Influence of trophic overlaps and trophic niche amplitude on microplastic intake of fish species in shallow areas of a neotropical coastal lagoon.

Plastic pollution is a global challenge that affects all marine ecosystems, and reflects all types of uses and activities of human society in these environments. In marine ecosystems, microplastics and mesoplastics interact with invertebrates and become available to higher predators, such as fish, which can ingest these contaminants. This study aimed to analyze how ecological food interactions (diet overlap and trophic niche amplitude) among fish species contribute to the ingestion of plastic particles. The gastrointestinal contents of six fish species (Atherinella brasiliensis, Eucinostomus melanopterus, Eucinostomus argenteus, Genidens genidens, Coptodon rendalli, and Geophagus brasiliensis) were analyzed to identify prey items and plastic ingestion. Based on the ontogenetic classification, A. brasiliensis, E. melanopterus, and G. genidens were divided into juveniles and adults, and the six fish species analyzed were divided into nine predator groups. Most of the plastics ingested by the fish species were blue microplastic (MP) fibers (< 0.05 mm) classified as polyester terephthalate, polyethylene, and polybutadiene. Considering all the analyzed predators, the average number and weight of plastics ingested per individual were 2.01 and 0.0005 g, respectively. We observed that predators with a high trophic overlap could present a relationship with the intake of MP fibers owing to predation on the same resources. In addition, we observed the general pattern that when a species expands its trophic diversity and niche, it can become more susceptible to plastic ingestion. For example, the species with the highest Levin niche amplitude, E. argenteus juveniles, had the highest mean number (2.9) of ingested MP fibers. Understanding the feeding ecology and interactions among species, considering how each predator uses habitats and food resources, can provide a better understanding of how plastic particle contamination occurs and which habitats are contaminated with these polluting substances.

Primary Squamous Cell Carcinoma of the Stomach: A Case Report.

Gastric squamous cell carcinoma (SCC) is a rare and puzzling entity that challenges conventional paradigms of gastric malignancies, especially in young adults. This case report presents a 22-year-old male with invasive SCC of the stomach, emphasizing the rarity of such occurrences and their diagnostic challenges. The literature review underscores the scarcity of information on gastric SCC, necessitating a critical examination of its clinical implications, etiological factors, and optimal management. The patient's complex medical history, diagnostic journey, and treatment course are detailed, highlighting the importance of multidisciplinary collaboration and advanced diagnostic techniques. Immunohistochemistry is a crucial tool for precise tumor characterization, and the absence of established risk factors emphasizes the enigmatic nature of gastric SCC. This case report contributes to the understanding of gastric SCC, prompting further research into its unique features, etiology, and therapeutic strategies in the context of gastric cancer.

Lost life expectancy following a hypothetical urban radiological incident.

The consequences of mass radiological events, particularly those involving the activation of a radiological dispersion device (RDD), have been extensively studied by scientific groups. However, the critical initial period of such an event, usually spanning the first 100 h, can be characterized by a scarcity of information, potentially leading to delays in mitigating strategies. In response, a research group utilized computer simulations to generate solid, conservative analytical details that can aid decision-making and guide the prioritization of initial care based on variables such as age, sex, location, and local atmospheric stability conditions. The study estimates the Lost Life Expectancy (LLE) and provides relevant information to increase support for decision-making and allow evaluation of data closer to the lay public. The research team behind the study has been granted funding by the Brazilian National Council for Scientific and Technological Development (CNPq), and further simulations will be conducted utilizing codes that implement numerical models, specifically in atmospheric data forecasting. The methodology used to evaluate the LLE can be applied to any location, provided that the relevant variables are updated accordingly. Overall, this study offers critical insights into the impact of mass radiological events and enhances simulations' predictive capacity and precision.

A NORMOCALORIC, LOW-FIBER DIET FOR COLONOSCOPY PREPARATION IS MORE ACCEPTABLE AND NON-INFERIOR TO A LIQUID, LOW-CALORIE DIET: A RANDOMIZED CONTROLLED TRIAL.

•This is the first study in Brazil about diets to prepare for colonoscopy. •The normocaloric diet was not inferior to the liquid diet regarding the quality of the colonoscopy preparation. •Both diets were well tolerated, but the normocaloric diet was more accepted than the liquid diet. Background - Several publications have shown greater acceptance of less restrictive diets for colonoscopy preparation, without impairing the quality of the preparation, when compared to the clear liquid diet. Objective - To evaluate the quality, tolerance and preference regarding the colonoscopy preparation of a low-fiber, normocaloric diet compared with a hypocaloric liquid diet. Methods - This is a randomized, controlled, observer-blind study to compare two low-fiber colonoscopy preparation diets (hypocaloric liquid diet vs. normocaloric diet). The Boston Bowel Preparation Scale was used to evaluate the qua-lity of the preparations, being considered adequate BBPS ≥6 in the global assessment and ≥2 in each segment. The same laxative was used in both groups as well as the "split-dose" regimen. Results - A total of 136 individuals were enrolled in each group. Adequate preparation was achieved in 90.4% of the individuals allocated to the liquid diet group and 92.6% to the normocaloric group. There was no significant difference in the quality of preparation and tolerance between groups. A higher patient acceptance to repeat the procedure if necessary was observed in the normocaloric diet group compared with the liquid diet group (P=0.005). Conclusion - The normocaloric diet has shown to be not inferior to the liquid diet regarding the quality of the colonoscopy preparation. Patient tolerance rates were similar between both diets, but a higher accep-tance rate was observed with the normocaloric diet as compared with the liquid diet.

Implante Transcateter de Valva Aórtica (TAVI) em anatomia bicúspide com anel aórtico e seio de valsava de dimensões grandes a próteses existentes / Transcatheter Aortic Valve Implantation (TAVI) in bicuspid anatomy with aortic ring and large valvular sinus to existing prostheses

APRESENTAÇÃO CLÍNICA Paciente do sexo masculino, 70 anos, com antecedentes de HAS, tabagismo e dislipidemia. História de dispneia progressiva nos últimos 5 meses. Ao exame físico, apresentava ritmo cardíaco regular e sopro sistólico ejetivo importante em foco aórtico. Exames realizados: Eletrocardiograma: ritmo sinusal e BRE Ecocardiograma: gradiente sistólico máximo de 58mmhg e médio de 34mmhg; velocidade de jato de 3,8m/s; área valvar aórtica de 0,6cm² e fração de ejeção de 35%. Insuficiência aórtica leve. O paciente foi encaminhado para cineangiocoronariografia cujo o resultado foi isento estenoses graves e para avaliação de tomografia protocolo TAVI. Tomada de decisão Heart team. Discutidas possibilidades de correção cirúrgica ou via percutânea, paciente recusa correção cirúrgica e opta pela TAVI, sabendo que a grande dimensão do anel que excedem os limites de todas as válvulas cardíacas transcateter auto expansíveis ou balão comercial disponíveis. Calculado risco de mortalidade cirúrgica: STS Score: maior 8% e EuroScore II: 28,26%. Conclusão: Paciente encaminhado para TAVI, com planejamento de implante de válvula (Myval 32 mm). Intervenção O procedimento foi realizado sob anestesia geral. Utilizado introdutor 14F através da artéria femoral direita e acesso secundário com introdutor 6F pela artéria femoral esquerda. Posicionado um marcapasso transvenoso provisório através da veia femoral esquerda e heparinização com administração de 100u/Kg de heparina não fracionada. Realizada aortografia de referência.Realizado implante transcateter de bioprótese valvar aórtico auto expansível ­ 32mm com liberação lenta e sob pacing de 180 bpm, em projeção OAE, com sucesso e sem intercorrências, em posição superficial satisfatória. O ecocardiograma transtorácico intra-procedimento confirmou posicionamento adequado da prótese, função valvar adequada, mínimo leak paravalvar e ausência de derrame pericárdico, com gradiente final VE-Ao de 6 mmHg. Não foram observados distúrbios graves de condução durante o procedimento, apenas bloqueio de ramo esquerdo prévio durante o implante da prótese com ao final do procedimento e eletrocardiograma final inalterado, com remoção do marcapasso provisório ao final do procedimento. Realizada hemostasia da artéria femoral direita com 2 dispositivos e artéria femoral esquerda com 1 dispositivo Perclose (Abbott). CONCLUSÃO e pontos de aprendizado A implantação do dispositivo Myval-XL de 32 mm em um grande anel e VAB parece segura com resultados hemodinâmicos e clínicos promissores e aceitáveis. Isso pode ser considerado um passo em direção à expansão da indicação clínica da prática de TAVR e destaca o conceito de seleção de dispositivo específico para o paciente, oferecendo um dispositivo dedicado projetado especificamente para pacientes com grande anatomia.

Dieta normocalórica e pobre em fibras, para preparo de colonoscopia, é melhor aceita e não inferior que uma dieta líquida hipocalórica: ensaio randomizado controlado / A normocaloric, low-fiber diet for colonoscopy preparation is more acceptable and non-inferior to a liquid, low-calorie diet: a randomized controlled trial

ABSTRACT Background: Several publications have shown greater acceptance of less restrictive diets for colonoscopy preparation, without impairing the quality of the preparation, when compared to the clear liquid diet. Objective: To evaluate the quality, tolerance and preference regarding the colonoscopy preparation of a low-fiber, normocaloric diet compared with a hypocaloric liquid diet. Methods: This is a randomized, controlled, observer-blind study to compare two low-fiber colonoscopy preparation diets (hypocaloric liquid diet vs. normocaloric diet). The Boston Bowel Preparation Scale was used to evaluate the qua­lity of the preparations, being considered adequate BBPS ≥6 in the global assessment and ≥2 in each segment. The same laxative was used in both groups as well as the "split-dose" regimen. Results: A total of 136 individuals were enrolled in each group. Adequate preparation was achieved in 90.4% of the individuals allocated to the liquid diet group and 92.6% to the normocaloric group. There was no significant difference in the quality of preparation and tolerance between groups. A higher patient acceptance to repeat the procedure if necessary was observed in the normocaloric diet group compared with the liquid diet group (P=0.005). Conclusion: The normocaloric diet has shown to be not inferior to the liquid diet regarding the quality of the colonoscopy preparation. Patient tolerance rates were similar between both diets, but a higher accep­tance rate was observed with the normocaloric diet as compared with the liquid diet.

RESUMO Contexto: Diversas publicações têm evidenciado uma maior aceitação de dietas menos restritivas para preparo de colonoscopia, sem prejuízo na sua qualidade, quando comparadas com a dieta de líquidos claros. Objetivo: Avaliar a qualidade, tolerância e preferência do preparo para colonoscopia de uma dieta líquida hipocalórica, quando comparada com uma dieta normocalórica, ambas pobres em fibras. Métodos: Trata-se de um estudo randomizado, controlado, observador "cego", para comparar duas dietas de preparo para colonoscopia (dieta líquida hipocalórica e dieta normocalórica, ambas pobres em fibras). Foi utilizada a escala de Boston para avaliar a qualidade do preparo, sendo considerado adequado BBPS ≥6 na avaliação global e ≥2 em cada segmento. Foram prescritos o mesmo laxativo e o regime "dose fracionada" para ambos os grupos. Resultados: Foram incluídos 136 indivíduos em cada grupo. O preparo adequado foi alcançado em 90,4% dos indivíduos alocados no grupo da dieta líquida e 92,6% da normocalorica. Não houve diferença significativa na qualidade do preparo e na tolerância entre ambas as dietas. Observou-se maior aceitação de repetir o procedimento se necessário, no grupo da dieta normocalórica quando comparado ao da dieta líquida (P=0,005). Conclusão: A dieta normocalórica não é inferior que à líquida na qualidade do preparo para colonoscopia, ambas apresentam tolerância similar, porém com maior aceitação da dieta normocalórica quando comparada à líquida.

DES Strut Thickness and Clinical Outcomes After CTO Recanalization: Insights From LATAM CTO Registry.

BACKGROUND: Ultra-thin strut drug-eluting stent (UTS-DES) may improve outcomes after percutaneous coronary intervention (PCI) but have received limited study in chronic total occlusion (CTO) PCI. AIMS: To compare of 1-year incidence of major adverse cardiac events (MACE) between patients who underwent CTO PCI with ultrathin (≤ 75 µm) versus thin (>75 µm) strut DES in the LATAM CTO registry. METHODS: Patients were considered for inclusion only if successful CTO PCI was performed and when only one type of stent strut thickness (ultrathin or thin) was used. A propensity score matching (PSM) was computed to produce similar groups in relation to clinical and procedural characteristics. RESULTS: Between January 2015 and January 2020, 2092 patients underwent CTO PCI, of whom 1466 were included in the present analysis (475 in the ultra-thin and 991 in the thin strut DES). In unadjusted analysis the UTS-DES group had lower rate of MACE (HR: 0.63 95 % CI 0.42 to 0.94, p = 0.04) and repeat revascularizations (HR: 0.50 95 % CI 0.31 to 0.81, p = 0.02) at 1-year follow-up. After adjustment for confounding factors in a Cox regression model there was no difference in 1-year incidence of MACE between groups (HR: 1.15 95 % CI 0.41 to 2.97, p = 0.85). On PSM of 686 patients (343 in each group) the 1-year incidence of MACE (HR 0.68 95 % CI 0.37-1.23; P = 0.22) and individual components of MACE did not differ between groups. CONCLUSIONS: One-year clinical outcomes after CTO PCI were similar with ultrathin and thin strut DES.

Oesophageal wall thickness assessment at endoscopic ultrasound in children and adolescents with eosinophilic oesophagitis: a case-control study.

PURPOSE: Eosinophilic oesophagitis (EoE) is a chronic immune-mediated disease, and an endosonographic evaluation may help the diagnosis. The main objectives of this study were to measure the thickness of the oesophageal wall using a radial endoscopic ultrasound (EUS), mucosa/submucosa (MSM), muscularis propria (MP) and mucosa to muscularis propria (MMP); to compare these measurements between patients with and without EoE; to correlate them with the Endoscopic Reference Score (EREFS); and to evaluate the diagnostic accuracy of these measurements. METHODS: Children and adolescents (aging from 4 to 17 years) were evaluated in this prospective cross-sectional study. A radial EUS at 12 MHz frequency was used, and EREFS was employed to grade macroscopic findings. Accuracy of the measurements for the diagnosis of EoE was assessed by receiver operating characteristics (ROC) curve. RESULTS: Twenty-six (19 M/7 F) patients (median age 10.83 years, range 5.65-17.46) were evaluated. EoE was diagnosed in 6 patients. The mean (and SD) oesophageal wall thicknesses in the distal oesophagus in millimetres in groups with and without EoE, respectively, were: MSM 1.07 (0.44) and 1.11 (0.33); MP 0.67 (0.25) and 0.60 (0.19); and MMP 1.73 (0.46) and 1.72 (0.32). Mid-oesophagus: MSM 1.16 (0.34) and 1.15 (0.34); MP 0.63 (0.16) and 0.60 (0.2); and MMP 1.79 (0.41) and 1.74 (0.34). In the ROC curve, the distal MP layer thickness presented better discriminative performance, with an area under the curve of 0.61 (95% CI 0.28-0.93) at 0.73 mm cut-off (66.67% sensitivity, 80% specificity, likelihood ratios of 3.33 for positive and 0.42 for negative test). CONCLUSION: The evaluation of oesophageal thickness measurements by EUS is not useful for diagnosing EoE.

Gender differences in psychiatric comorbidity and personality characteristics among adults seeking treatment for problematic internet use.

In the present study, we investigated gender differences in personality and psychiatric correlates among adults (N = 115) seeking treatment for problematic internet use (PIU) at a specialized clinic in São Paulo, Brazil. All participants were assessed at the beginning of their treatment for co-occurring psychiatric conditions, other addictive behaviors, and personality characteristics. Women (n = 20) were more likely to present with greater rates of psychiatric comorbidity compared to men (n = 95), including mood disorders, anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, and bulimia nervosa. Women also had a greater severity of certain behavioral addictions, such as compulsive buying and disordered eating. Gender differences were also found across personality characteristics, with women scoring higher on impulsivity, novelty seeking, and self-transcendence compared to men. To our knowledge, the present study is the first to investigate gender differences for PIU in a clinical sample. The results suggest that there are notable gender differences in individuals seeking treatment for PIU which underscores the importance of assessing for co-occurring conditions, especially in women. Understanding the characteristics associated with PIU can help serve to inform the most appropriate interventions to bolster treatment outcomes.

Delayed left main coronary obstruction following transfemoral inovare transcatheter aortic valve replacement: A challenging case.

Coronary obstruction is an uncommon and severe complication after a transcatheter aortic valve replacement (TAVR), that occurs during the procedure in the vast majority of patients. In the present case even in the absence of classic risk factors, an acute coronary syndrome occurred one day after TAVR. Selective angiography revealed a severe left main ostium obstruction by the bulky native leaflet calcification. This is the first case of delayed presentation of coronary obstruction with a transfemoral balloon-expandable valve using the Inovare bioprosthesis (Braile Biomedica, Brazil). In addition, after drug-eluting stent placement in the left main coronary, intravascular ultrasound revealed severe stent underexpansion, so that a second layer of a bare-metal stent and high-pressure balloon post-dilatation was necessary to improve the final result. The patient was discharged after 7 days, and at the 6-month follow-up remained asymptomatic. .

Saúde mental na segunda onda da pandemia de Coronavirus Disease 2019 no Brasil / Salud mental en la segunda ola de la pandemia de Coronavirus Disease 2019 en Brasil / Mental health in the second wave of the Coronavirus Disease 2019 pandemic in Brazil

Objetivo: identificar preditores de distress e fadiga em brasileiros na segunda onda de Coronavirus Disease 2019, observando marcadores político-identitários. Método: foi realizado um survey online com 1.328 respondentes brasileiros, com questionário socio-identitário, questionários sobre efeitos psicossociais da pandemia e escalas padronizadas para avaliar distress, fadiga, autoritarismo e conservadorismo. Resultados: foram encontradas diferenças significativas (através de análise de variância e testes t) acerca da saúde mental com relação a orientação sexual, gênero, identificação étnico-racial, orientação política, autoritarismo, conservadorismo, importância dada à religiosidade e tamanho da cidade de moradia. As regressões lineares realizadas destacaram que os problemas associados a pandemia, como uso de substâncias psicoativas e problemas com o peso, desempenham papel importante para saúde mental, juntamente com a afetação emocional provocada pela pandemia. Conclusões: os problemas associados à pandemia, a afetação emocional e os marcadores político-identitários são fundamentais para a compreensão e atuação acerca da saúde mental da população nesse contexto.(AU)

Objetivo: identificar los predictores de distrés y fadiga en los brasileños en la segunda onda de Coronavirus 2019, observando marcadores político-identitarios. Método: investigación online con 1.328 participantes brasileños, con cuestionario socio-identitario y efectos psicosociales de la pandemia y escalas estandarizadas para evaluar distrés, fatiga, autoritarismo y conservadurismo. Resultados: se encontraron diferencias significativas (mediante Análisis de variación y t-test) sobre salud mental en relación con orientación sexual, género, identificación étnico-racial, orientación política, autoritarismo, conservadurismo, importancia dada a la religiosidad y tamaño de la ciudad de residencia. Las regresiones lineales realizadas destacaron que problemas asociados a la pandemia, como consumo de sustancias psicoactivas y problemas de peso, desempeñan un papel importante para la salud mental, junto con la afectación emocional pandémica. Conclusiones: los problemas asociados a la pandemia, el efecto emocional y los marcadores político-identitarios son fundamentales para entender y actuar sobre la salud mental de la población.(AU)

Objective: to identify predictors of distress and fatigue in Brazilians during the second wave of Coronavirus Disease 2019 (Covid-19), examining identity and political markers. Method: an online survey was conducted with 1,328 Brazilian respondents, using a socio-identity questionnaire, questionnaires regarding the psychosocial effects of the pandemic and standardized scales to evaluate distress, fatigue, authoritarianism, and conservatism. Results: significant differences were observed (using ANOVA and t-tests) in mental health regarding sexual orientation, gender, ethnic-racial identification, political orientation, authoritarianism, conservatism, importance given to religiosity, and hometown size. Linear regressions illustrated that problems associated with the pandemic, like drug use and weight issues, play a significant role in mental health, alongside emotional effects caused by the pandemic. Conclusions: The problems associated with the pandemic, emotional effect, and political-identity markers are fundamental to understanding and acting upon the mental health of the population in this context.(AU)

Fishing plastics: A high occurrence of marine litter in surf-zone trammel nets of Southern Brazil.

Plastic is one of the most commonly found residues in the marine environment, which can cause several impacts. This study evaluated the interaction of marine litter with surf-zone trammel nets in Southern Brazil. Fifty fishing operations were sampled, where 4213 items were captured: 1500 discarded fish, 1384 fragments of marine litter, and 1329 utilized fishes. Plastics were the most abundant items (n = 1363), representing 98.4% of the registered marine litter, especially plastic bags (n = 1191). 94.5% of registered marine litter is considered as single-use waste. The interaction with marine litter can cause negative impacts to small-scale fisheries (e.g. economic and damage to fishing nets). We highlight the urgency in implementing actions for urban solid waste management and public policies to reduce single-use plastics and educational campaigns on the environmental theme.

Efficacy and safety of endoscopic ultrasound-guided drainage of pancreatic pseudocysts using double-pigtail plastic stents: A single tertiary center experience.

OBJECTIVES: Pancreatic pseudocysts (PPC) are fluid collections with a well-defined wall that persist for more than 4 weeks inside or around the pancreas as a result of pancreatic inflammation and/or a ductal lesion. PPC have been successfully treated with endoscopic ultrasound (EUS)-guided drainage using different stents. This study aimed to evaluate the safety and efficacy of EUS-guided drainage of PPC using double-pigtail plastic stents in a tertiary hospital. METHODS: Patients with PPC referred for EUS-guided drainage between May 2015 and December 2019 were included in this case series. The primary endpoint was to evaluate the efficacy (clinical success) and safety (adverse events and mortality) of EUS-guided drainage of PPC. Secondary endpoints included technical success and pseudocyst recurrence. RESULTS: Eleven patients (mean age, 44.5±18.98 years) were included in this study. The etiologies for PPC were acute biliary pancreatitis, chronic alcoholic pancreatitis, and blunt abdominal trauma. The mean pseudocyst size was 9.4±2.69 cm. The clinical success rate was 91% (10/11). Adverse events occurred in three of 11 patients (27%). There were no cases of mortality. The technical success rate was 100%. Pseudocyst recurrence was identified in one of 11 patients (9%) at 12 weeks after successful clinical drainage and complete pseudocyst resolution. CONCLUSION: EUS-guided transmural drainage of PPC using double-pigtail plastic stents is safe and effective with high technical and clinical success rates.

The history, importance and anatomy of the specimen that validated the giant Purussaurus brasiliensis Barbosa-Rodrigues 1892 (Crocodylia: Caimaninae).

The Solimões Formation is a southwest geological unit of the Brazilian Amazon, being well-known for the Cenozoic giant eusuchian fossils. Among the eight species of Crocodylia described for this formation, the alligatoroid Purussaurus brasiliensis is the best known worldwide due to its enormous size. The holotype was described in 1892 by Barbosa-Rodrigues, composed by a right hemimandible. Later, two other species were assigned to the genus, but the loss of the type specimen brought a series of doubts and discussions about genus and species validity. Here, we provide a historical reconstruction of the genus Purussaurus, especially with a new description of the specimen DGM 527-R, which was first described by L. I. Price. We also provide a review of Purussaurus brasiliensis as a valid species, highlighting the importance of the paleontologist Diogenes de Almeida Campos to the preservation, study availability and divulgation of the specimen. From the six mandibular features discussed, at least two are putative synapomorphies for the genus: the false ziphodont teeth and the thinning of the medial surface of the mandible posterior to the fourteen alveoli, while the lateral surface become laterally expanded from ninth alveoli to behind. The review of the other species of the genus was aggravated due to little sampling of photos and low quality of those contributions. Finally, the curatorial efforts initiated by Price and kept for decades by Campos turned possible the revision of DGM 527-R, an important specimen for understanding the paleobiology and evolution of the genus, and, consequently P. brasiliensis. Such importance was recognized here scientifically and by Campos when considered this specimen as the center-piece of the exhibition in honor of the centenary anniversary of Price.

Efficacy and safety of endoscopic ultrasound-guided drainage of pancreatic pseudocysts using double-pigtail plastic stents: A single tertiary center experience

OBJECTIVES: Pancreatic pseudocysts (PPC) are fluid collections with a well-defined wall that persist for more than 4 weeks inside or around the pancreas as a result of pancreatic inflammation and/or a ductal lesion. PPC have been successfully treated with endoscopic ultrasound (EUS)-guided drainage using different stents. This study aimed to evaluate the safety and efficacy of EUS-guided drainage of PPC using double-pigtail plastic stents in a tertiary hospital. METHODS: Patients with PPC referred for EUS-guided drainage between May 2015 and December 2019 were included in this case series. The primary endpoint was to evaluate the efficacy (clinical success) and safety (adverse events and mortality) of EUS-guided drainage of PPC. Secondary endpoints included technical success and pseudocyst recurrence. RESULTS: Eleven patients (mean age, 44.5±18.98 years) were included in this study. The etiologies for PPC were acute biliary pancreatitis, chronic alcoholic pancreatitis, and blunt abdominal trauma. The mean pseudocyst size was 9.4±2.69 cm. The clinical success rate was 91% (10/11). Adverse events occurred in three of 11 patients (27%). There were no cases of mortality. The technical success rate was 100%. Pseudocyst recurrence was identified in one of 11 patients (9%) at 12 weeks after successful clinical drainage and complete pseudocyst resolution. CONCLUSION: EUS-guided transmural drainage of PPC using double-pigtail plastic stents is safe and effective with high technical and clinical success rates.

The northernmost haulout site of South American sea lions and fur seals in the western South Atlantic.

We present estimates of the seasonal and spatial occupation by pinnipeds of the Wildlife Refuge of Ilha dos Lobos (WRIL), based on aerial photographic censuses. Twenty aerial photographic censuses were analysed between July 2010 and November 2018. To assess monthly differences in the numbers of pinnipeds in the WRIL we used a Generalized Linear Mixed Model. Spatial analysis was carried out using Kernel density analysis of the pinnipeds on a grid plotted along the WRIL. Subadult male South American sea lions (Otaria flavescens) were the most abundant pinniped in the WRIL. Potential females of this species were also recorded during half of the census. The maximum number of pinnipeds observed in the WRIL was 304 in September 2018, including an unexpected individual southern elephant seal (Mirounga leonina), and a high number of South American fur seal yearlings (Arctocephalus australis). However, there was no statistically significant difference in counts between months. In all months analysed, pinnipeds were most often found concentrated in the northern portion of the island, with the highest abundances reported in September. This study confirms the importance of the WRIL as a haulout site for pinnipeds in Brazil, recommends that land research and recreational activities occur in months when no pinnipeds are present, and encourages a regulated marine mammal-based tourism during winter and spring months.

When an advantageous reproductive trait turns bad: Eggs of the threatened fish Genidens barbus as a natural bait in recreational fisheries.

This study describes a recreational fishing method focused on marine catfish, Genidens barbus (Endangered-EN), through the adoption of its eggs as a natural bait during its reproductive period in southern Brazilian ecosystems. Male G. barbus perform parental care, collecting eggs released by females after the fertilization process. Owing to this male behavioural pattern during the reproductive period, these individuals are easily caught in recreational fisheries that use eggs of the same species as a natural bait. The current adoption of G. barbus eggs as bait may intensify the fishing pressure on its populations.

Eosinophilic meningitis outbreak related to religious practice.

Three patients with eosinophilic meningitis (EoM) were investigated in two hospitals in Porto Alegre, Southern Brazil. These patients had a common exposure after the ingestion of raw mollusks in a religious ritual. Two of them had an uncommon presentation with intense lower distal extremities pain and small fiber neuropathy as defined by an electroneuromyography (ENMG) study. All three patients were positive for Angiostrongylus cantonensis serology and recovered after antihelminthic and anti-inflammatory treatment. Increased awareness of A. cantonensis infection is important to avoid new infections and to improved recognition and handling of cerebral angiostrongyliasis.

Análise bibliométrica e de rede dos 40 anos da revista psicologia: ciência e profissão / Bibliometric and network analysis of the 40 years of the journal psicologia: ciência e profissão / Análisis bibliométrico y de redes de los 40 años de la revista psicologia: ciência e profissão

Resumo No ano de celebração dos 40 anos da revista Psicologia: Ciência e Profissão cabe verificar como esta revista foi delineando a sua própria história e do campo da Psicologia no Brasil. Neste sentido, o presente artigo teve como objetivo delimitar os principais autores, instituições e palavras-chave que trouxeram a revista até o momento atual. Partindo de uma análise bibliométrica e de redes, obteve-se como resultado os temas, autores e instituições que tiveram protagonismo e a interação entre esses atores. As conclusões apontam que a revista assume uma postura epistemológica pluralista e que tanto os aspectos científicos como os relacionados a práticas e atuação dos profissionais se mantêm ao longo desses 40 anos.

Abstract In the year of celebration of the 40th anniversary of the journal Psicologia: Ciência e Profissão (Psychology: Science and Profession), it is necessary to review how this journal has been outlining its own history and the field of Psychology in Brazil. In this sense, this article aimed to delimit which were the main authors, institutions and keywords that brought the journal to the present moment. Based on a bibliometric and network analysis, it was obtained as a result which themes, authors and institutions had protagonism and interaction among these actors. The conclusions indicate that the journal assumes a pluralist epistemological posture and that both the scientific aspects and those related to the practices and performance of professionals are maintained throughout these 40 years.

Resumen En el año en que se celebra el 40º aniversario de la revista Psicologia: Ciência e Profissão (Psicología: Ciencia y Profesión), es necesario revisar cómo esta revista ha ido perfilando su propia historia y el campo de la Psicología en el Brasil. En este sentido, este artículo pretendía delimitar cuáles fueron los principales autores, instituciones y palabras clave que llevaron a la revista al momento actual. Basándose en un análisis bibliométrico y de redes, se obtuvo como resultado qué temas, autores e instituciones eran los principales e interacción entre estos actores. Las conclusiones indican que la revista asume una postura epistemológica pluralista y que tanto los aspectos científicos como los relacionados con las prácticas y el desempeño de los profesionales se mantienen a lo largo de estos 40 años.

Gastroesophageal reflux in cystic fibrosis across the age spectrum.

BACKGROUND: Scientific advances have improved longevity in cystic fibrosis (CF) patients and many of these patients can expect to experience age-related gastrointestinal co-morbidities. We aimed to assess the extent to which age might impact gastroesophageal reflux (GER) in patients with CF. METHODS: Our esophageal pH-multichannel intraluminal impedance monitoring database was searched for tracings belonging to CF patients ≥2 years old without prior fundoplication and not taking anti-reflux medications immediately prior (within 7 days) and during the study. Tracings were retrospectively analyzed; Impedance and pH variables were evaluated with respect to age and pulmonary function. RESULTS: Twenty-eight patients were enrolled; 16 children (3.1-17.7 years) and 12 adults (18.2-48.9 years). Among pH probe parameters, correlation analysis showed DeMeester score (P=0.011) and number of acid reflux events lasting >5 minutes (P=0.047) to be significantly correlated with age. Age was not significantly correlated with any of the impedance parameters. Age was negatively correlated with baseline impedance (BI) in the distal esophagus (r=-0.424, P=0.023) and BI was negatively correlated with several pH parameters, including reflux index (r=-0.553, P=0.002), number of total acid reflux events (r=-0.576, P=0.001), number of acid reflux events lasting >5 minutes (r=-0.534, P=0.003), and DeMeester score (r=-0.510, P=0.006). Pulmonary function (percent predicted forced expiratory volume in one minute; ppFEV1) was negatively correlated with age (r=-0.494, P=0.0007). The interaction of age and ppFEV1 and any of the reflux parameters, however, was not significant (P>0.05); the strongest evidence for an interaction was found for the number of acid reflux events reaching the proximal esophagus, but this interaction still did not reach statistical significance (P=0.070). CONCLUSIONS: In a small cohort, we found evidence that age may be associated with increased acid exposure and that both age and increased acid exposure are associated with reduced BI in the distal esophagus. The negative relationship between pulmonary function and age in our cohort is not related to GER. This pilot study supports the need for esophageal assessment and treatment of GER as standard components of clinical care for an aging CF population.