A preliminary study of cutaneous wound healing on the upper eyelid in a small Brazilian population using Rhizophora mangle-based cream.

Plants used in traditional medicine offer an affordable new alternative in tissue repair therapy. This study aimed to evaluate the effectiveness of the 5% Rhizophora mangle cream compared to the 5% dexpanthenol cream in healing open surgical wounds on the upper eyelid. A total of 18 patients were submitted to the experiment and divided into 2 groups with 9 patients each who used topically and daily 5% dexpanthenol cream (control group) or 5% R.mangle cream (intervention group) for 7 days. Clinical, morphometric and histomorphometric analyses of wounds and surgical procedures for skin removal were performed. In the morphometric analysis, all wounds treated with R.mangle and dexpanthenol creams showed complete macroscopic scars, without inflammatory signs and infection free. The skin hydration values in pre and post application periods of the cream were 43.82 ± 43.93 and 62.12 ± 67.40 respectively. The histomorphometric study showed lower values of epithelium distance in R. mangle group and higher in dexpanthenol group with significant difference between groups (p < 0.05). The R.mangle 5% cream proved to be effective in healing wounds of human upper eyelid skin with a significant improvement in epithelization compared to dexpanthenol 5% cream.

Cardiorespiratory effects of different intraabdominal pressures in sheep: An experimental study.

Increased intraabdominal pressure (IAP) during laparoscopy can reduce venous return, but changes in respiratory system mechanics and their effect in left cardiac function are not well documented. This study evaluated the effects of different IAPs on respiratory mechanics and cardiac function in 10 healthy nonpregnant adult Santa Ines ewes randomly submitted to a crossover study using different IAPs: 0 mm Hg (G1), 10 mm Hg (G2), 12 mmHg (G3), and 15 mmHg (G4). Animals were anesthetized and mechanically ventilated (VT  = 15 ml/kg; positive end-expiratory pressure = 3 cmH2 O; FiO2  = 1.0). Pneumoperitoneum was induced by Hasson's trocar cannula. Variables were measured at INITIAL (IAP, 0 mmHg) and FINAL time points for each IAP after 1 h. At FINAL, driving airway pressure (ΔP,RS ), and percentage fraction of dead space (Vd/Vt) were higher in G3 and G4 than G1 (p = 0.002, difference in means [MD] 4.60, 95% CI: 7.91-1.28, and p < 0.001, MD 5.4, 95% CI: 8.7-2.0; p = 0.016, MD -9.5, 95% CI: -17.9 to -1.2; and p = 0.027, MD -8.7, 95% CI: -17.1 to -0.4). The ejection fraction and fractional shortening were lower in G3 (p = 0.039, MD -11.38, 95% CI: -0.07--22.68; p = 0.015, MD -13.05, 95% CI: -1.74--24.36) and G4 (p = 0.039, MD -9.94, 95% CI: -0.07 to -19.80; p = 0.015, MD -11.43, 95%CI: -1.57 to -21.30, respectively) than G2. In G3, the maximum pulmonary flow velocity correlated negatively with ΔP,RS (r = -0.740; p = 0.018), and Vd/Vt correlated positively with ΔP,RS (r = 0.738, p = 0.046). At IAP of 12 and 15 mm Hg impaired respiratory system mechanics, reduced left cardiac function and no change in maximum pulmonary artery flow velocity were detected. Therefore, respiratory mechanics should be monitored as an interplay to reduce left cardiac function.

Electrocardiographic, echocardiographic and heart biomarker parameters in sheep experimentally poisoned by Palicourea marcgravii (Rubiaceae) / Parâmetros eletrocardiográficos, ecocardiográficos e de biomarcadores cardíacos em ovinos intoxicados experimentalmente por Palicourea marcgravii (Rubiaceae)

The present study aimed to identify and describe cardiac alterations in sheep experimentally poisoned with Palicourea marcgravii through analysis of serum cardiac biomarkers (serum troponin I and creatine kinase - CK-MB) and electro and echocardiographic assessments to contribute to a better understanding of the poisoning pathophysiology. P. marcgravii is the main plant within a group of 22 species that cause sudden death in Brazil; its toxic principle is sodium monofluoroacetate. Eight healthy crossbreed male sheep, aged between five and twelve months, weighing 14 to 27kg, were evaluated. The animals received 1g kg-1 of P. marcgravii plants orally. The sheep were evaluated before administering the plant (T0) through electro and echocardiography and blood collection to assess cardiac biomarkers (CK-MB and cTnI). Collections and analyses were repeated every four hours until the animal's death. During the study, there was the presence of extravasation of serum troponin I carried out in a qualitative test, with positive values at time T4, and the serum CK-MB biomarker had a peak at T4 and slightly decreased at T8. The electro and echocardiographic examinations showed that the cause of death in these animals was due to acute heart failure characterized by arrhythmias, tachycardia/ventricular fibrillation, drop in cardiac output, left ventricular (LV) systolic dysfunction by the progressive decrease in the LV ejection fraction (EF), decrease in LV fractional shortening (FS), and decrease in aortic flow velocity and aortic flow gradient. This study seems to be the first to evaluate cardiac alterations in sheep poisoned by P. marcgravii through cardiac biomarkers and electro and echocardiographic exams.

O presente estudo objetivou identificar e descrever as alterações cardíacas de ovinos intoxicados experimentalmente por Palicourea marcgravii através das análises de biomarcadores cardíacos séricos (troponina I sérica e a creatinoquinase - MB) e das avaliações eletro e ecocardiográficas contribuindo para o melhor entendimento da fisiopatologia da intoxicação. Palicourea marcgravii é a principal planta dentro de um grupo de 22 espécies que causam "morte súbita" no Brasil e seu princípio tóxico é o monofluoracetato de sódio. Foram utilizados oito ovinos saudáveis machos, sem raça definida, com idades entre cinco e doze meses e peso de 14 a 27kg. Os animais receberam 1g/kg de Palicourea marcgravii por via oral. Os ovinos foram avaliados momentos antes da administração da planta (T0) através de eletro e ecocardiograma e coleta de sangue para avaliação dos biomarcadores cardíacos (CK-MB e cTnI). As análises e coletas foram repetidas a cada quatro horas até o óbito do animal. Durante o estudo observou-se extravasamento de troponina I sérica realizada em teste qualitativo, com valores positivos já em T4, assim como o biomarcador CK-MB sérico teve seu pico de aumento em T4 e em T8 houve uma leve redução. Aos exames eletro e ecocardiográfico foi possível determinar que a causa do óbito nestes animais ocorreu devido à insuficiência cardíaca aguda caracterizada por arritmias, taquicardia/fibrilação ventricular, queda no débito cardíaco, disfunção sistólica do ventrículo esquerdo (VE) pela diminuição progressiva da fração de ejeção (EF) do VE, diminuição na fração de encurtamento (FS) do VE, diminuição da velocidade do fluxo aórtico e do gradiente do fluxo aórtico. Este é o primeiro estudo que avalia as alterações cardiológicas de ovinos intoxicados por P. marcgravii através de biomarcadores cardíacos e exames eletro e ecocardiográficos.

Correction: Correlation between hospitalized patients' demographics, symptoms, comorbidities, and COVID-19 pandemic in Bahia, Brazil.

[This corrects the article DOI: 10.1371/journal.pone.0243966.].

Clinical and laboratory findings in sheep experimentally poisoned by Palicourea marcgravii and the use of magnesium chloride with possible therapeutic effect on poisoning / Achados clínicos e laboratoriais em ovinos experimentalmente intoxicados por Palicourea marcgravii e o uso do cloreto de magnésio com possível efeito terapêutico na intoxicação

This study aimed to examine the efficacy of magnesium chloride therapy in sheep experimentally poisoned by Palicourea marcgravii and describe the clinical and laboratory findings that may aid in early ante mortem diagnosis of this poisoning. P. marcgravii is an important plant within a group of 22 species in Brazil that cause "sudden death." Its toxic component is sodium monofluoroacetate. It was observed that a time for evolution of poisoning was longer in our study compared to other studies that used the same dose of P. marcgravii in sheep. However, all animals that were poisoned and subsequently treated with magnesium chloride died. The sheep presented characteristic clinical signs before death in addition to other signs that have not been previously described for this type of poisoning, such as abdominal breathing, coughing, head pressing, and nystagmus. This is the first evaluation of hematological parameters of sheep poisoned by P. marcgravii. Leukocytosis with neutrophilia, hyperfibrinogenemia, and hyperglycemia, associated with hypophosphatemia and elevated levels of serum aspartato aminotransferase (AST), glutamate dehydrogenase (GLDH), urea, creatinine, creatine kinase (CK) and lactate dehydrogenase (LDH), were observed. Additionally, changes were noted in necropsy, such as engorged jugular, large vessel congestion, pulmonary edema. Histological examination revealed vacuolar hydropic degeneration in the distal twisted uriniferous tubules in the kidneys, similar to those reported in previous studies on P. marcgravii poisoning.(AU)

O presente estudo objetivou verificar a eficácia terapêutica do cloreto de magnésio em ovinos intoxicados experimentalmente por Palicourea marcgravii e descrever os achados clínicos e laboratoriais que possam auxiliar no diagnóstico precoce ante mortem dessa intoxicação. P. marcgravii é a principal planta dentro de um grupo de 22 espécies que causam "morte súbita" no Brasil e seu princípio tóxico é o monofluoracetato de sódio. Durante o procedimento, observou-se maior tempo de evolução em relação a outros trabalhos utilizando-se a mesma dose da P. marcgravii em ovinos, entretanto todos os animais intoxicados e posteriormente tratados com cloreto de magnésio vieram a óbito. Os ovinos apresentaram sinais clínicos característicos antes da morte, associados a sinais nunca antes descritos nesse tipo de intoxicação, como respiração abdominal, tosse, "head pressing" e nistagmo. Trata-se da primeira avaliação dos parâmetros hematológicos de ovinos intoxicados por P. marcgravi. Foi observado leucocitose com neutrofilia, hiperfibrinogemia e hiperglicemia, associado a elevação dos valores séricos de AST, GLDH, ureia, creatinina, CK, LDH e hipofosfatemia. À necropsia foram notadas alterações como jugular ingurgitada, congestão de grandes vasos, edema pulmonar. Histologicamente havia degeneração hidrópica vacuolar nos túbulos uriníferos contorcidos distais no rim, semelhantes às já relatadas em estudos anteriores, na intoxicação por P. marcgravii.(AU)

Clinical and laboratory findings in sheep experimentally poisoned by Palicourea marcgravii and the use of magnesium chloride with possible therapeutic effect on poisoning / Achados clínicos e laboratoriais em ovinos experimentalmente intoxicados por Palicourea marcgravii e o uso do cloreto de magnésio com possível efeito terapêutico na intoxicação

This study aimed to examine the efficacy of magnesium chloride therapy in sheep experimentally poisoned by Palicourea marcgravii and describe the clinical and laboratory findings that may aid in early ante mortem diagnosis of this poisoning. P. marcgravii is an important plant within a group of 22 species in Brazil that cause "sudden death." Its toxic component is sodium monofluoroacetate. It was observed that a time for evolution of poisoning was longer in our study compared to other studies that used the same dose of P. marcgravii in sheep. However, all animals that were poisoned and subsequently treated with magnesium chloride died. The sheep presented characteristic clinical signs before death in addition to other signs that have not been previously described for this type of poisoning, such as abdominal breathing, coughing, head pressing, and nystagmus. This is the first evaluation of hematological parameters of sheep poisoned by P. marcgravii. Leukocytosis with neutrophilia, hyperfibrinogenemia, and hyperglycemia, associated with hypophosphatemia and elevated levels of serum aspartato aminotransferase (AST), glutamate dehydrogenase (GLDH), urea, creatinine, creatine kinase (CK) and lactate dehydrogenase (LDH), were observed. Additionally, changes were noted in necropsy, such as engorged jugular, large vessel congestion, pulmonary edema. Histological examination revealed vacuolar hydropic degeneration in the distal twisted uriniferous tubules in the kidneys, similar to those reported in previous studies on P. marcgravii poisoning.(AU)

O presente estudo objetivou verificar a eficácia terapêutica do cloreto de magnésio em ovinos intoxicados experimentalmente por Palicourea marcgravii e descrever os achados clínicos e laboratoriais que possam auxiliar no diagnóstico precoce ante mortem dessa intoxicação. P. marcgravii é a principal planta dentro de um grupo de 22 espécies que causam "morte súbita" no Brasil e seu princípio tóxico é o monofluoracetato de sódio. Durante o procedimento, observou-se maior tempo de evolução em relação a outros trabalhos utilizando-se a mesma dose da P. marcgravii em ovinos, entretanto todos os animais intoxicados e posteriormente tratados com cloreto de magnésio vieram a óbito. Os ovinos apresentaram sinais clínicos característicos antes da morte, associados a sinais nunca antes descritos nesse tipo de intoxicação, como respiração abdominal, tosse, "head pressing" e nistagmo. Trata-se da primeira avaliação dos parâmetros hematológicos de ovinos intoxicados por P. marcgravi. Foi observado leucocitose com neutrofilia, hiperfibrinogemia e hiperglicemia, associado a elevação dos valores séricos de AST, GLDH, ureia, creatinina, CK, LDH e hipofosfatemia. À necropsia foram notadas alterações como jugular ingurgitada, congestão de grandes vasos, edema pulmonar. Histologicamente havia degeneração hidrópica vacuolar nos túbulos uriníferos contorcidos distais no rim, semelhantes às já relatadas em estudos anteriores, na intoxicação por P. marcgravii.(AU)

Clinical and laboratory findings in sheep experimentally poisoned by Palicourea marcgravii and the use of magnesium chloride with possible therapeutic effect on poisoning

ABSTRACT: This study aimed to examine the efficacy of magnesium chloride therapy in sheep experimentally poisoned by Palicourea marcgravii and describe the clinical and laboratory findings that may aid in early ante mortem diagnosis of this poisoning. P. marcgravii is an important plant within a group of 22 species in Brazil that cause sudden death. Its toxic component is sodium monofluoroacetate. It was observed that a time for evolution of poisoning was longer in our study compared to other studies that used the same dose of P. marcgravii in sheep. However, all animals that were poisoned and subsequently treated with magnesium chloride died. The sheep presented characteristic clinical signs before death in addition to other signs that have not been previously described for this type of poisoning, such as abdominal breathing, coughing, head pressing, and nystagmus. This is the first evaluation of hematological parameters of sheep poisoned by P. marcgravii. Leukocytosis with neutrophilia, hyperfibrinogenemia, and hyperglycemia, associated with hypophosphatemia and elevated levels of serum aspartato aminotransferase (AST), glutamate dehydrogenase (GLDH), urea, creatinine, creatine kinase (CK) and lactate dehydrogenase (LDH), were observed. Additionally, changes were noted in necropsy, such as engorged jugular, large vessel congestion, pulmonary edema. Histological examination revealed vacuolar hydropic degeneration in the distal twisted uriniferous tubules in the kidneys, similar to those reported in previous studies on P. marcgravii poisoning.

RESUMO: O presente estudo objetivou verificar a eficácia terapêutica do cloreto de magnésio em ovinos intoxicados experimentalmente por Palicourea marcgravii e descrever os achados clínicos e laboratoriais que possam auxiliar no diagnóstico precoce ante mortem dessa intoxicação. P. marcgravii é a principal planta dentro de um grupo de 22 espécies que causam morte súbita no Brasil e seu princípio tóxico é o monofluoracetato de sódio. Durante o procedimento, observou-se maior tempo de evolução em relação a outros trabalhos utilizando-se a mesma dose da P. marcgravii em ovinos, entretanto todos os animais intoxicados e posteriormente tratados com cloreto de magnésio vieram a óbito. Os ovinos apresentaram sinais clínicos característicos antes da morte, associados a sinais nunca antes descritos nesse tipo de intoxicação, como respiração abdominal, tosse, head pressing e nistagmo. Trata-se da primeira avaliação dos parâmetros hematológicos de ovinos intoxicados por P. marcgravi. Foi observado leucocitose com neutrofilia, hiperfibrinogemia e hiperglicemia, associado a elevação dos valores séricos de AST, GLDH, ureia, creatinina, CK, LDH e hipofosfatemia. À necropsia foram notadas alterações como jugular ingurgitada, congestão de grandes vasos, edema pulmonar. Histologicamente havia degeneração hidrópica vacuolar nos túbulos uriníferos contorcidos distais no rim, semelhantes às já relatadas em estudos anteriores, na intoxicação por P. marcgravii.

Correlation between hospitalized patients' demographics, symptoms, comorbidities, and COVID-19 pandemic in Bahia, Brazil.

In this paper, we provide a retrospective cohort study with patients that have been hospitalized for general or intensive care unit admission due to COVID-19, between March 3 and July 29, 2020, in the state of Bahia, Brazil. We aim to correlate those patients' demographics, symptoms and comorbidities, with the risk of mortality from COVID-19, length of hospital stay, and time from diagnosis to definitive outcome. On the basis of a dataset provided by the Health Secretary of the State of Bahia, we selected 3,896 hospitalized patients from a total of 154,868 COVID-19 patients that included non-hospitalized patients and patients with invalid registration in the dataset. Then, we statistically analyzed whether there was a significant correlation between the patient record data and the COVID-19 pandemic, and our main findings reinforced by the use of a multivariable logistic regression were that older age (Odds Ratio [OR] = 1.03, 95% Confidence Interval [CI] = 1.03-1.04, p-value (p) <0.001), an initial symptom of shortness of breath (OR = 1.88, 95% CI = 1.60-2.20, p < 0.001), and the presence of comorbidities, mainly chronic kidney disease (OR = 2.41, 95% CI = 1.67-3.48, p < 0.001) are related to an increased risk of mortality from COVID-19. On the other hand, sore throat (OR = 0.74, 95% CI = 0.58-0.95, p = 0.02) and length of hospital stay (OR = 0.96, 95% CI = 0.58-0.95, p < 0.001) are more related to a reduced risk of mortality from COVID-19. Moreover, a multivariable linear regression conducted with statistically significant variables (p < 0.05) showed that age (OR = 0.97, 95% CI = 0.95-0.98, p < 0.001) and time from diagnosis to definitive outcome (OR = 1.67, 95% CI = 1.64-1.71, p < 0.001) are associated with the length of hospital stay.

From individual movement behaviour to landscape-scale invasion dynamics and management: a case study of lionfish metapopulations.

Modelling the dynamics of small, interconnected populations, or metapopulations, can help pinpoint habitat patches that are critical for population persistence in patchy habitats. For conservation purposes, these patches are typically earmarked for protection, but for invasive species management, these patches could be targeted to hasten the populations' demise. Here, we show how metapopulation modelling, coupled with an understanding of size-dependent dispersal behaviour, can be used to help optimize the distribution of limited resources for culling specific populations of invasive Indo-Pacific lionfish (Pterois volitans) in the western Atlantic. Through simulation using fitted model parameters, we derive three insights that can inform management. First, culling lionfish from target patches reduces the probability of lionfish occupancy at surrounding patches. Second, this effect depends on patch size and connectivity, but is strongest at the local scale and decays with distance. Finally, size-dependent dispersal in lionfish means that size-selective culling can change both a population's size distribution and dispersal potential, with cascading effects on network connectivity, population dynamics and management outcomes. By explicitly considering seascape structure and movement behaviour when allocating effort to the management of invasive species, managers can optimize resource use to improve management outcomes. This article is part of the theme issue 'Linking behaviour to dynamics of populations and communities: application of novel approaches in behavioural ecology to conservation'.

A histomorphometric classification system for normal and inflamed mouse duodenum-Quali-quantitative approach.

Gut-associated intestinal lymphoid tissue, the largest secondary lymphoid organ in the human body, constantly samples antigens from the gut lumen, presenting as a default response the activation of TCD4+ FOXP3+ regulatory T cells that secrete a profile of anti-inflammatory cytokines maintaining gut homeostasis denominated from an immunological perspective as mucosal tolerance. However, when antigens are sampled in an inflammatory setting, the immune response may either be protective, in the case of harmful pathogens, or cause further inflammatory reactions as in food allergy, inflammatory bowel diseases, coeliac disease or food protein-induced enterocolitis syndrome. Therefore, there is a need for accurate and consistent experimental models. However, a drawback in comparing these models is the lack of a classification system similar to that which is already used for humans. Thus, the aim of this work was to propose a classification system of the small intestinal histomorphology in experimental mice. To do this we used a mouse antigen-specific gut inflammation model developed by our research group. Duodenum sections stained with haematoxylin-eosin and Alcian blue were scanned using the APERIO scanning system and analysed with the ImageScope® software. The evaluated parameters were villus area, villus height and width, enterocyte count, mononuclear intra-epithelial leucocyte and goblet cell counts, and architectural and cellular ratios. Food-sensitized animals challenged with a diet containing the corresponding food allergen presented, as for humans, time-dependent shortened and widened villi accompanied by leucocyte infiltrate and loss of goblet cells. With these data, we were able to establish a classification system for experimental intestinal inflammation in mice thus permitting better comparisons among and between experiments than has been possible previously.

Planning and Executing the Neurosurgery Boot Camp: The Bolivia Experience.

BACKGROUND: The neurosurgical boot camp has been fully incorporated into U.S. postgraduate education. This is the first implementation of the neurosurgical boot in a developing country. To advance neurosurgical education, we developed a similar boot camp program, in collaboration with Bolivian neurosurgeons, to determine its feasibility and effectiveness in an international setting. METHODS: In a collective effort, the Bolivian Society for Neurosurgery, Foundation for International Education in Neurological Surgery, Solidarity Bridge, and University of Massachusetts organized and executed the first South American neurosurgical boot camp in Bolivia in 2015. Both U.S. and Bolivian faculty led didactic lectures followed by a practicum day using mannequins and simulators. South American residents and faculty were surveyed after the course to determine levels of enthusiasm and their perceived improvement in fund of knowledge and course effectiveness. RESULTS: Twenty-four neurosurgery residents from 5 South American countries participated. Average survey scores ranged between 4.2 and 4.9 out of 5. Five Bolivian neurosurgeons completed the survey with average scores of 4.5-5. This event allowed for Bolivian leaders in the field to unify around education, resulting in the formation of an institute to continue similar initiatives. Total cost was estimated at $40 000 USD; however, significant faculty, industry, and donor support helped offset this amount. CONCLUSION: The first South American neurosurgical boot camp had significant value and was well received in Bolivia. This humanitarian model provides a sustainable solution to education needs and should be expanded to other regions as a means for standardizing the core competencies in neurosurgery.

Effects of Protection and Sediment Stress on Coral Reefs in Saint Lucia.

The extent to which Marine Protected Areas (MPAs) benefit corals is contentious. On one hand, MPAs could enhance coral growth and survival through increases in herbivory within their borders; on the other, they are unlikely to prevent disturbances, such as terrestrial runoff, that originate outside their boundaries. We examined the effect of spatial protection and terrestrial sediment on the benthic composition of coral reefs in Saint Lucia. In 2011 (10 to 16 years after MPAs were created), we resurveyed 21 reefs that had been surveyed in 2001 and analyzed current benthic assemblages as well as changes in benthic cover over that decade in relation to protection status, terrestrial sediment influence (measured as the proportion of terrigenous material in reef-associated sediment) and depth. The cover of all benthic biotic components has changed significantly over the decade, including a decline in coral and increase in macroalgae. Protection status was not a significant predictor of either current benthic composition or changes in composition, but current cover and change in cover of several components were related to terrigenous content of sediment deposited recently. Sites with a higher proportion of terrigenous sediment had lower current coral cover, higher macroalgal cover and greater coral declines. Our results suggest that terrestrial sediment is an important factor in the recent degradation of coral reefs in Saint Lucia and that the current MPA network should be complemented by measures to reduce runoff from land.

Ductal carcinoma of the breast: morphological aspects according to the age / Carcinoma ductal da mama: aspectos morfológicos de acordo com a idade

ABSTRACTIntroduction:Breast cancer is the most common cancer in women worldwide, and its morphological characteristics, despite the current molecular classification, also provide important information about the pattern of this disease.Objective:To analyze the morphological characteristics of invasive ductal breast carcinoma among women older and younger than 50 years.Method:302 cases of invasive ductal carcinoma patients treated at the Division of Mastology of the Universidade Federal do Ceará, in the period 2005-2014, aged ≤ 50 years and older. The following morphological characteristics were analyzed: larger tumor diameter (TD), lymph node metastasis (MX), and histological grade (HG).Results:The mean age of patients was 55.6 years. The average tumor size was 3.4 cm, 40% of tumors have diameter ≤ 2 cm and 60% > 2 cm. As for the histological grade, 23.7% were grade 1, 32.1% grade 2, and 42% grade 3. Axillary metastasis were present in 66% of the cases and 34% did not. Women aged ≤ 50 years had fewer tumors grade 1 (p = 0.002), compared with grades 2 and 3. Women older than 50 years had more grade 3 tumors (p = 0.002), and more tumors larger than 2 cm diameter (p < 0.001). The presence of metastasis predominated in both age groups when analyzed separately (p < 0.001).Conclusion:Women older than 50 years had larger and more morphologically undifferentiated tumors. Women aged ≤ 50 years had less well-differentiated tumors. There were no differences in morphology between these two age groups when compared each other.

RESUMOIntrodução:O câncer de mama é o câncer que mais acomete mulheres no mundo, e suas características morfológicas, a despeito da atual classificação molecular, ainda fornecem informações importantes sobre o comportamento desta doença.Objetivo:Analisar as características morfológicas dos carcinomas ductais invasivos da mama em mulheres acima e abaixo de 50 anos de idade.Métodos:Trezentos e dois casos de carcinoma ductal de pacientes do serviço de Mastologia da Universidade Federal do Ceará (UFC), no período de 2005 a 2014, com idade ≤ 50 anos e acima de 50 anos. Foram analisadas as seguintes características morfológicas: maior diâmetro do tumor (DT), presença de metástase axilar (MX) e grau histológico (GH).Resultados:A idade média das pacientes foi de 55,6 anos; o tamanho médio dos tumores, de 3,4 cm. Quarenta por cento dos tumores possuíam diâmetro ≤ 2 cm e 60%, > 2 cm. Quanto ao grau histológico, 23,7% eram grau 1, 32,1%, grau 2 e 42%, grau 3. Sessenta e seis por cento dos casos apresentaram metástase axilar e 34% não. Mulheres com idade ≤ 50 anos apresentaram menos tumores grau 1 (p = 0,002) em relação aos graus 2 e 3. Mulheres acima de 50 anos apresentaram mais tumores grau 3 (p = 0,002) e mais tumores com mais de 2 cm de diâmetro (p < 0,001). A presença de metástase predominou nas duas faixas etárias quando analisadas isoladamente (p < 0,001).Conclusão:Mulheres acima de 50 anos apresentaram tumores maiores e de morfologia mais indiferenciada; mulheres com idade ≤ 50 anos, menos tumores bem diferenciados. Não houve diferença da morfologia entre as faixas etárias quando comparadas entre si.

Trait-based diet selection: prey behaviour and morphology predict vulnerability to predation in reef fish communities.

Understanding how predators select their prey can provide important insights into community structure and dynamics. However, the suite of prey species available to a predator is often spatially and temporally variable. As a result, species-specific selectivity data are of limited use for predicting novel predator-prey interactions because they are assemblage specific. We present a method for predicting diet selection that is applicable across prey assemblages, based on identifying general morphological and behavioural traits of prey that confer vulnerability to predation independent of species identity. We apply this trait-based approach to examining prey selection by Indo-Pacific lionfish (Pterois volitans and Pterois miles), invasive predators that prey upon species-rich reef fish communities and are rapidly spreading across the western Atlantic. We first generate hypotheses about morphological and behavioural traits recurring across fish species that could facilitate or deter predation by lionfish. Constructing generalized linear mixed-effects models that account for relatedness among prey taxa, we test whether these traits predict patterns of diet selection by lionfish within two independent data sets collected at different spatial scales: (i) in situ visual observations of prey consumption and availability for individual lionfish and (ii) comparisons of prey abundance in lionfish stomach contents to availability on invaded reefs at large. Both analyses reveal that a number of traits predicted to affect vulnerability to predation, including body size, body shape, position in the water column and aggregation behaviour, are important determinants of diet selection by lionfish. Small, shallow-bodied, solitary fishes found resting on or just above reefs are the most vulnerable. Fishes that exhibit parasite cleaning behaviour experience a significantly lower risk of predation than non-cleaning fishes, and fishes that are nocturnally active are at significantly greater risk. Together, vulnerable traits heighten the risk of predation by a factor of nearly 200. Our study reveals that a trait-based approach yields insights into predator-prey interactions that are robust across prey assemblages. Importantly, in situ observations of selection yield similar results to broadscale comparisons of prey use and availability, which are more typically gathered for predator species. A trait-based approach could therefore be of use across predator species and ecosystems to predict the outcomes of changing predator-prey interactions on community dynamics.

What doesn't kill you makes you wary? Effect of repeated culling on the behaviour of an invasive predator.

As a result of being hunted, animals often alter their behaviour in ways that make future encounters with predators less likely. When hunting is carried out for conservation, for example to control invasive species, these behavioural changes can inadvertently impede the success of future efforts. We examined the effects of repeated culling by spearing on the behaviour of invasive predatory lionfish (Pterois volitans/miles) on Bahamian coral reef patches. We compared the extent of concealment and activity levels of lionfish at dawn and midday on 16 coral reef patches off Eleuthera, The Bahamas. Eight of the patches had been subjected to regular daytime removals of lionfish by spearing for two years. We also estimated the distance at which lionfish became alert to slowly approaching divers on culled and unculled reef patches. Lionfish on culled reefs were less active and hid deeper within the reef during the day than lionfish on patches where no culling had occurred. There were no differences at dawn when removals do not take place. Lionfish on culled reefs also adopted an alert posture at a greater distance from divers than lionfish on unculled reefs. More crepuscular activity likely leads to greater encounter rates by lionfish with more native fish species because the abundance of reef fish outside of shelters typically peaks at dawn and dusk. Hiding deeper within the reef could also make remaining lionfish less likely to be encountered and more difficult to catch by spearfishers during culling efforts. Shifts in the behaviour of hunted invasive animals might be common and they have implications both for the impact of invasive species and for the design and success of invasive control programs.

A prospective emergency department-based study of pattern and outcome of neurologic and neurosurgical diseases in Haiti.

OBJECTIVE: To perform the first prospective survey of neurologic and neurosurgical emergency department (ED) admissions in Haiti. METHODS: Data of all ED admissions at 3 Haitian hospitals for 90 consecutive days per site were collected prospectively. Patients who were given a diagnosis of a neurologic or neurosurgical disorder by the ED physician were entered in a deidentified database including demographics, presenting symptoms, brain imaging (when available), requests for neurosurgical consultation, and outcome. RESULTS: Of the 7628 patients admitted to the ED during this study, 1243 patients had a neurologic disorder, yielding an ED-based neurologic disease prevalence of 16%. The 3 most common neurologic diseases were cerebrovascular disease (31%), neurotrauma (28%), and altered mental status (12%). Neurosurgical pathologies represented 19% of all neurologic admissions with a combined ED-based disease prevalence of 3%. Mortality rate was 9%. The most common neurosurgical disease was neurotrauma (87%), caused by motor vehicle accidents (59%), falls (20%), and assault (17%). Neurosurgical procedures were performed in 14 of 208 patients with a mortality rate of 33%. CONCLUSIONS: This prospective survey represents the first study of neurosurgical or neurologic disease patterns in Haiti. The results suggest specific disease priorities for this population that can guide efforts to improve Haitian health care and conduct more comprehensive epidemiologic studies in Haiti.

The role of chemical interactions between thorium, cerium, and lanthanum in lymphocyte toxicity.

Thorium, cerium, and lanthanum are metals present in several types of minerals, the most common of which is monazite. Cerium and lanthanum are elements in the lanthanides series. Thorium, an actinide metal, is a hazardous element due to its radioactive characteristics. There is a lack of information describing the possible chemical interactions among these elements and the effects they may have on humans. Toxicological analyses were performed using cell viability, cell death, and DNA damage assays. Chemical interactions were evaluated based on the Loewe additivity model. The results indicate that thorium and cerium individually have no toxic effects on lymphocytes. However, thorium associated with lanthanum increases the toxicity of this element, thereby reducing the viability of lymphocytes at low concentrations of metals in the mixture.

Is Jamaica a good model for understanding Caribbean coral reef dynamics?

Caribbean reefs have experienced unprecedented changes in the past 40 years. A major hypothesis to explain shifts in reef community composition relates to declining herbivory. This hypothesis was developed largely based on observations of Jamaican reefs from the 1980s onward, but it is widely held to be relevant regionally. We use a region-wide dataset on benthic composition to examine how well the pattern of ecological change on Jamaican reefs is mirrored by other Caribbean reefs. The extent to which macroalgal cover exceeds coral cover on Jamaican reefs is an order of magnitude more extreme than seen elsewhere. We suggest that Jamaican reefs are not representative of the degradation trajectory of Caribbean reefs and management based on the Jamaican experience may not be relevant elsewhere. However, the recovery of Jamaican reefs following the return of urchins gives us hope that Caribbean reefs are more resilient to catastrophic disturbances than previously thought.

Invasive lionfish drive Atlantic coral reef fish declines.

Indo-Pacific lionfish (Pterois volitans and P. miles) have spread swiftly across the Western Atlantic, producing a marine predator invasion of unparalleled speed and magnitude. There is growing concern that lionfish will affect the structure and function of invaded marine ecosystems, however detrimental impacts on natural communities have yet to be measured. Here we document the response of native fish communities to predation by lionfish populations on nine coral reefs off New Providence Island, Bahamas. We assessed lionfish diet through stomach contents analysis, and quantified changes in fish biomass through visual surveys of lionfish and native fishes at the sites over time. Lionfish abundance increased rapidly between 2004 and 2010, by which time lionfish comprised nearly 40% of the total predator biomass in the system. The increase in lionfish abundance coincided with a 65% decline in the biomass of the lionfish's 42 Atlantic prey fishes in just two years. Without prompt action to control increasing lionfish populations, similar effects across the region may have long-term negative implications for the structure of Atlantic marine communities, as well as the societies and economies that depend on them.