Cranial Masses in Sickle Cell Disease

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Comparison of protocols for genomic DNA extraction from ‘velame pimenta’ (Croton linearifolius), a native species to the Caatinga, Brazil

The Caatinga biome occupies some 12% of the Brazilian territory, which is present in at least nine states. The species that constitute its biodiversity have the potential to be used as natural resources, among them are approximately 700 species of the genus Croton. As an example of this potential, the Croton linearifolius specie is used by local communities as a natural insecticide. Associated with the economic potential of the Caatinga species, one must stress the risk of extinction or genetic erosion due to the growing deforestation of natural areas of this biome. These factors make it relevant in genetic studies in order to guide conservation strategies. Considering the lack of molecular studies involving C. linearifolius, we compared the efficiency of six protocols for genomic DNA extraction previously described in literature. The DNA extraction buffers [based on the use of Cetyl trimethylammonium bromide (CTAB), sodium dodecyl sulfate (SDS), mannitol and sorbitol] were different in their efficiency to obtaining the genomic DNA of C. linearifloius. In general, protocols using CTAB buffer were more efficient. The use of liquid nitrogen in the maceration process was also evaluated and its use was considered a no necessary factor in obtaining DNA in adequate quantity and quality for PCR platform procedures.Keywords: DNA Isolation, molecular markers, native species of CaatingaAfrican Journal of Biotechnology Vol. 12(30), pp. 4761-476

Cisatracurium – A “Safe” Neuromuscular Blocking Agent?

Os agentes anestésicos representam uma causa importante de anafilaxia a fármacos, sendo os relaxantes neuromusculares (RNM) dos principais responsáveis pelos casos de anafilaxia perioperatória. O cisatracúrio é o RNM mais recente, sendo um estereoisómero do atracúrio que se acreditava não ter potencial de libertação de histamina e, consequentemente, causar menos reações alérgicas do que os outros RNM. No entanto, têm sido relatados vários casos de reação anafilática grave após administração de cisatracúrio, não existindo, do nosso conhecimento, registo na literatura de nenhum em Portugal. As autoras apresentam dois casos de anafilaxia perioperatória grave (grau 4 na escala de Ring & Messmer) com paragem cardiorrespiratória. Na investigação alergológica foram realizados testes cutâneos, cujos intradérmicos se revelaram positivos para o cisatracúrio (1:100) em ambos os doentes. É importante alertar que este RNM não será tão desprovido de potencial alergénico como previamente pensado e esse facto deve ser considerado na investigação de uma reação alérgica que ocorra durante a indução anestésica.info:eu-repo/semantics/publishedVersio

A Diagnostic Algorithm for Posterior Fossa Tumors in Children: A Validation Study

BACKGROUND AND PURPOSE: Primary posterior fossa tumors comprise a large group of neoplasias with variable aggressiveness and short and long-term outcomes. This study aimed to validate the clinical usefulness of a radiologic decision flow chart based on previously published neuroradiologic knowledge for the diagnosis of posterior fossa tumors in children. MATERIALS AND METHODS: A retrospective study was conducted (from January 2013 to October 2019) at 2 pediatric referral centers, Children's Hospital of Philadelphia, United States, and Great Ormond Street Hospital, United Kingdom. Inclusion criteria were younger than 18 years of age and histologically and molecularly confirmed posterior fossa tumors. Subjects with no available preoperative MR imaging and tumors located primarily in the brain stem were excluded. Imaging characteristics of the tumors were evaluated following a predesigned, step-by-step flow chart. Agreement between readers was tested with the Cohen κ, and each diagnosis was analyzed for accuracy. RESULTS: A total of 148 cases were included, with a median age of 3.4 years (interquartile range, 2.1-6.1 years), and a male/female ratio of 1.24. The predesigned flow chart facilitated identification of pilocytic astrocytoma, ependymoma, and medulloblastoma sonic hedgehog tumors with high sensitivity and specificity. On the basis of the results, the flow chart was adjusted so that it would also be able to better discriminate atypical teratoid/rhabdoid tumors and medulloblastoma groups 3 or 4 (sensitivity = 75%-79%; specificity = 92%-99%). Moreover, our adjusted flow chart was useful in ruling out ependymoma, pilocytic astrocytomas, and medulloblastoma sonic hedgehog tumors. CONCLUSIONS: The modified flow chart offers a structured tool to aid in the adjunct diagnosis of pediatric posterior fossa tumors. Our results also establish a useful starting point for prospective clinical studies and for the development of automated algorithms, which may provide precise and adequate diagnostic tools for these tumors in clinical practice

Jejunal Diverticular Perforation due to Enterolith

Jejunal diverticulosis is a rare entity with variable clinical and anatomical presentations. Although there is no consensus on the management of asymptomatic jejunal diverticular disease, some complications are potentially life-threatening and require early surgical treatment. Small bowel perforation secondary to jejunal diverticulitis by enteroliths is rare. The aim of this study was to report a case of small intestinal perforation caused by a large jejunal enterolith. An 86-year-old woman was admitted with signs of diffuse peritonitis. After initial fluid recovery the patient underwent emergency laparotomy. The surgery showed that she had small bowel diverticular disease, mainly localized in the proximal jejunum. The peritonitis was due to intestinal perforation caused by an enterolith 12 cm in length, localized inside one of these diverticula. The intestinal segment containing the perforated diverticulum with the enterolith was removed and an end-to-end anastomosis was done to reconstruct the intestinal transit. The patient recovered well and was discharged from hospital on the 5th postoperative day. There were no signs of abdominal pain 1 year after the surgical procedure. Although jejunal diverticular disease with its complications, such as formation of enteroliths, is difficult to suspect in patients with peritonitis, it should be considered as a possible source of abdominal infection in the elderly patient when more common diagnoses have been excluded