Exercise promotes growth and rescues volume deficits in the hippocampus after cranial radiation in young mice

Human and animal studies suggest that exercise promotes healthy brain development and function, including promoting hippocampal growth. Childhood cancer survivors that have received cranial radiotherapy exhibit hippocampal volume deficits and are at risk of impaired cognitive function, thus they may benefit from regular exercise. While morphological changes induced by exercise have been characterized using magnetic resonance imaging (MRI) in humans and animal models, evaluation of changes across the brain through development and following cranial radiation is lacking. In this study, we used high-resolution longitudinal MRI through development to evaluate the effects of exercise in a pediatric mouse model of cranial radiation. Female mice received whole-brain radiation (7 Gy) or sham radiation (0 Gy) at an infant equivalent age (P16). One week after irradiation, mice were housed in either a regular cage or a cage equipped with a running wheel. In vivo MRI was performed prior to irradiation, and at three subsequent timepoints to evaluate the effects of radiation and exercise. We used a linear mixed-effects model to assess volumetric and cortical thickness changes. Exercise caused substantial increases in the volumes of certain brain regions, notably the hippocampus in both irradiated and nonirradiated mice. Volume increases exceeded the deficits induced by cranial irradiation. The effect of exercise and irradiation on subregional hippocampal volumes was also characterized. In addition, we characterized cortical thickness changes across development and found that it peaked between P23 and P43, depending on the region. Exercise also induced regional alterations in cortical thickness after 3 weeks of voluntary exercise, while irradiation did not substantially alter cortical thickness. Our results show that exercise has the potential to alter neuroanatomical outcomes in both irradiated and nonirradiated mice. This supports ongoing research exploring exercise as a strategy for improving neurocognitive development for children, particularly those treated with cranial radiotherapy.

What is the significance of a faecal elastase-1 level between 200 and 500μg/g?

Background

Pancreatic exocrine insufficiency is a cause of malabsorption. It is generally diagnosed if faecal elastase-1 (FE-1) levels are below 200 µg/g. Pancreatic function is assumed to be normal when faecal elastase levels are >500 µg/g. The significance of faecal elastase levels above 200 µg/g but less than 500 µg/g is unclear.

Methods

This retrospective study reports the response to treatment in patients who had an FE-1 level between 200 and 500 µg/g.

Results

Of these 82 patients, 28 were offered pancreatic enzyme replacement therapy (PERT). A clinical response, defined as an improvement in their initial symptoms after commencing PERT, was seen in 20 patients (71%), 7 with potentially predisposing conditions and 13 with functional diarrhoea. PERT particularly abolished or improved diarrhoea, steatorrhoea and flatulence.

Conclusion

Clinicians should, therefore, be aware that a trial of PERT given to patients with FE-1 levels between 200 and 500 µg/g may lead to improvement in gastrointestinal symptoms.

Comparing the long-term prognosis of myocardial infarction with non-obstructive coronary arteries to myocardial infarction with obstructive coronary artery disease

Background

The long-term survival rates of myocardial infarction with non-obstructive coronary arteries (MINOCA) patients is lower than in the general population. Nevertheless, there are conflicting results regarding the prognosis of MINOCA patients in comparison to myocardial infarction with obstructive coronary artery disease (MI-CAD) patients.

Purpose

The aim of this study was to assess the long-term all-cause mortality of MINOCA patients and compare it to MI-CAD patients.

Methods

Retrospective analysis of 2443 consecutively admitted patients for acute myocardial infarction (AMI), in a single coronary intensive care unit. Only patients with 5 years of follow-up and those who died before the 5-year mark were considered. Patients were divided into two groups according to the presence or absence of obstructive coronary artery disease on angiography (≥50% stenosis). Demographic characteristics, symptoms at presentation, past medical history, laboratory characteristics and medication at discharge were compared using the Mann-Whitney U or χ2 test (according to variable type) to ensure comparability between groups. Five-year all-cause mortality was the target endpoint. Five-year survival was modelled through the Cox proportional hazard regression model. The variable of interest (MINOCA vs MI-CAD) and possible confounders that displayed statistically significant differences in the initial demographic analysis were included in univariable Cox regressions, and those with statistically significant associations were included in a multivariable model. Those that displayed non-significant associations in the multivariable model were subsequently removed until we were left with significant associations only, giving us an adjusted hazard ratio.

Results

Comparison between groups is presented in table 1. MINOCA patients were younger and more often women. They were less likely to have smoking habits, diabetes, or a previous history of AMI. They had a lower Killip class, as well as lower troponin I, serum creatinine and low-density lipoprotein cholesterol at admission. On the other hand, they had higher left ventricular ejection fractions. They were also less likely to have beta-blockers or aspirin prescribed at discharge.

All-cause mortality at 5 years was 13.1% among MINOCA patients and 28.3% among MI-CAD patients, with an unadjusted hazard ratio (HR) of 0.421 (95% CI 0.322–0.550), p<0.001. Adjusting for known confounders, the HR was 0.461 (95% CI 0.261–0.816), p=0.008.

Conclusions

Compared with MI-CAD patients, those with MINOCA were slightly younger and had fewer comorbidities. In spite of having a worse long-term prognosis when compared to the general population, MINOCA patients have a significantly higher 5-year survival rate than MI-CAD patients, even after adjustment of confounding factors.

Funding Acknowledgement

Type of funding sources: None.

Maximum dose sacubitril/valsartan in heart failure with reduced ejection fraction: does atrial fibrillation compromise the benefits?

Background

In the PARADIGM-HF trial, sacubitril/valsartan (SV) was shown to be superior to enalapril in reducing hospitalizations for worsening heart failure (HF), cardiovascular mortality, and all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF). The 2021 ESC Guidelines recommends SV as a replacement for angiotensin-converting-enzyme inhibitors to reduce the risk of HF hospitalization and death. There is little information regarding the effects of SV according to atrial fibrillation (AF) status.

Purpose

The aim of this study was to compare the effects of maximum dose SV regarding symptomatic improvement, change in natriuretic peptides levels (NP) and left ventricular ejection fraction (LVEF) in patients with HFrEF with and without AF.

Methods

Retrospective analysis of 137 patients with HFrEF on maximum dose SV (97/103mg twice daily). Patients were divided into two groups according to AF status. Age, gender, relevant comorbidities, usual medication, baseline symptomatic status, NP levels and LVEF were assessed using the Mann-Whitney U or χ2 test (according to variable type) to ensure comparability between groups. Variation in NYHA class, NP levels and LVEF between baseline and 6-month follow-up was evaluated and compared between groups.

Results

Comparison between groups is presented in Table 1. In our studied population, ischemic aetiology was more common in the sinus rhythm group (49.5% vs 30.4%; p 0.034). There were no significant differences between groups regarding age, gender, hypertension, diabetes, and beta-blocker and mineralocorticoid receptor antagonist usage. At baseline, the AF group had higher NT-proBNP levels [median 1421 mg/dL (IQR 743–3087) vs 467 mg/dL (IQR 140–797); p<0.001]. There were no significant differences regarding baseline NYHA class or LVEF. After 6 months of follow-up, reductions in NYHA class [−1 (IQR −2, −1) for AF; −1 (IQR −1, 0) for SR; p=0.437] and NT-proBNP levels [−358 mg/dL (IQR −2275, −47) for AF; −162 mg/dL (IQR −364, 27) for SR; p=0.156], as well as LVEF improvement [11% (IQR 3–15) for AF; 12% (IQR 7–21) for SR; p=0.201], displayed no statistically significant differences between the two groups.

Conclusions

Our study shows that the beneficial effects of SV on symptomatic status, NP levels and LVEF were not compromised by the presence of AF at baseline.

Funding Acknowledgement

Type of funding sources: None.

Inflammation in acute coronary syndrome: prognostic significance

Funding Acknowledgements

Type of funding sources: None.

Background

In patients with acute coronary syndrome (ACS) the acute phase reactant, C-reactive protein (CRP), might be significantly elevated. Several reports suggest that CRP may play a direct pathophysiological role on the development and progression of atherosclerosis, and CRP values correlate with infarct size when measured by magnetic resonance imaging.

Purpose

The aim of the present study was to evaluate the prognostic value of CRP in patients presenting with an ACS.

Methods

Retrospective analysis of 635 consecutively admitted patients due to ACS in a single coronary intensive care unit. CRP levels were measured at admission. Clinical variables and therapeutic strategies were examined. The primary endpoint analysed during follow-up was all-cause mortality. Possible predictors for all-cause mortality were assessed by Cox regression models. When statistically significant values were found in univariate analysis, multivariate analysis was used to determine whether CRP was an independent predictor of outcome.

Results

In the studied sample, 75% were male. Median age was 69 [interquartile range (IQR) 57–78]. ST-elevation myocardial infarction (STEMI) occurred in 39.6%, non-ST segment elevation myocardial infarction in 44.9% and unstable angina in 15.5% of the patients. Median left ventricular ejection fraction (LVEF) was 48% (IQR 40–55%) and median CRP level at admission 0.7 mg/dL (IQR 0.5–1.9 mg/dL). Regarding important comorbidities and past medical history, 75.9% had hypertension (HTN), 34.0% diabetes, 20.3% chronic kidney disease (CKD), 68.6% dyslipidaemia and 17.3% heart failure (HF). The median follow-up was 34 months (IQR 22–72). In univariate analysis, CRP was significantly associated with all-cause mortality (HR 1.06 per 1 mg/dL increase, 95% CI 1.04–1.08, p<0.001), as was gender, age, LVEF, STEMI and previous history of diabetes, HTN, CKD or HF. In multivariate analysis, CRP remained significantly associated with the primary endpoint (HR 1.02, 95% CI 1.00–1.05, p=0.033), as did age, LVEF and previous history of HF.

Conclusions

In our study, CRP at admission was an independent risk factor for all-cause mortality following an ACS. This finding indicates that inflammation associated with the acute event has a significant impact in the long-term prognosis. More evidence is needed to determine if treating inflammation (and when, in the course of the disease) could result in better outcomes.

Examining the effect of chronic intranasal oxytocin administration on the neuroanatomy and behavior of three autism-related mouse models

Although initially showing great potential, oxytocin treatment has encountered a translational hurdle in its promise of treating the social deficits of autism. Some debate surrounds the ability of oxytocin to successfully enter the brain, and therefore modify neuroanatomy. Moreover, given the heterogeneous nature of autism, treatment will only amerliorate symptoms in a subset of patients. Therefore, to determine whether oxytocin changes brain circuitry, and whether it does so variably, depending on genotype, we implemented a large randomized, blinded, placebo-controlled, preclinical study on chronic intranasal oxytocin treatment in three different mouse models related to autism with a focus on using neuroanatomical phenotypes to assess and subset treatment response. Intranasal oxytocin (0.6IU) was administered daily, for 28 days, starting at 5 weeks of age to the 16p11.2 deletion, Shank3 (exon 4-9) knockout, and Fmr1 knockout mouse models. Given the sensitivity of structural magnetic resonance imaging (MRI) to the neurological effects of interventions like drugs, along with many other advantages, the mice underwent in vivo longitudinal and high-resolution ex vivo imaging with MRI. The scans included three in vivo T1weighted, 90um isotropic resolution scans and a T2-weighted, 3D fast spin echo with 40um isotropic resolution ex vivo scan to assess the changes in neuroanatomy using established automated image registration and deformation based morphometry approaches in response to oxytocin treatment. The behavior of the mice was assessed in multiple domains, including social behaviours and repetitive behaviours, among others. Treatment effect on the neuroanatomy did not reach significance, although the pattern of trending effects was promising. No significant effect of treatment was found on social behavior in any of the strains, although a significant effect of treatment was found in the Fmr1 mouse, with treatment normalizing a grooming deficit. No other treatment effect on behavior was observed that survived multiple comparisons correction. Overall, chronic treatment with oxytocin had limited effects on the three mouse models related to autism, and no promising pattern of response susceptibility emerged.

COVID-19 predictability in Portugal using Google Trends

Background

Infodemiology is a valuable public health tool which analyses internet sources and real-time data to establish populational trends, thus assisting disease surveillance. Google trends (GT) is a popular infodemiology source widely used in previous reports to study the correlation between internet relative search volume (RSV) and surges in various pathologies. This study aims to explore the association between GT and Covid-19 symptoms and to access the possibility of predicting new surges from internet searches.

Methods

Individual data was extracted from GT RSV on four main Covid-19 related symptoms in the Health category (fever, headache, cough and shortness of breath) in Portugal between 2020/03/02 and 2021/02/15, corresponding to each of the identified surges of daily new cases (DNC) in Portugal, retrieved from GitHub. Pearson's-correlation coefficient was used for assessment. Additionally, a 14 days time-lag correlation analysis between data for the same period of time was performed.

Results

Statistically significant correlations were found between ‘fever' web searches and the DNC in the first (p = 0.02) and third (p = 0.02) wave. No statistically significant correlations were found between any other variables. Through time lag analysis, we found a maximum Pearson association between web searches for ‘cough' and the DNC during the first wave at 14 days (r = 0.55), as well as during the third wave, with a maximum association at 3 days time lag (r = 0.55).

Conclusions

Monitoring behaviour and public interest in health related issues, such as crisis, is necessary and may help in the establishment of better and target oriented health policies. Despite previously stated potential, constraints such as the exclusion of social media platforms or internet users' representativeness, could partly explain our limited results for portuguese predictability of new COVID-19 surges. A better understanding of GT's algorithm may lead to more detailed and precise data.

Key messages

Monitoring behaviour and public interest in health related issues is necessary to establish better and more targeted health policies.

Google trends seems to be an helpful infodemiology source, but doesn’t allow for full representation of the population and needs better understanding.

Suberosis at Public Health Unit (PHU) of Santa Maria da Feira/Arouca (F/A) (Portugal)

Introduction

Santa Maria da Feira (SMF) is currently one of the largest producers of cork in Portugal. Suberosis is an occupational disease of workers in the cork processing industry, associated with repeated exposure to moldy cork dust, usually presenting itself as a disease of the pulmonary interstitium (Hypersensitivity Pneumonitis). This study aims to assess the impact of occupational health interventions on the cork industry, in terms of health promotion and risk prevention.

Methods

We assessed 10 different cork companies distributed in 10 parishes of SMF.

Results

With regard to health promotion, we highlight the development of healthy workplaces and the strong commitment to training health professionals with regard to the correct use of personal protective equipment (PPE). Regarding the prevention of risks, emphasis is placed on the two areas that imply greater professional risks: storage and the process of drilling and boring. The storage of cork is done most of the time in dark and humid places, providing ideal conditions for the development of mold and the process of drilling and boring exposes workers to large amounts of moldy cork dust. In these settings, investing in PPE namely protective gloves and mask, as well as collective prevention measures, namely effective ventilation systems and regular control of humidity conditions, are essential to health protection of workers.

Conclusions

SMF has a prevalence of Suberosis well above the national average. In order to respond to this issue, the cork industry must reinforce the investment in terms of PPE, with the use of uniform, cuffs, safety shoes and visor, variable with the specific production process. In terms of collective protection, the signaling of the main hazards and the information available in the workstations regarding mandatory/recommended PPE, isolation of the areas with the most dangerous tasks as well as the maximum possible turnover between tasks are essential in terms of Occupational Health.

Key messages

Suberosis is an occupational disease of workers in the cork industry, associated with repeated exposure to moldy cork dust, usually presenting itself as a disease of the pulmonary interstitium. The development of healthy workplaces, the correct use of PPE and the investment in effective ventilation systems and control of humidity, are essential to health protection of cork workers.

Prognostic significance of percutaneous coronary intervention associated blood loss in acute coronary syndrome

Background

Antiplatelet and anticoagulants are one of the mainstay treatment of acute coronary syndrome (ACS), however they are associated with a significant increase of bleeding risk. While anaemia is a recognized predictor of adverse outcomes, it is unknown if a variation of haemoglobin (HB) levels, even without associated anaemia, has the same impact.

Purpose

The aim of this study was to determine the prognostic impact of HB variation after percutaneous coronary intervention (PCI) in ACS patients.

Methods

Retrospective analysis of 822 consecutive patients admitted due to ACS and treated with PCI, in a single coronary intensive care unit. Delta HB – ΔHB – (HB at admission – HB 24 hours after PCI) was calculated. Clinical variables and therapeutic strategies were examined. The primary endpoint analysed during follow-up was all-cause mortality. Possible predictors for all-cause mortality were assessed by Cox regression models. When statistically significant values were found in univariate analysis, multivariate analysis was used to determine whether ΔHB was independent from other known factors in predicting the outcome.

Results

In the studied sample, 75.4% were male. Mean age was 66.4±13.1. ST-elevation myocardial infarction (STEMI) occurred in 45.5%, non-ST segment elevation myocardial infarction in 42.6% and unstable angina in 11 9% of the studied population. Moderate to severe systolic dysfunction was present in 23.5% of the cases. Regarding comorbidities and past medical history, 76% had hypertension (HTN), 30.3% diabetes, 16.4% chronic kidney disease (CKD), 62.2% dyslipidaemia and 10.5% heart failure (HF). Mean HB at admission was 13.8±1.8 g/dL, mean HB after PCI was 12.9±1.9 g/dL and mean ΔHB was 0.9±1.1 g/dL. The mean follow-up was 51.6±30.6 months. In univariate analysis, ΔHB was significantly associated with all-cause mortality (HR 1.15 per 1 g/dL loss, 95% CI 1.01–1.30, p=0.04), as was HB at admission, HB after PCI, age, sex, diabetes, HTN, dyslipidaemia, CKD and moderate to severe systolic dysfunction. In multivariate analysis, ΔHB remained significantly associated with the endpoint and gained even more statistical power (HR 1.25, 95% CI 1.10–1.43, p<0.01). HB at admission and after PCI, age, CKD and moderate to severe systolic dysfunction were also independent predictors of this outcome.

Conclusions

In our study, irrespective of the admission and discharge HB, ΔHB was associated with more adverse outcomes in patients submitted to PCI. Hence, even patients with a normal HB after PCI have a worse long-term prognosis if a negative variation of HB occurs. This highlights the importance of identifying and optimising all the correctable factors that might lead to an increased bleeding risk.

Funding Acknowledgement

Type of funding sources: None.

Spatiotemporal Mapping of Early Volume Loss in the Mouse Brain after Cranial Irradiation

Sequelae after pediatric cranial radiotherapy (CRT) result in long-term changes in brain structure. While past evidence indicates regional differences in brain volume change, it remains unclear how these manifest in the time course of change after CRT. In this study, we spatiotemporally characterized volume losses induced by cranial irradiation in a mouse model, with a dense sampling of measurements over the first week postirradiation. Wild-type mice received whole-brain irradiation (7 Gy) or sham irradiation (0 Gy) at 16 days of age. In vivo magnetic resonance imaging was performed at one time point before, and 2-4 time points postirradiation in each mouse, with a particular focus on sampling during the first week after cranial irradiation. Volume changes across the brain were measured, and the degree and timing of volume loss were quantified across structures from a predefined atlas. Volume measurements across the brain after cranial irradiation revealed a ∼2-day delay in which volume is not significantly altered, after which time volume change proceeds over the course of four days. Volume losses were 3% larger and emerged 40% slower in white matter than in gray matter. Large volume loss was also observed in the ventricles. Differences in the timing and magnitude of volume change between gray and white matter after cranial irradiation were observed. These results suggest differences in the mechanism and/or kinetics underlying the associated radio-response, which may have implications in development.

Neuroanatomy and behavior in mice with a haploinsufficiency of AT-rich interactive domain 1B (ARID1B) throughout development

BACKGROUND

One of the causal mechanisms underlying neurodevelopmental disorders (NDDs) is chromatin modification and the genes that regulate chromatin. AT-rich interactive domain 1B (ARID1B), a chromatin modifier, has been linked to autism spectrum disorder and to affect rare and inherited genetic variation in a broad set of NDDs.

METHODS

A novel preclinical mouse model of Arid1b deficiency was created and validated to characterize and define neuroanatomical, behavioral and transcriptional phenotypes. Neuroanatomy was assessed ex vivo in adult animals and in vivo longitudinally from birth to adulthood. Behavioral testing was also performed throughout development and tested all aspects of motor, learning, sociability, repetitive behaviors, seizure susceptibility, and general milestones delays.

RESULTS

We validated decreased Arid1b mRNA and protein in Arid1b+/- mice, with signatures of increased axonal and synaptic gene expression, decreased transcriptional regulator and RNA processing expression in adult Arid1b+/- cerebellum. During neonatal development, Arid1b+/- mice exhibited robust impairments in ultrasonic vocalizations (USVs) and metrics of developmental growth. In addition, a striking sex effect was observed neuroanatomically throughout development. Behaviorally, as adults, Arid1b+/- mice showed low motor skills in open field exploration and normal three-chambered approach. Arid1b+/- mice had learning and memory deficits in novel object recognition but not in visual discrimination and reversal touchscreen tasks. Social interactions in the male-female social dyad with USVs revealed social deficits on some but not all parameters. No repetitive behaviors were observed. Brains of adult Arid1b+/- mice had a smaller cerebellum and a larger hippocampus and corpus callosum. The corpus callosum increase seen here contrasts previous reports which highlight losses in corpus callosum volume in mice and humans.

LIMITATIONS

The behavior and neuroimaging analyses were done on separate cohorts of mice, which did not allow a direct correlation between the imaging and behavioral findings, and the transcriptomic analysis was exploratory, with no validation of altered expression beyond Arid1b.

CONCLUSIONS

This study represents a full validation and investigation of a novel model of Arid1b+/- haploinsufficiency throughout development and highlights the importance of examining both sexes throughout development in NDDs.

Characterization of mice bearing humanized androgen receptor genes (h/mAr) varying in polymorphism length

The androgen receptor (AR) is known for masculinization of behavior and brain. To better understand the role that AR plays, mice bearing humanized Ar genes with varying lengths of a polymorphic N-terminal glutamine (Q) tract were created (Albertelli et al., 2006). The length of the Q tract is inversely proporitional to AR activity. Biological studies of the Q tract length may also provide a window into potential AR contributions to sex-biases in disease risk. Here we take a multi-pronged approach to characterizing AR signaling effects on brain and behavior in mice using the humanized Ar Q tract model. We first map effects of Q tract length on regional brain anatomy, and consider if these are modified by gonadal sex. We then test the notion that spatial patterns of anatomical variation related to Q tract length could be organized by intrinsic spatiotemporal patterning of AR gene expression in the mouse brain. Finally, we test influences of Q tract length on four behavioral tests.Altering Q tract length led to neuroanatomical differences in a non-linear dosage-dependent fashion. Gene expression analyses indicated that adult neu- roanatomical changes due to Q tract length are only associated with neurode- velopment (as opposed to adulthood). No significant effect of Q tract length was found on the behavior of the three mouse models. These results indicate that AR activity differentially mediates neuroanatomy and behavior, that AR activity alone does not mediate sex differences, and that neurodevelopmen- tal processes are associated with spatial patterns of volume changes due to Q tract length in adulthood. They also indicate that androgen sensitivity in adulthood is not likely to lead to autism-related behaviors or neuroanatomy, although neurodevelopmental processes may play a role earlier. Further study into sex differences, development, other behaviors, and other sex-specific mech- anisms are needed to better understand AR sensitivity, neurodevelopmental disorders, and the sex difference in their prevalence.

Use of an intragastric balloon for management of obesity in a dog

While various bariatric surgeries are commonplace in obesity medicine for humans, these techniques have not been commonly used in veterinary medicine. A technique used in humans consists in endoscopically placing an intragastric balloon. The intragastric balloon takes volume in the stomach causing a feeling of satiety and reducing food intake. A 57.6 kg, 9-year-old neutered female Labrador dog with chronic hypothyroidism was presented for overweight management. Combined levothyroxine treatment and dietary management with specific alimentation for obesity had failed to control overweight. An intragastric balloon was placed endoscopically in the stomach to allow the reduction of the gastric capacity and resulted in effective weight loss. The dog weight decreased to 40.9 kg at the time of intragastric balloon removal 198 days after placement. Further research including a larger sample size and long term follow-up is required to establish safety and effectiveness of this procedure.

Tuberculosis at Public Health Unit of Santa Maria da Feira and Arouca (Portugal)

Introduction

In the last decade Portugal has seen a decrease of about 40% in the notification and incidence rate of tuberculosis, with incidence values below 20/100,000 inhabitants since 2015. In 2018, a notification rate estimated at a national level was 16,6/100,000 inhabitants and an incidence rate of 16.4/100,000 inhabitants. With this investigation we intend to I) determine the notification and incidence rate of tuberculosis at the Public Health Unit (PHU) of Santa Maria da Feira and Arouca (Portugal); II) analyze the clinical and sociodemographic characteristics.

Methods

The confirmed cases of tuberculosis between January 1, 2015 and December 31, 2019 were analyzed.

Results

105 cases of tuberculosis were identified, most of them male (67%), aged between the 1 year and 94 years age (median: 52 years). About ⅓ of the patients were retired. Among the co-morbidities that constitute a risk for tuberculosis, we highlight COPD (7.6%), alcohol abuse (5.7%) and HIV (3.8%). The pulmonary location prevailed (81.9%). We emphasize that 52 cases had positive smear microscopy and 42 cases cavitation. From 2017 to 2019 we have a median of 61 days from the onset of symptoms to diagnosis. From 2015 to 2019, 4 cases with poly-resistance to isoniazid and streptomycin were identified. In 2019, the incidence rate tuberculosis was 12.5/100,000 inhabitants and the notification rate of 16.3/100,000 inhabitants.

Conclusions

The incidence and notification rate like the median between the onset of symptoms and the diagnosis, by the public health unit (PHU), are below the national average. Regarding these results, we recommend that the strategy adopted by the PHU should be maintained.

Key messages

In the last decade Portugal has seen a decrease of about 40% in the notification and incidence rate of tuberculosis, with incidence values below 20/100,000 inhabitants since 2015. In 2019, the incidence rate tuberculosis at PHU was 12.5/100,000 inhabitants and the notification rate of 16.3/100,000 inhabitants.

Comparison between two databases regarding the classification of Drug Interactions and their mechanism of action

Introduction Many drug-related problems are caused by drug interactions (DIs) that result from the pharmacological influence of one drug on another when taken together. DIs may have beneficial and predictable effects, but may also cause undesirable results, such as treatment ineffectiveness or serious adverse effects. There are a number of available databases with information about DIs. Although the information they provide is not always consensual, it is a useful tool in analysing the occurrence of potential drug interactions (PDIs) and in preventing unwanted or even fatal consequences for patients.

Objectives To compare the convergence of two databases (Micromedex/Drugs.com) regarding the classification of DIs and their mechanism of action.

Methodology A cross-sectional, descriptive and exploratory observational study was carried out using prescriptions from users with diabetes, dyslipidaemia or both pathologies from pharmacies in two districts, Porto and Braga. Information from each sample group was further analysed using two databases, Micromedex/Drugs.com.

Results Of the 57 pairs whose interaction potential was analysed, 64.3% converged on the classifications in both databases. Micromedex assigns moderate potential interaction to 36 drug pairs, and of these, 28 get the same rating on Drugs.com. Regarding the major PDIs, the degree of agreement was 40%. There are 4 drug pairs with potential for major interaction at Micromedex to which Drugs.com assigns moderate PDI. Minor PDIs were found on Drugs.com in 4 drug pairs, which Micromedex rated as major or moderate. For the remaining twelve divergent rating pairs, Drugs.com does not assign them potential for interaction while Micromedex gives them potential for major or moderate PDIs. Regarding the consequences of the occurrence of PDIs, there is agreement between Micromedex and Drugs.com, except for pair AAS/Loop Diuretics.

Conclusion Micromedex identifies a higher number of PDIs and assigns higher severity to a higher number.

SUN-093 Early Life Exposure to High Fat Diet Induces Extensive Changes in the Adult Brain

Maternal environmental exposures, like high fat diets, diabetes and obesity, can induce long term programming in offspring, including metabolic abnormalities but also phenotypes associated with neurodevelopmental disorders (NDDs), such as autism spectrum disorder, anxiety and depression. However, previous studies have not fully assessed the mechanism(s) underlying these later life neurologic effects. We hypothesized that as part of the mechanism, maternal in utero and perinatal exposure to high fat diet would induce alterations in the structure of the adult brain. To test this hypothesis, we acclimated C57BL/6 mice for 6 weeks prior to breeding, with diets differing in fat percentage: control diet, with 10% of kcal from fat (CD); high fat diet, with 45 % of kcal from fat (HF45); and even higher fat diet, with 60% of kcal from fat (HF60). Mothers were maintained on their respective diets throughout gestation and lactation. At weaning, day (D) 21, all pups were switched to the CD until whole brain magnetic resonance imaging (MRI) was performed in adulthood, D65. MRI was also performed on mothers after weaning. Metabolic effects of the different diets on mothers and offspring were assessed throughout the study. We found that mothers fed HF60 but not HF45 gained weight compared to those fed CD during the initial acclimation. HF60 mothers also displayed glucose intolerance throughout the study period from acclimation through lactation. Among the offspring, male and female pups born from HF45 and HF60 diet weighed more at weaning than CD pups. Body weights converged among the male offspring by D35, while they continued to be higher in female offspring at D65. By the time of MRI, there were no differences in percentage body fat among all diets in both males and females. Having documented expected metabolic effects, we next analyzed the MRI data. Linear model relating absolute jacobians on the effects of fat percentage of diet on brain structure in both the offspring at D65 and mothers after weaning was performed. We observed that high fat diets led to extensive changes in the offspring adult brains. Related to NDDs, the strongest effects were seen among structures involved in anxiety, such as amygdala, thalamus, septum, anterior cingulate and basal forebrain. No statistically significant changes were observed in the maternal brains, indicating that the effects of diet are limited to a critical development window.These results underscore that early life is a sensitive period for brain development, as evidenced by the extensive changes caused in the adult brain by exposure to high fat diets during gestation and lactation. The potential link between these changes and the observed higher risk of neurodevelopmental disorders warrants further investigation.

The impact of glycemic variability on length of stay and mortality in diabetic patients admitted with community-acquired pneumonia or chronic obstructive pulmonary disease

AIM

To investigate the influence of glycemic variability (GV) on length of stay and in-hospital mortality in non-critical diabetic patients.

METHODS

A observation retrospective study was performed. Diabetic patients admitted between January and June 2016 with the diagnosis of community-acquire pneumonia (CAP) and/or acute exacerbation of chronic obstructive pulmonary disease (COPD) were enrolled and glycemic control (persistent hyperglycemia, hypoglycemia, mean glucose level (MGL) and respective standard deviation (SD) and coefficient of variation (CV)) were evaluated. Primary outcomes were length of stay and in-hospital mortality.

RESULTS

Data from 242 patients were analyzed. Fifty-eight percent of the patients were male, with a median age of 77 years (min-max, 29-98). Patients had on average 2.1 glucose readings-day and the MGL was 193.3 mg/dl (min-max, 84.3-436.6). Hypoglycemia was documented in 13.4% of the patients and 55.4% had persistent hyperglycemia. The median length of hospital stay was 10 days (min-max, 1-66) and in-hospital mortality was 7.4%. We found a significant higher in-hospital mortality in older patients, with history of cancer and with nosocomial infections. We did not find any correlation between MGL, SD, CV, hypoglycemia or persist hyperglycemia and in-hospital mortality. A longer length of stay was observed in patients with heavy alcohol consumption and nosocomial infections. The length of stay was negatively correlated with the mean glucose level (r²-0.147; p < 0.05) and positively correlated with the coefficient of variation (p 0.162; p < 0.05).

CONCLUSION

This study confirmed the negative impact of the glycemic variability in the outcomes of diabetic patients admitted with CAP or acute exacerbation of COPD.

An Unusual Case of Pulmonary Mucormycosis

Invasive fungal infections in solid organ transplant recipients are associated with significant morbidity and mortality. Of these fungal infections, mucormycosis presents as an aggressive, frequently fatal angioinvasive infection. Immunocompromised hosts and diabetes are important risk factors. These infections are frequently difficult to diagnose. A high index of suspicion in the appropriate setting and early, aggressive treatment with the newer antifungal agents have altered the previously grave prognosis. We present the first reported case of cavitating pulmonary mucormycosis in a renal transplant recipient caused by an unusual species of Mucorales. The patient was treated with a combination of lobectomy and antifungal treatment comprising of amphotericin B and posaconazole. He remains free of disease recurrence on monotherapy with posaconazole.

An unusual finding of obstructive jaundice—a case report and review of the literature

Biliary ascariasis is a tropical infectious disease, endemic in regions such as the Far East, Indian subcontinent and parts of the Middle East. The responsible organism is the Ascaris lumbricoides worm. This case study presents a 54-year-old British Caucasian female patient, admitted with a 1-week history of generalized abdominal pain. Ultrasound scan of the abdomen showed a collapsed and abnormal image of the gallbladder. Further imaging for better visualization by magnetic resonance cholangiography showed a 6 cm linear structure in the gallbladder. The morphology was characteristic of gallbladder ascariasis. Detailed history revealed that 6 months ago she had travelled to Turkey. Stool cultures confirmed the presence of ascaris eggs. She was treated conservatively with a 500 mg stat dose of Mebendazole. She was followed up in 6 weeks showing complete resolution of her symptoms.

Systematic Review on Effectiveness of Patient/Nurse Navigation on Health Outcomes of Breast Cancer Patients

Background: Continued advances in technology and cancer treatment have made cancer care more complex. A wide range of healthcare professionals are involved in the care and there is a potential for poor coordination and miscommunication. Hence there is a need to integrate and coordinate care to enhance quality care and improved health outcomes patient navigation approach was introduced by Dr Harold Freeman at Harlem Hospital Centre, the USA in 1990. Some literature identified nurses as a suitable candidate to assume this role. But there is a need to further explore the effectiveness of patient/nurse navigation program for its effectiveness on health outcomes such as anxiety, psychological distress, mood states, quality of life, symptom distress (nausea, vomiting, sleep disturbances) physical well being, psychological well being, coping, support and patient satisfaction. Aim: To synthesize the best available evidence on the effectiveness of patient/nurse navigation program in the care of women with breast cancer. Methods: This review was conducted according to Cochrane guidelines. An extensive literature search was conducted in PubMed, CINAHL, Proquest, Cochrane Library, IndMed (Indian database of studies) and Shodhganga, a reservoir of Indian theses from January 1990-January 2017 for relevant studies published in the English language. The search criteria were limited to randomized controlled trials with patient or nurse navigation interventions compared with routine/usual care interventions without patient/nurse navigator in women with diagnosis of breast cancer aged 18 years and above, at any stage of illness undergoing any treatment in a hospital setting, including inpatient and outpatient/ambulatory care and studies. Results: Out of 238 studies assessed for eligibility only 6 studies were assessed for methodological quality. Quality assessment was done by using Delphi checklist by two independent reviewers. The risks of bias in RCTs were assessed using Cochrane risk of bias tool. Due to the methodological heterogeneity of the studies, a meta-analysis was not performed. The reviewers categorized the main outcomes as quality of life, patient satisfaction with care, anxiety, psychological distress and physical problems and other outcomes (treatment adherence, barriers to care, diagnostic interval, timely access to care, time to completion of treatment, use of health care resources) and presented it in narrative form. Conclusion: This review provides evidence that navigation programs have some benefit on breast cancer patients' health outcomes. The findings from this review show that there are a limited number of studies reporting health outcomes of breast cancer patients from inpatient settings and especially no studies from Asian countries. This warrants the need for developing navigation programs in developing countries especially in Indian setting where no navigation programs are being reported in cancer care.

Development of a Nurse Navigator Programme for the Care of Breast Cancer Patients

Background: Breast cancer incidences in India are rapidly rising, amounting to a significant percentage of all cancers in women. The diagnosis and expenses for treatment make the patient to thrust on a journey that disorganizes their daily function and family roles with much fear and uncertainty. The care of the patients requires a comprehensive individualized care from a pivotal nurse to meet their informational and educational needs, support, and care coordination throughout their illness trajectory. Limited studies have been reported from developing countries on specific nursing roles in cancer care. Therefore, the researcher felt the need for developing a nurse navigation program for the care of breast cancer patients. Aim: The aim of the study was to develop, validate and assess the usefulness of the program in women with breast cancer. Methods: The content of Nurse Navigator Program was prepared by reviewing literature pertaining to nurse/patient navigation programs. The program has been validated by an expert committee consisting of experts from various fields. The program consists of preoperative education on surgery and postmastectomy care, progressive muscle relaxation training, information booklets on post mastectomy care, chemotherapy and radiation therapy, telephonic follow-up sessions and ONN visits. Readability testing of the information booklets was checked online by Flesch reading ease and Flesch Kincaid-Grade level. The educational program and information booklets were translated into Kannada and retranslated into English with help of 2 experts. Researcher had undergone training in progressive muscle relaxation. Finally the usefulness and acceptability of the program was tested in 60 breast cancer patients undergoing surgery followed by chemo/radiation therapy in surgery, chemo and radiotherapy wards of a tertiary care hospital in Karnataka. After obtaining ethical permission from institutional ethical committee written informed consent was obtained from participants before conducting study. Results: The mean ICVI, SCVI/UA and mean expert proportion of the Nurse Navigator Program was found to be −1.00 for each. Flesch reading ease was 77.3 and Flesch Kincaid-Grade level achieved was 4.8. 83.3% of women strongly agreed that information booklets were useful, 80% strongly agreed the user friendliness of this program & 70% of people reported that their emotional needs were taken care seriously and got additional emotional support. 90% strongly agreed navigation services are necessary and would recommend navigation service. Conclusion: The validated Nurse Navigator Program was found acceptable and useful for patients. The whole program may give evidence on the effectiveness of a nurse navigator program for the care of women with breast cancer. If significant effects are detected this program could be implemented in the hospital setting to improve cancer care.

Isolated Neurogenic Bladder Associated With Human T-Lymphotropic Virus Type 1 Infection in a Renal Transplant Patient From Central Australia: A Case Report

BACKGROUND

Human T-lymphotropic virus type 1 (HTLV-1) is endemic amongst the Aborigines of the Northern Territory of Australia. HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) has been associated with this infection. In general population, isolated neurogenic bladder dysfunction in HTLV-1-infected individuals without HAM/TSP has been reported, and the HTLV-1 proviral load has been found to be higher in such patients compared with asymptomatic carriers. In solid organ transplantation, few cases of HAM/TSP have been reported worldwide, but not an isolated neurogenic bladder.

CASE

A 50-year-old indigenous women from Alice Springs with end stage renal disease secondary to diabetic nephropathy with no prior history of bladder dysfunction received a cadaveric renal allograft following which she developed recurrent urinary tract infections. The recipient was seropositive for HTLV-1 infection. HTLV-1 status of donor was not checked. Urodynamic studies revealed stress incontinence and detrusor overactivity without urethral intrinsic sphincter deficiency. She had no features of myelopathy. There was elevation of the serum and cerebrospinal fluid HTLV-1 proviral load. The magnetic resonance imaging myelogram was normal. Pyelonephritis was diagnosed based on clinical features, positive cultures, and renal allograft biopsy. Continuous suprapubic catheter drainage helped preventing further episodes of allograft pyelonephritis in spite of chronic colonization of the urinary tract.

CONCLUSION

Isolated bladder dysfunction is a rare manifestation of HTLV-1 infection and is probably associated with high proviral loads. This may adversely affect renal allograft and patient outcomes.

Regenerative potential, metabolic profile, and genetic stability of Brachypodium distachyon embryogenic calli as affected by successive subcultures

Brachypodium distachyon, a model species for forage grasses and cereal crops, has been used in studies seeking improved biomass production and increased crop yield for biofuel production purposes. Somatic embryogenesis (SE) is the morphogenetic pathway that supports in vitro regeneration of such species. However, there are gaps in terms of studies on the metabolic profile and genetic stability along successive subcultures. The physiological variables and the metabolic profile of embryogenic callus (EC) and embryogenic structures (ES) from successive subcultures (30, 60, 90, 120, 150, 180, 210, 240, and 360-day-old subcultures) were analyzed. Canonical discriminant analysis separated EC into three groups: 60, 90, and 120 to 240 days. EC with 60 and 90 days showed the highest regenerative potential. EC grown for 90 days and submitted to SE induction in 2 mg L^-1 of kinetin-supplemented medium was the highest ES producer. The metabolite profiles of non-embryogenic callus (NEC), EC, and ES submitted to principal component analysis (PCA) separated into two groups: 30 to 240- and 360-day-old calli. The most abundant metabolites for these groups were malonic acid, tryptophan, asparagine, and erythrose. PCA of ES also separated ages into groups and ranked 60- and 90-day-old calli as the best for use due to their high levels of various metabolites. The key metabolites that distinguished the ES groups were galactinol, oxaloacetate, tryptophan, and valine. In addition, significant secondary metabolites (e.g., caffeoylquinic, cinnamic, and ferulic acids) were important in the EC phase. Ferulic, cinnamic, and phenylacetic acids marked the decreases in the regenerative capacity of ES in B. distachyon. Decreased accumulations of the amino acids aspartic acid, asparagine, tryptophan, and glycine characterized NEC, suggesting that these metabolites are indispensable for the embryogenic competence in B. distachyon. The genetic stability of the regenerated plants was evaluated by flow cytometry, showing that ploidy instability in regenerated plants from B. distachyon calli is not correlated with callus age. Taken together, our data indicated that the loss of regenerative capacity in B. distachyon EC occurs after 120 days of subcultures, demonstrating that the use of EC can be extended to 90 days.

Electronic Printed Ward Round Proformas: Freeing Up Doctors' Time

The role of a junior doctor involves preparing for the morning ward round. At a time when there are gaps on rotas and doctors' time is more stretched, this can be a source of significant delay and thus a loss of working time. We therefore looked at ways in which we could make the ward round a more efficient place by introducing specific electronic, printed ward round proformas. We used the average time taken to write proformas per patient and the average time taken per patient on the ward round. This would then enable us to make fair comparisons with future changes that were made using the plan, do, study, and act principles of quality improvement. Our baseline measurement found that the average time taken to write up the proforma for each patient was 1 minute 9 seconds and that the average time taken per patient on the ward round was 8 minutes 30 seconds. With the changes we made during our 3 PDSA cycles and the implementation of an electronic, printed ward round proforma, we found that we were able to reduce the average time spent per patient on the ward round to 6 minutes 32 seconds, an improvement of 1 min 58 seconds per patient. The project has thus enabled us to reduce the time taken per patient during the ward round. This improved efficiency will enable patients to be identified earlier for discharge. It will also aid in freeing up the time of junior doctors, allowing them to complete discharge letters sooner, order investigations earlier and enable them to complete their allocated tasks within contracted hours.

Improving Door to Needle time in Patients for Thrombolysis

Ischaemic stroke can result in approximately 2 million brain neurones being damaged for each minute that it is left untreated. Various trials and studies such as the National Institute of Neurologic Disorders (NINDS) trial, the European Cooperative Acute Stroke Study (ECASS), ECASS II, and the Alteplase Thrombolysis for Acute Noninterventional Therapy in Ischemic Stroke (ATLANTIS) study have clearly demonstrated the beneficial effects of intravenous tissue plasminogen activator (tPA) for treatment of acute stroke. Therefore to minimise damage and improve clinical outcome, we need to identify patients who present within 4.5 hours of symptom onset and reduce the time taken to adminster a thrombolytic agent. This time is commonly referred to as the 'door to needle' (DTN) time. Our standard, set by the Clinical Commissioning Group (CCG) is to achieve a median time of scanning and thrombolysis within 55 minutes from the time that the patient enters the hospital. The aim of our QIP was to collect data on what the DTN time was during November 2015, December 2015, and January 2016 and to evaluate how this can be improved after each month. This Quality Improvement Project in the DTN time in patients for thrombolysis has identified areas in the pathway that leads to delays. One major contributing factor is the time for a doctor to come and assess and administer the thrombolytic agent to the patient. Change was implemented by ensuring that the core medical trainee on call is allocated to respond as a priority to all possible thrombolysis calls. This has resulted in a reduction of mean DTN time, from 74 minutes in November to 43 minutes in January. As well as improving patient outcomes, it is proposed that the implementation of change has benefitted the training experience and development of key skills of the core medical trainees.

Pravastatin induces cell cycle arrest and decreased production of VEGF and bFGF in multiple myeloma cell line

Multiple myeloma (MM) is a B cell bone marrow neoplasia characterized by inflammation with an intense secretion of growth factors that promote tumor growth, cell survival, migration and invasion. The aim of this study was to evaluate the effects of pravastatin, a drug used to reduce cholesterol, in a MM cell line.Cell cycle and viability were determinate by Trypan Blue and Propidium Iodide. IL6, VEGF, bFGF and TGFβ were quantified by ELISA and qRT-PCR including here de HMG CoA reductase. It was observed reduction of cell viability, increase of cells in G0/G1 phase of the cell cycle and reducing the factors VEGF and bFGF without influence on 3-Methyl-Glutaryl Coenzyme A reductase expression.The results demonstrated that pravastatin induces cell cycle arrest in G0/G1 and decreased production of growth factors in Multiple Myeloma cell line.

Carbogenically coated silica nanoparticles and their forensic applications

The color-tunable C-SiO₂ are ideal powders for fingerprint enhancement, and they can also generate self-assembled nanotags suitable for object authentication.

Abundance of Harpy and Crested Eagles from a reservoir-impact area in the Low- and Mid-Xingu River

In the Brazilian Amazon, two monospecific genera, the Harpy Eagle and Crested Eagle have low densities and are classified by IUCN as Near Threatened due to habitat loss, deforestation, habitat degradation and hunting. In this study, we evaluate occurrence of these large raptors using the environmental surveys database from Belo Monte Hydroelectric Power Plant. Integrating the dataset from two methods, we plotted a distribution map along the Xingu River, including records over a 276-km stretch of river. Terrestrial surveys (RAPELD method) were more efficient for detecting large raptors than standardized aquatic surveys, although the latter were complementary in areas without modules. About 53% of the records were obtained during activities of wildlife rescue/flushing, vegetation suppression or in transit. Between 2012 and 2014, four Harpy Eagles were removed from the wild; two shooting victims, one injured by collision with power lines and one hit by a vehicle. Also, seven nests were mapped. The mean distance between Harpy Eagle records was 15 km along the river channel, with a mean of 20 km between nests near the channel, which allowed us to estimate 20 possible pairs using the alluvial forest, riverine forest and forest fragments. Territories of another ten pairs will probably be affected by inundation of the Volta Grande channel, which is far from the main river. The average distance between Crested Eagle records was 16 km along the river channel. The only nest found was 1.3 km away from a Harpy Eagle nest. The remnant forests are under threat of being replaced by cattle pastures, so we recommend that permanently protected riparian vegetation borders (APP) be guaranteed, and that forest fragments within 5 km of the river be conserved to maintain eagle populations.

Evaluating the impact of sprouting conditions on the glucosinolate content of Brassica oleracea sprouts

The glucosinolates content of brassica plants is a distinctive characteristic, representing a healthy advantage as many of these compounds are associated to antioxidant and anti-carcinogenic properties. Brassica sprouts are still an underutilized source of these bioactive compounds. In this work, four varieties of brassica sprouts (red cabbage, broccoli, Galega kale and Penca cabbage), including two local varieties from the North of Portugal, were grown to evaluate the glucosinolate profile and myrosinase activity during the sprouting. Also the influence of light/darkness exposure during sprouting on the glucosinolate content was assessed. Glucosinolate content and myrosinase activity of the sprouts was evaluated by HPLC methods. All sprouts revealed a higher content of aliphatic glucosinolates than of indole glucosinolates, contrary to the profile described for most of brassica mature plants. Galega kale sprouts had the highest glucosinolate content, mainly sinigrin and glucoiberin, which are recognized for their beneficial health effects. Penca cabbage sprouts were particularly richer in glucoraphanin, who was also one of the major compounds in broccoli sprouts. Red cabbage showed a higher content of progoitrin. Regarding myrosinase activity, Galega kale sprouts showed the highest values, revealing that the use of light/dark cycles and a sprouting phase of 7-9 days could be beneficial to preserve the glucosinolate content of this variety.

How gamma-rays and electron-beam irradiation would affect the antimicrobial activity of differently processed wild mushroom extracts?

AIMS

The effects of irradiation (gamma-rays and electron-beams), up to 10 kGy, in the antimicrobial activity of mushroom species (Boletus edulis, Hydnum repandum, Macrolepiota procera and Russula delica) differently processed (fresh, dried, freeze) were evaluated.

METHODS AND RESULTS

Clinical isolates with different resistance profiles from hospitalized patients in Local Health Unit of Mirandela, Northeast of Portugal, were used as target micro-organisms. The mushrooms antimicrobial activity did not suffer significant changes that might compromise applying irradiation as a possible mushroom conservation technology.

CONCLUSIONS

Two kGy dose (independently of using gamma-rays or electron-beams) seemed to be the most suitable choice to irradiate mushrooms.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study provides important results in antimicrobial activity of extracts prepared from irradiated mushroom species.

Carbon dot based nanopowders and their application for fingerprint recovery

Hybrid nanopowders with a minor content of non-toxic carbogenic nanoparticles exhibit remarkable colour-tuneability with respect to the incident radiation.

Evidence of altered fertility in female roach (Rutilus rutilus) from the River Seine (France)

A large variety of anthropogenic chemicals present in the aquatic environment have been shown to be able to alter the endocrine system of exposed organisms, potentially impacting their reproductive function. The aim of this study was to assess the effects of environmental pollution on the reproductive system of wild female roach (Rutilus rutilus) from the Seine River (Normandy, France). A suite of biomarkers of endocrine disruption including gonado-somatic index, plasmatic vitellogenin, gonadal aromatase activity and histological parameters (oocyte diameter and gonad maturation) were studied. Female fish from the polluted sites showed a number of reproductive alterations, including inhibited gonad maturation, reduced oocyte growth, reduced levels of plasmatic vitellogenin and 3-fold lower gonadal aromatase activity than females collected in the reference site. Overall, these results highlight the presence of endocrine disruption in female roach from the Seine River.