Should preoperative chest computed tomography be performed in all patients with colorectal cancer?

AIM: This study evaluated the accuracy of chest computed tomography (CCT) in the preoperative staging of patients with potentially resectable colorectal cancer (CRC). An attempt was made to determine whether CCT has a significant influence on management and clinical outcome. METHOD: A review was conducted of all preoperative CCTs and X-rays performed in patients submitted to elective resection of CRC at our institution between 2005 and 2012. All scans were revised by an independent radiologist who was unaware of the circumstances of each case. The findings were classified as benign, malignant or indeterminate. Patients were followed for at least 12 months after surgery to assess the clinical evolution of any lesion found on CCT and the oncological outcome. RESULTS: Two hundred and twenty-three patients were included. The CCT showed normal or benign findings in 157 (70.4%) patients, a malignant lesion in 17 (7.6%), and an indeterminate lung lesion (ILL) in 49 (22%). Of the 30 patients with proven lung metastases, a plain X-ray detected lesions in only 11 (36.7%) patients. During the postoperative follow-up, 14 (28.6%) of the 49 patients with ILL demonstrated malignant progression of the lung lesions. Among all 223 patients, only six (2.7%) underwent lung resection. CONCLUSION: CCT is superior to plain X-ray for the detection of lung metastases. Despite the medical and financial implications of preoperative CCT, only a small number of patients will eventually undergo lung resection. We call into question the role of routine CCT in the staging of patients with CRC. A more selective approach, reserving CT for patients at high risk of lung metastases, is suggested.

Exploring the interplay between small and large scales movements in a neotropical small mammal.

We record and analyze the movement patterns of the marsupial Didelphis aurita at different temporal scales. Animals trajectories are collected at a daily scale by using spool-and-line techniques and, with the help of radio-tracking devices, animals traveled distances are estimated at intervals of weeks. Small-scale movements are well described by truncated Lévy flight, while large-scale movements produce a distribution of distances which is compatible with a Brownian motion. A model of the movement behavior of these animals, based on a truncated Lévy flight calibrated on the small scale data, converges towards a Brownian behavior after a short time interval of the order of 1 week. These results show that whether Lévy flight or Brownian motion behaviors apply, will depend on the scale of aggregation of the animals paths. In this specific case, as the effect of the rude truncation present in the daily data generates a fast convergence towards Brownian behaviors, Lévy flights become of scarce interest for describing the local dispersion properties of these animals, which result well approximated by a normal diffusion process and not a fast, anomalous one. Interestingly, we are able to describe two movement phases as the consequence of a statistical effect generated by aggregation, without the necessity of introducing ecological constraints or mechanisms operating at different spatio-temporal scales. This result is of general interest, as it can be a key element for describing movement phenomenology at distinct spatio-temporal scales across different taxa and in a variety of systems.

Lévy like patterns in the small-scale movements of marsupials in an unfamiliar and risky environment.

We investigate the movement patterns of three different Neotropical marsupials in an unfamiliar and risky environment. Animals are released in a matrix from which they try to reach a patch of forest. Their movements, performed on a small spacial scale, are best approximated by Lévy flights. Patterns of oriented and non-oriented individuals - with forest patches within or beyond their perceptual range - differ only slightly in the value of their exponents. These facts suggest that, for these species, the appearance of Lévy flights is the product of animals innate behaviour that emerges spontaneously, as a neutral characteristic proper of a default movement mode for alerted animals.

Detecting and modelling delayed density-dependence in abundance time series of a small mammal (Didelphis aurita).

We study the population size time series of a Neotropical small mammal with the intent of detecting and modelling population regulation processes generated by density-dependent factors and their possible delayed effects. The application of analysis tools based on principles of statistical generality are nowadays a common practice for describing these phenomena, but, in general, they are more capable of generating clear diagnosis rather than granting valuable modelling. For this reason, in our approach, we detect the principal temporal structures on the bases of different correlation measures, and from these results we build an ad-hoc minimalist autoregressive model that incorporates the main drivers of the dynamics. Surprisingly our model is capable of reproducing very well the time patterns of the empirical series and, for the first time, clearly outlines the importance of the time of attaining sexual maturity as a central temporal scale for the dynamics of this species. In fact, an important advantage of this analysis scheme is that all the model parameters are directly biologically interpretable and potentially measurable, allowing a consistency check between model outputs and independent measurements.

A device and standard variables to describe microhabitat structure of small mammals based on plant cover.

Studies quantifying habitat structure generally use several instruments. This paper aims to propose a new and efficient device to characterize microhabitat structure of small mammals. Seven measurements were taken: plant cover, litter cover, rock cover, canopy cover, and vegetative obstruction at three heights. The device is a 0.25 m2 square wooden frame (0.50 m x 0.50 m) divided in to 100 open squares by wire mesh. Average time spent to measure each trapping station was six minutes. This new device is efficient, i.e., quick, practical, simple, and reliable. It can be used in any kind of forest. We propose this method as a standard method to describe habitat structure.

Differential trappability of small mammals in three habitats of Southeastern Brazil.

We compared the trappability of marked and unmarked individuals in species of marsupials and rodents of three tropical assemblages of small mammals in Brazil. Two studies used trapping grids, one in cerrado and the other in an Atlantic forest reserve, whereas the study in a rural area used transects. In the two studies using trapping grids, marked animals were frequently more trappable than unmarked ones, but in some species this difference was not significant. In the rural area, marked and unmarked animals did not differ significantly. The number of recaptures per resident animal was higher in the two studies using trapping grids than in the rural area where transects were used. Differences in trappability between the three studies might have been caused by differences not only in trapping design (grids vs. transects), but also in the type of trap used, bait, and habitat. Although differential trappability tends to be considered the rule in small mammals, these results suggest that trappability of marked and unmarked animals may be specific for the particular combination of sampling design, field methods, and habitat under study.

Oesophageal dysmotility in systemic sclerosis: comparison of HRCT and scintigraphy.

The aim of this study was to compare oesophageal abnormalities observed in high-resolution CT with radionuclide transit in patients with systemic sclerosis. 76 patients with systemic sclerosis were evaluated by high-resolution CT and oesophageal transit scintigraphy. Residual activity > or =20% (in relation to peak activity) at 15 s after the beginning of the swallow of the labelled liquid (in supine position) was considered indicative of oesophageal dysfunction. Supra-aortic and infra-aortic oesophageal coronal diameters were measured in high-resolution CT. Oesophageal dilatation was deemed present when the diameters exceeded 10 mm. 19 patients (25%) had supra-aortic oesophageal dilatation and 48 patients (63.1%) had infra-aortic dilatation. The prevalence of radionuclide transit delay was 77.6%. All patients (19/19) with supra-aortic dilatation had oesophageal dysfunction, compared with 70.2% (40/57) of the patients with no supra-aortic dilatation (p = 0.004). Oesophageal dysfunction was present in 97.9% (47/48) of patients with infra-aortic dilatation, compared with 42.9% (12/28) in patients without it (p < 0.001). Receiver operating characteristic (ROC) curves have demonstrated that the supra-aortic and infra-aortic diameters had good discriminatory capacity for oesophageal dysfunction in systemic sclerosis (area under the curve, 95% confidence interval: 0.80, 0.70-0.89 and 0.92, 0.86-0.98, respectively). There is a clinically significant association between oesophageal dysmotility and high-resolution CT findings of oesophageal coronal dilatation. The evaluation of infra-aortic oesophageal coronal diameter can provide additional useful information about the functional and anatomic conditions of the oesophagus in systemic sclerosis.

Influence of the stopcock on the efficiency of percutaneous drainage catheters: laboratory evaluation.

The effects of stopcocks on percutaneous fluid drainage were tested in a laboratory model by using a standard stopcock (6-French inner diameter) and a prototype stopcock (9-French inner diameter) connected to 8-, 10-, 12-, 14-, and 16-French catheters. Catheters were immersed in water alone or in viscous fluid with particulate matter, and the system was connected to low wall suction or gravity drainage. The average volume of fluid aspirated in a given period with and without a stopcock was compared for each catheter. The standard stopcock decreased drainage efficiency for these catheters by 13-42%. This decreased drainage efficiency was worse with the larger catheters. Particulate fluid blocked the stopcock connection for all catheters. With the prototype stopcock, drainage of water alone was reduced by 0-9% for the catheters of different sizes. Particulate fluid did not obstruct the prototype stopcock with any size catheter. With gravity drainage, the volume of water aspirated was reduced by 12-42% with the standard stopcock and by 3-6% with the prototype stopcock. These data suggest that stopcock connections greatly influence the efficiency of the percutaneous drainage systems. Stopcocks with larger inner diameters may improve drainage over that achievable with the stopcocks that are currently available.

Differential trappability of small mammals in three habitats of Southeastern Brazil

A taxa de captura de indivíduos marcados e não-marcados de espécies de marsupiais e roedores foi comparada entre três comunidades de pequenos mamíferos no Brasil. Em dois estudos, foram utilizadas grades de armadilhas, um no cerrado e outro em reserva de Mata Atlântica, e em um estudo em área rural foram utilizados transectos. Nos dois estudos que usaram grades de armadilhas, os animais marcados foram capturados com mais freqüência que os não-marcados, embora em algumas espécies essa diferença não tenha sido significativa. Na área rural, a captura de animais marcados e não-marcados não diferiu significativamente. O número de recapturas por animal residente foi maior nos dois estudos que usaram grades de armadilha. As diferenças de capturabilidade entre os três estudos podem resultar do uso de grades e transectos de armadilhas, mas também podem ser decorrentes das diferenças entre as armadilhas utilizadas, as iscas e os habitats. Independentemente da causa, a capturabilidade diferencial tende a ser considerada uma regra em pequenos mamíferos, mas os resultados apresentados sugerem que a capturabilidade de animais marcados e não-marcados seja específica da combinação particular de desenho amostral, métodos de campo e habitat de estudo.

A device and standard variables to describe microhabitat structure of small mammals based on plant cover

Studies quantifying habitat structure generally use several instruments. This paper aims to propose a new and efficient device to characterize microhabitat structure of small mammals. Seven measurements were taken: plant cover, litter cover, rock cover, canopy cover, and vegetative obstruction at three heights. The device is a 0.25 m² square wooden frame (0.50 m x 0.50 m) divided in to 100 open squares by wire mesh. Average time spent to measure each trapping station was six minutes. This new device is efficient, i.e., quick, practical, simple, and reliable. It can be used in any kind of forest. We propose this method as a standard method to describe habitat structure

Fibro-histiocitoma maligno de tecidos moles / Malignant fibrous histiocytoma ofthe soft tissues

O fibro-histiocitoma maligno é um tumor incomum e frequentemente indistinguível de várias outras patologias. Os autores descrevem 2 casos onde a doença ocorre nas partes moles (um do retroperitôneo e outro de membro inferior) e discutem os diagnósticos diferenciais e o papel dos métodos radiológicos na determinaçäo diagnóstica