First genome sequence of St. Louis encephalitis virus (SLEV) isolated from a human in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Adenocalymma ubatubensis Assis & Semir, a new species of Bignoniaceae from Ubatuba, São Paulo state, Brazil

Adenocalymma ubatubensis, a new species from southeastern coastal Brazil, is described and illustrated. The species is distinguished by its large pseudostipules and calyx without nectaries.

Staurogyne rubescens (Aeanthaeeae), a new species from southeastern Brazil

A new species of Acantbaceae, Staurogyne rubescens, is described and illustrated. It is endemic to the Brazilian moist forests on the eastern range of mountains named Serra do Mar and is thus far known only from the states of Rio de Janeiro and São Paulo. Staurogyne rubescens can be distinguished by its lax terminal racemes, with bracts and bracteoles that are foliaceous, and the flowers that have a pink calyx and red corolla. Staurogyne itatiaiae (Wawra) Leonard also has red flowers and occurs in the highlands of the Atlantic rain forest. The distinguishing characters for these two species are presented in tabular format.

Paronychia revoluta, a new species of caryophyllaceae from Brazil

A new species of Paronychia, P revollita, from the state of Rio Grande do Sul, Brazil, is described and illustrated. This species is closely related to P camphorosmoides, distinguished from it by linear-subulate leaves with a revolute margin and prominent midribs. It is also allied to P. fascicidata, from which it differs in the lanceolate, acuminate, fimbriate, and whitish stipules, and linear-subulate leaves.

Three New Species of Salacia from Mesoamerica (Celastraceae, Salacioideae)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A New Species of Meliosma (Sabiaceae) from Southeastern Brazil and Notes on the Genus

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Typification of Neotropical Species of Staurogyne (Acanthaceae)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A noteworthy new species of Peritassa (Celastraceae, Hippocrateoideae) from Amazonian Brazil

The new species Peritassa Manaoara, Lombardi differs from other species in Peritassa Miers by its unique 3-lobed stigma. The inclusion of this new taxon in Peritassa was based on the characteristics of non-confluent anther locules and the disc free from the ovary wall, which distinguishes this species from Tontelea Aublet, the Only other genus of Neotropical Hippoerateoideae species with a 3-lobed stigma and tubular nectariferous disc.

Three new South American species of Salacia with fasciculate inflorescences (Celastraceae, Hippocrateoideae)

Three new fasciculate flowered species of Salacia L. (Celastraceae, Hippocrateoideae) from the Amazon basin are described: S. acevedoi Lombardi is distinguished by its small flowers, stamens with short filaments, disc connate to ovary, and size of fruits; S. negrensis Lombardi differs by its habit, characteristics and shape of leaves, flower diameter, features and size of stamens, and number of ovules: and S. odorata Lombardi is characterized by its long pedicels, conical flower buds, strongly adherent petals. and flat disc with fimbriate outer border.

Three new species of Vitaceae from mesoamerica

Three new species, Cissus nicaraguensis, C. patellicalyx, and Ampelocissus mesoamericana, are described from Nicaragua, Costa Rica, and El Salvador, respectively. Cissus nicaraguensis can be distinguished from all other Neotropical species by the combination of urceolate calyx and simple leaves. Cissus patellicalyx is recognized by its subspherical floral buds, immature fruits minutely tuberculate when dried, and the distinctly raised nerves of the abaxial leaf surface. Ampelocissus mesoamericana is characterized by lenticels, indument, and the obpyriform flower buds.

Thyroid cell proliferation in Graves' disease - Use of MIB-1 monoclonal antibody

OBJECTIVE: To measure thyroid cell proliferation in patients with Graves' disease (GD) before and during treatment with antithyroid drugs.STUDY DESIGN: Patients were assessed by fine needle aspiration biopsy before (n=20) and after 4 (n=19) and 12 months of treatment (n=15) with propylthiouracil or methimazole. Cell proliferation index (CPI) was estimated by immunocytochemistry using MIB-1. CPI was studied in relation to the cytologic parameters of the smears; clinical parameters, such as Wayne's Clinical Index (WCI) and time without treatment; laboratory parameters, such as (131)Iuptake and dosage of serum free thyroxin and thyroid-stimulating hormone; and thyroid ultrasound.RESULTS: CPI varied from 0.00% to 25.00% before treatment, 0.00% to 23.00% at 4 months and 0.00% to 14.84% at 12 months. CPI median values were 6.50%, 4.30% and 3.30%, respectively (before and after 4 months and 12 months of treatment). CPI had a positive correlation with WCI and FT4 at 12 months of treatment.CONCLUSION: Thyroid CPI in GD varies from case to case. However, due to its decreasing pattern during follow-up and its positive correlation with thyrotoxicosis severity, CPI may indicate the functional status of the gland and contribute to a better understanding of GD.

Primary Pulmonary Choriocarcinoma After Human Chorionic Gonadotropin Normalization Following Hydatidiform Mole A Report of Two Cases

BACKGROUND: Primary pulmonary choriocarcinoma (PPC) is rare and frequently leads to death.CASES: Two young patients presented with previous molar pregnancy and spontaneous serum human chorionic gonadotropin (hCG) normalization. Patient 1 was referred to our center after partial response to chemotherapy. Pulmonary lobectomy was performed, and hCG rapidly declined. During further chemotherapy, liver metastasis was detected by positron emission tomography. Right hepatectomy was performed, and hCG declined for 28 days, but increased again despite chemotherapy. This patient died from hepatic failure 3 years after diagnosis. Patient 2 presented with persistently high hCG, though the affected organ was not identified. Chemotherapy was unsuccessful. Patient reevaluation showed an isolated pulmonary mass. Pulmonary lobectomy was performed; 2 weeks later, hCG was normal and consolidation with 2 cycles of chemotherapy was administered. The patient has been in remission for 24 months. PPC was confirmed by histo pathology and immunohistochemistry in both cases. Gestational origin of the tumor was confirmed by molecular genetic analysis (polymorphic microsatellite markers).CONCLUSION: The possibility of choriocarcinoma cannot be overlooked in young women with an isolated pulmonary mass. Early diagnosis, prompt chemotherapy, and surgical resection in a specialized center improves the prognosis. (J Reprod Med 2010;55:311-316)

Geographical Distribution and Demographic Characteristics of Gestational Trophoblastic Disease

OBJECTIVE: To outline the geographical distribution pattern of gestational trophoblastic disease (GTD) in a referral center in Bahia, Brazil, and determine the demographics of the disease.STUDY DESIGN: We conducted a study of data retrieved from medical records of 140 GTD patients referred to our Trophoblastic Diseases Center in 2002-2007, assessing geographical distribution across health care districts, demographics, referral sources, and previous pregnancy status.RESULTS: The most common GTD types were hydatidiform mole (106, 75.7%), invasive mole (32, 22.9%), choriocarcinoma (1, 0.7%), and placental site trophoblastic tumor (1, 0.7%). GTD incidence was 8.5 in 1,000 deliveries. Most patients originated from the coastal region (East district), which includes the state capital (77.9%). The 20-34 age group predominated (65%). Education level (67.9% attended elementary school only) and employment rate (42.9%) were low. Secondary hospitals were the principal source of referral (84.3%), followed by self-referrals (15.7%). Regarding previous pregnancy status, 42.1% (n = 59) had had term pregnancy, 39.3% (n = 55) no pregnancy, 15% (n = 21) miscarriage, and 0.7% (n = 1) ectopic pregnancy; 4 patients (2.9%) had previous hydatidiform mole.CONCLUSION: GTD predominated in the peak fertility age group and among patients of unfavorable sociodemographic status. (J Reprod Med 2010;55:305-310)

Assessment of Quality of Life and Psychologic Aspects in Patients with Gestational Trophoblastic Disease

OBJECTIVE: To assess quality of life (QoL) and psychological aspects in patients with gestational trophoblastic disease (GTD).METHODS: This cross-sectional self-report study was conducted among 54 women. Validated questionnaires assessed QoL (WHO-QOL-bref), symptoms of depression (Beck Depression Inventory [BDI]) and anxiety (State-Trait Anxiety Inventory [STAI]).RESULTS: Most patients rated overall QoL as good (44.44%) anti were satisfied with their health status (42.59%). Mean QoL domain score was lowest for psychologic health (53.86 +/- 21.46) and highest for social relationships (65.74 +/- 22.41). BDI mean was 15.81 +/- 11.15, indicating dysphoria. STAI means were 46 +/- 6.46 for trait-anxiety and 43.72 +/- 4.23 for state-anxiety, both evidencing medium-high anxiety. Among employed patients, environment domain mean was the highest (p = 0.024). Presence of children resulted in lowest means for physical health (p = 0.041) and environment (p = 0.045). Patients desiring children showed significantly higher means for physical health (p = 0.004), psychological health (p = 0.021) and environment (p = 0.003). Chemotherapy had no significant influence on QoL (p > 0.05).CONCLUSION: This study evidenced psychological impact on GTD patients, suggesting specialized care centers should provide psychological interventions during treatment and follow-up of GTD patients, highlighting the importance of a multidisciplinary approach. (J Reprod Med 2009;54:239-244)

Molar Pregnancy in Adolescents

OBJECTIVE: To describe the clinical presentation of hydatidiform molar pregnancy in women under the age of 20 years. In addition, we sought to understand if this adolescent population manifests differences in clinical factors compared to an adult population that may affect outcome.STUDY DESIGN: We used a database from the New England Trophoblastic Disease Center to analyze clinical data from all women followed for molar pregnancy between 1970 and 2009 with complete follow-up information. This population was stratified by age and clinical parameters including presenting signs, molar histology and development of gestational trophoblastic neoplasia (GTN). Univariable and multivariable logistic regression was employed to discern clinical factors that associated with adolescent age. The Partners Human Research Committee approved this study.RESULTS: We identified 1,494 women diagnosed with hydatidiform mole (HM), of which 220 (14.7%) were adolescents defined as age <20 years. The most common presenting clinical signs were vaginal bleeding and an enlarged uterus compared to dates. Median gestational age at diagnosis was 13.4 weeks, not different from that in the adult population. Similarly, no difference in presenting human chorionic gonadotropin was observed between the adult and adolescent populations. Adolescents presented with a significant overrepresentation of complete mole (86% vs. 75%, p < 0.001) compared to adults. Complete mole was associated with a heightened risk of developing GTN (OR 2.6, 95% CI 1.9-3.5), and despite the association of complete mole with young maternal age, univariable analysis showed no difference in the rate of GTN observed between adolescents and adults (24% vs. 30%, p = 0.08). Multivariable analysis controlling for molar histology demonstrated that adolescent age was associated with a decreased risk of GTN (hazard ratio 0.67, 95% CI 0.48 0.93).CONCLUSION: Adolescents account for a substantial proportion of the population with HM. They commonly present with vaginal bleeding. Though this population develops a complete mole with a higher frequency than adults, adolescents appear to have a significantly decreased risk of developing GTN. (J Reprod Med 2012; 57:225-230)