How Knowledgeable Are Spine Surgeons Regarding EMG-NCS for Cervical Spine Conditions? An International Aospine Survey.

STUDY DESIGN: Cross-sectional, international survey. OBJECTIVES: To evaluate the knowledge of spine surgeons regarding the use of electromyography (EMG) and nerve conduction studies (NCS) for degenerative cervical spine conditions (DCC). METHODS: All members of AO Spine International were emailed an anonymous survey to evaluate their clinical knowledge about the use of EMG and nerve conduction studies for DCC. Descriptive statistics were used to analyze the results, as well as to compare the answers among different groups of surgeons and assess demographic characteristics. RESULTS: A total of 402 participants answered the survey, 91.79% were men from the 5 continents. There were 221 orthopedic surgeons (55.39%) and 171 neurosurgeons (42.86%), more than a half of them with a complete spinal fellowship (56.44%). The most common reasons that surgeons obtain the test is to differentiate a radiculopathy from a peripheral nerve compression (88.06%). As a group, the responding surgeons' knowledge regarding EMG-NCS was poor. Only 53.46% of surgeons correctly answered that EMG-NCS is unable to differentiate a C5 from a C6 radiculopathy. Only 23.47% of the surgeons knew that EMG-NCS are not able to diagnose a pre vs a post-fixed brachial plexus. Only 25% of the surgeons correctly answered a question regarding the test's ability to diagnose other neurological diseases. CONCLUSIONS: We found that our respondents' knowledge regarding EMG-NCS for DCC was poor. Identifying the weak points of knowledge about EMG-NCS may help to educate surgeons on the indications for the test and the proper way to interpret the results.

Lip carcinoma mimicking keratoacanthoma: case reports / Carcinoma de lábio mimetizando queratoacantoma: relato de casos

ABSTRACT Oral amyloidosis is a disease characterized by extracellular and irreversible deposition of amorphous and fibrillar proteins in the oral cavity, being strongly associated with Multiple Myeloma. The objective of this study is to report a case of a 62-year-old woman diagnosed with Multiple Myeloma who, approximately 2 years after starting treatment for the underlying disease, presented a lesion on the lateral border of the tongue with exophytic growth, pinkish color, vascularized, painless, measuring 3cm in its largest diameter. After histopathological analysis through incisional biopsy, a final diagnosis of amyloidosis was obtained. As a local treatment, we opted for complete excision of the lesion. The patient evolved to death due to Multiple Myeloma influenced by the diagnosis of systemic amyloidosis. Oral amyloidosis is usually associated with the systemic presentation of the disease, making it necessary to conduct a thorough investigation of other organs. Its diagnosis is important since the prognosis is directly related and can negatively influence survival rates and treatment of the underlying disease.

RESUMO A amiloidose oral é uma doença caracterizada pela deposição extracelular e irreversível de proteínas amorfas e fibrilares na cavidade bucal, sendo fortemente associada com Mieloma Múltiplo. O objetivo deste trabalho é relatar o caso de uma mulher com 62 anos de idade diagnosticada com Mieloma Múltiplo que, aproximadamente 2 anos após o início do tratamento para a doença de base, apresentou lesão em borda lateral de língua com crescimento exofítico, de coloração rósea, vascularizada, indolor, medindo 3 cm em seu maior diâmetro. Após análise histopatológica através de biópsia incisional, obteve-se diagnóstico final de amiloidose. Como tratamento local, optou-se pela exérese completa da lesão. A paciente evoluiu para óbito por consequência do Mieloma Múltiplo com complicações associadas à amiloidose sistêmica. A amiloidose oral geralmente está associada com a apresentação sistêmica da doença, tornando necessária uma investigação aprofundada nos demais órgãos. Seu diagnóstico é importante uma vez que pode influenciar diretamente no prognóstico e, consequentemente, negativamente nas taxas de sobrevida e no tratamento da doença de base.

Randomized Trial of Botulinum Toxin Type A in Hereditary Spastic Paraplegia - The SPASTOX Trial.

BACKGROUND: Hereditary spastic paraplegia presents spasticity as the main clinical manifestation, reducing gait quality and producing incapacity. Management with botulinum toxin type A (BoNT-A) is not well elucidated. The objective of the current study was to evaluate the efficacy and safety of BoNT-A in patients with hereditary spastic paraplegias. METHODS: This was a double-blind, randomized, placebo-controlled crossover trial. Each participant was randomly assigned to receive 1 injection session of either BoNT-A (100 IU/2 mL of Prosigne in each adductor magnus and each triceps surae) or saline 0.9% (2 mL). The primary outcome measure was change from baseline in maximal gait velocity, and secondary outcome measures included changes in gait at self-selected velocity, spasticity, muscle strength, Spastic Paraplegia Rating Scale, pain, fatigue, and subjective perception of improvement. We also looked at adverse events reported by the patients. RESULTS: We enrolled 55 patients, 36 of whom were men and 41 with the pure phenotype. Mean age was 43 ± 13.4 years (range, 19-72 years), mean age of onset waws 27 ± 13.1 years (range, <1 to 55 yars), and mean disease duration was 17 ± 12.7 years (range, 1-62 years). Compared with baseline, we did not find significant differences between groups in primary and secondary outcomes, except for reduction in adductor tone (P = 0.01). The adverse events were transient and tolerable, and their incidence did not significantly differ between treatments (P = 0.17). CONCLUSIONS: BoNT-A was safe in patients with hereditary spastic paraplegias and reduced the adductor tone, but it was not able to produce functional improvement considering the doses, injection protocol, measures, and instruments used. © 2021 International Parkinson and Movement Disorder Society.

Comparison among chemical thinners applied to Maciel and Sensação peach trees / Comparação entre realentes químicos em pessegueiros 'Maciel' e 'Sensação'

Peach tree thinning, whichaims at reducing plant load so as to ensure productivity and fruit quality, has been manually carried out within a short period of time in the stage of fruit development. Due to the need and shortage of qualified man power, chemical thinning is one of the alternatives that can solve these difficulties found in manual thinning. This study aimed at evaluating the effect of different products which have been applied ­ either alone or in combination ­ to fruit thinning of peach tree cultivars 'Sensação' and 'Maciel' in Pelotas, Rio Grande do Sul (RS) state, Brazil. The experiment was conducted in the 2015/2016 crop in a commercial peach orchard located in Morro Redondo, RS, Brazil. The following seven treatments were carried out 40 days after full bloom (DAFB): plants with no thinning, manual thinning, metamitron, benzyladenine, benzyladenine + metamitron, ethephon, ethephon + metamitron. Fruit abscission, effective fructification, number of fruits and production per plant, mean mass and fruit classification into caliber classes, epidermis color, pulp firmness and soluble solids were evaluated. Production and number of fruits per plant decreased excessively, whereas fruits placed in categories of higher caliber increased when ethephon was either used alone or in combination with metamitron. When both metamitron and benzyladenine were applied, either alone or in combination, they led to fruit abscission and resulted in mean fruit size and weight, at harvest time, similar to those found in manual thinning. Application of chemical products ­ either alone or in combination ­ may be an alternative of peach tree thinning in orchard management.

O raleio em pessegueiro visa reduzir a carga da planta para assegurar a produtividade e a qualidade dos frutos, sendo realizado manualmente em um curto período durante a etapa de desenvolvimento dos frutos. Devido à exigência e falta de mão de obra qualificada, o raleio químico é uma das alternativas para suprir essa demanda encontrada no raleio manual. O objetivo deste trabalho foi avaliar o efeito de diferentes produtos aplicados de forma isolada ou combinada no raleio de frutos de pessegueiros das cultivares Sensação e Maciel na região de Pelotas. O experimento foi conduzido na safra 2015/2016, em pomar comercial de pessegueiro localizado no município de Morro Redondo, RS. Foram realizados sete tratamentos aos 40 dias após a plena floração, consistindo em plantas sem raleio, raleio manual, metamitron, benziladenina, benziladenina + metamitron, ethephon, ethephon + metamitron. Avaliou-se a abscisão dos frutos, frutificação efetiva, número de frutos e produção por planta, massa média e classificação dos frutos em classes de calibre, coloração da epiderme, firmeza de polpa e sólidos solúveis. A produção e o número de frutos por planta reduziram excessivamente, enquanto a alocação dos frutos em categorias de maior calibre aumentou, quando utilizado o ethephon isolado ou em combinação com o metamitron. O metamitron e a benziladenina aplicados isolados ou em combinação promoveram a abscisão dos frutos e resultaram em tamanho e peso médio dos frutos na colheita semelhantes aos provenientes do raleio manual. Aplicação de produtos químicos isolados ou em combinação pode ser uma alternativa de manejo dos pomares para o raleio de pessegueiros.

Performance of the pineapple sweet orange on different rootstocks / Desempenho da laranja doce abacaxi em diferentes porta-enxertos

This study aimed at evaluating the agronomical performance of 'Pineapple' sweet orange grafted on ten rootstocks, in 2011-2017 harvests, so as to recommend the best combinations to be commercially explored in citrus growing regions in Bahia and Sergipe states, Brazil. An experiment wasinstalled to test ten rootstock for 'pineapple' sweet orange: 'Santa Cruz' Rangpur lime, 'Red Rough' Lemon, 'Orlando' Tangelo, 'Sunki Tropical' Mandarin, 'Swingle' citrumelo, the citrandarins 'Indio' and 'Riverside' and the hybrids HTR-051, LVKxLCR-010 and TSKxCTTR-002. The trial was installed in 2008 in the municipalityof Umbauba in Sergipe. The experimental design was complete randomized blocks with four replications and two plants per plot. Plant spacing was 6 x 4 m which corresponds to 416 plants per hectare and the orchard was rainfed and followed conventional management. The following agronomical parameters were evaluated: vegetative growth, drought tolerance, yield and physico-chemical quality of fruits as well as the abundance of phytophagous mites. Both hybrids LVK x LCR ­ 010 and TSKC x CTTR-002 and the 'Santa Cruz' rangpur lime bestowed higher tolerance to the dry period on the 'Pineapple' orange tree, by comparison with higher water deficit susceptibility conferred by the 'Orlando' tangelo and the 'Swingle' citrumelo. Rootstocks HTR-051, 'Riverside' citrandarin, 'Swingle' citrumelo and TSKC x CTTR-02 induced plants to remain small and, thus, showed aptitude for culture densification. Cumulative yield of the 'Pineapple' orange was higher on rootstocks 'Red Rough' lemon and 'Santa Cruz' Rangpur lime, the hybrid LVK x LCR-010 and 'Sunki Tropical'. Yield efficiency was not influenced by the rootstocks. Physico-chemical quality of fruits of 'Pineapple' orange is affected by the rootstocks and meets the requirements of juice industries. Regarding plant resistance, the rootstocks did not influence the population density of mites P. oleivora, E. banksi and T. mexicanus on 'Pineapple' oranges. Results show that both rootstocks 'Red Rough' lemon and 'Santa Cruz' rangpur lime conferred high regularity to 'Pineapple' orange trees in citrus growing regions in Bahia and Sergipe states

O objetivo deste trabalho foi avaliar o desempenho agronômico da laranjeira 'Pineapple' em combinação com dez porta-enxertos, nas safras 2011-2017, com vistas à recomendação das melhores combinações para exploração comercial na região citrícola dos estados da Bahia e de Sergipe. O experimento consistiu de laranja doce 'pineapple' enxertado nos porta-enxertos limoeiros 'Cravo Santa Cruz', limoeiro 'Rugoso Vermelho', tangeleiro Orlando, tangerineira 'Sunki' Tropical, citrumelo 'Swingle', citrandarins 'Indio', 'Riverside', além dos híbridos HTR ­ 051 e LVK x LCR ­ 010 e 'TSKC x CTTR ­ 002'. O trabalho foi instalado em 2008, no município de Umbaúba, em Sergipe, no delineamento experimental de blocos ao acaso, com quatro repetições, duas plantas por parcela, no espaçamento de 6m x 4m, correspondendo a uma população de 416 plantas· ha-1, com manejo em sistema de produção convencional, sem o uso de irrigação. Os seguintes parâmetros agronômicos foram avaliados: crescimento vegetativo, tolerância à seca, produção e qualidade físico-química de frutos, além da abundância de ácaros fitófagos. Os híbridos LVK x LCR - 010 e TSKC x CTTR - 002, assim como o limoeiro 'Cravo Santa Cruz', conferiram um maior nível de tolerância ao período seco, em contraste com maior suscetibilidade à seca relacionada ao tangelo 'Orlando' e ao citrumelo 'Swingle'. Os porta-enxertos HTR - 051, citrandarin 'Riversidade', citrumelo 'Swingle' e TSKC x CTTR - 002 induziram menor porte às plantas, demonstrando aptidão ao adensamento de plantio. A produção acumulada da laranjeira 'Pineapple' foi maior sobre os porta-enxertos limoeiros 'Rugoso Vermelho' e 'Cravo Santa Cruz', híbrido LVK x LCR - 010 e tangerineira 'Sunki Tropical'. A eficiência produtiva não foi influenciada pelos porta-enxertos. A qualidade física e química de frutos da laranjeira 'Pineapple' foi afetada pelos porta-enxertos e atendeu aos padrões exigidos pela indústria de sucos. Os porta-enxertos estudados não causaram variações nos níveis de populações dos ácaros Phyllocptruta oleivora, Eutetranychus banksi e Tetranychus mexicanus. Com base nos resultados conclui-se que os limoeiros 'Rugoso Vermelho' e 'Cravo Santa Cruz' determinam maior regularidade de produção de frutos à laranjeira 'Pineapple' nas regiões produtoras da Bahia e de Sergipe

Misdiagnosis and diagnostic delay in non-paraneoplastic sensory neuronopathies.

METHODS: Sensory neuronopathies (SN) are a group of peripheral nerve disorders characterized by multifocal non-length-dependent sensory deficits and sensory ataxia. Its recognition is essential not only for proper management but also to guide the etiological investigation. The uncommon SN clinical picture and its rarity set the conditions for the misdiagnosis and the diagnostic delay, especially in non-paraneoplastic SN. Therefore, our objectives were to characterize the diagnostic odyssey for non-paraneoplastic SN patients, as well as to identify possible associated factors. We consecutively enrolled 48 non-paraneoplastic SN patients followed in a tertiary neuromuscular clinic at the University of Campinas (Brazil). All patients were instructed to retrieve their previous medical records, and we collected the data regarding demographics, disease onset, previous incorrect diagnoses made and the recommended treatments. RESULTS: There were 34 women, with a mean age at the diagnosis of 45.9 ± 12.2 years, and 28/48 (58%) of the patients were idiopathic. Negative sensory symptoms were the heralding symptoms in 25/48 (52%); these were asymmetric in 36/48 (75%) and followed a chronic course in 35/48 (73%). On average, it took 5.4 ± 5.3 years for SN to be diagnosed; patients had an average of 3.4 ± 1.5 incorrect diagnoses. A disease onset before the age of 40 was associated to shorter diagnosis delay (3.7 ± 3.4 vs. 7.8 ± 6.7 years, p = 0.01). CONCLUSIONS: These results suggest that diagnostic delay and misdiagnosis are frequent in non-paraneoplastic SN patients. As in other rare conditions, increased awareness in all the healthcare system levels is paramount to ensure accurate diagnosis and to improve care of these patients.

Deafness and Vestibulopathy in Cerebellar Diseases: a Practical Approach.

Cerebellar ataxias are a clinically heterogeneous group of neurological disorders. Besides the cerebellum, several forms of hereditary ataxias or non-genetic ataxias also affect other areas of the brain. Some forms of cerebellar ataxias may have cochlear and vestibular involvement and may present with deafness and symptoms or signs of vestibulopathy (dizziness, nystagmus and diplopia). Recognizing otoneurological symptoms in patients with cerebellar ataxias is mandatory, since these signs may guide a specific diagnosis, and clinicians may provide a suitable therapeutic approach. In this review, we describe and discuss the most common forms of cerebellar ataxias associated with deafness and vestibulopathy.

SPG11-related parkinsonism: Clinical profile, molecular imaging and l-dopa response.

BACKGROUND: Molecular imaging has proven to be a powerful tool to elucidate degenerated paths in a wide variety of neurological diseases and has not been systematically studied in hereditary spastic paraplegias. OBJECTIVES: To investigate dopaminergic degeneration in a cohort of 22 patients with hereditary spastic paraplegia attributed to SPG11 mutations and evaluate treatment response to l-dopa. METHODS: Patients and controls underwent single-photon emission computed tomography imaging utilizing 99m Tc-TRODAT-1 tracer. A single-blind trial with 600 mg of l-dopa was performed comparing UPDRS scores. RESULTS: Reduced dopamine transporter density was universal among patients. Nigral degeneration was symmetrical and correlated with disease duration and motor and cognitive handicap. No statistically significant benefit could be demonstrated with l-dopa intake during the trial. CONCLUSION: Disruption of presynaptic dopaminergic pathways is a widespread phenomenon in patients with SPG11 mutations, even in the absence of parkinsonism. Unresponsiveness to treatment could be related to postsynaptic damage that needs to be further investigated.

SPG11 mutations cause widespread white matter and basal ganglia abnormalities, but restricted cortical damage.

SPG11 mutations are the major cause of autosomal recessive Hereditary Spastic Paraplegia. The disease has a wide phenotypic variability indicating many regions of the nervous system besides the corticospinal tract are affected. Despite this, anatomical and phenotypic characterization is restricted. In the present study, we investigate the anatomical abnormalities related to SPG11 mutations and how they relate to clinical and cognitive measures. Moreover, we aim to depict how the disease course influences the regions affected, unraveling different susceptibility of specific neuronal populations. We performed clinical and paraclinical studies encompassing neuropsychological, neuroimaging, and neurophysiological tools in a cohort of twenty-five patients and age matched controls. We assessed cortical thickness (FreeSurfer software), deep grey matter volumes (T1-MultiAtlas tool), white matter microstructural damage (DTI-MultiAtlas) and spinal cord morphometry (Spineseg software) on a 3 T MRI scan. Mean age and disease duration were 29 and 13.2 years respectively. Sixty-four percent of the patients were wheelchair bound while 84% were demented. We were able to unfold a diffuse pattern of white matter integrity loss as well as basal ganglia and spinal cord atrophy. Such findings contrasted with a restricted pattern of cortical thinning (motor, limbic and parietal cortices). Electromyography revealed motor neuronopathy affecting 96% of the probands. Correlations with disease duration pointed towards a progressive degeneration of multiple grey matter structures and spinal cord, but not of the white matter. SPG11-related hereditary spastic paraplegia is characterized by selective neuronal vulnerability, in which a precocious and widespread white matter involvement is later followed by a restricted but clearly progressive grey matter degeneration.

Physicochemical characterization of banana fruit by univariate and multivariate procedures / Caracterização físico-química de frutos de bananeira por procedimentos uni e multivariados

Breeding genotypes need to be characterized and evaluated in different soil and climatic conditions. There are few studies on association between characters evaluated and their contribution to banana genetic diversity, being essential to guide genetic breeding programs. This study aimed to evaluate the physicochemical characters of banana genotypes, to estimate associations between characters, to determine the relative importance of characters to study on genetic dissimilarity, and to indicate new genotypes to coastal plain region of Sergipe. Fruits from thirteen genotypes were used: Prata (FHIA-18, BRS Platina, PV94-01, BRS Garantida, YB42-47, Pacovan, and Prata Anã), Maçã (BRS Princesa, BRS Tropical, and Maçã), Ibota (Caipira), Gros Michel (Bucaneiro), and Mysore (Thap Maeo). The experimental design was randomized blocks, with thirteen genotypes and three replications. There is physicochemical variability of fruits between genotypes of same genomic group and subgroup, and between hybrids originated from same progenitor. Content of total sugars has greater contribution to genetic diversity among the genotypes, followed by fruit mass and pulp mass, and starch content in two cycles. Associations between fruit length, fruit diameter, and fruit mass and pulp mass in two production cycles based on phenotypic correlation are highly significant. Hybrids FHIA-18, PA94-01, YB42-47, and BRS Tropical, BRS Princesa, and Bucaneiro cultivars are promising for recommendation on coastal plain regions.

Genótipos melhorados necessitam ser caracterizados e avaliados em diferentes condições edafoclimáticas. Existem poucos estudos sobre a associação entre os caracteres avaliados e sua contribuição para a diversidade genética da banana, sendo imprescindíveis para orientar programas de melhoramento genético. O objetivo desse trabalho foi avaliar os caracteres físico-químicos de frutos de genótipos de bananeira, estimar as associações entre caracteres, determinar a importância relativa dos caracteres para o estudo da dissimilaridade genética e indicar novos genótipos para a região de Tabuleiros Costeiros de Sergipe. Foram utilizados frutos de treze genótipos: tipo Prata (FHIA-18, BRS Platina, PV94-01, BRS Garantida, YB42-47, Pacovan e Prata-Anã), Maçã (BRS Princesa, BRS Tropical e Maçã), Ibota (Caipira), Gros Michel (Bucaneiro) e o Mysore (Thap Maeo). O delineamento experimental foi em blocos ao acaso, com treze genótipos e três repetições. Existe variabilidade físico-química dos frutos entre os genótipos do mesmo grupo genômico e subgrupo, e entre híbridos originados da mesma genitora. O teor de açúcares totais apresenta maior contribuição para a diversidade genética entre os genótipos, seguido da massa do fruto com e sem casca e teor de amido nos dois ciclos. As associações entre comprimento do fruto, o diâmetro, massa do fruto e da polpa nos dois ciclos de produção com base na correlação fenotípica são altamente significativas. Os híbridos FHIA-18, PA94-01, YB42-47 e as cultivares BRS Tropical, BRS Princesa e Bucaneiro são promissores para recomendação nos Tabuleiros Costeiros.

Spinal Cord Damage in Spinocerebellar Ataxia Type 1.

Spinocerebellar ataxia type 1 (SCA1) is an autosomal dominant disorder caused by a CAG repeat expansion, characterized by progressive cerebellar ataxia and pyramidal signs. Non-motor and extracerebellar symptoms may occur. MRI-based studies in SCA1 focused in the cerebellum and connections, but there are no data about cord damage in the disease and its clinical relevance. To evaluate in vivo spinal cord damage in SCA1, a group of 31 patients with SCA1 and 31 age- and gender-matched healthy controls underwent MRI on a 3T scanner. We used T1-weighted 3D images to estimate the cervical spinal cord area (CA) and eccentricity (CE) at three C2/C3 levels based on a semi-automatic image segmentation protocol. The scale for assessment and rating of ataxia (SARA) was used to quantify disease severity. The groups were significantly different regarding CA (47.26 ± 7.4 vs. 68.8 ± 5.7 mm2, p < 0.001) and CE values (0.803 ± 0.044 vs. 0.774 ± 0.043, p < 0.05). Furthermore, in the patient group, CA presented significant correlation with SARA scores (R = -0.633, p < 0.001) and CAGn expansion (R = -0.658, p < 0.001). CE was not associated with SARA scores (p = 0.431). In the multiple variable regression, CA was strongly associated with disease duration (coefficient -0.360, p < 0.05) and CAGn expansion (coefficient -1.124, p < 0.001). SCA1 is characterized by cervical cord atrophy and anteroposterior flattening. Morphometric analyses of the spinal cord MRI might be a useful biomarker in the disease.

Derek Denny-Brown: the man behind the ganglia.

The authors present an historical review about the main contributions of Professor Derek Denny-Brown to neurology. Some of his achievements include the first description of sensory neuronopathies, and some of the essential textbooks on the function and anatomy of the basal ganglia. In 2016, on the 35th anniversary of his death, modern neurologists are still strongly influenced by his legacy.

Citrus rootstocks influence the population densities of pest mites / Porta-enxertos cítricos influenciam a densidade populacional de ácaros fitófagos

Citrus are attacked by pest mites such as the citrus rust mite Phyllocoptruta oleivora (Ashmead) (Acari: Eriophyidae) and the spider mite Tetranychus mexicanus (McGregor) (Acari: Tetranychidae). However, little is known on citrus rootstocks influencing pest mites. We aimed to evaluate the influence of rootstocks on population densities of pest mites on the sweet oranges 'Pera CNPMF D-6' and 'Valencia Tuxpan' throughout time. Adults of both mite species were monthly counted during 19 months from June 2011 to February 2013. Rootstocks influenced the populations of pest mites, since lower densities of P. oleivora were found on 'Pera CNPMF D-6' sweet orange grafted on the hybrid TSKC × CTTR - 002 and on 'Swingle' citrumelo in comparison with the hybrid LVK × LCR - 010, 'Red' rough lime and 'Santa Cruz' rangpur lime as rootstocks. Similarly, lower densities of T. mexicanus were found on 'Valencia Tuxpan' sweet orange grafted on the hybrid HTR-051 in comparison to 'Indio' citrandarin, 'Sunki Tropical' mandarin and LVK × LCR - 010 as rootstocks. We concluded that densities of the mites P. oleivora and T. mexicanus on the sweet oranges 'Pera CNPMF D-6' and 'Valencia Tuxpan' were affected in some periods of the year by some rootstocks, suggesting influence of some genotypes on these pests.

Os citros são atacados por ácaros-praga como o ácaro-da-falsa-ferrugem Phyllocoptruta oleivora (Ashmead) (Acari: Eriophyidae) e Tetranychus mexicanus (McGregor) (Acari: Tetranychidae). No entanto, pouco é conhecido sobre o efeito de porta-enxertos sobre populações de pragas. O objetivo deste trabalho foi avaliar a influência de porta-enxertos nas densidades populacionais de ácaros-praga nas laranjeiras 'Pera CNPMF D-6' e 'Valência Tuxpan' ao longo do tempo. Adultos das espécies de ácaro citadas foram quantificados mensalmente, durante 19 meses, de junho de 2011 a fevereiro de 2013. Os porta-enxertos influenciaram as populações dos ácaros-praga, uma vez que menores densidades de P. oleivora foram encontradas em laranjeira 'Pera CNPMF D-6', enxertada no híbrido TSKC × CTTR - 002 e no citrumelo 'Swingle', em comparação com o que se observou em relação aos porta-enxertos LVK × LCR - 010, limoeiro 'Rugoso vermelho' e limoeiro 'Cravo Santa Cruz'. Similarmente, menores densidades de T. mexicanus ocorreram em laranjeira 'Valência Tuxpan' enxertada no híbrido HTR-051, em comparação com o que se deu em relação aos porta-enxertos citrandarin 'Indio', tangerineira 'Sunki Tropical' e LVK × LCR - 010. Concluiu-se que as densidades dos ácaros P. oleivora e T. mexicanus nas laranjeiras 'Pera CNPMF D-6' e 'Valencia Tuxpan' foram afetadas pelo porta-enxerto em determinados períodos do ano, sugerindo influência de alguns genótipos sobre essas pragas.

[Prevalence of oral mucosal alterations in Brazilian adolescents held in two juvenile re-education centers]. / Prevalência de alterações da mucosa bucal em adolescentes brasileiros institucionalizados em dois centros de reeducação.

The purpose of the present study was to verify the prevalence of oral mucosal alterations in Brazilian adolescents institutionalized. A total of 231 adolescents, all male were examined. The criteria used for clinical diagnostic of the lesions were the former proposed by SB 2000 (Brazil). The total oral mucosal lesions prevalence was 27.70% (64 lesions). The total prevalence of buccal mucosal lesions were 27.70% (64 lesions) in 24,24% of the adolescents. The most frequent one was plaque. It was found 293 mucosal alterations. 78.35% of the adolescents examined presented at least one alteration. The melanin pigmentation was the most common alteration. The data collected had been analyzed statistically through Kruskall Wallis non-parametric test and associations through Qui-Square test, considering significant level of 5%. Statistical significant difference was identified concerning between basic lesions and/or mucosal alterations and race (p=0,002) and skin colours and average number of the mucosal alteration (p=0,000) and the present of the melanin pigmentation and leukoedema and race (p=0,000 and p=0,002). There wasn't any statistically significant difference between average number of the mucosal lesions and race (p=0,618).

Prevalência de alterações da mucosa bucal em adolescentes brasileiros institucionalizados em dois centros de reeducação / Prevalence of oral mucosal alterations in Brazilian adolescents held in two juvenile re-education centers

O propósito do presente estudo foi verificar a prevalência de lesões fundamentais e alterações da normalidade na mucosa bucal de adolescentes brasileiros institucionalizados. Foram examinados 231 adolescentes, todos do gênero masculino. Os critérios clínicos de diagnóstico das lesões foram os propostos pelo SB (Brasil) 2000-Prevalência de fatores de riscos. A prevalência total de lesões da mucosa bucal foi de 27,70 por cento (64 lesões), com 24,24 por cento dos adolescentes as apresentando. A mais frequente foi a placa. Encontraram-se 293 alterações de normalidade, com 78,35 por cento dos examinados apresentando pelo menos uma delas. A pigmentação melânica fisiológica foi a mais encontrada. Os dados coletados foram analisados estatisticamente através do teste não paramétrico de Kruskall-Wallis e as associações pelo teste Qui-quadrado, considerando-se nível de significância de 5 por cento. Diferença estatisticamente significante foi identificada quando se avaliou a presença de lesão fundamental e/ou alteração da normalidade versus cor da pele (p=0,002), entre a cor da pele e o número médio de alterações de normalidade (p=0,000), entre a presença de pigmentação melânica fisiológica e leucoedema versus cor da pele do examinado com p=0,000 e p=0,002. Sobre o número médio de lesões da mucosa versus cor da pele, não houve diferença estatisticamente significante, com p=0,618.

The purpose of the present study was to verify the prevalence of oral mucosal alterations in Brazilian adolescents institutionalized. A total of 231 adolescents, all male were examined. The criteria used for clinical diagnostic of the lesions were the former proposed by SB 2000 (Brazil). The total oral mucosal lesions prevalence was 27.70 percent (64 lesions). The total prevalence of buccal mucosal lesions were 27.70 percent (64 lesions) in 24,24 percent of the adolescents. The most frequent one was plaque. It was found 293 mucosal alterations. 78.35 percent of the adolescents examined presented at least one alteration. The melanin pigmentation was the most common alteration. The data collected had been analyzed statistically through Kruskall Wallis non-parametric test and associations through Qui-Square test, considering significant level of 5 percent. Statistical significant difference was identified concerning between basic lesions and/or mucosal alterations and race (p=0,002) and skin colours and average number of the mucosal alteration (p=0,000) and the present of the melanin pigmentation and leukoedema and race (p=0,000 and p=0,002). There wasn't any statistically significant difference between average number of the mucosal lesions and race (p=0,618).

Clinical, histological and immunohistochemical features of ectomesenchymal chondromyxoid tumor.

OBJECTIVE: Ectomesenchymal chondromyxoid tumor is a rare oral soft tissue neoplasm that should be differentiated from other neural and chondromyxoid entities. The aim of this study was to report the clinical, histological, and immunohistochemical features of 3 additional cases of this condition. METHODS: Clinical data were obtained from the clinical records and all cases were evaluated through light microscopy and immunohistochemistry to cytokeratins, vimentin, S100 protein, desmin, smooth muscle actin, and glial fibrilary acidic protein. RESULTS: All 3 cases affected the tongue as a long-lasting submucosal swelling and were managed through conservative surgery. They all showed myxoid and chondroid histological patterns, and vimentin, S100, and glial fibrilary acidic protein immunoexpression. CONCLUSIONS: These findings reinforce the typical features of ectomesenchymal chondromyxoid tumor previously described, helping to confirm and establish the clinical, histopathological, and immunohistochemical profile of this uncommon lesion.

Advanced osteosarcoma of the maxilla: a case report.

Osteosarcomas are primary malignant bone tumours in which mesenchymal cells produce osteoid. It is generally the most common malignant bone neoplasm, although lesions of the jaw are uncommon. Osteosarcoma of the jaw (JOS) presents a lower incidence of metastasis and a better prognosis than osteosarcoma of the long bones. However, patients with JOS can exhibit advanced tumours, mainly when early diagnosis is not performed. This article reports on a case of an advanced osteosarcoma of the maxilla. A 38-year-old woman was referred for evaluation and treatment of recurrent fibrous dysplasia of the facial bones. The patient related that she had been diagnosed with fibrous dysplasia four years earlier and, since the first diagnosis, she was submitted to four surgical interventions, all followed by recurrences. The main clinical findings were redness and swelling of the facial skin, upper lip ulceration, and hard palate swelling. Computed tomography showed a large hyperdense mass in right maxilla extending to right orbit and left maxillary sinus. An incisional biopsy was performed and microscopic examination showed areas of osteoid and chondroid formation surrounded by a cellular stroma. The diagnosis of osteosarcoma was established and the patient was recommended for oncologic treatment. Unfortunately, she died six months after the diagnosis due to uncontrollable local spread.

Advanced osteosarcoma of the maxilla: A case report

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Osteosarcomas are primary malignant bone tumours in which mesenchymal cells produce osteoid. It is generallythe most common malignant bone neoplasm, although lesions of the jaw are uncommon. Osteosarcoma of the jaw(JOS) presents a lower incidence of metastasis and a better prognosis than osteosarcoma of the long bones. However, patients with JOS can exhibit advanced tumours, mainly when early diagnosis is not performed. This article reports on a case of an advanced osteosarcoma of the maxilla. A 38-year-old woman was referred for evaluation and treatment of recurrent fibrous dysplasia of the facial bones. The patient related that she had been diagnosed with fibrous dysplasia four years earlier and, since the first diagnosis, she was submitted to four surgical interventions, all followed by recurrences. The main clinical findings were redness and swelling of the facial skin, upper lip ulceration,and hard palate swelling. Computed tomography showed a large hyperdense mass in right maxilla extending to rightorbit and left maxillary sinus. An incisional biopsy was performed and microscopic examination showed areas ofosteoid and chondroid formation surrounded by a cellular stroma. The diagnosis of osteosarcoma was establishedand the patient was recommended for oncologic treatment. Unfortunately, she died six months after the diagnosisdue to uncontrollable local spread (AU)

Congenital granular cell tumor (congenital epulis): a lesion of multidisciplinary interest.

Congenital granular cell tumor (CGCT), or congenital epulis, is a very uncommon benign soft tissue lesion that usually arises from the alveolar mucosa of neonates and may cause respiratory and feeding problems. We report a case of a 3-day-old female newborn, who presented an intraoral tumor mass which was protruding from her mouth, and compromising feeding. Under general anesthesia, the lesion was completely removed and the patient had an uneventful postoperative course. Clinical features and treatment approaches are presented and discussed, emphasizing the necessity of a multidisciplinary approach in such cases.