An alternative approach to assess ecotoxicological effects of agrochemical combinations used in Brazilian aquaculture farms.

Agrochemicals used for treating and preventing aquaculture diseases are usually present in combination with other compounds, and the toxicity resulting from their chemical interactions presents an important reason to assess the ecotoxicity of compound mixtures in view to better understanding the joint action of chemicals and avoiding their environmental impacts. In this study, we evaluated the acute aquatic ecotoxicity of several compounds used in Brazilian fish farming (Oxytetracycline [OXT], Trichlorfon [TRC], and BioFish® [BIO]), both individually and in binary and ternary mixtures. Initial test concentrations were prepared according to the recommended concentrations for aquaculture application, and from these, a geometric dilution series was tested on two important fresh water quality indicator species, the microcrustacean Daphnia magna and the bacterium Aliivibrio fischeri. At the recommended pond application rate, TRC and BIO applied individually showed toxicity to the tested organisms in terms of the lowest-observed-effect concentration (LOEC), and D. magna was always more sensitive than A. fischeri. For the two test organisms, the results obtained with the binary mixtures showed that the TRC and BIO mixture was more toxic than TRC and OXT, which in turn was more toxic than OXT and BIO. The toxicity from all agrochemicals in the ternary mixture was more than that of the agrochemical combinations in the binary mixtures. Given the results presented in this study, it is evident that the mode of action and availability of the tested compounds undergo changes that increase toxicity when they are present in combination, and therefore, aquaculture wastewater treatment should be adopted to ensure decontamination of agrochemical residues.

COVID-19 pandemic impacts on mental health, burnout, and longevity in the workplace among healthcare workers: A mixed methods study.

To explore the mental health impacts of the COVID-19 pandemic on healthcare workers in Massachusetts and identify potential strategies to maintain the healthcare workforce we conducted a sequential exploratory mixed methods study. Fifty-two individuals completed interviews from April 22nd - September 7th, 2021; 209 individuals completed an online survey from February 17th - March 23rd, 2022. Interviews and surveys asked about the mental health impacts of working in healthcare during the COVID-19 pandemic, burnout, longevity in the workplace, and strategies for reducing attrition. Interview and survey participants were predominantly White (56%; 73%, respectively), female (79%; 81%) and worked as physicians (37%; 34%). Interviewees indicated high stress and anxiety levels due to frequent exposure to patient deaths from COVID-19. Among survey respondents, 55% reported worse mental health than before the pandemic, 29% reported a new/worsening mental health condition for themselves or their family, 59% reported feeling burned out at least weekly, and 37% intended to leave healthcare in less than 5 years. To decrease attrition, respondents suggested higher salaries (91%), flexible schedules (90%), and increased support to care for patients (89%). Healthcare workers' experiences with death, feeling unvalued, and overworked resulted in unprecedented rates of burnout and intention to leave healthcare.

[Evaluation of the epidemiological profile and the mortality rate of the patients with primary cutaneous melanoma in Florianopolis - SC, Brazil]. / Avaliação do perfil epidemiológico e da mortalidade dos pacientes com diagnóstico de melanoma cutâneo primário no município de Florianópolis - SC, Brasil.

BACKGROUND: Melanoma is the cutaneous cancer which has the greatest lethality. Santa Catarina is the Brazilian State that contributes the most to increase this rate. OBJECTIVES: To estimate the mortality rate of melanoma in the fifth year of illness. METHODS: The sample comprises 81 reports of primary cutaneous melanoma, in 75 patients, diagnosed in lorianopolis - SC in 2002 and 2003. The protocol of research includes age, sex, patient's color, anatomical location, histological type, degree of invasion, Breslow index, inflammatory reaction, ulceration, regression, angiolymphatic invasion and tumor staging. The patients were contacted by telephone to verify their status (alive, killed by melanoma or dead for another reason). Fisher's exact test and Kaplan-Meier's survival curve were used for the statistical analysis. RESULTS: The patients' profile was: female, white, 51.3 years of age, with invasive melanoma on the trunk and limbs, extensive spreading type, Breslow 2.63 mm. The mortality rate was 7.0%, greater among men (11.1%), Breslow above 4.0 mm (66.0%), with ulceration (33.3%) and stage IV (80.0%). The average survival period was 56.7 months. CONCLUSIONS: The mortality rate of primary cutaneous melanoma was 7.0%; ulceration and the final staging were the factors with statistic significance on the result.

Avaliação do perfil epidemiológico e da mortalidade dos pacientes com diagnóstico de melanoma cutâneo primário no município de Florianópolis - SC, Brasil / Evaluation of the epidemiological profile and the mortality rate of the patients with primary cutaneous melanoma in Florianopolis - SC, Brazil

FUNDAMENTOS: O melanoma é o câncer cutâneo com maior letalidade. Santa Catarina é o estado brasileiro com maior número de casos desse tumor. OBJETIVOS: Estimar a taxa de mortalidade por melanoma no quinto ano de doença. MÉTODOS: A amostra compreendeu 81 laudos de melanoma primário cutâneo, em 75 pacientes, emitidos em Florianópolis - SC em 2002 e 2003. O protocolo de pesquisa incluiu idade, sexo, cor do paciente e localização anatômica, tipo histológico, grau de invasão, índice de Breslow, infiltrado inflamatório, ulceração, regressão, invasão angiolinfática e estadiamento do tumor. Foi feito contato telefônico com os pacientes para verificar seu status (vivo, morto por melanoma ou morto por outra causa). Para análise estatística, utilizou-se o teste exato de Fisher e a curva de sobrevida de Kaplan-Meier. RESULTADOS: O perfil dos pacientes foi: feminino, branco, 51,3 anos, melanoma invasivo em tronco ou membros, tipo extensivo superficial, Breslow 2,63 mm. A taxa de mortalidade por melanoma cutâneo foi de 7,0 por cento, maior entre homens (11,1 por cento), com Breslow superior a 4,0 mm (66,0 por cento), com ulceração (33,3 por cento) e em estádio IV (80,0 por cento). A sobrevida média foi de 56,7 meses. Conclusões: A taxa de mortalidade por melanoma primário cutâneo foi de 7,0 por cento, e a ulceração e o estadiamento final foram os fatores com significância estatística sobre o resultado.

BACKGROUND: Melanoma is the cutaneous cancer which has the greatest lethality. Santa Catarina is the Brazilian State that contributes the most to increase this rate. OBJECTIVES: To estimate the mortality rate of melanoma in the fifth year of illness. METHODS: The sample comprises 81 reports of primary cutaneous melanoma, in 75 patients, diagnosed in lorianopolis - SC in 2002 and 2003. The protocol of research includes age, sex, patient's color, anatomical location, histological type, degree of invasion, Breslow index, inflammatory reaction, ulceration, regression, angiolymphatic invasion and tumor staging. The patients were contacted by telephone to verify their status (alive, killed by melanoma or dead for another reason). Fisher's exact test and Kaplan-Meier's survival curve were used for the statistical analysis. RESULTS: The patients' profile was: female, white, 51.3 years of age, with invasive melanoma on the trunk and limbs, extensive spreading type, Breslow 2.63 mm. The mortality rate was 7.0 percent, greater among men (11.1 percent), Breslow above 4.0 mm (66.0 percent), with ulceration (33.3 percent) and stage IV (80.0 percent). The average survival period was 56.7 months. Conclusions: The mortality rate of primary cutaneous melanoma was 7.0 percent; ulceration and the final staging were the factors with statistic significance on the result.

Comparação dos casos de melanoma cutâneo diagnosticados por diferentes especialistas / A comparison of cutaneous melanoma cases diagnosed by different medical specialists

FUNDAMENTOS: A importância do diagnóstico e intervenção precoces nos casos de melanoma cutâneo é vital para o prognóstico do paciente. OBJETIVO: Comparar os casos de melanoma cutâneo diagnosticados primariamente por diferentes especialidades médicas no município de Florianópolis, SC, Brasil. MÉTODO: Analisados 396 laudos de 332 pacientes com diagnóstico histopatológico de melanoma, de dois centros de serviços de Anatomia Patológica, em Florianópolis, entre 1° de janeiro de 1999 e 31 de dezembro de 2004. O protocolo, com base no questionário do Grupo Brasileiro de Melanoma, incluiu sexo, idade, localização, especialidade requisitante e espessura do tumor (índice de Breslow). RESULTADOS: Foram observados 186 melanomas in situ e 210 invasivos, predominantemente em mulheres (56 por cento). O pico etário ocorreu entre a quinta e a sexta décadas. O índice de Breslow foi semelhante nos grupos masculino e feminino (p = 0,424), mas apontou diferença entre a dermatologia (1,852mm) e demais especialidades médicas (4,383mm), com p = 0,037. Número maior de ulcerações foi encontrado no grupo diagnosticado pelos cirurgiões gerais (p = 0,05). Os dermatologistas diagnosticaram 217 melanomas cutâneos (54 por cento), e a maioria dos tipos clínicopatológicos, exceto o acral. CONCLUSÃO: O papel do dermatologista é fundamental para o diagnóstico precoce do melanoma cutâneo, que permite modificar o curso natural da doença.

BACKGROUND: Early diagnosis and intervention in melanoma cases are crucial for prognosis. OBJECTIVE: To compare the results of cutaneous melanoma cases diagnosed by different medical specialists, in the city of Florianopolis, Brazil. METHOD: A total of 396 reports of 332 patients with histopathological diagnosis of melanoma were analyzed. The reports were collected from two laboratories in Florianopolis from January 1st, 1999 to December 31st, 2004. The protocol was based on the questionnaire of the Brazilian Group of Melanoma, including sex, age, lesion site, medical specialty that ordered the exam and tumor thickness (Breslow index). RESULTS: Our findings showed 186 melanomas in situ and 210 invasive melanomas, predominantly in females (56 percent). The incidence peak was between the 5th and 6th decades of life. Breslow index was similar in both male and female groups (p = 0.424). The mean Breslow index was 1.852mm for dermatology and 4.383mm for other medical specialties (p = 0.037). A higher number of ulceration was found in the group diagnosed by general surgeons (p = 0.05). Dermatologists diagnosed 217 (54 percent) cutaneous melanomas from the sample and most clinical histological types, except for the acral type. CONCLUSION: The role played by dermatologists is essential for early diagnosis of cutaneous melanoma, therefore changing its outcome.

Avaliação de 496 laudos anatomopatológicos de melanoma diagnosticados no município de Florianópolis, Santa Catarina, Brasil / Assessment of 496 pathological reports of melanoma diagnosed in the city of Florianopolis, SC, Brazil

FUNDAMENTOS- O melanoma é a mais letal das neoplasias cutâneas, e sua incidência vem aumentando em todo o mundo. O conhecimento estatístico do comportamento biológico do melanoma cutâneo em Florianópolis é fundamental tanto para orientar o raciocínio clínico da prática ambulatorial diária como para auxiliar políticas de saúde pública. OBJETIVOS - Estabelecer dados epidemiológicos sobre melanoma em Florianópolis, Brasil. MÉTODOS - Foram analisados 496 laudos de 432 pacientes com diagnóstico histopatológico de melanoma, de dois centros de serviços de anatomia patológica entre primeiro de janeiro de 1999 e 31 de dezembro de 2004 em Florianópolis. O protocolo, baseado no questionário do Grupo Brasileiro de Melanoma, incluiu sexo, tipo histológico, presença de nevo no tumor, índice de Breslow, ulceração, mitose, presença de infiltrado inflamatório, margens e presença de metástase. RESULTADOS - Observaram-se 186 melanomas in situ, 210 invasivos, e 100 metastáticos. O tipo histológico mais comum foi o melanoma extensivo superficial (60 por cento). A média de Breslow dos melanomas lentigo maligno e extensivo superficial foi 1,829mm e dos melanomas nodular e acral de 5,035mm (p< 0,0001). Os principais locais de metástases foram a pele e o subcutâneo, linfonodos e o cérebro. CONCLUSÕES - O perfil histopatológico do melanoma cutâneo observado neste estudo foi de melanoma tipo extensivo superficial, invasivo, com Breslow de 1,25mm, com infiltrado inflamatório e margens livres.

BACKGROUND - Melanoma is the most lethal cutaneous neoplasm and its incidence has increased worldwide. Statistical knowledge about the biological behavior of cutaneous melanoma is fundamental to guide clinical reasoning in daily practice as well as to contribute to public health policies. OBJECTIVES - To establish epidemiological data on melanoma in Florianopolis, Brazil. METHODS : A total of 496 reports of two pathology laboratories on 432 patients with pathological diagnosis of melanoma were analyzed in a six-year period. The protocol, based on the questionnaire of the Brazilian Melanoma Group, included sex, histological type, presence of nevus, Breslow tumor thickness, tumor-infiltrating lymphocytes, mitotic index, ulceration, surgical margins and metastasis. RESULTS - A total of 186 in situ, 210 invasive and 100 metastatic melanomas were observed. The most common histological type was superficial spreading melanoma (60 percent). The mean Breslow thickness of malignant lentigo and superficial spreading melanomas was 1.829 mm, and of nodular and acral melanoma was 5.035 mm (p<0.0001). The main metastasis sites were skin and subcutaneous tissue, lymph nodes and brain. CONCLUSIONS - In this study, the histopathological profile was superficial spreading, invasive, 1.25-mm Breslow thickness, with inflammatory infiltrate and free margin cutaneous melanomas.