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In the California compliance cap-and-trade carbon market, improved forest management (IFM) projects generate carbon credits in the initial reporting period if their initial carbon stocks are greater than a baseline. This baseline is informed by a "common practice" stocking value, which represents the average carbon stocks of surveyed privately owned forests that are classified into the same general forest type by the California Air Resources Board. Recent work has called attention to the need for more ecologically informed common practice carbon stocking values for IFM projects, particularly those in areas with sharp ecological gradients. Current methods for estimating common practice produce biases in baseline carbon values that lead to a clustering of IFM projects in geographical areas and ecosystem types that in fact support much greater forest carbon stocks than reflected in the common practice. This phenomenon compromises additionality, or the increases in carbon sequestration or decreases in carbon emissions that would not have occurred in the absence of carbon crediting. This study seeks to expand upon recent work on this topic and establish unbiased common practice estimates along sharp ecological gradients using methods that do not rely upon discrete forest classification. We generated common practice values for credited IFM projects in the Southern Cascades using a principal components analysis on species composition over an extensive forest inventory to determine the ecological similarity between inventoried forests and IFM project sites. Our findings strengthen the results of recent research suggesting common practice bias and adverse selection. At several sites, even after controlling for private ownership, 100% of the initial carbon stocks could be explained by ecological variables. This result means that improved management did not preserve or increase carbon stocks above what was typical, suggesting that no carbon offsets should have been issued for these sites. This result reveals greater bias than that been found at project sites in this region by research that has used discrete forest categorization.
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Ecossistema , Florestas , Sequestro de Carbono , Propriedade , Inquéritos e QuestionáriosRESUMO
China's South to North Water Diversion (SNWD) project connects portions of the Yangtze River in the south to the Yellow River system in the north, overcoming biogeographic barriers to water movement. The diversion will supply potable water to over 110 million people and provide multiple other socioeconomic benefits. However, an inadvertent negative impact of this connection includes creation of conduits for species invasions. Alligator weed (Alternanthera philoxeroides), water hyacinth (Eichhornia crassipes), and water lettuce (Pistia stratiotes) are the only aquatic plant species on China's shortlists for special control. These species are mainly invasive in the Yangtze River basin. If these species are able to invade the SNWD and further spread via the SNWD, they have the potential to alter water supply, including water quantity and quality, as well as local ecology and agriculture, threatening the goals of the diversion. Understanding the full potential for these species to invade northern China is critical to early management decisions to avoid costly negative impacts. We used Maxent modeling to evaluate the probability that each of these species might become invasive in the receiving water regions. The models predict that all three species will be able to expand their ranges northward, with alligator weed and water hyacinth having the greatest potential for range expansion. These results suggest the need for prevention, monitoring, and management strategies for these species to reduce the risk and costs of impacts.
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Eichhornia , Água , China , Rios , Abastecimento de ÁguaRESUMO
Regional consistency is necessary for carbon credit integrity.
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The voluntary carbon market needs to embrace changes for the land sector.
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INTRODUCTION: There are currently various fixation or suspension techniques for pelvic organ prolapse (POP) surgery. Laparoscopic colposacropexy is considered the gold standard. We present the surgical steps of the laparoscopic latero-abdominal colposuspension (LACS) technique and the preliminary results obtained. MATERIAL AND METHODS: Patients with anterior and/or apical compartment symptomatic POP undergoing LACS are included. The Baden-Walker scale, the Overactive Bladder Questionnaire-Short Form (OAB-q SF), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and the Patient Global Impression of Improvement (PGI-I) scale were used to assess the degree of prolapse, urinary filling and sexual symptoms and the level of satisfaction before and after surgery, respectively. Conventional laparoscopic material and a polyvinylidene fluoride (PVDF) mesh were used. RESULTS: Eighteen patients were included with a minimum follow-up time of 6months. The mean surgical time was 70.3±23.8min. Anatomic correction of prolapse was seen in all cases. Only one recurrence was detected. High levels of patient satisfaction were achieved. CONCLUSION: LACS allowed the anatomical reconstruction of the pelvic floor and proved to be a minimally invasive, fast, effective, safe and reproducible technique. More series are needed to evaluate its role against laparoscopic colposacropexy.
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Laparoscopia/métodos , Prolapso de Órgão Pélvico/cirurgia , Abdome , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos/métodos , VaginaRESUMO
We report a 62-year-old female liver transplant patient who presented with sirolimus (SIR)-related pneumonitis (SIP) treated with a switch to everolimus (EVER). At 13-month follow-up, the patient is on EVER monotherapy with no recurrence of SIP. Despite common mechanisms of action, the safety profile of EVER is different from SIR, and a switch from SIR to EVER should be contemplated in cases of SIP to allow patients to benefit from the antifibrotic properties of antiproliferative immunosuppressants.
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Imunossupressores/uso terapêutico , Transplante de Fígado/imunologia , Pneumonia/induzido quimicamente , Sirolimo/análogos & derivados , Sirolimo/efeitos adversos , Everolimo , Feminino , Humanos , Imunossupressores/efeitos adversos , Pessoa de Meia-Idade , Sirolimo/uso terapêutico , Resultado do TratamentoRESUMO
Pacemakers (PMs) and implantable cardioverter defibrillators (ICDs) have become life-saving therapeutic tools for patients with cardiac arrhythmia. Complications include thrombosis, embolism and infections at a highly variable rate. Surgical removal of the infected device has been perceived as the only way to guarantee a successful outcome and to reduce the high risk of mortality. Recently, a transvenous extraction method has been developed to remove infected intracardiac leads without sternotomy. This survey was designed to evaluate the outcome of an approach combining antibiotic therapy with non-surgical transvenous complete removal for the management of cardiac device infections (CDIs). We reviewed case-histories of 121 patients (105 with PM and 16 with ICD infections). The aim of our retrospective survey was to ascertain that a non-invasive transvenous complete removal of the infected devices is safe and effective when associated with appropriate antibiotic therapy starting 10 days before the procedure and extending to at least three weeks after. The infected devices were successfully removed in all patients with a non-surgical transvenous technique. The infections were most frequently caused by coagulase-negative staphylococci (70%), Staphylococcus aureus (14%), and Gram-negative rods (12%). Polymicrobial infections were documented in 19 patients and represent 16% of all device-related infections. The removal of the devices was done during antibiotic therapy, administered for a median of 26 days (range 23 to 45 days). Neither fatalities nor relapse of infections were recorded in the patient population during the one-year follow-up visits. According to our experience, CDIs can be treated with antibiotic therapy and non-surgical removal of the entire infected device, thus allowing a successful reimplantation. This procedure prevents recurrent infections and operative mortality.
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Antibacterianos/uso terapêutico , Infecções Bacterianas/terapia , Desfibriladores Implantáveis/efeitos adversos , Remoção de Dispositivo , Endocardite Bacteriana/terapia , Marca-Passo Artificial/efeitos adversos , Infecções Relacionadas à Prótese/terapia , Infecções Bacterianas/etiologia , Terapia Combinada , Endocardite Bacteriana/etiologia , Humanos , Testes de Sensibilidade Microbiana , Infecções Relacionadas à Prótese/etiologia , Estudos Retrospectivos , Resultado do TratamentoAssuntos
Agricultura , Conservação dos Recursos Naturais , Edição de Genes , Biotecnologia , Governo , Estados UnidosRESUMO
PURPOSE: To determine the actuarial incidence (AI) and relative risk (RR) of second solid malignancies (SSM; solid tumors and non-Hodgkin's lymphoma) in patients with Hodgkin's disease who were treated with chemotherapy and adjuvant, low-dose radiation (combined modality therapy; CMT). PATIENTS AND METHODS: From 1969 to 1983, 102 patients with previously untreated advanced Hodgkin's disease (group A) and 81 patients with recurrent disease after radiation (group B) were treated with CMT. Patients were observed for the development of solid tumors (ST) and non-Hodgkin's lymphoma (NHL), and the AI and RR were calculated. RESULTS: Nearly half of the patients entering remission were observed for greater than 15 years. At 20 years, the AI for SSM was 12% in group A versus 41% in group B (P = .009). The overall RR for developing a ST in group A was 1.88 (not significant) versus 8.84 in group B (95% confidence interval, 5.3 to 15.4). The difference in the RR between groups A and B was significant (P < .001). The RR for developing NHL was significantly increased in both groups, but the difference between groups was not significant. CONCLUSION: Previously untreated patients with advanced disease who were treated with CMT (group A) had a modest but not significant increase in the RR of ST; however, patients treated with CMT for recurrent disease (group B) had a highly significant increase in the RR of ST. Possible explanations for the increase in ST in group B include more cumulative radiation or a greater carcinogenic effect of chemotherapy in previously irradiated patients, but it also is possible that the increase is due to a longer follow-up time.
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Doença de Hodgkin/terapia , Segunda Neoplasia Primária/etiologia , Adolescente , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Terapia Combinada , Feminino , Seguimentos , Humanos , Incidência , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/etiologia , Masculino , Pessoa de Meia-Idade , Segunda Neoplasia Primária/epidemiologia , Distribuição de Poisson , Lesões por Radiação/epidemiologia , Lesões por Radiação/etiologia , Radioterapia/efeitos adversos , Dosagem Radioterapêutica , Recidiva , Indução de Remissão , Fatores de RiscoRESUMO
PURPOSE: Late solid tumors (STs) are a significant cause of morbidity and mortality in long-term survivors of Hodgkin's disease. To investigate the carcinogenic potential of two different therapeutic approaches, we measured the relative risk (RR) of STs in patients with early-stage disease cured after primary full-dose (approximately 40 Gy) radiation therapy (RT) and in patients with advanced disease who were treated with chemotherapy followed by low-dose (15 to 30 Gy) involved-field radiation (CMT). PATIENTS AND METHODS: Because therapy-induced STs generally begin after a latency period of 5 to 10 years, we restricted our analysis to patients treated before 1986 who achieved durable remissions. Patients who required salvage chemotherapy or who died of Hodgkin's disease were excluded from analysis. The RR of STs was calculated by dividing the observed number of cases by the expected number in a matched population from the Connecticut Tumor Registry. The actuarial incidence of STs was also measured. RESULTS: A total of 197 patients formed the RT group and 116 the CMT group. The median follow-up period in the RT group was 12.8 years, versus 13.5 years in the CMT group. The overall RR of STs in the CMT group was 1.5 (95% confidence interval [CI], 0.6 to 3.5; P = .122). There were no cases of lung or breast cancer. In the RT group, the overall RR of STs was 3.3 (95% CI, 2.0 to 5.3; P < .001). There were seven cases of lung cancer (RR = 10.8; 95% CI, 5.3 to 22.2; P < .001) and two cases of breast cancer (RR = 2; 95% CI, 0.6 to 7.4; P = .07). All six benign tumors occurred in the RT group. CONCLUSION: In patients cured by initial treatment for Hodgkin's disease, RT was associated with a statistically significant increase in STs, particularly lung cancer. CMT was not associated with a significant increase in STs. These data may have important implications for the design of newer therapies for early-stage Hodgkin's disease.
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Doença de Hodgkin/terapia , Segunda Neoplasia Primária/etiologia , Análise Atuarial , Adolescente , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Feminino , Seguimentos , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/radioterapia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/etiologia , Radioterapia/efeitos adversos , Dosagem Radioterapêutica , Radioterapia Adjuvante , Fatores de RiscoRESUMO
Ureteral obstruction can be secondary to a lot of reason. We present a uncommon case report of ureteral obstruction to Rosai-Dorfman disease. The form of clinic presentation is described, the diagnostic methods used and the therapeutic management.
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Histiocitose Sinusal/complicações , Obstrução Ureteral/etiologia , Adulto , Biópsia , Glucocorticoides/uso terapêutico , Histiocitose Sinusal/tratamento farmacológico , Histiocitose Sinusal/patologia , Humanos , Masculino , Prednisona/uso terapêutico , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Obstrução Ureteral/diagnóstico por imagem , Obstrução Ureteral/tratamento farmacológico , UreteroscopiaRESUMO
We present an uncommon case of retroperitoneal malignant schwannoma diagnosed accidentally. The clinical, diagnostic and therapeutic features are discussed.
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Neurilemoma/patologia , Neoplasias Retroperitoneais/patologia , Humanos , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia , Espaço Retroperitoneal/diagnóstico por imagem , Espaço Retroperitoneal/patologia , Espaço Retroperitoneal/cirurgia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Inverted papilloma of the upper urinary tract is a rare tumor and generally considered to be a benign. We present two cases of benign ureteral inverted papilloma. They were discovered after to study a upper urinary infection and a gross hematuria respectively. Both cases appear to be associated with asynchronous and synchronous bladder carcinoma, so it is very important a strict follow-up.
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Papiloma Invertido/patologia , Neoplasias Ureterais/patologia , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Nefrectomia/métodos , Papiloma Invertido/diagnóstico por imagem , Papiloma Invertido/cirurgia , Resultado do Tratamento , Ureter/diagnóstico por imagem , Ureter/patologia , Ureter/cirurgia , Neoplasias Ureterais/diagnóstico por imagem , Neoplasias Ureterais/cirurgia , UrografiaRESUMO
Urothelial inverted papilloma is usually a solitary lesion with rare recurrences. Its behaviour is unclear, its potential for recurrence or progression is not well-known. We present a case of inverted papilloma of the bladder with recurrence in prostatic urethra after four years of follow-up. We review etiology, clinical presentation, diagnose, treatment and the present discussion about its malignancy ability.
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Papiloma Invertido/patologia , Neoplasias Uretrais/patologia , Neoplasias da Bexiga Urinária/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade NeoplásicaRESUMO
This report describes a horse presenting ileal impaction that went through a right flank laparotomy procedure while standing. The decision to use this technique was made under the influence of several factors: the patient exhibited a calm temperament and demonstrated responsiveness to the analgesic treatment for pain control; the abdominal lesion was amenable to correction by a standing right flank approach. Also, the owner reported financial problems. Ileal obstruction was relieved successfully, and the horse recovery was satisfactory. This case highlights that, in specific cases of colic syndrome, the use of surgical procedures in the standing position might be a viable option and promote fast recovery.(AU)
Este relato de caso descreve um equino com compactação de íleo corrigida por laparotomia em estação pelo flanco direito. A decisão dessa abordagem foi influenciada por vários fatores: o paciente exibiu um temperamento calmo e demonstrou responsividade ao tratamento analgésico para controle da dor; a afecção intestinal em questão foi passível de correção pela abordagem pelo flanco direito em estação; e o proprietário relatou limitações financeiras. A desobstrução ileal foi realizada com sucesso e o cavalo apresentou recuperação satisfatória. Este caso destaca que, em casos específicos da síndrome de cólica, o uso de um procedimento em estação pode ser uma abordagem viável e promover uma rápida recuperação.(AU)
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Animais , Cavalos/cirurgia , Doenças do Íleo/veterinária , Íleo/cirurgia , Obstrução Intestinal/urina , Laparotomia/veterináriaRESUMO
This report describes a horse presenting ileal impaction that went through a right flank laparotomy procedure while standing. The decision to use this technique was made under the influence of several factors: the patient exhibited a calm temperament and demonstrated responsiveness to the analgesic treatment for pain control; the abdominal lesion was amenable to correction by a standing right flank approach. Also, the owner reported financial problems. Ileal obstruction was relieved successfully, and the horse recovery was satisfactory. This case highlights that, in specific cases of colic syndrome, the use of surgical procedures in the standing position might be a viable option and promote fast recovery.(AU)
Este relato de caso descreve um equino com compactação de íleo corrigida por laparotomia em estação pelo flanco direito. A decisão dessa abordagem foi influenciada por vários fatores: o paciente exibiu um temperamento calmo e demonstrou responsividade ao tratamento analgésico para controle da dor; a afecção intestinal em questão foi passível de correção pela abordagem pelo flanco direito em estação; e o proprietário relatou limitações financeiras. A desobstrução ileal foi realizada com sucesso e o cavalo apresentou recuperação satisfatória. Este caso destaca que, em casos específicos da síndrome de cólica, o uso de um procedimento em estação pode ser uma abordagem viável e promover uma rápida recuperação.(AU)
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Animais , Cavalos/cirurgia , Doenças do Íleo/veterinária , Íleo/cirurgia , Obstrução Intestinal/urina , Laparotomia/veterináriaRESUMO
The Sea Level Affecting Marshes Model (SLAMM) was applied at six major estuaries along Florida's Gulf Coast (Pensacola Bay, St. Andrews/Choctawhatchee Bays, Apalachicola Bay, Southern Big Bend, Tampa Bay and Charlotte Harbor) to provide quantitative and spatial information on how coastal ecosystems may change with sea level rise (SLR) and to identify how this information can be used to inform adaption planning. High resolution LiDAR-derived elevation data was utilized under three SLR scenarios: 0.7 m, 1 m and 2 m through the year 2100 and uncertainty analyses were conducted on selected input parameters at three sites. Results indicate that the extent, spatial orientation and relative composition of coastal ecosystems at the study areas may substantially change with SLR. Under the 1 m SLR scenario, total predicted impacts for all study areas indicate that coastal forest (-69,308 ha; -18%), undeveloped dry land (-28,444 ha; -2%) and tidal flat (-25,556 ha; -47%) will likely face the greatest loss in cover by the year 2100. The largest potential gains in cover were predicted for saltmarsh (+32,922 ha; +88%), transitional saltmarsh (+23,645 ha; na) and mangrove forest (+12,583 ha; +40%). The Charlotte Harbor and Tampa Bay study areas were predicted to experience the greatest net loss in coastal wetlands The uncertainty analyses revealed low to moderate changes in results when some numerical SLAMM input parameters were varied highlighting the value of collecting long-term sedimentation, accretion and erosion data to improve SLAMM precision. The changes predicted by SLAMM will affect exposure of adjacent human communities to coastal hazards and ecosystem functions potentially resulting in impacts to property values, infrastructure investment and insurance rates. The results and process presented here can be used as a guide for communities vulnerable to SLR to identify and prioritize adaptation strategies that slow and/or accommodate the changes underway.
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Baías , Conservação dos Recursos Naturais/métodos , Ecossistema , Estuários , Áreas Alagadas , Aclimatação , Mudança Climática , Conservação dos Recursos Naturais/tendências , Florida , Geografia , Humanos , Modelos TeóricosRESUMO
RESUMEN Objetivo. Determinar la seroprevalencia y los factores epidemiológicos asociados a Mycobacterium avium subsp Paratuberculosis (MAP) en dos razas de bovinos criollos del centro de investigación AGROSAVIA-Turipaná. Materiales y métodos. Se realizó un estudio epidemiológico de corte transversal. Fueron muestreados 848 bovinos criollos, 403 Romosinuanos y 445 costeño con cuernos (CCC); para el diagnóstico serológico de anticuerpos se utilizó la prueba Elisa Indirecta mediante el kit comercial Parachek® de Prionics. Las variables sexo, edad, raza y tipo de hato fueron los factores epidemiológicos evaluados y correlacionados con la presencia de anticuerpos contra MAP; la asociación estadística fue determinada mediante Odds Ratio y con un modelo multivariado de regresión logística, utilizando un nivel de significancia con p<0.05. Resultados. La seroprevalencia general de los bovinos criollos a MAP fue de 2.35% (IC 95%, 1.34-3.38); sin embargo, en los Romosinuano fue de 0.74% y en los CCC fue de 3.82%, siendo las diferencias estadísticamente significativas (valor p=0.003). También, empleando un análisis univariado, fueron más afectados las hembras y los animales mayores a un año. El análisis multivariado identificó como factores epidemiológicos las variables raza y sexo. Conclusiones. En las razas criollas del centro de investigación AGROSAVIA-Turipaná, la seroprevalencia a MAP fue baja; sin embargo, en la raza CCC el riesgo de contraer la enfermedad es seis veces mayor con relación a la raza Romosinuano. Más aún, se pudo evidenciar que las hembras tienen mayor riesgo de adquirir la enfermedad.
ABSTRACT Objective. Determine the seroprevalence and epidemiological factors associated with Mycobacterium avium subsp. paratuberculosis (MAP) in two Creole cattle breeds of the Turipaná research center -AGROSAVIA. Materials and methods. A cross-sectional epidemiological study was conducted,a total of 848 Creole bovine animals were sampled, 403 Romosinuano and 445 costeño con cuernos (CCC); for the serological diagnosis of antibodies, the Elisa Indirect test was used with the commercial kit Parachek®2 by Prionics. The variables sex, age, breed and herd type were the epidemiological factors evaluated and correlated with the presence of antibodies against MAP; the statistical association was established using the Odds Ratio and a multivariate logistic regression model, employing a significance level with p<0.05. Results. The general seroprevalence of the Creole cattle to MAP was 2.35% (95% CI, 1.34-3.38); however, in the Romosinuano it was 0.74% and in the CCC it was 3.82%, being this difference statistically significant (p=0.003). Furthermore, employing a univariate way analysis, females and animals older than one year of age were more affected. The multivariate analysis identified the breed and sex variables as epidemiological factors. Conclusions. In the Creole breeds of the AGROSAVIA-Turipaná research center, MAP seroprevalence was low; however, in the Costeño Con Cuernos breed, the risk of contracting the disease is six times higher than in the Romosinuano breed. Moreover, it was shown that females have a higher risk of acquiring the disease.
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Animais , Bovinos , Paratuberculose , Bovinos , Testes Sorológicos , Mycobacterium avium subsp. paratuberculosisRESUMO
This is a prospective study designed to determine the toxicity, efficacy and antileukemic effect of high-dose cytosine arabinoside (ara-C), cyclophosphamide and total body irradiation (TBI) as a myeloablative regimen prior to allogeneic bone marrow transplantation for patients with hematologic malignancies. Fifty-eight patients with hematologic malignancies were treated with cyclophosphamide, high-dose ara-C and total body irradiation (TBI) followed by allogeneic bone marrow transplantation. Fifty patients had good prognosis disease and eight had poor prognosis disease. Cyclosporine and short-course methotrexate were used for graft-versus-host disease (GVHD) prophylaxis. The conditioning regimen consisted of ara-C 3000 mg/m2 twice a day x six doses on days -7, -6, and -5; cyclophosphamide 1800 mg/m2 on days -4 and -3; and TBI 1400 cGy midline dose at 5 cGy/min in eight total fractions administered twice a day on days -4, -3, -2, and -1. The bone marrow was infused on day 0 (zero). Toxicity related to the conditioning regimen was comparable to that reported with other conditioning regimens, except for diarrhea which appears to be more frequent. The actuarial survival at 1 year was 69% (58-82) and at 5 years was 54% (42-69) with the numbers in parentheses representing the 95% confidence interval of the Kaplan-Meier estimate. After a median follow-up of 28 months, 31 of 58 (53%) patients are alive without evidence of disease. Only four of the 58 patients (7%) have relapsed. Cyclophosphamide, ara-C and TBI is a safe and effective myeloablative regimen for patients with leukemia. The overall relapse rate in our study was 7% with a median follow-up of 28 months and appears to be lower than relapse rates reported in other series. This is probably due to the added antileukemic effect of ara-C. This regimen should be compared with other myeloablative regimens in a controlled study.