Malignant Perivascular Epithelioid Cell Neoplasm (PEComa) of the Pelvis: A Case Report

AbstractPerivascular epithelioid cell neoplasms (PEComa) are rare mesenchymal tumors that can occur in any part of the body and have unpredictable pathological behavior. They are usually benign, but may be malignant. We present a case of malignant PEComa of the pelvic retroperitoneum treated with radical surgery

A case of eosinophilic cystitis in patients with abdominal pain, dysuria, genital skin hyperemia and slight toxocariasis

Eosinophilic cystitis is a rare inflammatory disease with controversial aetiology and treatment. We report the case of a 61-year-old man presented with lower quadrant abdominal pain and lower urinary tract symptoms, non responsive to antibiotics and nonsteroidal antiinflammatory drugs. Physical examination was substantially negative, such as laboratory parameters, microscopic, bacteriological and serological evaluations. Cystoscopy revealed red areas involving the mucosa of the bladder and transurethral biopsies revealed infiltrating eosinophils. The patient was treated with corticosteroids and montelukast sodium with improving of the symptoms, and at 5 weeks postoperative pain score was reduced. After discontinuing corticosteroids dysuria recurred with the development of hyperemia at the genital skin; the specific enzyme-linked immunosorbent assay (ELISA) to detect antibodies against several parasites was slightly positive for Toxocara species. Montelukast sodium was discontinued and corticosteroid therapy was started together with albendazole, with improving of patient’s symptoms and pain decreasing after one week

Absence of the predisposing factors and signs and symptoms usually associated with overreaching and overtraining in physical fitness centers

OBJECTIVE: The aim of this study was to evaluate the occurrence of the well-known predisposing factors and signs and symptoms usually associated with either overreaching or overtraining syndrome in physical fitness centers in São Paulo City, Brazil. METHOD: A questionnaire consisting of 13 question groups pertaining to either predisposing factors (1-7) or signs and symptoms (8-13) was given to 413 subjects. The general training schedule of the volunteers was characterized by workout sessions of 2.18 ± 0.04 h for a total of 11.0 ± 0.3 h/week for 33 ± 2 months independent of the type of exercise performed (walking, running, spinning, bodybuilding and stretching). A mean score was calculated ranging from 1 (completely absent) to 5 (severe) for each question group. A low occurrence was considered to be a question group score lower than 4, which was observed in all 13 question groups. RESULTS: The psychological evaluation by POMS Mood State Questionnaire indicated a normal non-inverted iceberg. The hematological parameters, creatine kinase activity, cortisol, total testosterone and free testosterone concentrations were within the normal ranges for the majority of the volunteers selected for this analysis (n = 60). CONCLUSION: According to the questionnaire score analysis, no predisposing factors or signs and symptoms usually associated with either overreaching or overtraining were detected among the members of physical fitness centers in São Paulo City, Brazil. This observation was corroborated by the absence of any significant hematological or stress hormone level alterations in blood analyses of the majority of the selected volunteers (n = 60).Universidade Federal de São Paulo (UNIFESP) Departamento de PsicobiologiaUniversidade Federal de São Paulo (UNIFESP) Departamento de FisiologiaUniversidade Federal de São Paulo (UNIFESP) Departamento de MedicinaUniversidade Federal de São Paulo (UNIFESP) Departamento de BiofísicaUNIFESP, Depto. de PsicobiologiaUNIFESP, Depto. de FisiologiaUNIFESP, Depto. de MedicinaUNIFESP, Depto. de BiofísicaSciEL

Transrectal versus transperineal 14-core prostate biopsy in detection of prostate cancer: a comparative evaluation at the same institution.

Background: The ideal bioptic strategy for CaP detection is still to be completely defined. The aim of our study is to compare transperineal (TP) and transrectal (TR) approaches, in a 14-core initial prostate biopsy for CaP detection. Material and methods: A prospective controlled study was conducted enrolling 108 consecutive patients with a PSA level greater than 4 ng/mL and/or an abnormal DRE. TR versus TP 14-core initial prostatic biopsies were performed on 54 and 54 patients, respectively, with a randomisation ratio of 1:1. Results: The cancer detection rates were 46.29 (25 out of 54 patients), and 44.44% (24 out of 54 patients), respectively, using the TR or the TP approach (p = 0.846). The overall cancer core rate was significantly higher when the TP approach was used: 21.43% (162 out of 756 cores) and 16.79% (127 out of 756 cores), with the TP and the TR approach, respectively (p = 0.022). The cores were significantly longer performing TP approach: at the site "1" (14.92 versus 12.97 mm, p = 0.02); at "5" (15.53 versus 13.69 mm, p = 0.037); at "7" (15.06 versus 12.86 mm, p = 0.001); at "9" (14.92 versus 13.38 mm, p = 0.038); at "11" (16.32 versus 12.31 mm, p = 0.0001); at "12" (15.14 versus 12.19 mm, p = 0.0001); at "13" (17.49 versus 13.98 mm, p = 0.0001); at "14" (16.77 versus 13.36 mm, p = 0.0001). As to the biopsy related pain, the mean pain level perceived by patients during the TR approach was 1.56 ± 1.73 versus 1.42 ± 1.37 registered during TP approach (p = 0.591). Conclusions: No significant differences were found in cancer detection rate, cancer core rate between TP and TR approaches for prostatic biopsy. Even in terms of complication rate or pain level, it cannot be concluded that one procedure is superior to the other one. Apparently, strictly following our protocol, TP approach seems to offer a better sampling at the level of the apex and the TZ, however without adding any significant advantage in terms of overall cancer detection rate

The December 22nd 2012 eruption of the Copahue volcano, Neuquén, Argentina: Characterization of the eruptive cycle and its products

Se describen las características y naturaleza de los productos emitidos durante la erupción del 22 de diciembre de 2012 del volcán Copahue. La erupción tuvo carácter pulsatorio, con máxima explosividad al inicio de la erupción (VEI 2) declinando rápidamente en aproximadamente 48 hs. La máxima altura de la columna eruptiva (1.500-2.000 m) fue registrada al inicio de la erupción y estuvo acompañada por una importante emisión de SO2. La pluma alcanzó 250 km en dirección ESE con anchos de 20 km (zonas proximales) y 35 km (zonas distales). Un segundo pulso eruptivo ocurrió por la tarde del 22 de diciembre, generando una pluma de menores dimensiones. Estos pulsos explosivos emitieron i) bloques y bombas balísticas y ii) piroclastos dispersados en suspensión, donde se destacan grandes fragmentos aplanados de escoria altamente vesiculada. El depósito de tefra se distribuyó en ambientes proximales alcanzando distancias de hasta unos 40 km desde el cráter activo y extendiéndose en un área de aproximadamente 200 km2. La tefra está constituida por componentes juveniles con diversos grados de vesiculación y componentes accesorios de composición subvolcánica alterados hidrotermalmente. Las bombas y bloques balísticos se dispersaron hasta 1.800-1.900 m alrededor de la boca eruptiva. Se estima un volumen total eruptado de aproximadamente 0,005 km3. La fase inicial de la erupción se asoció a una columna de magma en ascenso que al interactuar con el sistema hidrotermal superficial del volcán, gatilló una erupción hidromagmática. Una vez abierto el sistema, la descompresión condujo a la predominancia de una fragmentación magmática pulsatoria.This paper describes the characteristics, nature and distribution of the products of the 12/22/2012 eruption of the Copahue volcano (Neuquén Province, Argentina). The eruptive cycle was dominated by a pulsatory behavior, with a continuous decrease in the released energy since the onset of the eruption in the morning of December 22, when the eruptive column reached its maximum height (1,500-2,000 m). The volcanic plume extended for almost 250 km toward the ESE of the volcano and was characterized by a mean width of 20 km in proximal areas and 35 km in distal areas. This initial pulse was accompanied by significant SO2 emissions. A second, less intense, eruptive pulse occurred during the afternoon of December 22, leading to the development of a smaller volcanic plume. Eruption products can be classified as: i) ballistic bombs and blocks emitted from the eruptive center, and ii) fallout pyroclasts deposited directly from the volcanic plume, including large flattened juvenile fragments of highly vesiculated scoria. The characteristics of the eruptive event lead to the accumulation of tephra up to a distance of about 40 km from the crater, distributed along a surface of about 200 km2 to the SE of the volcano. Petrographic analysis performed on the fallout deposits showed the presence of juvenile fragments with different degrees of vesiculation and accessory fragments of hydrothermally altered subvolcanic rocks. Ballistic bombs and blocks were dispersed to a distance of 1,800-1,900 m from the eruptive center. We estimate a VEI 2 eruption intensity, with an emitted volume of about 0.005 km3 , which rapidly declined in about 48 hours after the onset of the eruption. The initial stages of the eruption were related to the interaction of an ascending column of magma with the shallow hydrothermal system of the volcano, triggering a hydromagmatic eruption. Once the conduit was open, the progressive decompression of the system led to an eruption dominated by a pulsatory magmatic fragmentation.Fil: Petrinovic, Ivan Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Ciencias de la Tierra; ArgentinaFil: Villarosa, Gustavo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Patagonia Norte. Instituto de Investigación en Biodiversidad y Medioambiente; ArgentinaFil: D'elia, Leandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico La Plata. Centro de Investigaciones Geológicas (i); ArgentinaFil: Guzman, Silvina Raquel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Salta. Instituto de Bio y Geociencias del Noroeste Argentino; ArgentinaFil: Paez, Gerardo Nestor. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Instituto de Recursos Minerales; ArgentinaFil: Outes, Ana Valeria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Patagonia Norte. Instituto de Investigación en Biodiversidad y Medioambiente; ArgentinaFil: Manzoni, Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Patagonia Norte. Instituto de Investigación en Biodiversidad y Medioambiente; ArgentinaFil: Delménico, Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Patagonia Norte. Instituto de Investigación en Biodiversidad y Medioambiente; ArgentinaFil: Balbis, Catalina. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; ArgentinaFil: Carniel, Roberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Ciencias de la Tierra; ArgentinaFil: Hernando, Irene Raquel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico La Plata. Centro de Investigaciones Geológicas (i); Argentin

Malignant mesothelioma of tunica vaginalis testis: Report of a very rare case with review of the literature

Introduction: Mesothelioma of the tunica vaginalis testis is a extremely rare tumor and represents 0.3 to 0.5% of all malignant mesotheliomas. Exposure to asbestos often precedes illness. Because of its low incidence and nonspecific clinical presentation, it is mostly diagnosed accidentally during surgery for other reasons and the prognosis is usually poor. We present a case of a patient with a mesothelioma of tunica vaginalis testis, diagnosed secondarily during hydrocele surgery, with long-term survival after radical surgery. Materials and methods: a 40 years old patient was admitted to our department for routine surgery of a left hydrocele. During the operation a frozen section analysis was requested because of the unusual nodular thickening of the tunica vaginalis: the examination revealed a diffuse malignant mesothelioma with epithelioid structure and tubular-papillary proliferation. Therefore a left hemi-scrotectomy with left inguinal lymph node dissection was performed. Results: The definitive histology confirmed the previous report of diffuse malignant mesothelioma with angio-invasion but normal testicle findings and negative lymph nodes. No metastases were found on the CT-scan. For the first 2 years a CT was repeated every 4 months, for other 3 years every 6 months and then yearly. Six years after surgery the patient is classified as no evidence of disease. Conclusions: malignant mesothelioma of the tunica vaginalis testis is a rare entity, often initially thought to be a hydrocele or an epididymal cyst. An aggressive approach with hemiscrotectomy with or without inguinal and retroperitoneal lymphadenectomy can reduce the risk of recurrence

Comparison of the effects of continuous positive airway pressure, oral appliance and exercise training in obstructive sleep apnea syndrome

OBJECTIVE: There are several treatments for obstructive sleep apnea syndrome, such as weight loss, use of an oral appliance and continuous positive airway pressure, that can be used to reduce the signs and symptoms of obstructive sleep apnea syndrome. Few studies have evaluated the effectiveness of a physical training program compared with other treatments. The aim of this study was to assess the effects of physical exercise on subjective and objective sleep parameters, quality of life and mood in obstructive sleep apnea patients and to compare these effects with the effects of continuous positive airway pressure and oral appliance treatments. METHODS: Male patients with moderate to severe obstructive sleep apnea and body mass indices less than 30 kg/m2 were randomly assigned to three groups: continuous positive airway pressure (n = 9), oral appliance (n = 9) and physical exercise (n = 7). Polysomnographic recordings, blood samples and daytime sleepiness measurements were obtained prior to and after two months of physical exercise or treatment with continuous positive airway pressure or an oral appliance. Clinicaltrials.gov: NCT01289392 RESULTS: After treatment with continuous positive airway pressure or an oral appliance, the patients presented with a significant reduction in the apnea-hypopnea index. We did not observe changes in the sleep parameters studied in the physical exercise group. However, this group presented reductions in the following parameters: T leukocytes, very-low-density lipoprotein and triglycerides. Two months of exercise training also had a positive impact on subjective daytime sleepiness. CONCLUSIONS: Our results suggest that isolated physical exercise training was able to modify only subjective daytime sleepiness and some blood measures. Continuous positive airway pressure and oral appliances modified the apnea-hypopnea index.AFIPCEPECEMSACNPqFAPESPUniversidade Federal de São Paulo (UNIFESP) Departamento de PsicobiologiaUNIFESP, Depto. de Psicobiologia2009/01031-1 e 98/14303-3SciEL

Conociendo los volcanes: Guía didáctica para la enseñanza y aprendizaje del volcanismo, su relación con el ecosistema y el ser humano

Desde la perspectiva de la extensión universitaria esta guía didáctica para la enseñanza y aprendizaje del volcanismo, su relación con el ecosistema y el ser humano muestra el resultado de 4 años de trabajo interdisciplinario junto a actorxs de la educación formal y no formal del norte neuquino que viven al pie de volcanes. Desde una perspectiva constructivista de la ciencia y de la enseñanza-aprendizaje; y desde una mirada de la pedagogía crítica; se desarrollan una síntesis conceptual, una propuesta didáctica dirigidas a lxs docentes y actividades preparadas para lxs alumnxs. Se despliegan una serie de herramientas que a nuestro entender facilitan la enseñanza y la motivación de lxs alumnxs hacia el aprendizaje de un sistema complejo definido como el volcanismo y su relación con el medio. Se encontrarán aquí una serie de respuestas que hemos encontrado tras años de preguntas y repreguntas desarrolladas en conjunto todxs lxs actorxs involucradxs. Sin duda, el carácter finito de las cosas, hace que hoy presentemos ciertas respuestas, aunque esperamos que lxs lectorxs de este texto continúen y mejoren esta eterna tarea.Fil: D'Elia, Leandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigaciones Geológicas. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Centro de Investigaciones Geológicas; ArgentinaFil: Carrera, Julian. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones en Humanidades y Ciencias Sociales. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación. Instituto de Investigaciones en Humanidades y Ciencias Sociales; ArgentinaFil: Carrera, Joaquín Daniel. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Laboratorio de Anatomía Comparada; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: López, Luciano. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Instituto de Recursos Minerales. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Instituto de Recursos Minerales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Dabramo, Sergio Luis. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; ArgentinaFil: González Dobra, Mariano. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; ArgentinaFil: Moyano Paz, Damián. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigaciones Geológicas. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Centro de Investigaciones Geológicas; ArgentinaFil: Fortunato, Damián. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; ArgentinaFil: Liotta, Karen. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; ArgentinaFil: Pompei, Joaquín. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; ArgentinaFil: Massenzio, Antonella. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos "Don Pablo Groeber". Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Estudios Andinos "Don Pablo Groeber"; ArgentinaFil: Morote, Maria Laura. Universidad Nacional de La Plata; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Bilmes, Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto Patagónico de Geología y Paleontología; ArgentinaFil: Redigonda, Juan Ignacio. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; ArgentinaFil: Mendicino, Juan. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; ArgentinaFil: Albarrán, Katya Karla. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; ArgentinaFil: Funes, Daniela Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigaciones Geológicas. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Centro de Investigaciones Geológicas; ArgentinaFil: Cuevas, Carolina. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; Argentin