Schwannoma Of The Craniocervical Junction: Surgical Approach Of Two Cases

We report two cases of craniocervical junction schwannomas with a special focus on the surgical approach. The patients underwent a far-lateral approach in the sitting position that facilitated the lesion removal. This report is meant to improve the understanding of this surgical technique as well as improve awareness of its usefulness for similar cases.6103:00:00639641Baldwin, H., Christopher, G., The far lateral/combined supra- and infratentorial approach (1994) J Neurosurg, 81, pp. 60-68Oliveira, E., Rhoton A.L., Jr., Peace, D., Microsurgical anatomy of the region of the foramen magnum (1985) Surg Neurol, 24, pp. 293-352Salas, E., Sekhar, L.N., Ziyal, I.M., Caputy, A.J., Wright, D.C., Variations of the extreme-lateral craniocervical approach: Anatomical study and clinical analysis of 69 patients (1999) J Neurosurg, 90 (SPINE 2), pp. 206-219Martins, R.S., Suzuki, S.H., Sanematsu P., Jr., Plese, J.P.P., Acoustic neuroma in children without association with neurofibromatosis: Report of two cases (1999) Arq Neuropsiquiatr, 57, pp. 96-100Neto, P.M.A., Stamm, A.C., Braga, F.M., Mandibular trigeminal schwannoma: Case report (2001) Arq Neuropsiquiatr, 59, pp. 959-963Siqueira, M.G., Jennings, E., Moraes, O.J.S., Naso-ethmoid schwannoma with intracranial extension: Case report (2001) Arq Neuropsiquitr, 59, pp. 421-423Andrade, G.C., Neto, P.M.A., Braga, F.M., Thalamic intracerebral schwannoma: Case report (2002) Arq Neuropsiquiatr, 60, pp. 308-313Rhoton A.L., Jr., The far-lateral approach and its transcondylar, supracondylar, and paracondylar extensions (2000) Neurosurgery, 47, pp. 195-210Spetzler, R.F., Grahm, T.W., The far-lateral approach to file inferior clivus and the upper cervical region technical note (1990) BNI Quarterly, 6, pp. 35-38Samii, M., Klekamp, J., Carvalho, G., Surgical results for meningiomas of the craniocervical junction (1996) Neurosurgery, 39, pp. 1086-1095Al-Mefty, O., Borba, L.A.B., Aoki, N., Angtuaco, E., Pait, T.G., The transcondylar approach to extradural nonneoplastic lesions of the craniovertebral junction (1996) J Neurosurg, 84, pp. 1-6Bertalanffy, H., Seeger, W., The dorsolateral, suboccipital, transcondilar approach to the lower clivus and anterior portion of the craniocervical junction (1991) Neurosurgery, 29, pp. 815-82

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans – anteaters, sloths, and armadillos – have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with 24 domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, ten anteaters, and six sloths. Our dataset includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data-paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the south of the USA, Mexico, and Caribbean countries at the northern portion of the Neotropics, to its austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n=5,941), and Cyclopes sp. has the fewest (n=240). The armadillo species with the most data is Dasypus novemcinctus (n=11,588), and the least recorded for Calyptophractus retusus (n=33). With regards to sloth species, Bradypus variegatus has the most records (n=962), and Bradypus pygmaeus has the fewest (n=12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other datasets of Neotropical Series which will become available very soon (i.e. Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans dataset

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Consistent patterns of common species across tropical tree communities

Trees structure the Earth’s most biodiverse ecosystem, tropical forests. The vast number of tree species presents a formidable challenge to understanding these forests, including their response to environmental change, as very little is known about most tropical tree species. A focus on the common species may circumvent this challenge. Here we investigate abundance patterns of common tree species using inventory data on 1,003,805 trees with trunk diameters of at least 10 cm across 1,568 locations1,2,3,4,5,6 in closed-canopy, structurally intact old-growth tropical forests in Africa, Amazonia and Southeast Asia. We estimate that 2.2%, 2.2% and 2.3% of species comprise 50% of the tropical trees in these regions, respectively. Extrapolating across all closed-canopy tropical forests, we estimate that just 1,053 species comprise half of Earth’s 800 billion tropical trees with trunk diameters of at least 10 cm. Despite differing biogeographic, climatic and anthropogenic histories7, we find notably consistent patterns of common species and species abundance distributions across the continents. This suggests that fundamental mechanisms of tree community assembly may apply to all tropical forests. Resampling analyses show that the most common species are likely to belong to a manageable list of known species, enabling targeted efforts to understand their ecology. Although they do not detract from the importance of rare species, our results open new opportunities to understand the world’s most diverse forests, including modelling their response to environmental change, by focusing on the common species that constitute the majority of their trees

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time, and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space. While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes, vast areas of the tropics remain understudied. In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity, but it remains among the least known forests in America and is often underrepresented in biodiversity databases. To worsen this situation, human-induced modifications may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge, it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Paracoccidioidomycosis In Cerebral Hemisphere And Brainstem: Case Report [paracoccidioidomicose Em Hemisfério Cerebral E Tronco Encefálico: Relato De Caso]

We report on a 36 years-old man that had been at the Amazon forest four years before. Six months before the admission he had developed a progressive quadriparesis, gait ataxia, dysphagia, dysarthria, difficulty in breathing and hiccup. The gadoliniumenhanced T1-weighted MRI showed a lesion into the right parietoccipital area and another into the medulla, that was the largest. There was any evidence of tuberculosis or AIDS. The patient was submitted to microsurgical approach to the medulla. Pathological examination revealed paracoccidioidomycosis. Treatment with anphotericin B till 2100mg was administered followed by sulfamethoxazole-trimetoprim for three months plus physical therapy. The patient went back to his activities six months after the end of the treatment. Comments are presented about the participation of the immunological system and of the cytokines (interleukines). © 2006 Associação Arquivos de Neuro-Psiquiatria.6403:00:00Colli, B.O., Assirati Jr., J.A., Machado, H.R., Intramedullary spinal cord paracoccidioidomycosis: Report of two cases (1996) Arq Neuropsiquiatr, 54, pp. 466-473Pacheco, R.A.B., Arruda, W.O., Hunhevicz, S.C., Tsubouchi, M.H., Torres, L.F.B., Thoracic intraspinal paracoccidioidomycosis: Case report (1996) Arq Neuropsiquiatr, 54, pp. 474-478Tristano, A.G., Chollet, M.E., Willson, M., Perez, J., Troccoli, M., Central nervous system paracoccidioidomycosis: Case report and review (2004) Invest Clin, 45, pp. 277-288Magalhaes, A.C., Caramelli, P., Silva, E.D., Magnetic resonance imaging in intracranial paracoccidioidomycosis (1993) J Neuroimaging, 3, pp. 216-219Almeida, S.M., Central nervous system paracoccidioidomycosis: An overview (2005) Braz J Infect Dis, 9, pp. 126-133Silva, C.E.A.P., Cordeiro, A.F., Gollner, A.M., Cupolilo, S.M.N., Quesado-Filgueiras, M., Curzio, M.F., Paracoccidioidomicose do sistema nervoso central: Relato de caso (2000) Arq Neuropsiquiatr, 58, pp. 741-747Moraes-Vasconcelos, D., Grumach, A.S., Yamaguti, A., Paracoccidioides brasiliensis disseminated disease in a patient with inherited deficiency in the beta 1 subunit of the interleukin (IL)-12/IL-23 receptor (2005) Clin Infect Dis, 41, pp. 31-37Del Brutto, O.H., Central nervous system mycotic infections (2000) Rev Neurol, 30, pp. 447-459Elias Jr., J., Dos Santos, A.C., Carlotti Jr., C.G., Central nervous system paracoccidioidomycosis: Diagnosis and treatment (2005) Surg Neurol, 63 (SUPPL.), pp. S13-S21Gonzales, A., Sahaza, J.H., Ortiz, B.L., Restrepo, A., Cano, L.E., Production of proinflammatoty cytokines during the early stages of experimental Paracoccidioides brasiliensis infection (2003) Med Mycol, 41, pp. 391-399Mamoni, R.L., Blotta, M.H., Kinetics of cytokines and chemokines gene expression distinguishes Paracoccidioides brasiliensis infection from disease (2005) Cytokine, 32, pp. 20-29Neworal, E.P., Altemani, A., Mamoni, R.L., Noronha, I.L., Blotta, M.H., Immunocytochemical localization of cytokines and inducible nitric oxide synthase (iNOS) in oral mucosa and lymph nodes of patients with paracoccidioidomycosis (2003) Cytokine, 21, pp. 234-241Peracoli, M.T., Kurokawa, C.S., Calvi, S.A., Production of pro- and anti-inflammatory cytokines by monocytes from patients with paracoccidioidomycosis (2003) Microbes Infect, 5, pp. 413-418Souto, J.T., Aliberti, J.C., Campanelli, A.P., Chemokine production and leukocyte recruitment to the lungs of Paracoccidioides brasiliensis-infected mice is modulated by interferon-gamma (2003) Am J Pathol, 163, pp. 583-590Pina, A., Valente-Ferreira, R.C., Molinari-Madlum, E.E., Vaz, C.A., Keller, A.C., Calich, V.L., Absence of interleukin-4 determines less severe pulmonary paracoccidioidomycosis associated with impaired Th2 response (2004) Infect Immun, 72, pp. 2369-2378Arruda, C., Valente-Ferreira, R.C., Pina, A., Dual role of interleukin-4 (IL-4) in pulmonary paracoccidioidomycosis: Endogenous IL-4 can induce protection or exacerbation of disease depending on the host genetic pattern (2004) Infect Immun, 72, pp. 3932-3940Romano, C.C., Mendes-Giannini, M.J., Duarte, A.J., Benard, G., The role of interleukin-10 in the differential expression of interleukin-12p70 and its beta 2 receptor on patients with active or treated paracoccidioidomycosis and healthy infected subjects (2005) Clin Immunol, 114, pp. 86-94Almeida, S.M., Queiroz-Telles, F., Teive, H.A., Ribeiro, C.E., Werneck, L.C., Central nervous system paracoccidioidomycosis: Clinical features and laboratorial findings (2004) J Infect, 48, pp. 193-198Duarte, A.L., Baruffa, G., Terra, H.B., Renck, D.V., Moura, D., Petrucci, C., Systemic paracoccidioidomycosis with central nervous system involvement (1999) Rev Soc Bras Med Trop, 32, pp. 439-442Fernandes, Y.B., Ramina, R., Borges, G., Queiroz, L.S., Maldaun, M.V.C., Maciel Jr., J.A., Orbital apex syndrome due to aspergillosis: Case report (2001) Arq Neuropsiquiatr, 59, pp. 806-80

Case report: Rickettsia sp. strain atlantic rainforest infection in a patient from a spotted fever-endemic area in southern Brazil

Santa Catarina State in southern Brazil is the state with the second highest number of laboratoryconfirmed cases of spotted fever illness in Brazil. However, all these cases were confirmed solely by serological analysis (seroconversion to spotted fever group rickettsiae), which has not allowed identification of the rickettsial agent. Here, a clinical case of spotted fever illness from Santa Catarina is shown by seroconversion and molecular analysis to be caused by Rickettsia sp. strain Atlantic rainforest. This is the third confirmed clinical case due to this emerging rickettsial agent in Brazil. Like the previous two cases, the patient presented an inoculation eschar at the tick bite site. Our molecular diagnosis was performed on DNA extracted from the crust removed from the eschar. These results are supported by previous epidemiological studies in Santa Catarina, which showed that nearly 10% of the most common human-biting ticks were infected by Rickettsia sp. strain Atlantic rainforest.953551553CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPSem informaçãoSem informaçãoSem informaçã

Case Report: Rickettsia Sp. Strain Atlantic Rainforest Infection In A Patient From A Spotted Fever-endemic Area In Southern Brazil

Santa Catarina State in southern Brazil is the state with the second highest number of laboratoryconfirmed cases of spotted fever illness in Brazil. However, all these cases were confirmed solely by serological analysis (seroconversion to spotted fever group rickettsiae), which has not allowed identification of the rickettsial agent. Here, a clinical case of spotted fever illness from Santa Catarina is shown by seroconversion and molecular analysis to be caused by Rickettsia sp. strain Atlantic rainforest. This is the third confirmed clinical case due to this emerging rickettsial agent in Brazil. Like the previous two cases, the patient presented an inoculation eschar at the tick bite site. Our molecular diagnosis was performed on DNA extracted from the crust removed from the eschar. These results are supported by previous epidemiological studies in Santa Catarina, which showed that nearly 10% of the most common human-biting ticks were infected by Rickettsia sp. strain Atlantic rainforest. © Copyright 2016 by The American Society of Tropical Medicine and Hygiene.95355155