.

El procesamiento de la lectura es el resultado de la interacción de diferentes procesos cognitivos, como el reconocimiento de palabras, la comprensión oral y la fluidez. Existe evidencia sobre la importancia de la fluidez en la predicción de la comprensión lectora, pero a lo largo del desarrollo su papel no está claro. Esta revisión sistemática analizó estudios nacionales e internacionales sobre la relación entre las habilidades de reconocimiento de palabras y fluidez lectora con la comprensión lectora en estudiantes de 4° a 9° grado. La revisión se realizó de acuerdo con la metodología prisma y utilizó la base de datos PubMed, desde el 2000 hasta septiembre de 2019. Fueron incluidos artículos que respondieron a la pregunta guía y cumplieron con la temática establecida por los descriptores y palabras clave. Se encontraron 992 artículos, de los cuales 904 fueron excluidos por título y resumen, y 56 por lectura de texto completo. Esto permitió el análisis de 32 artículos. Los resultados sugieren que, a diferencia del reconocimiento de palabras, la habilidad de fluidez lectora tiende a mantener una relación significativa con la comprensión lectora durante el segundo ciclo de la escuela primaria.

Text processing results from the interaction of different cognitive processes, such as word recognition, listening comprehension, and fluency. There is evi-dence relating to the importance of fluency in pre-dicting reading comprehension, but its role during the course of development is still uncertain. The present systematic review has analyzed national and inter-national research on the relationship between word recognition skills and reading fluency with reading comprehension in students from the 4th to 9th grade. The review was conducted according to theprismamethodology and employed the PubMed database from 2000 to September 2019. The chosen papers answered the orienting question and corresponded to the topic established by the descriptors and keywords. We found 992 articles, of which 904 were excluded by reading the titles and abstracts and 56 by reading the full texts. It was possible to analyze 32 papers. The results suggest that, unlike word recognition, the ability to read fluently tends to uphold a significant relationship with reading comprehension during the second cycle of Elementary School.

Barriers to Care-Seeking and Treatment Adherence Among Dermatology Patients: A Cross-Sectional National Survey Study.

Disparities and inequities exist in dermatological access and outcomes, associated with demographics such as socioeconomic status (SES) and geography. Some studies have documented barriers to care and treatment adherence in dermatology such as financial and insurance challenges, logistical considerations, and sociocultural beliefs.

Skin Regenerative Potential of Cupuaçu Seed Extract (Theobroma grandiflorum), a Native Fruit from the Amazon: Development of a Topical Formulation Based on Chitosan-Coated Nanocapsules.

Scarless skin regeneration is a challenge in regenerative medicine. Herein, we explore the regenerative potential of a Cupuaçu seed extract (Theobroma grandiflorum) to develop an innovative skin regeneration formulation based on chitosan-coated nanocapsules. Cupuaçu seed extract significantly stimulated cell proliferation and migration. A reparative gene expression profile could be verified following extract treatment, which included high levels of MKI67, a cellular proliferation marker, and extracellular matrix genes, such as ELN and HAS2, which code for elastin and hyaluronic acid synthase 2. Formulations with Cupuaçu seed extract successfully entrapped into nanocapsules (EE% > 94%) were developed. Uncoated or coated nanocapsules with low-molecular-weight chitosan presented unimodal size distribution with hydrodynamic diameters of 278.3 ± 5.0 nm (PDI = 0.18 ± 0.02) and 337.2 ± 2.1 nm (PDI = 0.27 ± 0.01), respectively. Both nanosystems were physically stable for at least 120 days and showed to be non-irritating to reconstructed human epidermis. Chitosan coating promoted active penetration into undamaged skin areas, which were still covered by the stratum corneum. In conclusion, the present study demonstrated for the first time the biotechnological potential of the frequently discarded Cupuaçu seed as a valuable pharmaceutical ingredient to be used in regenerative skin products.

Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units.

Pseudomonas aeruginosa is one of the most common bacterium with a broad spectrum of human-associated infections. It is intrinsically resistant to many antimicrobial drugs, making carbapenems crucial in clinical management. The emergence and dissemination of carbapenemases among P. aeruginosa clinical isolates is a serious public health concern as it limits the options for the treatment of bacterial infections. Here, we described the molecular and epidemiological characteristics of 28 carbapenem-resistant P. aeruginosa strains isolated from patients hospitalized in an intensive care unit (ICU). The antimicrobial susceptibility of carbapenem-resistant P. aeruginosa strains was determined by broth microdilution. The presence of resistance genes was evaluated by PCR and DNA sequencing. Additionally, alterations in genes encoding P. aeruginosa outer membrane proteins were analyzed by PCR as well as SDS-PAGE. Clinical characteristics of the patients and the economic impact of hospitalization on the public health system were evaluated. PCR amplification showed that the blaKPC-2 and blaTEM genes were identified in three isolates (11%) and blaSHV gene in two isolates (7%). Outer membrane profiles obtained by SDS-PAGE indicated that the OprD porin was either absent or was produced at very low levels. A PCR assay using oprD-specific primers failed to show the presence of mutations in this gene. P. aeruginosa strains were isolated from 28 patients, among whom 43% (12/28) had sepsis, 31% (9/28) had respiratory failure, and 31% (9/28) had systemic arterial hypertension. A high mortality rate (39%) was observed in these patients, with an average duration of hospitalization of 34.6 days and a median cost of 3.275 dollars per patient. The production of carbapenemase was not the main mechanism of resistance in these strains. All carbapenem-resistant P. aeruginosa were isolated from patients hospitalized in the ICU. Besides the high mortality rate, many patients remained hospitalized for several days, resulting in a high cost of hospitalization for the public health system. Therefore, the evolution of this resistance and its dissemination should be actively monitored among critically ill patients to improve their health conditions.

Coronavirus Disease 2019 as a Possible Cause of Severe Orbital Cellulitis.

ABSTRACT: Infection by severe respiratory syndrome coronavirus 2 (coronavirus disease 2019) has been the most important public health event of the last 100 years. The number of cases and deaths caused by this disease, its potential to rapidly spread and the search for a vaccine have been the center of discussion all over the world for over 1 year. In addition to the number of cases and all social, economic, and public health consequences of the pandemic, the variety of symptoms and clinical signs presented by infected patients has been subject of several studies and case reports. At the time of this writing, even with promising research, the clinical outcome of some patients is still unpredictable. The purpose of this article is to report an unusual case, the diagnostic process, and early treatment of this severe and atypical clinical picture. The patient is a young man diagnosed with coronavirus disease 2019 who sought our hospital in Southern Brazil reporting a history of pansinusitis progressing to a severe orbital cellulitis, requiring immediate surgical intervention.

Reconhecimento de Palavras, Fluência e Compreensão de Leitura em Alunos com Transtorno do Espectro Autista / Word Recognition, Fluence and Reading Comprehension in Students with Autism Spectrum Disorder

RESUMO Tendo em vista que o desempenho acadêmico é um dos fatores associados ao bom prognóstico no Transtorno do Espectro Autista (TEA), este estudo avaliou diferentes aspectos cognitivos da leitura em oito meninos com TEA, entre 10 e 13 anos (M=10,87; DP=1,12), de escolas públicas e privadas. Avaliou-se o reconhecimento de palavras (TCLPP II), a fluência (TFL) e a compreensão de leitura (TCCL), bem como o Quociente de Inteligência (QI) Estimado (Vocabulário e Raciocínio Matricial do WASI). Os resultados demonstram frequência maior de desempenhos abaixo da média em compreensão de leitura e maior frequência de desempenhos na média tanto no reconhecimento de palavras quanto na fluência de leitura. Em relação ao tempo nas tarefas de fluência e compreensão, houve maior frequência de classificações na média. Não houve correlação significativa entre Vocabulário do WASI e o QI com os testes de leitura. Entretanto, houve correlação positiva, significativa e de alta magnitude entre reconhecimento de palavras com os escores em fluência e compreensão. Uma tendência de magnitude moderada foi observada entre essas duas últimas variáveis. Conhecer o perfil de leitura do aluno com TEA, a partir da avaliação do reconhecimento de palavras, da fluência e da compreensão, possibilita orientar adaptações escolares, com impacto no seu desenvolvimento acadêmico e prognóstico.

ABSTRACT Considering that academic performance is one of the factors associated with a good prognosis in the Autism Spectrum Disorder (ASD), this study evaluated different cognitive aspects of reading in 8 boys with ASD, between 10 and 13 years old (M=10.87; SD=1.12), of public and private schools. Word recognition (TCLPP II), fluency (TFL) and reading comprehension (TCCL) were evaluated, as well as Estimated IQ (Vocabulary and Matrix Reasoning of the WASI). The results demonstrate a higher frequency of below-average performances in reading comprehension skills, higher frequency of performances on average in word recognition and reading fluency. Regarding the time on fluency and comprehension tasks, there was a higher frequency of average classifications. There was no significant correlation between the Vocabulary and the IQ with the reading tests. However, there was a positive, significant and high magnitude correlation between word recognition with fluency and comprehension scores. A trend of moderate magnitude was observed between these last two variables. The knowledge about the reading profile of students with ASD obtained from the assessment of word recognition, fluency and comprehension makes it possible to guide school adaptations, with an impact on their academic development and prognosis.

Whole-genome sequencing of the endemic Antarctic fungus Antarctomyces pellizariae reveals an ice-binding protein, a scarce set of secondary metabolites gene clusters and provides insights on Thelebolales phylogeny.

The snow-covered surfaces of Antarctica comprise an extreme environment that favors the development of life forms with adaptations to adverse low-temperature habitats. The ability to survive and such temperatures might involve the production of antifreeze proteins and ice-binding proteins that attenuate the effects of intense cold temperatures. He, we sequenced and reconstructed the nuclear and mitochondrial genomes of the endemic Antarctic fungus Antarctomyces pellizariae UFMGCB 12416. We then have identified a putative ice-binding protein-coding gene, mapped the presence of secondary metabolite gene clusters, and reconstructed the phylogenetic relationships of a A. pellizariae with others Leotiomycetes from the alignment of hundreds of orthologous single-copy proteins. Our results will deepen the understanding of microbial ice-binding proteins and the genomic aspects of psychrophilic fungi. DATASET: The GenBank/EMBL/DDBJ accession number for the gene sequence of ice-binding protein from A. pellizariae determined in this study is MN867686. The Whole Genome Shotgun project of strain A. pellizariae UFMGCB 12416 has been deposited at DDBJ/ENA/GenBank under accession WCAA00000000. The version described in this paper is version WCAA01000000. The mitochondrial genome has been deposited under accession MT197497.

Chemical Composition and Antimicrobial Effectiveness of Ocimum gratissimum L. Essential Oil Against Multidrug-Resistant Isolates of Staphylococcus aureus and Escherichia coli.

The study investigated the antimicrobial activity of the essential oil extract of Ocimum gratissimum L. (EOOG) against multiresistant microorganisms in planktonic and biofilm form. Hydrodistillation was used to obtain the EOOG, and the analysis of chemical composition was done by gas chromatography coupled with mass spectrometry (GC/MS) and flame ionization detection (GC/FID). EOOG biological activity was verified against isolates of Staphylococcus aureus and Escherichia coli, using four strains for each species. The antibacterial action of EOOG was determined by disk diffusion, microdilution (MIC/MBC), growth curve under sub-MIC exposure, and the combinatorial activity with ciprofloxacin (CIP) and oxacillin (OXA) were determined by checkerboard assay. The EOOG antibiofilm action was performed against the established biofilm and analyzed by crystal violet, colony-forming unit count, and SEM analyses. EOOG yielded 1.66% w/w, with eugenol as the major component (74.83%). The MIC was 1000 µg/mL for the most tested strains. The growth curve showed a lag phase delay for both species, mainly S. aureus, and reduced the growth level of E. coli by half. The combination of EOOG with OXA and CIP led to an additive action for S. aureus. A significant reduction in biofilm biomass and cell viability was verified for S. aureus and E. coli. In conclusion, EOOG has relevant potential as a natural alternative to treat infections caused by multiresistant strains.

Implementação do modelo de resposta à intervenção em uma classe de 5º ano do ensino fundamental da rede pública de ensino: relato de experiência / Implementation of Response to Intervention Model in a class of 5th grade of a public elementary school: experience report

O presente estudo teve como objetivo a aplicação do modelo de Resposta à Intervenção (RTI) em uma turma do 5º ano do Ensino Fundamental de uma escola pública. Participaram 22 crianças, com idades entre 10 e 11 anos. Foi realizada a adaptação da Camada 1 do modelo RTI, que visa a uma intervenção de caráter instrucional, preventivo, ofertada pelo professor a todos os alunos, por meio de estratégias com base em evidências científicas. Os participantes foram avaliados em três momentos: início, meio e final do ano escolar. Testes normatizados de leitura, escrita, aritmética, atenção e motivação foram aplicados a fim de avaliar o progresso das crianças. Além dos testes padronizados, avaliações qualitativas e contínuas foram feitas atendendo o critério de monitoramento prescrito no modelo de RTI. De forma geral, a análise dos resultados demonstrou que o desempenho dos alunos em leitura, escrita, atenção e aritmética obteve melhoras estatisticamente significativas, sendo possível também identificar os alunos com desempenho abaixo da média em relação a seus pares. Tal relato corrobora a eficácia da aplicação do modelo RTI também ao final do ciclo do Ensino Fundamental I.

The present study aims to narrate an experience of application of the Response to Intervention model in a 5th grade class of a Public Elementary School. Twenty-two children, aged 10 and 11, took part in this experience. We used an adaptation of tier 1 of the RTI model that aims for an instructional, preventive intervention, offered by the teacher to all students, through scientific based strategies. The study consisted in three moments of administration of standardized tests for reading, writing, numeracy, attention and motivation: at the beginning of the school year and at the end of the first and last semesters. Besides these tests, we made use of other types of continuous and qualitative assessment, meeting the criteria for monitoring prescribed in the RTI model. The analysis of progress in reading, writing, attention and numeracy showed statistically significant improvement. It is also possible to identify students with below-average performance relative to their peers. This report corroborates the effectiveness of the application of the RTI model also at the end of the Elementary School cycle.

Complete and Sustained Response with a Doublet Chemotherapy Protocol in an 81-Year-Old Patient with Metastatic Breast Cancer.

Metastatic breast cancer (MBC) entails an overall 5-year survival of approximately 25%. The choice of therapy is influenced by expression of the HER2 gene and hormone receptors, by a disease-free interval, and by age. The use of paclitaxel combined with gemcitabine (doublet protocol) has shown efficacy as first-line treatment for MBC in either initial or maintenance therapy when compared to monotherapy with paclitaxel. There is evidence showing that the doublet protocol is a good alternative to maintenance therapy in women under 50 years old. Nevertheless, there is a lack of information concerning individuals above that age. We report the case of an 81-year-old patient presenting with recurrence of MBC, with lung and skin metastases both positive for hormone receptor and negative for HER2. We implemented a therapy based on the combination of gemcitabine and paclitaxel for 12 cycles, when complete response was achieved. Currently, 16 months after this achievement, the patient is receiving maintenance treatment under the doublet protocol, presenting acceptable parameters of toxicity since the beginning of treatment, which shows satisfactory tolerability and management of chemotherapy in an elderly patient. We suggest that the maintenance treatment protocol with a doublet might be an alternative with a satisfactory response in patients with MBC.

A checklist of the scorpions of Ecuador (Arachnida: Scorpiones), with notes on the distribution and medical significance of some species.

Ecuador harbors one of the most diverse Neotropical scorpion faunas, hereby updated to 47 species contained within eight genera and five families, which inhabits the "Costa" (n = 17), "Sierra" (n = 34), "Oriente" (n = 16) and "Insular" (n = 2) biogeographical regions, corresponding to the western coastal, Andean, Amazonian, and the Galápagos archipelago regions, respectively. The genus Tityus Koch, in the family Buthidae, responsible for severe/fatal accidents elsewhere in northern South America and the Amazonia, is represented in Ecuador by 16 species, including T. asthenes, which has caused fatalities in Colombia and Panama, and now in the Ecuadorian provinces of Morona Santiago and Sucumbíos. Underestimation of the medical significance of scorpion envenoming in Ecuador arises from the fact that Centruroides margaritatus (Gervais) (family Buthidae) and Teuthraustes atramentarius Simon (family Chactidae), whose venoms show low toxicity towards vertebrates, frequently envenom humans in the highly populated Guayas and Pichincha provinces. This work also updates the local scorpion faunal endemicity (74.5 %) and its geographical distribution, and reviews available medical/biochemical information on each species in the light of the increasing problem of scorpionism in the country. A proposal is hereby put forward to classify the Ecuadorian scorpions based on their potential medical importance.

Hemorragia alveolar na granulomatose com poliangeíte: um desafio favorável / Alveolar hemorrhage in granulomatosis with polyangiitis: a positive challenge

A granulomatose com poliangeíte (GPA) é uma vasculite necrosante multissistêmica de etiologia desconhecida que atinge vasos de pequeno e médio calibre, principalmente das vias aéreas e dos rins, acometendo, em sua maioria, indivíduos entre 30 e 50 anos, cuja evolução pode ser fatal se a terapêutica adequada não for instituída em tempo hábil...

Hemorragia alveolar na granulomatose com poliangeíte: um desafio favorável / Alveolar hemorrhage in granulomatosis with polyangiitis: a positive challenge

A granulomatose com poliangeíte (GPA) é uma vasculite necrosante multissistêmica de etiologia desconhecida que atinge vasos de pequeno e médio calibre, principalmente das vias aéreas e dos rins, acometendo, em sua maioria, indivíduos entre 30 e 50 anos, cuja evolução pode ser fatal se a terapêutica adequada não for instituída em tempo hábil...(AU)

A checklist of the scorpions of Ecuador (Arachnida: Scorpiones), with notes on the distribution and medical significance of some species

Ecuador harbors one of the most diverse Neotropical scorpion faunas, hereby updated to 47 species contained within eight genera and five families, which inhabits the "Costa" (n= 17), "Sierra" (n= 34), "Oriente" (n= 16) and "Insular" (n= 2) biogeographical regions, corresponding to the western coastal, Andean, Amazonian, and the Galápagos archipelago regions, respectively. The genusTityus Koch, in the family Buthidae, responsible for severe/fatal accidents elsewhere in northern South America and the Amazonia, is represented in Ecuador by 16 species, including T. asthenes, which has caused fatalities in Colombia and Panama, and now in the Ecuadorian provinces of Morona Santiago and Sucumbíos. Underestimation of the medical significance of scorpion envenoming in Ecuador arises from the fact thatCentruroides margaritatus (Gervais) (family Buthidae) andTeuthraustes atramentarius Simon (family Chactidae), whose venoms show low toxicity towards vertebrates, frequently envenom humans in the highly populated Guayas and Pichincha provinces. This work also updates the local scorpion faunal endemicity (74.5 %) and its geographical distribution, and reviews available medical/biochemical information on each species in the light of the increasing problem of scorpionism in the country. A proposal is hereby put forward to classify the Ecuadorian scorpions based on their potential medical importance.(AU)