Antimicrobial resistance in Aeromonas species isolated from aquatic environments in Brazil.

AIM: The current study was conducted to determine the antimicrobial resistance profile and genetic relatedness of Aeromonas sp. isolated from healthcare and urban effluents, wastewater treatment plant (WWTP) and river water. METHODS AND RESULTS: We detected the presence of genes conferring resistance to ß-lactam, quinolone and aminoglycoside. Multilocus sequence typing was carried out to differentiate the strains, and multilocus phylogenetic analysis was used to identify the species. A total of 28 cefotaxime-resistant Aeromonas sp. strains were identified, harbouring uncommon Guiana-extended-spectrum (GES)-type ß-lactamases (GES-1, GES-5, GES-7 and GES-16). Multidrug-resistant Aeromonas sp. were found in hospital wastewater, WWTP and sanitary effluent, and A. caviae was identified as the most prevalent species (85·7%). CONCLUSION: The release of untreated healthcare effluents, presence of antimicrobials in the environment, in addition to multidrug-resistant Aeromonas sp., are all potential factors for the spread of resistance. SIGNIFICANCE AND IMPACT OF THE STUDY: We identified a vast repertoire of antimicrobial resistance genes (ARG) in Aeromonas sp. from diverse aquatic ecosystems, including those that encode enzymes degrading broad-spectrum antimicrobials widely used to treat healthcare-associated infections. Hospital and sanitary effluents serve as potential sources of bacteria harbouring ARG and are a threat to public health.

[Osteosynthesis with locking plate and minimally invasive technique for proximal humeral fractures]. / Osteosíntesis con placa bloqueada y técnica de mínima invasión para las fracturas de húmero proximal.

OBJECTIVE: To report our experience in the treatment of 2-3 fragment proximal humeral fractures using a minimally invasive technique that involves an angular-stable locking implant and find out the factors affecting patients outcomes. MATERIAL AND METHODS: Descriptive, prospective study of the case series type. Twenty-two patients, 13 females and 9 males, were operated on between February 2010 and August 2012. Mean age was 50.8 years (24-82 years). Patients were placed in a beach-chair position. A lateral acromial approach was used under fluoroscopic guidance. Minimal follow-up period was 24.3 months (11-32). Follow-up consisted of X-ray review to check for bone healing and avascular necrosis, and functional assessment using the Constant-Murley scale. RESULTS: Bone healing occurred in all cases at 6 months. There were no cases of avascular necrosis. Two patients had varus healing (109º), and two had plate impingement. The functional assessment score according to the Constant-Murley scale was 68.8. There were no associated neurologic lesions. CONCLUSIONS: Fixation of proximal humeral fractures with a minimally invasive technique using locking plates represents a valid surgical approach. The avascular necrosis rate was low and early rehabilitation was possible in patients with poor bone quality.

OBJETIVO: Dar a conocer nuestra experiencia en el tratamiento de las fracturas de húmero proximal de 2 a 3 partes con técnica de mínima invasión mediante el uso de un implante con estabilidad angular bloqueado e investigar los factores que afectan los resultados de los pacientes. MATERIAL Y MÉTODOS: Estudio descriptivo y prospectivo tipo serie de casos. De 22 pacientes fueron intervenidos 13 mujeres y nueve hombres en el período comprendido entre Febrero de 2010 y Agosto de 2012. El rango de edad media fue 50.8 años (24-82 años). Se hizo un abordaje acromial lateral con el paciente en posición de silla de playa bajo visión fluoroscópica. El tiempo de seguimiento mínimo fue de 24.3 meses (11-32). El seguimiento se hizo mediante revisión de radiografías para la consolidación y necrosis avascular y la valoración funcional de la escala de Constant. RESULTADOS: En todos los casos se observó consolidación de la fractura a los seis meses. No se detectaron casos con necrosis avascular. Dos pacientes mostraron consolidación en varo (109o). Dos pacientes presentaron pinzamiento por la placa. El resultado funcional según la escala de valoración de Constant-Murley fue de 68.8 puntos. No hubo lesiones neurológicas asociadas. CONCLUSIONES: La fijación con técnica mínimamente invasiva para las fracturas de húmero proximal con placas bloqueadas es una alternativa válida como tratamiento quirúrgico. La incidencia de necrosis avascular fue baja y se permitió una rehabilitación temprana en pacientes de mala calidad ósea.

Osteosíntesis con placa bloqueada y técnica de mínima invasión para las fracturas de húmero proximal / Osteosynthesis with locking plate and minimally invasive technique for proximal humeral fractures

Resumen: Objetivo: Dar a conocer nuestra experiencia en el tratamiento de las fracturas de húmero proximal de 2 a 3 partes con técnica de mínima invasión mediante el uso de un implante con estabilidad angular bloqueado e investigar los factores que afectan los resultados de los pacientes. Material y métodos: Estudio descriptivo y prospectivo tipo serie de casos. De 22 pacientes fueron intervenidos 13 mujeres y nueve hombres en el período comprendido entre Febrero de 2010 y Agosto de 2012. El rango de edad media fue 50.8 años (24-82 años). Se hizo un abordaje acromial lateral con el paciente en posición de silla de playa bajo visión fluoroscópica. El tiempo de seguimiento mínimo fue de 24.3 meses (11-32). El seguimiento se hizo mediante revisión de radiografías para la consolidación y necrosis avascular y la valoración funcional de la escala de Constant. Resultados: En todos los casos se observó consolidación de la fractura a los seis meses. No se detectaron casos con necrosis avascular. Dos pacientes mostraron consolidación en varo (109o). Dos pacientes presentaron pinzamiento por la placa. El resultado funcional según la escala de valoración de Constant-Murley fue de 68.8 puntos. No hubo lesiones neurológicas asociadas. Conclusiones: La fijación con técnica mínimamente invasiva para las fracturas de húmero proximal con placas bloqueadas es una alternativa válida como tratamiento quirúrgico. La incidencia de necrosis avascular fue baja y se permitió una rehabilitación temprana en pacientes de mala calidad ósea.

Abstract: Objective: To report our experience in the treatment of 2-3 fragment proximal humeral fractures using a minimally invasive technique that involves an angular-stable locking implant and find out the factors affecting patients' outcomes. Material and methods: Descriptive, prospective study of the case series type. Twenty-two patients, 13 females and 9 males, were operated on between February 2010 and August 2012. Mean age was 50.8 years (24-82 years). Patients were placed in a beach-chair position. A lateral acromial approach was used under fluoroscopic guidance. Minimal follow-up period was 24.3 months (11-32). Follow-up consisted of X-ray review to check for bone healing and avascular necrosis, and functional assessment using the Constant-Murley scale. Results: Bone healing occurred in all cases at 6 months. There were no cases of avascular necrosis. Two patients had varus healing (109º), and two had plate impingement. The functional assessment score according to the Constant-Murley scale was 68.8. There were no associated neurologic lesions. Conclusions: Fixation of proximal humeral fractures with a minimally invasive technique using locking plates represents a valid surgical approach. The avascular necrosis rate was low and early rehabilitation was possible in patients with poor bone quality.

[Prevalence and frequency of factors associated with infection in patients older than 18 years with closed fractures]. / Prevalencia y frecuencia de factores asociados a infección en pacientes mayores de 18 años con fracturas cerradas.

INTRODUCTION: Surgical site infection (ISO) is the most common nosocomial infection and is a process associated with multiple factors, which together generate a condition that directly affects the welfare of the patient. MATERIAL AND METHODS: Cross-sectional study, conducted over 1 year period, the sample size was established for all patients who met the inclusion criteria. An instrument takes the variables; double tabulation of patients is performed in Excel 2013 and data are analyzed in Stata version 11. RESULTS: The average age was 44.3 ± 18.8 years and the male: female ratio is 1.7:1. Clinical features, lower limbs are the most affected and 21.9 % of cases affect the femur. A prevalence of 6.6 % was found, being the most common deep infection classification. Staphylococcus aureus was cultured in 38.5% of which 40% were methicillin sensible. CONCLUSION: ISO prevalence in patients with closed fractures in HUS is 6.6% higher compared with literature data. The findings of this study it was established that hemoglobin below 10 g/dl, transfusion, reoperation and surgical risk ASA were associated statistically with ISO.

La infección de sitio operatorio (ISO) es la infección nosocomial más común y es un proceso asociado a múltiples factores, los cuales en conjunto generan una alteración que afecta directamente el bienestar del paciente.

[Subtrochanteric fracture in children treated with minimally invasive surgery: case report]. / Fractura subtrocantérica en niños manejada con cirugía de mínima invasión: Reporte de casos.

Subtrochanteric fractures in children are rare events that occur in only 4% of all femur fractures; most injuries occur as a result of high-energy trauma, being young male patients the most affected. The management of this type of injury is controversial; there are many forms of treatment, including the use of plaster spica 90-90, closed reduction and use of elastic or rigid intramedullary nails, open reduction and plate placement, and the use of external fixators. Most suggest that for children under 10 a nonoperative approach should be preferred and that older ones should be managed surgically, but it is between six and 12-year-olds that most of the controversy exists. In this article, we present the management of this entity with a proximal fracture plate using a minimally invasive technique.

Las fracturas subtrocantéricas en niños son eventos poco frecuentes que se presentan en solo 4% de todas las fracturas de fémur; la mayoría de las lesiones ocurren como resultado de traumas de alta energía, siendo el paciente joven de sexo masculino el más afectado. El manejo de este tipo de lesión es controversial; existen muchas modalidades de tratamiento, como el uso de espica de yeso en 90-90, reducción cerrada y uso de clavos elásticos o rígidos endomedulares, reducción abierta y fijación con placas y, finalmente, el uso de fijadores externos. La mayoría proponen que para niños menores de 10 años, se debe preferir el manejo no quirúrgico y en mayores, el manejo quirúrgico, pero la discusión se produce entre los seis y 12 años de edad, en donde está la mayor parte de la polémica. En la actualidad, en el Hospital Universitario de Santander, tratamos este tipo de fracturas mediante técnica de mínima incisión con placa autobloqueada para fémur proximal en niños, con buenos resultados.

[Surgical treatment of subtrochanteric fractures in children]. / Tratamiento quirúrgico de fracturas subtrocantéricas en niños.

Subtrochanteric fractures in children are rare events, occur in only 4% of all femur fractures, most injuries occur as a result of high energy trauma, being young males patient the most affected. The management of this type of injury is controversial, there are many forms of treatment, including the use of plaster spica 90-90, closed reduction and use of elastic or rigid intramedullary nails, open reduction and plate placement and external fixators. Most suggest that children under 10 should be preferred non-operative and for older than 12 surgical management is indicated, but the discussion is between 6 and 12 years old. Through this article we present the treatment of such entity with a proximal fracture plate using a minimally invasive technique.

Las fracturas subtrocantéricas en niños son eventos poco frecuentes que se presentan en sólo 4% de todas las fracturas de fémur, la mayoría de lesiones ocurren como resultado de traumas de alta energía, siendo el paciente joven de sexo masculino el más afectado. El manejo de este tipo de lesión es controversial, existen muchas modalidades de tratamiento como el uso de espica de yeso en 90-90, reducción cerrada y uso de clavos elásticos o rígidos endomedulares, reducción abierta y fijación con placas y finalmente, el uso de fijadores externos. La mayoría propone que para niños menores de 10 años debe preferirse el manejo no quirúrgico y en mayores el manejo quirúrgico, pero la discusión se produce entre los 6 y 12 años de edad, período en el que radica la mayor parte de la polémica. En la actualidad tratamos este tipo de fracturas en el hospital universitario mediante técnica de mínima incisión con placa autobloqueada para fémur proximal en niños con buenos resultados.

[Femoral head chondroblastoma and reconstruction with osteochondral allograft. Case report]. / Condroblastoma de la cabeza femoral y reconstrucción con aloinjerto osteocondral. Reporte de caso.

Femoral head chondroblastoma is an infrequent tumor, accounting for approximately 1-2% of benign bone tumors. It occurs more frequently in young male patients. It's most frequent locations include the proximal humerus, proximal femur, distal femur and proximal tibia. The femoral head is the third most frequent site of this tumor. There is no specific treatment for this entity; reported treatments range from acetabular osteotomies and osteochondral grafts, to vascularized fibular grafts, all of them with good results. However, this tumor is clinically unpredictable if left untreated. We report a case managed with osteochondral graft and followed-up for three years after the surgical procedure.

Chromosome evolution in dendropsophini (Amphibia, Anura, Hylinae).

Dendropsophini is the most species-rich tribe within Hylidae with 234 described species. Although cytogenetic information is sparse, chromosome numbers and morphology have been considered as an important character system for systematic inferences in this group. Using a diversity of standard and molecular techniques, we describe the previously unknown karyotypes of the genera Xenohyla, Scarthyla and Sphaenorhynchus and provide new information on Dendropsophus and Lysapsus. Our results reveal significant karyotype diversity among Dendropsophini, with diploid chromosome numbers ranging from 2n = 22 in S. goinorum, 2n = 24 in Lysapsus, Scinax, Xenohyla, and almost all species of Sphaenorhynchus and Pseudis, 2n = 26 in S. carneus, 2n = 28 in P. cardosoi, to 2n = 30 in all known Dendropsophus species. Although nucleolar organizer regions (NORs) and C-banding patterns show a high degree of variability, NOR positions in 2n = 22, 24 and 28 karyotypes and C-banding patterns in Lysapsus and Pseudis are informative cytological markers. Interstitial telomeric sequences reveal a diploid number reduction from 24 to 22 in Scarthyla by a chromosome fusion event. The diploid number of X. truncata corroborates the character state of 2n = 30 as a synapomorphy of Dendropsophus.

Use of microsatellite markers in molecular analysis of segregating populations of papaya (Carica papaya L.) derived from backcrossing.

Brazil is the world leader in papaya production. However, only a small number of cultivars are registered for commercial planting, mainly owing to delays in obtaining cultivars and the high costs of the field phase of breeding programs. These costs can be reduced when molecular tools are combined with conventional breeding methods. In the present study, we conducted a molecular analysis of a self-fertilized population of a first backcrossing generation of BC1S1 papaya plants via microsatellite markers both to monitor the level of homozygosity and the gene/allele transfer that confers the Golden trait (fruit color) and to assess the parental genomic proportion in the genotypes studied. Based on the analysis of 20 polymorphic microsatellite loci, 19 genotypes with the Golden trait belonging to BC1S1 were evaluated in addition to the parental genotypes. Genetic distance was estimated through weighted index. The genotypes were then grouped using the hierarchical nearest neighbor method, and the analysis of principal coordinates was used to measure the proportion of parental genomes in the segregating genotypes. The mean value of the inbreeding coefficient was 0.36. The analysis of the principal coordinates revealed that on average, 64% of the recurrent parent genome was present in the population. Together, the analyses allowed the selection of 3 individuals for the next backcross cycle (33BC1S1-18, 34BC1S1-16, and 37BC1S1-10). These individuals had a higher proportion of the recurrent parent and were grouped close to the recurrent parent in the cluster analysis.

Influence of KIR genes and their HLA ligands in susceptibility to dengue in a population from southern Brazil.

Killer cell immunoglobulin-like receptors (KIR) form a group of regulatory molecules that specifically recognise human leukocyte antigen (HLA) class I molecules, modulating the cytolytic activity of natural killer cells. The purpose of this study was to investigate the influence of KIR genes and their class I HLA ligands in susceptibility to dengue fever in a population from southern Brazil through a case-control study. One hundred four subjects with confirmed diagnoses of dengue participated in this study, along with a control group of 172 individuals from the same geographic area. HLA and KIR genotyping was performed by polymerase chain reaction with sequence-specific oligonucleotide probes (PCR-SSOP) and with sequence-specific primer (PCR-SSP) techniques, respectively. Data analysis showed significant differences for the KIR2DS1 (54.8% vs 40.7%, P = 0.03), KIR2DS5 (50.0% vs 36.0%, P = 0.03) and KIR2DL5 (76.0% vs 56.4%, P = 0.001) genes. With regard to KIR-ligand pairs, positive associations with dengue were observed in KIR3DS1-Bw4 (45.2% vs 29.7%, P = 0.01), KIR3DL1-Bw4 (80.7% vs 65.1%, P < 0.001), KIR2DL1-C2 (75.0% vs 62.2%, P = 0.03) and KIR2DS1-C2 (40.4% vs 25.6%, P = 0.01) interactions, and a negative association in KIR2DL3-C1/C1 (18.2% vs 33.1%, P = 0.01). Furthermore, the analysis of KIR haplogroups showed a possible protective factor against dengue fever in individuals with the AA genotype. Taken together, these results suggest the existence of genetic predisposition to dengue fever in the population from southern Brazil.

[Dislocation and necrosis of the first, second and third wedges. Management with the Masquelet technique. A case report]. / Luxación y necrosis de la primera, segunda y tercera cuña, manejo con técnica de Masquelet. Reporte de un caso.

The induced membrane technique was first described by Masquelet in 1986. It was initially used for the reconstruction of long bone shaft defects, particularly of the femur and tibia. The technique consists of two stages. During the first stage a membrane is induced to provide support to the grafts and supply growth factors that contribute to provide a favorable receiving bed for the future graft. During the second stage the poly-methyl-methacrylate spacer is removed and replaced with bone grafts, usually harvested from the iliac crest. Given that this technique has proven good results, it started to be used at other bone sites. We present herein the case of a patient with a large bone defect in the midfoot in whom the Masquelet technique was used with iliac crest grafts. Arthrodesis with a distal radius plate was performed to improve medial column stability, with favorable clinical and functional results.

Colectomías totalmente laparoscópicas con extracción de la pieza quirúrgica por orificios naturales / Totally laparoscopic colectomy with natural orifice specimen extraction

Objetivo: comunicación de la de la factibilidad de las colectomías totalmente laparoscópicas con extracción de la pieza quirúrgica por orificios naturales. Diseño: Trabajo descriptivo, retrospectivo, observacional. Pacientes y Método: Se incluyó una serie de 6 pacientes en quienes se realizó colectomía totalmente laparoscópica (con anastomosis intracorpórea) y extracción de la pieza quirúrgica por orificio natural. Resultados: Desde enero de 2007 a Agosto de 2011, en el Servicio de Cirugía General del Hospital San Roque, se llevaron a cabo 467 cirugías colorrectales, en 355 pacientes (76%), se realizó abordaje a cielo abierto y en 112 (24%), abordaje videolaparoscopico. En seis de ellos, una neoplasia de sigmoides (T2), y cinco enfermedades diverticulares recurrentes se realizó extracción de la pieza quirúrgica por orificios naturales con anastomosis colorrectal totalmente intracorporea. En 3 pacientes se extrajo la pieza por vía transrectoanal (masculinos) y en los 3 restantes por vía transvaginal. No se presentaron complicaciones intraoperatorias, tampoco postquirúrgicas inmediatas. La recuperación del tránsito intestinal, la ingesta de líquidos y el alta hospitalaria fueron similares a las observadas en las colectomías videoasistidas. Conclusiones: La resección de colon izquierdo por laparoscopía, realizando anastomosis intracorpórea, más extracción de la pieza por oríficios naturales (NOSE), puede ser considerada como una técnica alternativa para pacientes que requieren colectomías electivas, en patología benigna y neoplasias tempranas.

Objective: Communication of totally laparoscopic colectomy with natural orifice specimen extraction. Design: descriptive, retrospective, observational work. Patients and Methods: A series of 6 patients underwent totally laparoscopic colectomy (with intracorporeal anastomosis) and extraction of surgical specimen through natural orifice. Results: From January 2007 to August 2011, 467 colorectal surgeries were performed in the General Surgery Service of the Hospital San Roque. 355 (76%) underwent an open approach and 112 (24%) laparoscopic approach. In six of these cases, a sigmoid tumor (T2), and five recurrent diverticular diseases, we performed totally laparoscopic colectomy, with intracorporeal colorectal anastomosis. In 3 patients, the specimen was removed via transanal (male) and the remaining 3 by transvaginal route. There were no intraoperative or postoperative complications. The recovery of intestinal transit, fluid intake and hospital discharge were similar to those observed in video-assisted colectomy. Conclusions: The left colon resection by a totally laparoscopic technique, with intracorporeal anastomosis and the use of natural orifice specimell extraction (NOSE), can be considered as an alternative for patients requiring elective colectomy in benign disease and early neoplasia.

Pulmón reumatoídeo: descripción de un caso clínico y revisión de la literatura / Rheumatoid lung: report of a case report and literature review

La enfermedad pulmonar intersticial difusa es un grupo heterogéneo de condiciones que involucran la pared alveolar y el tejido perialveolar. La forma de inicio es frecuentemente insidiosa, de curso crónico, constituyendo en más del 5 por ciento de los casos una causa importante de morbimortalidad. La injuria pulmonar está asociada con el reclutamiento de células inflamatorias y otras del sistema inmunológico dentro del tracto respiratorio bajo, resultando en alveolitis. La alveolitis como evento inicial puede ser detectada con el Lavado Bronquiolo Alveolar (LBA), donde el incremento en el número de neutrófilos, linfocitos y eosinófilos se correlaciona con el deterioro de la función pulmonar.

The diffuse interstitial lung disease is a heterogeneous group of conditions involving the alveolar wall and tissue perialveolar. The way to start is often insidious, chronic course, constitute more than 5 percent of cases, a major cause of morbidity and mortality. The lung injury is associated with the recruitment of inflammatory cells and other immune system in the respiratory tract low, resulting in socket. The socket as initial event, can be detected with the bronquio alveolar wash, where the increase in the number of neutrophils, lymphocytes and eosinophils correlates with the decline of lung function.

Primary cerebral fibrosarcoma in a child.

OBJECTIVE: To describe the case of a primary cerebral fibrosarcoma in a child. CLINICAL CASE: A 6-year-old boy presented with a history of headache, drowsiness, vomiting and seizures. He was referred to our institution and died shortly upon arrival to the ER. The autopsy revealed a large left frontoparietal mass with histopathologic features characteristic of fibrosarcoma. Immunohistochemical and ultrastructural studies allowed the exclusion of other mimickers such as meningiomas, and neoplasms of glial or neuronal origin. No other growths were found in the CNS or in other parts of the body. CONCLUSIONS: Brain fibrosarcoma is an exceedingly uncommon tumor. Only 41 cases have been reported to date. The diagnosis of fibrosarcoma must be based on the identification of a predominant herringbone architectural pattern, and immunohistochemical features, although the latter are of limited diagnostic value, its importance being that they facilitate the exclusion of other entities considered in the differential diagnosis.

[Epidemiologic studies of cerebellopontine angle tumors surgically treated in Maracaibo, Venezuela, in 1985-1999]. / Estudio epidemiológico de los tumores del ángulo pontocerebeloso operados en Maracaibo, Venezuela, durante el lapso 1985-1999.

OBJECTIVE: To analyze the epidemiological, clinical and neuropathological data of cases of cerebellopontine angle (CPA) tumors. MATERIAL AND METHODS: The clinical records, neuroimaging and neuropathological studies of 50 patients with diagnosis of CPA tumor operated in different hospitals of Maracaibo, Venezuela, during the lapse January 1st, 1985-December 31, 1999 were reviewed. The variables age, gender, side of the lesion and neuropathological diagnosis were analyzed. RESULTS: A 2:1 female to male ratio was observed. Median age was 48 +/- 12.7 years. Acoustic neuromas (AN) represented 48% of the cases, whereas nonacoustic neuroma tumors (NANT) made up for the rest (52%). Meningiomas were the second more commonly diagnosed lesions, they constituted 32% of the cases. Meningiomas and AN were more frequent in women, their ratios being 7:1 and 1.6:1, respectively. In 60% of the cases the signs and symptoms became eloquent in patients of the fourth and fifth decades of life. CONCLUSIONS: The difference between our results and the ones previously reported in the medical literature are due in part to the predominance of female patients in our series. Endocrinologic, genetic and biochemical factors could also be responsible; nevertheless, this does not constitute the objective of the present study.

Estudio epidemiológico de los tumores del ángulo pontocerebeloso operados en Maracaibo, Venezuela, durante el lapso 1985-1999 / Epidemiological study of the cerebellopontine angle tumors operated in Maracaibo, Venezuela, during the lapse 1985-1999

Objetivo: Analizar los datos epidemiológicos, clínicos y neuropatológicos relacionados con los tumores del ángulo pontocerebeloso (APC).Material y métodos: Se revisaron las historias clínicas, estudios por imágenes y estudios neuropatológicos correspondientes a 50 pacientes con diagnóstico de tumor de APC intervenidos en diferentes hospitales de Maracaibo, Venezuela, entre el 1° de enero de 1985 y el 31 de diciembre de 1999. Se recabaron los datos correspondientes a las variables edad, género, lado de la lesión y diagnóstico neuropatológico. Resultados: Se observó una razón de 2:1 entre el género femenino y el masculino. La media de edad fue de 48+/-12.7 años. Los neuromas acústicos (NA) representaron el 48 por ciento de los casos y los tumores no neuromas acústicos (TNNA) el 52 por ciento. Los meningiomas fueron segundos en frecuencia, constituyendo el 32 por ciento del total. Los Meningiomas y los NA fueron mas frecuentes en mujeres a razón de 7:1 y 1.6:1, respectivamente. El 60 por ciento de los casos se presentaron en pacientes correspondientes a las décadas cuarta y quinta. Conclusiones: La diferencia entre los resultados de nuestra serie y los comunicados previamente a la literatura médica mundial en relación con la incidencia de NA y TNNA en el APC obedece en parte al predominio de pacientes del género femenino en la presente muestra y probablemente al concurso de factores endocrinos, genéticos y bioquímicos, entre otros; sin embargo ello no formó parte de los objetivos del presente estudio (AU)

[The classical clinical and neuroimaging features of meningiomas are mimicked by other intracranial, supratentorial expansive lesions]. / Las características clínico-imaginológicas clásicas de los meningiomas son imitadas por otras lesiones expansivas.

OBJECTIVE: To analyze the surgical neurology cases in which both the clinical and neuroimaging features suggested supratentorial meningioma, and resulted in different entities from the neuropathological point of view. PATIENTS AND METHODS: The clinical histories of patients harboring intracranial, supratentorial mass lesions diagnosed as meningioma operated in different hospitals of Maracaibo, Venezuela, during the period 1993-1997 were reviewed. RESULTS: Our analysis revealed 15 cases with different neuropathological diagnosis. They were distributed as follows: three cases of hemangiopericytoma, two cases each of anaplastic ependymoma, metastatic carcinoma, and solitary intracranial plasmacytoma, and one case each of plasma cell granuloma, pleomorphic xanthoastrocytoma, chondroma, actinomycetoma, meningeal fibroma and chronic inflammation not otherwise specified. CONCLUSION: A heterogeneous group of intracranial, supratentorial expansive mass lesions can masquerade as meningiomas both from the clinical and neuroimaging points of view.

Solitary fibrous tumor of the meninges.

Intracranial fibrous tumors are unusual growths that occur almost exclusively in young individuals. Most of these lesions are intra-axial, however, on extremely rare occasions they arise from the leptomeninges and compress the adjacent brain. The authors report the case of a benign solitary fibrous tumor of the meninges in a 14-year-old girl who presented with a 5-month history of generalized headaches. NMR imaging displayed a left parietal mass, which mimicked a meningioma.