Erdheim-Chester disease: Typical radiologic findings of a multisystemic disease.

Erdheim-Chester disease is a rare and multisystemic entity. It results from the infiltration of tissues by foamy histiocytes. The etiology is unknown, but there are mutations in the MAPK pathway in over 80% of patients, more frequently BRAF mutation. The most commonly affected organs and systems are the skeleton, central nervous system, cardiovascular system, kidney, lungs, and skin. The most common clinical manifestations are bone pain, usually in the lower limbs, and diabetes insipidus. The diagnosis is challenging. It requires a combination of clinical, radiological, histopathological, and molecular findings. We present the case of a patient with typical clinical and radiological manifestations: bone pain and diabetes insipidus at presentation, bilateral long bone cortical sclerosis, hairy kidney appearance, coated aorta, right atrium pseudotumor, and periorbital masses.

Idiopathic pneumatosis cystoides coli: An uncommon cause of pneumoperitoneum.

Pneumatosis cystoides intestinalis (PCI) is a rare entity characterized by the presence of gaseous cystic within the intestinal wall. The primary or idiopathic type represents 15% of cases and is a self-limited or chronic benign entity. The secondary type represents 85% of cases and is associated with various factors, such as surgery, pharmacotherapy, chemotherapy, autoimmune diseases, inflammatory diseases, and pulmonary illness. Pneumatosis cystoides intestinalis affects the colon (pneumatosis cystoides coli) in about half of the cases. The differential diagnosis of PCI includes potentially life-threatening diseases that cause pneumatosis intestinalis. The misdiagnosis of PCI is common and can lead to unnecessary treatments and surgical procedures. We describe an asymptomatic pneumoperitoneum incidentally seen on chest radiograph. The cause was pneumatosis cystoides coli, which did not require treatment.

Large incidental esophageal leiomyoma: Radiological findings.

Benign tumors of the esophagus are rare, the most common of them being leiomyomas. Malignant transformation is extremely rare, and they are often asymptomatic. Tumors larger than 5 cm frequently cause symptoms such as epigastric discomfort, heartburn, or dysphagia. We describe the case of a 57-year-old male with the presumptive diagnosis of esophageal leiomyoma, asymptomatic and incidentally discovered on a chest radiograph. The computerized tomography demonstrated an isodense and well-demarcated lesion from the esophagus, and the upper endoscopy confirmed an intact mucosa. The lesion has been stable for at least 6 years, and the patient remains asymptomatic.

Controversial aspects of the concept of health needs and their impact on the accessibility of medicine and health services. / Aspectos controversos do conceito de necessidades de saúde e seus reflexos sobre a acessibilidade de medicamentos e serviços de saúde.

This article aimed to present the problems related to accessibility of health services by re-reading four case studies which illustrate the different dimensions of the definition of health needs and their impact on the accessibility of medicine and health services. The theoretical model of Vargas-Peláez et al.1, which allows a better understanding of the complexity of the definition of health needs and its impact on the demand for medicines and services, was adopted to re-read the case studies on the prices of patented medicines, the models of public provision, hemodynamic services, and prescription of anxiolytics. The results may shed some light on the complexity of the challenges to achieve health rights in a peripheral capitalist society where the production and distribution of goods and services is organized from the perspective of the market, even though public policies seek to regulate them. In this sense, it seems essential that the State plays a major role in guaranteeing equality in the achievement of social rights, not only influencing the industrial sector in reducing the prices of medicines and improving their supply, but also guaranteeing access to medicine and health services.

O objetivo do artigo é mostrar os problemas relativos à acessibilidade de serviços de saúde relendo quatro estudos de caso que ilustram as diferentes dimensões da definição de necessidades de saúde e os seus reflexos sobre a acessibilidade dos medicamentos e dos serviços de saúde. O modelo teórico de Vargas-Peláez et al.1, que permite um melhor entendimento da complexidade da definição das necessidades de saúde e os seus reflexos sobre a demanda de medicamentos e de serviços, foi adotado para reler os estudos de caso sobre preços dos medicamentos patenteados, os modelos de provisão pública, os serviços de hemodinâmica e a prescrição de ansiolíticos. Os resultados permitem iluminar a complexidade dos desafios presentes para obtenção dos direitos de saúde numa sociedade capitalista periférica em que a produção e a distribuição dos bens e serviços são organizadas na perspectiva do mercado ainda que as políticas públicas busquem regulá-las. Neste sentido, parece imprescindível que o Estado tenha um papel preponderante na garantia da equidade para o alcance dos direitos sociais, não só estimulando a indústria para redução dos preços dos medicamentos e melhoria de sua provisão, como garantindo acesso aos medicamentos e serviços de saúde.

Aspectos controversos do conceito de necessidades de saúde e seus reflexos sobre a acessibilidade de medicamentos e serviços de saúde / Controversial aspects of the concept of health needs and their impact on the accessibility of medicine and health services

Resumo O objetivo do artigo é mostrar os problemas relativos à acessibilidade de serviços de saúde relendo quatro estudos de caso que ilustram as diferentes dimensões da definição de necessidades de saúde e os seus reflexos sobre a acessibilidade dos medicamentos e dos serviços de saúde. O modelo teórico de Vargas-Peláez et al.1, que permite um melhor entendimento da complexidade da definição das necessidades de saúde e os seus reflexos sobre a demanda de medicamentos e de serviços, foi adotado para reler os estudos de caso sobre preços dos medicamentos patenteados, os modelos de provisão pública, os serviços de hemodinâmica e a prescrição de ansiolíticos. Os resultados permitem iluminar a complexidade dos desafios presentes para obtenção dos direitos de saúde numa sociedade capitalista periférica em que a produção e a distribuição dos bens e serviços são organizadas na perspectiva do mercado ainda que as políticas públicas busquem regulá-las. Neste sentido, parece imprescindível que o Estado tenha um papel preponderante na garantia da equidade para o alcance dos direitos sociais, não só estimulando a indústria para redução dos preços dos medicamentos e melhoria de sua provisão, como garantindo acesso aos medicamentos e serviços de saúde.

Abstract This article aimed to present the problems related to accessibility of health services by re-reading four case studies which illustrate the different dimensions of the definition of health needs and their impact on the accessibility of medicine and health services. The theoretical model of Vargas-Peláez et al.1, which allows a better understanding of the complexity of the definition of health needs and its impact on the demand for medicines and services, was adopted to re-read the case studies on the prices of patented medicines, the models of public provision, hemodynamic services, and prescription of anxiolytics. The results may shed some light on the complexity of the challenges to achieve health rights in a peripheral capitalist society where the production and distribution of goods and services is organized from the perspective of the market, even though public policies seek to regulate them. In this sense, it seems essential that the State plays a major role in guaranteeing equality in the achievement of social rights, not only influencing the industrial sector in reducing the prices of medicines and improving their supply, but also guaranteeing access to medicine and health services.

VARICOSITY OF THE COMMUNICATING VEIN BETWEEN THE LEFT RENAL VEIN AND THE LEFT ASCENDING LUMBAR VEIN.

32 years-old female patient presented with lumbar pain. Computed tomography revealed varicosity of the communicating vein between the left renal vein and the left ascending lumbar vein. This entity may pose technical difficulties during aortoiliac surgeries and renal surgeries as iatrogenic injury of this vessel may cause life- -threatening retroperitoneal hemorrhage.

Can the antral follicular count modulate the gene expression of bovine oviducts in Aberdeen Angus and Nelore heifers?

The number of visible ovarian antral follicles (antral follicle count-AFC) is repeatable in bovine individuals, but highly variable between animals, and with differences between Bos taurus and Bos indicus breeds. Several studies have tried to determine the correlation between AFC and increased fertility in cattle. While the impacts of AFC on embryo production, hormonal levels, and pregnancy rates have been described, the molecular effects of AFC on bovine oviducts have not yet been investigated. Here, the aim was to investigate the impact of breeds, such as Aberdeen Angus and Nelore heifer with high or low AFC, on abundance of transcripts and protein related to oviductal transport, sperm reservoir formation, monospermy control, and gamete interaction in the oviducts. In summary, the ovulation side was the major factor that affected transcript abundance on bovine oviducts. However, a discreet effect among AFC and cattle breeds was also observed. Based on this, we concluded and reinforced here that differential microenvironments between ipsilateral and contralateral oviducts have a major effect on modulating the transcripts related to oviductal transport, sperm reservoir formation, monospermy control, and gamete interaction. However, we cannot exclude that there is minimal effect of AFC or breed on regulation of some genes (such as AGTR1, ACE1, FUCA1, and VEGFA) in bovine oviducts.

Canine sporotrichosis: report of 15 advanced cases / Esporotricose canina: descrição de 15 casos avançados

Sporotrichosis is a chronic, granulomatous and usually lymphocutaneous infection of animals and humans, caused by a dimorphic fungus, Sporothrix schenckii complex. The disease in dogs is considered rare, however, in the last years a crescent registration of cases was observed in Brazil, especially in the city of Rio de Janeiro. Fifteen dogs with ulcerated cutaneous lesions were seen at the Dermatology Service in the Small Animal's Hospital at Universidade Federal Rural do Rio de Janeiro, between January 2014 and October 2015. Most lesions were located on the head, mainly the nose. Lesions were even seen on the chest, disseminated on the body and on the limbs. Three dogs (20%) exhibited the cutaneous-lymphatic form, with lesions initially on the distal aspect of one leg and ascending via lymphatics up the leg to the trunk and head. It was not ruled out the disseminated form in at least 3 dogs (20%). They had consistent signs of generalized or disseminated disease exhibiting respiratory symptoms (nasal discharge, sneezing, stertorous breathing), anorexia and weight loss. Draining tracts and cellulitis were very common. Some had large areas of skin necrosis with exposure of muscle and bone. Definitive diagnosis was obtained by cytological examination of exudates, histological examination, and/or isolation of S. schenckii complex by fungal culture. Because of the severity of the lesions that mimic other disorders like neoplasms or autoimmune skin diseases, and due to the difficulties of getting an accurate diagnosis, this study describes 15 advanced cases of canine sporotrichosis.(AU)

A esporitricose é uma doença infecciosa crônica, granulomatosa e frequentemente linfocutânea, causada por um fungo dimórfico do Complexo Sporothrix schenckii. A doença em cães é considerada rara, no entanto, nos últimos anos, um número crescente de casos foi registrado no Brasil, especialmente no Rio de Janeiro. Quinze cães com lesões cutâneas ulceradas foram atendidos no Setor de Dermatologia do Hospital Veterinário de Pequenos Animais da Universidade Federal Rural do Rio de Janeiro, entre Janeiro de 2014 e Outubro de 2015. Todos os animais foram submetidos ao exame clínico e dermatológico. A maioria das lesões estava localizada na cabeça, principalmente no plano nasal. Havia também lesões no tórax, disseminada pelo corpo e nos membros. Três cães (20%) apresentaram a forma cutâneo-linfática, com lesões inicialmente nos membros e se propagavam via vasos linfáticos para o tronco e a cabeça. Não foi descartada a forma disseminada em pelo menos 3 cães (20%). Estes cães apresentaram sinais consistentes de doença generalizada ou disseminada, exibindo sinais respiratórios (descarga nasal, espirros, estertoração), anorexia e perda de peso. Fístulas e celulite eram muito comuns. Alguns tinham grandes áreas de necrose que desencadearam a exposição de músculo e osso. O diagnóstico definitivo da infecção foi obtido por exame citológico de exsudato e por exame histológico, e/ou apenas isolamento do complexo S. schenckii pela cultura de fungos. Por causa da severidade das lesões que imitam outras enfermidades, principalmente neoplasias e doenças autoimunes, e pela dificuldade de se obter o diagnóstico correto, este estudo descreve 15 casos avançados de esporotricose canina.(AU)

Regulatory and junctional proteins of the blood-testis barrier in human Sertoli cells are modified by monobutyl phthalate (MBP) and bisphenol A (BPA) exposure.

The blood-testis barrier (BTB) is responsible for providing a protected environment and coordinating the spermatogenesis. Endocrine disruptors (EDs) might lead to infertility, interfering in the BTB structure and modulation. This study aimed to correlate the actions of two EDs, monobutyl phthalate (MBP) and bisphenol A (BPA) in different periods of exposure, in a low toxicity dose to the human Sertoli cells (HSeC) and its effects on the proteins of the BTB and regulatory proteins involved in its modulation. HSeC cells were exposed to MBP (10µM) and BPA (20µM) for 6 and 48h. Western Blot assay indicated that MBP was able to reduce the expression of occludin, ZO-1, N-cadherin and Androgen Receptor (AR), while BPA leads to a reduction of occludin, ZO-1, ß-catenin and AR. TGF-ß2 and F-actin were not modified. Phalloidin and Hematoxylin and Eosin assay revealed phenotically disruption in Sertoli cells adhesion, without changes in F-actin expression or localization. Our data suggested both EDs present potential for disrupting the structure and maintenance of the human BTB by AR dependent pathway.

Gestational and lactational exposition to Di-N-butyl-phthalate (DBP) increases inflammation and preneoplastic lesions in prostate of wistar rats after carcinogenic N-methyl-N-nitrosourea (MNU) plus testosterone protocol.

In the present study, it was evaluated the susceptibility of prostatic lesions in male adult rats exposed to Di-N-butyl-phthalate during fetal and lactational periods and submitted to MNU plus testosterone carcinogenesis protocol. Pregnant females were distributed into four experimental groups: CN (negative control); CMNU (MNU control); TDBP100 (100 mg/kg of DBP); TDBP500 (500 mg/kg of DBP). Females from the TDBP groups received DBP, by gavage, from gestation day 15 (GD15) to postnatal day 21 (DPN21), while C animals received the vehicle (corn oil). CMNU, TDBP100, and TDBP500 groups received a single intraperitoneal injection of MNU (50 mg/kg) on the sixth postnatal week. After that, testosterone cypionate was administered subcutaneously two times a week (2 mg/kg) for 24 weeks. The animals were euthanized on PND220. Distal segment fragments of the ventral (VP) and dorsolateral prostate (DLP) were fixed and processed for histopathological analysis. Protein extracts from ventral prostate were obtained, and western blotting was performed to AR, ERα, MAPK (ERK1/2), and pan-AKT. Stereological analysis showed an increase in the epithelial compartment in TDBP100 and TDBP500 compared to CN. In general, there was increase in the incidence of inflammation and metaplasia/dysplasia in the DBP-treated groups, mainly in DLP, compared to CN and CMNU. Proliferation index was significant higher in TDBP500 and PIN (prostatic intraepithelial neoplasia) was more frequent in this group compared to CMNU. Western blot assays showed an increase in the expressions of AR and MAPK (ERK1/2) in the TDBP100 compared to CN, and ERα and AKT expressions were higher in the TDBP500 group compared do CN. These results showed that different doses of DBP during prostate organogenesis in Wistar rats could increase the incidence of premalignant lesions in initiated rats inducing distinct biological responses in the adulthood. © 2015 Wiley Periodicals, Inc. Environ Toxicol 31: 1185-1195, 2016.

Extensão universitária e inclusão social de estudantes do ensino médio público / University extension and the social inclusion of public high school students / Extensión universitaria e inclusión social de estudiantes de la enseñanza media pública

A extensão universitária no processo educativo permite a elaboração da práxis e do conhecimento científico por meio de ações na comunidade, gerando um processo sistematizado de troca de saberes. Este estudo avaliou as intervenções educativas do ensino superior privado no ensino médio público aplicadas às áreas de ciências e prevenção em saúde, realizadas no período de fevereiro de 2005 a novembro de 2008. A intervenção capacitou vinte estudantes do ensino médio e realizou o Dia de Saúde do Jovem, com participação de 362 estudantes de Salvador, Bahia. Questionários anônimos foram preenchidos antes e depois de cada seminário e oficina, contendo questões sobre o tema abordado nas atividades. Observou-se a importância da intervenção do ensino superior privado na qualificação de estudantes do ensino médio da rede pública. O ensino superior privado pode participar da inclusão social, qualificando indivíduos para ingressarem no processo de formação profissional de forma mais atenta à dinâmica social. O grande desafio para o ensino superior da área da saúde continua sendo reconceituar o seu papel ativo na educação e na prevenção em saúde, com participação efetiva de acadêmicos, cientistas e educadores.

University extension in the educational process allows for the preparation of the praxis and scientific knowledge through actions in the community, generating a systematic process of knowledge exchange. This study evaluated the educational interventions of private higher education in public high school applied to the areas of sciences and prevention in health, conducted from February 2005 to November 2008. The intervention trained 20 high school students, and held the Youth Health Day, attended by 362 students from Salvador, Brazil. Anonymous questionnaires containing questions about the subject's activities were completed before and after each seminar and workshop. The importance of the intervention of private higher education in the training of public high school students was noted. Private higher education can participate in social inclusion, qualifying individuals to join the professional training process in a manner more attentive to the social dynamics. The challenge for higher education in the health field remains reconceptualizing its active role in health education and prevention, with the effective participation of academics, scientists, and educators.

La extensión universitaria en el proceso educativo permite la elaboración de la praxis y del conocimiento científico a través de acciones en la comunidad, generando un proceso sis temático de intercambio de conocimientos. Este estudio evaluó las intervenciones educativas de la educación superior privada en la enseñanza media pública aplicadas a las áreas de ciencias y prevención de la salud, realizadas entre febrero de 2005 y noviembre de 2008. La intervención capacitó a veinte estudiantes de la enseñanza media, y realizó el Día de la Salud del Joven, con la participación de 362 alumnos de Salvador, Brasil. Se rellenaron cuestionarios anónimos, antes y después de cada seminario y taller, c on preguntas sobre el tema tratado en las actividades. Se puntualizó la importancia de la intervención de la enseñanza superior privada en la calificación de los estudiantes de la enseñanza media de la red pública. La enseñanza superior privada puede participar en la inc lusión social, c alificando a lo s individuos para que ingresen en el proceso de formación profesional de forma más atenta a la dinámica social. El gran reto para la enseñanza superior en el campo de la salud sigue siendo reconceptualizar su papel activo en la educación y en la salud preventiva, con la participación efectiva de académicos, científicos y educadores.