Fly puparia and adult fragments of diptera muscid were found inside the esophagus of a mummified body from the early XIX century, buried inside the crypt of the Sacrament Church (Lisbon, Portugal)
Lymphomas are malignant lymphoid tumours arising from lymphocytic cells. They usually develop in the lymphoid tissues and can spread to other organs; however, primary extra-nodal locations such as the spinal epidural space are less common. The authors report the case of a primary diffuse large B-cell lymphoma of the thoracic spine in a 65-year-old man, who presented to the emergency department with signs of upper motor neuron lesion. The patient underwent surgery in order to decompress the spinal cord. The treatment was concluded with six cycles of chemotherapy with methotrexate, rituximab, cyclophosphamide, vincristine and prednisone followed by radiotherapy. At the 24-month follow-up, no signs of epidural lesion or bone contrast enhancement were observed in thoracic spine MRI. Surgical decompression is recommended in patients with signs of spinal cord injury in order to prevent irreversible neurological damage and is related to high rates of disease-free survival.
HYPERTENSION AND EXERCISE: THE BASIS FOR PRESCRIPTIONPhysical activity is associated with health benefits including a reduction in blood pressure (BP). A recent meta-analysis shows that exercise may reduce BP to a degree comparable to first-line BP-lowering drugs.It was originally thought that the BP-lowering effect of exercise was limited to endurance exercise and that resistance or isometric exercise was harmful. Recent evidence contests this idea. The evidence is scarce but suggests a role for exercise in the primary prevention of hypertensive disease. The favourable influence of exercise on important risk factors such as hypertriglyceridemia and overweight has already been demonstrated.Exercise is important in the primary and secondary prevention of hypertension. For most patients, the benefits of exercise largely exceed the risks. For individuals at risk, medical evaluation is indicated in order to allow safe and patient-oriented prescription of exercise.
Primary intraventricular haemorrhage (PIVH) is an uncommon type of intracerebral haemorrhage, accounting for only 0.31% of all strokes and 3.1% of all intracerebral haemorrhages. Due to the low incidence of PIVH, little is known about its clinical characteristics, risk factors, aetiologies, prognosis and treatment. Acute hydrocephalus is common and is associated with a poor prognosis. External ventricular drainage (EVD) could promptly reduce intracranial pressure by diverting cerebrospinal fluid and intraventricular blood; however, the incidence of complications such as central nervous system infection, catheter occlusion and rebleeding are relatively common. Despite being an invasive procedure, frontal minicraniotomy is an available therapeutic option to avoid complications of EVD. The authors report a case of a PIVH managed with frontal minicraniotomy and perform a literature review about epidemiological data, clinical features and treatment of PIVH.
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