RESUMEN
"Corymbiform" is a term found in medical literature as early as 1876 to describe a central larger lesion with smaller surrounding lesions, leading to the appearance of an irregular border. While the term in current medical literature most often describes a possible morphology of secondary syphilis, the authors have noted this pattern presenting in other cutaneous conditions. We present a commentary on the corymbiform pattern in dermatology including a series of photographs of cutaneous disorders presenting in a corymbiform morphology in pediatric patients. While the term corymbiform is not commonly used in the present-day dermatologic literature, increased recognition and use of this term may aid in the recognition of various dermatologic diagnoses presenting in a less common morphology and may also lend to increased fluidity of dermatologic descriptions in the literature.
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Dermatitis , Dermatología , Lupus Eritematoso Cutáneo , Sífilis , Humanos , Niño , Sífilis/diagnósticoRESUMEN
An 18-year-old Black female presented with a 2-year history of bilateral upper eyelid swelling and the recent onset of multiple subcutaneous nodules on the arms. She had previously undergone evaluation and treatment for presumed angioedema. Biopsies of the eyelid and an arm nodule demonstrated non-necrotizing granulomatous inflammation with special stains negative for acid-fast bacilli and fungi, and the patient was diagnosed with subcutaneous sarcoidosis. The isolated finding of bilateral eyelid swelling 2 years prior to the onset of additional cutaneous findings led to a significant delay in diagnosis, highlighting the importance of considering sarcoidosis in the differential diagnosis for bilateral eyelid swelling.
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Angioedema , Sarcoidosis , Humanos , Femenino , Adolescente , Sarcoidosis/complicaciones , Sarcoidosis/diagnóstico , Sarcoidosis/patología , Párpados/patología , Angioedema/diagnóstico , Edema/diagnóstico , Edema/etiología , Diagnóstico DiferencialRESUMEN
Ileo-ileal knotting is a rare cause of intestinal obstruction. In this condition, one bowel loop makes a knot with an adjacent bowel loop, resulting in mechanical obstruction and even gangrene of the bowel. We present a case of a young girl with ileo-ileal knotting resulting in a closed-loop obstruction and gangrene of the small bowel loop. This is a difficult condition to diagnose; a high index of suspicion and early surgical intervention are essential to reduce morbidity and mortality.
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Obstrucción Intestinal/diagnóstico , Intestino Delgado/fisiopatología , Intestino Delgado/cirugía , Adolescente , Femenino , Gangrena/etiología , Humanos , Obstrucción Intestinal/complicaciones , Obstrucción Intestinal/cirugía , Procedimientos de Cirugía Plástica , Procedimientos Quirúrgicos Operativos/métodos , Resultado del TratamientoRESUMEN
Although it is known that hormone concentrations vary considerably between individuals within a population, how they change across time and how they relate to an individual's reproductive effort remains poorly quantified in wild animals. Using faecal samples collected from wild red deer stags, we examined sources of variation in faecal cortisol and androgen metabolites, and the potential relationship that these might have with an index of reproductive effort. We also biologically validated an assay for measuring androgen metabolites in red deer faeces. We show that variation in hormone concentrations between samples can be accounted for by the age of the individual and the season when the sample was collected. Faecal cortisol (but not androgen) metabolites also showed significant among-individual variation across the 10-year sampling time period, which accounted for 20% of the trait's phenotypic variance after correcting for the age and season effects. Finally, we show that an index of male reproductive effort (cumulative harem size) during the mating season (rut) was positively correlated with male cortisol concentrations, both among and within individuals. We suggest that the highest ranking males have the largest cumulative harem sizes (i.e. invest the greatest reproductive effort), and that this social dominance may have associated behaviours such as increased frequency of agonistic interactions which are associated with corresponding high levels of faecal cortisol metabolites (FCM).
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Andrógenos/química , Hidrocortisona/metabolismo , Testosterona/metabolismo , Animales , Bioensayo , Ciervos , Masculino , ReproducciónRESUMEN
Testosterone is an important hormone that has been shown to have sex-specific links to fitness in numerous species. Although testosterone concentrations vary substantially between individuals in a population, little is known about its heritable genetic basis or between-sex genetic correlations that determine its evolutionary potential. We found circulating neonatal testosterone levels to be both heritable (0.160 ± 0.064 s.e.) and correlated between the sexes (0.942 ± 0.648 s.e.) in wild red deer calves (Cervus elaphus). This may have important evolutionary implications if, as in adults, the sexes have divergent optima for circulating testosterone levels.
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Andrógenos/sangre , Ciervos/fisiología , Carácter Cuantitativo Heredable , Testosterona/sangre , Animales , Animales Recién Nacidos , Ciervos/genética , Femenino , Técnicas para Inmunoenzimas/veterinaria , Masculino , Escocia , Caracteres SexualesRESUMEN
Chameleons (family Chamaeleonidae) are a distinctive group of reptiles, mainly found in Africa, which have high local endemism and face significant threats from the international wildlife trade. We review the scale and structure of international chameleon trade, with a focus on collection in and exports from Tanzania; a hotspot of chameleon diversity. Analysis used data from the CITES Trade Database 2000-2019, combined with assessment of online trade, and on-the-ground surveys in Tanzania in 2019. Between 2000 and 2019, 1,128,776 live chameleons from 108 species were reported as exported globally, with 193,093 of these (from 32 species) exported by Tanzania. Both global and Tanzanian chameleon exports declined across the study period, driven by decreased trade in generalist genera. Whilst the proportion of captive-bred individuals increased across time for the generalist taxa, the majority of range-restricted taxa in trade remained largely wild-sourced. For Tanzanian exports, 41% of chameleons were from one of the 23 endemic species, and 10 of the 12 Tanzanian endemic species in trade are categorised as threatened with extinction by IUCN. In terms of online trade, of the 42 Tanzanian species assessed, there was evidence of online sale for 83.3% species, and 69% were actively for sale with prices listed. Prices were on average highest for Trioceros species, followed by Kinyongia, Rieppeleon, Rhampholeon, and Chameleo. Field work in Tanzania provided evidence that the historic harvest of endemic chameleon species has been higher than the quantities of these species reported as exported by Tanzania in their annual trade reports to CITES. However, we found no field evidence for trade in 2020 and 2021, in line with Tanzanian regulations that applied a blanket ban on all exports of live wild animals. Literature evidence, however, suggests that illegal trade continued to Europe from seizures of Tanzanian chameleon species in Austria in 2021.
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Animales Salvajes , Comercio , Conservación de los Recursos Naturales , Lagartos , Animales , Tanzanía , Especies en Peligro de Extinción/estadística & datos numéricos , Especies en Peligro de Extinción/tendencias , Biodiversidad , Comercio de Vida SilvestreRESUMEN
Overexploitation is a major threat to biodiversity and international trade in many species is regulated through the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). However, there is no established method to systematically determine which species are most at risk from international trade to inform potential trade measures under CITES. Here, we develop a mechanism using the International Union for Conservation of Nature's Red List of Threatened Species to identify species that are likely to be threatened by international trade. Of 2,211 such species, CITES includes 59% (1,307 species), leaving two-fifths overlooked and in potential need of international trade regulation. Our results can inform deliberations on potential proposals to revise trade measures for species at CITES Conference of the Parties meetings. We also show that, for taxa with biological resource use documented as a threat, the number of species threatened by local and national use is four times greater than species likely threatened by international trade. To effectively address the overexploitation of species, interventions focused on achieving sustainability in international trade need to be complemented by commensurate measures to ensure that local and national use and trade of wildlife is well-regulated and sustainable.
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Comercio , Conservación de los Recursos Naturales , Animales , Conservación de los Recursos Naturales/métodos , Internacionalidad , Especies en Peligro de Extinción , Animales SalvajesRESUMEN
PURPOSE: To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2019. MATERIALS AND METHODS: The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 36 journals monthly for impactful articles and reviewed 113 articles during 2019 according to Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria. RESULTS: Articles with a 1A grade, including three clinical practice guidelines, six meta-analyses, and five original research trials are reviewed here from those included in the monthly CCPLU. Clinical practice guidelines on the use of polymyxins and antiarrhythmic drugs in cardiac arrest as well as meta-analyses on antipsychotic use in delirium, stress ulcer prophylaxis (SUP), and vasoactive medications in septic shock and cardiac arrest were summarized. Original research trials evaluated delirium, sedation, neuromuscular blockade, SUP, anticoagulation reversal, and hemostasis. CONCLUSION: This clinical review and expert opinion provides summary and perspectives of clinical practice impact on influential critical care pharmacotherapy publications in 2019.
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Úlcera Péptica , Choque Séptico , Cuidados Críticos , HumanosRESUMEN
Although hormones are key regulators of many fitness and life history traits, the causes of individual level variation in hormones, particularly in wild systems, remain understudied. Whilst we know that androgen and glucocorticoid levels vary within and among individuals in mammalian populations, how this relates to key reproductive processes such as gestation and lactation, and their effects on a female's measurable hormone levels are poorly understood in wild systems. Using fecal samples collected from females in a wild red deer population between 2001 and 2013, we explore how fecal androgen (FAM) and cortisol (FCM) metabolite concentrations change with age and season, and how individual differences relate to variation in reproductive state. Both FAM and FCM levels increase toward parturition, although this only affects FCM levels in older females. FCM levels are also higher when females suckle a male rather than a female calf, possibly due to the higher energetic costs of raising a son. This illustrates the importance of accounting for a female's life history and current reproductive status, as well as temporal variation, when examining individual differences in hormone levels. We discuss these findings in relation to other studies of mammalian systems and in particular to the relatively scarce information on variation in natural levels of hormones in wild populations.
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Myosin heavy chain (MHC) isoforms in vertebrate striated muscles are distinguished functionally by differences in chemomechanical kinetics. These kinetic differences may influence the cross-bridge-dependent co-operativity of thin filament Ca(2+) activation. To determine whether Ca(2+) sensitivity of unloaded thin filament sliding depends upon MHC isoform kinetics, we performed in vitro motility assays with rabbit skeletal heavy meromyosin (rsHMM) or porcine cardiac myosin (pcMyosin). Regulated thin filaments were reconstituted with recombinant human cardiac troponin (rhcTn) and alpha-tropomyosin (rhcTm) expressed in Escherichia coli. All three subunits of rhcTn were coexpressed as a functional complex using a novel construct with a glutathione S-transferase (GST) affinity tag at the N-terminus of human cardiac troponin T (hcTnT) and an intervening tobacco etch virus (TEV) protease site that allows purification of rhcTn without denaturation, and removal of the GST tag without proteolysis of rhcTn subunits. Use of this highly purified rhcTn in our motility studies resulted in a clear definition of the regulated motility profile for both fast and slow MHC isoforms. Maximum sliding speed (pCa 5) of regulated thin filaments was roughly fivefold faster with rsHMM compared with pcMyosin, although speed was increased by 1.6- to 1.9-fold for regulated over unregulated actin with both MHC isoforms. The Ca(2+) sensitivity of regulated thin filament sliding speed was unaffected by MHC isoform. Our motility results suggest that the cellular changes in isoform expression that result in regulation of myosin kinetics can occur independently of changes that influence thin filament Ca(2+) sensitivity.