Social dynamics and individual hunting tactics of white sharks revealed by biologging.

Social foraging, where animals forage in groups, takes many forms but is less studied in marine predators as measuring social associations in the wild is challenging. We used biologging (activity, cameras and telemetry receivers) sensors to measure social associations and simultaneous behaviour, in white sharks (Carcharodon carcharias) off Guadalupe Island, Mexico. Animal-borne telemetry receivers revealed that sharks varied in the number of associations they formed and occurred most often when sharks were swimming in straight paths or when they were turning frequently. While many associations were likely random, there was evidence of some stronger associations. Sharks varied in the depths they used and their activity, with some individuals more active in shallow water while others were more active 200-300 m deep. We propose that white sharks associate with other individuals so they can inadvertently share information on the location or remains of large prey. However, there may be a wide range of individual variability in both behaviour and sociality. Biologging now enables social associations of animals to be measured, concurrent with measures of their behaviour, so that social foraging of large marine predators can be quantified in the wild.

The Twilight Zone as a Major Foraging Habitat and Mercury Source for the Great White Shark.

The twilight zone contains the largest biomass of the world's ocean. Identifying its role in the trophic supply and contaminant exposure of marine megafauna constitutes a critical challenge in the context of global change. The white shark (Carcharodon carcharias) is a threatened species with some of the highest concentrations of neurotoxin methylmercury (MeHg) among marine top predators. Large white sharks migrate seasonally from coastal habitats, where they primarily forage on pinnipeds, to oceanic offshore habitats. Tagging studies suggest that while offshore, white sharks may forage at depth on mesopelagic species, yet no biochemical evidence exists. Here, we used mercury isotopic composition to assess the dietary origin of MeHg contamination in white sharks from the Northeast Pacific Ocean. We estimated that a minimum of 72% of the MeHg accumulated by white sharks originates from the consumption of mesopelagic prey, while a maximum of 25% derives from pinnipeds. In addition to highlighting the potential of mercury isotopes to decipher the complex ecological cycle of marine predators, our study provides evidence that the twilight zone constitutes a crucial foraging habitat for these large predators, which had been suspected for over a decade. Climate change is predicted to expand the production of mesopelagic MeHg and modify the mesopelagic biomass globally. Considering the pivotal role of the twilight zone is therefore essential to better predict both MeHg exposure and trophic supply to white sharks, and effectively protect these key vulnerable predators.

An estimate of the number of white sharks Carcharodon carcharias interacting with ecotourism in Guadalupe Island.

The aim of the present study is to provide an estimate of the number of white sharks Carcharodon carcharias that seasonally interact with ecotourism boats in Guadalupe Island using Schnabel's mark-recapture method and 6316 records of white sharks during 2012-2014. The results of the estimation highlight an abundance of 78 white sharks 95% C.I. (62.1, 105.6) interacting with ecotourism. The regulations regarding the number of tourists, boats and the monitoring of white sharks should be assessed to improve management decisions regarding the conservation and sustainable use of this threatened species.

Gross anatomy of the elbow capsule: a cadaveric study.

PURPOSE: The elbow is an inherently stable joint because of its bony articulation and surrounding capsuloligamentous structures. Anatomic and biomechanical studies have focused on the medial and lateral collateral ligamentous contributions to stability. In 1918, Gray provided a qualitative description of the elbow capsule and its fibers. Our study was performed to detail the gross anatomy of the elbow capsule. METHODS: We evaluated the elbow capsule of 6 paired, fresh-frozen cadaveric specimens to detail gross capsular anatomy. RESULTS: We identified 3 distinct bands within the anterior capsule and 3 distinct bands within the posterior capsule. CONCLUSIONS: Further study is needed to delineate the functional meaning of these anatomic findings. CLINICAL RELEVANCE: Greater understanding of elbow capsule gross anatomy may lead to improved understanding of acute and chronic elbow pathoanatomy and treatment modalities.

Increased risk of hospitalization and death in Mexican children and adolescents with COVID-19 and comorbidities.

BACKGROUND: Although COVID-19 (coronavirus disease 2019) in children is usually mild, they need hospitalization and intensive care in exceptional cases. Adverse outcomes have been observed mainly among children with comorbidities, justifying their vaccination. This study aimed to assess the risk of hospitalization and death in Mexican children and adolescents with COVID-19 and comorbidities. METHODS: A cross-sectional study was performed on 366,542 confirmed COVID-19 cases under 18 years, reported by the Mexican Ministry of Health up to July 9, 2022. Logistic regression models were performed. RESULTS: The mean age was 10.98 years, 50.6% were male, and 7.3% reported at least one comorbidity. The percentage of hospitalization and death in COVID-19 patients with and without comorbidities was 3.52%, and 0.20%, respectively; children with comorbidities presented a higher percentage of hospitalization (14.0%) and death (1.9%). The probability of hospitalization was 5.6 times greater in pediatric patients with COVID-19 and comorbidities, and the comorbidities that showed the greatest risk were immunosuppression (odds ratio (OR) 22.06), chronic kidney disease (CKD) (11.36), and cardiovascular diseases (5.66). The probability of death in patients with comorbidities was 11.01 times higher than in those without diseases, and the highest risk was observed in those with CKD (OR 12.57), cardiovascular diseases (6.87), and diabetes (5.83). CONCLUSIONS: Pediatric patients with comorbidities presented a higher risk of severe COVID-19. It is suggested that vaccination should be promoted with greater emphasis on pediatric patients with comorbidities.

INTRODUCCIÓN: Aunque COVID-19 (enfermedad por coronavirus 2019) en niños es usualmente leve, en casos excepcionales requieren hospitalización y cuidados intensivos. Los resultados adversos han sido observados principalmente en los niños con comorbilidades, justificando su vacunación. El objetivo de este estudio fue evaluar el riesgo de hospitalización y muerte en niños y adolescentes mexicanos con COVID-19 y comorbilidades. MÉTODOS: Estudio transversal en 366,542 casos de COVID-19 confirmados, menores de 18 años y reportados por la Secretaría de Salud de México, hasta el 9 de julio del 2022. Se ejecutaron modelos multivariados de regresión logística. RESULTADOS: El promedio de edad fue de 10.98 años, 50.6% de sexo masculino, y 7.3% reportaron al menos una comorbilidad. El porcentaje de hospitalización y muerte en pacientes con COVID-19 sin comorbilidades fue 3.52% y 0.20%, respectivamente; mientras que los pacientes con comorbilidades presentaron más elevados porcentajes de hospitalización (14.0%) y muerte (1.9%). La probabilidad de hospitalización fue 5.6 veces más en los pacientes con COVID-19 y comorbilidades, comparando con aquellos sin comorbilidades. Las comorbilidades que mostraron más riesgo fueron inmunosupresión (razón de momios (RM) 22.06), enfermedad renal crónica (ERC) (RM 11.36) y enfermedades cardiovasculares (RM 5.66). La probabilidad de muerte en los pacientes con comorbilidades fue 11.01 veces más que en aquellos sin enfermedades, y fue más elevado en aquellos con ERC (RM 12.57), enfermedades cardiovasculares (RM 6.87) y diabetes (RM 5.83). CONCLUSIONES: Los pacientes pediátricos con comorbilidades presentaron mayor riesgo de COVID-19 severo, por lo que se sugiere promover con mayor énfasis la vacunación en ellos.

Foraging plasticity diversifies mercury exposure sources and bioaccumulation patterns in the world's largest predatory fish.

Large marine predators exhibit high concentrations of mercury (Hg) as neurotoxic methylmercury, and the potential impacts of global change on Hg contamination in these species remain highly debated. Current contaminant model predictions do not account for intraspecific variability in Hg exposure and may fail to reflect the diversity of future Hg levels among conspecific populations or individuals, especially for top predators displaying a wide range of ecological traits. Here, we used Hg isotopic compositions to show that Hg exposure sources varied significantly between and within three populations of white sharks (Carcharodon carcharias) with contrasting ecology: the north-eastern Pacific, eastern Australasian, and south-western Australasian populations. Through Δ200Hg signatures in shark tissues, we found that atmospheric Hg deposition pathways to the marine environment differed between coastal and offshore habitats. Discrepancies in δ202Hg and Δ199Hg signatures among white sharks provided evidence for intraspecific exposure to distinct sources of marine methylmercury, attributed to population and ontogenetic shifts in foraging habitat and prey composition. We finally observed a strong divergence in Hg accumulation rates between populations, leading to three times higher Hg concentrations in large Australasian sharks compared to north-eastern Pacific sharks, and likely due to different trophic strategies adopted by adult sharks across populations. This study illustrates the variety of Hg exposure sources and bioaccumulation patterns that can be found within a single species and suggests that intraspecific variability needs to be considered when assessing future trajectories of Hg levels in marine predators.

Diving deeper into the underlying white shark behaviors at Guadalupe Island, Mexico.

Fine-scale movement patterns are driven by both biotic (hunting, physiological needs) and abiotic (environmental conditions) factors. The energy balance governs all movement-related strategic decisions.Marine environments can be better understood by considering the vertical component. From 24 acoustic trackings of 10 white sharks in Guadalupe Island, this study linked, for the first time, horizontal and vertical movement data and inferred six different behavioral states along with movement states, through the use of hidden Markov models, which allowed to draw a comprehensive picture of white shark behavior.Traveling was the most frequent state of behavior for white sharks, carried out mainly at night and twilight. In contrast, area-restricted searching was the least used, occurring primarily in daylight hours.Time of day, distance to shore, total shark length, and, to a lesser extent, tide phase affected behavioral states. Chumming activity reversed, in the short term and in a nonpermanent way, the behavioral pattern to a general diel vertical pattern.

Evidence of interactions between white sharks and large squids in Guadalupe Island, Mexico.

Shark-cephalopod interactions have been documented in trophic ecology studies around the world. However, there is little information about the encounters between white sharks Carcharodon carcharias and squids in the eastern North Pacific Ocean. Here we provide evidence of interactions between white sharks and large squids in the waters of Guadalupe Island, Mexico. Through the use of non-invasive techniques, we found the presence of evident scars made by large squids on the body of the white sharks, mainly on the head and trunk, of at least 14 sharks recorded during August-December in the years 2008, 2012, 2013, 2017 and 2019. The mean length of the white sharks was 3.7 m (SD ± 0.6; total length), although the majority of the sharks with scars were adult and subadult males (n = 9; 64%). One of these males was photographically recaptured during the same season in which the individual showed new scars, confirming that the squid-white shark interaction likely occurs near Guadalupe Island. Our results highlight the importance of the twilight zone for white sharks and the use of shared habitat and trophic interactions between squid and white sharks, in which future ecosystem studies should consider both species for management and conservation purposes.

Prevalence of undifferentiated inflammatory arthropathy in patients with Hashimoto's thyroiditis in an endocrinology clinic.

AIM: Rheumatic manifestations are common in patients with Hashimoto's thyroiditis (HT). Since previous reports on the prevalence of arthritis in this disease may have a rheumatology referral bias, we sought to establish the prevalence of undifferentiated inflammatory arthropathy (UIA) in unselected HT patients as seen in an endocrinology clinic. METHODS: Cross-sectional study of 92 consecutive HT patients and no definite rheumatic disease from the Endocrinology Division, Hospital Universitario de Caracas diagnosed by the presence of anti-thyroid peroxidase antibodies (n = 68) or typical ultrasonographic findings (n = 24). Undifferentiated inflammatory arthropathy was defined as combination of morning stiffness and joint pain with ≥2 characteristics of inflammatory joint pain. The study was revised and approved by the Ethics Committee of our hospital and all patients signed an informed consent form. RESULTS: Twenty-three patients (25%; 95% CI 16-34) met the criteria for UIA. Joints most commonly affected were the knees, hands and ankles and the most common pattern was oligoarticular (82.6%). In the multivariate analysis, variables associated to the presence of UIA were the presence of myalgia (odds ratio [OR] = 19.41; 95% CI = 2.38-158.38) and Raynaud's phenomenon (OR = 4.32; 95% CI = 1.01-18.60). No association was found with demographics, duration of disease, comorbidities or thyroid function status. CONCLUSIONS: Almost 1 in 4 patients with HT had no definite rheumatic disease present with UIA. An early identification of concurrent arthritis in HT patients is necessary for thorough differential diagnosis and prompt treatment initiation to halt potential joint damage and disability.

Carcinosarcoma ovárico asociado a carcinoma seroso intraepitelial tubárico

El carcinosarcoma primario ovárico es una neoplasia de baja incidencia, que suele ser diagnosticado en estadios avanzados y cursa con un mal pronóstico. Se comunica el caso de una paciente de 64 años con una tumoración abdominopélvica de 15 cm. El examen histológico evidenció una neoplasia maligna bifásica ovárica asociada a un carcinoma seroso intraepitelial tubárico, hallazgo que estaría en relación con la patogénesis de esta neoplasia.

Primary ovarian carcinosarcoma is a low incidence neoplasm that is usually diagnosed in advanced stages and has a poor prognosis. We report the case of a 64-yearold female patient with a 15 cm abdominopelvic tumor. Histological examination revealed a malignant ovarian biphasic malignancy associated with a serous tubal intraepithelial carcinoma, a finding that would be related to the pathogenesis of this neoplasm.

Increased risk of hospitalization and death in Mexican children and adolescents with COVID-19 and comorbidities / Riesgo incrementado de hospitalización y muerte en niños y adolescentes mexicanos con COVID-19 y comorbilidad

Abstract Background: Although COVID-19 (coronavirus disease 2019) in children is usually mild, they need hospitalization and intensive care in exceptional cases. Adverse outcomes have been observed mainly among children with comorbidities, justifying their vaccination. This study aimed to assess the risk of hospitalization and death in Mexican children and adolescents with COVID-19 and comorbidities. Methods: A cross-sectional study was performed on 366,542 confirmed COVID-19 cases under 18 years, reported by the Mexican Ministry of Health up to July 9, 2022. Logistic regression models were performed. Results: The mean age was 10.98 years, 50.6% were male, and 7.3% reported at least one comorbidity. The percentage of hospitalization and death in COVID-19 patients with and without comorbidities was 3.52%, and 0.20%, respectively; children with comorbidities presented a higher percentage of hospitalization (14.0%) and death (1.9%). The probability of hospitalization was 5.6 times greater in pediatric patients with COVID-19 and comorbidities, and the comorbidities that showed the greatest risk were immunosuppression (odds ratio (OR) 22.06), chronic kidney disease (CKD) (11.36), and cardiovascular diseases (5.66). The probability of death in patients with comorbidities was 11.01 times higher than in those without diseases, and the highest risk was observed in those with CKD (OR 12.57), cardiovascular diseases (6.87), and diabetes (5.83). Conclusions: Pediatric patients with comorbidities presented a higher risk of severe COVID-19. It is suggested that vaccination should be promoted with greater emphasis on pediatric patients with comorbidities.

Resumen Introducción: Aunque COVID-19 (enfermedad por coronavirus 2019) en niños es usualmente leve, en casos excepcionales requieren hospitalización y cuidados intensivos. Los resultados adversos han sido observados principalmente en los niños con comorbilidades, justificando su vacunación. El objetivo de este estudio fue evaluar el riesgo de hospitalización y muerte en niños y adolescentes mexicanos con COVID-19 y comorbilidades. Métodos: Estudio transversal en 366,542 casos de COVID-19 confirmados, menores de 18 años y reportados por la Secretaría de Salud de México, hasta el 9 de julio del 2022. Se ejecutaron modelos multivariados de regresión logística. Resultados: El promedio de edad fue de 10.98 años, 50.6% de sexo masculino, y 7.3% reportaron al menos una comorbilidad. El porcentaje de hospitalización y muerte en pacientes con COVID-19 sin comorbilidades fue 3.52% y 0.20%, respectivamente; mientras que los pacientes con comorbilidades presentaron más elevados porcentajes de hospitalización (14.0%) y muerte (1.9%). La probabilidad de hospitalización fue 5.6 veces más en los pacientes con COVID-19 y comorbilidades, comparando con aquellos sin comorbilidades. Las comorbilidades que mostraron más riesgo fueron inmunosupresión (razón de momios (RM) 22.06), enfermedad renal crónica (ERC) (RM 11.36) y enfermedades cardiovasculares (RM 5.66). La probabilidad de muerte en los pacientes con comorbilidades fue 11.01 veces más que en aquellos sin enfermedades, y fue más elevado en aquellos con ERC (RM 12.57), enfermedades cardiovasculares (RM 6.87) y diabetes (RM 5.83). Conclusiones: Los pacientes pediátricos con comorbilidades presentaron mayor riesgo de COVID-19 severo, por lo que se sugiere promover con mayor énfasis la vacunación en ellos.

Xanthogranulomatous Prostatitis, a Rare Prostatic Entity.

There are several benign prostatic pathologies that can clinically mimic a prostate adenocarcinoma. Xanthogranulomatous prostatitis is a benign inflammatory condition of the prostate and a rare entity. A 47-year old male, with 3 years of lower urinary tract symptoms, with a palpable hypogastric tumor, digital rectal examination: solid prostate, of approximately 60 g. Initial PSA was 0.90 ng/mL. He underwent surgical excision of the lower abdominal nodule and prostatectomy. Histopathology showed xanthogranulomatous prostatitis, without malignancy. Xanthogranulomatous prostatitis is an extremely rare entity that can simulate prostate adenocarcinoma, therefore having a correct histopathological diagnosis is essential.

Embarazo ectópico tubárico seis años después de una histerectomía supracervical. Reporte de caso / Tubal ectopic pregnancy six years after supracervical hysterectomy. A case report

Resumen El embarazo ectópico en pacientes histerectomizadas es un evento poco común y rara vez se considera en el diagnóstico diferencial en mujeres con esa condición. Se comunica el caso de una paciente de 30 años con antecedentes de histerectomía realizada hacía 6 años, que se presentó en el servicio de urgencias con evolución de tres días de dolor abdominal bajo. La ecografía mostró un saco gestacional con embrión y presencia de líquido libre en el fondo de saco Douglas. El examen histológico de la muestra operatoria reveló vellosidades coriónicas y un embrión dentro de la trompa uterina.

Abstract Ectopic pregnancy in hysterectomized patients is an uncommon event and it is rarely considered in the differential diagnosis. We present the case of a 30-year-old patient with hysterectomy performed 6 years before who presented to the emergency service with a 3-day evolution of lower abdominal pain. Ultrasonography showed a gestational sac with embryo and the presence of free fluid in the Douglas sac. Histological examination of the surgical piece revealed chorionic villi and an embryo within the uterine tube.

[Preoperative embolization with microspheres of giant supratentorial meningiomas: 5-year experience]. / Embolización preoperatoria con microesferas en meningiomas gigantes supratentoriales: experiencia de 5 años.

BACKGROUND: Preoperative embolization of hypervascular tumours such as meningiomas has proven to be a favorable factor for resection of the latter because it diminishes intraoperative bleeding and the need for blood transfusions. OBJECTIVES: Evaluation of surgical outcomes of preoperative embolization with microspheres of giant supratentorial meningiomas. METHODS: We retrospectively analyzed patient records from 2007 to 2012 with the diagnosis of giant supratentorial meningiomas (> 5 cm) (n= 27) and obtained two samples: those with preoperative embolization (n= 14) and patients without any properative embolization (n= 13). We evaluated and compared statistically significant surgical bleeding, surgical time and resection grade (via Simpson scale). Additionally, we evaluated internal/external vascularization rate and the histopathologic diagnosis. RESULTS: According to the Simpson scale, the mean resection grade was 1.21 for embolized meningiomas, whereas for non-embolized meningiomas it was 1.92 . No differences were found in surgical bleeding and operative time. We used microspheres whose diameters were 40-120 µm, and these were easily observed with common microscopy techniques. In all cases we observed predominance in extracranial vascularization. No morbidity and mortality were recorded with the endovascular procedure. CONCLUSIONS: Embolization with microspheres improves resection rate evaluated by the Simpson scale in patients with giant supratentorial meningiomas.

ANTECEDENTES: la embolización preoperatoria de tumores hipervascularizados, como los meningiomas, ha demostrado ser un factor favorable para su resección quirúrgica en términos de menor sangrado transquirúrgico y transfusiones sanguíneas. OBJETIVOS: evaluar el beneficio quirúrgico de la embolización preoperatoria con microesferas en meningiomas gigantes supratentoriales. MATERIAL Y MÉTODOS: estudio retrospectivo de los expedientes de pacientes postoperados entre 2007 y 2012 con diagnóstico de meningiomas gigantes supratentoriales (>5 cm) (n= 27). La muestra se dividió en dos grupos: pacientes embolizados antes de la intervención (n= 14), y pacientes a quienes no se realizó embolización (n= 13). Se comparó la cantidad de sangrado transoperatorio, el tiempo quirúrgico, y el grado de resección evaluado por la escala de Simpson. Además, se evaluó el tamaño tumoral, la tasa de vascularización de la carótida interna y externa y el diagnóstico histopatológico. RESULTADOS: el promedio de resección de acuerdo con la escala de Simpson para meningiomas embolizados fue de 1.21, mientras que para meningiomas no embolizados fue de 1.92 (t de Student, p= < 0.014). No encontramos diferencias significativas en tiempo quirúrgico o en el sangrado transoperatorio. En más de la mitad de los casos utilizamos microesferas de 40-120 µm de diámetro. Las microesferas se observaron fácilmente con los métodos usuales de microscopia y tinción, su existencia se correlacionó con áreas focales de necrosis. En todos los casos se encontró predominio de vascularización extracraneal, sin que el procedimiento endovascular se asociara con mortalidad. CONCLUSIONES: la embolización de meningiomas gigantes supratentoriales con microesferas mejora el grado de resección quirúrgica evaluada por la escala de Simpson.

Biological evaluation of a multi-targeted small molecule inhibitor of tumor-induced angiogenesis.

RO4396686 is a small molecule KDR, FGFR, and PDGFR inhibitor with good pharmacokinetic properties in rodents. In a mouse corneal neovascularization assay, this compound inhibited VEGF-induced angiogenesis. Tested in a H460a xenograft tumor model this agent effected significant tumor growth inhibition at doses as low as 50mg/kg.

Prostatotomía transuretral estudio prospectivo / Transurethral prostatomy prospective study

Se presentan 20 pacientes con adenoma prostático sintomático tratados con prostatotomía transuretral. El 83% era bilobar obstructivo y el 90% tenía peso no superior a 30 grs. La técnica fue resección de un canal a las 7 desde cuello hasta vero. Los resultados fueron buenos en el 70%. Los 3 pacientes con mal resultado tenían lóbulo medio desarrollado

Factores de riesgo de mortalidad por infarto agudo al miocardio en pacientes Hospitalizados en el Departamento de Medicina Interna del HALF durante el 2005-2007 / Risk factors of mortality from acute myocardial infarction in patients hospitalized in the Department of Internal Medicine during the 2005-2007 HALF

Con el objetivo de determinar los factores de riesgo de mortalidad por infarto agudo al miocardio en pacientes hospitalizados en el Servicio de Medicina Interna del Hospital Antonio Lenin Fonseca, se realizó un estudio de caso-control no pareado, comparando dos grupos de pacientes con diferentes características pero con diagnóstico de 1AM, determinando en éstos los factores de riesgo que influyeron como predictores de mortalidad en el grupo de casos incluidos en el período de estudio. Para tal fin se realizo revisión de expedientes clínicos apoyado por un formulario de recolección de la información basado estrictamente en los factores de riesgo presentados por ambos grupos de pacientes, tiempo de evolución prehospitalaria del evento, antecedentes de infarto y complicaciones presentadas en los mismos. De los 137 pacientes se excluyo un total de nueve por no cumplir con los criterios de inclusión para el estudio y por falta de información registrada en el expediente clínico, encontrando así un total de 38 casos y 90 controles (n=1 28); de los cuales se obtuvo que la edad mayor de 65 años, el tiempo prehospitalario de 16 horas vs. 11 (casos-control), las complicaciones presentadas basadas en los grados Killip (Killip III y 1V), antecedentes de 1AM y la hipertensión arterial, fueron las variables con significancia estadística, encontrando una colinealidad entre estas y el riesgo de muerte. Las demás variables del estudio no tuvieron significancia estadística a pesar de que en la literatura consultada se demuestra lo contrario; esto se debe fundamentalmente a la calidad de la información registrada en el expediente clínico y por los factores de confusión de las variables y de clasificación, no significando, por tanto que dicho estudio no tenga validez ni que se niegue la evidencia encontrada den la literatura internacional...