Non epileptogenic Rasmussen`s encephalitis: a case report

Introduction: Rasmussen's encephalitis (RE) is a very rare chronic inflammatory unilateral encephalopathy with still unknown etiology. It predominantly affects children under the age of 10, but can also affect adolescents and adults. Current evidence on possible etiologies are divided in two main theories. The first one is based on brain inflammation caused by a reaction to a foreign antigen. The second one is based on an autoimmune disease that is limited to a single hemisphere of the brain. The common presentation is intractable and frequent focal motor seizures, often associated with progressive neurological decline, and progressive unilateral focal cortical atrophy. Progression of the inflammatory process in MRI is considered a good biomarker in RE. Objectives: Report a rare case of a female infant presenting atypical manifestations of uncommon symptoms without seizures caused by Rasmussen's encephalitis. Case Report: A ten-year-old right-handed female presented to the emergency department with sudden onset of abnormal involuntary movements of the right upper and lower limbs, face paresia of the same side and loss of attention without loss of consciousness. The involuntary contractions were brief, random, irregular, and worsened with activity, along with a positive milkmaid grip sign. She also displayed reduced movement speed and hyperactive biceps, triceps, patellar and ankle jerk reflexes. Associated with the motor abnormalities, the girl presented with a recent but progressive decrease in cognitive functions, which caused a decline in school performance and impaired reasoning, and affective blunting. She had no sign of previous neuropsychomotor development abnormality. She was taken to a quaternary hospital where a MRI and a CT of the brain were performed. MRI showed atrophy of the left cerebral hemisphere, predominantly in the operculum and head of the caudate nucleus, hypersignal in the insular cortex and adjacent white matter. CT presented with hypoattenuation of the left frontal lobe and parieto-occipital white matter associated with atrophy of the head of the caudate nucleus of the same side and enlargement of the adjacent fissures and sulcus. A subsequent PET-CT showed a left cerebral hemisphere hypometabolism, predominantly in the basal ganglia, temporal, frontal and insular lobes. Functional evaluation detected diffuse unilateral disorganization of brain electric activity, but no epileptic paroxysmal discharges were found on the electroencephalogram. After hospitalization, human immunoglobulin at the dose 2g/kg/day was used for five days. The girl remained stable, with no complications. After sixteen days, she was discharged with a rehabilitation program and follow-up care

Omphalophlebitis in a Calf - Treatment with Umbilical Vein Marsupialization

Background: Omphalophlebitis is characterized as an omphalopathy that affects the umbilical vein. In these cases, ultrasonography can help identify the severity of abdominal lesions and guide the choice of treatment. Marsupialization of the umbilical vein is a surgical procedure indicated in cases where this vessel presents with purulent secretion up to the liver parenchyma. This report describes a case of omphalophlebitis in a heifer treated by marsupialization of the umbilical vein. The preoperative and postoperative sonographic findings are also described. Case: A 4-day-old Holstein calf was attended at the Veterinary Hospital (HV) of the Universidade Federal de Goiás (UFG), Goiânia, Brazil. On physical examination, the animal was found to be apathetic, with tachycardia, tachypnea, hyperthermia, hyperemic mucous membranes, and moderate dehydration. An increase in volume was observed in the umbilical region, with local hyperthermia, firm consistency, and sensitivity to palpation. On deep palpation of the abdomen, a mass originating in the umbilical region and extending cranially was observed, leading to the suspicion of omphalophlebitis. Abdominal ultrasonography revealed external umbilical abscess and omphalophlebitis. Initially, conservative treatment with antibacterial and anti-inflammatory drugs was performed; however, there was no improvement in the clinical picture. Therefore, exploratory celiotomy was performed to remove the umbilical infectious focus. During the procedure, it was verified that the umbilical vein was dilated with a thickened wall until its insertion in the hepatic parenchyma, hence removal of the infected region through a ligature was not possible. Thus, marsupialization of the umbilical vein was performed to create a cutaneous opening for drainage of the purulent contents. In the postoperative period, antibacterial, anti-inflammatory, and analgesic drugs were administered. Dressing of the surgical wound and of the umbilical vein lumen was performed with topical polyvidone at 0.2%. Removal of the stitches was done 14 days postoperatively. Weekly ultrasonographic examinations were performed, which showed a gradual reduction in the diameter of the umbilical vein throughout the postoperative period. Thirty days after the surgical procedure, no further drainage of the purulent content was observed from the umbilical vein, and healing of the stump was demonstrated. After 7 months, a repeat ultrasonography was performed, revealing normal echogenicity and echotexture of the hepatic parenchyma and complete atrophy of the umbilical vein. Discussion: Umbilical vein marsupialization is a surgery rarely described in the literature, and no report has followed the evolution of a case by ultrasonography. The ultrasound examination of the umbilical structures was essential for the definitive diagnosis and choice of surgical treatment. Marsupialization of the umbilical vein was chosen due to the impossibility of ligature of this vessel, which presented with thickened walls and lumen filled with purulent content until its insertion into the liver. Postoperative monitoring via serial ultrasonography examinations allowed follow up of the evolution of the case and animal recovery. At the sonographic reevaluation after 7 months, the findings were unremarkable, indicating complete recovery of the patient. Umbilical marsupialization is a surgical technique that allows complete recovery of calves with severe omphalophlebitis. Ultrasonography is fundamental for the diagnosis of omphalophlebitis and in determining the best therapeutic protocol. Sonographic evaluation during the postoperative period allows follow-up of the progression of lesions in abdominal structures and helps in defining the prognosis. Keywords: omphalophlebitis, ultrasonography, hepatic abscess, liver, surgery. Título: Onfaloflebite em bezerra - tratmento com marsupialização da veia umbilical Descritores: onfaloflebite, ultrassonografia, abscesso hepático, fígado, cirurgia

UTILIZAÇÃO DO TESTE HIPOSMÓTICO PARA AVALIAR A EFICÁCIA DE DIFERENTES PROTOCOLOS DE CRIOPRESERVAÇÃO DO SÊMEN CAPRINO

Este estudo teve por objetivo comparar a eficácia de quatro protocolos de congelação do sêmen caprino (glicerol, glicerol+EDTA; etilenoglicol; etilenoglicol+EDTA), através da utilização do teste hiposmótico (HOST). O sêmen foi colhido de dois machos da raça Alpina, sexualmente maduros, diluído nos diferentes meios, congelado e armazenado em nitrogênio líquido. Após a colheita, 20ìL do sêmen fresco foram incubados com 01mL de solução hiposmótica (combinação de citrato de sódio e frutose em água destilada com osmolaridade de 125mOsmol), em banho-maria a 370C por 30 minutos. Este procedimento foi repetido após a descongelação e, em seguida, uma amostra foi colocada sobre lâmina/lamínula e avaliada em contraste de fase com mil vezes de aumento. Um total de 100 células foi contado, e as médias percentuais de espermatozóides com edema ou dobramento de cauda, após o HOST, foram – para o sêmen fresco, glicerol, glicerol+EDTA; etilenoglicol; etilenoglicol+EDTA –, respectivamente, 53,89; 16,90; 10,25; 52,64 e 57,54. PALAVRAS-CHAVE: Caprinos, criopreservação, sêmen, teste hiposmótic

Rarity of monodominance in hyperdiverse Amazonian forests.

Tropical forests are known for their high diversity. Yet, forest patches do occur in the tropics where a single tree species is dominant. Such "monodominant" forests are known from all of the main tropical regions. For Amazonia, we sampled the occurrence of monodominance in a massive, basin-wide database of forest-inventory plots from the Amazon Tree Diversity Network (ATDN). Utilizing a simple defining metric of at least half of the trees ≥ 10 cm diameter belonging to one species, we found only a few occurrences of monodominance in Amazonia, and the phenomenon was not significantly linked to previously hypothesized life history traits such wood density, seed mass, ectomycorrhizal associations, or Rhizobium nodulation. In our analysis, coppicing (the formation of sprouts at the base of the tree or on roots) was the only trait significantly linked to monodominance. While at specific locales coppicing or ectomycorrhizal associations may confer a considerable advantage to a tree species and lead to its monodominance, very few species have these traits. Mining of the ATDN dataset suggests that monodominance is quite rare in Amazonia, and may be linked primarily to edaphic factors

Local hydrological conditions influence tree diversity and composition across the Amazon basin

Tree diversity and composition in Amazonia are known to be strongly determined by the water supplied by precipitation. Nevertheless, within the same climatic regime, water availability is modulated by local topography and soil characteristics (hereafter referred to as local hydrological conditions), varying from saturated and poorly drained to well-drained and potentially dry areas. While these conditions may be expected to influence species distribution, the impacts of local hydrological conditions on tree diversity and composition remain poorly understood at the whole Amazon basin scale. Using a dataset of 443 1-ha non-flooded forest plots distributed across the basin, we investigate how local hydrological conditions influence 1) tree alpha diversity, 2) the community-weighted wood density mean (CWM-wd) – a proxy for hydraulic resistance and 3) tree species composition. We find that the effect of local hydrological conditions on tree diversity depends on climate, being more evident in wetter forests, where diversity increases towards locations with well-drained soils. CWM-wd increased towards better drained soils in Southern and Western Amazonia. Tree species composition changed along local soil hydrological gradients in Central-Eastern, Western and Southern Amazonia, and those changes were correlated with changes in the mean wood density of plots. Our results suggest that local hydrological gradients filter species, influencing the diversity and composition of Amazonian forests. Overall, this study shows that the effect of local hydrological conditions is pervasive, extending over wide Amazonian regions, and reinforces the importance of accounting for local topography and hydrology to better understand the likely response and resilience of forests to increased frequency of extreme climate events and rising temperatures

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 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 or ganism 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 ne glected 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 lostinfo:eu-repo/semantics/publishedVersio