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1.
AJNR Am J Neuroradiol ; 41(1): 174-177, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31806601

RESUMO

Since 2005, it has been known that mother-to-child transmission of the chikungunya virus is possible. Transmission generally occurs in the perinatal period. In the present study, we describe the brain lesions seen on MR imaging of 6 cases of perinatal chikungunya infection. Patients who underwent brain MR imaging in the acute phase presented with areas of restricted diffusion in the white matter, suggesting a perivascular distribution, whereas those in the subacute/late phase showed cystic lesions, also with a perivascular distribution, with or without brain atrophy. One patient also presented with scattered hemorrhages in the frontal and parietal lobes. Important differential diagnoses include rotavirus, Parechovirus, herpes simplex infection, and hypoxic-ischemic encephalopathy, depending on the disease phase.


Assuntos
Encéfalo/diagnóstico por imagem , Febre de Chikungunya/congênito , Febre de Chikungunya/diagnóstico por imagem , Atrofia/patologia , Encéfalo/patologia , Febre de Chikungunya/transmissão , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Imageamento por Ressonância Magnética/métodos , Masculino , Neuroimagem/métodos , Gravidez
4.
Chem Biol Interact ; 291: 245-252, 2018 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-29964003

RESUMO

We conducted an investigation to evaluate the effects of Brazilian Pampa biome honey and its major phenolic compounds on the development of an erected wings posture phenotype and related mitochondrial aspects induced by Hypoxia/Reoxygenation (H/R) in Drosophila melanogaster. Flies were pre-treated for 3 days with a 10% honey solution and different concentrations of caffeic acid and ρ-coumaric acid and then submitted to hypoxia for 3 h. We observed that after reoxygenation, some flies acquired an erected wings posture and that this feature may be related to mortality. In addition, H/R induced down-regulation of ewg mRNA expression, which could be associated to the observed complex phenotype. H/R also caused a dysregulation in opa1-like, ldh and diap genes expression and reduced O2 fluxes in flie's mitochondria. Honey mitigated opa1-like mRNA expression changes provoked by H/R. Differently from honey, caffeic and ρ-coumaric acids displayed no protective effects. In conclusion, we report for the first time the protective effects of honey against complex phenotypes and mitochondrial changes induced by H/R in adult flies.


Assuntos
Envelhecimento/fisiologia , Drosophila melanogaster/metabolismo , Mel , Hipóxia/patologia , Mitocôndrias/metabolismo , Oxigênio/farmacologia , Substâncias Protetoras/farmacologia , Asas de Animais/metabolismo , Animais , Comportamento Animal/efeitos dos fármacos , Respiração Celular/efeitos dos fármacos , Drosophila melanogaster/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos dos fármacos , Locomoção/efeitos dos fármacos , Mitocôndrias/efeitos dos fármacos , Músculos/citologia , Músculos/efeitos dos fármacos , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Asas de Animais/efeitos dos fármacos
5.
AJNR Am J Neuroradiol ; 39(11): 1967-1974, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29773562

RESUMO

When the first suspected cases of neurologic disorders associated with the Zika virus were noticed in Brazil in late 2015, several studies had been conducted to understand the pathophysiology of the disease and its associated complications. In addition to its well-established association with microcephaly in neonates, the Zika virus infection has also been suggested to trigger other severe neurologic complications in adults, such as Guillain-Barré syndrome, radiculomyelitis, and meningoencephalitis. Hence, the Zika virus should be deemed a global threat that can cause devastating neurologic complications among individuals in all age ranges. The aim of this review was to further describe neuroimaging findings of Zika virus infection and associated neurologic complications found in adults.


Assuntos
Doenças do Sistema Nervoso/diagnóstico por imagem , Doenças do Sistema Nervoso/virologia , Complicações Infecciosas na Gravidez/diagnóstico por imagem , Infecção por Zika virus/complicações , Infecção por Zika virus/diagnóstico por imagem , Adulto , Brasil , Feminino , Humanos , Recém-Nascido , Neuroimagem , Gravidez , Complicações Infecciosas na Gravidez/virologia , Zika virus
6.
Neurochem Res ; 41(1-2): 116-29, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26518676

RESUMO

We aimed to investigate the potential beneficial effects of the Brazilian Pampa biome honey in a Drosophila-based hypoxia model. Adult flies were reared in standard medium in the presence or absence of honey (at a final concentration of 10 % in medium). Then, control flies (4 % sucrose in medium) and honey-treated flies were submitted to hypoxia. Subsequently, flies were analyzed for mortality, neurolocomotor behavior (negative geotaxis), mitochondrial/oxidative stress parameters and expression of hypoxia/stress related genes by RT-qPCR. The HPLC analysis revealed the presence of phenolics and flavonoids in the studied honey. Caffeic acid was the major compound followed by p-coumaric acid and kaempferol. The presence of such compounds was correlated with a substantial antioxidant activity in vitro. Flies subjected to hypoxia presented marked mortality, locomotor deficits and changes in oxidative stress and mitochondrial activity parameters. Honey treatment was able to completely block mortality and locomotor phenotypes. In addition, honey was able to reverse ROS production and hypoxia-induced changes in mitochondrial complex I and II activity. Hypoxia also induced an up-regulation in mRNA expression of Sima (HIF-1), NFκß, NRF2, HOX, AKT-1, InR, dILP2, dILP5 and HSP27. Honey treatment was not able to modulate changes in the tested genes, indicating that its protective effects involve additional mechanisms other than transcriptional activity of hypoxia-driven adaptive responses in flies. Our results demonstrated, for the first time, the beneficial effects of honey against the deleterious effects of hypoxia/reperfusion processes in a complex organism.


Assuntos
Mel , Locomoção , Estresse Oxidativo , Traumatismo por Reperfusão/prevenção & controle , Animais , Antioxidantes/farmacologia , Cromatografia Líquida de Alta Pressão , Drosophila melanogaster/genética , Flavonoides/análise , Expressão Gênica , Mel/análise , Fenóis/análise , Espectrofotometria Ultravioleta
7.
Environ Sci Pollut Res Int ; 22(20): 15526-35, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26006076

RESUMO

Aquatic ecosystems are under constant risk due to industrial, agricultural, and urban activities, compromising water quality and preservation of aquatic biota. The assessment of toxicological impacts caused by pollutants to aquatic environment using biomarker measurements in fish can provide reliable data to estimate sublethal effects posed by chemicals in contaminated areas. In this study, fish (Astyanax sp. and Danio rerio) exposed to agricultural and urban effluents at the Vacacaí River, Brazil, were tested for potential signs of aquatic contamination. This river comprehends one of the main watercourses of the Brazilian Pampa, a biome with a large biodiversity that has been neglected in terms of environmental and social-economic development. Sites S1 and S2 were chosen by their proximity to crops and wastewater discharge points, while reference site was located upstream of S1 and S2, in an apparently non-degraded area. Fish muscle and brain tissues were processed for determination of acetylcholinesterase as well as oxidative stress-related biomarkers. The results showed signs of environmental contamination, hallmarked by significant changes in cholinesterase activity, expression of metallothionein, antioxidant enzymes, glutathione levels, and activation of antioxidant/cell stress response signaling pathways in fish exposed to contaminated sites when compared to reference. Based on these results, it is evidenced that urban and agricultural activities are posing risk to the environmental quality of water resources at the studied area. It is also demonstrated that cell stress biomarkers may serve as important tools for biomonitoring and development of risk assessment protocols in the Pampa biome.


Assuntos
Characidae/metabolismo , Estresse Oxidativo , Poluentes Químicos da Água/toxicidade , Proteínas de Peixe-Zebra/metabolismo , Peixe-Zebra/metabolismo , Acetilcolinesterase/metabolismo , Agricultura , Animais , Biomarcadores/metabolismo , Brasil , Catalase/metabolismo , Ecossistema , Feminino , Glutationa Peroxidase/metabolismo , Glutationa Transferase/metabolismo , Masculino , Metalotioneína/metabolismo , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/enzimologia , Rios/química , Compostos de Sulfidrila/metabolismo , Superóxido Dismutase/metabolismo , Águas Residuárias/química , Águas Residuárias/toxicidade , Poluentes Químicos da Água/análise , Qualidade da Água
8.
Int J Food Sci ; 2014: 470214, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-26904632

RESUMO

We characterized, for the first time, the quality and identity of Brazilian Pampa biome honey and its antioxidant properties in vitro (FRAP, DDPH and ABTS). The potential protective effect of honey against oxidative stress induced by iron (Fe) and paraquat, (PQ) in a Drosophila melanogaster model (in vivo) was also tested. The results indicated that all honey samples tested showed antioxidant activity in vitro. Flies treated with honey showed increased lifespan and were protected against oxidative stress induced by Fe and PQ. Despite the high concentration of sugars in honey (approximately 70-80%), our results demonstrate a hypoglycemic-like effect of honey in Drosophila. Thus, this study demonstrates the high quality of Brazilian Pampa biome honey as well as its significant antioxidant activity in vitro and in vivo, pointing to the potential use of this natural product as an alternative in the therapy of oxidative stress-associated diseases.

10.
Chemosphere ; 92(9): 1177-82, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23466093

RESUMO

Organic and inorganic forms of mercury are highly neurotoxic environmental contaminants. The exact mechanisms involved in mercury neurotoxicity are still unclear. Oxidative stress appears to play central role in this process. In this study, we aimed to validate an insect-based model for the investigation of oxidative stress during mercury poisoning of lobster cockroach Nauphoeta cinerea. The advantages of using insects in basic toxicological studies include the easier handling, rapid proliferation/growing and absence of ethical issues, comparing to rodent-based models. Insects received solutions of HgCl2 (10, 20 and 40mgL(-1) in drinking water) for 7d. 24h after mercury exposure, animals were euthanized and head tissue samples were prepared for oxidative stress related biochemical determinations. Mercury exposure caused a concentration dependent decrease in survival rate. Cholinesterase activity was unchanged. Catalase activity was substantially impaired after mercury treatment 40mgL(-1). Likewise, GST had a significant decrease, comparing to control. Peroxidase and thioredoxin reductase activity was inhibited at concentrations of 20mgL(-1) and 40mgL(-1) comparing to control. These results were accompanied by decreased GSH levels and increased hydroperoxide and TBARS formation. In conclusion, our results show that mercuric compounds are able to induce oxidative stress signs in insect by modulating survival rate as well as inducing impairments on important antioxidant systems. In addition, our data demonstrates for the first time that Nauphoeta cinerea represents an interesting animal model to investigate mercury toxicity and indicates that the GSH and thioredoxin antioxidant systems plays central role in Hg induced toxicity in insects.


Assuntos
Cloreto de Mercúrio/toxicidade , Estresse Oxidativo/efeitos dos fármacos , Poluentes Químicos da Água/toxicidade , Animais , Baratas/efeitos dos fármacos , Baratas/metabolismo , Glutationa Transferase/metabolismo , Dose Letal Mediana , Cloreto de Mercúrio/química , Modelos Biológicos , Peroxidases/metabolismo , Tiorredoxina Dissulfeto Redutase/metabolismo , Poluentes Químicos da Água/química
11.
AJNR Am J Neuroradiol ; 34(4): 860-3, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23042921

RESUMO

BACKGROUND AND PURPOSE: Trigeminal nerve injury or dysfunction is associated with denervation atrophy of muscles innervated by the mandibular branch of the trigeminal nerve. The purpose of our study was to evaluate the association between chronic CN V denervation and parotid gland atrophy. MATERIALS AND METHODS: Twenty-six patients with chronic masticator muscle atrophy were retrospectively identified and evaluated for the presence of ipsilateral parotid gland atrophy. Twenty-six age-matched control subjects with no clinical or imaging evidence of chronic masticator space atrophy were also identified. Segmentation of the parotid gland was performed to calculate a parotid asymmetry index. The Fisher exact test and t test were respectively used to determine the correlation between parotid gland atrophy and ipsilateral masticator muscle atrophy and to evaluate any difference in the size of the involved parotid gland when compared with that in the control subjects. RESULTS: Ipsilateral parotid gland atrophy was seen in 9/26 (42.8%) patients with fatty replacement of the masticator group of muscles, suggesting a correlation between parotid gland atrophy and CN V denervation (P<.001). The parotid asymmetry index was significantly different in patients with CN V denervation (0.59±0.25) compared with control subjects (0.92±0.03) (P<.001). CONCLUSIONS: Ipsilateral parotid gland atrophy can accompany chronic CN V denervation change, and its clinical significance remains to be determined.


Assuntos
Doenças Parotídeas/etiologia , Doenças Parotídeas/patologia , Glândula Parótida/patologia , Doenças do Nervo Trigêmeo/complicações , Adulto , Atrofia , Doença Crônica , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Músculos da Mastigação/inervação , Músculos da Mastigação/patologia , Pessoa de Meia-Idade , Atrofia Muscular/etiologia , Atrofia Muscular/patologia , Glândula Parótida/inervação , Estudos Retrospectivos
12.
AJNR Am J Neuroradiol ; 32(11): 1978-85, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21393407

RESUMO

The current standard of care for newly diagnosed cases of high-grade glioma is surgical resection followed by RT with concurrent chemotherapy. The most widely used criteria for assessing treatment response are based on a 2D measurement of the enhancing area on MR imaging known as the Macdonald Criteria. Recently, nontumoral increases (pseudoprogression) and decreases (pseudoresponse) in enhancement have been found, and these can confuse outcome evaluation. Here we review pseudoprogression and pseudoresponse and describe how better understanding of these phenomena can aid interpretation.


Assuntos
Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/terapia , Encéfalo/patologia , Glioma/diagnóstico , Glioma/terapia , Imageamento por Ressonância Magnética/métodos , Progressão da Doença , Humanos , Prognóstico , Resultado do Tratamento
13.
Neotrop Entomol ; 40(6): 677-81, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-23939274

RESUMO

In Hymenoptera, midgut changes begin in the last instar. At this stage, the larval epithelial digestive cells degenerate, leaving only the basal membrane and the regenerative cells which will develop into a new epithelium during the pupal stage and in the adult. Epithelium renewal is followed by changes in volume and shape of the midgut. Morphometric analysis of digestive cells and total midgut volume of Melipona quadrifasciata anthidioides (Lepeletier) were conducted to verify whether cell volume increase are sufficient to account for the total midgut volume increase that occurs during metamorphosis. An increase in midgut volume was verified in spite of the scarcity of cell proliferation found during metamorphosis. At the end of metamorphosis, the increase in cell volume was not sufficient to explain the increase in volume of the midgut, indicating that an increase in the number of digestive cells is apparently necessary. Nevertheless, the mechanism by which regenerative cells reconstitute the epithelium during metamorphosis remains unknown.


Assuntos
Abelhas/anatomia & histologia , Abelhas/crescimento & desenvolvimento , Metamorfose Biológica , Animais , Sistema Digestório/anatomia & histologia , Sistema Digestório/crescimento & desenvolvimento
15.
AJNR Am J Neuroradiol ; 29(1): 154-8, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17947370

RESUMO

BACKGROUND AND PURPOSE: The T2-weighted gradient-echo (GRE) imaging is currently the gold standard MR imaging sequence for the evaluation of patients with cerebral cavernous malformation (CCM) lesions. We aimed to compare the sensitivity of susceptibility-weighted imaging (SWI) with T2-weighted fast spin-echo (FSE) and GRE imaging in assigning the number of CCM lesions in patients with the familial form of the disease. MATERIALS AND METHODS: We studied 15 patients (8 men, 7 women; mean age, 34 years) with familial CCM. All patients underwent MR imaging with the following sequences: T1-weighted spin echo, T2-weighted FSE, T2-weighted GRE, and SWI. Two neuroradiologists read the images regarding the number of lesions seen on each sequence. The final decisions were reached by consensus. The number of lesions on the different sequences was compared with analysis of variance, followed by a nonparametric Wilcoxon matched-pairs signed rank test. RESULTS: The number of lesions was higher on T2-weighted GRE than on T2-weighted FSE (P = .001). In addition, more lesions were seen on SWI than on T2-weighted GRE (P = .001) and FSE (P = .001) sequences. CONCLUSION: The sensitivity of SWI in assigning the number of CCM lesions in patients with the familial form of the disease is significantly higher than that of T2-weighted FSE and GRE sequences.


Assuntos
Algoritmos , Veias Cerebrais/anormalidades , Veias Cerebrais/patologia , Imagem Ecoplanar/métodos , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Malformações Arteriovenosas Intracranianas/diagnóstico , Adulto , Feminino , Predisposição Genética para Doença , Humanos , Malformações Arteriovenosas Intracranianas/genética , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Marcadores de Spin
16.
Meat Sci ; 77(3): 389-96, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22061792

RESUMO

We previously demonstrated that postmortem water buffalo meat had higher tenderness than Brahman beef. In order to explain this difference in tenderness, the objective of the current study was to investigate the protease activity in these two meats. Five female crossbred water buffalo (Philippine Carabao×Bulgarian Murrah) and five female crossbred cattle (Brahman×Philippine Native) were slaughtered at 30months of age, followed by immediate sampling of Longissimus thoracis muscle for measurement of protease activity. Results showed that buffalo meat had significantly higher protease activity compared to beef (P<0.05). Furthermore, calpain inhibitor 1, a specific inhibitor of calpains 1 and 2, was the most effective inhibitor of protease activity. There was no difference in calpastatin activity, and no major differences were observed in calpains 1, 2, and calpastatin expression by Western blotting. This study suggests that higher calpain activity in early postmortem buffalo meat was responsible for the increased tenderness of water buffalo meat compared to beef.

17.
Meat Sci ; 75(3): 499-505, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22063807

RESUMO

The objective of this research was to determine the difference in tenderness and some characteristics of water buffalo meat and beef during postmortem aging. Five female crossbred water-buffalo (Philippine Carabao×Bulgarian Murrah) and five female crossbred cattle (Brahman×Philippine Native), were finished on the same diet for 6 months and slaughtered at 30 months of age. The muscle pH was measured at 40min, 3h, 7h, 24h, and 48h postmortem. Longissimus thoracis (LT) and semimembranosus (SM) muscles were excised at 2d postmortem, and shear force was measured at 2, 4, 7, and 14d postmortem. Glycogen and lactate concentrations were determined from 0, 2, and 4d LT samples, and myosin heavy chain type of buffalo and cattle LT was determined by ELISA methods. Myofibrillar protein degradation was also observed by SDS-PAGE and Western blotting of fast-type troponin T. Results showed that the buffalo meat had significantly lower shear force values compared to beef for LT and SM muscles, which was supported by a difference in troponin T degradation. Postmortem pH decline of buffalo meat was significantly slower than that of beef, which was confirmed by lactic acid concentrations, but was not explained by glycogen content. In addition, there was no significant difference in the ratio of slow to fast type muscle fibers in buffalo and cattle, indicating that myosin heavy chain type was not responsible for the difference in pH decline and tenderness between the buffalo meat and beef. This study demonstrated that the tenderness of water buffalo meat was superior to that of Brahman beef, which may have been due to the difference in pH decline and the subsequent effect on muscle protease activity.

18.
AJNR Am J Neuroradiol ; 22(8): 1455-61, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11559490

RESUMO

BACKGROUND AND PURPOSE: Previous studies have shown that lesions in posterior reversible encephalopathy syndrome are often isointense on diffusion-weighted MR images. We hypothesized that 1) apparent diffusion coefficient (ADC) maps using various thresholds would show larger abnormalities in posterior white matter (WM) and 2) isointense appearance of lesions on isotropic diffusion-weighted images results from a balance of T2 prolongation effects and diffusibility effects. METHODS: T2-weighted MR images from 11 patients were reviewed. Hyperintense lesions were located in both anterior and posterior WM in eight patients and solely in posterior WM in three patients. The ADC maps were produced by use of ADC values > or = 3 SD and > or = 10 SD above the mean value of normal WM. Lesions on diffusion-weighted images were classified as isointense or hypointense. ADC values within lesions (ADC(L)) were compared with those of normal WM (ADC(N)), and compared for isointense lesions and hypointense lesions. RESULTS: The distribution of lesions with ADC values > or = 3 SD was essentially identical to that on T2-weighted images. Regions with ADC values > or = 10 SD were found in both anterior WM and posterior WM in two patients and solely in posterior WM in nine patients. On diffusion-weighted images, lesions appeared isointense in seven patients and hypointense in four patients. Mean ADC(L)/ADC(N) for all lesions was 1.81; for hypointense lesions, 2.30. CONCLUSION: Vasogenic edema was more severe in posterior WM. Isointense lesions result from a balance of T2 effects and increased water diffusibility. Hypointense lesions have higher ADC values, which are not balanced by T2 effects.


Assuntos
Encéfalo/patologia , Confusão/diagnóstico , Cefaleia/diagnóstico , Imageamento por Ressonância Magnética/métodos , Convulsões/diagnóstico , Transtornos da Visão/diagnóstico , Adulto , Difusão , Edema/diagnóstico , Edema/etiologia , Feminino , Humanos , Masculino , Síndrome , Doenças Vasculares/complicações
19.
Neuroradiology ; 43(5): 370-4, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11396740

RESUMO

The combination of high signal and reduced apparent diffusion coefficients (ADC) within abscesses on diffusion-weighted MRI (DWI) has been reported as characteristic of abscesses, and useful for distinguishing them from cystic or necrotic neoplasms. To assess whether these are consistent findings in abscesses, we used DWI-derived ADC to investigate changes in water diffusibility in cerebral abscesses. We reviewed the MRI studies and clinical records of five patients with brain abscesses, who underwent DWI. Regions of interest were drawn within the abscesses on ADC maps, to obtain the ADC. The center of all five abscesses gave signal higher than that of white matter on DWI. The three largest also appeared bright on ADC maps, i. e., showed ADC substantially lower than those of normal white matter, consistent with restricted diffusion. However, the two smaller abscesses were not visible on ADC maps because their ADC were essentially the same as that of white matter; they did not show restricted diffusion. The absence of restricted diffusion within small abscesses may be related to intrinsic differences in molecular microenvironment between small and large abscesses, or to greater influence of volume averaging with surrounding edema on the ADC in smaller abscesses.


Assuntos
Abscesso Encefálico/patologia , Imageamento por Ressonância Magnética , Difusão , Humanos , Masculino , Pessoa de Meia-Idade
20.
Rev Inst Med Trop Sao Paulo ; 40(3): 203-7, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9830738

RESUMO

The authors report a case of paraplegia caused by a lumbar intraspinal paracoccidioidomycosis (PCM) granuloma. Clinical neurological diagnosis of a compressive spinal cord lesion was confirmed by spinal magnetic resonance imaging (MRI). Patient was submitted to surgery with total excision of the lesion. Histopathological analysis confirmed the diagnosis of PCM. Patient is on sulfamethoxazole/trimethoprim combined with fluconazole and is experiencing positive neurological recovery.


Assuntos
Granuloma/diagnóstico , Paracoccidioidomicose/diagnóstico , Paraplegia/etiologia , Doenças da Medula Espinal/diagnóstico , Adulto , Seguimentos , Granuloma/complicações , Granuloma/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Paracoccidioidomicose/complicações , Paracoccidioidomicose/cirurgia , Doenças da Medula Espinal/cirurgia
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