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Once established within a water resource, harmful algal blooms (HABs) can occur seasonally with an intense and rapid onset, giving water resource managers limited time to respond to lessen risks. An attractive strategy to decrease human, ecological, and economic risks from HABs is to implement proactive algaecide treatments applied to overwintering cyanobacteria (i.e., akinetes and quiescent vegetative cells) in sediments prior to the formation of a HAB; however, this approach is novel and very limited efficacy data exist. Therefore, the specific objectives of this research were to 1) evaluate copper- and peroxide-based algaecides, applied as single and repeat treatments at the bench scale, to identify effective proactive treatments, and 2) compare correlations between cell density and other response measurements (i.e., in vivo chlorophyll a and phycocyanin concentrations and percent benthic coverage), to identify informative metrics to assess overwintering cyanobacteria responses. Twelve treatment scenarios using copper- and peroxide-based algaecides were applied to sediments containing overwintering cyanobacteria prior to a 14 d incubation under favorable growth conditions. Responses of cyanobacteria in the planktonic (i.e., cell density, in vivo chlorophyll a and phycocyanin concentrations) and benthic (percent coverage) phases after a 14 d incubation were evaluated in treatments and controls. The HAB-forming cyanobacteria present after a 14 d incubation were: Aphanizomenon, Dolichospermum, Microcystis, Nostoc, and Planktonthrix. Successive treatments of copper sulfate (CuSulfate) followed by sodium carbonate peroxyhydrate (PeroxiSolid) (second algaecide applied after 24 h) as well as repeat applications of a single algaecide, PeroxiSolid (second treatment applied after 24 h) resulted in statistically significant (p ≤ 0.05; α = 0.05) declines in cell density relative to untreated controls. Planktonic cyanobacteria responses measured in terms of phycocyanin concentrations were strongly correlated with cyanobacteria density measurements (Pearson's correlation coefficient (r) = 0.89). Chlorophyll a concentrations and percent benthic coverage did not correlate with planktonic cyanobacteria density measurements (r = 0.37 and -0.49, respectively) and therefore, were unreliable metrics for cyanobacterial responses in this study. These data provide initial evidence of the efficacy of algaecides for treating overwintering cells in sediments and contribute to our overarching hypothesis that proactive treatments may delay the onset and intensity of HABs in impacted waterbodies.
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This is the first investigation of the bioavailability of PCBs associated with paint chips (PC) dispersed in sediment. Bioavailability of PCB-containing PC in sediment was measured using ex situ polyethylene passive samplers (PS) and compared to that of PCBs from field-collected sediments. PC were mixed in freshwater sediment from a relatively uncontaminated site with no known PCB contamination sources and from a contaminated site with non-paint PCB sources. PC < 0.045 mm generated concentrations in the PS over one order of magnitude higher than coarser chips. The bioavailable fraction was represented by the polymer-sediment accumulation factor (PSAF), defined as the ratio of the PCB concentrations in the PS and organic carbon normalized sediment. The PSAF was similar for both field sediments. The PSAFs for the field sediments were ~ 50-60 and ~ 5 times higher than for the relatively uncontaminated sediment amended with PC for the size fractions 0.25-0.3 mm and < 0.045 mm, respectively. These results indicate much lower bioavailability for PCBs associated with PC compared to PCBs associated with field-collected sediment. Such information is essential for risk assessment and remediation decision-making for sites where contamination from non-paint PCBs sources is co-located with PCB PC.
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Bifenilos Policlorados , Poluentes Químicos da Água , Arocloros , Disponibilidade Biológica , Monitoramento Ambiental , Sedimentos Geológicos , Pintura , Bifenilos Policlorados/análise , Poluentes Químicos da Água/análiseRESUMO
Blasting used in construction of waterborne infrastructure may impact fish eggs in adjacent spawning habitats through introduction of mechanical vibrations as peak particle velocities (PPV). However, there are limited studies applying risk-based approaches to evaluate and mitigate these impacts. A navigation improvement project in the Soo Locks near the St. Marys Rapids provided an opportunity to evaluate existing data to inform blasting risks to fish eggs. To assess this risk, existing data were used to calculate species sensitivity distributions that were used to estimate a hazardous concentration for 5% of the salmon and trout species evaluated (HC5) and predicted no effect concentrations (PNEC). The HC5 ranged from 14.0 to 89.2 cm/s PPV, and the 'safe level' PNEC thresholds ranged from 2.8 to 17.8 cm/s PPV. This study provides a demonstration of how a risk-based approach can be effectively used to assess and manage dry blasting effects on underwater biota.
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Ecossistema , Óvulo , Salmão , Truta , Animais , Efeitos AntropogênicosRESUMO
The potential bioaccumulation of sediment-associated contaminants is one of the primary concerns associated with the aquatic placement of dredged sediment. Laboratory bioaccumulation tests with representative infaunal organisms exposed to dredged sediment and reference sediment are used to assess the potential for contaminant-related bioaccumulation impacts. Dredged sediment testing and evaluation guidance provides statistical inferences and numerous assessment factors (e.g., the magnitude of difference (MOD)) to interpret results; however, detailed information for applying these factors is lacking. Therefore, the focus of this work was to provide context for the application of the MOD as a line of evidence for evaluating bioaccumulation risk associated with dredged material placement in aquatic environments by considering variance (as coefficient of variation (CV)), MOD, and statistical differences associated with bioaccumulation bioassay tissue concentrations in three case studies. Based on peer-reviewed data and dredged material monitoring data, relatively low within-sample variability (CVs < 50%) of tissue concentrations can be achieved for commonly assessed constituents (e.g., polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), metals, and butyl tins). Thus, statistical comparisons were generally able to detect significant differences (p < 0.05; α = 0.05) across tissue concentrations with relatively low MODs (< 2-fold difference). Based on the observed variance, MOD, and statistical differences associated with bioaccumulation bioassay tissue concentrations, a 2-fold MOD can provide an additional line of evidence to evaluate bioaccumulative risk when statistical significance is observed. These results indicated that a judicious consideration of the sample variance and MOD is a useful factor when discerning meaningful differences among contaminant tissue concentrations.
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Bioacumulação , Sedimentos Geológicos/química , Poluentes Químicos da Água , Monitoramento Ambiental , Bifenilos Policlorados , Hidrocarbonetos Policíclicos AromáticosRESUMO
Given the reported extent of microplastics in the aquatic environment, environmentally relevant exposure information for sediments dredged by the US Army Corps of Engineers will lend context to the risks posed by this contaminant during dredging. We measured the occurrence, abundance, and polymer composition of microplastics in sediments collected from nine dredged waterways and two non-dredged reference areas. The number of particles in sediment samples ranged from 162 to 6110 particles/kg dry wt., with a mean of 1636 particles/kg dry wt. Fragments were the most prevalent shape observed among the 11 study sites (100% frequency of occurrence), followed by fibers (81%), spheres (75%), foams (38%) and films (34%). Based on analyses of chemical composition of the particles using Fourier transform infrared spectroscopy, polyethylene:propylene was the most common polymer type observed. Consistent with results presented by other investigators, microplastic concentrations and polymer types in bottom sediments in this study were also aligned with the most widely used plastics worldwide.
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Monitoramento Ambiental/métodos , Água Doce/química , Sedimentos Geológicos/química , Microplásticos/análise , Água do Mar/química , Poluentes Químicos da Água/análise , Espectroscopia de Infravermelho com Transformada de Fourier , Inquéritos e Questionários , Estados UnidosRESUMO
Energy-derived waters containing naphthenic acids (NAs) are complex mixtures often comprising a suite of potentially problematic constituents (e.g. organics, metals, and metalloids) that need treatment prior to beneficial use, including release to receiving aquatic systems. It has previously been suggested that NAs can have biostatic or biocidal properties that could inhibit microbially driven processes (e.g. dissimilatory sulfate reduction) used to transfer or transform metals in passive treatment systems (i.e. constructed wetlands). The overall objective of this study was to measure the effects of a commercially available (Fluka) NA on sulfate-reducing bacteria (SRB), production of sulfides (as acid-volatile sulfides [AVS]), and precipitation of divalent metals (i.e. Cu, Ni, Zn). These endpoints were assessed following 21-d aqueous exposures of NAs using bench-scale reactors. After 21-days, AVS molar concentrations were not statistically different (p<0.0001; α=0.05) among NA treatments (10, 20, 40, 60, and 80mg NA/L) and an untreated control (no NAs). Extent of AVS production was sufficient in all NA treatments to achieve ∑SEM:AVS <1, indicating that conditions were conducive for treatment of metals, with sulfide ligands in excess of SEM (Cu, Ni, and Zn). In addition, no adverse effects to SRB (in terms of density, relative abundance, and diversity) were measured following exposures of a commercial NA. In this bench-scale study, dissimilatory sulfate reduction and subsequent metal precipitation were not vulnerable to NAs, indicating passive treatment systems utilizing sulfide production (AVS) could be used to treat metals occurring in NAs affected waters.
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To make informed decisions regarding management of noxious algal growths, water resource managers require information on responses of target and non-target species to algaecide exposures. Periodic treatments of Phycomycin®-SCP (sodium carbonate peroxyhydrate) followed by Algimycin®-PWF (gluconate and citrate chelated copper) to control Lyngbya wollei growths for ten years provided an opportunity for a risk evaluation of treated coves in Lay Lake, AL. Abiotic sediment characteristics (acid soluble copper concentrations, acid volatile sulfides, percent organic matter and cation exchange capacity) and survival of Hyalella azteca and Chironomus dilutus were measured in sediment samples from treated and untreated coves to assess the bioavailability of potential copper-residuals. In laboratory studies to seek a more effective approach for managing the growth of Lyngbya, six algaecide treatments consisting of combinations of copper-based algaecides (Cutrine®-Ultra, Clearigate® and Algimycin®- PWF), a hydrogen peroxide based algaecide (Phycomycin®-SCP) and an adjuvant (Cide-Kick II) were assessed for efficacy in controlling L. wollei sampled from Lay Lake. The most efficient algaecide treatment was determined based on post-treatment algal wet weight and visual observations of responses to exposures. To estimate the margin of safety for non-target organisms, Pimephales promelas was exposed to the most efficacious treatment and a treatment of Phycomycin®-SCP followed by Algimycin®-PWF. Results from sediment experiments demonstrated that there were no measureable copper residuals and no adverse effects on H. azteca and C. dilutus from sediments following ten years of copper-based algaecide treatments. Based on the laboratory results, a treatment of Phycomycin®-SCP at 10.1 mg H2O2/L followed by Cide-Kick II at 0.2 mg/L and Algimycin®- PWF at 0.26 mg Cu/L could control the growth of Lyngbya wollei from Lay Lake, AL and enhance the margin of safety for non-target species (e.g. P. promelas).
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Chironomidae/efeitos dos fármacos , Cianobactérias/efeitos dos fármacos , Proliferação Nociva de Algas/efeitos dos fármacos , Herbicidas/toxicidade , Poluentes Químicos da Água/toxicidade , Anfípodes/efeitos dos fármacos , Animais , Cobre/análise , Cobre/toxicidade , Sulfato de Cobre/toxicidade , Etanolaminas/toxicidade , Peróxido de Hidrogênio/toxicidade , Lagos , Compostos Organometálicos/toxicidade , Sulfetos/análise , Água/química , Poluentes Químicos da Água/análiseRESUMO
In major harbors and ports in the United States and its territories, the US Army Corps of Engineers maintains federal navigation channels in proximity to coral reefs (e.g., Honolulu Harbor, HI; Miami Harbor, FL; Apra Harbor, Guam) and other sensitive habitats. To effectively predict potential adverse impacts from dredging activities near these sensitive habitats, a holistic approach to improve understanding of the pressures on these habitats is needed to foster a more complete prediction of risk drivers. To achieve this, risk-based frameworks that account for the full range of natural and anthropogenic impacts need to be adapted and applied specifically for assessing and managing indirect dredging impacts on sensitive environments. In this article, we address this need by incorporating a drivers-pressures-stressors-condition-response (DPSCR4 ) conceptual framework to broaden a comprehensive conceptual model of the coupled human-ecological system. To help understand these complex interactions, DPSCR4 was applied to evaluate dredging and other unrelated environmental pressures (e.g., terrestrial runoff) in a proof-of-concept dredging project in Honolulu Harbor, Hawai'i, USA, with a focus on the indirect effects of dredge plumes. Particle tracking models and risk-based tools were used to evaluate sediment resuspended during a hypothetical mechanical dredging activity near sensitive coral habitats. Stoplight indicators were developed to predict indirect sediment plume impacts on coral and then compared to exposure modeling results. The strengths and limitations of the approach are presented and the incorporation of the risk framework into environmental management decisions is discussed. Integr Environ Assess Manag 2024;20:547-561. Published 2023. This article is a U.S. Government work and is in the public domain in the USA.
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Antozoários , Recifes de Corais , Animais , Humanos , Havaí , Monitoramento Ambiental/métodos , Sedimentos Geológicos , Ecossistema , Antozoários/fisiologiaRESUMO
Incidental findings (IFs) in the head & neck are a frequent challenge to the reporting radiologist. A combination of complex anatomy, widely varied imaging techniques and the high prevalence of benign pathology, makes safe and appropriate management of head & neck IFs problematic. The non-head & neck radiologist is unlikely to have prior personal experience of the relevant specialties or current involvement with the pertinent multidisciplinary teams, creating unfamiliarity with both the clinical aspects of head & neck disease and the value of examination techniques. This triumvirate of complex anatomy, pathology and imaging creates the perfect environment for excessive investigation and overdiagnosis. In this article, the most frequently encountered and clinically relevant head & neck IFs are summarised. To reflect daily clinical practice, we will firstly consider anatomic abnormalities identified on cross-sectional imaging and ultrasound, followed by a review of PET-CT incidental findings.
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Neoplasias de Cabeça e Pescoço , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Pescoço/diagnóstico por imagem , Cabeça/diagnóstico por imagem , Ultrassonografia , Achados Incidentais , Neoplasias de Cabeça e Pescoço/diagnóstico por imagemRESUMO
Despite the evolution over the last half century of regulatory programs and frameworks developed for the evaluation of safety and management of risks associated with chemicals and materials, new and emerging contaminant issues continue to be identified. These recurring issues suggest a need for review and reflection on current approaches and strategies for ensuring the safety of chemicals and materials. Twelve existing frameworks relating to the evaluation and management of chemical or material risk were reviewed to identify potential process improvements for facilitating early identification of potentially problematic substances and better inform risk management strategies (e.g., prohibition, restricted use, or selection of safer alternatives). The frameworks were selected to represent a broad spectrum of regional, national, and international authorities and purposes, including preproduction evaluation of new substances, classification and hazard communication, identification of persistent pollutants, and identification of safer alternatives. Elements common to the frameworks were identified, as well as features unique to select frameworks. A comparative evaluation was performed, and potential new strategies and approaches were identified to inform process improvement recommendations. These recommendations include requiring validated analytical procedures to enable measurement in environmental media, improved data transparency and accessibility, flexibility to incorporate advances into the state of the practice (e.g., new approach methodologies and high-throughput assessment tools), and incorporation of monitoring and adaptive management strategies to enable more timely intervention. Process improvement recommendations are discussed and summarized in a conceptual risk management framework. Integr Environ Assess Manag 2023;19:1192-1206. © 2022 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC). This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.
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Ecotoxicologia , Poluentes Ambientais , Humanos , Gestão de Riscos , Poluentes Ambientais/análise , Medição de Risco/métodosRESUMO
OBJECTIVE: Advanced laryngeal cancers are clinically complex; there is a paucity of modern decision-making models to guide tumour-specific management. This pilot study aims to identify computed tomography-based radiomic features that may predict survival and enhance prognostication. METHODS: Pre-biopsy, contrast-enhanced computed tomography scans were assembled from a retrospective cohort (n = 72) with advanced laryngeal cancers (T3 and T4). The LIFEx software was used for radiomic feature extraction. Two features: shape compacity (irregularity of tumour volume) and grey-level zone length matrix - grey-level non-uniformity (tumour heterogeneity) were selected via least absolute shrinkage and selection operator-based Cox regression and explored for prognostic potential. RESULTS: A greater shape compacity (hazard ratio 2.89) and grey-level zone length matrix - grey-level non-uniformity (hazard ratio 1.64) were significantly associated with worse 5-year disease-specific survival (p < 0.05). Cox regression models yielded a superior C-index when incorporating radiomic features (0.759) versus clinicopathological variables alone (0.655). CONCLUSIONS: Two radiomic features were identified as independent prognostic biomarkers. A multi-centre prospective study is necessary for further exploration. Integrated radiomic models may refine the treatment of advanced laryngeal cancers.
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Coastal Louisiana (USA) continues to sustain immense land and habitat losses due to subsidence, sea-level rise, and storm events. Approximately 65 million m3 (85 million cubic yards) of sediment is dredged annually from Gulf Coast federal navigation channels to maintain safe waterway passage. The beneficial use of these sediments continues to increase, and now this sediment is recognized as a critical resource in large-scale (estimated multibillion dollar) ecosystem restoration efforts to mitigate land and habitat losses along the US Gulf Coast. However, the documentation of restoration benefits where dredged sediments are the primary resource is lacking, which limits the potential for future applications. Therefore, this study documents the progress to restore marsh habitat and the resultant benefits in West Bay, Louisiana, and investigates how the restoration practices align with principles of the US Army Corps of Engineers (USACE) Engineering with Nature® (EWN® ) and UN Sustainable Development Goals (UN SDGs). West Bay, a 4964-ha subdelta adjacent to the Mississippi River, typifies risks of coastal land loss that also threatens the integrity of the adjacent federal navigation channel. To help restore coastal marsh habitat on a large spatial and temporal scale, the USACE constructed an uncontrolled diversionary channel from the Mississippi River and with subsequent direct and strategic placement of dredged sediment. Restoration performance was assessed through remotely sensed methods using data spanning approximately 70 years. To date, placement of dredged sediment in the bay has facilitated the creation of over 800 ha of new land in the formerly open waters of West Bay. The West Bay restoration project aligns with the principles of the EWN initiative, which supports more sustainable practices to deliver economic, environmental, and social benefits through collaborative processes and meaningfully integrates 10 of the UN SDGs designed to achieve a better and more sustainable future. Integr Environ Assess Manag 2022;18:1162-1173. Published 2021. This article is a U.S. Government work and is in the public domain in the USA.
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Ecossistema , Áreas Alagadas , Engenharia , Sedimentos Geológicos , RiosRESUMO
OBJECTIVE: To compare the outcomes and evaluate the relative risk of thyroid cancer by using the UK thyroid fine-needle aspiration (FNA) cytological diagnostic categories, with the main objective being the clarity of patient management. STUDY DESIGN: Results of thyroid FNA reported as Thy3a, Thy3f, Thy4, and Thy5 were correlated with histological outcomes. The specificity and positive predictive value (PPV; risk of malignancy) for each reporting category was assessed. RESULTS: Of a total of 873 thyroid FNAs, 237 (27%) were reported as 'abnormal': 40 (4.6%) as Thy3a, 119 (13.6%) as Thy3f, 20 (2.2%) as Thy4, and 58 (6.6%) as Thy 5. The final outcomes were available in 136 (57%) cases which underwent surgical resection (25, 60, 55, and 74% of Thy3a, Thy3f, Thy4, and Thy5, respectively). The known outcomes of the Thy3a category were too low to be statistically significant. The specificity and PPV of the Thy3f, Thy4, and Thy5 (equivalent to the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) IV, V, and VI) categories were 50, 50, and 100% and 28, 64, and 100%, respectively. The PPV of Thy3f for diagnosis of 'neoplasms' (benign and malignant) was 63%. CONCLUSION: The current thyroid FNA classification system used in the UK, which is comparable to TBSRTC, offers a sound basis for clear communication on which the management of patients with abnormal thyroid FNA findings can be based. Categories Thy3f, Thy4, and Thy5 carry a progressively rising risk of malignancy, justifying their continuing use. Diagnostic category Thy5 'malignant' is robust and can be used as a sure indication of a definitive surgical management.
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Biópsia por Agulha Fina , Transformação Celular Neoplásica/patologia , Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Gerenciamento Clínico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Valor Preditivo dos Testes , Prognóstico , Risco , Terminologia como Assunto , Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/classificação , Nódulo da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia , Reino UnidoRESUMO
OBJECTIVES: Radiomics is the conversion of medical images into quantitative high-dimensional data. Laryngeal cancer, one of the most common head and neck cancers, has risen globally by 58.7%. CT, MRI and PET are acquired during the diagnostic process providing potential data for radiomic analysis and correlation with outcomes.This review aims to examine the applications of this technique to laryngeal cancer and the future considerations for translation into clinical practice. METHODS: A comprehensive systematic review-informed search of the MEDLINE and EMBASE databases was undertaken. Keywords "laryngeal cancer" OR "larynx" OR "larynx cancer" OR "head and neck cancer" were combined with "radiomic" OR "signature" OR "machine learning" OR "artificial intelligence". Additional articles were obtained from bibliographies using the "snowball method". RESULTS: The included studies (n = 15) demonstrated that radiomic features are significantly associated with various clinical outcomes (including stage, overall survival, treatment response, progression-free survival) and that predictive models incorporating radiomic features are superior to those that do not. Two studies demonstrated radiomics could improve laryngeal cancer staging whilst 12 studies affirmed its predictive capability for clinical outcomes. CONCLUSIONS: Radiomics has potential for improving multiple aspects of laryngeal cancer care; however, the heterogeneous cohorts and lack of data on laryngeal cancer exclusively inhibits firm conclusions. Large prospective well-designed studies in laryngeal cancer are required to progress this field. Furthermore, to implement radiomics into clinical practice, a unified research effort is required to standardise radiomics practice. ADVANCES IN KNOWLEDGE: This review has highlighted the value of radiomics in enhancing laryngeal cancer care (including staging, prognosis and predicting treatment response).
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Interpretação de Imagem Assistida por Computador/métodos , Neoplasias Laríngeas/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada por Raios X/métodos , Humanos , Laringe/diagnóstico por imagem , Aprendizado de MáquinaRESUMO
There is an increasing international focus to understand and quantify the potential ecological risks of low-frequency underwater sounds produced from anthropogenic activities (e.g., commercial shipping, dredging, construction, and offshore energy production). For dredge operations, a risk-based approach has been proposed for identifying, assessing, and managing risks; however, specific details of the framework and demonstration of the approach are lacking. Thus, the goal of this study was to provide a practical, concise, and reliable framework for assessing the effects of dredging sounds on aquatic life. The specific objectives were to 1) further specify a risk assessment approach for assessing underwater sounds from dredging operations, 2) demonstrate the utility of the approach in practice using a case study, and 3) document the strengths and challenges of the approach. The risk framework was adapted for underwater sounds to include a project formulation step, an analysis step to analyze and assess exposure and biological responses, a risk characterization process in which the preceding steps are integrated and uncertainty is addressed, and a risk management step. A key beneficial component of this framework is the use of a phased approach, whereby a screening step offers a process that utilizes existing or readily available information to evaluate risk. In general, a limitation of evaluating risks due to dredge operations is the degree of uncertainty surrounding effect thresholds for many marine species; however, this approach emphasizes the importance of documenting and communicating uncertainty to regulators, stakeholders, and practitioners in the decision-making process. A case study example is included to illustrate how the framework can be applied in practice. The primary strength of this method is the intrinsic flexibility of the framework to adapt as the scientific understanding improves and new data become available in the rapidly evolving field of underwater acoustics. Integr Environ Assess Manag 2020;16:481-493. © 2020 SETAC.
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Acústica , Medição de Risco , Som , Sedimentos Geológicos , Gestão de Riscos , NaviosRESUMO
1. This review summarises knowledge on the ecology, toxin production, and impacts of toxic freshwater benthic cyanobacterial proliferations. It documents monitoring, management, and sampling strategies, and explores mitigation options. 2. Toxic proliferations of freshwater benthic cyanobacteria (taxa that grow attached to substrates) occur in streams, rivers, lakes, and thermal and meltwater ponds, and have been reported in 19 countries. Anatoxin- and microcystin-containing mats are most commonly reported (eight and 10 countries, respectively). 3. Studies exploring factors that promote toxic benthic cyanobacterial proliferations are limited to a few species and habitats. There is a hierarchy of importance in environmental and biological factors that regulate proliferations with variables such as flow (rivers), fine sediment deposition, nutrients, associated microbes, and grazing identified as key drivers. Regulating factors differ among colonisation, expansion, and dispersal phases. 4. New -omics-based approaches are providing novel insights into the physiological attributes of benthic cyanobacteria and the role of associated microorganisms in facilitating their proliferation. 5. Proliferations are commonly comprised of both toxic and non-toxic strains, and the relative proportion of these is the key factor contributing to the overall toxin content of each mat. 6. While these events are becoming more commonly reported globally, we currently lack standardised approaches to detect, monitor, and manage this emerging health issue. To solve these critical gaps, global collaborations are needed to facilitate the rapid transfer of knowledge and promote the development of standardised techniques that can be applied to diverse habitats and species, and ultimately lead to improved management.
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Doenças das Glândulas Salivares/diagnóstico , Doenças das Glândulas Salivares/terapia , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Biópsia por Agulha Fina , Diagnóstico por Imagem , Humanos , Infecções/complicações , Infecções/tratamento farmacológico , Litotripsia , Complicações Pós-Operatórias , Radioterapia Adjuvante , Encaminhamento e Consulta , Doenças das Glândulas Salivares/epidemiologia , Glândulas Salivares/patologia , Glândulas Salivares/cirurgia , SialografiaRESUMO
BACKGROUND: The purpose of this study was to identify the role of transoral robotic surgery (TORS) in the management of residual and recurrent oropharyngeal cancer. METHODS: IDEAL (Idea, Development, Exploration, Assessment, Long-term Follow-up) 2a framework. RESULTS: Of 26 patients assessed for TORS, 21 underwent the procedure, 5 underwent open resection (4 due to unsuitable anatomy/tumor extent and 1 on the basis of patient choice). Three patients underwent intraoperative ultrasound-assisted robotic resection, and 3 received robotic-assisted free flap inset. A technical refinement for TORS of residual and recurrent oropharyngeal cancer of the tongue base is described. Actuarial plots showed estimated overall survival of 48.2%, local control of 76.6%, and disease-specific survival of 77.1% at 42.6 months. CONCLUSION: TORS is a valid management option for residual and recurrent oropharyngeal cancer. Oncologic outcomes are comparable to open surgery and transoral laser microsurgery, with the added advantages of en bloc resections, facility for intraoperative ultrasound imaging, and inset of free flaps without mandibular split.
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Cirurgia Endoscópica por Orifício Natural/métodos , Neoplasias Orofaríngeas/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Idoso , Idoso de 80 Anos ou mais , Deglutição/fisiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Neoplasias Orofaríngeas/mortalidade , Neoplasias Orofaríngeas/patologia , Recuperação de Função Fisiológica , Resultado do TratamentoRESUMO
Breast cancer among men is rare and accounts for < 1% of all breast cancer diagnoses. We report a 75-year-old man who presented with a painless breast lump and was found to have 2 separate foci of cancer in the same breast. Several cases of bilateral male breast cancer exist in the literature, but we are not aware of any previous reports of multifocal male breast cancer. Key issues surrounding the diagnosis and treatment of multifocal male breast cancer are discussed.
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Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama Masculina/diagnóstico , Neoplasias da Mama Masculina/terapia , Tamoxifeno/uso terapêutico , Idoso , Quimioterapia Adjuvante , Humanos , MasculinoRESUMO
Copper exposures from algaecide applications in aquatic systems are hypothesized to impede bacterial degradation of microcystin (MC), a cyanobacterial produced hepatotoxin. Despite regulatory implications of this hypothesis, limited data exist on influences of copper-exposures on MC-degrading bacteria and consequent MC-degradation. In this study, influences of copper-algaecide concentrations and formulations on bacterial composition and microcystin-LR (MCLR) degradation were investigated. Microcystis aeruginosa was exposed to four concentrations (0-5.0 mg Cu L-1) of three copper-algaecide formulations, and rates and extents of MCLR degradation were measured. In untreated controls and following exposures of 0.1, 0.5, and 1.0 mg Cu L-1, MCLR concentrations decreased at a rate of â¼41-53 µg MCLR/L d-1. Following exposure to 5.0 mg Cu L-1 MCLR degradation rates decreased an order of magnitude to â¼3-7 µg MCLR/L d-1. Bacterial diversity decreased following copper-exposures greater than 0.1 mg Cu L-1 for all formulations. Relative abundance of certain groups of MC-degrading bacteria identified in treatments increased with increasing copper concentration, suggesting they may be less sensitive to copper exposures than other, MCLR and non MC-degrading heterotrophic bacteria present in the assemblage. Results from this study revealed that copper concentration can influence degradation rates of MCLR, however this influence was not significant within copper concentrations currently registered for use (≤1.0 mg Cu L-1) of the tested algaecides. Copper formulation did not significantly alter degradation rates or bacterial composition. These data augment our understanding of the influences of copper algaecide-exposures on MCLR degradation, and can be used to inform more accurate risk evaluations and use of copper-algaecides for management of MCLR-producing cyanobacteria.