The latest freshwater giants: a new Peltocephalus (Pleurodira: Podocnemididae) turtle from the Late Pleistocene of the Brazilian Amazon.

Overkill of large mammals is recognized as a key driver of Pleistocene megafaunal extinctions in the Americas and Australia. While this phenomenon primarily affected mega-mammals, its impact on large Quaternary reptiles has been debated. Freshwater turtles, due to the scarcity of giant forms in the Quaternary record, have been largely neglected in such discussions. Here we present a new giant podocnemidid turtle, Peltocephalus maturin sp. nov., from the Late Pleistocene Rio Madeira Formation in the Brazilian Amazon, that challenges this assumption. Morphological and phylogenetic analyses of the holotype, a massive partial lower jaw, reveal close affinities to extant Amazonian species and suggest an omnivorous diet. Body size regressions indicate Pe. maturin possibly reached about 180 cm in carapace length and is among the largest freshwater turtles ever found. This finding presents the latest known occurrence of giant freshwater turtles, hinting at coexistence with early human inhabitants in the Amazon.

[Translated article] Family Planning Concerns Among Women With Psoriasis: A Descriptive, Cross-Sectional, Multicenter Study.

BACKGROUND AND OBJECTIVE: A significant proportion of women of childbearing age have psoriasis. The aim of this study was to examine family planning concerns in this population. MATERIAL AND METHODS: Observational, descriptive, cross-sectional, multicenter study conducted between March 2020 and October 2021. We collected sociodemographic data and analyzed responses to a family planning questionnaire administered to women aged 18 to 45 years with plaque psoriasis who were candidates for systemic treatment. RESULTS: We studied 153 patients (mean [SD] age, 35.4 [8.0] years; mean disease duration, 16.7 years) being treated at 11 Spanish hospitals. Overall, 38.4% of women were considered to have moderate to severe psoriasis by their physicians; perceived severity ratings were significantly higher among women. Psoriasis affected the women's desire to become pregnant or led to their delaying pregnancy in 1 in 3 respondents. They were concerned that their condition might worsen if they had to discontinue or switch treatment or that the treatment might harm the baby. Approximately half of the women had not received family planning counseling from their physicians, and this was more likely to be the case among never-pregnant women. Women on biologic therapy (58.7%) had better psoriasis control and a better quality of life than women on other treatments. Their sexual health was also less affected. CONCLUSIONS: Women with psoriasis have numerous family planning concerns, which in some cases can lead them to delay pregnancy or affect their desire to become pregnant. Dermatologists need to receive better training regarding family planning in women with psoriasis so that they can provide their patients with more and better information.

[Incorporation of patient-reported outcomes into pharmacy and dermatology departments, in psoriasis and atopic dermatitis patients, as a tool to improve the healthcare quality and health outcomes]. / Incorporación de resultados informados por pacientes con psoriasis y dermatitis atópica en las consultas de atención farmacéutica y dermatología: herramienta que mejora la calidad asistencial y resultados en salud.

INTRODUCTION: Patient-reported outcomes (PROs) provide subjective information about their disease, treatment, and quality of life. OBJECTIVE: To introduce a new system of work coordinated between pharmacists and dermatologists, based on the collection and analysis of PROs to assess its clinical impact as well as patients satisfaction. METHOD: A prospective single-centre observational study was conducted under clinical conditions and included adult patients diagnosed with psoriasis (PS) and atopic dermatitis (AD) between April-2021 and February-2022. Pharmacists and dermatologists agreed on this systematic work. A REDCap® database was designed to facilitate data collection and the subsequent analysis. RESULTS: A total of 288 and 41 patients with PS and AD, respectively, were included. Those who started treatment showed significant improvement with a decrease in PROs and clinical parameters (p < 0.001). The pharmacist made 168 and 7 recommendations to dermatologists for PS and AD patients, respectively, of which 66.07% and 57.1% were accepted. The most common recommendations were «consult with rheumatologist¼ (20.83%), «extend drug regimen¼ (19.64%) and «consider change in treatment¼ (11.90%). Adverse events were reported in 55 and 17 patients with PS and AD, respectively. Of 103 patients, 75% were «very satisfied¼ and 20% «satisfied¼ with the system. CONCLUSIONS: This new working system helps to evaluate the short and long-term effectiveness of treatments and also to identify adverse events, alarm symptoms and co-morbidities in order to optimize therapies. Collaboration between pharmacists and dermatologists reduces decision-making time and patients appreciate better clinical care leading to higher patient satisfaction.

Family Planning Concerns Among Women With Psoriasis: A Descriptive, Cross-Sectional, Multicenter Study. / Percepción de la mujer con psoriasis en la planificación familiar: Estudio descriptivo, transversal y multicéntrico.

BACKGROUND AND OBJECTIVE: A significant proportion of women of childbearing age have psoriasis. The aim of this study was to examine family planning concerns in this population. MATERIAL AND METHODS: Observational, descriptive, cross-sectional, multicenter study conducted between March 2020 and October 2021. We collected sociodemographic data and analyzed responses to a family planning questionnaire administered to women aged 18 to 45 years with plaque psoriasis who were candidates for systemic treatment. RESULTS: We studied 153 patients (mean [SD] age, 35.4 [8.0] years; mean disease duration, 16.7 years) being treated at 11 Spanish hospitals. Overall, 38.4% of women were considered to have moderate to severe psoriasis by their physicians; perceived severity ratings were significantly higher among women. Psoriasis affected the women's desire to become pregnant or led to their delaying pregnancy in 1 in 3 respondents. They were concerned that their condition might worsen if they had to discontinue or switch treatment or that the treatment might harm the baby. Approximately half of the women had not received family planning counseling from their physicians, and this was more likely to be the case among never-pregnant women. Women on biologic therapy (58.7%) had better psoriasis control and a better quality of life than women on other treatments. Their sexual health was also less affected. CONCLUSIONS: Women with psoriasis have numerous family planning concerns, which in some cases can lead them to delay pregnancy or affect their desire to become pregnant. Dermatologists need to receive better training regarding family planning in women with psoriasis so that they can provide their patients with more and better information.

Risk of a Second Skin Cancer in a Cohort of Patients With Nonmelanoma Skin Cancer -Basal Cell Carcinoma or Squamous Cell Carcinoma-Treated With Mohs Micrographic Surgery: A National Prospective Cohort Study. / Riesgo de aparición de segundas neoplasias cutáneas en una cohorte de pacientes diagnosticados de carcinoma queratinocítico (carcinoma basocelular y carcinoma epidermoide) tratados con cirugía de Mohs. Estudio de cohortes prospectivo nacional.

OBJECTIVE: Patients with nonmelanoma skin cancer (NMSC)-ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)-have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). MATERIAL AND METHODS: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. RESULTS: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). CONCLUSION: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex.

Characterization of nutritional and functional properties of "Blanco Sinaloa" chickpea (Cicer arietinum L.) variety, and study of the rheological behavior of hummus pastes.

In this work the preparation of a hummus pastes from a Mexican variety of chickpea (Blanco Sinaloa, BS) was investigated. With this purpose, the nutritional and functional properties of the raw chickpea were evaluated, which revealed a content of protein, fiber and lipids of 19, 1.6 and 10.3%, respectively. Meanwhile the values of hydration capacity, water absorption index, water solubility index, emulsifying activity and foam capability were 0.65 g/seed, 2.26 g/g, 22.3%, 40.7% and 29.2%, respectively. Based on these results this variety of chickpea was considered suitable for the target application. The preparation of the paste was done by further sterilization of the paste promoted a decreased on the activity of lipoxygenase (68%) and starch content (40%). The rheological characterization of the hummus paste showed that the sterilization induced the formation of a tridimensional structure, due to the gelatinization of the starch and protein denaturation. Moreover, the linear viscoelastic zone shifted to higher values of strain (%γ), whereas the storage modulus (G') increased in about two orders of magnitude. The results of frequency sweeps showed that the paste exhibits a solid-like behavior (weak gel). Measurements of shear rate of the paste (unsterilized and sterilized) revealed that the shear viscosity exhibited a shear thickening behavior and a thixotropic behavior.

Mohs micrographic surgery in the elderly: comparison of tumours, surgery and first-year follow-up in patients younger and older than 80 years old in REGESMOHS.

BACKGROUND: The elderly population is increasing and more patients in this group undergo Mohs micrographic surgery (MMS). The few publications investigating MMS in elderly people conclude that it is a safe procedure; however, these are single-centre studies without a comparison group. OBJECTIVE: To compare the characteristics of patients, tumours, MMS and 1-year follow-up in patients younger than 80 years, with patients older than 80 years at the time of surgery. METHODS: Data was analysed from REGESMOHS, a prospective cohort study of patients treated with MMS. The participating centres were 19 Spanish hospitals where at least one MMS is performed per week. Data on characteristics of the patient, tumour and surgery were recorded. Follow-up data were collected from two visits; the first within 1 month postsurgery and the second within the first year. RESULTS: From July 2013 to October 2016, 2575 patients that underwent MMS were included in the registry. Of them, 1942 (75.4%) were aged <80 years and 633 (24.6%) were ≥80 years old. In the elderly, the tumour size was significantly higher with a higher proportion of squamous cell carcinoma. Regarding surgery, elderly more commonly had tumours with deeper invasion and required a higher number of Mohs surgery stages, leaving larger defects and requiring more time in the operating room. Despite this, the incidence of postoperative complications was the same in both groups (7%) and there were no significant differences in proportion of relapses in the first-year follow-up. CONCLUSION: The risk of short-term complications and relapses were similar in elderly and younger groups. MMS is a safe procedure in the elderly.

Deciphering pyritization-kerogenization gradient for fish soft-tissue preservation.

Soft-tissue preservation provides palaeobiological information that is otherwise lost during fossilization. In Brazil, the Early Cretaceous Santana Formation contains fish with integument, muscles, connective tissues, and eyes that are still preserved. Our study revealed that soft-tissues were pyritized or kerogenized in different microfacies, which yielded distinct preservation fidelities. Indeed, new data provided the first record of pyritized vertebrate muscles and eyes. We propose that the different taphonomic pathways were controlled by distinct sedimentation rates in two different microfacies. Through this process, carcasses deposited in each of these microfacies underwent different residence times in sulphate-reduction and methanogenesis zones, thus yielding pyritized or kerogenized soft-tissues, and a similar process has previously been suggested in studies of a late Ediacaran lagerstätte.

Retronychia: A Case Report Including Ultrasound Imaging and Surgical Treatment. / Retroniquia: estudio ecográfico y tratamiento quirúrgico de un caso.

Retronychia is a recently described disorder caused by ingrowth of the proximal nail plate into the proximal nail fold. This situation provokes chronic paronychia refractory to antimicrobial therapy. Ultrasound has been proposed as the noninvasive method of choice to confirm the diagnosis and rule out other differential diagnoses, particularly local tumors and arthritic disease. The presence of 2 or more overlapping nail plates and a reduced distance between the root of the nail plate and the base of the distal phalanx could be the ultrasound hallmarks of this condition. Nail plate avulsion is the treatment of choice and is curative. Knowledge of retronychia is still limited among dermatologists, which can lead to diagnostic and therapeutic errors and delay. This has prompted us to present this new case.

Adição de lisina digestível em rações experimentais para juvenis de tilápia-do-nilo / Addition of lysine in experimental diets for Nile tilapia juveniles

Objetivou-se por meio deste estudo determinar a necessidade nutricional de lisina digestível em rações para juvenis de tilápia-do-nilo (Oreochromis niloticus). Setecentos e vinte peixes masculinizados (7,30±0,11g) foram alimentados durante 30 dias com oito rações (26,81% de proteína digestível e 3090kcal/kg de energia digestível da ração) contendo teores crescentes de lisina digestível (1,24; 1,36; 1,48; 1,60; 1,72; 1,84; 1,96 e 2,08%). As tilápias foram distribuídas em delineamento inteiramente ao acaso, com oito tratamentos, seis repetições e 15 peixes por unidade experimental. Foram avaliadas variáveis de desempenho (ganho de peso, taxa de crescimento específico, taxa de sobrevivência, consumo de ração, consumo de lisina digestível, conversão alimentar aparente, eficiência proteica para ganho, eficiência de lisina para ganho e eficiência de retenção de nitrogênio) e de composição corporal (teores de umidade, gordura, proteína, matéria mineral corporal e as taxas de deposição diária de proteína e gordura corporais). A elevação do teor de lisina digestível na ração não influenciou (P>0,05) o consumo de ração, a taxa de sobrevivência e os teores de umidade e de matéria mineral corporal, mas melhorou de forma quadrática (P<0,05) os demais parâmetros avaliados, com exceção do consumo de lisina e da eficiência de lisina para ganho, que aumentou e reduziu, respectivamente, de forma linear (P<0,05). Recomenda-se que rações para juvenis de tilápia-do-nilo devam conter 1,84% de lisina digestível para máximo ganho de peso...

The aim of this study was to determine the nutritional need of lysine in diets for juvenile Nile tilapia (Oreochromis niloticus). Seven hundred and twenty masculinized fish (7.30±0.11g) were fed for 30 days with eight diets (26.81% of digestible protein and 3090 kcal/kg digestible energy of feed) containing increasing levels of lysine (1.24, 1.36, 1.48, 1.60, 1.72, 1.84, 1.96 and 2.08%). The tilapia were distributed in a completely randomized design with eight treatments and six replicates of 15 fish per experimental unit. We evaluated the performance variables (weight gain, specific growth rate, survival rate, feed intake, digestible lysine intake, feed conversion, protein efficiency for gain, efficiency of lysine for gain and efficiency of retention nitrogen) and body composition (moisture, fat, protein, ash body and deposition rates of daily protein and fat). The high levels of dietary lysine did not affect (P>0.05) feed intake, the survival rate and the moisture and ash body, but improved (P<0.05) other parameters, except for lysine intake and efficiency of lysine for gain, which increased and decreased, respectively, linearly (P<0.05). It is recommended that diets for juvenile Nile tilapia should contain 1.84% digestible lysine for maximum weight gain...

Lidocaína liposomal: nuevo anestésico tópico en dermatología / No disponible

La anestesia tópica constituye una herramienta no invasiva idónea para aliviar el dolor asociado a una multitud de procedimientos diagnósticos y terapéuticos frecuentes en dermatología clínica y cosmética. Aunque su eficacia ha quedado demostrada en múltiples estudios, la formulación tópica más utilizada hasta la actualidad, constituida por una mezcla eutéctica de anestésicos locales en crema (2,5% de lidocaína y 2,5% de prilocaína) y conocida como EMLA en su denominación anglosajona, carece de algunos de los parámetros de referencia esenciales para su consideración como anestésico ideal. Sin embargo, la reciente aparición en el mercado de una nueva formulación tópica que contiene lidocaína al 4% en un sistema de liberación liposomal, que facilita su penetración a través del estrato córneo de la epidermis, supone una alternativa a la EMLA por su fácil aplicación sin necesidad de oclusión, su mayor rapidez de acción, idéntica eficacia y mayor seguridad, especialmente en cuanto al desarrollo de metahemoglobinemia. En el presente artículo se revisa la utilización clínica de la crema de lidocaína encapsulada en liposomas al 4%, tomando como referencia una serie de estudios comparativos con placebo y otros anestésicos tópicos y locales, llevados a cabo sobre todo en población pediátrica. En ellos se valora la eficacia analgésica, rapidez de acción, toxicidad, efectos adversos e indicaciones actuales de este nuevo anestésico tópico, así como sus posibles indicaciones futuras en dermatología (AU)

Arrugamiento acuagénico palmar en unniño con fibrosis quística / Aquagenic wrinkling of the palmas in a young boy with cystic fibrosis

El arrugamiento acuagénico es una afección cutánea descrita en la última década. Se considera poco frecuente, característico de mujeres jóvenes eidiopático; aunque en al menos tres enfermos se ha relacionado con la toma de antiinflamatorios inhibidores selectivos de la ciclooxigenasa-2. Recientementese ha recuperado su vinculación, realizada hace más de 30 años, con la fibrosis quística, y se ha referido en tres pacientes con dicha enfermedad.Describimos un nuevo caso en un niño de 5 años con fibrosis quística, documentada con estudio genético. Discutimos su eventual consideracióncomo marcador cutáneo de la fibrosis quística (AU)

Aquagenic wrinkling is a cutaneous condition described in the last decade. It is considered to be uncommon, typical in young females and idiopathic;although it has been related with selective inhibitor of cyclooxygenasa-2 anti-inflammatory medication intake in at least three patients. Recently itsrelationship with cystic fibrosis, recognised more than 30 years earlier, has been recovered and three patients have been reported in with that disease.A new genetically documented cystic fibrosis case in a 5 year old boy is described. The eventual consideration of this condition as a cystic fibrosis cutaneousmarker is discussed (AU)

Supramolecular interactions of humic acids with organic and inorganic xenobiotics studied by capillary electrophoresis.

Methodology based on capillary electrophoresis (CE) to study humic acids (HAs)-xenobiotics interactions is proposed. The interactions of HAs with organic and inorganic xenobiotics like paraquat, diquat, p,p(')-DDE, p,p(')-DDT, potassium ferrocyanide, potassium ferricyanide, chloride, 4-nitrocatechol and other organic compounds were studied. They were found to be of different kind depending on the structure of the xenobiotic molecule and on its charge (neutral, positive or negative). Ion binding, hydrogen bonding, van der Waals forces, ligand exchange, hydrophobic and hydrophilic adsorption, charge-transfer complexes and sequestration are some of the different mechanisms proposed to bind inorganic and organic compounds to HAs. It was also observed that some of the pollutants are strongly complexed (bound) only with some of the HA fractions forming quite stable entities of supramolecular kind, which can migrate independently. In addition, the stability constant of HA-Cl (negatively charged species) was estimated to be logk=3.1+/-0.95. In order to explain the interaction between negatively charged HAs and inorganic anions (like Cl(-), [Fe(CN)(6)](3-) and [Fe(CN)(6)](4-)), it is proposed that macropolycyclic polyamine structures are present in HA supramolecules, and that they are responsible for such strong binding.

Highly reproducible capillary zone electrophoresis of humic acids in cyclodextrin- or oligosaccharide-modified background electrolytes.

Capillary zone electrophoresis has been used for the characterization and separation of humic acids. It was found that addition of saccharides like alpha-, beta-, gamma-cyclodextrins, maltose, hydroxyethylcellulose or dextran sulfate in the background electrolyte (50 mM Na2 B4 O7, pH 9.6) yields better separation patterns and highly reproducible electropherograms. Electropherograms with higher numbers of peaks and high reproducibility were obtained with alpha- and beta-cyclodextrins or with a mixture of alpha- + gamma-cyclodextrin-modified background electrolytes. Separation was carried out with the cathode at the detector end of the column. Adsorption of humic acids to the capillary wall was diminished using an epoxy-coated capillary tube.

[Evaluation by users of hospitals which participate in the hospital quality program of the State of São Paulo, Brazil]. / Avaliação pelos usuários dos hospitais participantes do programa de qualidade hospitalar no Estado de São Paulo, Brasil.

INTRODUCTION: The Hospital Quality Program (HQP) in S. Paulo State, Southeastern Brazil, has been conducted by Medical Association of the S. Paulo State--"Associação Paulista de Medicina (APM)", since 1991. General and specialised, public and private hospitals have taken part in the HQP/APM. Such hospitals are evaluated by their users by means of the HQP-06 ("users' evaluation") questionnaire, with closed and open-ended questions for observations and suggestions. The results of the HQP-06 questionnaire of the HQP/APM are evaluated. MATERIAL AND METHODOLOGY: The 23,751 questionnaires (i.e., from 5.27% of all discharged patients), received by 66 hospitals during 1994, were analysed. The questionnaire flow, the quantity and quality of answers, the data from the closed of and open-ended answers and the comparison of closed and open-ended answers, were all taken into consideration in the analysed. RESULTS AND CONCLUSIONS: The following aspects were observed:-the importance of the direct flow of questionnaires from users to HQP/APM:-the need for HQP-06 to contain general items that permit a comparison between the hospitals concerned; the importance of the hospital staff being motivated to offer explanations when giving the questionnaires to users and the latters' being motivated to answer them with a view to the greater quantity and better quality of the answers:-in the hospitals of the HQP the user's evaluation presents a median of 4.32% (25%ile = 1.83% and 75%ile = 7.92%), and the number of questionnaires containing observations about the service as compared with the total presents a median of 42.11% (25%ile = 27.28% and 75%ile = 57.82%). Finally, hospital managements are recommended to take their users opinions into consideration with a view to obtaining feed-back and the continuous quality improvement of the hospitals of the HQP/APM.