PAHs in franciscana dolphins from the Southwestern Atlantic Ocean: Concentration and maternal transfer assessments.

Polycyclic aromatic hydrocarbons (PAHs) are organic compounds ubiquitous in the environment and known for their toxic, mutagenic, and carcinogenic effects. These compounds can bioaccumulate in the biota and be transferred through trophic webs. The franciscana dolphin (Pontoporia blainvillei), as top predators, can be an environmental sentinels. Thus, this study aimed to provide data about PAHs concentration in their hepatic tissue collected on the coast of Espírito Santo (Franciscana Management Area, FMA Ia), Rio de Janeiro (FMA IIa), and São Paulo states (FMA IIb), in Southeastern Brazil. PAHs were detected in 86 % of franciscana dolphins (n = 50). The highest ∑PAHsTotal median concentration was reported in FMA Ia followed by FMA IIb and FMA IIa (1055.6; 523.9, and 72.1 ng.g-1 lipid weight, respectively). Phenanthrene was detected in one fetus and two neonates, showing maternal transfer of PAHs in these dolphins. Evaluating PAHs with potential toxic effects is of utmost importance for the conservation of a threatened species.

Back on top: Resuspended by dredging and other environmental disturbances, organochlorine compounds may affect the health of a dolphin population in a tropical estuary, Sepetiba Bay.

Organochlorine compounds (OCs) are persistent organic pollutants linked to damaging the immune and endocrine systems, leading to a greater susceptibility to infectious diseases at high concentrations. Sepetiba Bay, in the Southeastern Brazilian coast, historically presents anthropogenic activities and environmental contamination that could negatively impact resident populations. In this context, this study aimed to investigate the temporal trends in the accumulation of organochlorine compounds over a 12-year database in the Guiana dolphins' (Sotalia guianensis) resident population from Sepetiba Bay, including individuals collected before, during, and after an unusual mortality event triggered by morbillivirus (n = 85). The influence of biological parameters was also evaluated. The OCs concentrations in the blubber ranged from 0.98 to 739 µg/g of ΣPCB; 0.08-130 µg/g of ΣDDT; <0.002-4.56 µg/g of mirex; <0.002-1.84 µg/g of ΣHCH and <0.001-0.16 µg/g of HCB in lipid weight. Increased temporal trends were found for OCs in Guiana dolphins coinciding with periods of large events of dredging in the region. In this way, our findings suggest that the constant high OCs concentrations throughout the years in this Guiana dolphin population are a result of the constant environmental disturbance in the area, such as dredging. These elevated OCs levels, e.g., ΣPCB concentrations found above the known thresholds, may impair the response of the immune system during outbreak periods, which could lead the population to a progressive decline.

Survey of selected viral agents (herpesvirus, adenovirus and hepatitis E virus) in liver and lung samples of cetaceans, Brazil.

Hepatic and pulmonary lesions are common in cetaceans, despite their poorly understood viral etiology. Herpesviruses (HV), adenoviruses (AdV) and hepatitis E virus (HEV) are emerging agents in cetaceans, associated with liver and/or pulmonary damage in mammals. We isolated and molecularly tested DNA for HV and AdV (n = 218 individuals; 187 liver and 108 lung samples) and RNA for HEV (n = 147 animals; 147 liver samples) from six cetacean families. All animals stranded or were bycaught in Brazil between 2001 and 2021. Positive-animals were analyzed by histopathology. Statistical analyses assessed if the prevalence of viral infection could be associated with the variables: species, family, habitat, region, sex, and age group. All samples were negative for AdV and HEV. Overall, 8.7% (19/218) of the cetaceans were HV-positive (4.8% [9/187] liver and 11.1% [12/108] lung), without HV-associated lesions. HV-prevalence was statistically significant higher in Pontoporiidae (19.2%, 10/52) when compared to Delphinidae (4.1%, 5/121), and in southeastern (17.1%, 13/76)-the most industrialized Brazilian region-when compared to the northeastern region (2.4%, 3/126). This study broadens the herpesvirus host range in cetaceans, including its description in pygmy sperm whales (Kogia breviceps) and humpback whales (Megaptera novaeangliae). Further studies must elucidate herpesvirus drivers in cetaceans.

Economic impact of periprosthetic hip fractures / Impacto económico de las fracturas periprotésicas de cadera

Introduction: Hip replacement is one of the most successful operations in orthopaedic surgery. Periprosthetic hip fractures (PPHF) have very serious consequences for the patient, and they also entail a very important economic impact on healthcare systems. The aim of the study was to provide the first detailed cost analysis of PPHF in a traumatology and orthopaedics service in a third level hospital in Spain. Methods: The study included all patients admitted between 2009 and 2019 with a diagnosis of “PPHF”. We assessed hospital stay cost, total cost of the operating theatre, cost of the implants used, analyses, consultations with other specialists, rehabilitation sessions, radiological tests, microbiology, blood transfusions and other surgical operations during the same admission. Results: 78 patients were included in the study, 49 women and 29 men, with a mean age of 78.74 years (R 45–92). 69 patients received surgical treatment, 75% had open reduction and internal fixation (ORIF), and 25% had revision surgery. The total cost was €1,139,650.17. The average cost was €14,610.90. Significantly higher costs were incurred for revision compared to ORIF treatments, admissions that lasted more than 30 days, and patients who required more than one operation during admission. The most costly factors were the hospital stay (46%), the cost of the surgery itself (35%), and the implants (24%). Conclusions: Revision arthroplasty versus ORIF treatment, admissions lasting more than 30 days, and patients requiring more than one operation on admission incurred significantly higher costs. The average cost, from a hospital perspective, generated by a PPHF was €14,610.90. The most costly factors were, in descending order, the hospital stay, the cost of the surgery itself, and the implants. It is necessary to establish protocols and updated therapeutic algorithms in the perioperative management of PPHF in order to reduce both morbidity rates and associated costs.(AU)

Introducción: La artroplastia de cadera es una de las operaciones con mejores resultados en cirugía ortopédica. Las fracturas periprotésicas de cadera (FPPC) tienen consecuencias muy graves para el paciente y además suponen un impacto económico muy importante para los sistemas sanitarios. El objetivo del estudio es realizar el primer análisis detallado de los costes de las FPPC en un Servicio de Cirugía Ortopédica y Traumatología en un hospital universitario de tercer nivel en España. Métodos: El estudio incluyó a todos los pacientes ingresados entre 2009 y 2019 con el diagnóstico de «FPPC». Se evaluaron el coste de la estancia hospitalaria, el coste total del quirófano, el coste de los implantes utilizados, los análisis de sangre, las consultas con otros especialistas, las sesiones de rehabilitación, las pruebas radiológicas, la microbiología, las transfusiones de sangre y otras intervenciones quirúrgicas durante el mismo ingreso. Resultados: Se incluyó a un total de 78 pacientes, 49 mujeres y 29 hombres, con una edad media de 78,74 años (R 45-92); 69 pacientes recibieron tratamiento quirúrgico, el 75% se sometió a reducción abierta y fijación interna (RAFI) y el 25% a revisión protésica. El coste total fue de 1.139.650,17 €. El coste medio fue de 14.610,90 €. Los costes fueron significativamente más elevados en la revisión protésica que en la RAFI, en los ingresos que duraron más de 30 días y en los pacientes que requirieron más de una intervención quirúrgica durante el ingreso. Los factores que más influyeron en el coste fueron la estancia hospitalaria (46%), el coste de la intervención quirúrgica (35%) y el de los implantes (24%). Conclusiones: La cirugía de revisión protésica frente a RAFI, los ingresos de más de 30 días y los pacientes que requirieron más de una intervención quirúrgica durante el ingreso supusieron costes significativamente mayores. El coste medio, desde el punto de vista hospitalario, generado por una FPPC fue de 14.610,90 €.(AU)

[Artículo traducido] Impacto económico de las fracturas periprotésicas de cadera / Economic impact of periprosthetic hip fractures

Introduction: Hip replacement is one of the most successful operations in orthopaedic surgery. Periprosthetic hip fractures (PPHF) have very serious consequences for the patient, and they also entail a very important economic impact on healthcare systems. The aim of the study was to provide the first detailed cost analysis of PPHF in a traumatology and orthopaedics service in a third level hospital in Spain. Methods: The study included all patients admitted between 2009 and 2019 with a diagnosis of “PPHF”. We assessed hospital stay cost, total cost of the operating theatre, cost of the implants used, analyses, consultations with other specialists, rehabilitation sessions, radiological tests, microbiology, blood transfusions and other surgical operations during the same admission. Results: 78 patients were included in the study, 49 women and 29 men, with a mean age of 78.74 years (R 45–92). 69 patients received surgical treatment, 75% had open reduction and internal fixation (ORIF), and 25% had revision surgery. The total cost was €1,139,650.17. The average cost was €14,610.90. Significantly higher costs were incurred for revision compared to ORIF treatments, admissions that lasted more than 30 days, and patients who required more than one operation during admission. The most costly factors were the hospital stay (46%), the cost of the surgery itself (35%), and the implants (24%). Conclusions: Revision arthroplasty versus ORIF treatment, admissions lasting more than 30 days, and patients requiring more than one operation on admission incurred significantly higher costs. The average cost, from a hospital perspective, generated by a PPHF was €14,610.90. The most costly factors were, in descending order, the hospital stay, the cost of the surgery itself, and the implants. It is necessary to establish protocols and updated therapeutic algorithms in the perioperative management of PPHF in order to reduce both morbidity rates and associated costs.(AU)

Introducción: La artroplastia de cadera es una de las operaciones con mejores resultados en cirugía ortopédica. Las fracturas periprotésicas de cadera (FPPC) tienen consecuencias muy graves para el paciente y además suponen un impacto económico muy importante para los sistemas sanitarios. El objetivo del estudio es realizar el primer análisis detallado de los costes de las FPPC en un Servicio de Cirugía Ortopédica y Traumatología en un hospital universitario de tercer nivel en España. Métodos: El estudio incluyó a todos los pacientes ingresados entre 2009 y 2019 con el diagnóstico de «FPPC». Se evaluaron el coste de la estancia hospitalaria, el coste total del quirófano, el coste de los implantes utilizados, los análisis de sangre, las consultas con otros especialistas, las sesiones de rehabilitación, las pruebas radiológicas, la microbiología, las transfusiones de sangre y otras intervenciones quirúrgicas durante el mismo ingreso. Resultados: Se incluyó a un total de 78 pacientes, 49 mujeres y 29 hombres, con una edad media de 78,74 años (R 45-92); 69 pacientes recibieron tratamiento quirúrgico, el 75% se sometió a reducción abierta y fijación interna (RAFI) y el 25% a revisión protésica. El coste total fue de 1.139.650,17 €. El coste medio fue de 14.610,90 €. Los costes fueron significativamente más elevados en la revisión protésica que en la RAFI, en los ingresos que duraron más de 30 días y en los pacientes que requirieron más de una intervención quirúrgica durante el ingreso. Los factores que más influyeron en el coste fueron la estancia hospitalaria (46%), el coste de la intervención quirúrgica (35%) y el de los implantes (24%). Conclusiones: La cirugía de revisión protésica frente a RAFI, los ingresos de más de 30 días y los pacientes que requirieron más de una intervención quirúrgica durante el ingreso supusieron costes significativamente mayores. El coste medio, desde el punto de vista hospitalario, generado por una FPPC fue de 14.610,90 €.(AU)

Economic impact of periprosthetic hip fractures. / [Artículo traducido] Impacto económico de las fracturas periprotésicas de cadera.

INTRODUCTION: Hip replacement is one of the most successful operations in orthopaedic surgery. Periprosthetic hip fractures (PPHF) have very serious consequences for the patient, and they also entail a very important economic impact on healthcare systems. The aim of the study was to provide the first detailed cost analysis of PPHF in a traumatology and orthopaedics service in a third level hospital in Spain. METHODS: The study included all patients admitted between 2009 and 2019 with a diagnosis of «PPHF¼. We assessed hospital stay cost, total cost of the operating theatre, cost of the implants used, analyses, consultations with other specialists, rehabilitation sessions, radiological tests, microbiology, blood transfusions and other surgical operations during the same admission. RESULTS: Seventy-eight patients were included in the study, 49 women and 29 men, with a mean age of 78.74 years (R 45-92). Sixty-nine patients received surgical treatment, 75% had open reduction and internal fixation (ORIF), and 25% had revision surgery. The total cost was €1 139 650.17. The average cost was €14 610.90. Significantly higher costs were incurred for revision compared to ORIF treatments, admissions that lasted more than 30 days, and patients who required more than one operation during admission. The most costly factors were the hospital stay (46%), the cost of the surgery itself (35%), and the implants (24%). CONCLUSIONS: Revision arthroplasty versus ORIF treatment, admissions lasting more than 30 days, and patients requiring more than one operation on admission incurred significantly higher costs. The average cost, from a hospital perspective, generated by a PPHF was €14 610.90. The most costly factors were, in descending order, the hospital stay, the cost of the surgery itself, and the implants. It is necessary to establish protocols and updated therapeutic algorithms in the perioperative management of PPHF in order to reduce both morbidity rates and associated costs.

Spatial trends of trace elements bioaccumulation in the most endangered dolphin from the Southwestern Atlantic Ocean: The franciscana (Pontoporia blainvillei).

Trace elements bioaccumulation patterns can be an important tool to assess differences among cetaceans' populations. In this work, their use as potential chemical markers to differentiate franciscanas (Pontoporia blainvillei) populations was evaluated. Franciscanas were collected from three states in southeastern Brazil, which comprise three different Franciscana Management Areas (FMAs): Espírito Santo (FMA Ia), southern Rio de Janeiro (FMA IIa), and central São Paulo (FMA IIb). The concentrations of As, Cd, Cu, Fe, Hg, Mn and Zn were determined in the muscle, liver and kidney of the animals. Cadmium was the most valuable chemical marker to differentiate stocks, separating at least FMA IIa from the others. The higher Cd levels in FMA IIa, along with dietary information, indicate that the predominant consumption of cephalopods by this population is the main reason for the differences found. Additionally, environmental characteristics of the areas should also be considered as divergent sources of trace elements. Our findings suggest that non-essential trace elements, such as Cd, can be successful markers to differentiate populations. The Mn concentrations in FMA Ia raised concern and must be carefully monitored, as well as other elements that compose the iron ore tailings that have impacted the Espírito Santo coastal area. Additionally, this is the first study to report trace element concentration in the franciscanas from FMA IIa (southern Rio de Janeiro). Trace element concentrations found in franciscanas may represent different contamination levels in their preys and environments, which might pose specific threats to distinct populations. Therefore, our findings are important to characterize and differentiate franciscana populations and to guide precise management and conservation actions for the distinct stocks of this endangered species.

Economic impact of periprosthetic hip fractures.

INTRODUCTION: Hip replacement is one of the most successful operations in orthopaedic surgery. Periprosthetic hip fractures (PPHF) have very serious consequences for the patient, and they also entail a very important economic impact on healthcare systems. The aim of the study was to provide the first detailed cost analysis of PPHF in a traumatology and orthopaedics service in a third level hospital in Spain. METHODS: The study included all patients admitted between 2009 and 2019 with a diagnosis of "PPHF". We assessed hospital stay cost, total cost of the operating theatre, cost of the implants used, analyses, consultations with other specialists, rehabilitation sessions, radiological tests, microbiology, blood transfusions and other surgical operations during the same admission. RESULTS: 78 patients were included in the study, 49 women and 29 men, with a mean age of 78.74 years (R 45-92). 69 patients received surgical treatment, 75% had open reduction and internal fixation (ORIF), and 25% had revision surgery. The total cost was €1,139,650.17. The average cost was €14,610.90. Significantly higher costs were incurred for revision compared to ORIF treatments, admissions that lasted more than 30 days, and patients who required more than one operation during admission. The most costly factors were the hospital stay (46%), the cost of the surgery itself (35%), and the implants (24%). CONCLUSIONS: Revision arthroplasty versus ORIF treatment, admissions lasting more than 30 days, and patients requiring more than one operation on admission incurred significantly higher costs. The average cost, from a hospital perspective, generated by a PPHF was €14,610.90. The most costly factors were, in descending order, the hospital stay, the cost of the surgery itself, and the implants. It is necessary to establish protocols and updated therapeutic algorithms in the perioperative management of PPHF in order to reduce both morbidity rates and associated costs.

Petrography of construction and demolition waste (CDW) from Abruzzo region (Central Italy).

The density, colour and texture, plus mineral and chemical features of 18 ceramic-like CDW samples from the Abruzzo region (Central Italy) were characterised. The concretes, natural stones, tiles, roof-tiles, bricks and perforated bricks are either aphanitic to porphyric. Concretes and natural stones are grey to white and tend to be > 2.0 g/cm3; the masonries are brown to reddish and close to < 2.0 g/cm3. Concrete and natural stone are rich or even exclusively made up of calcite, with high amounts of CaO (>40 wt%) and LOI (volatiles, CO2 + H2O). The masonries are instead calcite-, CaO- (<25 wt%) and LOI-poor (<8 wt%) but enriched in SiO2 (45 to 70 wt%) stabilised as quartz and/or cristobalite, with significant amount of Al2O3 (12 to 20 wt%). S and Cl contents are similar among concrete, bricks and perforated bricks. The petrography of CDW concretes is similar among geographical areas with abundance of limestones used as aggregates. However, in limestone-poor areas CDW are SiO2- and Al2O3-rich, reflecting the prevalent use of masonry and/or silicate-rich construction materials, implying that each geographical area is characterised by peculiar CDW composition. Therefore, the knowledge of mesoscopic, physical and petrographic aspects has to be known for planning adequate sorting methods, promoting upcycling reusing applications. Some of the studied CDW samples are susceptible to release relative high Cr and As content.

Temporal trends of trace elements bioaccumulation by a vulnerable cetacean (Pontoporia blainvillei) before and after one of the largest mining disasters worldwide.

One of the largest environmental disasters worldwide occurred on November 5th, 2015, when the Fundão dam collapsed in Mariana (Minas Gerais State, Southeast Brazil). The tailing mud flooded the Doce River basin and reached the sea in the coast of Espírito Santo State (ES), Southeast Brazil. This coastal region is the habitat of the most isolated population of franciscana dolphins (Pontoporia blainvillei), with the lowest populational census and lowest genetic diversity in Franciscana Management Area Ia (FMA Ia) - 18° 25'S and 21° 17'S. This study aimed to assess the bioaccumulation of trace-elements (As, Cd, Cu, Fe, Hg, Mn, and Zn) in muscle, liver and kidney of franciscana dolphins collected near the Doce River's mouth before (n = 32) and after (n = 19) the tailing mud reached the sea. The Generalized Additive Model (GAM) showed increasing temporal trends of Hg and Zn in muscle and liver after the dam failure, probably related to higher concentrations and bioavailability in the water column and sediments from the Doce River. Declining trends were found for As and Cu muscular and hepatic concentrations and Fe concentrations in kidney due to their lower bioavailability after the disaster, caused by association with tailings mud trapped in the riverbanks and suspended particulate material. Additionally, higher As and Hg concentrations found in the first period of sampling may be due to historical contamination by mining activities. The full extent of the impacts caused by the Fundão dam failure is still unknown. However, due to their rapid increase and remobilization process, toxic effects can be induced in the biota by these elements. Elements' bioaccumulation in this study contributes to the knowledge of franciscana dolphins from FMA Ia. Considering the conservation concern regarding this franciscana population and its scarce knowledge, the impact of this disaster can be alarming for species conservation.

Utilização da cirurgia de mohs no tratamento de neoplasias malignas não melanocíticas da pele ­ uma revisão sistemática / Mohs micrographic surgery in the treatment of non-melanocytic skin neoplasms ­ a systematic review

Objetivo: Averiguar a efetividade da utilização da cirurgia de MOHS no manejo de tumores cutâneos tipo não melanoma em comparação a outros métodos de terapia. Métodos: O estudo consiste em uma revisão sistemática, cuja coleta de artigos ocorreu nas bases de dados MEDLINE, PubMed Central (PMC), LILACS e SciELO, utilizando os termos "Cirurgia de MOHS", "Câncer de pele", "Ensaio clínico", excluindo "melanoma". Resultados: Do total de 132 artigos identificados, foram considerados elegíveis 11. A análise dos artigos demonstrou que a CMM, comparada a outros métodos, apresentou resultados estéticos melhores, além de menor grau de complicações em tumores recorrentes e um custo/benefício variável com o país onde foi feita operação. A CMM também apresentou menores índices de recorrência em todos os estudos. Conclusão: No geral, a cirurgia de MOHS se mostrou um método terapêutico promissor. No entanto, existem ainda poucos estudos comparativos sobre a eficácia da CMM e os que existem se concentram em poucas regiões do mundo. (AU)

Objective: Evaluating the effectiveness of using MOHS surgery in the management of non-melanoma skin tumors compared to other therapy methods. Methods: The study consists of a systematic review, whose search for articles was performed using databases MEDLINE, PubMed Central (PMC), LILACS and SciELO, using the terms "MOHS surgery", "Skin cancer", "Clinical trial", excluding "melanoma". Results: from a total of 132 identified articles, 11 were considered eligible. The analysis of the articles showed that MMS, compared to other methods, presented better cosmetic results, in addition to a lower grade of complications in recurrent tumors and a variable cost/benefit according to the country where the surgery was performed. MMS also had lower recurrence rates in all studies. Conclusion:Overall, MOHS surgery has shown promising therapeutic results. However, there are still few comparative studies on the effectiveness of MMS and those that exist are concentrated in a few regions of the world. (AU)

Epithelioma cuniculatum of the sole of the foot mimicking an infection.

Epithelioma cuniculatum is characterized as a slow growing lesion on the sole of the foot. A diagnosis is usually delayed by a low clinical suspicion and misdirection due to its similarity to an infection. This tumor rarely metastasize but a local invasion of adjacent soft tissues is common, requiring ample surgical resection or even amputation in advanced cases. We report a case a 76-year-old patient with a 5-year-old lesion on the sole of the foot, which was originally treated as a wart without improvement while the lesion slowly evolved. The patient was referred to our center with a diagnosis of chronic osteomyelitis. An excisional biopsy revealed an invasive keratinizing squamous carcinoma. In this advanced phase of the disease the only possible treatment was a Syme amputation.

El epitelioma cuniculatum se caracteriza por una lesión de crecimiento lento en la planta del pie cuyo diagnóstico suele retrasarse por la baja sospecha clínica y por su similitud con una infección. Este tumor raramente metastatiza, pero es común que produzca una invasión local a los tejidos blandos adyacentes, requiriendo una amplia resección quirúrgica o incluso una amputación en casos avanzados. Presentamos un caso de un paciente de 76 años con una lesión de 5 años de edad en la planta del pie, que originalmente fue tratada como una verruga plantar común sin mejoría, mientras que la lesión evolucionó lentamente. El paciente fue remitido a nuestro centro con un diagnóstico de osteomielitis crónica. Una biopsia excisional reveló un carcinoma escamoso queratinizante invasivo. En esta fase avanzada de la enfermedad el único tratamiento posible fue una amputación de Syme.

[Quantitative and qualitative analysis of the influence of confinement by COVID-19 in fracture patients entered in a traumatology service at a third level hospital]. / Análisis cuantitativo y cualitativo de la influencia del confinamiento por COVID-19 en los pacientes con fractura ingresados en un servicio de traumatología en un hospital de tercer nivel.

INTRODUCTION: The COVID-19 pandemic has led to the confinement of approximately one third of the world population, causing a drastic change in the activities of daily life with many repercussions at the health, economic and social levels. OBJECTIVES: The objective of the present work is to present the epidemiological variations in the production of fractures in the period of mandatory confinement in our reference population. METHODS: Analytical retrospective comparative study of two groups of patients: Group A: patients admitted before the state of alarm that forced confinement in the period from January 13 to March 13 compared to Group B: patients admitted in the two months of confinement, until the de-escalation period began, March 13-May 13. Epidemiological variables including age, personal history, type of fracture, mechanism of injury, outpatient rate, and hospital stay were recorded. RESULTS: A total of 190 patients were included. 112 in the pre-confinement period and 78 in the confinement (30% decrease). The mean age (p = 0.007) and falls at home (p < 0.001) were higher in the confinement group. The postoperative (p = 0.006) and overall (p < 0.001) hospital stay were significantly less in the confinement group. No differences were found in the anatomical location of the lesion, sex, comorbidities, mechanism of injury, outpatient rate, or death. CONCLUSIONS: Based on the results of our study, the period of forced confinement due to the COVID-19 pandemic has produced a drastic decrease in the total number of fractures admitted to the traumatology service of a third level hospital. On the other hand, osteoporotic hip fractures have not varied in their incidence and a decrease in the average postoperative and overall stay has been observed.

Effects of water produced by oil segment on aquatic organisms after treatment using advanced oxidative processes.

The water produced (PW) by the petroleum industry is a potential contaminant to aquatic biota, due to its complex mixture that may contain polycyclic aromatic hydrocarbons (PAHs), organic chemical compounds, including benzene, toluene, ethylbenzene and xylene (BTEX), metals and other components that are known to be toxic. The aim of this investigation was to examine the acute toxicity produced by a PW sample in aquatic organisms Vibrio fischeri and Daphnia similis prior to and after 4 treatments using advanced oxidative processes such as photocatalysis, photoelectrocatalysis, ozonation and photoelectrocatalytic ozonation. Data demonstrated that exposure to PW was toxic to both organisms, as evidenced by reduced luminescence in bacterium Vibrio fischeri and induced immobility in Daphnia similis. After treatment of PW with 4 different techniques, the PW remained toxic for both tested organisms. However, photoelectrocatalysis was more efficient in decreasing toxicity attributed to PW sample. Therefore, data demonstrate the importance of treating PW for later disposal in the environment in order to mitigate ecotoxicological impacts. Further photoelectrocatalysis appeared to be a promising tool for treating PW samples prior to disposal and exposure of aquatic ecosystems.

Epithelioma cuniculatum of the sole of the foot mimicking an infection / Epitelioma cuniculatum de la planta del pie simulando una infección

Abstract: Epithelioma cuniculatum is characterized as a slow growing lesion on the sole of the foot. A diagnosis is usually delayed by a low clinical suspicion and misdirection due to its similarity to an infection. This tumor rarely metastasize but a local invasion of adjacent soft tissues is common, requiring ample surgical resection or even amputation in advanced cases. We report a case a 76-year-old patient with a 5-year-old lesion on the sole of the foot, which was originally treated as a wart without improvement while the lesion slowly evolved. The patient was referred to our center with a diagnosis of chronic osteomyelitis. An excisional biopsy revealed an invasive keratinizing squamous carcinoma. In this advanced phase of the disease the only possible treatment was a Syme amputation.

Resumen: El epitelioma cuniculatum se caracteriza por una lesión de crecimiento lento en la planta del pie cuyo diagnóstico suele retrasarse por la baja sospecha clínica y por su similitud con una infección. Este tumor raramente metastatiza, pero es común que produzca una invasión local a los tejidos blandos adyacentes, requiriendo una amplia resección quirúrgica o incluso una amputación en casos avanzados. Presentamos un caso de un paciente de 76 años con una lesión de 5 años de edad en la planta del pie, que originalmente fue tratada como una verruga plantar común sin mejoría, mientras que la lesión evolucionó lentamente. El paciente fue remitido a nuestro centro con un diagnóstico de osteomielitis crónica. Una biopsia excisional reveló un carcinoma escamoso queratinizante invasivo. En esta fase avanzada de la enfermedad el único tratamiento posible fue una amputación de Syme.

Additional Pressure to a Threatened Species: High Persistent Organic Pollutant Concentrations in the Tropical Estuarine Batoid Gymnura altavela.

Persistent organic pollutants (POPs) were determined in Gymnura altavela liver samples from one of the most impacted estuarine environments in the Atlantic Ocean (Guanabara Bay, Brazil). PCBs were the predominant compounds (91.2%) averaging 6773 ± 4659 ng.g-1 lipid weight (lw). DDT, Mirex, HCH and HCB concentrations were 633 ± 715, 6.2 ± 9.3, 3.4 ± 1.4 and 0.5 ± 0.5 ng.g-1 lw, respectively. Recent DDT input in the estuary was minimum, as verified by the p,p'-DDE/∑DDT ratio (0.67). The prevalence of industrial compounds was highlighted by the ΣDDT/ΣPCB ratio (0.08). A negative correlation detected between disc width and PCBs, Mirex and HCH concentrations may be a consequence of maternal offloading. High POP concentrations in G. altavela liver samples from Guanabara Bay suggests that PCBs, in particular, may pressure the conservation of this threatened with extinction tropical estuarine batoid species.

Adoption of Active Surveillance for Very Low-Risk Differentiated Thyroid Cancer in the United States: A National Survey.

CONTEXT: Active surveillance (AS) of thyroid cancer with serial ultrasounds is a newer management option in the United States. OBJECTIVE: This work aimed to understand factors associated with the adoption of AS. METHODS: We surveyed endocrinologists and surgeons in the American Medical Association Masterfile. To estimate adoption, respondents recommended treatment for 2 hypothetical cases appropriate for AS. Established models of guideline implementation guided questionnaire development. Outcome measures included adoption of AS (nonadopters vs adopters, who respectively did not recommend or recommended AS at least once; and partial vs full adopters, who respectively recommended AS for one or both cases). RESULTS: The 464 respondents (33.3% response) demographically represented specialties that treat thyroid cancer. Nonadopters (45.7%) were significantly (P < .001) less likely than adopters to practice in academic settings, see more than 25 thyroid cancer patients/year, be aware of AS, use applicable guidelines (P = .04), know how to determine whether a patient is appropriate for AS, have resources to perform AS, or be motivated to use AS. Nonadopters were also significantly more likely to be anxious or have reservations about AS, be concerned about poor outcomes, or believe AS places a psychological burden on patients. Among adopters, partial and full adopters were similar except partial adopters were less likely to discuss AS with patients (P = .03) and more likely to be anxious (P = .04), have reservations (P = .03), and have concerns about the psychological burden (P = .009) of AS. Few respondents (3.2%) believed patients were aware of AS. CONCLUSION: Widespread adoption of AS will require increased patient and physician awareness, interest, and evaluation of outcomes.

Changes in mercury distribution and its body burden in delphinids affected by a morbillivirus infection: Evidences of methylmercury intoxication in Guiana dolphin.

An unusual mortality event (UME) attributed to morbillivirus infection was identified in two Guiana dolphin populations from the Southeastern Brazilian coast. The aim of this study was to characterize total mercury (THg), methylmercury (MeHg) and selenium (Se) bioaccumulation and body burden in Guiana dolphins from Sepetiba Bay (RJ) collected before (n = 61) and during the UME (n = 20). Significantly lower Se concentrations were found in the livers of individuals collected during the UME (Mann-Whitney test; p = 0.03), probably due to impairment of the detoxification process in the liver. There were differences in THg and Se concentrations in the organs and tissues of individuals (Kruskal-Wallis test, p < 0.05), but not MeHg (Kruskal-Wallis test, p = 0.07). For THg, the liver showed the higher concentrations and differed among organs and tissues analyzed such as blubber (Tukey's test for unequal N; p = 0.003). For Se concentrations, the skin and kidney presented the higher concentrations and varied among other tissues/organs, like muscle (Tukey's test for unequal N; p = 0.02). Differences in body burdens were observed among specimens collected previously and during the UME probably due to the remobilization and transport of the muscle-stored MeHg to other tissues/organs. This abrupt input of MeHg into the bloodstream may cause serious health damage. Indeed, evidences of methylmercury intoxication was observed in Guiana dolphins in Sepetiba Bay. In conclusion, bioaccumulation patterns, the detoxification process and body burden were affected by morbillivirus.

Anthropogenic noise influences on marine soundscape variability across coastal areas.

Acoustic data was collected across 15 sites distributed through the coastal area of Rio de Janeiro, Brazil, encompassing regions of different natural characteristics. Noise levels and the acoustic complexity index were calculated. Quantity and composition of anthropogenic sound sources varied across recording sites, with at least one type of sound source being registered in each location. A cluster analysis using third-octave levels from eight frequency bands divided recording sites into two groups, one considered as impacted by anthropogenic noise and the other as less-impacted. The noisiest recording locations were those with higher numbers of anthropogenic sound sources, specifically large ships. It was evidenced that anthropogenic noise affects not only noise levels, but also low-frequency acoustic complexity, which decreased in the presence of vessel traffic. The constant noise input of human activities tended to mask natural variability in the soundscape at lower frequencies.

Effects of Local Environmental and Landscape Variables on the Taxonomic and Trophic Composition of Aquatic Insects in a Rare Forest Formation of the Brazilian Amazon.

In the present study, we analyzed a unique phytophysiognomy in the Amazon region, which is formed by savanna-like vegetation on iron-rich soil (known locally as canga) located within an iron-ore mining region. We used the habitat template theory to test the hypothesis that changes in the physical-chemical properties of streams and the physical structure of their habitats at in-stream and micro-basin (landscape) levels affect the taxonomic and trophic composition of immature aquatic insects. For this, we used a local environmental matrix composed of nine physical-chemical and structural habitat variables, together with the Habitat Integrity Index. We also calculated landscape metrics based on the area of the micro-basin, such as relief, slope, mean current flow, and vegetation cover. We divided the aquatic insects into five functional feeding groups based on their diet and food sources. Our results indicate that changes in the trophic level of the insects of the orders Ephemeroptera, Plecoptera, and Trichoptera are more easily observed than the taxonomic structure of communities. The loss of environmental integrity and vegetation cover were responsible for 84% of the variation observed in the composition of functional feeding groups (FFGs). Our study shows that aquatic insect communities in the canga and in the Amazon regions dominated by forest require specific in-stream and landscape conditions. These findings reinforce the need for the preservation of areas of canga vegetation, which not only have a unique levels of biological diversity, but are also targeted for the exploitation of their economically valuable natural resources.