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This systematic review compiles reports of clinical pythiosis in horses, mules and donkeys from 1960 to 2023 worldwide, focusing on Brazil. We searched databases and included 71 articles detailing clinical characteristics, geographic distribution, epidemiology, diagnostic methods, therapies, and outcomes. The results showed that publications on equine pythiosis have significantly increased since 2010. Brazil reported the highest incidence, comprising 55% of cases, predominantly in the southern, northeastern, and central-western regions during summer and autumn. Cutaneous pythiosis was the most prevalent form, generally presenting as single lesions in the appendicular region, and affected females more than males. Diagnosis typically involved histopathology, used alone or with other methods. Various treatments have been employed, with surgery, often combined with chemotherapy and immunotherapy, being the most common. Notably, 80.84% of treated animals recovered, highlighting the effectiveness of these therapies in enhancing survival rates. The limitations of the study included the lack of data in published case reports, which made it difficult to collect and calculate epidemiological data. Additionally, we recognize that pythiosis in Brazil is underreported, since this disease does not have mandatory notification and several cases are not registered and/or reported in the literature. Lastly, it is hypothesized that equid pythiosis may be more widespread than currently known, and its real occurrence in Brazil remains uncertain.

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OBJECTIVE: Nasal or extranasal natural killer/T-cell lymphoma (NKTCL) is a very rare aggressive lymphoma, but it is increasingly diagnosed. To evaluate some specificity by comparative analysis between primary upper aerodigestive tract (UAT) and non-upper aerodigestive tract (NUAT)NKTCL. METHODS: A retrospective analysis was performed on NKTCL patients from January 2013 to November 2022 in our cancer center. RESULTS: The majority of the lesions were UAT-NKTCL 70 cases (92.1%), the primary NUAT occurred in 6 cases. Patients in the UAT group were mainly in the early stage and in the low and medium risk, while those in the NUAT group were late stage and in high risk (p = 0.000). The expressions of CD3 and TIA-1 in UAT group were higher than those in NUAT group (p = 0.031, p = 0.003), while CD7 was dominant in NUAT group (p = 0.009). For early stage NKTCL, multivariate analysis suggested that gender and PINK score were independent factors affecting PFS and OS (p < 0.05). The 3 year OS rate in initial CR group was 90.1% versus 46.4% in non-CR group (p = 0.000). In advanced stage, KI67% and bone marrow involvement were independent factors affecting OS (p = 0.022, p = 0.038). CONCLUSION: It was difficult to distinguish between UAT and NUAT-NKTCL from histopathology. NUAT-NKTCL patients did have advanced stage and poor outcome. The prognostic value of PINK score and bone marrow involvement was proposed. We aimed to improve initial CR rates, as well as to find new predictive models to predict the whole population.

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Abstract Objectives: To analyze and summarize the clinical features and image characteristics of Meniere's Disease (MD) patients with Endolymphatic Hydrops (EH) confirmed by enhanced Magnetic Resonance Imaging (MRI). Methods: 252 MD patients with EH confirmed by MRI were enrolled. All patients met the diagnostic criteria forMD and underwent intravenous gadolinium injection. After 4 h, MR examinations were performed. The Nakashima grading standard was used to classify EH and evaluate its correlation with clinical features. Results: Different degrees of EH were shown in all MD patients, and 157 of the 252 (62.3%) patients showed significant EH, 95 of the 252 (37.7%) patients showed mild EH. Only 89 (35.3%) met the diagnostic criteria for definite MD, and the remaining 163 (64.7%) patients met the diagnostic criteria for probable MD. Compared with patients with unilateral EH, the symptoms of the first affected ear of patients with bilateral EH were more serious. The degree of EH was related to the degree of hearing loss (p< 0.05). Conclusion: MRI with intravenous gadolinium injection can provide a better assessment of EH in MD patients. The clinical features of MD patients with EH confirmed by enhanced MRI did not fully meet the existing diagnostic criteria for definite MD. Including the diagnosis of EH in the diagnostic criteria of MD can increase the diagnosis rate of MD. The degree and distribution of EH may be related to the degree of hearing loss. Level of evidence: 4.

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OBJECTIVES: To analyze and summarize the clinical features and image characteristics of Meniere's Disease (MD) patients with Endolymphatic Hydrops (EH) confirmed by enhanced Magnetic Resonance Imaging (MRI). METHODS: 252 MD patients with EH confirmed by MRI were enrolled. All patients met the diagnostic criteria for MD and underwent intravenous gadolinium injection. After 4 h, MR examinations were performed. The Nakashima grading standard was used to classify EH and evaluate its correlation with clinical features. RESULTS: Different degrees of EH were shown in all MD patients, and 157 of the 252 (62.3%) patients showed significant EH, 95 of the 252 (37.7%) patients showed mild EH. Only 89 (35.3%) met the diagnostic criteria for definite MD, and the remaining 163 (64.7%) patients met the diagnostic criteria for probable MD. Compared with patients with unilateral EH, the symptoms of the first affected ear of patients with bilateral EH were more serious. The degree of EH was related to the degree of hearing loss (p < 0.05). CONCLUSION: MRI with intravenous gadolinium injection can provide a better assessment of EH in MD patients. The clinical features of MD patients with EH confirmed by enhanced MRI did not fully meet the existing diagnostic criteria for definite MD. Including the diagnosis of EH in the diagnostic criteria of MD can increase the diagnosis rate of MD. The degree and distribution of EH may be related to the degree of hearing loss.

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Although Chikungunya infection is emerging as an important public health problem in many countries, it is not regarded as a life-threatening disease. Information dealing with fatal cases is scarce. We herein describe three patients with Chickungunya infection who presented with multiple organ failure and died within 24h of admission. Two cases had positive anti-dengue IgM, but dengue coinfection was rejected based on the clinical features and results of real-time reverse transcription polymerase chain reaction. These cases illustrate the challenges of the diagnosis and management of severe Chikungunya infection.

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Introducción: la arteritis temporal constituye una arteritis de células gigantes, la más común en la población en la población mayor de 50 años y usualmente mal diagnosticada. Objetivo: mostrar elementos novedosos en el diagnóstico, presentación clínica, histoquímica y aspectos imagenológicos de la arteritis temporal. Material y Métodos: se realizó una revisión bibliográfica mediante la consulta de bases de datos de los sistemas referativos: MEDLINE, PubMed, Scielo y EBSCO, con la utilización de descriptores como Arteritis temporal, arteritis de células gigantes, diagnóstico, características clínicas y hallazgos imagenológicos. Resultados: es la arteritis de células gigantes más frecuente después de 50 años, etiológicamente asociada a la inmunosenescencia, factores genéticos e infecciones virales; constituyendo la biopsia el elemento pilar en su diagnóstico; empleando en su manejo terapéutico esteroides, inmunosupresores y anticuerpos monoclonales con éxito variable. Conclusiones: la arteritis temporal de células gigantes inmunomediada es una entidad asociada al envejecimiento, con cuadro clínico variado y modificaciones de laboratorio específicas, tratadas por diferentes terapias donde el manejo con glucocorticoides sigue siendo el predominante.

Introduction: the temporal arteritis is a giant cell arteritis, the most common in the population with more than fifty years, and usually are misdiagnosed. Objectiv: to show novel elements in the diagnosis: clinical feature, histochemical aspects, and imagenology of this arteritis. Material and Methods: reference systems such as MEDLINE, PUBMED, SCIELO and ESBCO were consulted. It was also made a revision of descriptors like temporal arteritis, giant cell arteritis, clinical feature, and images findings. Results: is a most common giant cell arteritis in patients with more than fifty years old, associated usually to immunosenescence, genetics factors and viral infections; the biopsy is a main resource in its diagnosis. Steroids, immunosupresors and monoclonal antibodies have been used in its treatment. Conclusions: the temporal arteritis is a immunomediated giant cell arteritis, aging associated, with varied clinical feature and specifics laboratory parameters, treated with different therapies but the steroids therapy is predominant.

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Introducción: el dengue constituye un serio problema de salud y una alerta constante para el sistema epidemiológico nacional, presentando un complejo sintomático que involucra el sistema estomatognático. Objetivo: se realizó este estudio con el objetivo de caracterizar la muestra socio-demográficamente y acorde con formas clínicas de dengue, identificar las lesiones bucales y faciales presentes, y describir los hallazgos de laboratorio de la muestra. Material y Método: un estudio descriptivo de corte transversal en 368 pacientes del total de pacientes internados con diagnóstico clínico de dengue en los Hospitales «Freyre de Andrade¼ y «Clínico Quirúrgico 10 de Octubre¼ en el período julio 2012 a noviembre 2012. Se tomaron datos sociodemográficos y clasificación de dengue de historias clínicas, se efectuó examen clínico del complejo bucofacial y se registraron los valores de exámenes complementarios los que se promediaron y se determinó su desviación standard. Resultados: de los 368 pacientes, 57,1% fueron del sexo femenino, 32,3% tenían entre 20-29 años de edad y 14,4% diagnosticados de dengue hemorrágico. El 86,1% de los casos presentó eritema facial; el dolor retrorbitario y las petequias palatinas se reportaron en 77,4 y 23,9% de los casos respectivamente. Conclusiones: los hallazgos bucofaciales se asocian frecuentemente a la infección por dengue, relacionados con su forma clínica y sus modificaciones en los parámetros de laboratorio.

Introduction: dengue constitutes a serious problem of health and a constant alert for the National epidemiological System, presenting a symptomatic complex that involves the orofacial region. Objective: this study was done with the objectives:, to characterize the sample social-demographically and according with a clinical type of dengue; to identify Orofacial findings , and to describe laboratory findings of sample. Material and Method: a descriptive cross-sectional study was conducted in 368 patients of the total of patients who were hospitalyzed with the diagnosis of dengue in the Hospitals «Freyre de Andrade¼ and «10 de Octubre¼, La Havana. Cuba, from july 2012 to November 2012. Social-demographical data and clinical type of dengue were obtained of medical records. Clinical examination of orofacial complex was done, and the values of lab exams obtained were averaged and standard desviation was obtained. Results: 368 patients were studied, the 57,1% of the sample were female, the 32,2% of the patients were with age among 20-29 years, the 14,4% were diagnosed of hemorragic fever of dengue. The 86,1% had facial erythema; the retrobital pain and palatine petechiae were reported in 77,4 and 23,9% respectively. Conclusions: the orofacial findings are associated to dengue infection frequently, being these related with their clinical type and their modifications in the laboratory parameters.

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El Fibroma Traumático (FT) se considera la patología reactiva de tejido conjuntivo más frecuente de la cavidad bucal, cuya etiología es el trauma crónico. Es más frecuente en la segunda década de la vida, se presenta sin predilección por grupo étnico o género y aparece en áreas frecuentemente traumatizadas como carrillos, bordes laterales de lengua y labio inferior. Se presentan dos casos, ambos pacientes presentados en este trabajo fueron de sexo femenino, la primera de ellas de 59 años de edad y portadora de prótesis total superior, que mostró al examen clínico una lesión particular donde la presión mecánica de la prótesis ocasionó un crecimiento tumoral de 1cm de diámetro, color rosa pálido, lisa y brillante que se desprende del paladar duro a través de un pedículo. Esta lesión al examen clínico podría pasar desapercibida por la forma como se apoya sobre la mucosa del paladar. La otra paciente mostraba la lesión típica que caracteriza al FT, patología tumoral, sésil, en labio superior lado izquierdo, antre la comisura y la línea media del paciente, aproximadamente 6mm de diámetro, color rojizo y erosionada en la superficie, asociada a fricción crónica posterior a un trauma. La conducta a seguir para ambos casos fue extirpación quirúrgica y estudio histopatológico, obteniéndose como diagnóstico definitivo FT. La importancia de estos casos se basa en que ambas patologías aunque tienen el mismo diagnóstico histopatológico poseen presentaciones clínicas completamente distintas y una de ellas inusual, esto probablemente originado por el agente causal

Traumatic fibrosis (TF) is considered the reactive connective tissue disease more common in the oral cavity, the etiology is chronic trauma. It is more common in the second decade of life, is presented without preference for gender or ethnic group and appears frequently traumatized areas such as cheeks, lateral edges of tongue and lower lip. Both cases was in female patients, the first is 59 years old and superior total prosthesis, clinical examination showed a particular injury where the mechanical pressure of the prosthesis caused a tumor growth completely flattened 1cm in diameter, pale pink, smooth and bright that it appears the hard palate through a pedicle. This injury to the clinical examination may go unnoticed by the way is based on the mucosa of the palate. The other patient showed the typical lesion characteristic of the FT, tumor pathology, sessile on the upper lip, approximately 6mm of diameter, reddish and eroded on the surface friction associated with chronic post-trauma. The conduct to be followed in both cases was surgical excision and histopathology, obtained as a definitive diagnosis: TF. The importance of these cases is based on both disorders but have the same histopathological diagnosis have completely different clinical presentations and one of them is unusual, this probably originated by the causal agent

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