Nutritional assessment of servicemen in relation to area of duty and feeding habits: a Pakistani prospective

Abstract The present study was carried out to determine incidence of overweight and obesity in Pakistani servicemen with reference to their area of duty, feeding habits and also to identify risk factors. Accordingly, 2,501 servicemen selected from all over Pakistan using multiple stage stratified sampling protocol. Nutrition assessment performed using body mass index (BMI), waist to hip ratio (WHR) and dietary assessment using food frequency questionnaire. Collected data was analyzed using the SPSS version 25. Regression was used to find risk factors of obesity and WHR. Results indicated that about 1/4th of servicemen were smokers. Approximately, 1/5th of them were overweight and about one quarter were eating fruits and vegetables for 3 days/ week and 4 days/week, respectively. Only 1/3rd of them were physically active for at least 40 minutes per day. Age and fruits intake were significantly predicting BMI with a direct relation and vegetable intake was negatively correlated to BMI of the servicemen. Age and rank were significant predictors of WHR while, physical activity was negatively correlated to WHR. It is concluded and suggested from our study that there is a need to modify eating patterns and habits as well as improving physical activity on daily basis for healthy and long life of the servicemen.

Resumo

Oral manifestations and injuries related to covid- 19: an experience report on the role of hospital dentistry / Manifestações orais e lesões relacionadas à covid-19: um relatório de experiência sobre o papel da odontologia hospitalar / Manifestaciones orales y lesiones relacionadas con covid- 19: un informe de experiencia sobre el papel de la odontología hospitalaria

SARS-COV-2 is transmitted among human beings by saliva droplets that come in direct contact with the oral cavity, nose, and eyes. Since the mouth is one of the anatomical sites primarily contaminated, oral manifestations have also been reported beyond the serious consequences inherent to progressive respiratory failure. This study aimed to identify oral manifestations possibly related to the infection by COVID-19 in hospitalized patients. A prospective study was carried out with patients diagnosed with COVID-19 in the period between March and June 2021, admitted to the Moderate COVID-19 Care Unit of the Hans Dieter Schmidt Regional Hospital, by applying a form and performing a clinical exam of the oral cavity. Out of all patients (n=45), 33.3% reported both olfactory (anosmia) and taste dysfunction (dysgeusia), with an average duration of 5.9 ±3.0 days. Regarding other oral manifestations evaluated, two patients reported dry and burning mouth and one patient reported a change in taste associated with plaque-like changes in the tongue. No patients presented ulcers or other lesions in the oral cavity. Olfactory and taste dysfunction were symptoms recognized of the novel coronavirus disease (COVID-19). However, the association with other oral manifestations is still controversy. Unfortunately, dentistry professionals are still not part of most teams in the hospital environment, mostly because of the lack of prioritization of dental care. Working with a multidisciplinary team may avoid possible systemic complications due to poor dental care.

Sars-COV-2 é transmitida entre os seres humanos por gotículas de saliva que entram em contato direto com a cavidade oral, nariz e olhos. Uma vez que a boca é um dos sítios anatômicos principalmente contaminados, as manifestações orais também foram relatadas para além das graves consequências inerentes à insuficiência respiratória progressiva. Este estudo teve como objetivo identificar manifestações orais possivelmente relacionadas à infecção por Covid-19 em pacientes hospitalizados. Foi realizado um estudo prospetivo com pacientes diagnosticados com Covid-19 no período entre março e junho de 2021, internados na Unidade de Atendimento Moderado contra a Covid-19 do Hospital Regional Hans Dieter Schmidt, aplicando um formulário e realizando um exame clínico da cavidade oral. De todos os pacientes (n=45), 33,3% relataram disfunção olfativa (anosmia) e gustativa (disgeusia), com duração média de 5,9 ±3,0 dias. Em relação a outras manifestações orais avaliadas, dois pacientes relataram boca seca e ardente e um paciente relatou alteração no paladar associada a alterações semelhantes a placas na língua. Nenhum paciente apresentou úlceras ou outras lesões na cavidade oral. Disfunção olfativa e gustativa foram sintomas reconhecidos do novo coronavírus (Covid-19). No entanto, a associação com outras manifestações orais ainda é controversa. Infelizmente, os profissionais de odontologia ainda não fazem parte da maioria das equipes do ambiente hospitalar, principalmente por causa da falta de priorização dos cuidados odontológicos. Trabalhar com uma equipe multidisciplinar pode evitar possíveis complicações sistêmicas devido a cuidados odontológicos deficientes.

SARS-COV-2 se transmite entre los seres humanos por las gotitas de saliva que entran en contacto directo con la cavidad oral, la nariz y los ojos. Dado que la boca es uno de los sitios anatómicos principalmente contaminados, también se han informado manifestaciones orales más allá de las consecuencias graves inherentes a la insuficiencia respiratoria progresiva. El objetivo de este estudio fue identificar las manifestaciones bucales posiblemente relacionadas con la infección por COVID-19 en pacientes hospitalizados. Se realizó un estudio prospectivo con pacientes diagnosticados de COVID-19 en el periodo comprendido entre marzo y junio de 2021, ingresados en la Unidad de Cuidados Moderados de COVID-19 del Hospital Regional Hans Dieter Schmidt, mediante la aplicación de un formulario y la realización de un examen clínico de la cavidad oral. De todos los pacientes (n=45), el 33,3% notificó tanto disfunción olfativa (anosmia) como gustativa (disgeusia), con una duración media de 5,9 ±3,0 días. En cuanto a las demás manifestaciones orales evaluadas, dos pacientes notificaron sequedad y ardor de boca y un paciente notificó un cambio en el gusto asociado a cambios en la lengua en forma de placa. Ningún paciente presentó úlceras u otras lesiones en la cavidad oral. La disfunción olfativa y gustativa fueron síntomas reconocidos de la nueva enfermedad por coronavirus (COVID-19). Sin embargo, la asociación con otras manifestaciones orales es aún controvertida. Desafortunadamente, los profesionales de la odontología todavía no son parte de la mayoría de los equipos en el entorno hospitalario, principalmente debido a la falta de priorización de la atención odontológica. Trabajar con un equipo multidisciplinario puede evitar posibles complicaciones sistémicas debido a la mala atención dental.

Mobilidade como um Serviço: Indicações de Estratégias Interventivas no Hábito de Usar Automóvel Baseadas na Revisão da Literatura / Mobility as a Service: Indications for Intervention Strategies in Car Use Habits Based on Literature Review

A mobilidade integrada poderia ser prejudicada pelo hábito de usar o automóvel? Essa é uma questão central para a mobilidade que precisa ser discutida. Nessa perspectiva, objetivou-se, por meio da revisão da literatura, identificar as estratégias que favoreçam a implementação da mobilidade sustentável, a fim de apontar uma agenda de pesquisa baseada na literatura. Assim, iniciou-se com a conceituação acerca da Mobilidade como um Serviço (MaaS). Aborda-se a viabilidade da mobilidade alternativa, considerando-se o hábito de usar o automóvel, visto que a literatura aponta essa variável como uma barreira para a promoção da Mobilidade complementar. Segue-se com a discussão sobre os comportamentos habituais de se usar o automóvel e como eles podem ser modificados. Como um resultado, sugerem-se várias estratégias para a promoção da quebra do hábito de usar automóvel de modo que se favoreça a mobilidade complementar. Por último, a partir das diretrizes indicadas para promoção da Mobilidade como Serviço, sugere-se uma agenda de pesquisa futura para dar suporte à área de conhecimento.

Could integrated mobility be hindered by the habit of using the car? This is a central issue for mobility that needs to be discussed. In this perspective, it was aimed, through a literature review, to identify strategies that favor the implementation of sustainable mobility policies, in order to point out a research agenda. The literature review is started with the conceptualization of Mobility as a Service (MaaS). The viability of alternative mobility is addressed, considering the habit of using the car, since the literature points to this variable as a barrier to the promotion of complementary mobility. This is followed by a discussion of car-use behavior and how it can be modified. As a result, several strategies are suggested for the promotion of breaking the habit of car use and in order to favor complementary mobility. Finally, based on the guidelines indicated for the promotion of Mobility as a Service, a future research agenda is suggested to support the knowledge field.

Comportamento dos tecidos peri-implantares pós- reabilitação unitária em região estética comparando pilares protéticos pré-fabricados versus personalizados / Behavior of peri-implant tissues after unitary rehabilitation in the aesthetic region comparing prefabricated versus customized prosthetic abutments

A estética e estabilidade dos tecidos moles e ósseo ao redor do implante é um componente crítico para o sucesso do implante em longo prazo e pode ser influenciado por fatores como os tipos de conexões protéticas. OBJETIVO: Comparar o comportamento do tecido peri-implantar em reabilitação com coroas implantossuportadas cimentadas na região estética usando um pilar protético pré-fabricado em titânio (GT) e um pilar protético personalizado em zircônia (GZ). METODOLOGIA: Neste estudo longitudinal do tipo ensaio clínico controlado, cego e não randomizado, 30 coroas cimentadas sobre implantes dentários unitários em região estética anterior foram alocados sequencialmente: 15 reabilitados sobre um sistema de implante com pilar protético pré-fabricado em titânio (GT) e 15 sobre um sistema de implantes com pilar protético personalizado em zircônia (GZ). O comportamento do tecido peri-implantar foi avaliado em T0 (início do condicionamento tecidual), T1 (fim do condicionamento tecidual), T2 (7 dias após cimentação final), T3 (6 meses após cimentação final). Índice de Placa Visível (IPV), Índice de Sangramento Gengival (ISG), Sangramento a sondagem (SS), Profundidade de Sondagem (PS), Relação Altura/Largura da papila interdental (AP/LP), Faixa de Mucosa Ceratinizada (MC), Espessura gengival (EG), Fenótipo periodontal (FP), Recessão Gengival (RG), distância radiográfica da crista óssea para o ponto de contato e Pink Esthetic Score (PES) foram avaliados. A análise dos dados foi realizada utilizando os seguintes testes estatísticos: Friedman, Mann-Whitney e Qui- quadrado/Exato de Fisher, com nível de significância de 5%. RESULTADOS: Não houve diferenças estatísticas significativas entre os grupos para nenhum dos parâmetros clínicos periodontais nos tempos avaliados (p>0,05). Entretanto, a análise intragrupo mostrou uma redução estatística no IPV e ISG entre T1 e T2 apenas para o GZ (p<0,05). Houve diminuição significativa entre os tempos T0 e T3 para o parâmetro de EG (1,67 mm - 1,47 mm no GT; 1,70 mm -1,47mm no GZ) e aumento da razão AP/LP (0,56 ­ 0,80 no GT; 0,70-0,83 no GZ) em ambos os grupos (p<;0.001). O PES também aumentou significativamente para ambos os grupos (9 ­ 12 no GT; 7 ­ 12 no GZ) de T0 para T1, mantendo-se elevado nos demais tempos analisados. CONLUSÃO: Os resultados mostraram que os pilares protéticos utilizados não impactaram em diferenças nas variáveis clínicas e estética relacionadas ao comportamento dos tecidos periimplantares ao longo do tempo. Sendo assim, a decisão pela seleção dos componentes para a reabilitação em região estética poderia se basear em aspectos como o custo, fluxo e tempo de trabalho (AU).

The esthetics and stability of the soft tissue and bone around the implant is a critical component to the long-term success of the implant and can be influenced by factors such as the type of prosthetic connections. OBJECTIVE: To compare the behavior of the periimplant tissue of single implant-supported crowns in the anterior aesthetic area using prefabricated titanium prosthetic abutments (GT) and customized zirconia prosthetic abutments (GZ). METHODOLOGY: In this controlled, blinded, non- randomized clinical trial, 30 single cemented crown over anterior implants were sequentially allocated: 15 implants rehabilitated on implant system with a prefabricated titanium prosthetic abutment (GT) and 15 on implant system with customized zirconia prosthetic abutment (GZ). The behavior of the peri- implant tissue was evaluated at T0 (beginning of tissue conditioning), T1 (end of tissue conditioning), T2 (7 days after final cementation), T3 (6 months after final cementation). Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), Bleeding on Probing (BoP), Probing Depth (PD), Interdental Papilla Height/Width Ratio (PH/PW), Keratinized Mucosa Width (KM), Gingival Thickness (PT), Periodontal Phenotype (PF), Gingival Recession (GR), radiographic distance from the bone crest to the contact point and Pink Esthetic Score (PES) were registered. The results were analyzed with the following statistical tests: Friedman, Mann-Whitney and Chi- square/Fisher; Exact test with a significance level of 5%. RESULTS: No statistically significant differences were observed between groups for any of the clinical parameters in any, (p>0.05). However, intragroup analysis showed a statistical reduction in VPI between T1 and T2 only for GZ (p< 0.05). There was a significant decrease between T0 and T3 for GT (1.67 mm - 1.47 mm in GT, and 1.70 mm -1.47 mm in GZ) and increase in the ratio PH/PW (0.56 - 0.80 in GT and 0.70- 0.83 in GZ) in both groups (p<0.0001). PES also increased significantly for both groups (9 ­ 12 in GT and 7 ­ 12 in GZ) from T0 to T1 and remained high in the other periods. CONCLUSION: The results showed that the prosthetic abutments used did not impact differences in clinical and aesthetic variables related to the behavior of peri-implant tissues during the study. Therefore, the decision to select components an aesthetic area should be based on aspects such as cost, workflow and timing (AU).

Respostas cardiorrespiratórias do teste de sentar e levantar em indivíduos pré e pós-cirurgia cardíaca: corte transversal / Cardiopulmonary responses of the sit-to-stand test in individuals pre and post-heart surgery: cross section

| INTRODUÇÃO: As repercussões cardiorrespiratórias da cirurgia cardíaca podem ser avaliadas por teste submáximo. OBJETIVO: comparar as respostas cardiorrespiratórias do teste de sentar e levantar em um minuto (TSL1) nos indivíduos, entre o momento pré e pós de cirurgia cardíaca. MÉTODOS: Estudo de caráter transversal e analítico, incluiu 45 indivíduos de ambos os sexos, estáveis hemodinamicamente, com fração de ejeção maior que 45%, que foram submetidos à cirurgia de revascularização do miocárdio no Instituto do Coração de um Hospital do interior do estado do Rio Grande do Sul, entre 2018 e 2019. As variáveis de desfechos foram coletadas no repouso e ao final do teste, um dia antes da cirurgia e no pós-operatório: pressão arterial sistólica e diastólica (PAS e PAD em mmHg), frequência cardíaca (FC bpm), frequência respiratória (FR rpm), saturação periférica de oxigênio (SpO2 %), fadiga de membros inferiores (Fmm 0-10) e dispneia (Di 0-10), número de repetições e interrupções do teste. Foi utilizado o programa R para o tratamento dos dados, para avaliar a normalidade foi aplicado o teste de Shapiro Wilk, a comparação dos grupos pelo teste não paramétrico de Wilcoxon. RESULTADOS: A maioria do sexo masculino (71%) e média de idade foi de 61± 9 anos. No pré-operatório, ocorreu aumento entre o repouso e o final do teste, PAS, FC, FR, Fmm e Di (p<0,05). No pós-operatório, houve aumento entre o repouso e o final do teste, para FC, FR, Fmm e Di (P<0,05), contudo, sem elevação da PAS. Ao comparar as variáveis entre os momentos pré e pós, observamos maiores valores da FC, FR e número de interrupções na condição pós (p<0,05), bem como menores valores para a PAS, SpO2 e número de repetições (p<0,05) para essa condição. CONCLUSÃO: Os dados desta pesquisa comprovam que o TSL1 realizado no pré-operatório de cirurgia cardíaca, assim como entre o 4° ou 5° dia de pós-cirurgia cardíaca, é seguro e eficaz, representado pela ausência das repercussões cardiorrespiratórias que comprometessem ou agravassem o quadro clínico do paciente. O TSL1 foi capaz de induzir respostas cardiorrespiratórias fisiológicas no pré-operatório; contudo, na condição pós acarretou respostas cardiorrespiratórias mais elevadas no repouso e atenuada resposta em exercício em comparação ao pré-operatório.

INTRODUCTION: The cardiorespiratory repercussions of heart surgery can be assessed through submaximal testing. OBJECTIVE: Compare cardiorespiratory responses to the one-minute sit-and-stand test in individuals pre- and post-heart surgery. METHODS: An analytical, cross-sectional study was conducted involving 45 hemodynamically stable male and female patients with an ejection fraction greater than 45% submitted to coronary artery bypass surgery at a cardiology service of a hospital in the interior of the state of REDACTED between 2018 and 2019. The following variables were collected at rest and the end of the test one day before surgery and postoperatively: systolic and diastolic blood pressure (SBP and DBP, mmHg), heart rate (HR, bpm), respiratory rate (RR, rpm), peripheral saturation oxygen (SpO2, %), lower limb fatigue (LLF, 0-10), dyspnea (0-10), number of test repetitions and number of interruptions. The R program was used to process the data. The Shapiro-Wilk test was used for the determination of normality. The groups were compared using the non-parametric Wilcoxon test. RESULTS: Most participants were male (71%), and the mean age was 61±9 years. In the preoperative period, statistically significant increases (p≤0.05) were found for SBP, HR, RR, LLF, and dyspnea between resting values and the end of the test. Significant increases (p≤0.05) were found in the postoperative period for HR, RR, LLF, and dyspnea between rest and the end of the test, with no increase in SBP. Comparing the preoperative and postoperative evaluations variables, higher HR, RR, the number of interruptions and lower SBP, SpO2, and the number of repetitions were found after surgery (p≤0.05). CONCLUSION: The one-minute sit-to-stand test induced physiological cardiorespiratory responses in the preoperative evaluation. However, higher cardiorespiratory responses at rest and an attenuated response to exercise were found in the postoperative evaluation compared to the preoperative evaluation.

Strategic ventilation reduces non-ventilated contralateral lung injury induced by one-lung ventilation in rabbits / [Ventilação estratégica reduz lesão pulmonar contralateral não ventilada induzido pela ventilação pulmonar unilateral em coelhos]

One lung ventilation (OLV) often results in trauma to the unventilated contralateral lung. This study aims to evaluate the effects of different OLV regimens on the injury of the unventilated contralateral lung to identify the best conditions for OLV. Forty rabbits were divided into five groups: a sham group, OLV group I (fraction of inspired oxygen (FIO2) 1.0, tidal volume (VT) 8mL/kg, respiratory rate (R) 40 breaths/min and inspiratory/expiratory ratio (I:E) 1:2), OLV group II (FIO2=1.0, VT 8mL/kg, R 40 breaths/min, I:E 1:2, and positive end-expiratory pressure (PEEP) 5 cm H2O), OLV group III (FIO2 1.0, VT 6mL/kg, R 40 breaths/min, I:E 1:2 and PEEP 5 cm H2O) and OLV group IV (FIO2 0.8, VT 6mL/kg, R 40 breaths/min, I:E 1:2 and PEEP 5 cm H2O). Animals from all OLV groups received two-lung ventilation (TLV) to establish a baseline, followed by one of the indicated OLV regimens. The rabbits in the sham group were intubated through trachea and ventilated with fresh air. Arterial blood gas samples were collected, lung injury parameters were evaluated, and the concentrations of TNF-α and IL-8 in bronchoalveolar lavage fluid (BALF) and pulmonary surfactant protein A (SPA) in the unventilated lung were also measured. In OLV group I, the unventilated left lung had higher TNF-α, IL-8 and lung injury score but lower SPA than the ventilated right lung. In OLV groups I to III, the concentrations of TNF-α, IL-8 and lung injury score in the left lung decreased but SPA increased. No differences in these parameters between OLV groups III and IV were observed. Strategic ventilation designed for OLV groups III and IV reduced OLV-induced injury of the non-ventilated contralateral lung in rabbits.(AU)

Ventilação pulmonar unilateral (OLV) frequentemente resulta em trauma no pulmão contralateral não ventilado. Este estudo visa avaliar os efeitos de diferentes regimes de OLV sobre a lesão do pulmão contralateral não ventilado para identificar as melhores condições para OLV. Quarenta coelhos foram divididos em cinco grupos: um grupo falso, OLV grupo I (fração de oxigênio inspirado (FIO2) 1.0, volume corrente (VT) 8mL/kg, frequência respiratória (R) 40 respirações/min e relação inspiração/expiração (I:E) 1:2), OLV grupo II (FIO2=1.0, VT 8mL/kg, R 40 respirações/min, I:E 1:2, e pressão positiva expiratória final (PEEP) 5 cm H2O), OLV grupo III (FIO2 1.0, VT 6mL/kg, R 40 respirações/min, I:E 1:2 e PEEP 5 cm H2O) e OLV grupo IV (FIO2 0.8, VT 6mL/kg, R 40 respirações/min, I:E 1:2 e PEEP 5 cm H2O). Os animais de todos os grupos OLV receberam ventilação nos dois pulmões (TLV) para estabelecer uma linha de base, seguida por um dos regimes OLV indicados. Os coelhos do grupo falso foram intubados através da traqueia e ventilados com ar fresco. Amostras de gases no sangue arterial foram coletadas, parâmetros de lesão pulmonar foram avaliados e as concentrações de TNF-α e IL-8 no fluido de lavagem bronco alveolar (BALF) e proteína A do surfactante pulmonar (SPA) no pulmão não ventilado também foram medidas. No grupo OLV I, o pulmão esquerdo não ventilado tinha maior índice de TNF-α, IL-8 e lesão pulmonar, mas menor SPA do que o pulmão direito ventilado. Nos grupos OLV I a III, as concentrações de TNF-α, IL-8 e a pontuação de lesão pulmonar no pulmão esquerdo diminuíram, mas o SPA aumentou. Não foram observadas diferenças nestes parâmetros entre os grupos OLV III e IV. A ventilação estratégica projetada para os grupos OLV III e IV reduziu a lesão induzida por OLV do pulmão contralateral não ventilado em coelhos.(AU)

IRF6 polymorphisms in Brazilian patients with non-syndromic cleft lip with or without palate / Polimorfismos do gene IRF6 em pacientes brasileiros com fenda labial não sindrômica com ou sem fenda palatina

Abstract Introduction: Non-syndromic orofacial clefts have a complex etiology due to the contribution from both genetic and environmental risk factors, as well as the interaction between them. Among the more than 15 susceptibility loci for non-syndromic orofacial clefts with considerable statistical and biological support, the IRF6 is the most validated gene by the majority of studies. Nonetheless, in genetically heterogeneous populations such as Brazilian, the confirmation of association between non-syndromic orofacial clefts and IRF6 common variants is not a consolidated fact and unrecognized IRF6 variants are poorly investigated. Objective: The aim of this study was to investigate the association of IRF6 polymorphisms with non-syndromic orofacial clefts development in a population from northeast Brazil. Methods: Blood samples of 186 non-syndromic orofacial clefts patients and 182 controls from Rio Grande do Norte, Brazil, were obtained to analyze IRF6 polymorphisms (rs2235371, rs642961, rs2236907, rs861019, and rs1044516) by real-time polymerase chain reaction. Non-syndromic orofacial clefts patients were classified in cleft lip and palate, cleft palate only and cleft lip only groups. Results: The genotype and allele frequencies of single nucleotide polymorphism rs2235371 in IRF6 showed significant differences in patients with cleft palate when compared to the controls, whereas no association was shown between rs642961, rs2236907, rs861019, and rs1044516 and non-syndromic orofacial clefts. Conclusion: The association found between rs2235371 and isolated cleft palate should be interpreted with caution due to the low number of individuals investigated, and more studies with larger sample size are needed to confirm these association. In addition, there is a lack of association of the rs642961, rs2236907 and rs861019 polymorphisms with non-syndromic orofacial clefts susceptibility.

Resumo Introdução: As fendas orofaciais não sindrômicas possuem uma etiologia complexa devido à contribuição de fatores de risco genéticos e ambientais, assim como a interação entre eles. Dentre os mais de 15loci de susceptibilidade para as fendas orofaciais não sindrômicas com considerável suporte estatístico e biológico, o IRF6 é o gene mais validado pela maioria dos estudos. Apesar disso, em populações geneticamente heterogêneas como a brasileira, a confirmação da associação entre as fendas orofaciais não sindrômicas e as variantes mais comuns do IRF6 ainda não é um fato consolidado e outras variantes não tão conhecidas IRF6 são pouco investigadas. Objetivo: O objetivo deste estudo foi investigar a associação de variados polimorfismos do IRF6 com o desenvolvimento das fendas orofaciais não sindrômicas em uma população do nordeste do Brasil. Método: Amostras de sangue de 186 pacientes com fendas orofaciais não sindrômicas e 182 controles do estado do Rio Grande do Norte, Brasil, foram obtidas para analisar os polimorfismos do IRF6 (rs2235371, rs642961, rs2236907, rs861019 e rs1044516) por reação em cadeia da polimerase em tempo real. Os pacientes com fendas orofaciais não sindrômicas foram classificados em fenda labiopalatina, fenda palatina isolada e fenda labial isolada. Resultados: As frequências genotípica e alélica do polimorfismo de único nucleotídeo rs2235371 no IRF6 mostraram-se significativamente diferentes em pacientes com fenda palatina isolada quando comparadas às dos controles, enquanto que nenhuma associação foi encontrada entre rs642961, rs2236907, rs861019 e rs1044516 e risco para o desenvolvimento das fendas orofaciais não sindrômicas. Conclusão: A associação encontrada entre rs2235371 e fenda palatina isolada deve ser interpretada com cautela devido ao baixo número de indivíduos investigados, sendo necessários mais estudos com um tamanho amostral maior para confirmar essa associação. Além disso, não foram encontradas associações significativas entre os demais polimorfismos do IRF6 rs642961, rs2236907, rs861019 e rs1044516 e a susceptibilidade às fendas orofaciais não sindrômicas.

Knockdown of circ_0001273 inhibits the proliferation, migration and invasion of oral squamous cell carcinoma cells / 口腔疾病防治

Objective@#To explore the effect of circ_0001273 on the proliferation, migration and invasion of oral squamous cell carcinoma（OSCC） cells and to provide a relevant research basis for the use of targeted therapy in OSCC. @*Methods@#Data from twelve patients with a clinical diagnosis of OSCC were collected from tumor specimens and adjacent tissues. qRT-PCR was used to detect the expression levels of circ_0001273, circ_0018569, circ_0027152, and circ_0001273 which had the highest difference in expression in cancer and adjacent tissues was selected. siRNA was used for the knockdown of circ_0001273 in two types of OSCC cell lines, UM1 and CAL27, and the effects on the proliferation, migration, and invasion of UM1 and CAL27 cells were measured by MTS and Transwell experiments, respectively. @*Results@#The expression of circ_0001273 was abnormally increased in the 12 OSCC tissues (P < 0.05). After knocking down circ_0001273 in UM1 and CAL27 cells, the proliferation, migration and invasion abilities of UM1 and CAL27 cells were significantly reduced (P < 0.05).@*Conclusion@#The knockdown of circ_0001273 can inhibit the proliferation, migration and invasion of OSCC cells.

Expression of CD39 in head and neck squamous cell carcinoma tissues and its prognostic value / 中国肿瘤生物治疗杂志

@#[Abstract] Objective: To detect the expression of CD39 in head and neck squamous cell carcinoma (HNSCC) tisseus, and to analyze its correlation with patients’clinicopathological features and its prognostic significance. Methods: Tissue specimens and case data of 85 patients with HNSCC underwent surgery at Cancer Hospital of Tianjin from May 2012 to December 2013 were collected for this study. Gene chips were obtained from Oncomine database, and HNSCC cell lines SCC15, UM1, and Cal25 were selected for this study. Online analysis was performed to compare the differential expression of CD39 in buccal mucosa (BM) tissues and HNSCC tissues, Western blotting and Immunohistochemistry (IHC) were used to detect the protein expression of CD39 in HNSCC tissues. Spearman’ s correlation analysis was used to study the correlation between the expressions of CD39 and clinicopathological features of HNSCC patients. Both Kaplan-Meier curve analysis and Log rank test were used to analyze the association between the expression of CD39 in HNSCC tissues and the survival of patients, and Cox risk proportional regression model was used to evaluate the relationship between CD39 expression and the risk of relapse. Results: The transcription level of CD39 was obviously up-regulated in HNSCC tissues than in BM tissues (P<0.01), and CD39 expression was detected in HNSCC cell lines SCC15, UM1 and Cal25. Dexamethasone (DXM) could enhance the expression of CD39 in UM1 cells in dose-dependent manner. CD39 was highly expressed in 53 (62.4%) HNSCC patients, which was positively correlated with preoperative chemotherapy (r=0.234, P<0.05). The recurrence-free survival (RFS) of patients with high CD39 expression was significantly shortened (P<0.05), and high CD39 expression was an independent relapse risk factor (HR=2.328, 95%CI=1.091-4.967; P<0.05) for patients with HNSCC. Conclusion: CD39 is DXM-inducively and constitutively expressed in HNSCC. And over-expression of CD39 is an independent predictor of poor prognosis in HNSCC patients, indicating its important role in the progression of HNSCC.

Influence of Group Membership, Moral Values and Belief in a Just World in Blaming the Victim / Influência da Pertença Grupal, Valores Morais e Crença no Mundo Justo na Culpabilização da Vítima / Influencia de la Pertenencia Grupal, Valores Morais y Creencia en el Mundo Justo en la Culpabilización de la Víctima

Abstract This study investigated the relationship between the victim's group membership and secondary victimization she suffers, moderated by Moral Values and Belief in a Just World (BJW). The victim of the ingroup was blamed more for the sexual violence she suffered (Study 1, N = 250). In turn, that relationship was moderated by binding values (Study 2, N = 117) and by BJW (Study 3, N = 258). Together, the results suggest that the victim blaming is greater when she belongs to the ingroup; and that this relationship is predicted by high adherence to binding values and low adherence to BJW. This research contributes to the extent that it demonstrates that the relationship between adherence to binding values and victim derogation does not occur exclusively at the cognitive level, as information processing in which high adherence to these values would produce greater secondary victimization regardless of group membership of the victim. Additionally, it highlights the importance of considering the psychosocial processes underlying violence against women in order to promote more effective discussions and actions.

Resumo Este trabalho investigou a relação entre pertença grupal da vítima (endogrupo vs. exogrupo) e vitimização secundária por ela sofrida moderada pelos valores morais e Crença em um Mundo Justo (CMJ). Em consonância com estudos anteriores, a vítima do endogrupo foi mais responsabilizada pela violência sexual por ela sofrida (Estudo 1, N = 250). Por sua vez, essa relação foi moderada pelos valores vinculativos (Estudo 2, N = 117) e pela CMJ (Estudo 3, N = 258). Em conjunto, os resultados sugerem que a responsabilização da vítima de violência sexual é maior quando ela pertence ao endogrupo; e que esta relação é predita pela alta adesão aos valores vinculativos e baixa adesão à Crença em um Mundo Justo (CMJ). Esta investigação traz contribuições na medida em que demonstra que a relação entre adesão aos valores vinculativos e a derrogação da vítima não ocorre exclusivamente ao nível cognitivo, como um processamento de informação no qual a alta adesão a esses valores produziria maior vitimização secundária independente da pertença grupal da vítima. Adicionalmente, sinaliza a importância de considerar os processos psicossociais subjacentes à violência contra as mulheres com a finalidade de promover discussões e ações mais efetivas.

Resumen Este estudio investigó la relación entre la pertenencia a un grupo de la víctima y la victimización secundaria que sufre, moderada por los valores morales y la creencia en un mundo justo (BJW). Se culpó más a la víctima del ingroup por la violencia sexual que sufrió (Estudio 1, N = 250). A su vez, esa relación fue moderada por los valores de enlace (Estudio 2, N = 117) y por BJW (Estudio 3, N = 258). Juntos, los resultados sugieren que la culpa de la víctima es mayor cuando pertenece al ingroup; y que esta relación se predice por una alta adherencia a los valores de unión y una baja adherencia a BJW. Esta investigación contribuye en la medida en que demuestra que la relación entre la adherencia a los valores vinculantes y la derogación de la víctima no se produce exclusivamente a nivel cognitivo, ya que el procesamiento de la información en el que la alta adherencia a estos valores produciría una mayor victimización secundaria independientemente de la pertenencia al grupo de la victima. Además, destaca la importancia de considerar los procesos psicosociales subyacentes a la violencia contra las mujeres para promover debates y acciones más efectivas.

Preparation of lithium-doped poly-glycerol sebacate scaffold and its properties / 吉林大学学报(医学版)

Objective: To prepare the lithium-doped poly-glycerol sebacate (PGS-Li) scaffold using the specific effects of lithium ions and the excellent performance of PCS, and to provide the basis for its application prospects in cementation tissue engineering scaffold. Methods: The scaffolds were divided into two groups. The PGS-Li scaffolds prepared by adding lithium phosphate during the PGS cross-linking process were used as PGS-Li group, and the PGS scaffolds synthesized by the equal-purification of sebacic acid and glycerol were used as PGS group. The molecular weights of the scaffolds in two groups were determined by gel permeation chromatography. The structures of the scaffolds in two groups were analyzed by fourier transform infrared spectroscope. The surface morphology and the porosities and the pore sizes of the scaffolds in two groups were observed by scanning electron microscope. X-ray photoelectron (XPS) spectroscope and inductively coupled plasma optical emission spectrometer were used to determine the Li ion contents in the scaffolds in two groups. Thermogravimetric analyzer was used to analyze the thermal stabilities of the scaffolds in two groups. Contact angle measuring instrument was used to compare the hydrophilicities of the scaffolds in two groups. In vitro weight loss test was used to determine the degradation rates of the scaffolds in two groups. The OCCM-30 cells were divided into experimental group (added with PGS-Li scaffold extract), PGS group (added with PGS scaffold extract) and blank control group (added with DMEM culture medium). MTT assay was used to detect the proliferation activities of cells in various groups at different time (24, 48 and 72 h); the cell morphology was observed by calcein-AM staining. Results: The gel permeation chromatography results showed that the molecular weight of the PGS-Li scaffold was slightly larger than that of the PGS scaffold. The specific absorption peak of phosphate was detected in the fourier infrared spectrum of the PGS-Li scaffold. The scaffolds in two groups had irregular three-dimensional network structures under scanning electron microscope∗ and the pore size was 20- 160 /im, the porosity of PGS scaffold was (53. 92 ±2. 18) %∗ and the porosity of PGS-Li scaffold was (53. 58± 1. 73)% ? there was no statistical difference between two groups ( P> 0.05). The XPS results showed that a peak appeared at 54. 9 eV in PGS-Li group, which coincided with the Li Is binding energy, while the inductively coupled plasma emission spectrometer results showed that the Li ion content in the PGS-Li scaffold was 0.084%. The thermogravimetric analysis results showed that PGS-Li scaffolds began to degrade at a higher temperature and ceased at a lower temperature compared with PGS scaffolds. The contact angle measurement results indicated that both the materials were hydrophilic materials; the contact angle of PGS scaffold meterial was 78. 26 ±2. 00 , and the contact angle of the PGS-Li scaffold material was 69. 78 ±1.15 ; there was statistical difference between two groups (P0. 05). The calcein-AM staining results showed the green fluorescence in the OCCM-30 cells in PGS and PGS-Li groups, and there were no significant changes in the morphology of cementoblasts. Conclusion: PGS-Li scaffolds have similar composition and structure to PGS scaffolds, and have better performance in hydrophilicity and thermal stability. PGS-Li scaffolds have no effect on the proliferation of cementoblasts and have broad application prospects in cementum tissue engineering.

Role of TLR4/NF-κB signaling pathway in development of postoperative chronic pain in rats: the relationship with expression of Nav 1. 7 in dorsal root ganglion / 中华麻醉学杂志

Objective To evaluate the role of Toll-like receptor 4 ( TLR4)/nuclear factor kappa B ( NF-κB) signaling pathway in the development of postoperative chronic pain and the relationship with ex-pression of voltage-gated sodium channel 1. 7 (Nav 1. 7) in the dorsal root ganglion (DRG) of rats. Meth-ods Thirty-six clean-grade healthy male Sprague-Dawley rats, aged 9-11 weeks, weighing 200-250 g, were divided into 3 groups ( n=12 each) using a random number table method: control group ( group C) , normal saline group ( group NS) and TLR4 antagonist LPS-RS group ( group R) . Postoperative chronic pain was produced by skin/muscle incision and retraction (SMIR). From 1 day before SMIR to 10 days after SMIR, NS group received continuous intrathecal injection of normal saline 10μl, while R group received continuous intrathecal injection of LPS-RS 20μg/10μl. Six rats were randomly selected in each group, and the mechanical pain threshold was measured at 1 day before SMIR and 1, 5, 10, 15 and 20 days after SMIR. The 6 rats left in each group were sacrificed at day 10 after SMIR, and the DRGs of the lumbar seg-ment (L4,5) were removed for determination of the expression of phosphorylated NF-κB (p-NF-κB) and Nav 1. 7. Results Compared with group C, the mechanical pain threshold was significantly decreased at 5-20 days after SMIR, and the expression of p-NF-κB and Nav1. 7 was up-regulated at 10 days after SMIR in group NS ( P＜0. 01) . Compared with group NA, the mechanical pain threshold was significantly increased at 5-20 days after SMIR, and the expression of p-NF-κB and Nav 1. 7 was down-regulated at 10 days after SMIR in group R (P＜0. 01). Conclusion Up-regulated expression of Nav1. 7 in DRGs after activating TLR4/NF-κB signaling pathway is involved in the development of postoperative chronic pain in rats.

Association of Interleukin-10 -1082A>G (rs1800896) Polymorphism with Predisposition to Breast Cancer: a Meta-Analysis based on 17 Case-Control Studies

SUMMARY INTRODUCTION The association between the between IL-10 -1082A>G (rs1800896) polymorphism and breast cancer has been evaluated by several number case-control studies. However, these studies might be underpowered to reveal the true association. OBJECTIVE We have performed a comprehensive meta-analysis to investigate the association IL-10 -1082A>G polymorphism and breast cancer. MATERIALS AND METHODS A systematic literature search was conducted using PubMed, Google Scholar, and Web of Science up to September 20, 2017. Data was analysed with CMA software to identify the strength of the association by pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs). RESULTS A total of 17 case-control studies involving 3275 cases and 3416 controls obtained from database searches were examined. Overall, there was no significant association between IL-10 -1082A>G polymorphism and breast cancer risk under all genetic models. No significant publication bias was found for the five genetic models (G vs. A OR = 1.184, 95% CI = 0.895-1.180, p= 0.230; GG vs. AA: OR = 1.430, 95% CI = 0.927-2.204, p= 0.106; GA vs. AA: OR = 0.966, 95% CI = 0.765-1.221, p= 0.774; GG+GA vs. AA: OR = 0.957, 95% CI = 0.697-1.314, p= 0.786; and GG vs. GA+AA: OR = 1.221, 95% CI = 0.981-1.518, p= 0.073). Moreover, there was no significant association between the IL-10 -1082A>G polymorphism and breast cancer risk by ethnicity. CONCLUSION Our findings indicated that IL-10 -1082A>G (rs1800896) polymorphism might not be a risk factor for the development of breast cancer.

RESUMO

Research progress of mitochondria in diabetic cardiomyopathy / 中国药理学通报

Diabetic cardiomyopathy (DCM) is one of the major cardiovascular complications of diabetes mellitus. Currently, there is a lack of effective treatment for DCM,and its pathophys-iology is quite complex. Mitochondria are the main source of car-diomyocyte energy and play an important role in regulating ener-gy metabolism. Mitochondria are swollen and fragmented in dia-betic patients, leading to impaired mitochondrial function, sug-gesting that mitochondrial damage and dysfunction may play an important role in the pathogenesis of DCM. In this paper, the relationship between mitochondrial damage and the pathogenesis of DCM was reviewed from the aspects of abnormal mitochondrial energy metabolism,mitochondrial oxidative stress enhancement, mitochondrial kinetics,mitochondrial heart lecithin change,and mitochondrial calcium disorder.

Serotype distribution characteristics and molecular typing of Salmonella in Yunnan Province from 2015 to 2017 / 中华微生物学和免疫学杂志

Objective To study the serotype distribution characteristics and genotypes of Salmo-nella strains isolated in Yunnan Province from 2015 to 2017. Methods Automatic microbiological identifi-cation system and mass spectrometer were used to identify Salmonella strains. Their serotypes were detected using the White-Kauffmann-Le Minor (WKL) scheme based on serological detection. Genotyping was car-ried out by referring to the molecular typing method of Salmonella serotype pulse field gel electrophoresis (PFGE) in PulsenetChina. Cluster analysis was performed with Bionumerics (7.6). Results A total of 408 strains of Salmonella were detected in food and patients in Yunnan Province form 2015 to 2017,belong-ing to 70 serotypes. Thirty-four Salmonella derby strains were detected in food,accounting for 19.10% of all Salmonella strains detected in food. Among the Salmonella strains detected in patients,71 were Salmonella enteritis and 67 were Salmonella typhimurium,accounting for 30.34% and 27.63%, respectively. Results of PFGE revealed that Salmonella derby and Salmonella typhimurium were polymorphic,and Salmonella en-teritis had obvious advantages PFGE band patterns. No obvious time or geographical aggregation was found in the PFGE bands of the three Salmonella species. Conclusion Seventy Salmonella serotypes had been iden-tified in Yunnan Province by 2017. Salmonella derby was the predominant serotype detected in food, while Salmonella enteritidis and Salmonella typhimurium were the predominant serotypes in patients. These three Salmonella species caused sporadic infections in Yunnan Province.

The Differential Outcomes Effect Using Sensory Outcomes in a Many-to-One Matching-to-Sample Task / Consequências Diferenciais Sensoriais em uma Tarefa de Pareamento ao Modelo "Muitos para Um"

Abstract The present study was designed to evaluate the use of sensory outcomes (visual vs. auditory) using a differential outcomes procedure to facilitate learning in a many-to-one matching-to-sample task. For one group of participants (differential outcomes) each correct stimulus-choice sequence was always followed by a different outcome; whereas for the rest of participants (non-differential outcomes) each correct sequence was followed by the same outcome. Participants trained with differential outcomes showed a faster acquisition and higher overall accuracy than participants trained with non-differential outcomes. The results provide a new extension the differential outcomes effect by using sensory outcomes and many-to-one matching to-sample task; applications of the differential outcomes procedure are discussed.

Resumo O presente estudo foi delineado para avaliar o uso de consequências sensoriais utilizando um procedimento de consequências diferenciais em uma tarefa de pareamento ao modelo "muitos para um". Para um grupo de participantes, cada sequência correta de escolha de estímulos era sempre seguida por uma consequência diferente; enquanto para os outros participantes, cada sequência correta era seguida pela mesma consequência. Participantes treinados com consequências diferenciais apresentaram aquisição mais rápida e, em geral, maior acurácia do que participantes treinados com consequências não diferenciais. Esses resultados demonstram uma nova extensão do efeito de consequências diferenciais por meio do uso de consequências sensoriais e de uma tarefa de pareamento ao modelo "muitos para um". Aplicações do procedimento de consequências diferenciais são discutidas.

O PASSO DO PARMÊNIDES / THE STEP OF PARMENIDES

Resumo: O presente trabalho objetiva mostrar como, para elaborar uma lógica pautada na não relação e independente de uma ontologia, Jacques Lacan procedeu a uma leitura do Parmênides de Platão. Partimos de duas referências fundamentais ao diálogo platônico no ensino do psicanalista e, com recurso aos textos do linguista Ferdinand de Saussure e de psicanalistas, pensadores e estudiosos do tema, passamos ao operador Há d'Um forjado por Lacan. Serão discutidas a função de nomeação na cadeia borromeana e a não relação sexual. Duas hipóteses do diálogo platônico acerca da unidade do múltiplo serão examinadas a fim de que tanto a relação quanto a não relação entre Ser e Um sejam tratadas em termos de sujeito barrado, significante e gozo.

Abstract: The present work aims to show how Jacques Lacan carried out the reading of Plato's Parmenides in order to develop a logic based on the non-relationship and independent from an ontology. We start from two fundamental references of the Platonic dialogue in the teaching of the psychoanalyst and with the aid of the texts of the linguist Ferdinand de Saussure, psychoanalysts, scholars and thinkers of the same theme, we move to the operator There is Something of the One forged by Lacan. The naming function in the Borromean chain and the non-sexual relationship will be discussed. Two hypotheses of the Platonic dialogue about the unit of the multiple will be examined so that both the relationship and the non-relationship between Being and the One are looked into in terms of the barred subject, the signifier and jouissance.

Avaliação da previsibilidade da sutura de menisco através da ressonância magnética / Predictability of meniscal suture by magnetic resonance imaging

The prediction of meniscus reparability is quite useful for surgeons to optimize surgical planning. The main objective of this study was to evaluate the ability of magnetic resonance imaging (MRI) to predict the suture of meniscal lesions. This was an unicentric retrospective study that included 104 patients who underwent knee joint ligament reconstruction and / or arthroscopy for the treatment of meniscal injury at knee joint level. The MRI images of the meniscus were evaluated and later the arthroscopic findings were used as the gold standard. After the operative procedure, the cases were allocated into two groups according to the necessity of meniscus suture: Sutured Group "MSu" (n = 58) and Non sutured Group "MNSu" (n = 150). Considering the lesion detection capacity in the medial meniscus, the sensitivity, specificity and accuracy of MR were 85.3%, 63.9% and 77.9%, respectively. The positive predictive value (PPV) was 81.7% and the negative predictive value (NPV) was 69.7%. The agreement between MRI and arthroscopy was moderate. For the lateral meniscus, sensitivity, specificity and accuracy of MRI were 80.6%, 89.0% and 86.5%, respectively, with PPV of 75.7% and NPV of 91.5% and a substantial agreement. Regarding suture predictability, the sensitivity, specificity and accuracy were respectively 60.3%, 66.7% and 64.9% with PPV of 41.2% and NPV of 81.3%, with weak agreement. According to the arthroscopy, the 58 meniscal lesions of the MSu group were more frequent in the posterior horn, had the longitudinal pattern and were located in the red-red vascular zone. In our study, MRI was not a good predictor of meniscal suture, although it is an useful tool for the diagnosis of medial and lateral meniscal lesions

Lacan e o Deus-infinito de Pascal: considerações sobre a aposta pascaliana e o início de uma análise / Lacan and the God-infinite of Pascal: considerations about Pascal's wager and the beginning of a psychoanalysis treatment / Lacan y el Dios-infinito de Pascal: consideraciones sobre la apuesta de Pascal y el inicio de un análisis

O artigo tem como objetivo analisar a utilização que Jaques Lacan faz de um ponto específico da obra de Blaise Pascal, relacionado à aposta em um Deus-infinito. Lacan complementa o estudo da aposta pascaliana com uma referência à graça religiosa como momento inaugural de abertura ao infinito. A partir dessas considerações, sustenta-se a hipótese de que a aposta de Pascal pode ser aproximada à operação necessária para o início de uma análise. A aposta de Pascal coloca em jogo o infinito. Com a ajuda do filósofo Alain Badiou, tentaremos demonstrar que Lacan parte da mesma ideia ao considerar que não há abertura ao inconsciente - correlativa ao início de uma análise - sem alguma dimensão de infinitude

The article aims to analyze the use of a certain point in the work of Blaise Pascal, according to Jacques Lacan's, specifically about the wager on a God-infinite. Lacan complements the study of the Pascal's wager referring to the concept of the religious grace as the inaugural moment of opening to the infinite. From these considerations, the supported hypothesis is that Pascal's wager approaches the course necessary to the beginning of the psychoanalysis treatment. Pascal's wager puts infinite at stake. With the help of the philosopher Alain Badiou, we will try to demonstrate that Lacan shares the same idea when he considers that there is no opening to the unconscious - correlative to the beginning of an analysis - without some dimension of infinity

El artículo tiene como objetivo analizar la utilización que Jaques Lacan hace de un punto específico de la obra de Blaise Pascal, relacionada con apostar en un Dios-infinito. Lacan complementa el estudio de la apuesta de Pascal con una referencia a la gracia religiosa como momento inaugural de apertura al infinito. A partir de estas consideraciones se apoya la hipótesis de que la apuesta de Pascal se aproxima a la operación requerida para iniciar un análisis. La apuesta de Pascal pone en juego el infinito. Con la ayuda del filósofo Alain Badiou, trataremos de demostrar que Lacan parte de la misma idea al considerar que no hay apertura al inconsciente - correlativo al comienzo de un análisis- sin alguna dimensión de infinidad

Primary Intracranial Ewing's Sarcoma (Peripheral Primitive Neuroectodermal Tumour of Parietal Bone) with Spinal and Pelvic Metastasis in a Young Female Child: Rare Case Report and Review

Introduction The Peripheral Primitive Neuroectodermal Tumour (pPNET)/Ewing's sarcoma family tumor (ESFT) group is a recently redefined term which includes all small round cell tumors of bone, soft tissue, and nerve with a common neuroectodermal origin. These highly aggressive pediatric soft tissue tumors occur less frequently in the craniospinal axis. Primary cranial lesion associated with spinal and pelvic metastasis is a rare presentation. Clinical Presentation A 9-year old girl was hospitalized with features of progressive increase in intracranial pressure with quadriparesis. The patient had ⅘ quadriparesis with bilateral papilledema. Brain MRI showed a large, hetero intense, contrast enhancing right parietal bony lesion infiltrating the dura with mass effect over the brain. Brain CT showed bony expansion and multiple calvarial lytic lesions. MRI cervical spine revealed collapsed fourth cervical vertebral body with extensive paravertebral and paraspinal soft tissue components with cord compression. Metastatic workup revealed a lytic lesion in the left iliac bone and left lung. The patient underwent a surgically challenging C4 corpectomy with cage fixation followed by craniotomy and excision of parietal bony lesion with titanium mesh cranioplasty in the same sitting. Histopathology revealed pPNET and was confirmed by CD99 positivity. Conclusion This rare multiple site tumor presentation was carefully planned and effectively managed by a combined single-stage surgical approach involving total excision of primary parietal bone and metastatic cervical spine tumors with primary titanium mesh cranioplasty and cervical spine stabilization, followed with radiotherapy and chemotherapy, which resulted in good recovery and improved the overall prognosis for the patient.

Introdução O grupo 'tumor neuroectodérmico primitivo periférico (pPNET) / tumor da família dos sarcomas de Ewing (ESFT)' é um termo recentemente redefinido o qual inclui todos as pequenas arredondadas células de tumor ósseo, tecidos moles e nervos com origem neuroectodérmica comum. Estes tumores pediátricos de tecido mole altamente agressivos ocorrem com menor frequência no eixo cranioespinal. Lesões primárias do crânio associadas a metástase espinhal e pélvica são raras. Relato de Caso Criança de 9 anos de idade hospitalizada com fraturas e pressão intracraniana crescente com quadriparesia. A paciente teve ⅘ de quadriparesia com papiledema bilateral. RM do cérebro por contraste mostrou uma lesão óssea parietal direita extensa e hétero-intensa infiltrando a dura-máter com efeito maciço sobre o cérebro. TC do cérebro mostrou expansão óssea e múltiplas lesões líticas na calota craniana. RM da espinha cervical revelou colapso da quarta vertebra cervical com componentes paravertebral e paraespinal de tecido mole com compressão da medula. Workup metastático revelou uma lesão lítica no ilíaco esquerdo e pulmão esquerdo. A paciente foi submetida a difícil corpectomia da C4 com fixação de cage seguida de craniotomia e excisão da lesão parietal óssea com cranioplastia com malha de titânio na mesma posição. Histopatologia revelou pPNET, confirmada por positividade de CD99. Conclusão Este raro caso com apresentação de múltiplos tumores foi cuidadosamente planejado e eficazmente conduzido por acessos cirúrgicos combinados em fase única envolvendo excisão total do osso parietal primário e tumores metastáticos da espinhal cervical com cranioplastia com malha de titânio e estabilização da espinha cervical, seguida de radioterapia e quimioterapia, resultando em boa recuperação e melhora no prognóstico geral da paciente.