Radiation Therapy Skin Marking with Lancets Versus Electric Marking Pen (COMFORTATTOO)-6 Months Results on Cosmesis, Fading, and Patients' Satisfaction From a Randomized, Double-Blind Trial.

Purpose: Most of radiation oncology centers rely on set-up skin markings for patient setup during treatment delivery. Permanent dark-ink tattooing is the most popular marking method. COMFORTATTOO is a unicentric, randomized trial testing 2 permanent methods: lancets against an electric marking pen (Comfort Marker 2.0, CM). One substudy was undertaken to test if using the CM translates into a cosmesis, fading, or satisfaction benefit compared with the lancets. Methods and Materials: Patients aged 18 years or older referred to our department to receive RT were recruited. They were randomly assigned, in a 1:1 ratio, to receive set-up markings using lancets or CM. This substudy aimed to recruit all the living participants included in the main study. The primary endpoints were tattoos cosmesis, tattoos fading, and patients' satisfaction 6 months after finishing the RT. Cosmetic and fading assessments were scored on a 5-point ascending scale and patients' satisfaction on a 10-point ascending scale. The trial is registered at ClinicalTrials.gov (number NCT05371795). Results: Between April and September 2022, 92 patients were enrolled (45 assigned to lancets and 47 to CM) and assessed for the outcomes. Patients receiving CM had significantly better cosmetic markings, with a median score of 4.4 (vs 3.7 for lancets, P<.001). On the fading assessment, the CM was associated with lower scores compared with the lancets (median score of 1.3 and 3.3, respectively; P<.001). No differences in patients' satisfaction were observed with either method (median score of 10 for both arms, P=.952). Conclusions: Our substudy results demonstrated that, 6 months after the end of RT, the CM produces better cosmetic markings with less fading compared with the lancets. These differences didn't translate into patients' satisfaction superiority toward any method.

Meningioma Presenting With Intratumoral Hemorrhage on Active Surveillance.

Meningiomas are relatively common primary adult brain tumors. They are slow-growing, highly vascular, and graded according to histology, phenotypic and genotypic features. We present a case of a 66-year-old male with a history of tongue squamous cell carcinoma, which presented multiple risk factors for cardiovascular and thromboembolic events. A brain lesion was initially detected on a computed tomography (CT) scan and later characterized by magnetic resonance imaging (MRI). The multidisciplinary team decided to maintain surveillance due to the lack of associated symptoms. Upon expansion in size and acute intralesional hemorrhage seen on follow-up imaging, the patient was submitted to surgical excision. The histopathological testing determined it to be an atypical meningioma. Two months later, the patient received stereotactic radiotherapy, and a post-surgical MRI showed no evidence of tumor recurrence. This case report describes a rare occurrence of intratumoral hemorrhage in a meningioma during surveillance, highlighting the importance of vigilant monitoring and consideration of potential risk factors for hemorrhagic events.

Sex-association experiments reveal the true identity of Physetopoda lampedusia (Invrea, 1957) (Hymenoptera, Mutillidae, Smicromyrmini).

Arthropod biodiversity is still insufficiently known in large areas of Europe, such as the Iberian Peninsula, regarding several insect groups. Mutillid wasps (Mutillidae), markedly sexually dimorphic ectoparasitic species, are poorly known Hymenoptera, with a number of species awaiting formal description and others known only from one sex. Sexual associations have been historically difficult to establish for most mutillid wasp species; in an European context, the species in tribe Smicromyrmini, particularly in the genera Smicromyrme Thomson, 1870 and Physetopoda Schuster, 1949, have presented the biggest challenges. In this paper, the hitherto unknown male of Physetopoda lampedusia (Invrea, 1957) is recognized as Ephutomma montarcense ((Mercet MS.) Giner Marí, 1944), with the former name falling into synonymy. A total of 63 females identified as P. lampedusia and 35 males identified as E. montarcense were collected in Portugal from 1999-2022. The correct sex association was confirmed through pairing experiments in captivity and is supported by circumstantial field observations in situ. Redescriptions of both male and female, as well as behavioural notes, are presented. Ephutomma montarcense is new for Portugal and its distribution is thus extended to Lampedusa Island (Italy) and Morocco, where it had been recorded as P. lampedusia, with Ephutomma representing a new genus for these three countries. The reliability of the method used, as well as the generic position and authorship of the species are briefly discussed.

Malignant Transformation of Retroauricular Hidradenoma in Hidradenocarcinoma in a Nine-Year-Old Patient: A Case Report.

Hidradenocarcinoma, a rare malignant entity that derives from sweat glands, is especially rare in the pediatric population. The treatment of choice is surgery. Radiation therapy is used only in selected patients. Chemotherapy is not used extensively because its effectiveness has not been demonstrated yet. This case report describes a nine-year-old female patient who presented in 2018 with a vegetative lesion in the right parietal region. After excisional surgery, pathology confirmed that the lesion was a benign hidradenoma. However, the lesion recurred six months later, and subsequent surgery revealed nodular hidradenoma with positive margins. In July 2019, a new heterogenous lesion appeared in the right retroauricular region, which was surgically removed. The pathology report found possible malignant characteristics, and the patient was referred to our hospital where she was diagnosed with poorly differentiated right retroauricular carcinoma with infiltrative and perineural permeation, along with homolateral lymph node metastasis. It was histologically compatible with a hidradenocarcinoma. The patient underwent a wide-margin excision and homolateral total cervical lymphadenectomy, followed by adjuvant radiotherapy. The last follow-up MRI was negative for disease recurrence or metastasis; however, a slow-growing node on the left jugular chain (level II) was noted. The patient is on regular follow-ups to monitor disease status and treatment-related adverse events. This case highlights the challenges of diagnosing and treating hidradenocarcinoma, a rare malignancy that requires aggressive management with a multidisciplinary approach. More robust clinical evidence is needed to define the best treatment approach for these aggressive tumors.

Smicromyrme ceballosi Surez, 1959 and S. plantourianus Schwartz, 1986: two little known species new for Portugal (Hymenoptera, Mutillidae).

The mutillid wasps (Hymenoptera, Mutillidae) of the Iberian Peninsula, and particularly of Portugal, are insufficiently researched. In this paper, two species in the genus Smicromyrme are added to the Portuguese fauna: S. ceballosi Surez, 1959 and S. plantourianus Schwartz, 1986, both currently poorly known species. The former was hitherto recorded only from Spain, for which notes complementing the original description are given. The latter species was unexpected, as it was known only from Southern France and is thus also new for the Iberian Peninsula; given its original description may be considered insufficient by modern standards, a full redescription is here presented; the presently known localities in Portugal suggest S. plantourianus has a wide distribution and is probably a mainly Iberian species, which thus reaches in France the north-eastern limit of its distribution. In addition, the putative male of S. plantourianus is here newly described. A key to the Iberian Smicromyrme is presented, currently represented by 13 species and three subspecies.

Understanding the mechanisms of antitropical divergence in the seabird White-faced Storm-petrel (Procellariiformes: Pelagodroma marina) using a multilocus approach.

Analytical methods that apply coalescent theory to multilocus data have improved inferences of demographic parameters that are critical to understanding population divergence and speciation. In particular, at the early stages of speciation, it is important to implement models that accommodate conflicting gene trees, and benefit from the presence of shared polymorphisms. Here, we employ eleven nuclear loci and the mitochondrial control region to investigate the phylogeography and historical demography of the pelagic seabird White-faced Storm-petrel (Pelagodroma marina) by sampling subspecies across its antitropical distribution. Groups are all highly differentiated: global mitochondrial ΦST = 0.89 (P < 0.01) and global nuclear ΦST varies between 0.22 and 0.83 (all P < 0.01). The complete lineage sorting of the mitochondrial locus between hemispheres is corroborated by approximately half of the nuclear genealogies, suggesting a long-term antitropical divergence in isolation. Coalescent-based estimates of demographic parameters suggest that hemispheric divergence of P. marina occurred approximately 840 000 ya (95% HPD 582 000-1 170 000), in the absence of gene flow, and divergence within the Southern Hemisphere occurred 190 000 ya (95% HPD 96 000-600 000), both probably associated with the profound palaeo-oceanographic changes of the Pleistocene. A fledgling sampled in St Helena (tropical South Atlantic) suggests recent colonization from the Northern Hemisphere. Despite the great potential for long-distance dispersal, P. marina antitropical groups have been evolving as independent, allopatric lineages, and divergence is probably maintained by philopatry coupled with asynchronous reproductive phenology and local adaptation.

HIV type 1 diversity from newly diagnosed patients in Santos metropolitan area/Brazil.

HIV-1 from infected subjects has been characterized in order to provide a more accurate view of the strains that are currently found in a given region. In this report, we focused on characterizing the pol gene diversity obtained from newly diagnosed patients in Santos metropolitan area, Brazil. This region is composed of nine cities and an international port. Analysis of the 33 samples revealed that 22 strains belonged to subtype B, 4 to subtype F, and 2 to subtype C; 5 strains were B/F recombinants. Our results demonstrated that 18.2% of samples were primary antiretroviral resistance genotypic mutations, with high-level resistance to reverse transcriptase inhibitors in both subtypes B and F and in recombinant forms B/F. Our data revealed that the primary antiretroviral resistance genotypic mutations should be carefully investigated in developing countries with widespread access to antiretrovirals, such as Brazil.