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BACKGROUND: Post-operative hypoparathyroidism is the most frequent complication after total thyroidectomy. The identification of preoperative predictors could be helpful to identify patients at risk. This study aimed to evaluate the potential influence of preoperative PTH levels and their perioperative dynamics as a predictor of transient, protracted, and permanent post-operative hypoparathyroidism. METHODS: A prospective, observational study that includes 100 patients who underwent total thyroidectomy between September 2018 and September 2020. RESULTS: Transient hypoparathyroidism was present in 42% (42/100) of patients, 11% (11/100) developed protracted hypoparathyroidism, and 5% (5/100) permanent hypoparathyroidism. Patients who presented protracted hypoparathyroidism had higher preoperative PTH levels. The protracted and permanent hypoparathyroidism rate was higher in groups with greater preoperative PTH [0% group 1 (<40 pg/mL) vs. 5.7% group 2 (40-70 pg/mL) vs. 21.6% group 3 (>70 pg/mL); p = 0.03] and (0 vs. 8.3 vs. 20%; p = 0.442), respectively. The rate of protracted and permanent hypoparathyroidism was higher in patients with PTH at 24 h lower than 6.6 pg/mL and whose percentage of PTH decline was higher than 90%. The rate of transient hypoparathyroidism was higher in patients who showed a PTH decline rate of more than 60%. The percentage of PTH increase one week after surgery in patients with permanent hypoparathyroidism was significantly lower. CONCLUSION: The prevalence of protracted hypoparathyroidism was higher in groups with higher preoperative PTH levels. PTH levels 24 h after surgery lower than 6.6 pg/mL and a decline of more than 90% predict protracted and permanent hypoparathyroidism. The percentage of PTH increase a week after surgery could predict permanent hypoparathyroidism.
Patients who presented protracted and permanent hypoparathyroidism had higher preoperative PTH levels.Patients in groups with higher preoperative PTH levels showed higher rates of protracted and permanent hypoparathyroidism.The percentage of PTH variance one week after surgery in patients with permanent hypoparathyroidism was significantly lower and could predict permanent hypoparathyroidism.
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Hipocalcemia , Hipoparatireoidismo , Humanos , Estudos Prospectivos , Hipoparatireoidismo/epidemiologia , Hipoparatireoidismo/etiologia , Tireoidectomia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Hormônio Paratireóideo , Hipocalcemia/complicaçõesRESUMO
INTRODUCTION: Thyroidectomy is one of the most commonly performed surgical procedures worldwide. Although the mortality rate is currently approaching 0%, the incidence of complications in such a frequent surgery is not insignificant. The most frequent are postoperative hypoparathyroidism, recurrent injury, and asphyxial hematoma. The size of the thyroid gland has traditionally been considered one of the most important risk factors, but there is currently no study that analyzes it independently. The objective of this study is to analyze whether the size of the thyroid gland is an isolated risk factor for the development of postoperative complications. PATIENTS AND METHOD: A prospective review of all patients who underwent total thyroidectomy at a third-level hospital between January 2019 and December 2021 was conducted. The thyroid volume was calculated preoperatively using ultrasound and, together with the weight of the definitive piece, was correlated with the development of postoperative complications. RESULTS: One hundred twenty-one patients were included. When analyzing the incidence of complications based on the quartiles of weight and glandular volume, there were no significant differences in the incidence of transient or permanent hypoparathyroidism in any of the groups. No differences were found in terms of recurrent paralysis. No fewer parathyroid glands were visualized intraoperatively in patients with larger thyroid glands, nor did the number of them accidentally removed during surgery increase. In fact, a certain protective trend was observed with regard to the number of glands visualized and glandular size or in the relationship between thyroid volume and accidental gland removal, with no significant differences. CONCLUSION: The size of the thyroid gland has not been shown to be a risk factor for the development of postoperative complications, contrary to what has traditionally been considered.
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Bócio , Hipoparatireoidismo , Neoplasias da Glândula Tireoide , Humanos , Estudos Prospectivos , Bócio/complicações , Bócio/cirurgia , Tireoidectomia/efeitos adversos , Tireoidectomia/métodos , Hipoparatireoidismo/epidemiologia , Hipoparatireoidismo/etiologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Neoplasias da Glândula Tireoide/cirurgiaRESUMO
BACKGROUND: Conducting research during specialty training provides an opportunity to develop critical thinking and leadership skills along with a better understanding of the scientific literature. However, trainees often find it difficult to undertake research, in the context of labor-intensive surgical training. The aim of this study is to evaluate the research output and limitations of plastic surgery residents in different countries. METHODS: An international cross-sectional study involving plastic surgery trainees and recent postgraduates from Brazil, Chile, Germany, and the United Kingdom was conducted. A survey inquiring into academic productivity, limitations to conducting research, and working-hours patterns was distributed among eligible participants. RESULTS: From September to December 2019, 106 surveys were retrieved. Most respondents declared having participated in at least 1 project that resulted in a presentation or publication during their training (90.6% in national presentations, 68% international presentations, 67% in national publications, and 66% international publications). Having completed a previous research fellowship was associated with a statistically higher academic output (P < 0.05). Seventy-nine percent of respondents felt that their participation in research activities would have been greater if limiting factors had been addressed, including lack of time (72.5%) and insufficient supervision and mentoring (55%). CONCLUSIONS: Optimizing plastic surgery trainees' participation in scientific research is beneficial both for residents and their mentors. Research fellowships can provide an opportunity for academically oriented trainees to further develop their research skills. Protected time and adequate mentoring can help not only to increase residents' research output, but also to recruit the next generation of academic plastic surgeons.
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Internato e Residência , Cirurgia Plástica , Estudos Transversais , Bolsas de Estudo , Humanos , Mentores , Cirurgia Plástica/educação , Inquéritos e QuestionáriosRESUMO
Unspecific peroxygenases (UPOs) are fungal heme-thiolate enzymes able to catalyze a wide range of oxidation reactions, such as peroxidase-like, catalase-like, haloperoxidase-like, and, most interestingly, cytochrome P450-like. One of the most outstanding properties of these enzymes is the ability to catalyze the oxidation a wide range of organic substrates (both aromatic and aliphatic) through cytochrome P450-like reactions (the so-called peroxygenase activity), which involves the insertion of an oxygen atom from hydrogen peroxide. To catalyze this reaction, the substrate must access a channel connecting the bulk solution to the heme group. The composition, shape, and flexibility of this channel surely modulate the catalytic ability of the enzymes in this family. In order to gain an understanding of the role of the residues comprising the channel, mutants derived from PaDa-I, a laboratory-evolved UPO variant from Agrocybe aegerita, were obtained. The two phenylalanine residues at the surface of the channel, which regulate the traffic towards the heme active site, were mutated by less bulky residues (alanine and leucine). The mutants were experimentally characterized, and computational studies (i.e., molecular dynamics (MD)) were performed. The results suggest that these residues are necessary to reduce the flexibility of the region and maintain the topography of the channel.
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Agrocybe/enzimologia , Domínio Catalítico , Oxigenases de Função Mista/química , Fenilalanina/química , Saccharomyces cerevisiae/metabolismo , Biocatálise , Heme/química , Peróxido de Hidrogênio/química , Oxigenases de Função Mista/genética , Simulação de Dinâmica Molecular , Mutagênese Sítio-Dirigida/métodos , Mutação , Saccharomyces cerevisiae/genéticaRESUMO
Large wildfires can cover millions of hectares of forest every year worldwide, causing losses in ecosystems and assets. Fire simulation and modeling provides an analytical scheme to characterize and predict fire behavior and spread in several and complex environments. Spatial dynamics of large wildfires can be analyzed using satellite active fire data, a cost-effective way to acquire information systematically worldwide. The simulated growth of three large wildland fires from the USA, Chile and Spain with different fire spread pattern, duration and size has been compared to satellite active fire data. Additionally, a new approach to reinitialize fire simulations in near real-time and predict a more accurate fire spread is shown in this work. Discrepancies between the simulated fire growth and satellite active data were measured spatially and temporally in the three fires, increasing along the fire duration. The reinitialization approach meaningfully improved the accuracy of fire simulations in all case studies. Satellite active fire data showed a high potential to be used in real fire incidents, improving fire monitoring and simulation and, therefore, supporting the decision-making process of the fire analyst. The reinitialization approach could be applied by using the current satellite active fire data such as MODIS or VIIRS as well as Unmanned Aerial Vehicles or GPS locations from suppression resources.
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Incêndios , Incêndios Florestais , Chile , Ecossistema , EspanhaAssuntos
Carcinoma Neuroendócrino , Neoplasias da Glândula Tireoide , Humanos , Metástase Linfática/patologia , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Carcinoma Neuroendócrino/cirurgia , Carcinoma Neuroendócrino/patologia , Linfonodos/patologia , Tireoidectomia , Excisão de LinfonodoRESUMO
In recent years, there has been increasing interest in understanding the implications of diagnosing normocalcaemic primary hyperparathyroidism (nPHPT). Many patients hope that nPHPT might explain some of their symptoms, but surgeons hesitate to offer treatment to patients whose calcium levels are normal but whose parathyroid hormone (PTH) levels are elevated in the absence of secondary causes of hyperparathyroidism. This potential new diagnosis is not well understood and may lead to inappropriate investigation and possible unnecessary operations. However, because a significant number of patients with nPHPT progress to hypercalcaemic primary hyperparathyroidism (PHPT), some consider nPHPT to be an early or mild form of hypercalcaemia. Rather than being an indolent disease, nPHPT was reported to be associated with systemic complications similar to 'classical' PHPT, and hence there is growing interest to understand who should be offered surgical treatment and who should be monitored. Further standardisation of diagnostic definition, associated complications, patient selection, surgical management and long-term outcomes are necessary. The recommendations outlined in this review are based on limited evidence from non-randomised cohort studies and expert opinion.
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Hipercalcemia/complicações , Hiperparatireoidismo Primário/diagnóstico , Hiperparatireoidismo Primário/terapia , Algoritmos , Cálcio/sangue , Humanos , Hipercalcemia/sangue , Hiperparatireoidismo Primário/complicações , Hormônio Paratireóideo/sangue , Paratireoidectomia , Seleção de PacientesRESUMO
BACKGROUND: Thyroidectomy is considered to be a safe procedure. Although very uncommon, death may occur after thyroid resection. The aim of this study was to investigate the prevalence and causes of death after thyroidectomy and the associated risk factors in the modern era of thyroid surgery. PATIENTS AND METHODS: A structured questionnaire was sent to all endocrine surgery units in Spain to report all deaths that occurred after thyroidectomy in recent years. RESULTS: Twenty-six surgical units, encompassing 30.495 thyroidectomies, returned the questionnaire. A total of 20 deaths (0.065%) were recorded: 12 women (60%) and 8 men (40%) with a median age of 65 years (range 32-86). Half of the patients had a retrosternal goiter with a median weight of 210 g. The median operative time was 185 min. Histological diagnoses were benign goiter (35%) or thyroid carcinoma (65%): differentiated (30%), medullary (20%), poorly differentiated/anaplastic (10%), and colorectal cancer metastasis (5%). Causes of death were cervical hematoma (30%), respiratory distress/pneumonia due to prolonged endotracheal intubation (25%), tracheal injury (15%), heart failure (15%), sepsis (wound infection/esophageal perforation) (10%) and mycotic aneurysm (5%). The median time from surgery to death was 14 days (range 1-85). CONCLUSIONS: Death after thyroidectomy is very uncommon, and most often results from a combination of advanced age, giant goiters, and upper airway complications.
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Bócio/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Neoplasias da Glândula Tireoide/mortalidadeRESUMO
Climate teleconnections (CT) remotely influence weather conditions in many regions on Earth, entailing changes in primary drivers of fire activity such as vegetation biomass accumulation and moisture. We reveal significant relationships between the main global CTs and burned area that vary across and within continents and biomes according to both synchronous and lagged signals, and marked regional patterns. Overall, CTs modulate 52.9% of global burned area, the Tropical North Atlantic mode being the most relevant CT. Here, we summarized the CT-fire relationships into a set of six global CT domains that are discussed by continent, considering the underlying mechanisms relating weather patterns and vegetation types with burned area across the different world's biomes. Our findings highlight the regional CT-fire relationships worldwide, aiming to further support fire management and policy-making.
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Clima , Incêndios , Ecossistema , Tempo (Meteorologia) , Biomassa , Mudança ClimáticaRESUMO
INTRODUCTION: Four-dimensional computerized tomography (4D-CT) offers a good sensitivity for the localization of the pathological gland responsible of primary hyperparathyroidism. The aim was to evaluate its results as a second line preoperative localization test after inconclusive or discordant results of usual preoperative studies. MATERIAL AND METHODS: Observational retrospective study that included all patients intervened for primary hyperparathyroidism with 4D-CT scan as preoperative study, from 1st October 2016 to 1st October 2021, in a tertiary referral centre. The results of 4D-CT, cervical ultrasound, and Nuclear Medicine explorations (scintigraphy, SPECT and SPECT-CT) were compared with the gold standard of the surgical exploration and the pathological result. The correct lateralization and the approximate localization rates of the pathological gland were evaluated. RESULTS: A total of 64 patients were analysed, with a 93,8% (60/64) remission rate. 4DCT showed a correct lateralization in 57,8% (37/64) of the cases and revealed the approximate localization of the gland in 48,4% (31/64) of the cases. The cervical ultrasound had a rate of 31,1% (19/61) and 18% (11/61) for the correct lateralization and approximate localization, respectively, compared to 34,9% (22/63) and 28,6% (18/63) in Nuclear Medicine explorations, and 32,7% (16/49) and 24,5% (12/49) in SPECT-CT. These differences were statistically significant. CONCLUSION: 4D-CT demonstrated acceptable results for the localization of the lesions responsible of primary hyperparathyroidism, thus its use should be considered with the absence of localization in routinely studies.
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Hiperparatireoidismo Primário , Humanos , Tomografia Computadorizada Quadridimensional/métodos , Hiperparatireoidismo Primário/diagnóstico por imagem , Hiperparatireoidismo Primário/cirurgia , Estudos RetrospectivosRESUMO
The destructive and empirical methods commonly used to estimate carbon pools in forests managed timber are time-consuming, expensive and unfeasible at a large scale; satellite images allow evaluations at different scales, reducing time and costs. The objective of this study was to evaluate the tree biomass (TB) and carbon content (CC) through satellite images derived from Sentinel 2 in underutilized stands in southern Mexico. In 2022, 12 circular sites of 400 m2 with four silvicultural treatments (STs) were established in a targeted manner: 1st thinning (T1), free thinning (FT), regeneration cut (RC) and unmanaged area (UA). A tree inventory was carried out, and samples were obtained to determine their TB based on specific gravity and CC through the Walkey and Black method. The satellite image of the study area was downloaded from Sentinel 2 to fit a simple linear model as a function of the Normalized Difference Vegetation Index (10 m pixel-1) showing significance (p ≤ 0.01) and a adjusted R2 = 0.92. Subsequently, the TB and CC (t ha-1) were estimated for each ST and managed area. The total managed area (3,201 ha-1) had 126 t TB ha-1 and 57 t C ha-1. Of the areas with STs, the area with FT showed the highest accumulation of TB (140 t ha-1) and C (63 t ha-1) without showing differences (p > 0.05) with respect to those of the UA, which presented 129 t TB ha-1 and 58 t C ha-1. The satellite images from Sentinel 2 provide reliable estimates of the amounts of TB and CC in the managed stands. Therefore, it can be concluded that an adequate application of STs maintains a balance in the accumulation of tree C.
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Pinus , Quercus , Carbono , México , Florestas , ÁrvoresRESUMO
Carnivorous mammals disperse seeds through endozoochory and diploendozoochory. The former consists of ingestion of the fruit, passage through the digestive tract, and expulsion of the seeds, a process that allows scarification and dispersal of the seeds over long or short distances. The latter is typical of predators that expel seeds that were contained in the prey and the effects of which may differ from those of endozoochory with respect to the retention time of the seeds in the tracts, as well as their scarification and viability. The objective of this study was to conduct an experimental evaluation comparing the capacity of each mammal species in terms of the dispersal of Juniperus deppeana seeds and, at the same time, to compare this capacity through the two dispersal systems: endozoochory and diploendozoochory. We measured dispersal capacity using indices of recovery, viability, changes in testas, and retention time of seeds in the digestive tract. Juniperus deppeana fruits were collected in the Sierra Fría Protected Natural Area in Aguascalientes, Mexico, and were administered in the diet of captive mammals: gray fox (Urocyon cinereoargenteus), coati (Nasua narica) and domestic rabbits (Oryctolagus cuniculus). These three mammals represented the endozoochoric dispersers. For the diploendozoochoric treatment, seeds excreted by rabbits were incorporated into the diets of captive mammals: bobcat (Lynx rufus) and cougar (Puma concolor), in a local zoo. Seeds present in the scats were then collected, and recovery rates and retention times were estimated. Viability was estimated by X-ray optical densitometry and testa thicknesses were measured and surfaces checked using scanning electron microscopy. The results showed a recovery of seeds greater than 70% in all the animals. The retention time was <24 h in the endozoochory but longer at 24-96 h in the diploendozoochory (p < .05). Seed viability (x¯ ± SD) was decreased in rabbits (74.0 ± 11.5%), compared to fruits obtained directly from the canopy (89.7 ± 2.0%), while gray fox, coati, bobcat, and cougar did not affect seed viability (p < .05). An increase in the thickness of the testas was also observed in seeds excreted from all mammals (p < .05). Through evaluation, our results suggest that mammalian endozoochory and diploendozoochory contribute to the dispersal of J. deppeana by maintaining viable seeds with adaptive characteristics in the testa to promote forest regeneration and restoration. In particular, feline predators can provide an ecosystem service through scarification and seed dispersal.
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Wildfire events have resulted in unprecedented social and economic losses worldwide in the last few years. Most studies on reducing wildfire risk to communities focused on modeling wildfire behavior in the wildland to aid in developing fuel reduction and fire suppression strategies. However, minimizing losses in communities and managing risk requires a holistic approach to understanding wildfire behavior that fully integrates the wildland's characteristics and the built environment's features. This complete integration is particularly critical for intermixed communities where the wildland and the built environment coalesce. Community-level wildfire behavior that captures the interaction between the wildland and the built environment, which is necessary for predicting structural damage, has not received sufficient attention. Predicting damage to the built environment is essential in understanding and developing fire mitigation strategies to make communities more resilient to wildfire events. In this study, we use integrated concepts from graph theory to establish a relative vulnerability metric capable of quantifying the survival likelihood of individual buildings within a wildfire-affected region. We test the framework by emulating the damage observed in the historic 2018 Camp Fire and the 2020 Glass Fire. We propose two formulations based on graph centralities to evaluate the vulnerability of buildings relative to each other. We then utilize the relative vulnerability values to determine the damage state of individual buildings. Based on a one-to-one comparison of the calculated and observed damages, the maximum predicted building survival accuracy for the two formulations ranged from [Formula: see text] for the historical wildfires tested. From the results, we observe that the modified random walk formulation can better identify nodes that lie at the extremes on the vulnerability scale. In contrast, the modified degree formulation provides better predictions for nodes with mid-range vulnerability values.
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Incêndios , Incêndios Florestais , Conservação dos Recursos Naturais/métodos , Probabilidade , Gestão de RiscosRESUMO
BACKGROUND: Bone disease in primary hyperparathyroidism is a clear indication for surgical treatment. However, it is not known whether surgery benefits hypercalcemic primary hyperparathyroidism and normocalcemic primary hyperparathyroidism equally. The aim of our study was to evaluate the bone changes in patients undergoing parathyroidectomy based on the biochemical profile 1 and 2 years after surgery. METHODS: This prospective study included 87 consecutive patients diagnosed with primary hyperparathyroidism who underwent surgery between 2016 and 2018. Bone densitometry (1/3 distal radius, lumbar, and femur) and bone remodeling markers (osteocalcin, type 1 procollagen [P1NP], ß-cross-linked telopeptide of type I collagen [BCTX]) were performed preoperatively and postoperatively. Postoperative changes in bone mineral density and bone markers were compared and evaluated according to the clinical characteristics and the individual biochemical profile. RESULTS: One year after surgery, all patients showed an increase in bone mineral density at the lumbar site (mean, 0.029 g/cm2; range, 0.017-0.04; P < .001) and femur neck (mean, 0.025 g/cm2; range, 0.002-0.05; P < .001); however, there were no changes in the distal third of the radius (mean, -0.003 g/cm2; range, -0.008 to 0.002; P = NS). There were no significant differences when comparing normocalcemic primary hyperparathyroidism and hypercalcemic primary hyperparathyroidism. Serum osteocalcin (37 ± 17.41), P1NP (67.53 ± 31.81) and BCTX (0.64 ± 0.37) levels were elevated before surgery. One year after the surgery, we observed a significant decrease in P1NP (33.05 ± 13.16, P = .001), osteocalcin (15.80 ± 6.19, P = .001), and BCTX (0.26 ± 0.32, P < .001) levels. CONCLUSION: Our findings indicate that parathyroidectomy has similar benefits for normocalcemic primary hyperparathyroidism and hypercalcemic primary hyperparathyroidism in terms of bone improvement. Although the most substantial improvement occurred during the first postoperative year in both groups, we consider that studies with longer follow-up are warranted.
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Hipercalcemia , Hiperparatireoidismo Primário , Densidade Óssea , Cálcio , Colágeno Tipo I , Humanos , Hipercalcemia/cirurgia , Hiperparatireoidismo Primário/complicações , Hiperparatireoidismo Primário/cirurgia , Osteocalcina , Hormônio Paratireóideo , Paratireoidectomia , Estudos ProspectivosRESUMO
Contamination of food chains by toxigenic fungi and aflatoxins is a global problem that causes damage to human health, as well as to crop and livestock production. The objective is to evaluate Aspergillus flavus and total aflatoxins (AFs) occurrence in totally mixed rations (TMRs) for dairy cows and aflatoxin M1 (AFM1) in milk for human consumption. Ninety-nine dairy production units located in Aguascalientes, Mexico, were randomly selected, and samples were collected from TMRs, raw milk, and milk marketed in the city in two consecutive agricultural cycles. AFs were quantified in TMRs and milk by indirect enzyme immunoassay and HPLC; aflatoxigenic and molecular (PCR) capacity of monosporic A. flavus isolates in the feed was characterized. All feed, raw, and pasteurized milk samples showed aflatoxin contamination (26.0 ± 0.4 µg/kg, 32.0 ± 1.0, and 31.3 ± 0.7 ng/L, respectively), and a significant proportion (90.4, 11.3, and 10.3%) exceeded the locally applied maximum permissible limits for feed and milk (20.0 µg/kg and 50 ng/L). Aflatoxin contamination in both TMRs and milk indicated a seasonal influence, with a higher concentration in the autumn-winter cycle when conditions of higher humidity prevail. The results obtained suggest the existence of contamination by aflatoxigenic A. flavus and aflatoxins in the diet formulated for feeding dairy cows and, consequently, in the dairy food chain of this region of the Mexican Highland Plateau.
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Aflatoxina M1 , Aflatoxinas , Aflatoxina M1/análise , Aflatoxinas/análise , Animais , Aspergillus flavus , Bovinos , Feminino , México , Leite/químicaRESUMO
INTRODUCTION: Scintigraphy with technetium-sestamibi (MIBI) is the test of choice for localising adenomas in patients with primary hyperparathyroidism (PHPT). In some studies it has emerged that the increase in sensitivity of this test could be associated with a decrease in the uptake of the radiotracer by the thyroid gland. The aim of this study is to analyse our experience in patients with a negative scintigraphy with MIBI, and in whom the study was repeated after suppression of thyroid function with thyroxine. MATERIAL AND METHODS: A prospective evaluation was performed on 17 patients who, between January 2006 and April 2011, had PHPT and negative imaging using scintigraphy with MIBI and who had the test repeated after the administration of thyroxine. The scintigraphy data and the correlation with the findings in the surgical intervention are reviewed. RESULTS: The mean TSH at the time of repeating the MIBI was 0.12+0.1mlU/L. Of the 17 patients included, the scintigraphy under thyroid suppression was positive in 13 of them (76.5%), and in the other 4 (23.5%) patients no image suggestive of adenoma was found. In the cases where the MIBI was positive after suppression, the positive predictive value (PPV) was 100%. CONCLUSION: Suppression of thyroid function by giving thyroxine can help to improve the sensitivity of MIBI in patients with previously negative scintigraphy studies and help in the minimally invasive treatment of patients with PHPT.
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Hiperparatireoidismo Primário/diagnóstico por imagem , Cuidados Pré-Operatórios , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Sestamibi , Testes de Função Tireóidea , Reações Falso-Negativas , Feminino , Humanos , Hiperparatireoidismo Primário/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Cintilografia , TiroxinaRESUMO
Projections of future climate change impacts suggest an increase of wildfire activity in Mediterranean ecosystems, such as southern California. This region is a wildfire hotspot and fire managers are under increasingly high pressures to minimize socio-economic impacts. In this context, predictions of high-risk fire seasons are essential to achieve adequate preventive planning. Regional-scale weather patterns and climatic teleconnections play a key role in modulating fire-conducive conditions across the globe, yet an analysis of the coupled effects of these systems onto the spread of large wildfires is lacking for the region. We analyzed seven decades (1953-2018) of documentary wildfire records from southern California to assess the linkages between weather patterns and large-scale climate modes using various statistical techniques, including Redundancy Analysis, Superposed Epoch Analysis and Wavelet Coherence. We found that high area burned is significantly associated with the occurrence of adverse weather patterns, such as severe droughts and Santa Ana winds. Further, we document how these fire-promoting events are mediated by climate teleconnections, particularly by the coupled effects of El Niño Southern Oscillation and Atlantic Multidecadal Oscillation.
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Ethers can be found in the environment as structural, active or even pollutant molecules, although their degradation is not efficient under environmental conditions. Fungal unspecific heme-peroxygenases (UPO were reported to degrade low-molecular-weight ethers through an H2O2-dependent oxidative cleavage mechanism. Here, we report the oxidation of a series of structurally related aromatic ethers, catalyzed by a laboratory-evolved UPO (PaDa-I) aimed at elucidating the factors influencing this unusual biochemical reaction. Although some of the studied ethers were substrates of the enzyme, they were not efficiently transformed and, as a consequence, secondary reactions (such as the dismutation of H2O2 through catalase-like activity and suicide enzyme inactivation) became significant, affecting the oxidation efficiency. The set of reactions that compete during UPO-catalyzed ether oxidation were identified and quantified, in order to find favorable conditions that promote ether oxidation over the secondary reactions.
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The seed dispersal mechanisms and regeneration of various forest ecosystems can benefit from the actions of carnivores via endozoochory. This study was aimed to evaluate the role of carnivores in endozoochory and diploendozoochory, as well as their effect on seed viability, scarification, and germination in two forest ecosystems: temperate and tropical dry forest. We collected carnivore scat in the Protected Natural Area of Sierra Fría in Aguascalientes, Mexico, for 2 years to determine the abundance and richness of seeds dispersed by each carnivore species, through scat analysis. We assessed seed viability through optical densitometry using X-rays, analyzed seed scarification by measuring seed coat thickness using a scanning electron microscope, and evaluated seed germination in an experiment as the percentage of seeds germinated per carnivore disperser, plant species, and forest type. In the temperate forest, four plant species (but mainly Arctostaphylos pungens) were dispersed by four mammal species. The gray fox dispersed the highest average number of seeds per scat (66.8 seeds). Bobcat dispersed seeds through diploendozoochory, which was inferred from rabbit (Sylvilagus floridanus) hair detected in their scats. The tropical dry forest presented higher abundance of seeds and richness of dispersed plant species (four species) than in the temperate forest, and the coati dispersed the highest number of seeds (8,639 seeds). Endozoochory and diploendozoochory did not affect viability in thick-testa seeds (1,480 µm) in temperate forest and thin-testa seeds (281 µm) in tropical dry forest. Endozoochory improved the selective germination of seeds. Nine plant species were dispersed by endozoochory, but only one species (Juniperus sp.) by diploendozoochory. These results suggest that carnivores can perform an important ecological function by dispersing a great abundance of seeds, scarifying these seeds causing the formation of holes and cracks in the testas without affecting viability, and promoting the selective germination of seeds.