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ABSTRACT Traumatic chiasmal syndrome is one of the rare etiologies of chiasmal syndrome, characterized by optic chiasm injury following head trauma. The main visual defect associated is bitemporal hemianopia with macular splitting; however, it can present with a variety of other visual defects and neurologic signs. The authors report a case of complete bitemporal hemianopia after head trauma, with multiple frontal and skull base fractures and no other neurologic deficits, or hypothalamic-pituitary abnormality. Most cases of traumatic chiasmal syndrome are caused by mechanical stretch or compression of the chiasma. Nevertheless, in this case, the radiologic findings excluded macroscopic disruption or external compression of the chiasma, raising the possibility of a contusion necrosis associated with functional impairment of the optic chiasma. Traumatic chiasmal syndrome must be considered in the differential diagnosis of patients presenting with complete bitemporal hemianopia after head injury caused by frontal and skull base fracture.

RESUMO A síndrome quiasmática traumática é uma das raras etiologias da síndrome do quiasma óptico, que se caracteriza pela presença de lesão do quiasma óptico causada por traumatismo craniencefálico. O principal defeito visual associado é a hemianopsia bitemporal com macular splitting. No entanto, pode se manifestar por uma variedade de outros defeitos visuais e sinais neurológicos. Os autores relatam um caso de hemianopsia bitemporal completa após traumatismo craniencefálico com múltiplas fraturas frontais e da base do crânio na ausência de outros défices neurológicos ou alterações do eixo hipotálamo-hipofisário. A maioria dos casos de síndrome quiasmática traumática é causada por estiramento mecânico ou compressão do quiasma. No entanto, no caso apresentado, os achados radiológicos excluíram lesão macroscópica ou compressiva do quiasma, levantando a possibilidade de uma necrose após contusão associada ao compromisso funcional do quiasma óptico. A síndrome quiasmática traumática deve ser considerada no diagnóstico diferencial de doentes que apresentam hemianopsia bitemporal completa após traumatismo craniencefálico, especialmente em casos de fratura do osso frontal e da base do crânio.

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Diphterostomum brusinae (Zoogonidae) is a digenean species that has been recorded worldwide parasitizing marine fishes. Several species have been synonymized with D. brusinae because they lack conspicuous morphological differences. However, due to the breadth of its geographic distribution and the variety of hosts involved in the life cycles, it is likely to be an assemblage of cryptic species. Diphterostomum flavum n. sp. is described here as a morphologically cryptic relative of D. brusinae, in the fish Pinguipes brasilianus (Pinguipedidae) off the Patagonian coast, Southwestern Atlantic Ocean, and its life cycle is elucidated through morphology and molecular analysis. This species uses the gastropod Buccinanops deformis (Nassariidae) as first and second intermediate host with metacercariae encysting within sporocysts. They also, however, use the polychaete Kinbergonuphis dorsalis (Onuphidae) as second intermediate host. No morphological differences were found between adults of D. flavum n. sp. and D. brusinae; however, the number of penetration glands of the cercariae, a diagnostic feature, differed (9 vs. 3 pairs), as well as the ITS2 sequences for the two species. This work provides morphological and molecular evidence of cryptic diversification among species described as D. brusinae, in which the only clear differences are in larval morphology and host spectrum. The strict specificity to the snail acting as the first intermediate host and the variety of fishes with different feeding habits acting as definitive hosts support the likely existence of multiple cryptic species around the world.

TITLE: Spéciation cryptique du Digène Zoogonidae Diphterostomum flavum n. sp. démontrée par des données morphologiques et moléculaires. ABSTRACT: Diphterostomum brusinae (Zoogonidae) est une espèce de digène, parasite des poissons marins, qui a été signalée dans le monde entier. Plusieurs espèces ont été synonymisées avec D. brusinae parce qu'elles ne montrent pas de différences morphologiques visibles. Cependant, en raison de l'étendue de sa répartition géographique et de la variété d'hôtes impliqués dans les cycles de vie, il est probable qu'il s'agisse d'un assemblage d'espèces cryptiques. Diphterostomum flavum n. sp. est décrit ici comme une espèce morphologiquement cryptique de D. brusinae, chez le poisson Pinguipes brasilianus (Pinguipedidae) au large de la côte de la Patagonie, dans le sud-ouest de l'océan Atlantique, et son cycle de vie est élucidé par la morphologie et l'analyse moléculaire. Cette espèce utilise le gastéropode Buccinanops deformis (Nassariidae) comme premier et deuxième hôte intermédiaire avec des métacercaires s'enkystant dans les sporocystes. Cependant, elle utilise également le polychète Kinbergonuphis dorsalis (Onuphidae) comme deuxième hôte intermédiaire. Aucune différence morphologique n'a été trouvée entre les adultes de D. flavum n. sp. et D. brusinae, mais le nombre de glandes de pénétration des cercaires, une caractéristique diagnostique, diffère (9 paires contre 3), ainsi que les séquences ITS2 pour les deux espèces. Ce travail fournit des preuves morphologiques et moléculaires de la diversification cryptique parmi les espèces décrites comme D. brusinae, dans lesquelles les seules différences claires sont dans la morphologie des larves et le spectre de l'hôte. La spécificité stricte au mollusque servant de premier hôte intermédiaire et la variété de poissons avec différentes habitudes alimentaires servant d'hôtes définitifs soutiennent l'existence probable de plusieurs espèces cryptiques dans le monde.

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RESUMO Introdução: Na sarcoidose, as manifestações oculares são comuns e podem constituir a manifestação inicial da doença ou mesmo a única. O objetivo deste trabalho foi analisar os parâmetros demográficos, manifestações clínicas, terapêutica e principais complicações oculares em doentes com sarcoidose ocular. Métodos: Estudo descritivo e retrospectivo que incluiu doentes com o diagnóstico de sarcoidose ocular, observados nas consultas de Inflamação Ocular e de Doenças Auto-Imunes do Hospital Prof. Doutor Fernando Fonseca, no período entre 2009 e 2015. Resultados: Foram identificados 11 doentes com o diagnóstico de sarcoidose ocular, com predomínio do sexo feminino (54,5%) e caucasianos. A média da idade ao diagnóstico foi de 45±14 anos. A sarcoidose manifestou-se de forma exclusivamente ocular em 36% dos casos. O envolvimento ocular foi a manifestação inicial em 90,9% dos casos. Identificaram-se 9 casos de uveíte, 1 de esclerite anterior nodular e 1 de queratite intersticial. O tratamento com corticoterapia tópica foi realizado em 100% dos casos, sendo o tratamento único em apenas 1 doente. Nos restantes, foi necessário associar corticoterapia oral. Em 4 desses doentes, pela gravidade da doença e atingimento binocular, utilizou-se também corticoterapia pulsada endovenosa. O tratamento adjuvante imunossupressor mais frequentemente utilizado foi o metotrexato (45%). Um doente necessitou de terapia biológica com infliximabe para controle da doença. Conclusão: A manifestação ocular mais comum foi a uveíte, com predomínio da panuveíte. O tratamento mais utilizado e com maior taxa de controle da doença foi a corticoterapia sistêmica em associação com o metotrexato.

ABSTRACT Purpose: In sarcoidosis, ocular manifestations are common and can be the initial or even the only clinical manifestation. The aim of this study was to analyze the demographic parameters, clinical manifestations, treatment and the major ocular complications in patients with ocular sarcoidosis. Methods: We conducted a descriptive and retrospective study that included patients with the diagnosis of ocular sarcoidosis, followed by inflammatory ophthalmology and immune-mediated disease consults at the Prof. Doutor Fernando Fonseca Hospital, between 2009 and 2015. Results: Eleven patients with the diagnosis of ocular sarcoidosis were identified, with a predominance of females (54,5%) and Caucasians. The average age at diagnosis was 45 ± 14 years. Sarcoidosis was exclusively ocular in 36%. The first manifestation of sarcoidosis was eye disease in 90.9 % of cases. Nine cases of uveitis, one of nodular scleritis and one of interstitial keratitis were observed. Topical corticoid treatment was applied in 100% of cases, with only one achieving remission of the disease. Oral corticoid treatment was necessary in 10 cases, four of which needed a high dose methylprednisolone induction. Methotrexate was the adjunctive immunosuppressive treatment of choice in 45% of cases. There was one refractory case for conventional immunosuppressive therapy, having achieved remission with biologic agent infliximab. Conclusion: Uveitis was the commonest ocular manifestation, and there was a predominance of panuveitis. Systemic corticoid and methotrexate were the most used immunosuppressive treatments for maintaining the controlled stated of the disease.

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The adult monorchiid, Postmonorcheides maclovini Szidat, 1950, digenean parasite of the Patagonian blennie Eleginops maclovinus (Cuvier) (Eleginopidae) from Puerto Deseado (47° 45' S, 65° 55' W), Argentina, was characterized and its life cycle elucidated. P. maclovinus is the only species of the genus Postmonorcheides, proposed by Szidat (1950) from Tierra del Fuego province (~54° S), Argentina. This digenean uses the Patagonian blennie as definitive host, and the intertidal bivalve Lasaea adansoni (Gmelin) (Lasaeidae) as both first and second intermediate hosts (metacercariae encyst inside sporocysts), being the first record of this clam as intermediate host of trematode parasites. The cercaria may, in addition to encysting in the sporocyst, emerge and presumably infect other intermediate hosts. This is the second report of a monorchiid species with metacercariae encysting inside the sporocyst. Adults were found parasitizing the fish stomach, pyloric caeca and intestine with a prevalence of 100%; sporocysts with cercariae and/or metacercariae were found parasitizing the gonad of the bivalve with a prevalence of 2.78%. The cercariae possess a well-developed tail and eye-spots are absent. The ITS1 sequence from the adult digeneans found in the Patagonian blennie, identified as P. maclovini, was found to be identical to the ITS1 sequences obtained both from sporocysts containing cercariae and encysted metacercariae found in L. adansoni.

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Morphological and molecular evidence suggest that specimens formerly described as Lacunovermis sp. from Nacella (Patinigera) spp. (Patellogastropoda: Patellidae) belong to a new species of Gymnophalloides Fujita, 1925 . Based on the new information, they are identified as Gymnophalloides nacellae n. sp. The new species differs from Gymnophalloides tokiensis, Gymnophalloides seoi , and Gymnophalloides heardi mainly through the presence of a group of papillae located on the ventral surface between oral and ventral suckers. A detailed morphological study revealed the lack of pars prostatica, a character previously reported in G. seoi , which is why it was formerly placed in the Gymnophallinae. Molecular information proved that G. nacellae is close to G. seoi , being nestled together with Parvatrema representatives. This molecular information, along with the absence of pars prostatica, allows these 2 genera to be placed in Parvatrematinae. An amended diagnosis of Gymnophalloides is provided. Histological sections of mantle epithelium of the limpet show metacercariae attached by their oral and ventral suckers in a similar manner to G. seoi in its host, the oyster Crassostrea gigas . Tissue reaction includes cells of outer mantle epithelium being stretched by sucker attachment, hemocyte infiltration of connective tissue between mantle epitheliums, and abnormal calcareous deposition on the inner surface of the shell.

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