Functional Outcomes in Upper Limb Replantation-A Systematic Review.

Functionality after upper limb replantation is a decisive factor when considering the success of the intervention. Therefore, its evaluation is fundamental. The aim of this article was to conduct a systematic review of upper limb functions after replantation or reimplantation, seeking to identify reported functional outcomes as well as the level and mechanism of injury. To achieve this objective, a literature search was conducted in PubMed, ScienceDirect, Cochrane and Web of Science. Studies from the last 10 years which included patients with upper limb replantation and reported their functional outcomes were included. Out of 523 articles, 12 studies (n = 607) were finally included. DASH and CISS were the most commonly used assessments to report functional outcomes. In conclusion, functional outcomes after replantation are assessed using widely varying scales; therefore, due to this methodological variability, it is difficult to compare functional success between studies and further studies on functionality are needed to provide new data.

Risk factors associated with glomerular filtration rate in Mexican adults with type 2 diabetes mellitus.

INTRODUCTION: Type 2 diabetes mellitus (T2DM) is related to glomerular filtration rate (GFR) impairment, which is one of the main causes of chronic kidney disease. The objective of this study was to identify the risk factors related to GFR in Mexican adults with T2DM, using a validated multiple linear regression model (MLRM), with emphasis in body adiposity, glycemic control, duration of the diabetes and other relevant risk factors. MATERIALS AND METHODS: A cross-sectional, analytical, and observational study was carried out in 252 adults with a previous diagnosis of T2DM. Body mass index (BMI) and waist circumference (WC) were determined and a fasting blood sample was collected for glucose, creatinine and HbA1c determinations. GFR was calculated with the Cockcroft-Gault equation adjusted for body surface area. Four MLRM were performed to determine the factors related to the GFR; it was evaluated whether these models complied with the statistical assumptions of the linear regression model. RESULTS: The average age of the participants was 60 ±â€¯12 years, 62.3% of them were women. GFR correlated with BMI and WC; age and duration of the diabetes were associated inversely. Model 4 of the MLRM reported a coefficient of determination of 53.5% where the variables BMI (ß = 1.31), male sex (ß = -6.01), duration of T2DM (ß = -0.57), arterial hypertension (ß = -6.53) and age (ß = -1.45) were simultaneously and significantly related to the GFR. CONCLUSIONS: Older age, male sex, longer duration of T2DM and the presence of arterial hypertension were associated with a decrease in the GFR; BMI and WC were directly associated. No effect of glucose and HbA1c on GFR was observed.

Treatment and Improvement of Healing after Surgical Intervention.

The development of abnormal scars has a great impact on people's well-being, and improving scarring outcomes after surgery is a field that currently lacks consensus. This review aims to identify newly researched approaches to improving the quality of surgical scars. A systematic search of PubMed, Scopus, Web of Science, and ScienceDirect was conducted between 13 May 2023 and 17 May 2023, in accordance with the recommendations of the PRISMA Statement. Study selection and analysis of methodological quality were performed in parts, independently and blindly, based on eligibility criteria. The 21 prospective, comparative, and randomized studies reviewed included 1057 subjects and studied approaches such as topical applications of creams with herbal extracts and silicone gels, growth factors, negative pressure dressings, oligonucleotides, intralesional injection of compounds such as botulinum toxin, skin closure techniques such as suturing and tissue adhesive, and laser treatments. There are recent research techniques that generate good results and are really promising to improve the results of surgical scars; however, the available evidence is extremely limited in some cases, and it is necessary to deepen its analysis to obtain reliable action protocols in each type of surgery.

Responses of native and invasive woody seedlings to combined competition and drought are species-specific.

Woody species invasions are a major threat to native communities with intensified consequences during increased periods of summer drought as predicted for the future. Competition for growth-limiting nitrogen (N) between native and invasive tree species might represent a key mechanism underlying the invasion process, because soil water availability and N acquisition of plants are closely linked. To study whether the traits of invasive species provide an advantage over natives in Central Europe in the competition for N under drought, we conducted a greenhouse experiment. We analyzed the responses of three native (i.e., Fagus sylvatica L., Quercus robur L. and Pinus sylvestris L.) and two invasive woody species (i.e., Prunus serotina Ehrh. and Robinia pseudoacacia L.) to competition in terms of their organic and inorganic N acquisition, as well as allocation of N to N pools in the leaves and fine roots. In our study, competition resulted in reduced growth and changes in internal N pools in both native and invasive species mediated by the physiological characteristics of the target species, the competitor, as well as soil water supply. Nitrogen acquisition, however, was not affected by competition indicating that changes in growth and N pools were rather linked to the remobilization of stored N. Drought led to reduced N acquisition, growth and total soluble protein-N levels, while total soluble amino acid-N levels increased, most likely as osmoprotectants as an adaptation to the reduced water supply. Generally, the consequences of drought were enhanced with competition across all species. Comparing the invasive competitors, P. serotina was a greater threat to the native species than R. pseudoacacia. Furthermore, deciduous and coniferous native species affected the invasives differently, with the species-specific responses being mediated by soil water supply.

Species-Specific Outcome in the Competition for Nitrogen Between Invasive and Native Tree Seedlings.

The outcome of competition for nitrogen (N) between native and invasive tree species is a major concern when considering increasing anthropogenic N deposition. Our study investigated whether three native (i.e., Fagus sylvatica, Quercus robur, and Pinus sylvestris) and two invasive woody species (i.e., Prunus serotina and Robinia pseudoacacia) showed different responses regarding morphological and physiological parameters (i.e., biomass and growth indices, inorganic vs. organic N acquisition strategies, and N allocation to N pools) depending on the identity of the competing species, and whether these responses were mediated by soil N availability. In a greenhouse experiment, tree seedlings were planted either single or in native-invasive competition at low and high soil N availability. We measured inorganic and organic N acquisition using 15N labeling, total biomass, growth indices, as well as total soluble amino acid-N and protein-N levels in the leaves and fine roots of the seedlings. Our results indicate that invasive species have a competitive advantage via high growth rates, whereas native species could avoid competition with invasives via their higher organic N acquisition suggesting a better access to organic soil N sources. Moreover, native species responded to competition with distinct species- and parameter-specific strategies that were partly mediated by soil N availability. Native tree seedlings in general showed a stronger response to invasive P. serotina than R. pseudoacacia, and their strategies to cope with competition reflect the different species' life history strategies and physiological traits. Considering the responses of native and invasive species, our results suggest that specifically Q. robur seedlings have a competitive advantage over those of R. pseudoacacia but not P. serotina. Furthermore, native and invasive species show stronger responses to higher soil N availability under competition compared to when growing single. In conclusion, our study provides insights into the potential for niche differentiation between native and invasive species by using different N forms available in the soil, the combined effects of increased soil N availability and competition on tree seedling N nutrition, as well as the species-specific nature of competition between native and invasive tree seedlings which could be relevant for forest management strategies.

Responses to competition for nitrogen between subtropical native tree seedlings and exotic grasses are species-specific and mediated by soil N availability.

Competitive interactions between native tree seedlings and exotic grasses frequently hinder forest restoration. We investigated the consequences of competition with exotic grasses on the growth and net nitrogen (N) uptake capacity of native rainforest seedlings used for reforestation depending on soil N availability and N source. Tree seedlings and grasses were grown in the greenhouse in different competition regimes (one tree species vs one grass species) and controls (grass monocultures or single tree seedlings) at low and high soil N. After 8 weeks, we quantified net N uptake capacity using 15N-labelled organic (i.e., glutamine and arginine) and inorganic (i.e., ammonium and nitrate) N sources and biomass indices. Depending on soil N availability, we observed different species-specific responses to growth and N acquisition. Tree seedlings generally increased their net N uptake capacity in response to competition with grasses, although overall seedling growth was unaffected. In contrast, the responses to competition by the grasses were species-specific and varied with soil N availability. The different N acquisition strategies suggest the avoidance of competition for N between trees and grasses. Overall, the results highlight that quantifying underlying mechanisms of N acquisition complements the information on biomass allocation as a measure of responses to competition, particularly with varying environmental conditions.

Soil seed bank and the effect of needle litter layer on seedling emergence in a tropical pine plantation.

The soil seed bank is the basis for community establishment and permanence and plays a primary role in natural restoration of degraded or altered ecosystems. As part of a restoration project, this study aimed to quantify the soil seed bank and to evaluate the effect of the needle litter layer on seedling emergence. Soil samples from a pine plantation were collected at random in the field and set to germinate in a greenhouse. Half of them were covered by a 6cm layer of dead pine needles simulating field conditions. In the field, 20 x 20cm plots were established, half were left intact and half were cleaned from the litter needles. All four treatments had 15 replicates and seedling emergence was recorded during six months. Soil seed bank density was 1 222/m2 from 17 morphotypes. In the field, the number of morphotypes and seedlings was only 9% and 6% respectively, of those emerged in the greenhouse, possibly due to watering and lack of predation in the latter. In both cases, herbs and graminoids were the dominant emerging seedlings, making up to 70-90% of the total. The needle layer didn't prevent seeds from reaching the soil but strongly reduced (> 50%) seedling emergence, although high variability within treatments resulted in no statistically significant differences. These results show that the needle layer hinders germination and/or emergence of seedlings from the seed bank. Its removal may be a recommended technique to accelerate natural restoration in pine plantations.

Soil seed bank and the effect of needle litter layer on seedling emergence in a tropical pine plantation

The soil seed bank is the basis for community establishment and permanence and plays a primary role in natural restoration of degraded or altered ecosystems. As part of a restoration project, this study aimed to quantify the soil seed bank and to evaluate the effect of the needle litter layer on seedling emergence. Soil samples from a pine plantation were collected at random in the field and set to germinate in a greenhouse. Half of them were covered by a 6cm layer of dead pine needles simulating field conditions. in the field, 20x20cm plots were established, half were left intact and half were cleaned from the litter needles. All four treatments had 15 replicates and seedling emergence was recorded during six months. Soil seed bank density was 1 222/m² from 17 morphotypes. in the field, the number of morphotypes and seedlings was only 9% and 6% respectively, of those emerged in the greenhouse, possibly due to watering and lack of predation in the latter. in both cases, herbs and graminoids were the dominant emerging seedlings, making up to 70-90% of the total. The needle layer didn’t prevent seeds from reaching the soil but strongly reduced (>50%) seedling emergence, although high variability within treatments resulted in no statistically significant differences. These results show that the needle layer hinders germination and/or emergence of seedlings from the seed bank. its removal may be a recommended technique to accelerate natural restoration in pine plantations. Rev. Biol. Trop. 59 (3): 1071-1079. Epub 2011 September 01.

El banco de semillas del suelo es la base para el establecimiento y la permanencia de una comunidad y desempeña un papel fundamental en la restauración natural de los ecosistemas degradados o alterados. Como parte de un proyecto de restauración, este estudio tuvo como objetivo cuantificar el banco de semillas del suelo y evaluar el efecto de la capa de hojarasca de pino sobre la emergencia de las plántulas. Las muestras de suelo de la plantación de pinos fueron recolectadas al azar en el campo y se pusieron a germinar en un invernadero. La mitad de ellas estaban cubiertas por una capa de 6cm de hojarasca simulando condiciones de campo. En el campo se establecieron parcelas de 20x20cm, la mitad se dejaron intactas y la otra mitad se limpiaron de la hojarasca. Para los cuatro tratamientos se realizaron 15 repeticiones y la emergencia de plántulas se registró durante seis meses. La densidad del banco de semillas del suelo fue de 1 222/m² de 17 morfotipos. En el campo, el número de morfotipos y plántulas fue sólo de 9% y 6% respectivamente, de los que emergieron en el invernadero, posiblemente debido al riego y la falta de depredación. En ambos casos las plántulas dominantes fueron las hierbas y gramíneas, alcanzando el 70-90% del total. La capa de hojarasca no impidió que las semillas llegaran al suelo, pero se presentó una emergencia de plántulas muy reducida (>50%), debido a la alta variabilidad de los tratamientos no se produjeron diferencias estadísticamente significativas. Estos resultados muestran que la capa de hojarasca impide la germinación y/o la emergencia de las plántulas del banco de semillas del suelo. Su eliminación puede ser una técnica recomendada para acelerar la restauración natural en las plantaciones de pino.

Patterns of spatial variation of assemblages associated with intertidal rocky shores: a global perspective.

Assemblages associated with intertidal rocky shores were examined for large scale distribution patterns with specific emphasis on identifying latitudinal trends of species richness and taxonomic distinctiveness. Seventy-two sites distributed around the globe were evaluated following the standardized sampling protocol of the Census of Marine Life NaGISA project (www.nagisa.coml.org). There were no clear patterns of standardized estimators of species richness along latitudinal gradients or among Large Marine Ecosystems (LMEs); however, a strong latitudinal gradient in taxonomic composition (i.e., proportion of different taxonomic groups in a given sample) was observed. Environmental variables related to natural influences were strongly related to the distribution patterns of the assemblages on the LME scale, particularly photoperiod, sea surface temperature (SST) and rainfall. In contrast, no environmental variables directly associated with human influences (with the exception of the inorganic pollution index) were related to assemblage patterns among LMEs. Correlations of the natural assemblages with either latitudinal gradients or environmental variables were equally strong suggesting that neither neutral models nor models based solely on environmental variables sufficiently explain spatial variation of these assemblages at a global scale. Despite the data shortcomings in this study (e.g., unbalanced sample distribution), we show the importance of generating biological global databases for the use in large-scale diversity comparisons of rocky intertidal assemblages to stimulate continued sampling and analyses.

Hepatites na gestação / Hepatitis in the gestation

Os autores fazem uma revisão das principais hepatites virais ocorridas durante a gestação enfatizando suas manifestações clínicas, repercussões no feto e medidas a serem tomadas.

Higiene bucal infantil: atençäo primária para prevençäo e manutençäo da saúde / Infant oral hygiene: primary attention to health prevention and maintenance

O índice cariogênico de Londrina vem caindo consideravelmente desde 1981(4,06) por cento até 1992 (1,90) por cento, segundo dados fornecidos pela Secretaria deSaúde do município de Londrina(tabela 1) comprovandoque o atendimento odontológico eficiente garante a manutençäo da saúde 33 populaçäo. A cárie se faz preocupante à medida que essa enfermidade aumenta com a idade, além disso, poderá preceder ao desenvolvimento davárias infecçöes sistêmicas, citando por exemplo o abscesso pulmonar, considerando a principal afliçäo da infäncia constituindo o maior problema da saúde pública. A fluoretaçäo da água no Conjunto Joäo Paz, situado na regiäo norte do município de Londrina, alvo de nossas pesquisas, foi somente instalada a pouco tempo, segundo dados de 1990 fornecidos pela Sanepar(Companhia de Saneamento do Paraná), constatando que o índice cariogênico de crianças atendidas no posto excedia as demais totalidadesda cidade, acompanhando a dificuldade de aquisiçäo de material e a falta de educaçäo sanitária. Apesar das doenças crônicas que atingem esta regiäo, o grupo GIM 13 escolheu a prevençäo da cárie como tema e através de trabalhos efetivos com a populaçäo e a ajuda da Clínica Universitária Odontológica Norte do Paraná, pode encaminhar propostas de soluçöes para grande parte deste problema