Pilocytic astrocytoma in adults: Histopathological, immunohistochemical and molecular study with clinical association.

Pilocytic astrocytoma is the most common primary CNS neoplasm in children and adolescents, rare after the first two decades of life. While some authors report a favorable prognosis in the adult age group with the tumor, others have associated it with higher mortality. The molecular alteration most observed in cases of pilocytic astrocytoma in the pediatric group is the BRAF-KIAA1549 gene fusion, and there are still few studies confirming the presence of this fusion in the adult population. This work investigated genetic alterations involving the 7q34 region in BRAF gene in 21 adult individuals with pilocytic astrocytoma, by FISH. In addition, was identified the immunohistochemical expression of BRAFV600E, correlating these findings with histopathological and clinical ones. BRAF-KIAA1549 fusion appeared in only one case, while in two other cases were found deletions related to the FAM131B-BRAF fusion, suggesting that maybe the latter is more frequently in this population. Through the evaluation of immunoreactivity, 71% of the cases were considered positive and 29% negative. Cases considered positive for BRAFV600E immunoreactivity can potentially be treated through drug therapy with BRAF inhibitors; however, it is always recommended to carry out a molecular study for diagnostic confirmation. This is the first Brazilian study that aimed to investigate possible genetic alterations in the BRAF gene in pilocytic astrocytomas, specifically in adults. Only 1 patient died, but due to operative complications and not the disease itself, suggesting a good evolution of these individuals.

Pathophysiological evaluation of pilocytic astrocytoma in adults: Histopathological and immunohistochemical analysis.

Pilocytic astrocytoma is a central nervous system tumor of slow growth, which represents 5 % of all gliomas and most often develops in the cerebellum (42-60 %), but can also arise in other neural areas, such as the optic pathway or hypothalamus (9-30 %); brainstem (9 %); spinal cord (2 %). In the pediatric population, this tumor is the second most common cause of neoplasms and, on the other hand, in adults, it is often rare, probably due to its aggressiveness in these individuals. Studies reveal that the origin of pilocytic astrocytoma is characterized by a fusion between the BRAF gene and the KIAA1549 locus, and the application of the immunohistochemistry technique for the analysis of BRAF protein expression can be a valuable tool for diagnostic purposes. Due to the relative rarity of this disease in adults, there are few publications on the most effective diagnostic and treatment strategies for this tumor. The general objective of this study was to analyze the histopathological and immunohistochemical characteristics of pilocytic astrocytoma in these patients. For this, a retrospective study of patients aged over 17 years with a diagnosis of pilocytic astrocytoma was carried out at the Department of Pathology of UNIFESP/EPM, from 1991 to 2015. In order to define BRAF positivity in the immunohistochemical analysis, at least three consecutive fields with more than 50 % immunostaining were used as criteria and, thus, it was inferred that the 7 cases analyzed were considered positive for the cytoplasmic marker BRAF V600E. Histopathological analysis associated with BRAF immunostaining is of paramount importance as a diagnostic method in these cases. However, future molecular studies will be necessary both for a better understanding of the aggressiveness and prognostic of this tumor and for research involving specific therapies for pilocytic astrocytoma in adults.

Complementary tool in diagnosis of hydatidiform mole: Review.

Hydatidiform mole is an abnormal pregnancy in which two copies of paternal genetic material are present. Molar gestation is divided into complete and partial hydatidiform moles. Clinical, morphological, and cytogenetic characteristics are usually sufficient to distinguish them, but and the rare cases that are necessary to know the paternal origin to establish the diagnosis and segment? Mutations in the Gene for Factor V Leiden and G20210A prothrombin polymorphism in women with recurrent spontaneous abortion: a retrospective study in a Brazilian population.

The involvement of the MAPK pathway in pilocytic astrocytomas.

Pilocytic astrocytomas are the primary tumors most found in the first two decades of life, accounting for around 15% of all brain tumors. Research at the molecular level of pilocytic astrocytoma makes possible to compose an overview of what is known about the origin and development of the tumor. It is known that there are alterations in the Mitogen Activated Protein Kinase (MAPK) signaling pathway that are important auxiliary markers in diagnosis. This study seeks to list the main points about the involvement of this pathway in tumor formation in pilocytic astrocytoma. A review was conducted in search of published studies available in NCBI, PubMed, MEDLINE, Scielo and Google Scholar. The most frequent alteration is the gene fusion between BRAF and KIAA1549 genes, found in approximately 90% of pediatric cases. The second most common event is the BRAFV600E mutation, also often found in children than in adult cases. The molecular origin of pilocytic astrocytomas is related to alterations in the MAPK pathway, which acts with several functions in the brain such as memory formation, pain perception, induction of cortical neurogenesis, and midbrain and cerebellum development. Alterations in this pathway can be therapeutic targets in the treatment of patients with pilocytic astrocytoma. The MAPK pathway is extremely important and knowledge about its involvement in astrocytic tumors is essential for a better approach to the patient.

Functions of astrocytes in multiple sclerosis: A review.

BACKGROUND: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system (CNS), which usually affects young adults between 20 and 40 years old. In chronic neurodegenerative diseases such as multiple sclerosis, CNS cells take on several adaptations during neuroinflammation. The main cells involved in this inflammatory process are the glial cells, in which the astrocytes stand out. These cells play a complex role, and several studies report that reactive astrocytes lose their supporting role and gain toxic function in the progression of these diseases. RESULTS: The beneficial and injurious effects of this group of cells in MS are addressed in this work, as well as some drugs that are already used in the treatment of patients with multiple sclerosis, aiming to regulate astrocytic activities. CONCLUSIONS: The knowledge about the functions of astrocytes is essential for the expansion of scientific research in this area, since these cells are so important and involved in different mechanisms of action, especially in neurodegenerative and autoimmune diseases.

Compartilhando conhecimento sobre o novo coronavírus: relato de experiência / Sharing knowledge about the new coronavirus: experience report / Compartir conocimientos sobre el nuevo coronavirus: informe de experiencia

Introdução: Em março de 2020 a Organização Mundial da Saúde decretou pandemia pelo novo coronavírus (SARS-CoV-2), causador da doença COVID-19. Objetivo: relatar a experiência sobre a disseminação de informações acerca do coronavírus. Método: Trata-se de um relato de experiência de graduandos do curso de enfermagem e pós-graduandos em patologia da Universidade Federal de São Paulo, na campanha Pílulas do conhecimento sobre a pandemia do novo coronavírus, realizada em março de 2020. Foi elaborado um boletim informativo e um vídeo educativo, baseado na literatura, com informações sobre o coronavírus (o que é, sintomas, transmissão, grupos de risco, prevenção, ação, uso de máscara e vacina) e o material foi disponibilizado virtualmente. Resultado: O boletim informativo e o vídeo educativo foram elaborados baseados na literatura. O vídeo obteve 151 visualizações no canal do Clube do Saber no YouTube e 490 pessoas no Facebook. Conclusão: A disseminação de informações sobre o novo coronavírus obteve grande alcance da população.

Introduction: In March 2020, World Health Organization declared a pandemic due tothenew coronavirus (SARS-CoV-2), which causes COVID-19. Objective: to promote health education, bringing relevant, clear and objective information about diseases. Methods: Thisisan experience report of undergraduate nursing students and graduate students in pathology, Universidade Federal de São Paulo, in the Pills of Knowledge campaign on the new coronavirus pandemic, held in March 2020. A newsletter and an educational video, withinformation about the coronavirus (what is, symptoms, transmission, risk groups, prevention, action, use of mask and vaccine) and, the material was made available virtually. Result: Thevideo obtained 151 views on the Clube do Saber channel on YouTube and 490 peoplebyFacebook. Conclusion: The dissemination of information about the coronavirus has reachedawide reach of the population

Introducción: en marzo de 2020, la Organización Mundial de la Salud declaró una pandemia debido al nuevo coronavirus (SARS-CoV-2), que causa COVID-19. Objetivo: realizar uninforme de experiencia acerca de la difusión de la información sobre el coronavirus. Métodos: Este es un informe de experiencia de estudiantes de la carrera de enfermería y estudiantes de posgrado en patología de la Universidad Federal de San Pablo, en la campaña Píldoras del conocimiento sobre la pandemia del nuevo coronavirus, realizada en marzo de 2020. Se elaboró un boletín informativo y un video educativo, con información sobre el coronavirus (qué es, síntomas, transmisión, grupos de riesgo, prevención, acción, uso de mascarilla y vacuna) y el material se puso a disposición de forma virtual. Resultado: la elaboración del boletín informativo y del video educativo se realizó en base a la literatura. El videoobtuvo151 visitas en el canal Clube do Saber en YouTube y llegó a 490 personas en Facebook. Conclusión: La difusión de información sobre el coronavirus tuvo un gran alcance en la población.

Meningiomas: A review of general, histopathological, clinical and molecular characteristics.

OBJECTIVES: In this review, the main histological and molecular characteristics of meningiomas will be addressed, as well as the aspects most related to clinical conditions, treatment, and survival of patients, enabling a better understanding of these tumors behavior. METHODS: This study was conducted with the search for published studies available on NCBI, PubMed, MEDLINE, Scielo and Google Scholar. Relevant documents have been identified and 50 articles were selected. RESULTS: The main points about meningiomas were characterized, as well as the histological presence of spontaneous necrosis in grade I and brain invasion as diagnostic criteria, their molecular origin related to deletion of chromosome 22 and mutations in theNF2 and TERT genes, in addition to their clinical characteristics. The preferential treatment remains the total resection of the tumor. CONCLUSION: The information about meningiomas is well known and necessary, but it is expected that more work will emerge related to the behavior of these tumors, and that the scientific community will obtain more clarity about the best ways to conduct the patients treatment.

Entendendo o câncer de mama: educação em saúde / Understanding breast cancer: health education

Objetivo: Demonstrar os benefícios da educação em saúde sobre o câncer de mama para a população. Métodos: Trata-se de um relato de experiência sobre educação em saúde, utilizando boletins informativos e banners elaborados pelos discentes, monitorado pelos alunos de pós-graduação em patologia e supervisionados pelos colaboradores e coordenadores do projeto, divulgados presencialmente para a comunidade. Resultados: Essa experiência trouxe como resultado maior aproveitamento das atividades didáticas e dinâmicas do ambulatório, com uma metodologia ativa, assim como o empoderamento dos usuários para a autonomia, capacidade de identificar determinantes para sua saúde e cuidar de si e dos outros a sua volta. Conclusão: Conclui-se então que esta atividade de educação foi enriquecedora tanto para os discentes que a organizaram quanto para clientes do ambulatório, expondo uma relação entre a prevenção e a promoção da saúde dos usuários e com um projeto de extensão que visa compartilhar o conhecimento adquirido na academia, transcendendo seus muros para todos. (AU)

Objective: To demonstrate the benefits of health education on breast cancer for the population. Methods: Descriptive-exploratory study with a qualitative approach, using newsletters and banners prepared by students, monitored by graduate students in pathology and supervised by project collaborators and coordinators and disseminated to the community. Results: This experience resulted in greater use of the didactic and dynamic activities of the clinic, with an active methodology, as well as the empowerment of users for autonomy, the ability to identify determinants for their health and to take care of themselves and others around them. Conclusion: We conclude then that the campaign was enriching both for the students who organized it and for clients of the outpatient clinic, exposing a relationship between prevention and health promotion of users and with an extension project that aims to share the knowledge acquired in the academy, transcending their walls for everyone. (AU)

Objetivo: Demostrar los beneficios de la educación para la salud sobre el cáncer para la población. Métodos: Estudio descriptivo-exploratorio con un enfoque cualitativo, utilizando boletines y pancartas preparados por estudiantes, monitoreados por estudiantes graduados en patología y supervisados por colaboradores y coordinadores del proyecto y entregado a la comunidad. Resultados: Esta experiencia resultó en un mayor uso de las actividades didácticas y dinámicas de la clínica, con una metodología activa, así como el empoderamiento de los usuarios para la autonomía, la capacidad de identificar determinantes para su salud y para cuidarse a sí mismos y a los demás a su alrededor. Conclusión: Concluimos entonces que la campaña fue enriquecedora tanto para los estudiantes que la organizaron como para los clientes de la clínica ambulatoria, exponiendo una relación entre prevención y promoción de la salud de los usuarios y con un proyecto de extensión que tiene como objetivo compartir el conocimiento adquirido en la academia, trascendiendo sus muros para todos. (AU)

Pilocytic Astrocytoma: A Review of General, Clinical, and Molecular Characteristics.

Pilocytic astrocytomas are the primary tumors most frequently found in children and adolescents, accounting for approximately 15.6% of all brain tumors and 5.4% of all gliomas. They are mostly found in infratentorial structures such as the cerebellum and in midline cerebral structures such as the optic nerve, hypothalamus, and brain stem. The present study aimed to list the main characteristics about this tumor, to better understand the diagnosis and treatment of these patients, and was conducted on search of the published studies available in NCBI, PubMed, MEDLINE, Scielo, and Google Scholar. It was possible to define the main histologic findings observed in these cases, such as mitoses, necrosis, and Rosenthal fibers. We described the locations usually most affected by tumor development, and this was associated with the most frequent clinical features. The comparison between the molecular diagnostic methods showed great use of fluorescent in situ hybridization, polymerase chain reaction (PCR), and reverse transcriptase-PCR, important techniques for the detection of BRAF V600E mutation and BRAF-KIAA1549 fusion, characteristic molecular alterations in pilocytic astrocytomas.

Necrosis is a consistent factor to recurrence of meningiomas: should it be a stand-alone grading criterion for grade II meningioma?

The purpose of this study was to evaluate spontaneous necrosis as a possible isolated factor for progression and recurrence in grade I meningiomas classified according to the current World Health Organization (WHO) classification. Meningiomas are the most frequently reported primary intracranial tumours, accounting for more than 35%. The 2016 WHO classification of central nervous system tumors stratifies meningiomas in grades I (benign), II (atypical), and III (malignant), according to histopathological aspects and the risk of progression or recurrence. Among 110 patients with intracranial meningiomas, 70 were WHO grade I meningiomas with no findings of atypia (G1WON), 15 were WHO grade I with necrosis (G1WN), 21 were WHO grade II (G2), and 4 were WHO grade III (G3). The mean follow-up was 5.9 ± 0.2 years. High performance scale (KPS ≥ 80) was different (p < 0.001) between WHO grade I meningiomas without (81.4%) and with (60%) necrosis. The 5-year mortality rate was 1.4, 6.7 and 5.9% for G1WON, G1WN and G2, respectively, with significant difference (p = 0.011) related to the presence of necrosis. The risk of recurrence was 3.7 times higher in G1WN than in G1WON (p = 0.017), and 4.2 times in G2 (p = 0.010). Progression-free survival (PFS) was clearly higher in patients with G1WON compared to G1WN and G2 (p = 0.002 and p < 0.001, respectively). There was no significant difference in PFS between G1WN and G2 (p = 0.692). Retreatment was also superior in meningioma with necrosis. Our findings provide clear statistical data to consider that patients with benign meningiomas and histologic findings of spontaneous necrosis are at increased risk of progression and recurrence compared to those with benign lesion without atypical features. Statistical analysis curves also suggest that these lesions behave more similarly to those currently classified as WHO grade II meningioma.

Weight loss and changes in surface roughness of denture base and reline materials after simulated toothbrushing in vitro.

OBJECTIVE: To evaluate the weight loss and the surface roughness of acrylic resins after simulated brushing tests. MATERIAL AND METHODS: Ten specimens of each material (Tokuyama Rebase II-TR, New Truliner-NT, Ufi Gel Hard-UH and Lucitone 550-L) were made. The wear loss (mg) by weight and the surface roughness (Ra µm) of each specimen was determined before and after brushing. The specimens were placed on the brushing machine and a total of 20,000 brushing cycles was performed. The results of weight loss and roughness values were submitted to the anova followed by the Tukey's test (p = 0.05). RESULTS: The mean weight loss of material L was statistically higher (p < 0.001) than that of the relines TR, UH and NT. No significant differences were found among the roughness values of resins TR, UH and L (p > 0.05). Only for L, toothbrushing increased the surface roughness. After toothbrushing, there was no significant difference between the roughness values of materials L and NT. The highest mean weight loss during the simulated toothbrushing tests was observed for L. Before the toothbrushing tests, the NT exhibited the highest mean roughness. CONCLUSION: Brushing resulted in increase in roughness only for resin L.