Morphological variation of the brachial plexus in four phyllostomid bat species (Chiroptera, Phyllostomidae).

Despite the remarkable morphological modifications that occurred in the thoracic limbs of bats, information about the brachial plexus in this group is still scarce. The present study aimed to describe the origin, structure, and distribution of these peripheral nerves in four Phyllostomidae species. Both antimeres of six Artibeus lituratus, five Desmodus rotundus, seven Glossophaga soricina, and five Phyllostomus hastatus-all adult males from the Adriano Lúcio Peracchi Collection (UFRRJ)-were dissected. After complete exposure of the structure, we found that the brachial plexus of D. rotundus and P. hastatus is formed by the same roots (C5-T1), whereas the fourth cervical spinal nerve and the second thoracic spinal nerve are present in G. soricina (C4-T1) and A. lituratus (C5-T2), respectively. There was intraspecific variation and asymmetry in the origin of the structure and the combinations of nerve segments forming terminal branches. The distribution to the target muscles and patagium, however, was not subject to significant variation in our sample. Data presented here support the presence of two prevailing conditions in distribution of nerves to the bat muscles, and the innervation of the membranes seems to be explained by embryogenesis. Although the brachial plexus in phyllostomid bats is similar to that of other terrestrial Laurasiatheria, aspects identified in these bats, apparently unique to Chiroptera, may be related to anatomical changes in the thoracic limbs functionally linked to flight.

Linfoma no Hodgkin: primera y segunda neoplasia o, transformación histológica: dificultad diagnóstica: reporte de un caso / Non-Hodgkin's lymphoma: first and second neoplasia or, histological transformation: diagnostic difficulty: a case report

El LF es una enfermedad heterogénea con muchos diferentes subgrupos, en términos de edad de inicio, órganos involucrados (especialmente sitios extranodales) y anormalidades genéticas. Con grandes variaciones en el curso clínico, algunas veces muy indolente o no; puede mostrar transformación a linfomas de alto grado, se han reportado transformaciones a Linfoma de Células Grandes B Difusas (siendo este el más común), de Burkitt, Leucemia/Linfoma, Linfoma Linfoblástico (reportado en raras ocasiones), con un curso clínico agresivo. En el 2008 la OMS estableció 3 nuevas variantes: 1) LF Pediátrico, 2) LF Primario Intestinal y 3) LF in situ. Patólogos y clínicos debemos considerar estas patologías cuando se decide el diagnóstico y el tratamiento. La transformación histológica se refiere al evento biológico que lleva al desarrollo de un Linfoma No Hodgkin agresivo de alto grado en pacientes con un LF subyacente. El Linfoma Folicular (LF) pediátrico es una neoplasia excesivamente rara, que difiere del LF del adulto.

FL is a heterogeneous disease with many different subgroups, in terms of age of onset, organs involved (especially extranodal sites) and genetic abnormalities. With great variations in the clinical course, sometimes very indolent or not; can show transformation to high-grade lymphomas, transformations to Diffuse Large B Cell Lymphoma (this being the most common), Burkitt's, Leukemia / Lymphoma, Lymphoblastic. Lymphoma (reported rarely), with an aggressive clinical course have been reported. In 2008 the WHO established 3 new variants: 1) Pediatric FL, 2) Intestinal Primary FL and 3) in situ FL. Pathologists and clinicians must consider these pathologies when deciding on diagnosis and treatment. Histological transformation refers to the biological event that leads to the development of high-grade aggressive Non-Hodgkin's Lymphoma in patients with an underlying FL. Pediatric Follicular Lymphoma (FL) is an excessively rare neoplasm, which differs from adult FL.

Hiperemesis gravídica: manejo y consecuencias nutricionales; reporte de caso y revisión de literatura / Hyperemesis gravidarum: management and nutritional implications; case report and review of literature

Introducción: La hiperemesis gravídica es un estado de naúsea y vómito constante durante el embarazo, asociada a deshidratación, trastornos electrolíticos y ácido - base, desnutrición y pérdida de peso (>5%). La prevalencia de la hiperemesis gravídica es del 0.3-2.3% en todos los embarazos. Objetivo: Demostrar la efectividad del soporte nutricional en un caso de Hiperemesis gravídica asociado a desnutrición severa. Se trata de una femenina de 25 años con hiperemesis gravídica, que tuvo pérdida de peso de 17.7%, deshidratación, trastornos electolíticos y arritmias, manejada con nutrición enteral y parenteral en domicilio hasta la semana 26 de gestación logrando cubrir el 70% de sus requerimientos alóricos por vía oral, obteniendo un producto sano y una madre estable nutricionalmente al final del embarazo. Conclusiones: El manejo multidisciplinario y un soporte nutricional especializado en este tipo de casos es imprecindible para llevar al paciente y al producto al final del embarazo en óptimas condiciones (AU)

Introduction: Hyperemesis gravidarum is a state of severe nausea and vomiting during pregnancy, leading to dehydration, electrolyte and acid-base disorders, malnutrition and weight loss (> 5%). The prevalence of hyperemesis gravidarum is 0.3-2.3% of all pregnancies. Objetive: To demonstrate the effectiveness of nutritional support in a case of a complicated hyperemesis gravidarum. A case of a 25 years old woman with hyperemesis gravidarum, who had weight loss of 17.7%, dehydration, electrolyte disorders and arrhythmias, managed with enteral and parenteral nutrition at home until week 26 of gestation reaching to cover 70% of her caloric requirements orally, getting a healthy product and a stable nutritionally mother in late pregnancy. Conclusions: The multidisciplinary management and specialized nutritional management in such cases it is compulsory to carry the patient and the product at the end of pregnancy in optimal conditions (AU)

Unsaturated fatty acids and insulin resistance in childhood obesity.

OBJECTIVE: Obesity is characterized by increased levels of plasma free fatty acids (FFAs) that interfere with insulin signaling. The aim of our study was to assess the FFA profile in obese children and adolescents and to determine their relation with different degrees of insulin resistance. METHODS: A transversal study was conducted of 51 children and adolescents (mean age, 11.7±1.6 years; 47% males) with obesity (body mass index ≥95 percentile). Anthropometric, clinical, and biochemical parameters were assessed. Insulin resistance was determined using the homeostasis model assessment of insulin resistance (HOMA-IR) index. Plasma fatty acids were quantified by high-performance liquid chromatography with heptadecanoic acid as the internal standard. RESULTS: The mean concentration of myristic acid, linoleic acid, palmitic acid, oleic acid, stearic acid, and total fatty acids was 9.3±2.2, 86.5±38.3, 93.0±35.5, 177.0±83.6, 48.5±14.9, and 414.3±160.9 µmol/L, respectively. Total fatty acids and unsaturated fatty acids such as oleic acid and linoleic acid showed an inverse significant correlation with insulin resistance. Children with high insulin resistance (HOMA-IR >2.5) showed a decrease in unsaturated fatty acids compared with children having a HOMA-IR of <2.5. There were no changes in saturated fatty acid concentrations between those groups. CONCLUSIONS: A decrease in unsaturated fatty acids was correlated with insulin resistance in childhood obesity.

[Hyperemesis gravidarum: management and nutritional implications; case report and review of literature]. / Hiperemesis gravídica: manejo y consecuencias nutricionales; reporte de caso y revisión de literatura.

INTRODUCTION: Hyperemesis gravidarum is a state of severe nausea and vomiting during pregnancy, leading to dehydration, electrolyte and acid-base disorders, malnutrition and weight loss (> 5%). The prevalence of hyperemesis gravidarum is 0.3-2.3% of all pregnancies. OBJECTIVE: To demonstrate the effectiveness of nutritional support in a case of a complicated hyperemesis gravidarum. A case of a 25 years old woman with hyperemesis gravidarum, who had weight loss of 17.7%, dehydration, electrolyte disorders and arrhythmias, managed with enteral and parenteral nutrition at home until week 26 of gestation reaching to cover 70% of her caloric requirements orally, getting a healthy product and a stable nutritionally mother in late pregnancy. CONCLUSIONS: The multidisciplinary management and specialized nutritional management in such cases it is compulsory to carry the patient and the product at the end of pregnancy in optimal conditions.

Introducción: La hiperemesis gravídica es un estado de naúsea y vómito constante durante el embarazo, asociada a deshidratación, trastornos electrolíticos y ácido ­ base, desnutrición y pérdida de peso (>5%). La prevalencia de la hiperemesis gravídica es del 0.3-2.3% en todos los embarazos. Objetivo: Demostrar la efectividad del soporte nutricional en un caso de Hiperemesis gravídica asociado a desnutrición severa. Se trata de una femenina de 25 años con hiperemesis gravídica, que tuvo pérdida de peso de 17.7%, deshidratación, trastornos electolíticos y arritmias, manejada con nutrición enteral y parenteral en domicilio hasta la semana 26 de gestación logrando cubrir el 70% de sus requerimientos calóricos por vía oral, obteniendo un producto sano y una madre estable nutricionalmente al final del embarazo. Conclusiones: El manejo multidisciplinario y un soporte nutricional especializado en este tipo de casos es imprecindible para llevar al paciente y al producto al final del embarazo en óptimas condiciones.

Prevalence of Mycoplasma pneumoniae infection among children with acute respiratory tract infection: A prospective case control study

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Mycoplasma pneumoniae has been implicated as a significant etiologic agent of lower respiratory tract infection among children to 18 years old, however, its prevalence in younger children age 5 years and below appears to be increasing.<br /><strong>OBJECTIVES:</strong> This study was performed to determine the prevalence, clinical and radiologic features associated with children 5 years old and below admitted with respiratory tract infection.<br /><strong>METHODS:</strong> This is a prospective case control study involving children 5 years old and below with signs and symptoms of respiratory tract infection, and were tested for M. pneumoniae IgM at the Makati Medical Center and admitted between May 1, 2012 to September 30, 2012. Subjects were children with positive M pneumoniae IgM test (MPP) and controls were children with negative M pneumoniae IgM test (MPN). Clinical, radiologic and laboratory characteristics of MPP and MPN were recorded.<br /><strong>RESULTS:</strong> Twenty-one out of 82 (25.6%) subjects were MPP. The male to female ratio was 1:1.05 witha mean age of 34 months. Clinical, radiologic characteristic and laboratory findings between MPP and MPN were not statistically significant.<br /><strong>CONCLUSION:</strong> The prevalence of M. pneumoniae infection among the subjects was 25.6%. distinguish M. pneumoniae infection.</p>

Psicose e desencadeamento: sustentação e ruptura / Psychosis and unchaining: sustentation and rupture

Com o presente artigo, pretende-se discutir o desencadeamento da psicose, considerando sua passagem do momento anterior (pré-psicose). É possível inferir que o desencadeamento da psicose possa ser evitado por uma relação dual imaginária estabelecida pelo sujeito, a qual evita o surto. De forma a examinar as razões presentes no desencadeamento da psicose, utilizou-se primeiramente as referências de Lacan sobre o crime das irmãs Papin, publicado em sua tese de doutorado em Medicina (1932). Posteriormente, selecionou-se partes do filme Entre elas, que se baseia em relatos do crime. Finalmente, uma hipótese é proposta sobre o motivo do desencadeamento, seguida de referências adicionais da teoria posterior de Lacan, que centra a questão da psicose no conceito da Verwerfung (foraclusão) (AU)