Microplastic in the stomachs of open-ocean and deep-sea fishes of the North-East Atlantic.

The presence of microplastic in marine fishes has been well documented but few studies have directly examined differences between fishes occupying contrasting environmental compartments. In the present study, we investigated the gut contents of 390 fishes belonging to three pelagic (blue jack mackerel, chub mackerel, skipjack tuna) and two deep-sea species (blackbelly rosefish, blackspot seabream) from the Azores archipelago, North-East Atlantic for microplastic contamination. Our results revealed that pelagic species had significantly more microplastic than the deep-water species. In all of the species studied, fragments were the most common plastic shape recovered and we found a significant difference in the type of polymer between the pelagic and deep-water species. In deep-sea fish we found almost exclusively polypropylene, whereas in the pelagic fish, polyethylene was the most abundant polymer type. Overall, the proportion of fish containing plastic items varied across our study species from 3.7% to 16.7% of individuals sampled, and the average abundance of plastic items ranged from 0.04 to 0.22 per individual (the maximum was 4 items recovered in one stomach). Despite the proximity of the Azores archipelago to the North Atlantic subtropical gyre, a region of elevated plastic abundance, the proportion of individuals containing plastic (9.49%) were comparable with data reported elsewhere.

The kinetics of cellular and humoral immune responses of common carp to presporogonic development of the myxozoan Sphaerospora molnari.

BACKGROUND: Sphaerospora molnari is a myxozoan parasite causing skin and gill sphaerosporosis in common carp (Cyprinus carpio) in central Europe. For most myxozoans, little is known about the early development and the expansion of the infection in the fish host, prior to spore formation. A major reason for this lack of information is the absence of laboratory model organisms, whose life-cycle stages are available throughout the year. RESULTS: We have established a laboratory infection model for early proliferative stages of myxozoans, based on separation and intraperitoneal injection of motile and dividing S. molnari stages isolated from the blood of carp. In the present study we characterize the kinetics of the presporogonic development of S. molnari, while analyzing cellular host responses, cytokine and systemic immunoglobulin expression, over a 63-day period. Our study shows activation of innate immune responses followed by B cell-mediated immune responses. We observed rapid parasite efflux from the peritoneal cavity (< 40 hours), an initial covert infection period with a moderate proinflammatory response for about 1-2 weeks, followed by a period of parasite multiplication in the blood which peaked at 28 days post-infection (dpi) and was associated with a massive lymphocyte response. Our data further revealed a switch to a massive anti-inflammatory response (up to 1456-fold expression of il-10), a strong increase in the expression of IgM transcripts and increased number of IgM+ B lymphocytes, which produce specific antibodies for the elimination of most of the parasites from the fish at 35 dpi. However, despite the presence of these antibodies, S. molnari invades the liver 42 dpi, where an increase in parasite cell number and indistinguishable outer cell membranes are indicative of effective exploitation and disguise mechanisms. From 49 dpi onwards, the acute infection changes to a chronic one, with low parasite numbers remaining in the fish. CONCLUSIONS: To our knowledge, this is the first time myxozoan early development and immune modulation mechanisms have been analyzed along with innate and adaptive immune responses of its fish host, in a controlled laboratory system. Our study adds important information on host-parasite interaction and co-evolutionary adaptation of early metazoans (Cnidaria) with basic vertebrate (fish) immune systems and the evolution of host adaptation and parasite immune evasion strategies.

Shoulder Strength Changes One Year After Axillary Lymph Node Dissection or Sentinel Lymph Node Biopsy in Patients With Breast Cancer.

OBJECTIVES: To assess the changes in shoulder strength of patients with breast cancer during the first year after surgery; and to compare the effect of sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND) on shoulder strength. DESIGN: Prospective longitudinal observational study from presurgery to 1 year after. SETTING: Tertiary hospital. PARTICIPANTS: Of 129 consecutive patients examined for eligibility, a sample of women (N=112) with breast cancer were included (44 underwent ALND, and 68 underwent SLNB). INTERVENTIONS: Not applicable. MAIN OUTCOMES MEASURES: Difference between the affected and unaffected arm in strength of shoulder external rotators, internal rotators, abductors, and serratus anterior, measured by dynamometry. Evaluations were performed prior to surgery and at 1, 6, and 12 months after surgery. RESULTS: After breast cancer ALND surgery, strength decreased significantly at the first month for internal rotators, without having recovered presurgery values after 1 year of follow-up, with a mean difference of 2.26kg (P=.011). There was no significant loss of strength for patients treated with SLNB. The loss of shoulder range of motion was only significant the first month for the ALND group. The factors identified as associated with strength loss in the general estimating equation models were the ALND surgery and having received physical/occupational therapy during follow-up. CONCLUSIONS: One year after breast cancer surgery, patients treated with ALND had not recovered their previous shoulder internal rotators strength, whereas those who underwent SLNB presented no significant loss of strength. This provides important information for designing rehabilitation programs targeted specifically at the affected muscle group after nodal surgical approach.

Lymphedema Predictor Factors after Breast Cancer Surgery: A Survival Analysis.

BACKGROUND: Factors associated with lymphedema development after breast cancer surgery are not well established. The purpose is to assess the value of patient, disease and treatment-related factors predicting lymphedema development. METHODS AND RESULTS: This study included 371 women with primary invasive breast cancer treated surgically between 2005 and 2009 with follow-up until December 2011. At each follow-up visit, both upper limb circumferences were measured at seven points to calculate the upper limb volume. Kaplan-Meier and Cox regression models for survival were applied. By the end of the follow-up period, 33.4% of women (n=124) had developed lymphedema. According to volume, lymphedema at diagnosis was mild in 78.5%, moderate in 19.0%, and severe in 2.5% of them. A 77.4% of lymphedema had enough clinical relevance to be treated. The probability of developing lymphedema within 12, 24, and 36 months post-surgery was 28.7% (95%CI 24.1-34.0%), 34.6% (95%CI 29.5-40.2%), and 38.3% (95%CI 32.8-44.3%), respectively. High stages, axillary lymph node dissection, chemotherapy, radiotherapy, and postoperative seroma were predictors of lymphedema in the bivariate survival analysis. Only axillary lymph node dissection and radiotherapy maintained their significance in the multivariate model. When the analysis was restricted to patients who underwent axillary lymph node dissection, the number of nodes excised did not influence the occurrence of lymphedema. CONCLUSIONS: Axillary lymph node dissection and radiotherapy affected lymphedema development. This study provides support that breast cancer patients with such characteristics should be closely monitored, especially during the first year after surgery.

Long thoracic nerve injury in breast cancer patients treated with axillary lymph node dissection.

PURPOSE: The objectives of this study were to electromyographically (EMG) describe and analyze factors associated with long thoracic nerve injuries in breast cancer patients after axillary lymph node dissection. METHODS: This was a prospective longitudinal observational study. Two hundred sixty-four women with primary invasive breast cancer were included between 2008 and 2011. All of them were treated by axillary lymph node dissection. Patients were evaluated at 1, 6, and 12 months following surgery. The presence of winged scapula was systematically tested at each follow-up and an EMG performed whenever it was observed. Affected and unaffected groups were compared for demographic, tumour, and treatment variables. Student t test, Mann-Whitney U test, chi-squared or Fisher test were computed as appropriate. RESULTS: Among the 36 (13.6%) winged scapula observed, the EMG confirmed long thoracic nerve injury in 30 (11.3%) of them, 27 were partial axonotmesis and three were severe axonotmesis. At 12 months, the EMG showed that injury persisted in six (2.27%) patients. Patients with long thoracic nerve injury had a lower body mass index than unaffected patients (26.2 vs. 28.2, p = 0.045). Age, tumour stage, type of breast surgery, nodes excised, surgical complications, previous chemotherapy and previous hormonotherapy were not factors associated with winged scapula. CONCLUSIONS: A lower body mass index was the only factor associated to long thoracic nerve injury. In most of the patients, the EMG showed partial axonotmesis. At 12 months, 2.27% of studied patients remained with an unsolved long thoracic nerve injury.

Balance 1 year after TKA: correlation with clinical variables.

Knee osteoarthritis results in changes that affect balance. It has been reported that osteoarthritis worsens proprioception and increases the risk of falling. The objective of this study was to assess changes in balance among patients with knee osteoarthritis at 1 year after total knee arthroplasty (TKA) surgery and its relationship with clinical variables. This prospective, observational study evaluated 44 patients before and 1 year after TKA. Variables analyzed included age, body mass index, pain, range of motion for both knees, bilateral quadriceps and hamstrings muscle strength, gait velocity, and Knee Society score. Balance and posture control were assessed using the following computerized posturography tests: the weight bearing test, modified Clinical Test of Sensory Interaction on Balance (mCTSIB) test, and sit-to-stand test. Pre- and postoperative differences were analyzed using Wilcoxon and chi-square tests, and effect size was measured using standardized response mean. Correlations were assessed by the Spearman test. One year after TKA, some improvement in balance tests was observed. Significant differences were observed in the mCTSIB test: foam surface with open eyes (P≤.001), foam surface with closed eyes (P≤.001), and composite value (P≤.001). Effect size was moderate to high. Age showed significant correlation with mCTSIB composite value changes (-0.369; P=.037). No significant correlations were found between posturographic tests and other analyzed variables. Balance measured by computerized posturography improved 1 year after TKA. Significant changes were observed between open and closed eyes using a foam surface for the mCTSIB test. A mild negative correlation was found between age and posturographic changes.