A modelling framework to assess multiple metals impacts on marine food webs: Relevance for assessing the ecological implications of deep-sea mining based on a systematic review.

Industrial deep-sea mining will release plumes containing metals that may disperse over long distances; however, there is no general understanding of metal effects on marine ecosystems. Thus, we conducted a systematic review in search of models of metal effects on aquatic biota with the future perspective to support Environmental Risk Assessment (ERA) of deep-sea mining. According to results, the use of models to study metal effects is strongly biased towards freshwater species (83% freshwater versus 14% marine); Cu, Hg, Al, Ni, Pb, Cd and Zn are the best-studied metals, and most studies target few species rather than entire food webs. We argue that these limitations restrain ERA on marine ecosystems. To overcome this gap of knowledge, we suggest future research directions and propose a modelling framework to predict the effects of metals on marine food webs, which in our view is relevant for ERA of deep-sea mining.

Collegiate women's soccer players suffer greater cumulative head impacts than their high school counterparts.

Soccer is the source of the highest concussion rates among female athletes and is associated with neurological deficits at many levels of play. Despite its importance to our understanding of head trauma in female athletes, little is known about the number and magnitude of head impacts experienced by female soccer players. Head impacts experienced by high school and collegiate athletes were quantified using xPatch sensors (X2 Biosystems) affixed behind the right ear of each player. The average peak translational acceleration (PTA) sustained by players at the high school level was significantly lower than that of the collegiate players, but the average peak angular accelerations (PAA) were not significantly different. Given that the collegiate players took many more impacts throughout the season, their mean cumulative exposure to translational (cPTA) and angular accelerations (cPAA) were significantly higher than those of the high school players. Additional research is required to determine whether the differences in cumulative exposure are responsible for the elevated risk of concussion in collegiate soccer players or if there are additional risk factors.

Predicting the variation in Echinogammarus marinus at its southernmost limits under global warming scenarios: can the sex-ratio make a difference?

Understanding the environmental parameters that constrain the distribution of a species at its latitudinal extremes is critical for predicting how ecosystems react to climate change. Our first aim was to predict the variation in the amphipod populations of Echinogammarus marinus from the southernmost limit of its distribution under global warming scenarios. Our second aim was to test whether sex-ratio fluctuations - a mechanism frequently displayed by amphipods - respond to the variations in populations under altered climate conditions. To achieve these aims, scenarios were run with a validated model of E. marinus populations. Simulations were divided into: phase I - simulation of the effect of climate change on amphipod populations, and phase II - simulation of the effect of climate change on populations with male and female proportions. In both phases, temperature (T), salinity (S) and temperature and salinity (T-S) were tested. Results showed that E. marinus populations are highly sensitive to increases in temperature (>2 °C), which has adverse effects on amphipod recruitment and growth. Results from the climate change scenarios coupled with the sex-ratio fluctuations depended largely on the degree of female bias within population. Temperature increase of 2 °C had less impact on female-biased populations, particularly when conjugated with increases in salinity. Male-biased populations were highly sensitive to any variation in temperature and/or salinity; these populations exhibited a long-term decline in density. Simulations in which temperature increased more than 4 °C led to a continuous decline in the E. marinus population. According to this work, E. marinus populations at their southernmost limit are vulnerable to global warming. We anticipate that in Europe, temperature increases of 2 °C will incite a withdrawal of the population of 5°N from the amphipod species located at southernmost geographical borders. This effect is discussed in relation to the distribution of E. marinus along the Atlantic coast.

Arterial percutaneous angioplasty in upper limbs with vascular access devices for haemodialysis.

BACKGROUND: The purpose of this study was to evaluate retrospectively the clinical context and effectiveness of arterial percutaneous transluminal angioplasty (PTA) of arterio-venous fistulae in chronic haemodialysis patients. METHODS: Between May 1992 and June 1997, arterial PTA was performed in 33 patients with a total of 35 angioaccess devices of the upper limbs (18 arterio-venous fistulae and 17 PTFE grafts). Clinical indications for arterial PTA were unexplained acute thrombosis in 12 patients (34.3%), insufficient blood flow in 13 patients (37.1%), and severe limb ischaemia in 10 patients (28.6%), two of whom had skin ulcerations and one had severe neurological damage. Follow-up periods varied between 1 and 55 months (mean 15.5 months). RESULTS: PTA was attempted in 22 radial, 10 brachial and seven ulnar arteries. Angioplasty was successful (i.e. residual stenosis of

Tumor carcinoide retroperitoneal: presentación de un caso clínico y revisión de la literatura / Retroperitoneal carcinoid tumor: case report and review literature

La presentación clínica de los tumores carcinoides varia dependiendo de sus características físicas, lugar de origen y de si son o no productores de sustancias hormonalmente activas. Los tumores carcinoides pueden calcificarse desde un punto de vista anatomopatológico o bien embriológico, siendo esta la mas frecuente. Se presenta el caso de un paciente masculino de 49 años de edad, a quien en control medico se evidenció tumor en epigastrio. En la valoración paraclínica con TAC de abdomen, se demostró un tumor heterogéneo en relación con lóbulo hepático izquierdo con realce del contraste endovenoso. Se realizó una laparotomía exploradora, evidenciándose tumor de aproximadamente 14 cm de diámetro de localización tretroperineal; la anatomía patológica reporta tumor neuroendocrino y a las tinciones de inmunohistoquimica reportaron tumor carcinoide. Debido a la poca frecuencia de la localización retroperitoneal de esta patología, se presenta el caso clínico y se revisa la literatura

Lesiones vasculares de extremidades: resultados del tratamiento quirúrgico / Vascular trauma of extremities: surgical treatment

El objetivo es evaluar los métodos diagnósticos, tratamiento quirúrgico y factores adversos en la preservación del miembro después de lesión vascular. Pacientes con lesión vascular de esxtremidades, sometidos a tratamiento quirúrgico entre noviembre 2000 y octubre 2002. 116 pacientes conforman esta serie, edad media 26 años, sexo predominante masculino (91 por ciento). Promedio de tiempo transcurrido (TE) desde el momento de la lesión hasta el tratamiento fue de 6.51 horas. La evaluación clínica fue el único método diagnóstico en 112 (97 por ciento) pacientes, 106 (91 por ciento) presentaron signos severos de lesión vascular. Lesiones arteriales más frecuentes fueron: femoral superficial (41 por ciento), poplítea 24 (21 por ciento), branquiales 9 (8 por ciento); y las lesiones venosas: femoral superficial 28 (17 por ciento), poplítea 16 (14 por ciento), femoral profunda 12 (10 por ciento). Se practicaron 146 procedimientos quirúrgicos: 7 (6 por ciento) reparaciones directas, 5 (4 por ciento) resecciones y anastomosis, 73 (63 por ciento) puentes venosos, 1 prótesis de Goretex, 57 (49 por ciento) ligaduras de vasos. Amputaciones de miembros inferiores 4 (4 por ciento), 3 por lesiones de arteria femoral superficial, y otra de arteria poplítea, el tiempo transcurrido promedio fue de 11,5 horas comparada con 5,5 en es resto de los pacientes. Fasciotomías de miembros inferiores 13 (14 por ciento). La evaluación clínica es un excelente método diagnóstico, el puente venoso con safena magna es un procedimiento seguro en el tratamiento de estas lesiones, el tiempo transcurrido es factor crítico para la preservación del miembro

Infecçäo respiratória em crianças e adolescentes imunodeprimidos / Respiratoy tract infection in children and adolescent ommunossupressed

As imunodeficiências tornam os pacientes suscetíveis a uma variedade de infecçoes oportunistas que representam uma constelaçao de manifestaçoes clínicas e patológicas. O trabalho apresenta as inter-relaçoes entre as causas mais comuns de imunossupressao e as infecçoes oportunistas e faz um estudo dos tipos de imunossupressao, agentes etiológicos e patologias mais comuns. Detendo-se sobre as infecçoes oportunistas do Sistema Respiratório, esta revisao visa a elucidar os efeitos e perigos dessas em imunodeprimidos.

Complicaciones agudas de la enfermedad diverticular / Acute complications of diverticular disease

Evaluar los resultados del tratamiento médico y quirúrgico, y los factores que afectan la morbimortalidad. Estudio retrospectivo, pacientes con diagnóstico de enfermedad diverticular colónica complicada ingresados a la emergencia del Hospital "Dr. Miguel Pérez Carreño" entre noviembre de 1997 y diciembre de 2002, se analizan variables clínicas, paraclínicas y terapéuticas. Un total de 99 pacientes, edad media 72 años, 52 (53 por ciento) del sexo masculino y 47 (47 por ciento) féminas. Motivo de consulta más frecuente dolor abdominal 54 (55 por ciento), y sangrado rectal 51 (52 por ciento), 80 (81 por ciento) pacientes era su primer episodio, 55 (54 por ciento) tenían enfermedades médicas importantes asociadas. Se reliazron 70 colonoscopias, 28 ecos abdominopélvicos, y 12 tomografías. La enfermedad se localizó: colon izquierdo 66 pacientes (43 en el sigmoides exclusivamente), 28 enfermedad universal, 2 colon descendente y transverso, 3 en el colon derecho. Tratamiento médico 83 (84 por ciento) pacientes, cirugía 16 (16 por ciento): 8 sigmoidectomías, siete hemicolectomías, 1 colectomía total, 6 anastomosis primarias con fugas, la cirugía se indicó por hemorragia en 5 y diverticultis en 11. Medida de hospitalización 8 días, evolución tórpida en 12 (12 por ciento), fallecieron 5 (5 por ciento) todos con diagnóstico de hemorragia y enfermedades asociadas, media de 84 años, 4 con anemia severa, 3 oligúricos e hipotensos. El tratamiento médico es de elección en los pacientes con episodios agudos, sólo un número reducido amerita cirugía. La cirugía en 2 etapas es segura. Las enfermedades asociadas, media de 84 años, 4 con anemia severa aumentan la mortalidad