Abscesso hepático e êmbolos sépticos pulmonares: uma rara associação causada por E.Coli<br> doi: 10.20513/2447-6595.2016v56n1p75-78

A Embolia Séptica Pulmonar (ESP) é uma condição mórbida rara caracterizada pela presença de múltiplos abscessos na periferia do parênquima pulmonar, em adição ao isolamento de bactérias no sangue ou em locais de infecção. Relatamos o caso de um homem de 52 anos com história de colecistite litiásica crônica, admitido com quadro de êmbolos sépticos pulmonares por Escherichia coli secundários a abscesso hepático causado por fístula enterobiliar. Em virtude da raridade dessa associação na literatura, descreveremos esse caso com o objetivo de promover seu reconhecimento precoce, já que o tratamento adequado com antibioticoterapia proporciona um melhor prognóstico aos pacientes

The nature of excessive sleepiness and sudden sleep onset in Parkinson׳s disease

Objectives: Excessive daytime sleepiness (EDS) and sudden sleep onset (SOS) episodes are frequent in Parkinson׳s disease (PD). The objectives are to identify clinical characteristics and factors associated with EDS and SOS episodes. Methods: Clinical demographic data were recorded (N=100, mean age=65.0±10.4). EDS was identified by the Epworth Sleepiness Scale (ESS>10) and SOS episodes were registered. Disease severity was evaluated by the Unified Parkinson׳s Disease Rating Scale (UPDRS, I, II, and III), sleep disturbances by the Parkinson׳s Disease Sleep Scale (PDSS10) and rapid eye movement (REM) sleep behavior disorder (RBD) by the REM sleep behavior scale. Levodopa equivalent dose was measured. Results: PD patients with EDS (67%) were predominately male (73.1%) and had worse disease severity (UPDRS II and III p= 0.005); SOS episodes (39%) were associated with disease duration, diabetes, sleep disturbances (PDSS Scale), disease severity (UPDRS I, II, III) and RBD symptoms (p<0.05). Stepwise regression analysis showed that EDS was independently associated with motor-symptoms severity (UPDRS III scale, p=0.003). SOS episodes were independently associated with disease duration (p=0.006) and sleep disturbances (PDSS scale, p=0.03): patients had more uncomfortable immobility at night, tremor on waking and snoring or difficult breathing. Discussion: EDS and or SOS episodes are frequent and manifest a differential pattern in PD. SOS episodes are associated with longer disease duration, diabetes, sleep disturbances and RBD symptoms indicating that these “sleep attacks” are of multifactorial origin and probably influenced by brain structural abnormalities

Neoplasia de células blásticas dendríticas plasmocitoides com manifestação cutânea exuberante: relato de caso

A Neoplasia de células bláticas dendríticas plasmocitoides (NCBDP) é caracterizada pela co-expressão dos marcadores CD4 e CD56, pelo menos um antígeno de células dendríticas e plasmocitoides e ausência de outros marcadores de linhagens hematopoiéticas. Envolvimento cutâneo é a apresentação inicial mais comum. Relata-se o caso de um paciente de 44 anos que apresentava placas e nódulos eritemato-violáceos distribuídos na face, tronco e membros e aumento importante de gânglios em várias cadeias linfonodais. A biópsia e imunohistoquímica de pele e medula óssea foram realizadas e o diagnóstico de NCBDP foi estabelecido. O paciente realizou quimioterapia com remissão completa do quadro. Nesse cenário, o dermatologista deve estar ciente do seu papel no diagnóstico precoce dessa doença

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora