A giant solid cystic inferior fourth ventricle subependymoma: Case report and literature review

Subependymomas are a rare subtype of ependymomas, slow growing WHO grade I tumors that develop either intracranial from the subependymal glial precursor cells layer of the ventricles or intramedullary. These tumors originate in the undifferentiated Subependymal layer of cells that can become either ependymocytes or astrocytes. Most of the subependymomas are located inside the fourth ventricle (50-60%). We reviewed the case of a 40 years old woman with a giant solid cystic fourth ventricle ependymoma. The patient underwent total resection of the tumor through a subociipital transvermian approach. We discussed the characteristics of these benign tumors and reviewed the literature on this subject and concluded that total resection is the treatment of choice for symptomatic Subependymomas localized in posterior fossa

Thymus transplantation for complete DiGeorge syndrome: European experience

Background: Thymus transplantation is a promising strategy for the treatment of athymic complete DiGeorge syndrome (cDGS). Methods: Twelve patients with cDGS were transplanted with allogeneic cultured thymus. Objective: To confirm and extend the results previously obtained in a single centre. Results: Two patients died of pre-existing viral infections without developing thymopoeisis and one late death occurred from autoimmune thrombocytopaenia. One infant suffered septic shock shortly after transplant resulting in graft loss and the need for a second transplant. Evidence of thymopoeisis developed from 5-6 months after transplantation in ten patients. The median (range) of circulating naïve CD4 counts (x10663 /L) were 44(11-440) and 200(5-310) at twelve and twenty-four months post-transplant and T-cell receptor excision circles were 2238 (320-8807) and 4184 (1582 -24596) per106 65 T-cells. Counts did not usually reach normal levels for age but patients were able to clear pre-existing and later acquired infections. At a median of 49 months (22-80), eight have ceased prophylactic antimicrobials and five immunoglobulin replacement. Histological confirmation of thymopoeisis was seen in seven of eleven patients undergoing biopsy of transplanted tissue including five showing full maturation through to the terminal stage of Hassall body formation. Autoimmune regulator (AIRE) expression was also demonstrated. Autoimmune complications were seen in 7/12 patients. In two, early transient autoimmune haemolysis settled after treatment and did not recur. The other five suffered ongoing autoimmune problems including: thyroiditis (3); haemolysis (1), thrombocytopaenia (4) and neutropenia (1). Conclusions: This study confirms the previous reports that thymus transplantation can reconstitute T cells in cDGS but with frequent autoimmune complications in survivors

Effect of magnesium and vitamin B6 supplementation on mental health and quality of life in stressed healthy adults: Post‐hoc analysis of a randomised controlled trial

Magnesium status and vitamin B6 intake have been linked to mental health and/or quality of life (QoL). In an 8‐week Phase IV randomised controlled study in individuals with low magnesemia and severe/extremely severe stress but who were otherwise healthy, greater stress reduction was achieved with magnesium combined with vitamin B6 than with magnesium alone. We present a previously unreported secondary analysis of the effect of magnesium, with and without vitamin B6, on depression, anxiety, and QoL. Adults with Depression Anxiety Stress Scales (DASS‐42) stress subscale score >18 were randomised 1:1 to magnesium + vitamin B6 combination (Magne B6®; daily dose 300 and 30 mg, respectively) or magnesium alone (Magnespasmyl®; daily dose 300 mg). Outcomes included changes from baseline in DASS‐42 depression and anxiety scores, and QoL (Short Form‐36 Health Survey). DASS‐42 anxiety and depression scores significantly improved from baseline to week 8 with both treatments, particularly during the first 4 weeks. Improvement in QoL continued over 8 weeks. Participants' perceived capacity for physical activity in daily life showed greater improvement with magnesium + vitamin B6 than magnesium alone (Week 4). In conclusion, magnesium supplementation, with or without vitamin B6, could provide a meaningful clinical benefit in daily life for individuals with stress and low magnesemia

A extrafiscalidade e os controles de proporcionalidade e de igualdade

O presente estudo tem como foco central a definição da forma de sindicância das imposições e exonerações tributárias extrafiscais. A relevância do tema se faz sentir em razão do considerável aumento de emprego destas espécies de medidas, sem a respectiva atenção aos seus reflexos no âmbito das garantias e direitos fundamentais. O objetivo último da análise proposta ao longo do estudo é demonstrar que - diferentemente do entendimento predominante em nosso Poder Judiciário - o emprego de instrumentos tributários para a perseguição de finalidades não arrecadatórias ou, ainda, causadores de efeitos preponderantemente não-arrecadatórios não é imune ao controle judicial. Ao contrário, pretende-se esclarecer que os postulados da proporcionalidade e da igualdade servem como critérios para assegurar a compatibilidade entre as finalidades perseguidas ou efeitos causados por estes instrumentos tributários extrafiscais e os demais valores resguardados pelo ordenamento jurídico. Neste sentido, sustentar-se-á que, ao invés de representar um obstáculo absoluto ao exame do mérito das medidas adotadas pelo Poder Legislativo, o sobreprincípio da separação de poderes apenas modifica a extensão e forma de execução do controle judicial. A realização do estudo parte de premissas doutrinárias sobre a extrafiscalidade e do exame do estágio atual de evolução da jurisprudência nacional para definir as causas e conseqüências da ausência de um controle efetivo neste campo do Direito Tributário. Posteriormente, apresenta-se aqueles critérios que deveriam ser empregados para este mesmo controle.The present paper's central scope is to establish the definition and the form in which the scrutiny of regulatory taxes are imposed and exempted. The relevance of the subject is perceived in light of the considerable increase of the use of these kinds of measures without the respective attention to its reflexes in the realm of fundamental rights and guarantees. The final purpose of the analysis presented throughout this study is to demonstrate that, differently from what is stated in the dominant precedents in our Judiciary, the use of regulatory taxes for non-collection purposes, or even that may cause preponderantly non-collection effects are not immune to judicial control. On the contrary, the object of this paper is to clarify that the principles of proportionality and equality are to be used as criteria to insure the compatibility between the ends pursued and the effects caused by these regulatory taxes and other principles safeguarded by the legal system. In this sense, it is sustained that instead of representing an absolute obstacle to performing the merits exam of the measures taken by the Legislative Power, the separation of powers sobreprincípio only modifies the extension and form of the judicial control that is to be performed. The completion of the study is based upon doctrinarian premises about the regulatory taxes and the exam of the current stage and evolution of the national jurisprudence in defining causes and consequences of the absence of an effective control in this field of Tax Law. Afterwards, the criteria that should be used for this same control are presented

A extrafiscalidade e os controles de proporcionalidade e de igualdade

O presente estudo tem como foco central a definição da forma de sindicância das imposições e exonerações tributárias extrafiscais. A relevância do tema se faz sentir em razão do considerável aumento de emprego destas espécies de medidas, sem a respectiva atenção aos seus reflexos no âmbito das garantias e direitos fundamentais. O objetivo último da análise proposta ao longo do estudo é demonstrar que - diferentemente do entendimento predominante em nosso Poder Judiciário - o emprego de instrumentos tributários para a perseguição de finalidades não arrecadatórias ou, ainda, causadores de efeitos preponderantemente não-arrecadatórios não é imune ao controle judicial. Ao contrário, pretende-se esclarecer que os postulados da proporcionalidade e da igualdade servem como critérios para assegurar a compatibilidade entre as finalidades perseguidas ou efeitos causados por estes instrumentos tributários extrafiscais e os demais valores resguardados pelo ordenamento jurídico. Neste sentido, sustentar-se-á que, ao invés de representar um obstáculo absoluto ao exame do mérito das medidas adotadas pelo Poder Legislativo, o sobreprincípio da separação de poderes apenas modifica a extensão e forma de execução do controle judicial. A realização do estudo parte de premissas doutrinárias sobre a extrafiscalidade e do exame do estágio atual de evolução da jurisprudência nacional para definir as causas e conseqüências da ausência de um controle efetivo neste campo do Direito Tributário. Posteriormente, apresenta-se aqueles critérios que deveriam ser empregados para este mesmo controle.The present paper's central scope is to establish the definition and the form in which the scrutiny of regulatory taxes are imposed and exempted. The relevance of the subject is perceived in light of the considerable increase of the use of these kinds of measures without the respective attention to its reflexes in the realm of fundamental rights and guarantees. The final purpose of the analysis presented throughout this study is to demonstrate that, differently from what is stated in the dominant precedents in our Judiciary, the use of regulatory taxes for non-collection purposes, or even that may cause preponderantly non-collection effects are not immune to judicial control. On the contrary, the object of this paper is to clarify that the principles of proportionality and equality are to be used as criteria to insure the compatibility between the ends pursued and the effects caused by these regulatory taxes and other principles safeguarded by the legal system. In this sense, it is sustained that instead of representing an absolute obstacle to performing the merits exam of the measures taken by the Legislative Power, the separation of powers sobreprincípio only modifies the extension and form of the judicial control that is to be performed. The completion of the study is based upon doctrinarian premises about the regulatory taxes and the exam of the current stage and evolution of the national jurisprudence in defining causes and consequences of the absence of an effective control in this field of Tax Law. Afterwards, the criteria that should be used for this same control are presented