Ultrasonography in the Assessment of Tumors of the Cheek: Water Mouth Distension Technique.

PURPOSE: To describe a new B-mode ultrasound examination technique to assess cheek tumors. MATERIALS AND METHODS: 30 cheek oral cavity lesions of different histological types (11 benign and 19 malignant) from 23 patients (11 women and 12 men, 7-82 years old, mean age of 49.5 years) were analyzed. Transcutaneous oral B-mode ultrasound (5-12 MHz transducer) was carried out in two stages. Initially it was performed conventionally with an empty mouth. Next, the patient was asked to keep their oral cavity filled with water (like when using a mouthwash) during imaging for the new test examination technique. The anatomical layers of this region and the characteristics of the tumors were evaluated. Lesions were classified as ill defined, partially defined, or defined. Conventional findings were compared to those of the new technique using the Wilcoxon signed-rank test. Ultrasound results were compared to histological findings analyzed by an independent team. RESULTS: The conventional empty mouth technique was able to confidently define lesion extension in only 6 of the 30 lesions, while the water-filled mouth technique was able to confidently define lesion extension in 29 of the 30 lesions (p<0.00001). CONCLUSION: We present a novel technique that dramatically improves ultrasound staging of cheek oral cavity tumors. In addition to the increase in ultrasound accuracy, this technique does not require any special equipment or extra cost, is very well tolerated by patients, and thus should be considered in the evaluation of every patient undergoing transcutaneous cheek ultrasound for oral cavity lesion characterization.

Exploring the macrostructural anatomy of dendrochirotid sea cucumber's (Echinodermata) calcareous rings under micro-computed tomography and its bearing on phylogeny.

Despite descending from heavily calcified ancestors, the holothuroid skeleton is fully internal and composed of microscopic ossicles and a ring of plates bound by connective tissue, the calcareous ring. The calcareous ring exhibits a complex and poorly understood morphology; as a result, establishing unambiguous homology statements about its macrostructure has been challenging and phylogenetic studies have had to simplify this important structure. Here, we provide the first broad comparative study of Dendrochirotida calcareous rings using micro-computed tomography (µCT). A detailed description of the three-dimensional macrostructure of the calcareous ring of 10 sea cucumber species, including rare and type specimens, is presented. The structures observed were highly variable at the subfamily level, especially at the point of tissue attachment. The relationship between the calcareous ring and its associated organs, and their functional morphology are discussed. To aid future phylogenetic studies, we listed 22 characters and performed a preliminary cladistic analysis. The topology obtained supports the idea that the simple, cucumariid ring is ancestral to the mosaic-like phyllophorid ring; however, it did not support the monophyly of the cucumariids. It also did not support the family Sclerodactylidae, which was described based on the ring morphology. Differently from the dermal ossicles, which are highly homoplastic, the general homoplasy index of the calcareous ring characters was relatively low. This result highlights the importance of this structure for phylogenetic inference. Unfortunately, time since collection, rough collection methods and fixation can damage the skeleton, and the calcareous ring is often overlooked in taxonomic descriptions. The data presented here will improve our understanding of holothuroid relationships and facilitate studies on holothuroid functional morphology and biomechanics.

Two new species and two new records of deep-water caridean shrimps from Brazil (Decapoda: Pandalidae, Palaemonidae, Crangonidae).

The present study deals with four species of benthic deep-water caridean shrimps collected on the continental slope off southeastern Brazil, between 360 m and 900 m. The deepwater pandalid Bitias stocki Fransen, 1990, previously known only from a few localities in the eastern Atlantic, is reported for the first time from the western Atlantic (Brazil). The Brazilian material of B. stocki also represents the first record of the genus Bitias Fransen, 1990 in the western Atlantic. The palaemonid Periclimenes tenellus (Smith, 1882), previously known only from South Carolina and New Jersey, USA, is reported for the first time from Brazil, representing a considerable range extension of this uncommon species into the southwestern Atlantic. Another deepwater palaemonid shrimp is described as new: Periclimenes bathyalis sp. nov. The new species is morphologically closest to the echinoid associates Periclimenes milleri Bruce, 1986 and Periclimenes ingressicolumbi Berggren & Svane, 1989. Finally, the bizarre deepwater crangonid genus Prionocrangon Wood-Mason in Wood-Mason & Alcock, 1891 is reported for the first time from Brazil and the southwestern Atlantic, where it is represented by a new species, Prionocrangon brasiliensis sp. nov.

Prevalence of DICER1 variants in large multinodular goiter: thyroid function, clinical and imaging characteristics.

Objective: Mutations in DICER1 are found in differentiated thyroid carcinoma (DTC) and in multinodular goiter (MNG) at a younger age with other tumors, which characterizes DICER1 syndrome. DICER1 is one driver to DTC; however, it is also found in benign nodules. We speculated that patients with mutations in DICER1 may present long-lasting MNG. Our aim was to investigate the frequency of DICER1 variants in patients with MNG. Subjects and methods: Patients who submitted to total thyroidectomy due to large MNG with symptoms were evaluated. DICER1 hotspots were sequenced from thyroid nodule samples. To confirm somatic mutation, DNA from peripheral blood was also analyzed. Results: Among 715 patients, 154 were evaluated with 56.2 ± 12.3 years old (28-79) and the thyroid volume was 115.7 ± 108 mL (16.2-730). We found 11% with six DICER1 variations in a homo or heterozygous state. Only rs12018992 was a somatic DICER1 variant. All remaining variants were synonymous and likely benign, according to the ClinVar database. The rs12018992 was previously described in an adolescent with DTC, measuring 13 mm. There were no significant differences according to gender, familial history of goiter, age, thyroid volume, TSH and TI-RADS classification between DICER1 carriers. Free T4 were lower in patients with DICER1 polymorphisms (13.77 ± 1.8 vs. 15.44 ± 2.4 pmol/L, p = 0.008), regardless of TSH levels. Conclusion: We conclude that germline DICER1 variants can be found in 11% of large goiters but no second-hit somatic mutation was found. DICER1 is one driver to thyroid lesion and a second-hit event seems unnecessary in the MNG development.

NORAD-Regulated Signaling Pathways in Breast Cancer Progression.

Long non-coding RNA activated by DNA damage (NORAD) has recently been associated with pathologic mechanisms underlying cancer progression. Due to NORAD's extended range of interacting partners, there has been contradictory data on its oncogenic or tumor suppressor roles in BC. This review will summarize the function of NORAD in different BC subtypes and how NORAD impacts crucial signaling pathways in this pathology. Through the preferential binding to pumilio (PUM) proteins PUM1 and PUM2, NORAD has been shown to be involved in the control of cell cycle, angiogenesis, mitosis, DNA replication and transcription and protein translation. More recently, NORAD has been associated with PUM-independent roles, accomplished by interacting with other ncRNAs, mRNAs and proteins. The intricate network of NORAD-mediated signaling pathways may provide insights into the potential design of novel unexplored strategies to overcome chemotherapy resistance in BC treatment.

A new species of Robertsella Guinot, 1969 (Crustacea: Brachyura: Panopeidae) from the southwestern Atlantic.

A new species of deep-water brachyuran crab, Robertsella meridionalis, from Brazil is described and illustrated. The new species can be easily separated from its northwestern Atlantic counterpart, R. mystica Guinot, 1969, by a suite of carapace and appendage characters. Robertsella mystica is redescribed and illustrated. Putative sound-producing structures in the genus Robertsella are first described.

Significance of the sexual openings and supplementary structures on the phylogeny of brachyuran crabs (Crustacea, Decapoda, Brachyura), with new nomina for higher-ranked podotreme taxa.

The patterns of complexity of the male and female sexual openings in Brachyura, which have been the source of uncertainties and conflicting opinions, are documented, together with a study of the morphologies of the coxal and sternal gonopores in both sexes, penises, spermathecae, and gonopods. The vulvae, male gonopores and penises are described among selected taxa of Eubrachyura, and their function and evolution examined in the context of a wide variety of mating behaviours. The location of female and male gonopores, the condition of the penis (coxal and sternal openings and modalities of protection), and related configurations of thoracic sternites 7 and 8, which are modified by the intercalation of a wide sternal part (thoracic sternites 7 and 8) during carcinisation, show evidence of deep homology. They represent taxonomic criteria at all ranks of the family-series and may be used to test lineages. Of particular significance are the consequences of the posterior expansion of the thoracic sternum, which influences the condition, shape, and sclerotisation of the penis, and its emergence from coxal (heterotreme) to coxo-sternal, which is actually still coxal (heterotreme), in contrast to a sternal emergence (thoracotreme). The heterotreme-thoracotreme distinction results from two different trajectories of the vas deferens and its ejaculatory duct via the P5 coxa (Heterotremata) or through the thoracic sternum (Thoracotremata). Dissections of males of several families have demonstrated that this major difference not only affects the external surface (perforation of the coxa or the sternum by the ejaculatory duct) but also the internal anatomy. There is no evidence for an ejaculatory duct passing through the articular membrane between the P5 coxa and the thoracic sternum in any Brachyura, even when the sternal male gonopore is very close to the P5 coxa. Trends towards the coxo-sternal condition are exemplified by multistate characters, varying from a shallow depression to a long groove along expanded sternites 7 and 8, and ultimately their complete, extended junction typifying the most derived coxo-sternal condition. The coxo-sternal condition is indicative of a long evolutionary history, as evidenced by the presence of multistate characters (e.g., Dorippidae, Goneplacoidea) or by a single, well-established condition (e.g., Chasmocarcinidae, Ethusidae, Panopeidae Eucratopsinae, Rhizopidae, Scalopidiidae). The penial area proves to be an essential diagnostic feature in Brachyura, with a value comparable to that of the gonopods. Penis protection is ubiquitous in Brachyura irrespective of length, and several modalities of protection prevail, which necessitate different modifications of associated structures. A long penis in a gutter developed from a partial invagination of sternite 8 induces the formation of a new "suture" at the same level as the preceding suture 6/7. Such a "supplementary suture 7/8" exists among unrelated heterotreme families (e.g., Ethusidae, Panopeidae Eucratopsinae, Pseudorhombilidae, Rhizopidae). A fully protected penis, concealed in a groove within a complete invagination of sternite 8 in the form of two contiguous plates, evolved independently (homoplasy) in Palicoidea and Chasmocarcinidae (Goneplacoidea), with sternite 8 present as a single plate in females. In condylar protection, described for the first time and occurring in several heterotreme families, the penis emerges from the extremity of the P5 coxo-sternal condyle or from its anterior border instead of from the coxa itself. A penis precisely lodged in a small excavation on sternite 8, which is lined by a row of stiff setae, is unique to Brachyura, and represents a new synapomorphy of the Homoloidea. Five modalities of penis protection are recognised in Podotremata, eight in Eubrachyura (six in Heterotremata and two in Thoracotremata). Special attention has been paid to Dorippoidea (Dorippidae and Ethusidae), which shows transformation series from coxal to coxo-sternal conditions. The coxo-sternal condition is not an intermediate towards the thoracotreme organisation, and a step in heterotreme evolution is the adoption of the coxo-sternal condition. An extreme carcinisition may also result in the sternal arrangement of male gonopores in the form of a "sternitreme" disposition, as in the case of Hymenosomatoidea, which displays a broad thoracic sternum and true sternal male gonopores (as in thoracotremes) together with several plesiomorphic traits that are assumed to represent an old, deeply-rooted heterotreme clade. A sternitreme condition evolved independently in the most ancestral heterotreme clades (such as Hymenosomatoidea) and in Thoracotremata. The older the lineage of a heterotreme is, the higher the possibility of having evolved carcinisation. Evidence that "derived" traits may be the consequence of a strong carcinisation, rather than being recently acquired, necessitates reconsidering certain character states in Brachyura. Eubrachyurans can only evolve either the heterotreme or the thoracotreme arrangement, the consistency of the inferred ancestral characters states providing a useful criterion for evaluating ancestral trait reconstructions. A widened thoracic sternum together with sternal gonopores may be present in carcinised heterotremes such as hymenosomatoids. The thoracic sternum provides a reliable complex of characters that must be carefully interpreted. The hypothesis of a coxo-sternal disposition in Cryptochiroidea and Pinnotheroidea, generally considered thoracotremes, is rejected, and an alternative interpretation of their status is discussed. A new interpretation of the phylogeny of Cryptochiroidea is outlined, but the origin of Pinnotheroidea remains puzzling. The sella turcica, frequently regarded a synapomorphy of Eubrachyura, is redefined as the structure formed by the endosternal intertagmal phragma that connects the tagma/thorax and the tagma/abdomen to thoracic interosternite 7/8. It is here termed the "brachyuran sella turcica" and is shown to be synapomorphic to all Brachyura. The Eubrachyura synapomorphically shares the fusion of the thoracic interopleurite 7/8 with the brachyuran sella turcica, forming the "eubrachyuran sella turcica". In contrast, some Podotremata (Cyclodorippoidea and Raninoidea) share a connection between the sella turcica and the thoracic interosternite 6/7. Six main patterns of the thoracic sternum in relation to variations in sutures 4/5-7/8 are recognised in Eubrachyura, whereas several subpatterns that include variations in the median line are distinguished. The evolution of the thoracic sternum and axial skeleton is reassessed in Podotremata and Eubrachyura. A posteriormost location of the male gonopore (coxal or sternal) in relation to sternite 8 characterises many brachyurans (Cryptochiroidea, Hymenosomatoidea, Majoidea, Matutidae, Menippidae, Orithyioidea, Parthenopoidea, Ucididae, Grapsoidea--including Percnidae, Plagusiidae, Varunidae), in contrast to a location close to suture 7/8 in other groups. The thoracic sternum/pterygostome junction, which has multistate characters, is shown to be a valuable taxonomic criterion. The shapes of the sterno-abdominal depression and sterno-abdominal cavity provide diagnostic features that are helpful in suprageneric assignments. The monophyly of Brachyura, Eubrachyura, and Thoracotremata is reaffirmed. The monophyly of Brachyura is supported by the interdependence of the two pairs of gonopods and penis. An abdomen permanently flexed and held by the pereopods and/or the homoloid press button (on sternite 4) or typical eubrachyuran press-button (on sternite 5) may be considered a synapomorphy of Brachyura, the absence of this condition considered a loss. The double abdominal-locking system ("double peg") on sternite 5, a device discovered in three families of the extinct Palaeocorystoidea from the Upper Aptian, is similar to the double hook present in living lyreidids, although it is lost in all other raninoid extant members. New evidence shows that the abdominal holding was an early occurrence for a brachyuran crab. The Raninoidea, sister to Palaeocorystoidea, is characterised by gymnopleurity, a condition that results from the lifting of the carapace and thus the exposure of several pleurites. The narrowing of the body and thoracic sternum, almost certainly associated with their burrowing behaviour, is a diagnostic feature of raninoid evolution, in contrast to the widening observed in the remaining Brachyura. The monophyly of Heterotremata is discussed. Although the correct assignment of the coxal male gonopore and sternal female gonopore (vulva) at the base of Decapoda and Eubrachyura, respectively, left no synapomorphies to support the Heterotremata, the group nevertheless should be regarded as the sister group to Thoracotremata. The controversial monophyly of Podotremata is discussed and arguments are presented against the suppression of this taxon. The distinction of Homoloidia from Dromioidia is argued, and a classification of Podotremata, which considers the fossil record whenever possible, is presented. The earliest brachyurans are re-examined, and a new interpretation of the phylogeny of several basal eubrachyuran groups (Dorippoidea, Inachoididae, Palicoidea, Retroplumoidea) is proposed. Stenorhynchus shares a number of characters with the Inachoididae that differentiate them from Inachidae, and also has some distinctive features that warrants its assignment to a separate inachoidid subfamily, Stenorhynchinae, which is resurrected. The concealment strategies among Brachyura are documented and discussed. Podotremes use carrying behaviour, often combined with burying and concealment under substrates, whereas living within a host, burying, and decoration are used by heterotremes, burrowing being essentially a thoracotreme strategy.(ABSTRACT TRUNCATED)

Unveiling the hidden threat of microplastics to coral reefs in remote South Atlantic islands.

The widespread presence of marine microplastics (< 5 mm) is a significant concern, as it may harm marine biodiversity and ocean ecosystems. Corals' capacity to ingest microplastics has emerged as a significant threat to reef ecosystems, owing to the detrimental physiological and ecological effects it can trigger. The extent of the impact of microplastics on Brazilian corals remains unclear and this study aimed to investigate its distribution and characteristics in four coral species: Favia gravida, Mussismilia hispida, Montastrea cavernosa, and Siderastrea stellata, found in the Trindade and Martim Vaz Islands - the most isolated archipelago of Brazil, located about 1200 km (680 miles) east of the coast. This study aims to reveal the extent of microplastic distribution in the coral reef environment, assess the amount of microplastics in different coral species, and compare each species' capacity to adhere and accumulate microplastics. A high concentration of ingested and adhered microplastics was detected in all coral species evaluated in the present study. No significant differences were observed in the sampling points which indicates that although the sampling points are located at different distances from the coast, the microplastic pollution is equally distributed in the region. Polyethylene (PE), polyvinyl chloride (PVC), polypropylene (PP), poly(methyl methacrylate) (PMMA), Rayon, and Nylon particles were detected, with a predominance of PE (45.5 %). No significant differences in microplastic concentration were detected among the various species and locations studied. Our research presents findings that demonstrate the extensive occurrence of microplastic contamination in coral colonies located on remote islands.

Guidelines from the Brazilian society of surgical oncology regarding indications and technical aspects of neck dissection in papillary, follicular, and medullary thyroid cancers.

Objective: The purpose of these guidelines is to provide specific recommendations for the surgical treatment of neck metastases in patients with papillary, follicular, and medullary thyroid carcinomas. Materials and methods: Recommendations were developed based on research of scientific articles (preferentially meta-analyses) and guidelines issued by international medical specialty societies. The American College of Physicians' Guideline Grading System was used to determine the levels of evidence and grades of recommendations. The following questions were answered: A) Is elective neck dissection indicated in the treatment of papillary, follicular, and medullary thyroid carcinoma? B) When should central, lateral, and modified radical neck dissection be performed? C) Could molecular tests guide the extent of the neck dissection? Results and conclusion: Recommendation 1: Elective central neck dissection is not indicated in patients with cN0 well-differentiated thyroid carcinoma or in those with noninvasive T1 and T2 tumors but may be considered in T3-T4 tumors or in the presence of metastases in the lateral neck compartments. Recommendation 2: Elective central neck dissection is recommended in medullary thyroid carcinoma. Recommendation 3: Selective neck dissection of levels II-V should be indicated to treat neck metastases in papillary thyroid cancer, an approach that decreases the risk of recurrence and mortality. Recommendation 4: Compartmental neck dissection is indicated in the treatment of lymph node recurrence after elective or therapeutic neck dissection; "berry node picking" is not recommended. Recommendation 5: There are currently no recommendations regarding the use of molecular tests in guiding the extent of neck dissection in thyroid cancer.

Expression of NORAD correlates with breast cancer aggressiveness and protects breast cancer cells from chemotherapy.

The recently discovered human lncRNA NORAD is induced after DNA damage in a p53-dependent manner. It plays a critical role in the maintenance of genomic stability through interaction with Pumilio proteins, limiting the repression of their target mRNAs. Therefore, NORAD inactivation causes chromosomal instability and aneuploidy, which contributes to the accumulation of genetic abnormalities and tumorigenesis. NORAD has been detected in several types of cancer, including breast cancer, which is the most frequently diagnosed and the second-leading cause of cancer death in women. In the present study, we confirmed upregulated NORAD expression levels in a set of human epithelial breast cancer cell lines (MDA-MB-231, MDA-MB-436, and MDA-MB-468), which belong to the most aggressive subtypes (triple-negative breast cancer). These results are in line with previous data showing that high NORAD expression levels in basal-like tumors were associated with poor prognosis. Here, we demonstrate that NORAD downregulation sensitizes triple-negative breast cancer cells to chemotherapy, through a potential accumulation of genomic aberrations and an impaired capacity to signal DNA damage. These results show that NORAD may represent an unexploited neoadjuvant therapeutic target for chemotherapy-unresponsive breast cancer.

Dapagliflozin in patients with critical illness: rationale and design of the DEFENDER study.

BACKGROUND: Critical illness is a major ongoing health care burden worldwide and is associated with high mortality rates. Sodium-glucose cotransporter-2 inhibitors have consistently shown benefits in cardiovascular and renal outcomes. The effects of sodium-glucose cotransporter-2 inhibitors in acute illness have not been properly investigated. METHODS: DEFENDER is an investigator-initiated, multicenter, randomized, open-label trial designed to evaluate the efficacy and safety of dapagliflozin in 500 adult participants with acute organ dysfunction who are hospitalized in the intensive care unit. Eligible participants will be randomized 1:1 to receive dapagliflozin 10mg plus standard of care for up to 14 days or standard of care alone. The primary outcome is a hierarchical composite of hospital mortality, initiation of kidney replacement therapy, and intensive care unit length of stay, up to 28 days. Safety will be strictly monitored throughout the study. CONCLUSION: DEFENDER is the first study designed to investigate the use of a sodium-glucose cotransporter-2 inhibitor in general intensive care unit patients with acute organ dysfunction. It will provide relevant information on the use of drugs of this promising class in critically ill patients. CLINICALTRIALS.GOV REGISTRY: NCT05558098.

Voltage-driven ring confinement in a graphene sheet: assessing conditions for bound state solutions.

We have systematically studied the single-particle states in quantum rings produced by a set of concentric circular gates over a graphene sheet placed on a substrate. The resulting potential profiles and the interaction between the graphene layer and the substrate are considered within the Dirac Hamiltonian in the framework of the envelope function approximation. Our simulations allow microscopic mapping of the character of the electron and hole quasi-particle solutions according to the applied voltage. General conditions to control and operate the bound state solutions are described as functions of external and controllable parameters that will determine the optical properties ranging from metallic to semiconductor phases. Contrasting behaviors are obtained when comparing the results for repulsive and attractive voltages as well as for variation of the relative strength of the graphene-substrate coupling parameter.

Additions to the morphology of the Phyllophoridae and the Sclerodactylidae. I. Type species of Phyllophorella, Selenkiella, Cladolella and Clarkiella, with the description a new species of Thorsonia (Holothuroidea: Dendrochirotida).

The phyllophorids Phyllophorella robusta, Selenkiella siamense and Cladolella virgo, as well as the sclerodactylid Clarkiella discoveryi, are the type species of their respective genera, all described by Heding Panning (1954) and each known only from a single specimen, were revisited in order to reassess their morphology by means of optical and electron microscopy, and micro-computed tomography. Additionally, a new species of phyllophorid is described, the fourth of the genus Thorsonia.

New record and a new species of Lissosabinea Christoffersen, 1988 (Decapoda: Caridea: Crangonidae) from Brazil.

Lissosabinea tridentata (Pequegnat, 1970) known hitherto from the Gulf of Mexico off Florida (24N) and only western Atlantic representative of the genus, is reported here for the first time from much further south, Brazil off the coast of Esprito Santo, Vitria-Trindade Seamount Chain, Montague Bank (20S), between 310 and 391 m. A second western Atlantic species, Lissosabinea christofferseni sp. nov., is described here as new from material collected in the Abrolhos Bank, at depth between 340360 m. One exuviae and one damaged specimen, reported in 1988 from off the coast of Chu, Brazil (34S) (at that time mistakenly referred to as Uruguay) and attributed to Lissosabinea cf. tridentata are herein referred to the new species. It has been clarified that Lissosabinea christofferseni sp. nov. and L. tridentata have a transverse row of teeth adjacent to the posterior margin of the sixth pleonal sternite; in crangonids, such a feature is so far known only in Placopsicrangron formosa Komai Chan, 2009.

Brachyuran crabs (Crustacea, Decapoda) from the remote oceanic Archipelago Trindade and Martin Vaz, South Atlantic Ocean.

Forty species of shore and shallow water brachyuran crabs are reported from the remote oceanic Archipelago Trindade and Martin Vaz (TMV), 11 of which were previously known from Trindade Island, 28 are recorded from the Archipelago for the first time, and one is a new species, Epialtus parvulus sp. nov. This brings the total known shore and shallow water decapod fauna of TMV to 99 species. The opportunity is taken here to elaborate on the taxonomy of the species reported from TMV. One new genus, Mecataleptodius, is recognized for two species, Cancer parvulus Fabricius, 1793, its type species, and Cataleptodius olsoni Manning Chace, 1990, endemic to Ascension Island. The following seven nominal species are synonymized: Acanthonyx dissimulatus Coelho in Coelho Torres, 1993; A. scutiformis (Dana, 1851a); Dromia gouveai Melo Campos Junior, 1999; Epialtus portoricensis Rathbun, 1923; Ranilia guinotae Melo Campos Junior, 1994; R. saldanhai H. Rodrigues da Costa, 1970; and Omalacantha garthi (Lemos de Castro, 1953). TMV is a subset of the western Atlantic crab fauna (23 species or 57.5%), also including 8 (20%) amphi-Atlantic species, 3 (7.5%) amphi-American, 3 (7.5%) endemic, 2 (5%) cosmopolitan, 1 (2.5%) known from both sides of the Atlantic and the Indo-West Pacific. The crab fauna of TMV, Ascension (AS) and Saint Helena (SH) are compared with one another as well as with that of the oceanic islands Fernando de Noronha (FN) and the Rocas Atoll (RA) by means of nonmetric multidimensional scaling (NMDS) applied to a dissimilarity matrix generated by Jaccards coefficient. TMV-FN-RA and AS-SH clustered into two distinct groups according to the composition of their crab fauna. The NMDS analysis ranked the species that cause segregation of the crab faunal assemblages among TMV, AS, and SH, while revealing a gradient in species composition between the two groups of islands (TMV-FN-RA and AS-SH) formed by the amphi-Atlantic species. Island isolation, age and size alone do not explain the existing differences in species richness among TMV, AS and SH. The taxonomic composition of the shallow water fauna in these islands is likely to have been determined by several variables that were interwoven differently along their evolutionary history.

Risk factors associated with disease-specific mortality in papillary thyroid cancer patients with distant metastases.

PURPOSE: Papillary thyroid carcinoma (PTC) is among the most curable cancer types. Even though uncommon, some patients present distant metastatic disease at diagnosis or during the follow-up and most of them have long-term survival. However, there continues to be controversies regarding what clinicopathological features are associated with mortality in these patients. This paper evaluates the factors related to poor disease-specific survival (DSS) in patients with metastatic PTC. METHODS: A retrospective cohort study included PTC patients with distant metastasis from a tertiary public oncological center. Clinicopathological features, treatment modalities, and outcome were reviewed. RESULTS: Between 1986 and 2014, 108 patients were diagnosed with metastatic PTC. In the multivariate analysis male sex (HR = 2.65; 95%CI: 1.08-6.53; P = 0.033), radioiodine refractory disease (HR = 9.50; 95%CI: 1.23-73.38; P = 0.031) and metastasis at multiple sites (HR = 5.91; 95%CI: 1.80-19.32; P = 0.003) were independent risk factors for death in patients with metastatic PTC. CONCLUSION: Male patients with metastatic PTC, with radioiodine refractory disease and metastasis at multiple sites have a high risk of death.

Characteristics and prevalence of orofacial pain as an initial symptom of oral and oropharyngeal cancer and its impact on the patient's functionality and quality of life.

OBJECTIVE: To evaluate the prevalence and characteristics of orofacial pain in oral and oropharyngeal cancer (OOC), at diagnosis. MATERIAL AND METHODS: a) Study group (SG; n = 74) patients with cancer were divided into 2 subgroups: oral cancer (OC) and oropharyngeal cancer (OPC); b) control group (CG; n = 74) patients within dental care. STUDY DESIGN: An Orofacial Pain Assessment, verbal descriptive scale, Helkimo dysfunction index, Quality of Life questionnaire, and Karnofsky performance status (KPS) was used for evaluation. RESULTS: The mean age was 58.46 years (79.7% male) in SG, 58.61 years (20.3% male) in CG. The pain within the SG was indicated by the following: prevalence = 91.9% (21.6% in stages 0, I, or II; 70.3% in III or IV); reason for seeking care = 50.1%; main complaint = 55.4%; most important issue in the past 7 days = 74.3%; breakthrough-like pain = 64.9%; main features: chewing or swallowing as triggering factors, wake up patient, variable duration, independent of daytime, multiple descriptors, and earache. The following indexes were worse within the SG: clinical dysfunction, quality of life, and KPS. In addition, the OC subgroup reported toothache-like pain and burning; whereas the OPC subgroup reported heavy swallowing as triggering factor, throat as location, and a bilateral earache. CONCLUSION: At diagnosis, orofacial pain, including breakthrough-like pain, was prevalent in patients with OOC, and the pattern was heterogeneous. Predominantly, the pain was moderate to severe, related to stage of cancer, and already compromising the patients' quality of life and functionality.

Risk profiles and penetrance estimations in multiple endocrine neoplasia type 2A caused by germline RET mutations located in exon 10.

Multiple endocrine neoplasia type 2 is characterized by germline mutations in RET. For exon 10, comprehensive molecular and corresponding phenotypic data are scarce. The International RET Exon 10 Consortium, comprising 27 centers from 15 countries, analyzed patients with RET exon 10 mutations for clinical-risk profiles. Presentation, age-dependent penetrance, and stage at presentation of medullary thyroid carcinoma (MTC), pheochromocytoma, and hyperparathyroidism were studied. A total of 340 subjects from 103 families, age 4-86, were registered. There were 21 distinct single nucleotide germline mutations located in codons 609 (45 subjects), 611 (50), 618 (94), and 620 (151). MTC was present in 263 registrants, pheochromocytoma in 54, and hyperparathyroidism in 8 subjects. Of the patients with MTC, 53% were detected when asymptomatic, and among those with pheochromocytoma, 54%. Penetrance for MTC was 4% by age 10, 25% by 25, and 80% by 50. Codon-associated penetrance by age 50 ranged from 60% (codon 611) to 86% (620). More advanced stage and increasing risk of metastases correlated with mutation in codon position (609→620) near the juxtamembrane domain. Our data provide rigorous bases for timing of premorbid diagnosis and personalized treatment/prophylactic procedure decisions depending on specific RET exon 10 codons affected.