Fatal interactions of albatrosses with weather radiosondes/balloons on the Southern and Southeastern coasts of Brazil.

Weather radiosondes play a crucial role in gathering atmospheric data for weather modeling and forecasting. However, their impact on marine wildlife, particularly seabirds, has raised concerns regarding the potential threats posed by these instruments. This study aims to assess the adverse effects of weather balloons on albatrosses, with a focus on the Southwest Atlantic region. The research reveals seven cases of entanglement of radiosonde equipment, leading to severe injuries and mortality along the Southern and Southeastern coasts of Brazil. Recommendations for mitigating the environmental impact of weather balloons include the adoption of biodegradable materials in their design and the implementation of improved retrieval protocols. Furthermore, the study stresses the importance of continued monitoring and research to address the interaction of weather radiosondes with marine animals. This approach is vital for ensuring the sustainable collection of scientific data while minimizing harm to marine life and ecosystems.

HLA-B27 did not protect against COVID-19 in patients with axial spondyloarthritis - data from the ReumaCov-Brasil Registry.

BACKGROUND: Some studies have suggested the HLA-B27 gene may protect against some infections, as well as it could play a benefit role on the viral clearance, including hepatitis C and HIV. However, there is lack of SARS-CoV-2 pandemic data in spondyloarthritis (SpA) patients. AIM: To evaluate the impact of HLA-B27 gene positivity on the susceptibility and severity of COVID-19 and disease activity in axial SpA patients. METHODS: The ReumaCoV-Brasil is a multicenter, observational, prospective cohort designed to monitor immune-mediated rheumatic diseases patients during SARS-CoV-2 pandemic in Brazil. Axial SpA patients, according to the ASAS classification criteria (2009), and only those with known HLA-B27 status, were included in this ReumaCov-Brasil's subanalysis. After pairing them to sex and age, they were divided in two groups: with (cases) and without (control group) COVID-19 diagnosis. Other immunodeficiency diseases, past organ or bone marrow transplantation, neoplasms and current chemotherapy were excluded. Demographic data, managing of COVID-19 (diagnosis, treatment, and outcomes, including hospitalization, mechanical ventilation, and death), comorbidities, clinical details (disease activity and concomitant medication) were collected using the Research Electronic Data Capture (REDCap) database. Data are presented as descriptive analysis and multiple regression models, using SPSS program, version 20. P level was set as 5%. RESULTS: From May 24th, 2020 to Jan 24th, 2021, a total of 153 axial SpA patients were included, of whom 85 (55.5%) with COVID-19 and 68 (44.4%) without COVID-19. Most of them were men (N = 92; 60.1%) with mean age of 44.0 ± 11.1 years and long-term disease (11.7 ± 9.9 years). Regarding the HLA-B27 status, 112 (73.2%) patients tested positive. There were no significant statistical differences concerning social distancing, smoking, BMI (body mass index), waist circumference and comorbidities. Regarding biological DMARDs, 110 (71.8%) were on TNF inhibitors and 14 (9.15%) on IL-17 antagonists. Comparing those patients with and without COVID-19, the HLA-B27 positivity was not different between groups (n = 64, 75.3% vs. n = 48, 48%, respectively; p = 0.514). In addition, disease activity was similar before and after the infection. Interestingly, no new episodes of arthritis, enthesitis or extra-musculoskeletal manifestations were reported after the COVID-19. The mean time from the first symptoms to hospitalization was 7.1 ± 3.4 days, and although the number of hospitalization days was numerically higher in the B27 positive group, no statistically significant difference was observed (5.7 ± 4.11 for B27 negative patients and 13.5 ± 14.8 for B27 positive patients; p = 0.594). Only one HLA-B27 negative patient died. No significant difference was found regarding concomitant medications, including conventional or biologic DMARDs between the groups. CONCLUSIONS: No significant difference of COVID-19 frequency rate was observed in patients with axial SpA regarding the HLA-B27 positivity, suggesting a lack of protective effect with SARS-CoV-2 infection. In addition, the disease activity was similar before and after the infection. TRIAL REGISTRATION: This study was approved by the Brazilian Committee of Ethics in Human Research (CONEP), CAAE 30186820.2.1001.8807, and was registered at the Brazilian Registry of Clinical Trials - REBEC, RBR-33YTQC. All patients read and signed the informed consent form before inclusion.

Magnifying chromoendoscopy is a reliable method in the selection of rectal neoplasms for local excision.

PURPOSE: Adequate staging of early rectal neoplasms is essential for organ-preserving treatments, but magnetic resonance imaging (MRI) frequently overestimates the stage of those lesions. We aimed to compare the ability of magnifying chromoendoscopy and MRI to select patients with early rectal neoplasms for local excision. METHODS: This retrospective study in a tertiary Western cancer center included consecutive patients evaluated by magnifying chromoendoscopy and MRI who underwent en bloc resection of nonpedunculated sessile polyps larger than 20 mm, laterally spreading tumors (LSTs) [Formula: see text] 20 mm, or depressed-type lesions of any size (Paris 0-IIc). Sensitivity, specificity, accuracy, and positive and negative predictive values of magnifying chromoendoscopy and MRI to determine which lesions were amenable to local excision (i.e., [Formula: see text] T1sm1) were calculated. RESULTS: Specificity of magnifying chromoendoscopy was 97.3% (95% CI 92.2-99.4), and accuracy was 92.7% (95% CI 86.7-96.6) for predicting invasion deeper than T1sm1 (not amenable to local excision). MRI had lower specificity (60.5%, 95% CI 43.4-76.0) and lower accuracy (58.3%, 95% CI 43.2-72.4). Magnifying chromoendoscopy incorrectly predicted invasion depth in 10.7% of the cases in which the MRI was correct, while magnifying chromoendoscopy provided a correct diagnosis in 90% of the cases in which the MRI was incorrect (p = 0.001). Overstaging occurred in 33.3% of the cases in which magnifying chromoendoscopy was incorrect and 75% of the cases in which MRI was incorrect. CONCLUSION: Magnifying chromoendoscopy is reliable for predicting invasion depth in early rectal neoplasms and selecting patients for local excision.

Caffeine attenuates liver damage and improves neurologic signs in a rat model of hepatic encephalopathy.

INTRODUCTION AND AIMS: Cirrhosis is the common outcome of liver diseases. It can be decompensated and lead to the development of complications, such as encephalopathy. Hyperammonemia that develops due to liver dysfunction is etiopathologically related to hepatic encephalopathy. Caffeine increases the activity of the urea cycle in the liver, augmenting ammonia degradation. By antagonizing adenosine receptors, it also has a hepatoprotective effect, impeding the formation of fibrosis, as well as having a stimulating effect on the central nervous system. The present study analyzed the effects of caffeine on the progression of cholestatic liver fibrosis and hepatic encephalopathy. MATERIALS AND METHODS: An experimental model of cholestatic liver fibrosis, through common bile duct ligature, and of hepatic encephalopathy, through the administration of a high-protein diet, was constructed. Male Wistar rats (n=32) were equally divided into 4 groups. The experiment lasted 28 days, with the administration of 50mg/kg/day of caffeine. Laboratory tests, histologic analyses of the liver and encephalon, open field tests (OFTs), and daily behavioral analyses were carried out. RESULTS: The ligated animals treated with caffeine had lower mean transaminase levels and improved histologic aspects of the liver and encephalon. The untreated ligated animals were clearly lethargic and apathetic at the last week of the experiment, confirmed by reduced exploratory activity during the OFT. CONCLUSION: Caffeine improved the microarchitecture of the liver and encephalon of the cirrhotic animals and prevented the decrease in exploratory behavior of the animals during the OFT.

Dissemination of Consumer Law and Policy in Brazil: The Impact of EU Law.

This paper analyses the influence of European Law on Brazilian Consumer Law. It starts by describing the general features of Brazilian Consumer Protection law, including the constitutional dimension of consumer protection, and the introduction of the Brazilian Consumer Protection and Defence Code (CDC). It also highlights product liability, product safety, and product warranties. Some of these topics are illustrated by the case of the telecommunications sector.

Mesotelioma peritoneal epitelioide papilar maligno em bovino gir – Relato de caso / Malignant papillary epitelioid mesothelioma in the peritoneal cavity of a gir cattle – Case report

O objetivo deste trabalho foi relatar um caso de mesotelioma peritoneal epitelioide papilar em um bovino. Foi atendida uma vaca Gir, com dez anos de idade, apresentando taquicardia, taquipneia, 8% de desidratação, hipomotilidade ruminal, edema de barbela e aumento da circunferência abdominal bilateral ventral. Os achados de palpação consistiram na presença de múltiplos nódulos abdominais firmes, de tamanhos variados, localizados na parede abdominal e presença de grande quantidade de líquido intra-abdominal, confirmados pela ultrassonografia transretal. O líquido peritoneal coletado foi classificado como transudato modificado. Foi realizada laparotomia exploratória pelo flanco, identificando-se aproximadamente 150 litros de líquido peritoneal e múltiplos nódulos de coloração esbranquiçada, firmes, irregulares e difusos no peritônio e na superfície serosa de diferentes órgãos. O exame histopatológico dos fragmentos coletados por biopsia confirmou o diagnóstico de mesotelioma peritoneal classificado como sendo do tipo epitelioide papilar. A maioria dos casos de mesotelioma ocorre de forma incidiosa e sua manifestação clínica ocorre em quadros mais avançados, quando o prognóstico se torna desfavorável ao animal. A partir das condições encontradas no presente relato, foi indicada eutanásia do animal em razão do comprometimento do bem-estar.

The aim of this paper was to report a case of papillary epithelial mesothelioma of the peritoneal surface in a cattle. A ten-yearold Gir cow was examined on a rural property, presenting tachycardia, tachypnea, 8% dehydration, ruminal hypomotility submandibular edema and bilateral ventral abdominal enlargement. Rectal palpation showed multiple firm abdominal nodules, of varying sizes, located in the abdominal wall and the presence of large amounts of intra-abdominal fluid, confirmed by transrectal ultrasonography. The peritoneal fluid collected was classified as modified transudate. Exploratory laparotomy was performed along the flank, identifying approximately 150 liters of peritoneal fluid and multiple whitish-colored nodules, firm, irregular and diffuse on the peritoneum and on the serous surface of different organs. Histopathological examination of the biopsy pieces confirmed the diagnosis of peritoneal mesothelioma classified as papillary epithelioid type. Most cases of mesothelioma occur insidious, and its clinical manifestation occurs in more advanced cases, when the prognosis becomes unfavorable for the animal. Based on the conditions found in this report, euthanasia of the animal was indicated due to compromised well-being.

Mesotelioma peritoneal epitelioide papilar maligno em bovino gir Relato de caso / Malignant papillary epitelioid mesothelioma in the peritoneal cavity of a gir cattle Case report

O objetivo deste trabalho foi relatar um caso de mesotelioma peritoneal epitelioide papilar em um bovino. Foi atendida uma vaca Gir, com dez anos de idade, apresentando taquicardia, taquipneia, 8% de desidratação, hipomotilidade ruminal, edema de barbela e aumento da circunferência abdominal bilateral ventral. Os achados de palpação consistiram na presença de múltiplos nódulos abdominais firmes, de tamanhos variados, localizados na parede abdominal e presença de grande quantidade de líquido intra-abdominal, confirmados pela ultrassonografia transretal. O líquido peritoneal coletado foi classificado como transudato modificado. Foi realizada laparotomia exploratória pelo flanco, identificando-se aproximadamente 150 litros de líquido peritoneal e múltiplos nódulos de coloração esbranquiçada, firmes, irregulares e difusos no peritônio e na superfície serosa de diferentes órgãos. O exame histopatológico dos fragmentos coletados por biopsia confirmou o diagnóstico de mesotelioma peritoneal classificado como sendo do tipo epitelioide papilar. A maioria dos casos de mesotelioma ocorre de forma incidiosa e sua manifestação clínica ocorre em quadros mais avançados, quando o prognóstico se torna desfavorável ao animal. A partir das condições encontradas no presente relato, foi indicada eutanásia do animal em razão do comprometimento do bem-estar.(AU)

The aim of this paper was to report a case of papillary epithelial mesothelioma of the peritoneal surface in a cattle. A ten-yearold Gir cow was examined on a rural property, presenting tachycardia, tachypnea, 8% dehydration, ruminal hypomotility submandibular edema and bilateral ventral abdominal enlargement. Rectal palpation showed multiple firm abdominal nodules, of varying sizes, located in the abdominal wall and the presence of large amounts of intra-abdominal fluid, confirmed by transrectal ultrasonography. The peritoneal fluid collected was classified as modified transudate. Exploratory laparotomy was performed along the flank, identifying approximately 150 liters of peritoneal fluid and multiple whitish-colored nodules, firm, irregular and diffuse on the peritoneum and on the serous surface of different organs. Histopathological examination of the biopsy pieces confirmed the diagnosis of peritoneal mesothelioma classified as papillary epithelioid type. Most cases of mesothelioma occur insidious, and its clinical manifestation occurs in more advanced cases, when the prognosis becomes unfavorable for the animal. Based on the conditions found in this report, euthanasia of the animal was indicated due to compromised well-being.(AU)

Outcomes of surgical treatment for patients with distal rectal cancer: A retrospective review from a single university hospital. / Desenlaces de tratamiento quirúrgico para pacientes con cáncer de recto distal: Una revisión retrospectiva en un hospital universitario.

INTRODUCTION AND AIM: Surgery for distal rectal cancer (DRC) can be performed with or without sphincter preservation. The aim of the present study was to analyze the outcomes of two surgical techniques in the treatment of DRC patients: low anterior resection (LAR) and abdominoperineal resection (APR). METHODS: Patients with advanced DRC that underwent surgical treatment between 2002 and 2012 were evaluated. We compared the outcomes of the type of surgery (APR vs LAR) and analyzed the associations of survival and recurrence with the following factors: age, sex, tumor location, lymph nodes obtained, lymph node involvement, and rectal wall involvement. Patients with distant metastases were excluded. RESULTS: A total of 148 patients were included, 78 of whom were females (52.7%). The mean patient age was 61.2years. Neoadjuvant chemoradiation therapy was performed in 86.5% of the patients. APR was performed on 86 (58.1%) patients, and LAR on 62 (41.9%) patients. No differences were observed between the two groups regarding clinical and oncologic characteristics. Eighty-seven (62%) patients had pT3-4 disease, and 41 patients (27.7%) had lymph node involvement. In the multivariate analysis, only poorly differentiated tumors (P=.026) and APR (P=.009) correlated with higher recurrence rates. Mean follow-up time was 32 (16-59.9) months. Overall 5-year survival was 58.1%. The 5-year survival rate was worse in patients that underwent APR (46.5%) than in the patients that underwent LAR (74.2%) (P=.009). CONCLUSIONS: Patients with locally advanced DRC that underwent APR presented with a lower survival rate and a higher local recurrence rate than patients that underwent LAR. In addition, advanced T/stage, lymph node involvement, and poor tumor differentiation were associated with recurrence and a lower survival rate, regardless of the procedure.

A Brazilian multicentre study evaluating pregnancies induced by cabergoline in patients harboring prolactinomas.

OBJECTIVE: To evaluate the maternal-fetal outcomes of CAB-induced pregnancies in patients with prolactinoma in a large cohort. METHODS: The prevalence of tumor growth, miscarriage, preterm, low birth weight, congenital malformations and impairment in neuropsychological development in children among women treated with CAB were assessed in a Brazilian multicentre retrospective observational study, RESULTS: We included 194 women with a mean age of 31 (17-45) years, 43.6% presenting microadenomas and 56.4% macroadenomas, at prolactinoma diagnosis. In 233 pregnancies, CAB was withdrawn in 89%, after pregnancy confirmation. Symptoms related to tumor growth occurred in 25 cases, more frequently in macroadenomas. The overall miscarriage rate was 11%, although higher in the subgroup of patients with CAB maintainance after pregnancy confirmation (38% vs. 7.5%). Amongst the live-birth deliveries, preterm occurred in 12%, low birth weight in 6% and congenital malformations in 4.3%. Neuropsychological development impairment was reported in 7% of cases. CONCLUSIONS: Our findings confirm previous results of safety in maternal and fetal outcomes in CAB-induced pregnancies; nevertheless, CAB maintenance after pregnancy confirmation was associated with higher miscarriage rate; result that must be further confirmed.

Fluoranthene Biodegradation by Serratia sp. AC-11 Immobilized into Chitosan Beads.

The intensive production of polycyclic aromatic hydrocarbons by anthropogenic activities is a serious environmental problem. Therefore, new bioremediation methods are required to avoid widespread contamination. In this work, Serratia sp. AC-11 strain isolated from a tropical peat was selected for immobilization into chitosan beads, which were employed in the biodegradation of fluoranthene. The sizes of the produced beads were relatively uniform with an average diameter of 3 mm. The material was characterized by SEM and FT-IR, confirming the cells immobilization and the protective barrier formed by the chitosan surrounding the biomass. The immobilized bacteria were able to degrade 56% of fluoranthene (the initial concentration was 100 mg L-1) in just 1 day at twice the degradation rate achieved by free-living cells. Furthermore, the immobilized bacteria showed excellent removal during five reuse cycles, from 76% to 59% of biodegradation. These results showed the potential of this approach for remediation of contaminated sites.

Assistive devices: an effective strategy in non-pharmacological treatment for hand osteoarthritis-randomized clinical trial.

This study aims to evaluate the use of assistive devices as a strategy in non-pharmacological treatment for hand osteoarthritis (HOA). This is a randomized, prospective, parallel, assessor-blinded clinical trial, in which patients with a diagnosis of HOA were randomly allocated to an intervention group (IG), where they received assistive devices for daily life activities, or to a control group (CG), where they received a guideline leaflet with information on joint protection and disease features. The primary outcomes considered were occupational performance, measured by the Canadian Occupational Performance Measure (COPM), and hand function was evaluated through the Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands (SACRAH). The secondary outcomes were pain, measured by the visual analog scale (VAS), and quality of life, measured by the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF). We compared both outcomes before and after interventions and outcomes between groups. Participants from the two groups were assessed at the time of inclusion in the study, 30, and 90 days after initial evaluation. Out of the 39 patients included, 19 were allocated to the IG and 20 to the CG. Only two patients from the CG did not complete the follow-up period. The patients' hand function and occupational performance improved after intervention (30 days-SACRAH-p < 0.05; COPM-p < 0.05; VAS-p < 0.05). When comparing results between the groups, there was a statistical difference in COPM (performance-p < 0.001; and satisfaction-p < 0.001), in the first reevaluation carried out. The use of assistive devices has proved to be an effective alternative in non-pharmacological treatment for HOA. CLINICAL TRIAL REGISTRATION: NCT02667145.

Parâmetros hematológicos e bioquímicos de cabras lactantes alimentadas com dietas contendo glicerina bruta oriunda da produção de biodiesel proveniente de óleo de fritura / Hematological and biochemical parameters of lactating goats fed diets containing crude glycerin from biodiesel production from waste frying oil

Objetivou-se analisar os efeitos da inclusão da glicerina bruta (GB), oriunda da produção de biodiesel proveniente de óleos residuais de fritura, sobre o consumo, e os parâmetros hematológicos e bioquímicos em cabras em lactação. Oito cabras com 42,06±3,5kg de peso corporal foram utilizadas, recebendo dietas contendo 0, 7, 14 e 21% de GB com base na MS total da dieta. O experimento foi conduzido em quadrado latino duplo 4×4, com duração de 80 dias, sendo quatro períodos de 20 dias, dos quais 15 para a adaptação e cinco para a coleta de dados. As amostras de sangue foram coletadas pela punção da veia jugular. Os consumos de MS, proteína bruta e matéria mineral decresceram linearmente, enquanto o de extrato etéreo aumentou quadraticamente. As concentrações do hematócrito, hemoglobina, hemácias e fósforo reduziram linearmente. Tendência quadrática foi observada para as concentrações séricas de cálcio. Não foram verificados efeitos para as concentrações de magnésio, glicose, colesterol total, triglicerídeos, proteínas plasmáticas totais, albumina, globulinas, ureia, creatinina, aspartato aminotransferase e fosfatase alcalina. Conclui-se que a GB pode ser utilizada em até 7% da MS total da dieta, sem promover problemas metabólicos.(AU)

The aim of this study was to analyze the effects of the inclusion of crude glycerin (CG) from biodiesel production from waste frying oils on nutrients intake, hematological and biochemical parameters in lactating goats. Eight goats with 42.06±3.5kg of body weight were used, receiving diets containing 0, 7, 14 and 21% of CG based on total dietary DM. The experiment was carried out in a 4×4 double Latin square, with a duration of 80 days, four periods of 20 days, of which 15 days were for adaptation and five days for data collection. Blood samples were collected by puncture of the jugular vein. Dry matter, crude protein, and mineral matter intakes decreased linearly, while intake of ether extract increased quadratically. The concentrations of hematocrit, hemoglobin, red blood cells, and phosphorus reduced linearly. A quadratic tendency for serum calcium concentrations was observed. No effects were observed for concentrations of magnesium, glucose, total cholesterol, triglycerides, total plasmatic protein, albumin, globulins, urea, creatinine, aspartate aminotransferase, and alkaline phosphatase. It can be concluded that CG can be used in up to 7% of total dietary DM without promoting metabolic problems.(AU)

Parâmetros hematológicos e bioquímicos de cabras lactantes alimentadas com dietas contendo glicerina bruta oriunda da produção de biodiesel proveniente de óleo de fritura / Hematological and biochemical parameters of lactating goats fed diets containing crude glycerin from biodiesel production from waste frying oil

Objetivou-se analisar os efeitos da inclusão da glicerina bruta (GB), oriunda da produção de biodiesel proveniente de óleos residuais de fritura, sobre o consumo, e os parâmetros hematológicos e bioquímicos em cabras em lactação. Oito cabras com 42,06±3,5kg de peso corporal foram utilizadas, recebendo dietas contendo 0, 7, 14 e 21% de GB com base na MS total da dieta. O experimento foi conduzido em quadrado latino duplo 4×4, com duração de 80 dias, sendo quatro períodos de 20 dias, dos quais 15 para a adaptação e cinco para a coleta de dados. As amostras de sangue foram coletadas pela punção da veia jugular. Os consumos de MS, proteína bruta e matéria mineral decresceram linearmente, enquanto o de extrato etéreo aumentou quadraticamente. As concentrações do hematócrito, hemoglobina, hemácias e fósforo reduziram linearmente. Tendência quadrática foi observada para as concentrações séricas de cálcio. Não foram verificados efeitos para as concentrações de magnésio, glicose, colesterol total, triglicerídeos, proteínas plasmáticas totais, albumina, globulinas, ureia, creatinina, aspartato aminotransferase e fosfatase alcalina. Conclui-se que a GB pode ser utilizada em até 7% da MS total da dieta, sem promover problemas metabólicos.(AU)

The aim of this study was to analyze the effects of the inclusion of crude glycerin (CG) from biodiesel production from waste frying oils on nutrients intake, hematological and biochemical parameters in lactating goats. Eight goats with 42.06±3.5kg of body weight were used, receiving diets containing 0, 7, 14 and 21% of CG based on total dietary DM. The experiment was carried out in a 4×4 double Latin square, with a duration of 80 days, four periods of 20 days, of which 15 days were for adaptation and five days for data collection. Blood samples were collected by puncture of the jugular vein. Dry matter, crude protein, and mineral matter intakes decreased linearly, while intake of ether extract increased quadratically. The concentrations of hematocrit, hemoglobin, red blood cells, and phosphorus reduced linearly. A quadratic tendency for serum calcium concentrations was observed. No effects were observed for concentrations of magnesium, glucose, total cholesterol, triglycerides, total plasmatic protein, albumin, globulins, urea, creatinine, aspartate aminotransferase, and alkaline phosphatase. It can be concluded that CG can be used in up to 7% of total dietary DM without promoting metabolic problems.(AU)

Erratum to: One-level step section histological analysis is insufficient to confirm complete pathological response after neoadjuvant chemoradiation for rectal cancer.

Unfortunately, one of the author name was wrongly published in the original publication. The complete correct name should read as follows "Beatriz Camargo Azevedo". The original article was updated.

One-level step section histological analysis is insufficient to confirm complete pathological response after neoadjuvant chemoradiation for rectal cancer.

BACKGROUND: Neoadjuvant chemoradiation therapy (nCRT) for rectal cancer may lead to cure. As we currently lack reliable methods to clinically confirm the absence of disease, some patients undergo radical resection and have pathological complete response (pCR) still undergo surgery. Furthermore, it is uncertain if conventional one-level histopathological analysis is accurate enough to determine complete response. Confirming pCR is essential to determine the prognosis and to consider the patient's inclusion in trials of adjuvant therapy. The aim of this study was to determine whether the current 1-level approach is sufficient to confirm pCR. METHODS: Four hundred and thirty-five patients with rectal cancer who received nCRT followed by radical resection were analyzed. All cases identified as pCR by 1-level step section histological evaluation were reassessed with 3-level step sections and immunohistochemical analysis to verify the presence of residual disease. RESULTS: Out of 435 patients, 75 (17.2%) were staged as ypT0. Of these, 6 had lymph node involvement and 1 had distant metastasis, leaving 68 (15.6%) who had pCR. After the additional step sections, residual tumor was detected in 12 (17.6%) of these 68. The final pCR rate was 12.9%. Distant recurrence was detected in 7.1% of real-pCR patients compared to 16.7% in the false-pCR group (p = 0.291). Sensitivity of clinical assessment for detecting pCR was 35.7%, and the accuracy of 1-section histological evaluation to identify pCR was 82.4%. CONCLUSIONS: Histopathological analysis with 1-level step section is insufficient to determine complete tumor eradication. The 3-level sections methodology revealed residual tumor cells in patients initially classified as ypT0. Further studies with larger sample size are required to verify the clinical relevance of these residual tumor cells. Caution should continue to be applied to watch and wait strategies following nCRT.

Understanding the factors associated with reduction in the number of lymph nodes in rectal cancer patients treated by neoadjuvant treatment.

INTRODUCTION: Rectal cancer patients frequently present with locally advanced disease for which the standard of care includes neoadjuvant chemoradiotherapy followed by total mesorectal excision. Positive lymph nodes are one of the most powerful risk factors for recurrence and survival in colorectal cancer. In the absence of specific rectal guidelines, the literature recommends to the pathologist to optimize the number of rectal lymph nodes (LN) retrieved. We made a literature review in order to identify factors that could potentially affect the number of LN retrieved in specimens of patients with rectal cancer treated by chemoradiotherapy (CRT) followed by total mesorectal excision (TME). RESULTS: Age did not have a significant effect on LN yield. The effect of sex on LN number is not consistent in the literature. Most of the papers did not find a relationship between lower LN obtained and gender. Laparoscopy for primary rectal cancer is associated with a greater number of LN as well as short-term benefits. Tumors in the upper rectum are associated with a higher number of LN than those in the mid and lower rectum. The type of surgery had no effect on lymph node yield either. Tumors with complete or almost complete pathologic regression were exactly the ones with lower number of lymph nodes detected. Approximately one-third of patients with neoadjuvant treatment had less than 12 LN yield. CONCLUSION: The tumor regression grade is the most important factor for the decrease in the number of lymph nodes.

Possible evidence of systemic lupus erythematosus and periodontal disease association mediated by Toll-like receptors 2 and 4.

Toll-like receptors (TLRs) participate in the innate immune response and trigger the immune responses of the body. Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown aetiology, characterized by an excessive autoimmune response in the body affecting the connective tissues. The disease is possibly triggered by both environmental aetiological factors and pathological organic processes such as exposure to sunlight, chronic infectious processes and genetic factors. Conversely, periodontal disease is an infectious disease caused by microorganisms in the oral cavity, resulting in a chronic inflammatory process which continuously stimulates the immune response, thus causing damage to the periodontal tissues. The expression of both TLR-2 and TLR-4 receptors are increased in both SLE and periodontal disease. Periodontitis might trigger excessive activation of immune response occurring in SLE by maintaining a high expression of TLRs, leading in turn to the acceleration of the onset and progression of autoimmune reactions. In addition, periodontal treatment is able to reduce the expression of these receptors and therefore the symptoms of SLE. Here we discuss the possible interaction between SLE and periodontitis, and suggest further studies evaluating common features in both factors that could explored, due to morbidity and mortality of SLE and the high incidence of periodontal infections around the world.

Efficacy of Tolypocladium cylindrosporum against Aedes aegypti eggs, larvae and adults.

AIMS: The aim of this study was to test the activity of seven Tolypocladium cylindrosporum isolates against different developmental stages of Aedes aegypti. METHODS AND RESULTS: Ovicidal activity (≤30% of eclosion; at a 84% eclosion of control eggs) and lowest cumulative emergence of adults (≤30%; at a 66·3% control emergence) originating from eclosing larvae was found 15 and 30 days, respectively, after applying conidia of ARSEF 962 or 1580 onto the eggs. All isolates induced larval mortality when third-instar larvae were treated with conidia (≤5% control mortality); the lowest lethal concentration (LC50) at 5 days after treatment was found with ARSEF 1580 (9·2 × 10(5) conidia ml(-1)), and the shortest lethal time (LT50 ) with ARSEF 2912 (2·8 days at 3·3 × 10(6) conidia ml(-1)). The pathogenicity of T. cylindrosporum to A. aegypti adults is corroborated. ARSEF 1027, 1580 and 2912 induced the highest cumulative mortality in adults (≥90%) 15 days after application (≤5% control mortality). CONCLUSIONS: Findings emphasized an isolate- and developmental stage-related virulence of T. cylindrosporum. SIGNIFICANCE AND IMPACT OF THE STUDY: ARSEF 1580, in the group of tested isolates, is the most promising isolate for use against terrestrial eggs, aquatic larvae and adults of this important vector.