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The hallmark of chronic Chagas disease cardiomyopathy (CCC) is the finding of a T cell-rich inflammatory mononuclear cell infiltrate in the presence of extremely few parasites in the heart lesions. The scarcity of parasites in affected heart tissue casts doubt on the direct participation of Trypanosoma cruzi in CCC heart tissue lesions, and suggests the possible involvement of autoimmunity. The cells in the infiltrate are presumably the ultimate effectors of tissue damage, and there is evidence that such cells recognize cardiac myosin in molecular mimicry with T. cruzi proteins rather than primary reactivity to T. cruzi antigens (Cunha-Neto et al. (1996) Journal of Clinical Investigation, 98: 1709-1712). Recently, we have studied heart-infiltrating T cells at the functional level. In this short review we summarize the studies about the role of cytokines in human and experimental T. cruzi infection, along with our data on heart-infiltrating T cells in human Chagas cardiomyopathy. The bulk of evidence points to a significant production of IFN-γ and TNF-α which may be linked to T.

Ascaris in the biliary tract may cause cholecystitis and obstruction of the common bile ducts. Two cases are presented where worms that were identified in the common bile duct caused obstructive jaundice. The image of the ascaris is typical in its morphology and movement. Ultrasonography is useful in the identification of this parasite in the biliary tract where other conventional radiological methods are frequently unsatisfactory.

Citation: Pontes MDS, Pires BPF, Albuquerque FP, Herrero CFPS. Assessment of the posterior approach for surgical treatment of spinal metastatic breast cancer. Acta Ortop Bras. [online]. 2020;28(1):22-5. Available from ABSTRACTObjective: To assess the clinical and radiological aspects of patients with spinal metastatic breast cancer who underwent surgical treatment by posterior approach. Methods: This is a retrospective and descriptive study. Clinical assessment included the patient's sex, age, surgical treatment employed and complications. Radiological assessment comprised the study of the morphopathological characteristics of the lesions. Results: Data from 44 patients (93.2% female) submitted to surgical treatment of spinal metastasis were collected. The average age of diagnosis was 56.79 years. Decompression and posterior fixation with pedicle screws were performed in 43.1% of patients, while 36.3% underwent decompression and posterior fixation with pedicle screws associated with corpectomy and replacement with intersomatic device filled with bone cement. In 20.4%, kyphoplasty was the chosen procedure. Eighteen percent of patients had surgical complications, and the thoracic spine was most affected by the tumor. Conclusion: The clinical and radiological presentation of this group of patients is variable. The posterior portion of the vertebrae was more affected than the anterior. Although surgical treatment by posterior approach does not have the objective of curing the underlying disease, it can present favorable results, with higher rate of complication in major surgeries. Level of evidence IV, Therapeutic Studys.

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