Aim This present study aims to compare the data from the Brazilian Unified Health System on the number of clinical consultations of Oral Medicine from the first 6 months (March-August 2020) of the COVID-19 pandemic in Brazil with the last 6 months (September-February 2020/2021) to update the data, verify the measures’ effectiveness to return clinical activities in the following months. Methods perform a literature review of recent articles that report the impact of the COVID-19 pandemic on Oral Medicine. Results There was an increase in the number of Oral Medicine clinical consultations in the second half of the pandemic throughout Brazil (+64.2%), representing over 9,235 appointments in this period. Conclusion measures for the return of health assistance and the practice of Telemedicine proved to be effective after the second period of the pandemic. Even so, strengthening security measures against the coronavirus is essential to ward off a new wave since the Omicron variant emerged in the country and, consequently, possible new lockdowns that might affect healthcare in Brazil. MarchAugust March August 2020 COVID19 COVID 19 COVID-1 SeptemberFebruary September February 2020/2021 20202021 2021 +64.2%, 642 +64.2% , 64 2 (+64.2%) 9235 9 235 9,23 so consequently 202 COVID1 1 COVID- 2020/202 2020202 +64.2 (+64.2% 923 23 9,2 20 2020/20 202020 +64. (+64.2 92 9, 2020/2 20202 +64 (+64. 2020/ +6 (+64 + (+6 (+ (

Abstract This study aims to reevaluate and compare the data from the Brazilian Unified Health System (SUS) on the number of diagnoses of systemic lupus erythematosus (SLE) in the pre-pandemic period with those in the pandemic period, as well as to compare the first year (2020) of the COVID-19 pandemic in Brazil with the last year (2021), to update the data, and to verify whether SLE disease control measures were effective in 2021. There was a consistent and significant increase in the incidence of SLE cases all over Brazil between the first and second pandemic years and between the pre-pandemic triennium and the second pandemic year. Therefore, it is inescapable to have larger clinical studies with different populations to better understand the relationship between these two conditions and find measures to improve the control of this disease. SUS (SUS (SLE prepandemic pre 2020 (2020 COVID19 COVID 19 COVID-1 2021, 2021 , (2021) Therefore 202 (202 COVID1 1 COVID- (2021 20 (20 2 (2 (

ABSTRACT Edible coating are commonly used as they minimize post-harvest losses and extend the shelf life of fruits. Therefore, in this study, analyzed the effect of edible coatings containing gibberellic acid (GA3) on the shelf life of tomatoes (Solanum lycopersicum L.). Tomatoes were divided into six groups: Uncoated (CT); coating with 75 and 100 mg L-1 of GA3 solubilized in water without adding pectin (A75 and A100, respectively); coating with 75 and 100 mg L-1 of GA3 with added pectin (P75 and P100, respectively); coating pectin only (PEC). Pectin-based coatings (PEC, P75, and P100) were produced by solubilizing pectin (3%) in water, followed by adding different concentrations of GA3.Treatments A75 and A100 were prepared with distilled water and 75 and 100 mg L-1 GA3. Tomatoes (turning stage) were immersed in the solutions for 3 min, dried at room temperature, and stored at 12 °C (90% RH). The pH, titratable acidity, soluble solids, color and weight loss were analyzed every four days for 32 days, and the firmness of the tomatoes was analyzed every seven days for 35 days. Coatings with GA3 maintained firmness, delayed weight loss, and decreased acidity, pH, sugar content, and color changes. Pectin-based coatings (P75, P100) were the most effective in delaying weight loss. The application of GA3 associated with pectin-based coatings delayed the ripening process, maintained the quality, and prolonged the shelf life of fruits. As this is an inexpensive technique, it may be used commercially. postharvest post harvest fruits Therefore study GA (GA3 Solanum L.. L L. . L.) groups CT (CT) 7 10 L1 1 L- A (A7 respectively respectively) P75 P (P7 P100 PEC. PEC (PEC) Pectinbased Pectin based PEC, (PEC 3% (3% GA3Treatments GATreatments Treatments A7 A10 turning stage min temperature C 90% 90 (90 RH. RH RH) pH acidity solids content changes pectinbased process quality technique commercially (GA (CT (A P7 (P P10 (3 A1 9 (9 P1 (

RESUMO Revestimentos comestíveis são comumente utilizados pois minimizam perdas pós-colheita e prolongam a vida útil dos frutos. Neste estudo, analisou-se o efeito de coberturas comestíveis contendo ácido giberélico (GA3) na vida útil de tomates (Solanum lycopersicum L.). Dividiu-se os tomates em seis grupos: Não revestidos (CT); revestimento com 75 e 100 mg L-1 de GA3 sem adição de pectina (A75 e A100); revestimento com 75 e 100 mg L-1 de GA3 com adição de pectina (P75 e P100); revestimento com pectina (PEC). Revestimentos à base de pectina (PEC, P75 e P100) foram produzidos solubilizando a pectina (3%) em água, seguida da adição das concentrações de GA3. Os tratamentos A75 e A100 foram preparados com água destilada e 75 e 100 mg L-1 de GA3. Os tomates (fase de viragem) foram imersos nas soluções durante 3 minutos, secos à temperatura ambiente e armazenados a 12 ° C (90% UR). O pH, acidez titulável, sólidos solúveis, cor e perda de massa foram analisados a cada quatro dias durante 32 dias, e a firmeza a cada sete dias durante 35 dias. As coberturas com GA3 mantiveram a firmeza, retardaram a perda de massa e diminuíram a acidez, pH, teor de açúcar e as alterações de cor. Revestimentos à base de pectina (P75, P100) foram os mais eficazes em retardar a perda de peso. A aplicação deste revestimento retardou o amadurecimento, manteve a qualidade e prolongou a vida útil dos frutos. É uma técnica economicamente viável, podendo ser utilizada comercialmente. póscolheita pós colheita frutos estudo analisouse analisou se GA (GA3 Solanum L.. L L. . L.) Dividiuse Dividiu grupos CT (CT) 7 10 L1 1 L- (A7 A100) P (P7 P100 PEC. PEC (PEC) PEC, (PEC P7 3% (3% A7 A10 fase viragem minutos 90% 90 (90 UR. UR UR) pH titulável solúveis P75, peso amadurecimento viável comercialmente (GA (CT (A (P P10 (3 A1 9 (9 P1 (

Abstract INTRODUCTION: Coronavirus disease 2019 (COVID-19) has limited the access of patients with Hansen's disease (HD) to care due to changes in routine health services. METHODS: To ascertain this, we compared the number of HD cases diagnosed before and after the COVID-19 pandemic. RESULTS: The decrease in HD cases in Brazil reached 18,223 (-48.4%), corresponding to an average reduction of 1,518 cases per month during the COVID-19 pandemic. CONCLUSION: Therefore, effective measures should be implemented to minimize the damage and the consequent negative health impact of COVID-19 on the care of HD patients.

A study was carried out in order to evaluated a model that estimates the net radiation (Rn) flux over a tomato crop (Lycopersicon esculentum Mill.) cv. Heinz 2150, under clear and cloudy conditions. For that purpose, an automatic meteorological station (EMA) was installed in the central part of the crop, located in the Panguilemo Experimental Station of the Faculty of Agronomy of the University of Talca (35º23’ S lat, 71°40’ W long, 110.5 m.o.s.l.). The EMA measured solar radiation, air temperature, relative humidity and vapor pressure at 20-min time intervals. Results indicated that the model was able to estimate the net radiation fluxes at 20-min time intervals with a standard error of estimate (DEE) of 34 W m-2 and absolute error (Ea) less than 3.2%. On a daily basis, the model estimated the Rn with a DEE and an Ea of 0.6 MJ m-2 d-1 (0.24 mm d-1)and 4.1% , respectively.

Se realizó un estudio para evaluar un modelo que estima el flujo de radiación neta (Rn) sobre un cultivo de tomates (Licopersicon esculentum Mill.) variedad Heinz 2150, bajo condiciones de día despejado y nublado. Para esto, una estación meteorológica automática (EMA) se instaló en la parte central del cultivo, localizado en la Estación Experimental de Panguilemo perteneciente a la Facultad de Ciencias Agrarias de la Universidad de Talca (35°26’ lat. Sur; 71°41’ long. Oeste, 110,5 m.s.n.m.). La EMA fue usada para medir el flujo de radiación neta, flujo de radiación solar, temperatura del aire, humedad relativa y presión de vapor en intervalos de 20 min. Los resultados indicaron que el modelo fue capaz de estimar el flujo de radiación neta en intervalos de 20 min, con una desviación estándar del error (DEE) igual a 34 W m-2 y un error absoluto (Ea) menor a 3,2%. En términos diarios, el modelo estimó el flujo de Rn con una DEE y Ea iguales a 0,6 MJ m-2 d-2 (0,24 mm d-1)y 4,1%, respectivamente.

O tratamento cirúrgico dos aneurismas cerebrais através de sua clipagem é reconhecido como eficaz e definitivo. Entretanto alguns casos sofrem nova hemorragia algum tempo após a cirurgia, deixando dúvidas sobre a "cura" pelo tratamento. Onze pacientes submetidos anteriormente a clipagem do aneurisma e que apresentaram nova hemorragia foram analisados. O intervalo de tempo da cirurgia para a nova hemorragia foi de 3 a 10 anos. Após a nova hemorragia, 4 pacientes tiveram evolução desfavorável. O novo episódio de hemorragia subaracnóide ocorreu devido a fatores intrínsicos dos vasos cerebrais ou a problemas técnicos. Dentre os fatores intrínsicos temos: l.um ponto fraco da parede do vaso próximo ao aneurisma, 2. um ponto fraco em outro vaso longe do aneurisma, 3. dilataçâo infundibular já existente próximo a artéria comunicante posterior. Devido a problemas técnicos encontramos: 1. aneurismas não identificados no tratamento anterior, 2. aneurisma deliberadamente não tratado, 3. persistência do aneurisma por cirurgia inapropriada, 4. persistência de parte do colo do aneurisma após a cirurgia, S. escorregamento do clip. As medidas para prevenir a nova hemorragia subaracnóide iniciam-se no estudo angiográfico pré-operatório, inspeção cuidadosa da posição do clip e no esvaziamento do aneurisma. A angiografia precoce pode revelar a persistência do colo e a tardia pode revelar o desenvolvimento de novos aneurismas. A hemorragia subaracnóide após a clipagem de aneurisma é um evento tardio e severo, e o conceito de "cura" após a cirurgia deve ser visto com reservas.

The surgical treatment of intracranial aneurysms by clipping is recognized as effective and definitive. However some cases that suffered a new subarachnoid hemorrhage (SAH) some time after they were submitted to aneurysm clipping have raised doubts about the concept of "cure"after this treatment. Eleven patients previously submitted to aneurysm clipping who presented a new SAH were analyzed. The time elapsed from surgery to SAH varied from 3 to 10 years. After SAH four patients had a poor outcome. The new episode of SAH occurred due to intrinsic factors of the cerebral vasculature: 1. a weak point of the vessel wall near the previous aneurysm, 2. a weak point of another vessel far from the previous aneurysm, 3. a previous infundibular dilation of the posterior communicating artery; and due to technical problems: 1. aneurysm not identified during the previous treatment, 2. aneurysm deliberately left untreated, 3. persistence of the aneurysm due to inappropriate surgery, 4. persistency of part of the aneurysm neck after clipping and 5. slipping of the clip from the neck of the aneurysm. The measures to prevent new SAH after surgery start with adequate preoperative angiographic studies, a careful inspection of the position of the clip and emptying of the aneurysm. Early angiography studies may reveal a persistent neck and later ones may reveal newly developed aneurysms. In conclusion, SAH after aneurysm clipping is a late and severe phenomenon and the concept of "cure" after this surgery should be interpreted with caution.

Neste estudo são analisadas as evoluções clínicas de 225 pacientes que apresentaram hemorragia subaracnóidea (HSA) por ruptura de aneurismas, atendidos no período de 1985 a 1990. A idade dos pacientes variou de 7 a 84 anos, com predomínio na faixa de 30 a 50 anos (60%). Quanto ao sexo, houve predomínio do feminino (62,2%). Quanto à localização dos aneurismas rotos, os pacientes distribuiram-se em: 75 na artéria carótida interna, 66 na comunicante anterior, 61 na cerebral média, 14 na circulação posterior, 1 na cerebral anterior distal; e 8 em localização não identificada. Quarenta e cinco pacientes (20%) apresentaram mais de um aneurisma. Quarenta e quatro pacientes foram submetidos a tratamento cirúrgico nas primeiras 72 horas após a HSA, 40 no período de 4 a 7 dias, 16 no período de 8 a 10 dias e 57 após o 10º dia. As evoluções clínicas dos pacientes estudados são analisadas, baseadas na época da cirurgia em relação à HSA.

The clinical course of patients with subarachnoid hemorrhage (SAH) due to rupture of cerebral aneurysm admitted during the last five years is analysed: 157 patients were treated by direct surgical approach of the aneurysm, 58 localized in the anterior communicating artery (ACoA), 48 in the internal ctarotid artery (ICA), 43 in the middle cerebral artery (MCA), and 8 in the posterior circulation. Fourty-four patients were operated on during the first 72 hours (early surgery), 40 during the 4th and 7th days, 16 during the 8th and the 10th, and 57 after the 10th (late surgery), According to main localizations, the outcome of patients with aneurysms in the ACoA was good in 79.1%, in the ICA in 69.7%, and in the MCA in 69.7%. Patients treated in Hunt & Hess grade I and II had both good results in 77.5%, grade HI patients had good results in 71.3%, and grade IV in 56.2%. According to timing of surgery good results were observed in 61.4% for patients submitted to early surgery, in 80% for patients treated during the 4th and 7th days, in 81.2% for patients treated during the 8th and the 10th days, and in 70.2% for that submitted to late surgery. The overall mortality was 14.6%. For grade I patients mortality was 6.4%, for grade, II was 12.2%, for grade III was 15.2%, for grade" IV was 25%, and all patients operated on in grade V died. Mortality for patients operated on during the first 72 hours was 29.5%, during the 4th and the 7th days was 15.0%, during the 8th and the 10th days was 6.2%, and after the 10th day was 8.7%. The mortality of non operated patients was 88.2%. The overall outcome for patients with aneurysm rupture was 52% and the overall mortality was 36.8%. Based on the results regarding the final clinical outcome early surgery for treatment of intracranial aneurysms was effective as late surgery, although

Os autores apresentam sua experiência em 102 crianças com hidrocefalia de diversas etiologias, acompanhadas por 5 1/2 anos. Cerca de 80% dessas crianças tinham idade inferior a dois anos, o que possibilitou seu acompanhamento com a ultra-sonografia craniana (4,4 exames por paciente). Os resultados a longo prazo são comparáveis aos obtidos na literatura com redação ao número de procedimentos por paciente (1,66), índice de infecqões (5,2%), mortalidade (6,8%) e desenvolvimento intelectual. A ultra-sonografia mostrou-se útil porque é inócua, tem baixo custo operacional, é comparável à tomografia computadorizada nessa faixa etária, podendo ser repetida rotineiramente e permitindo um relacionamento entre o médico, a criança e sua mãe que afetam favoravelmente o diagnóstico precoce de complicações e a melhor compreensão da patologia pelos pais.

A personal series (in 94% of the cases) of 102 children who underwent 170 procedures (1.66 procedures/patient) for hydrocephalus has been followed for 5 1/2 years (Jan-S3 to Jun-88). Most of the children were under two years of age (80%) and in these cases brain sonography was the examination of choice for both diagnosis and follow-up (307 examinations, 4.4 per patient). Only occasionally was computed tomography necessary for better study in these cases. Our results suggest that there was no significant difference between our cases and those published in the litterature concerning the number of procedures/patient (1.66)., infection rate (5.2%), mortality rate (6.8%) and intellectual performance. We recommend the use of brain sonography both in diagnosis and follow-up studies for hydrocephalic children since this examination is innocuous, inexpensive and easy to perform by neurosurgeons. Also it provides a good interaction between the examiner, the child and the parents, which is of utmost importance for the comprehension of the disease by the parents and early diagnosis of complications by the neurosurgeon.

Foram analisados retrospectivamente 42 pacientes com aneurismas múltiplos (17,8% do total de pacientes com aneurismas) atendidos no período de 1975 a março de 1986. Vinte e sete eram do sexo feminino e 15 do masculino, com idade variando da terceira à sétima décadas. Trinta e um pacientes tinham 2 aneurismas (15 uni e 16 bilaterais), 6 tinham 3 (2 uni e 4 bilaterais), 3 tinham 4 (todos bilaterais) e 2 tinham 5 (bilaterais), totalizando 102 aneurismas (61 na carótida interna, 27 na cerebral média, 9 no complexo cerebral anterior/comunicante anterior, 3 na basilar e 2 na cerebral anterior distai). Todos os casos foram internados por hemorragia subaracnóidea e 11 foram classificados em grau I, 12 em grau II, 15 em grau III e 4 em grau IV na internação. Os pacientes foram mantidos em repouso absoluto, sob sedação e a evolução pré-operatória mostrou melhora clínica da maioria dos pacientes (29 operados em grau I, 7 em grau II e 6 em grau III). A cirurgia foi realizada tardiamente na maioria dos casos (28 entre o 11º e o 30º dia) e os 42 pacientes foram submetidos a 57 craniotomias para clipagem dos aneurismas. Dos 24 pacientes com aneurismas bilaterais, 15 foram operados dos dois lados (11 estão assintomáticos e 1 com hemiparesia e 3 faleceram tardiamente por outras causas que não hemorragia subaracnóidea). Dos 9 pacientes submetidos a craniotomia unilateral, 4 faleceram e 5 estão bem. Dos 18 pacientes com aneurismas unilaterais, 11 estão assintomáticos, 2 apresentam hemiparesia, 1 apresenta diplegia e distúrbios do comportamento e 4 faleceram. A mortalidade global foi de 26,1% durante todo o seguimento, a mortalidade operatória foi 11,9% e não houve mortalidade nos casos operados nos últimos 5 anos. A conduta preconizada para o tratamento destes pacientes é discutida.

A retrospective study was conducted on 42 patients with multiple aneurysms surgically treated from 1975 to 1986. Thirty one of them had 2 aneurysms 6 had 3, 3 had 4 and 2 had 5 (62 in the internal carotid, 27 in the middle cerebral artery, 11 in the anterior cerebral and 3 in the basilar artery). All patients had subarachnoid hemorrhage and were classified as follows upon admission: 11, grade I; 12, grade II; 15, grade III, and 4, grade IV, and most of them improved before surgery (29, grade I, 7, grade II, and 6, grade III). In most cases, surgery was delayed and the 42 patients needed 57 craniotomies for clipping the aneurysms. Of the 24 patients with bilateral aneurysms, 15 were operated on both sides (11 are asymptomatic, 1 has hemiparesis, and 3 died later). Of the 9 patients submitted to unilateral craniotomy, 4 died and 5 are alive and well. Of the 18 patients with unilateral aneurysms, 11 are asymptomatic, 2 have hemiparesis, 1 has diplegia and behavioral disorders, and 4 died. Overall mortality was 26.1%, intraoperative mortality was 11.9%, and no mortality occurred among the patients operated over the last 5 years. The management of the these patients is discussed.

Foram analisados 353 pacientes que faleceram por hemorragia subaracnóidea autopsiados nos últimos 10 anos no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. A hemorragia subaracnóidea estava associada a hipertensão arterial em 180 casos, a ruptura de aneurismas em 102 e a outras patologias em 71 casos. O sexo masculino predominou nos pacientes com hemorragia associada a hipertensão arterial e o feminino nas hemorragias por ruptura de aneurismas. As hemorragias associadas a hipertensão arterial predominaram em faixas etárias mais altas em relação às hemorragias por aneurismas. Dos pacientes com aneurismas, 36 (35,3%) apresentaram aneurismas no complexo cerebral anterior/comunicante anterior, 30 (29,4%) na carótida interna e 23 (22,5%) na cerebral média. Nos casos de aneurismas, o vasoespasmo predominou no período do 3º ao 10º dia e o ressangramento predominou no período do 9º ao 16º e respectivamente 59,1% e. 61,5% desses pacientes apresentaram-se nos graus I e II na admissão e evoluíram para o grau IV após estas intercorrências. Ambas as intercorrências foram mais freqüentes entre os pacientes com aneurismas do complexo cerebral anterior/comunicante anterior. Sessenta e oito por cento dos óbitos por aneurismas ocorreram nos 9 primeiros dias após a hemorragia. Os pacientes admitidos em grau I e II e que sofreram vasoespasmo ou ressangramento e que poderiam beneficiar-se do tratamento cirúrgico precoce não tiveram esta oportunidade porque a nossa conduta naquela época era de operar sistematicamente no final da segunda ou no início da terceira semana após a hemorragia subaracnóidea.

A study was conducted on the medical records of 353 patients who died of a subarachnoid hemorrhage (SAH) and who were submitted to autopsy over the last 10 years. SAH was associated with arterial hypertension in 180 (51%) cases, with ruptured aneurysms in 102 (28.9%), and with other pathologies in 71 (20.1%). The patients with hemorrhage associated with arterial hypertension were mostly males, and those with hemorrhage due to aneurysms were mostly females. Of the patients with aneurysms, 36 (35.3%) had aneurysms in the anterior communicating artery, 30 (29.4%) in the internal carotid artery, and 23 (22.6%) in the middle cerebral artery. Among the patients with aneurysms who suffered rebleeding and vasospasm, 59.1% and 61.5%, respectively, were classified as grade I and II upon admission, and all evolved toward grade IV after these complications, Vasospasm predominated from the 3rd to the 10th day after hemorrhage, and rebleedine from the 9 to 16th day and both were most frequent among patients with aneurysms of the anterior communicant artery. Sixty eight percent of the patients with aneurysms died during the first 9 days after hemorrhage. Because of our conduct was to operate systematically late, a considerable number of patients lost the oportunity to be treated surgically with possible favorable evolution due to vasospasm or rebleeding.

A observação de lesões múltiplas na tomografia computadorizada do crânio é sempre motivo de preocupação devido à possibilidade frequente de etiologia neoplásica, embora patologias granulomatosas, infecto-parasitárias ou não, e acidentes vasculares cerebrais possam produzir lesões semelhantes. Neste trabalho são analisados 5 casos de pacientes que se apresentaram com quadros neurológicos sugestivos de processos expansivos intracranianos e que na tomografia computadorizada mostraram lesões hipercaptantes múltiplas que induziram ao diagnóstico inicial de neoplasia. Em todos os pacientes a complementação diagnóstica e/ou a evolução clínica mostraram a natureza não neoplásica das lesões. Em três pacientes a lesão era inflamatória (um paciente com tuberculomas intracranianos e dois pacientes com neurocisticercose) e os dois pacientes restantes apresentavam infartos cerebrais múltiplos, sem outro substrato. O conhecimento das várias patologias que ocasionam lesões múltiplas na tomografia computadorizada do crânio permite o direcionamento do diagnóstico etiológico que é fundamental para o tratamento adequado, evitando-se a irradiação de lesões não neoplásicas e cirúrgicas desnecessárias. Portanto, especialmente em nosso meio, as doenças granulomatosas parasitárias, principalmente a neurocisticercose, a tuberculose e as micoses profundas, devem constar do diagnóstico diferencial das lesões múltiplas intracranianas observadas na tomografia computadorizada, juntamente com os infartos cerebrais e as neoplasias.

Multiple intracranial lesions observed in the computerized tomography ever cause worry due to the possibility of neoplastic etiology, although granulomatous diseases (parasitic or not) and vascular diseases can produce this type of lesions. Five patients with clinical picture that sugested expansive intracranial masses and that had multiple lesions in the computerized tomography that sugested neoplastic diseases are presented. In all patients the clinical evolution and/or other complementary diagnostic tests showed the non neoplastic etiology of the lesions. In three patients the lesions were due to parasitic diseases (intracranial tuberculomas in one case and neurocysticercosis in two cases) and in the other two cases the lesions were due to vascular disturbs (cerebral infarcts). The knowledge of the several diseases that can cause multiple intracranial lesions as seen in the computerized tomography allows to direct the etiologic diagnostic that is essential to introduce the correct treatment avoiding irradiation of non neoplastic lesions and unnecessary surgical procedures. In our country, granulomatous parasitic diseases, mainly neurocysticercosis, tuberculosis and fungal diseases must be considered in the differential diagnosis of multiple intracranial lesions observed in the computerized tomography, together with cerebral infarcts and neoplasms.

O caso descrito refere-se a paciente do sexo feminino, com 22 anos, com história de dois episódios de crise convulsiva lateralizada à direita, hemiparesia direita e disfasia. O exame neurológico mostrou ainda edema de papila bilateral. A tomografia computadorizada (TC) do crânio mostrou um cisto de 70x77 mm, ocupando a região fronto-parieto-temporal esquerda, ocasionando grande desvio da linha média, além de outras lesões menores, semelhantes, esparsas no parênquima. Com o diagnóstico de neurocisticercose foi submetida a craniotomia, sendo removidos o cisto maior (cisticerco racemoso) e pequeno cisticerco cortical (10x10 mm) para exame. Teve alta 13 dias após a cirurgia, com regressão completa do quadro neurológico, exceto o edema de papila (regressão parcial). Um mês após foi submetida a tratamento com praziquantel (50 mg/kg/dia durante 20 dias). O exame de LCR foi normal antes deste tratamento e, durante ele, apresentou reação celular eosinofílica, com positivação da reação de fixação de complemento para a cisticercose, ambas transitórias. A TC prévia ao tratamento mostrou várias áreas hipodensas de 10 a 40 mm, esparsas no parênquima, inclusive na área operada- A TC realizada três meses após mostrou diminuição do número de cistos do parênquima, persistindo apenas uma área hipodensa de 20 mm no local operado e dilatação do corno frontal do ven-trículo do mesmo lado. A evolução clínica foi excelente e o exame neurológico foi normal 3 meses depois.

The authors report a case of a female patient, age 22, who presented episodes of focal seizures, right hemiparesis and dysphasia of five months duration. The neurologic exam revealed bilateral papilledema and computarized tomography of the head showed a cystic lesion (70x77 mm) in the left fronto-temporo-parietal area, midline shift and similar lesions scattered in the brain parenchyma. She was submitted to a left craniotomy with the diagnosis of cerebral cysticercosis and the major cyst (Cysticercus racemosus) and a small cortical cyst (10x10 mm) were removed to aliviate the increased intracraneal pressure and for histopathological examination. Thirteen days after surgery she was discharged without neurological deficits, except mild papilledema. One month later she was treated with praziquantel (50 mg/kg/day) during 21 days. The CSF examination was normal before the treatment started and showed a transient eosinophilic cellular reaction with positivation of the complement fixation test for cysticercosis while on treatment. The CT-Scan performed before the medical treatment revealed ventricular dilatation and several low density areas (10 to 40 mm) scattered in the cerebral parenchyma, including the operative site. CT-Scan performed three months later showed small low density areas only in the left cerebral hemisphere, including the operative site, calcification in the parenchyma, and slight dilatation of the left lateral ventricle. The clinical evolution was uneventfull and the neurologic examination was normal three months later.

Estudo das alterações observadas nas tomografias computadorizadas (TCs) de 16 casos de neurocisticercose, com hipertensão intracraniana por hidrocefalia. Todos os casos foram submetidos a radiografias simples do crânio e 12, à ventriculografia com Dimer-X. Nas radiografias simples foram observados sinais de hipertensão intracraniana em 7, calcificações em um, e d foram normais. A TC mostrou parênquima cerebral normal em 9 casos e nos 7 restantes áreas hipodensas arredondadas de tamanho variado, com ou sem retenção de contraste na periferia, e/ou calcificações esparsas no parenquima. Hidrocefalia foi a única alteração observada no sistema ventricular nos casos em que o exame foi realizado previamente à derivação do LCR. As ventriculografias foram analisadas em trabalho anterior e permitiram localizar e determinar as características da obstrução e a presença de massas ocupando espaço dentro dos ventrículos. A comparação das ventriculografias e TCs realizadas na mesma época evidenciou que a primeira fornece melhores informações sobre o sistema ventricular mas, por outro lado, a tomografia fornece informações adicionais sobre o parênquima cerebral. A TC e a ventriculografia são exames que se completam na avaliação e no diagnóstico destes pacientes.

The authors reviewed the alterations observed on computorized tomography (CT) examinations of 16 patients with increased intracranial pressure and obstructive hydrocephalus due to cerebral cysticercosis. Plain radiograms of the skull were available in all cases and Dimer-X ventriculography in 12 cases. In 7 cases there were radiologic signs of increased intracranial pressure. CT scan showed normal cerebral parenchyma in 9 cases and low density areas, with various size, with or without surround contrast enhancement, and/or small calcifications in the parenchyma. Hydrocephalus was the only alteration observed in the ventricular system in the case that the examination was done before ventricular drainage. Ventriculography was analyzed in other paper and permitted to situate the obstruction, determine its morphological characteristics and identify occuping space lesions within the ventricles. Comparison between ventriculography and CT scan made in the same period evidenced that the former gives best information about the ventricular system and that tomography gives additional information about the cerebral parenchyma. In conclusion, CT scan and ventriculography are investigations that complete each the other for evaluation and diagnosis of cerebral cysticercosis.

Os autores expõem a experiência adquirida com a utilização da ultra-sonografia (Modo-B e real-time) na avaliação de crianças com afecções neurológicas durante o primeiro ano de vida. A rapidez com que o exame é realizado (20 minutos), seu baixo custo, a desnecessidade de sedação e ausência de irradiação e o fato de ser um exame dinâmico tornam esta técnica útil, mesmo quando comparado com a Tomografia Computadorizada. Seu valor maior está na análise, diagnóstico e acompanhamento dos hidrocéfalos, embora sua utilização se estenda a outros diagnósticos dentro da faixa etária estabelecida.

The ultrasonography (Mode B - Real Time) experience was analyzed to evaluate neurological diseases in children during their first year of life. Forty-two examination were accomplished in twenty-eight children with the following diagnosis: hydrocephalus (22), normal (15), subdural hygroma (3), intracranial cyst and hydrocephalus (1), giant encephalocele (1). The technique consists of positioning the transducer in the coronal, sagital and axial direction and selecting dynamically the images to be photographed. In the coronal position, the height of the lateral ventricle and the width of the third ventricule were obtained. In the axial position, the ventricular ratio-lateral ventricle width cerebral hemisphere width was obtained. Although it was a small group of patients, those indexes can objectify the ventricular size variation in children with well or poor functioning shunts. The importance of this method was the possibility to follow the development of hydrocephalus in cases of myelomeningocele and to analyze the etiology and features of hydrocephalus with or without shunts. In conclusion, this test is very usefull, mainly because it is very brief (about 20 minutes), the patient does not need sedation, it is innocuous, very precise even when compared with computarized tomography and for its low cost.