Predictors of autosomal dominant polycystic kidney disease progression: a Brazilian single-center cohort.

INTRODUCTION: Identifying risk factors for autosomal dominant polycystic kidney disease (ADPKD) progression is important. However, studies that have evaluated this subject using a Brazilian sample is sparce. Therefore, the aim of this study was to identify risk factors for renal outcomes and death in a Brazilian cohort of ADPKD patients. METHODS: Patients had the first medical appointment between January 2002 and December 2014, and were followed up until December 2019. Associations between clinical and laboratory variables with the primary outcome (sustained decrease of at least 57% in the eGFR from baseline, need for dialysis or renal transplantation) and the secondary outcome (death from any cause) were analyzed using a multiple Cox regression model. Among 80 ADPKD patients, those under 18 years, with glomerular filtration rate <30 mL/min/1.73 m2, and/or those with missing data were excluded. There were 70 patients followed. RESULTS: The factors independently associated with the renal outcomes were total kidney length - adjusted Hazard Ratio (HR) with a 95% confidence interval (95% CI): 1.137 (1.057-1.224), glomerular filtration rate - HR (95% CI): 0.970 (0.949-0.992), and serum uric acid level - HR (95% CI): 1.643 (1.118-2.415). Diabetes mellitus - HR (95% CI): 8.115 (1.985-33.180) and glomerular filtration rate - HR (95% CI): 0.957 (0.919-0.997) were associated with the secondary outcome. CONCLUSIONS: These findings corroborate the hypothesis that total kidney length, glomerular filtration rate and serum uric acid level may be important prognostic predictors of ADPKD in a Brazilian cohort, which could help to select patients who require closer follow up.

A study on interoperability between two Personal Health Train infrastructures in leukodystrophy data analysis.

The development of platforms for distributed analytics has been driven by a growing need to comply with various governance-related or legal constraints. Among these platforms, the so-called Personal Health Train (PHT) is one representative that has emerged over the recent years. However, in projects that require data from sites featuring different PHT infrastructures, institutions are facing challenges emerging from the combination of multiple PHT ecosystems, including data governance, regulatory compliance, or the modification of existing workflows. In these scenarios, the interoperability of the platforms is preferable. In this work, we introduce a conceptual framework for the technical interoperability of the PHT covering five essential requirements: Data integration, unified station identifiers, mutual metadata, aligned security protocols, and business logic. We evaluated our concept in a feasibility study that involves two distinct PHT infrastructures: PHT-meDIC and PADME. We analyzed data on leukodystrophy from patients in the University Hospitals of Tübingen and Leipzig, and patients with differential diagnoses at the University Hospital Aachen. The results of our study demonstrate the technical interoperability between these two PHT infrastructures, allowing researchers to perform analyses across the participating institutions. Our method is more space-efficient compared to the multi-homing strategy, and it shows only a minimal time overhead.

Increased expression of miR-320b in blood plasma of patients in response to SARS-CoV-2 infection.

Coronavirus disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Recent research has demonstrated how epigenetic mechanisms regulate the host-virus interactions in COVID-19. It has also shown that microRNAs (miRNAs) are one of the three fundamental mechanisms of the epigenetic regulation of gene expression and play an important role in viral infections. A pilot study published by our research group identified, through next-generation sequencing (NGS), that miR-4433b-5p, miR-320b, and miR-16-2-3p are differentially expressed between patients with COVID-19 and controls. Thus, the objectives of this study were to validate the expression of these miRNAs using quantitative real-time polymerase chain reaction (qRT-PCR) and to perform in silico analyses. Patients with COVID-19 (n = 90) and healthy volunteers (n = 40) were recruited. MiRNAs were extracted from plasma samples and validated using qRT-PCR. In addition, in silico analyses were performed using mirPath v.3 software. MiR-320b was the only miRNA upregulated in the case group com-pared to the control group. The in silico analyses indicated the role of miR-320b in the regulation of the KITLG gene and consequently in the inflammatory process. This study confirmed that miR-320b can distinguish patients with COVID-19 from control participants; however, further research is needed to determine whether this miRNA can be used as a target or a biomarker.

Genetic diversity and population structure of Piper nigrum (black pepper) accessions based on next-generation SNP markers.

Despite the economic importance of Piper nigrum (black pepper), a highly valued crop worldwide, development and utilization of genomic resources have remained limited, with diversity assessments often relying on only a few samples or DNA markers. Here we employed restriction-site associated DNA sequencing to analyze 175 P. nigrum accessions from eight main black pepper growing regions in Sri Lanka. The sequencing effort resulted in 1,976 million raw reads, averaging 11.3 million reads per accession, revealing 150,356 high-quality single nucleotide polymorphisms (SNPs) distributed across 26 chromosomes. Population structure analysis revealed two subpopulations (K = 2): a dominant group consisting of 152 accessions sourced from both home gardens and large-scale cultivations, and a smaller group comprising 23 accessions exclusively from native collections in home gardens. This clustering was further supported by principal component analysis, with the first two principal components explaining 35.2 and 12.1% of the total variation. Genetic diversity analysis indicated substantial gene flow (Nm = 342.21) and a low fixation index (FST = 0.00073) between the two subpopulations, with no clear genetic differentiation among accessions from different agro-climatic regions. These findings demonstrate that most current black pepper genotypes grown in Sri Lanka share a common genetic background, emphasizing the necessity to broaden the genetic base to enhance resilience to biotic and abiotic stresses. This study represents the first attempt at analyzing black pepper genetic diversity using high-resolution SNP markers, laying the foundation for future genome-wide association studies for SNP-based gene discovery and breeding.

The incidence of osteoradionecrosis of the jaws in oral cavity cancer patients treated with intensity-modulated radiotherapy: a systematic review and meta-analysis.

OBJECTIVE: A systematic review with meta-analysis was conducted to define the incidence of osteoradionecrosis (ORN) in patients with oral cavity cancer (OCC) treated with intensity-modulated radiotherapy (IMRT), and to identify the risk factors influencing its development. STUDY DESIGN: Six databases were searched systematically. A meta-analysis was performed to determine overall, spontaneous, and dental extraction-attributed incidences of ORN. The Grading of Recommendations Assessment, Development, and Evaluation tool evaluated evidence certainty. RESULTS: Out of 11 eligible studies, 6 underwent meta-analysis for the overall aggregated ORN incidence in OCC patients receiving IMRT, resulting in an incidence rate of 8% (95% CI: 6%-11%). Regarding development reasons, 2 studies were assessed, revealing an incidence of 36% (95% CI: 1%-98%) for spontaneous ORN, and 17% (95% CI: 5%-44%) ensued from dental extraction exclusively pre-RT. All rates had very low certainty of evidence. Factors significantly correlated with ORN development included postoperative RT use (78%), employment of therapeutic doses above 50 Gy, and mandibular involvement (80.5%). CONCLUSION: The findings suggest that IMRT alone is not sufficient to decrease ORN rates in OCC patients, underscoring the importance of precisely identifying the involved risk factors. However, further detailed primary studies will be necessary.

Predicting kidney allograft survival with explainable machine learning.

INTRODUCTION: Despite significant progress over the last decades in the survival of kidney allografts, several risk factors remain contributing to worsening kidney function or even loss of transplants. We aimed to evaluate a new machine learning method to identify these variables which may predict the early graft loss in kidney transplant patients and to assess their usefulness for improving clinical decisions. MATERIAL AND METHODS: A retrospective cohort study was carried out with 627 kidney transplant patients followed at least three months. All these data were pre-processed, and their selected features were used to develop an automatically working a machine learning algorithm; this algorithm was then applied for training and parameterization of the model; and finally, the tested model was then used for the analysis of patients' features that were the most impactful for the prediction of clinical outcomes. Our models were evaluated using the Area Under the Curve (AUC), and the SHapley Additive exPlanations (SHAP) algorithm was used to interpret its predictions. RESULTS: The final selected model achieved a precision of 0.81, a sensitivity of 0.61, a specificity of 0.89, and an AUC value of 0.84. In our model, serum creatinine levels of kidney transplant patients, evaluated at the hospital discharge, proved to be the most important factor in the decision-making for the allograft loss. Patients with a weight equivalent to a BMI closer to the normal range prior to a kidney transplant are less likely to experience graft loss compared to patients with a BMI below the normal range. The age of patients at transplantation and Polyomavirus (BKPyV) infection had significant impact on clinical outcomes in our model. CONCLUSIONS: Our algorithm suggests that the main characteristics that impacted early allograft loss were serum creatinine levels at the hospital discharge, as well as the pre-transplant values such as body weight, age of patients, and their BKPyV infection. We propose that machine learning tools can be developed to effectively assist medical decision-making in kidney transplantation.

Resistance of the fiber-derived geotextile from Typha domingensis submitted to field degradation.

Geotextiles made from plant fibers creates a suitable environment for plant growth as part of soil bioengineering techniques. The faster decomposition of plant fiber geotextiles compared to synthetic ones demands the use of composites that enhance their waterproofing and extend their durability in the environment. The objective of this work was to evaluate the resistance of a geotextile made with Thypha domingensis to degradation caused by climatic variables. Tensile strength tests were conducted in the laboratory in order to evaluate the degradation of geotextiles treated with single and double layers of waterproofing resin. Based on Scanning Electron Microscopy (SEM) images, it was verified that applying double layer of waterproofing resin delays the fibers degradation up to 120 days of exposure to the effects of climatic variables other than temperature. The maximum resistance losses due to the geotextile's exposure to degradation were statistically significant for all three treatments: control-without waterproofing resin, with one layer resin, and with two layers resin. Therefore, waterproofing resin, provides a long-term protective solution for geotextiles made from cattail fibers.

Brazilian Women in Paralympic Sports: Uncovering Historical Milestones in the Summer Paralympic Games.

The journey of Brazilian female Paralympians transcends mere statistical increases in women's participation. Behind the modest athlete growth lies the reality of women who are doubly marginalized by the intersection of gender and disability in an arena tailored for able-bodied men. Our study aimed to catalyze critical discourses surrounding the historical trajectory of Paralympic women's sports. Through a comprehensive documentary analysis based on the Brazilian Paralympic Committee's official documents from 1976 to 2021, we sought to shed light on this complex scenario. Numerically, Brazil's representation comprised 229 women who, predominantly, had physical impairments and engaged in individual sports. In addition to a sporting legacy deeply entrenched in physical rehabilitation with limited opportunities for team-based sports, we observed negative influences stemming from ableist and sexist narratives. A thorough investigation into Paralympic milestones revealed a multitude of social barriers and highlighted the significant impact of societal changes in reshaping athletic opportunities and challenging traditional stereotypes.

Paralympic Versus Olympic Canoe Sprint: Comprehension of the Development Trajectory of the Kayak 200 Meters.

Improvements in race times for male and female Para canoe athletes across different sports classes have led to a reduction in relative differences between classes over time. However, there is a lack of research examining the comparative developmental trajectories between high-performance Paralympic (PCS) and Olympic (OCS) canoe sprint. In this study, we compared the developmental trajectories of 200-meter kayak performances among PCS and OCS athletes. In total, we analyzed 628 race results obtained from public online databases, for nine competitions between 2015 and 2023. Race times were reduced over the years except in specific sports classes (KL3-M, K1-M, and K1-F; KL: Kayak Level, M: male, F: female), with a poor positive correlation (r = 0.17 to 0.33) between time and the years. For the remaining sports classes, these correlations ranged from poor to fair (r = -0.58 to -0.13). OCS K1 athletes outperformed their Paralympic counterparts. Among Paralympic classes, KL1 had slower times than KL2 and KL3 (p ≤ .05), with KL2 times significantly lower than KL3 in the female category. OCS athletes exhibited less variability in race times compared to PCS athletes. In the male category, there were no significant differences in the coefficients of variation (CV) and amplitude of race times between sport classes, except for KL1-M, which had a larger CV than K1 (p ≤ .05). In the female category, the CV and amplitude of race times were significantly higher in KL1-F compared to KL3-F and K1-F. OCS times remained stable from 2015, with KL3-M following a similar trend. PCS displayed greater race time variability, particularly in higher impairment classes, notably KL1. This underscores the existence of distinct developmental stages within the canoe sprint modality, particularly emphasizing the early developmental phase of KL1. It also provides valuable insights for coaches and sports selection, especially concerning athletes with more severe impairments, including those in Rehabilitation Centers and during athlete recruitment.

CAM evolution is associated with gene family expansion in an explosive bromeliad radiation.

The subgenus Tillandsia (Bromeliaceae) belongs to one of the fastest radiating clades in the plant kingdom and is characterised by the repeated evolution of Crassulacean acid metabolism (CAM). Despite its complex genetic basis, this water-conserving trait has evolved independently across many plant families and is regarded as a key innovation trait and driver of ecological diversification in Bromeliaceae. By producing high-quality genome assemblies of a Tillandsia species pair displaying divergent photosynthetic phenotypes, and combining genome-wide investigations of synteny, transposable element (TE) dynamics, sequence evolution, gene family evolution and temporal differential expression, we were able to pinpoint the genomic drivers of CAM evolution in Tillandsia. Several large-scale rearrangements associated with karyotype changes between the two genomes and a highly dynamic TE landscape shaped the genomes of Tillandsia. However, our analyses show that rewiring of photosynthetic metabolism is mainly obtained through regulatory evolution rather than coding sequence evolution, as CAM-related genes are differentially expressed across a 24-hour cycle between the two species but are not candidates of positive selection. Gene orthology analyses reveal that CAM-related gene families manifesting differential expression underwent accelerated gene family expansion in the constitutive CAM species, further supporting the view of gene family evolution as a driver of CAM evolution.

Bridging the gap between movement data and connectivity analysis using the Time-Explicit Habitat Selection (TEHS) model.

BACKGROUND: Understanding how to connect habitat remnants to facilitate the movement of species is a critical task in an increasingly fragmented world impacted by human activities. The identification of dispersal routes and corridors through connectivity analysis requires measures of landscape resistance but there has been no consensus on how to calculate resistance from habitat characteristics, potentially leading to very different connectivity outcomes. METHODS: We propose a new model, called the Time-Explicit Habitat Selection (TEHS) model, that can be directly used for connectivity analysis. The TEHS model decomposes the movement process in a principled approach into a time and a selection component, providing complementary information regarding space use by separately assessing the drivers of time to traverse the landscape and the drivers of habitat selection. These models are illustrated using GPS-tracking data from giant anteaters (Myrmecophaga tridactyla) in the Pantanal wetlands of Brazil. RESULTS: The time model revealed that the fastest movements tended to occur between 8 p.m. and 5 a.m., suggesting a crepuscular/nocturnal behavior. Giant anteaters moved faster over wetlands while moving much slower over forests and savannas, in comparison to grasslands. We also found that wetlands were consistently avoided whereas forest and savannas tended to be selected. Importantly, this model revealed that selection for forest increased with temperature, suggesting that forests may act as important thermal shelters when temperatures are high. Finally, using the spatial absorbing Markov chain framework, we show that the TEHS model results can be used to simulate movement and connectivity within a fragmented landscape, revealing that giant anteaters will often not use the shortest-distance path to the destination patch due to avoidance of certain habitats. CONCLUSIONS: The proposed approach can be used to characterize how landscape features are perceived by individuals through the decomposition of movement patterns into a time and a habitat selection component. Additionally, this framework can help bridge the gap between movement-based models and connectivity analysis, enabling the generation of time-explicit connectivity results.

Contributions to Odontogryllini (Orthoptera: Gryllidae: Landrevinae) with comments on its taxonomic status and description of a new species of Xulavuna de Mello & Campos, 2014.

Odontogryllini is a tribe of ground-dwelling crickets exclusive to America. After several taxonomic rearrangements, this tribe has five genera and 23 species now placed in the subfamily Landrevinae. These crickets have dorsoventrally depressed bodies and are moderately to densely covered with bristles. The males may bear tegminal, metanotal, or tergal glands. In this contribution, we discuss the taxonomic status and the morphological features of Odontogryllini and the other two tribes of Landrevinae: Landrevini and Prolandrevini. The presence of dorsal spines between the outer spurs of the hind tibia distinguishes Odontogryllini from Prolandrevini, and the straight or slightly arcuate but never S-shaped stridulum from Landrevini. We also propose the enlarged and plate-like rami as a diagnostic characteristic to distinguish Odontogryllini from Landrevini. Additionally, we describe a new species of the genus Xulavuna de Mello & Campos from the Brazilian Amazon Rainforest, named Xulavuna krenakore sp. nov..

Assessment of the ecological quality status of the Sepetiba Bay (SE Brazil): When metabarcoding meets morphology on foraminifera.

In recent years, the region surrounding Sepetiba Bay (SB; SE Brazil) has become a hub of intense urban expansion and economic exploitation in response to ore transport and industrial and port activities. As a result, contaminants have been introduced into the bay, leading to an overall worsening of the environmental quality. The present work applies for the first time a foraminiferal morphology-based approach (M) and eDNA-based metabarcoding sequencing (G), along with geochemical data to assess the ecological quality status (EcoQS) in the SB. Principal component analysis shows that the eDNA and morphospecies diversity as well as most of the taxa relative abundance decline in response to the environmental stress (ES) gradient related to total organic carbon (TOC) and metal pollution. Based on ecological indices, Exp(H'bc) (G), Exp(H'bc) (M), foraminifera ATZI marine biotic index (Foram-AMBI), Foram Stress Index (FSI), and geochemical indices (TOC and Potential Ecological Risk Index), the lowest values of EcoQS (i.e., bad to moderate) are inferred in the innermost part of the SB. Despite minor discrepancies among the six EcoQS indices, an agreement has been found for 63% of the stations. To improve the agreement between the ecological indices, it is necessary to fill the gap in species ecology; information on the ecology of many species is still unknown. This work reinforces the importance of molecular analysis and morphological methods in environmental impact studies and confirms the reliability of foraminiferal metabarcoding in EcoQS assessment. This is the first study evaluating the EcoQS in the South Atlantic by using combined foraminiferal eDNA metabarcoding with morphological data.

Why adverse outcome pathways need to be FAIR.

Adverse outcome pathways (AOPs) provide evidence for demonstrating and assessing causality between measurable toxicological mechanisms and human or environmental adverse effects. AOPs have gained increasing attention over the past decade and are believed to provide the necessary steppingstone for more effective risk assessment of chemicals and materials and moving beyond the need for animal testing. However, as with all types of data and knowledge today, AOPs need to be reusable by machines, i.e., machine-actionable, in order to reach their full impact potential. Machine-actionability is supported by the FAIR principles, which guide findability, accessibility, interoperability, and reusability of data and knowledge. Here, we describe why AOPs need to be FAIR and touch on aspects such as the improved visibility and the increased trust that FAIRification of AOPs provides.

New approach methodologies (NAMs) can detect biological phenomena that occur before they add up to serious problems like cancer, infertility, death, and others. NAMs detect key events (KE) along well-proven and agreed adverse outcome pathways (AOP). If a substance tests positive in a NAM for an upstream KE, this signals an early warning that actual adversity might follow. However, what if the knowledge about these AOPs is a well-kept secret? And what if decision-makers find AOPs too exotic to apply in risk assessment? This is where FAIR comes in! FAIR stands for making information findable, accessible, interoperable and re-useable. It aims to increase availability, usefulness, and trustworthiness of data. Here, we show that by interpreting the FAIR principles beyond a purely technical level, AOPs can ring in a new era of 3Rs applicability ‒ by increasing their visibility and making their creation process more transparent and reproducible.

Comparing plasma and skin imprint metabolic profiles in COVID-19 diagnosis and severity assessment.

As SARS-CoV-2 continues to produce new variants, the demand for diagnostics and a better understanding of COVID-19 remain key topics in healthcare. Skin manifestations have been widely reported in cases of COVID-19, but the mechanisms and markers of these symptoms are poorly described. In this cross-sectional study, 101 patients (64 COVID-19 positive patients and 37 controls) were enrolled between April and June 2020, during the first wave of COVID-19, in São Paulo, Brazil. Enrolled patients had skin imprints sampled non-invasively using silica plates; plasma samples were also collected. Samples were used for untargeted lipidomics/metabolomics through high-resolution mass spectrometry. We identified 558 molecular ions, with lipids comprising most of them. We found 245 plasma ions that were significant for COVID-19 diagnosis, compared to 61 from the skin imprints. Plasma samples outperformed skin imprints in distinguishing patients with COVID-19 from controls, with F1-scores of 91.9% and 84.3%, respectively. Skin imprints were excellent for assessing disease severity, exhibiting an F1-score of 93.5% when discriminating between patient hospitalization and home care statuses. Specifically, oleamide and linoleamide were the most discriminative biomarkers for identifying hospitalized patients through skin imprinting, and palmitic amides and N-acylethanolamine 18:0 were also identified as significant biomarkers. These observations underscore the importance of primary fatty acid amides and N-acylethanolamines in immunomodulatory processes and metabolic disorders. These findings confirm the potential utility of skin imprinting as a valuable non-invasive sampling method for COVID-19 screening; a method that may also be applied in the evaluation of other medical conditions. KEY MESSAGES: Skin imprints complement plasma in disease metabolomics. The annotated markers have a role in immunomodulation and metabolic diseases. Skin imprints outperformed plasma samples at assessing disease severity. Skin imprints have potential as non-invasive sampling strategy for COVID-19.

Odontogenic maxillary sinusitis associated with foreign body displacement after tooth extraction: report of an unusual case / Sinusite maxilar odontogênica por corpo estranho após extração dentária: relato de um caso incomum

Background: Odontogenic maxillary sinusitis caused by a foreign body presents diagnostic and therapeutic challenges due to its infrequent occurrence and unique characteristics compared to sinusitis originating from other sources. CaseReport:Illustrating such fact, this report presents the clinical case of a 37-year-old woman referred complaining of pain in the same region where she had extracted her upper right first molar five days before. The intraoral examination revealed the presence of an orifice in the region, suggesting oroantral communication. Imaging exams revealed opacification of the right maxillary sinus and the unexpected presence of a highly radiodense object. With the diagnosis of maxillary sinusitis due to a foreign body established, the surgical approach initially consisted of administering preoperative medication, preceded by access to the maxillary antrum using the Caldwell-Luc technique. The object was found and removed, consisting of a surgical drill. At follow-up there was complete absence of symptoms and complete closure of communication. Conclusion: Cases of odontogenic maxillary sinusitis caused by drill detachment after tooth extraction are fairly uncommon. A thorough clinical evaluation proved to be essential and the Caldwell-Luc access was effective, safe and with good postoperative results, even with the absence of standardized diagnostic and management methods(AU)

Contexto: A sinusite maxilar odontogênica causada por corpo estranho apresenta desafios diagnósticos e terapêuticos devido à sua ocorrência infrequente e características únicas em comparação com sinusites originadas de outras fontes. Relato do Caso: Ilustrando tal fato, este relato apresenta o caso clínico de uma mulher de 37 anos de idade encaminhada com queixa de dor em mesma região que havia extraído o primeiro molar superior direito cinco dias antes. Ao exame intraoral verificou-se a presença de um orifício na região, sugerindo comunicação oroantral. Os exames de imagem revelaram opacificação do SM direito e a inesperada presença de um objeto altamente radiodenso. Com o diagnóstico de sinusite maxilar por corpo estranho estabelecido, a abordagem cirúrgica consistiu inicialmente na administração de medicação pré-operatória, precedida pelo acesso ao antro maxilar através da técnica de Caldwell-Luc. O objeto foi encontrado e removido, consistindo em uma broca cirúrgica. Ao acompanhamento houve ausência completa dos sintomas e total fechamento da comunicação. Conclusão: Casos de sinusite maxilar odontogênica causada por descolamento da broca após extração dentária são bastante incomuns. Uma avaliação clínica minuciosa mostrou-se primordial e o acesso de Caldwell-Luc eficaz, seguro e com bons resultados pós-operatórios, mesmo com as ausências de métodos de diagnóstico e manejo padronizados.(AU)

Sarcoma de Ewing da cabeça aos pés: Uma revisão dos achados radiológicos / Ewing sarcoma from head to toe: A review of radiological findings

O Sarcoma de Ewing (SE) é uma neoplasia agressiva, pertencente à família dos tumores de pequenas células azuis e redondas, semelhante as células primitivas, de aspecto semelhante aos tumores neuroectodérmicos primitivos (PNET) que acomete as partes moles. O SE ocorre principalmente em crianças e adultos jovens, com incidência variando de 1 a 3 casos / milhão de habitantes, sendo mais frequente em descendentes europeus. Representa cerca de 2% das neoplasias malignas na faixa pediátrica, sendo o segundo tumor ósseo mais comum nas crianças. Cerca de 20% dos SE são extraósseos, acometendo principalmente adultos. Os achados clínicos dos SE são bem variados, estando relacionado principalmente com a localização. A avaliação por imagem é de extrema importância no diagnóstico do SE, principalmente ósseo. Esse estudo tem como objetivo apresentar os diversos aspectos radiológicos das lesões do SE. As características presentes nas imagens do SE ósseo são bastante sugestivas do diagnóstico. A radiografia (Rx) evidencia lesões líticas, com limites imprecisos, destruição óssea agressiva, com áreas de osso sadio de permeio (aspecto roído de traça), principalmente na região metadiafisária do osso. Além disso, o Rx fornece informações acerca do crescimento subperiosteal da lesão, traduzindo-se em reação periosteal que pode ser em "raios de sol", em "casca de cebola" ou triângulo de Codman. A tomografia computadorizada (TC) auxilia na identificação e melhor caracterização da lesão óssea e a presença de calcificações em tecidos moles. Na TC, o SE pode apresentar-se como lesão expansiva, com captação heterogênea ao meio de contraste e extensão para partes moles. Na TC, as lesões são líticas, com reação periosteal agressiva. Na ressonância magnética (RM), os SE tendem a apresentar baixo sinal em T1, com realce heterogêneo ao contraste paramagnético e sinal heterogêneo nas sequências em T2, estreitando as possibilidades diagnósticas. A RM também auxilia na determinação do real tamanho das lesões, com a distinção entre edema, hemorragia e lesão. Quando esses achados ocorrem em adolescentes e adultos jovens, o SE deve ser considerado como hipótese diagnóstica

Ewing's Sarcoma (SE) is an aggressive neoplasm, belonging to the family of small blue and round cell tumors, similar to primitive cells, with an appearance similar to primitive neuroectodermal tumors (PNET) that affects soft tissues. SE occurs mainly in children and young adults, with an incidence ranging from 1 to 3 cases/million inhabitants, being more frequent in people of European descent. It represents around 2% of malignant neoplasms in pediatrics, being the second most common bone tumor in children. Around 20% of ES are extra-osseous, affecting mainly adults. The clinical findings of ES are quite varied, being mainly related to the location. Imaging assessment is extremely important in the diagnosis of SE, especially bone. This study aims to present the different radiological aspects of ES injuries. The characteristics present in the bone SE images are quite suggestive of the diagnosis. The radiograph (X-ray) shows lytic lesions, with imprecise limits, aggressive bone destruction, with areas of healthy bone in between (moth-eaten appearance), mainly in the metadiaphyseal region of the bone. Furthermore, the X-ray provides information about the subperiosteal growth of the lesion, translating into a periosteal reaction that can be in the form of "sun rays", "onion skin" or Codman's triangle. Computed tomography (CT) helps to identify and better characterize the bone lesion and the presence of calcifications in soft tissues. On CT, SE may appear as an expansile lesion, with heterogeneous contrast medium uptake and extension to soft tissues. On CT, the lesions are lytic, with an aggressive periosteal reaction. On magnetic resonance imaging (MRI), ES tend to present low signal on T1, with heterogeneous enhancement on paramagnetic contrast and heterogeneous signal on T2 sequences, narrowing the diagnostic possibilities. MRI also helps to determine the real size of the lesions, with the distinction between edema, hemorrhage and injury. When these findings occur in adolescents and young adults, SE should be considered as a diagnostic hypothesis