Embryonal Tumors of the Central Nervous System: The WHO 2016 Classification and New Insights.

Central nervous system tumors comprise 26% of cancer in children, representing the most frequent solid neoplasms. Embryonal tumors comprise 15% of them, and they are defined as "small round blue cells" in which morphology is reminiscent of the developing embryonic nervous system. They are the most common high-grade central nervous system neoplasms. Over the years, molecular research has been improving our knowledge concerning these neoplasms, stressing the need for tumor reclassification. Indeed, the revised 2016 fourth edition of the World Health Organization classification introduced genetic parameters in the classification. Specific molecular signatures allow a more accurate risk assessment, leading to proper therapeutic approach and potentially improved prognosis. Holding this new approach, medulloblastoma is noteworthy. The present classification combines the previous histologic classification with a new genetic definition in WNT-activated, sonic hedgehog-activated and non-WNT/non-sonic hedgehog. Molecular data are also a defining feature in the diagnosis of atypical teratoid/rhabdoid tumors and embryonal tumors with multilayered rosettes. However, there are still embryonal tumors that challenge the present World Health Organization classification, and new molecular data have been underlining the need for novel tumor entities. Likewise, recent research has been highlighting heterogeneity in recognized entities. How to translate these molecular developments into routine clinical practice is still a major challenge.

On ciprofloxacin concentration in chronic rhinosinusitis / Acerca de la concentración de ciprofloxacino en la rinosinusitis crónica

Objective: Considering that all the evidence indicates that chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) are distinct entities, the aim of this study was to compare the concentrations obtained in plasma and in sinonasal mucosa with oral and nasal topical ciprofloxacin, in patients with and without nasal polyps, without evaluating the effectiveness of the use of an antibiotic. Methods: Prospective clinical study with single-blind randomization. The population consisted of patients with chronic rhinosinusitis with eligible for endonasal surgery, over 18 years old. It took place between January 2010 and December 2014. A single preoperative dose of ciprofloxacin (oral or nasal topic- spray, gel or drops) was given and samples of plasma and nasal mucosa (inferior turbinate, middle turbinate, ethmoid and maxillary sinus) were collected prior to surgery. The plasma and mucosal ciprofloxacin concentrations were assayed with high performance liquid chromatography (HPLC) with fluorescence detection (FD). Results: The oral ciprofloxacin achieved better mucosal concentrations but had a significant plasmatic expression in all patients. None of the topical formulations achieved measurable ciprofloxacin plasmatic levels. Among the topical formulations, the gel had the best mucosal results, despite the existence of polyposis (AU)

Objetivo: Considerando todas las evidencias de que la rinosinusitis crónica sin poliposis nasal (RSCsPN) y la rinosinusitis crónica con poliposis nasal (RSCcPN) son entidades distintas, el objetivo de este estudio fue comparar las concentraciones obtenidas en el plasma y en la mucosa nasal con ciprofloxacino oral y tópico nasal en pacientes con y sin pólipos nasales, sin evaluar la efectividad del uso del antibiótico. Métodos: Estudio clínico prospectivo con asignación aleatoria. La población se componía de pacientes con rinosinusitis crónica propuestos para cirugía endonasal, mayores de 18 años. Se desarrolló entre enero de 2010 y diciembre de 2014. Se administró una dosis única preoperatoria de ciprofloxacino (oral o tópico nasal, en aerosol, gel o gotas) y se recogieron muestras de plasma y mucosa nasal (cornetes, etmoides y seno maxilar) antes de la cirugía. La concentración de ciprofloxacino en el plasma y en la mucosa se ensayó mediante cromatografía líquida de alto rendimiento con detección de fluorescencia. Resultados: El ciprofloxacino oral logró las concentraciones mucosas más altas pero tuvo una expresión plasmática significativa en todos los pacientes. Ninguna de las formulaciones tópicas ha generado niveles plasmáticos de ciprofloxacino medibles. Entre las formulaciones tópicas, el gel fue el que presentó mejores resultados mucosos, a pesar de la existencia de poliposis (AU)

Minimally invasive measurement of vesical pressure for diagnosis of infravesical obstruction.

AIMS: This study was focused on the clinical test of an improved and portable version of a previously described urethral connector (UC), designed for minimally invasive measurement of vesical pressure and diagnosis of infravesical obstruction in men. METHODS: The conventional pressure-flow study (PFS) and the test with the new version of UC were applied to individuals reporting lower urinary tract symptoms (LUTS), who were then classified as obstructed or non-obstructed/equivocal based on the bladder outlet obstruction index (BOOI) from PFS data. Two-way analysis of variance was used to compare the values of urine flow rate and vesical pressure between methods and diagnoses. RESULTS: Vesical pressure and urine flow values were not significantly different between methods (P > 0.05), while the former was greater in the group classified as obstructed. CONCLUSION: The present results showed that the UC test can support the diagnosis of infravesical obstruction in a comparable way as that of the conventional urodynamic method, however with the advantages of simplicity and minimal invasiveness, having thus the potential to be an alternative method for long term follow-up of individuals reporting LUTS.

On ciprofloxacin concentration in chronic rhinosinusitis.

OBJECTIVE: Considering that all the evidence indicates that chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) are distinct entities, the aim of this study was to compare the concentrations obtained in plasma and in sinonasal mucosa with oral and nasal topical ciprofloxacin, in patients with and without nasal polyps, without evaluating the effectiveness of the use of an antibiotic. METHODS: Prospective clinical study with single-blind randomization. The population consisted of patients with chronic rhinosinusitis with eligible for endonasal surgery, over 18 years old. It took place between January 2010 and December 2014. A single preoperative dose of ciprofloxacin (oral or nasal topic- spray, gel or drops) was given and samples of plasma and nasal mucosa (inferior turbinate, middle turbinate, ethmoid and maxillary sinus) were collected prior to surgery. The plasma and mucosal ciprofloxacin concentrations were assayed with high performance liquid chromatography (HPLC) with fluorescence detection (FD). RESULTS: The oral ciprofloxacin achieved better mucosal concentrations but had a significant plasmatic expression in all patients. None of the topical formulations achieved measurable ciprofloxacin plasmatic levels. Among the topical formulations, the gel had the best mucosal results, despite the existence of polyposis.

Prevalence of intestinal parasites versus knowledge, attitudes, and practices of inhabitants of low-income communities of Campos dos Goytacazes, Rio de Janeiro State, Brazil.

Intestinal parasites are the causative agents of common infections responsible for significant public health problems in developing countries and generally linked to lack of sanitation, safe water, and improper hygiene. More than two billion people throughout the world live with unrelenting illness due to intestinal parasitic infections (IPIs). The purposes of this study are to assess knowledge, attitudes, and practices on IPIs and investigate the relationship with prevalence of intestinal parasites among a low-income group of inhabitants from two communities of the Travessão District area, Campos dos Goytacazes, north of Rio de Janeiro State, Brazil. The two communities are known as "Parque Santuário," which is an urban slum with miserable living conditions, and "Arraial," where the socioeconomic and educational levels are better, neither having a sanitary infrastructure with an excreta collection system. Questionnaires revealed that both communities had local and specific codification to denominate the intestinal parasites and present correct knowledge on the theme but ignored some aspects of IPI transmission, with the Arraial population being better informed (p < 0.05). The overall prevalence of IPIs in Parque Santuário (49.7%) was greater than in Arraial (27.2%) (p < 0.001; prevalence ratio/95% confidence interval 1.83/1.50-2.23). This study reports the real IPI situation in the Travessão District and also reinforces the need to continue the investigation on the impact of combined prophylactic methods, educational measures, and socioeconomic and sanitary improvements by governmental authorities and the local popular organization.

Cytochemical characterization of microvillar and perimicrovillar membranes in the posterior midgut epithelium of Rhodnius prolixus.

Perimicrovillar membranes (PMM) are structures present on the surface of midgut epithelial cells of the hematophagous insect, Rhodnius prolixus. They cover the microvilli and are especially evident 10 days after blood meal, providing the compartmentalization of the enzymatic processes in the intestinal microenvironment. Using an enzyme cytochemical approach, Mg2+-ATPase and ouabain-sensitive Na+K+-ATPase activities were observed in the plasma (or microvillar) membrane (MM) of midgut cells and in the PMM. In contrast, alkaline phosphatase was only detected in MM. Using cationized ferritin and colloidal iron hydroxide particles, anionic sites were found only on the luminal surface of the PMM. Using fluorescein isothiocyanate (FITC)-labeled lectins, residues of alpha-d-galactose, mannose, N-acetyl-neuraminic acid, N-acetyl-d-galactosamine and N-acetyl-galactosamine-alpha-1,3-galactose were detected on the apical surface of posterior midgut epithelial cells. On the other hand, using FITC-labeled neoglycoproteins (NGP) it was possible to detect the presence of carbohydrate binding molecules (CBM) recognizing N-acetyl-d-galactosamine, alpha-d-mannose, alpha-l-fucose and alpha-d-glucose in the posterior midgut epithelium. The use of digitonin showed the presence of sterols in the MM and PMM. These results have led the authors to suggest that for some components the PMM resembles the MM lining the midgut cells of R. prolixus, composing a system which covers the microvilli and stretches to the luminal space.

Ca(2+) sequestering in the early-branching amitochondriate protozoan Tritrichomonas foetus: an important role of the Golgi complex and its Ca(2+)-ATPase.

Total membrane vesicles isolated from Tritrichomonas foetus showed an ATP-dependent Ca(2+) uptake, which was not sensitive to 10 microM protonophore FCCP but was blocked by orthovanadate, the inhibitor of P-type ATPases (I(50)=130 microM), and by the Ca(2+)/H(+) exchanger, A-23187. The Ca(2+) uptake was prevented also by thapsigargin, an inhibitor of the SERCA Ca(2+)-ATPases. The sensitivity of the Ca(2+) uptake by the protozoan membrane vesicles to thapsigargin was similar to that of Ca(2+)-ATPase from rabbit muscle sarcoplasmic reticulum. Fractionation of the total membrane vesicles in sucrose density gradient revealed a considerable peak of Ca(2+) transport activity that co-migrated with the Golgi marker guanosine diphosphatase (GDPase). Electron microscopy confirmed that membrane fractions of the peak were enriched with the Golgi membranes. The Golgi Ca(2+)-ATPase contributed to the Ca(2+) uptake by all membrane vesicles 80-85%. We conclude that: (i) the Golgi and/or Golgi-like vesicles form the main Ca(2+) store compartment in T. foetus; (ii) Ca(2+) ATPase is responsible for the Ca(2+) sequestering in this protozoan, while Ca(2+)/H(+) antiporter is not involved in the process; (iii) the Golgi pump of this ancient eukaryotic microorganism appears to be similar to the enzymes of the SERCA family by its sensitivity to thapsigargin.