Amaurose fugaz como sintoma inicial de carcinoma de células renais metastático

Introdução: Neste caso, descrevemos a apresentação rara da metástase orbitária de um carcinoma renal de células claras. Apresentação do caso: Apresentamos um caso de um homem de 57 anos de idade, que subitamente perdeu a visão em seu olho esquerdo associada à paralisia da abdução do mesmo. A ressonância magnética do crânio revelou um tumor intra-orbitário esquerdo com dimensões de 21,8 x 19,6 mm, provocando um deslocamento centro-lateral com consequente compressão do nervo óptico e do músculo reto lateral homolateral. O paciente foi submetido à remoção cirúrgica da lesão. O diagnóstico histológico indicou metástase de carcinoma renal de células claras confirmada pela tomografia computadorizada abdominal (TC), que apresentou neoplasia no terço superior do rim esquerdo, medindo 3,5 x 3,4 cm com reforço heterogêneo após administração intravenosa de contraste. Conclusão: Este caso descreveu a apresentação rara de uma metástase orbital de carcinoma renal de células claras. A apresentação inicial do paciente foi amarose fugaz e paralisia homolateral do nervo abducente. A metástase orbital de carcinoma renal de células claras é rara, no entanto, o exame histológico conclui o diagnóstico.Background: In this case we describe the rare presentation of orbital metastasis of a clear cell renal carcinoma. Case Report: We present a case of a 57-year-old male with suddenly lost the vision in his left eye and homolateral abducens palsy. The magnetic resonance imaging of the skull revealed a left intraorbital tumor with center-lateral displacement measuring 21.8 x 19.6 mm, compressing the optic nerve and the homolateral lateral rectus muscle. The patient underwent surgical removal of the lesion. The histologic diagnosis indicated clear cell renal carcinoma metastasis confirmed by the abdominal computed tomography (CT), which showed a neoplasia in the upper third of the left kidney measuring 3.5 x 3.4 cm with heterogeneous reinforcement after intravenous contrast administration. Conclusion: This case described the rare presentation of a clear cell renal carcinoma metastasis in orbit. The initial presentation of patient was amarosis fugax and homolateral abducens palsy. Orbital metastasis of clear cell renal carcinoma are rare, however, the histologic exam conclude the diagnosis

The prevalence of headache and psychosocial factors associated among medical students in a university of northeast Brazil

Introdução: A cefaleia é uma afecção que impacta negativamente a qualidade de vida da pessoa. O curso de medicina é reconhecidamente um gerador de esgotamento e, de acordo com a literatura, fatores estressantes são mais comuns em alunos de medicina que na população em geral, podendo desencadear a cefaleia. Esses fatores estressores podem ser intensificados em períodos que antecedem as provas devido a mudanças nos hábitos de sono e de estudo, havendo uma possível relação com o surgimento de cefaleias primárias. Objetivo: Avaliar a prevalência de cefaleia primária nos estudantes de medicina (EM) em períodos de provas e relacionar com fatores psicossociais. Métodos: Trata-se de um estudo transversal, baseado na aplicação de dois questionários a uma amostra de 219 EM do 1º ao 8º semestre de uma universidade no interior do Ceará. Um questionário relacionou a cefaleia com fatores psicossociais em períodos de provas. O segundo questionário: HSQ-DV, foi utilizado para o diagnóstico de enxaqueca e cefaleia do tipo tensional (CTT). Resultados: 98% dos EM relataram já ter sentido cefaleia. A prevalência de CTT e enxaqueca encontradas foi de 61,9% e 18,1%, respectivamente, dados maiores que a média para a população geral. Estudantes com enxaqueca têm mais crises antes de provas, se automedicam mais, ingerem mais psicoestimulantes, são mais ansiosos, mais depressivos, mais sedentários, mais estressados e dormem menos que aqueles com CTT. Conclusão: De fato, os EM são um grupo de risco para o desenvolvimento de cefaleias, merecendo, portanto, uma maior ênfase de pesquisas científicas sobre as cefaleias primárias neste grupo.Introduction: Headache is a condition that impacts negatively the patients’ quality of life. The medical course is a known generator of exhaustion and, according to the literature, stressors are more common in medical students (MS) than in the general population, which can trigger a headache. These stressors can be intensified in periods that precede the tests due to changes in sleep and in study habits, with a possible relation with the appearance of primary headache. Objective: To associate the presence of primary headache in MS during periods of tests and to relate to psychosocial factors. Methods: This is a cross-sectional study based on the application of two questionnaires to a sample of 219 MS from the 1st to the 8th semester of a university in Northeast Brazil. The first questionnaire related headache with psychosocial factors in periods of tests. The second questionnaire: HSQ-DV, was used for the diagnosis of migraine and tension-type headache (TTH). Results: 98% of MS reported having experienced headache. The prevalence of TTH and migraine was 61.9% and 18.1%, respectively, higher than the average for the general population. Students with migraine have more attacks before tests, self-medicate more, ingest more psychostimulants, are more anxious, more depressed, more sedentary, more stressed, and sleep less than those with TTH. Conclusion: In fact, MS are a risk group for the development of headache, thus deserving a greater emphasis of scientific research on primary headaches in this group

Diffusion tensor imaging abnormalities of the trigeminal nerve root in patients with classical trigeminal neuralgia: a pre- and postoperative comparative study 4 years after microvascular decompression

International audienc

Complete C4-C5 Dislocation Secondary to Shallow Water Diving in a Child: A Case-Based Update

Introduction Pediatric spinal cord injury (PSCI) is rare, especially secondary to shallow water diving, with only a few cases recorded in the literature. Due to the low standardization in the diagnosis and treatment of this condition, each of these cases requires a personalized approach

Genomic epidemiology reveals how restriction measures shaped the SARS-CoV-2 epidemic in Brazil

Abstract Brazil has experienced some of the highest numbers of COVID-19 infections and deaths globally and made Latin America a pandemic epicenter from May 2021. Although SARS-CoV-2 established sustained transmission in Brazil early in the pandemic, important gaps remain in our understanding of local virus transmission dynamics. Here, we describe the genomic epidemiology of SARS-CoV-2 using near-full genomes sampled from 27 Brazilian states and an adjacent country - Paraguay. We show that the early stage of the pandemic in Brazil was characterised by the co-circulation of multiple viral lineages, linked to multiple importations predominantly from Europe, and subsequently characterized by large local transmission clusters. As the epidemic progressed, the absence of effective restriction measures led to the local emergence and international spread of Variants of Concern (VOC) and under monitoring (VUM), including the Gamma (P.1) and Zeta (P.2) variants. In addition, we provide a preliminary genomic overview of the epidemic in Paraguay, showing evidence of importation from Brazil. These data reinforce the need for the implementation of widespread genomic surveillance in South America as a toolkit for pandemic monitoring and providing a means to follow the real-time spread of emerging SARS-CoV-2 variants with possible implications for public health and immunization strategies

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data