Facilitation of macrofaunal assemblages in marinas by the habitat-forming invader Amathia verticillata (Bryozoa: Gymnolaemata) across a spatiotemporal scale

Widespread habitat-forming invaders inhabiting marinas, such as the spaghetti bryozoan Amathia verticillata, allow exploring facilitation processes across spatiotemporal contexts. Here we investigate the role of this bryozoan as habitat for native and exotic macrofaunal assemblages across different ecoregions of Western Mediterranean and East Atlantic coasts, and a monthly variation over a year. While only 7 (all peracarid crustaceans) of the 54 associated species were NIS, they dominated macrofaunal assemblages in terms of abundance, raising the potential for invasional meltdown. NIS richness and community structure differed among marinas but not among ecoregions, highlighting the importance of marina singularities in modulating facilitation at spatial scale. Despite facilitation did not depend on bryozoan abundance fluctuations, it was affected by its deciduous pattern, peaking in summer and disappearing in late winter. Monitoring A. verticillata in marinas, especially in summer periods, may improve the detection and management of multiple associated NIS.

Evaluation of Mpox Knowledge, Stigma, and Willingness to Vaccinate for Mpox: Cross-Sectional Web-Based Survey Among Sexual and Gender Minorities

BACKGROUND

The 2022 multicountry mpox outbreak positioned the condition as a public health emergency of international concern. By May 2023, Brazil ranked second globally in the cumulative number of mpox cases and deaths. The higher incidence of mpox among gay and other men who have sex with men in the current mpox outbreak deepens the stigma and discrimination against sexual and gender minorities (SGM). This might worsen the structural barriers impacting access to health services, which ultimately leads to undertesting and underreporting of cases. There are no data available on mpox knowledge and stigma in Latin America.

OBJECTIVE

We aimed to evaluate mpox knowledge, stigma, and willingness to vaccinate for mpox among SGM, and to describe sociodemographic and behavioral characteristics according to self-reported mpox diagnosis.

METHODS

A cross-sectional, internet-based survey was conducted in a convenience sample of adults (aged >18 years) living in Brazil recruited through advertisements on dating apps, social media, referral institutions for infectious diseases websites, and mass media (October-November 2022). We compared participants' characteristics according to self-reported mpox diagnosis using chi-square test or Fisher exact test for qualitative variables and Kruskal-Wallis test for quantitative variables.

RESULTS

We enrolled 6236 participants: 5685 (91.2%) were cisgender men; 6032 (96.7%) were gay, bisexual, or pansexual; 3877 (62.2%) were White; 4902 (78.7%) had tertiary education; and 4070 (65.2%) reported low or middle income. Most participants (n=5258, 84.4%) agreed or strongly agreed that "LGBTQIA+ individuals are being discriminated and stigmatized due to mpox." Mpox awareness was 96.9% (n=6044), and 5008 (95.1%) were willing to get vaccinated for mpox. Overall, 324 (5.2%) reported an mpox diagnosis. Among these, 318 (98.1%) reported lesions, 178 (56%) local pain, and 316 (99.4%) sought health care. Among participants not reporting a diagnosis, 288 (4.9%) had a suspicious lesion, but only 158 (54.9%) of these had sought health care. Compared to participants with no diagnosis, those reporting an mpox diagnosis were younger (P<.001), reported more sex partners (P<.001), and changes in sexual behavior after mpox onset (P=.002). Moreover, participants diagnosed with mpox reported more frequently being tested for HIV in the prior 3 months (P<.001), living with HIV (P<.001), currently using HIV pre-exposure prophylaxis (P<.001), and previous sexually transmitted infection diagnosis (P<.001).

CONCLUSIONS

Our results point to high mpox knowledge and willingness to vaccinate among SGM in Brazil. Participants self-reporting mpox diagnosis more frequently reported to be living with HIV, STI diagnosis, and current pre-exposure prophylaxis use, highlighting the importance of an mpox assessment that includes comprehensive sexual health screenings. Efforts to decrease stigma related to mpox among SGM are necessary to avoid mpox underdiagnosis.

Long-Acting Injectable Cabotegravir for HIV Preexposure Prophylaxis Among Sexual and Gender Minorities: Protocol for an Implementation Study

BACKGROUND

Long-acting injectable cabotegravir (CAB-LA) for preexposure prophylaxis (PrEP) has proven efficacious in randomized controlled trials. Further research is critical to evaluate its effectiveness in real-world settings and identify effective implementation approaches, especially among young sexual and gender minorities (SGMs).

OBJECTIVE

ImPrEP CAB Brasil is an implementation study aiming to generate critical evidence on the feasibility, acceptability, and effectiveness of incorporating CAB-LA into the existing public health oral PrEP services in 6 Brazilian cities. It will also evaluate a mobile health (mHealth) education and decision support tool, digital injection appointment reminders, and the facilitators of and barriers to integrating CAB-LA into the existing services.

METHODS

This type-2 hybrid implementation-effectiveness study includes formative work, qualitative assessments, and clinical steps 1 to 4. For formative work, we will use participatory design methods to develop an initial CAB-LA implementation package and process mapping at each site to facilitate optimal client flow. SGMs aged 18 to 30 years arriving at a study clinic interested in PrEP (naive) will be invited for step 1. Individuals who tested HIV negative will receive mHealth intervention and standard of care (SOC) counseling or SOC for PrEP choice (oral or CAB-LA). Participants interested in CAB-LA will be invited for step 2, and those with undetectable HIV viral load will receive same-day CAB-LA injection and will be randomized to receive digital appointment reminders or SOC. Clinical appointments and CAB-LA injection are scheduled after 1 month and every 2 months thereafter (25-month follow-up). Participants will be invited to a 1-year follow-up to step 3 if they decide to change to oral PrEP or discontinue CAB-LA and to step 4 if diagnosed with HIV during the study. Outcomes of interest include PrEP acceptability, choice, effectiveness, implementation, and feasibility. HIV incidence in the CAB-LA cohort (n=1200) will be compared with that in a similar oral PrEP cohort from the public health system. The effectiveness of the mHealth and digital interventions will be assessed using interrupted time series analysis and logistic mixed models, respectively.

RESULTS

During the third and fourth quarters of 2022, we obtained regulatory approvals; programmed data entry and management systems; trained sites; and performed community consultancy and formative work. Study enrollment is programmed for the second quarter of 2023.

CONCLUSIONS

ImPrEP CAB Brasil is the first study to evaluate CAB-LA PrEP implementation in Latin America, one of the regions where PrEP scale-up is most needed. This study will be fundamental to designing programmatic strategies for implementing and scaling up feasible, equitable, cost-effective, sustainable, and comprehensive alternatives for PrEP programs. It will also contribute to maximizing the impact of a public health approach to reducing HIV incidence among SGMs in Brazil and other countries in the Global South.

TRIAL REGISTRATION

Clinicaltrials.gov NCT05515770; https://clinicaltrials.gov/ct2/show/NCT05515770.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/44961.

Beta-blockers in acute coronary syndrome: does rhythm matter?

Introduction

Beta-blockers (BB) are recommended in patients with previous acute myocardial infarction (AMI), aiming to reduce morbidity and mortality. Their benefit is greater in patients with associated left ventricular dysfunction. However, in patients with atrial fibrillation (AF) its prognostic benefit is controversial.

Purpose

To assess and compare the in-hospital and 1-year prognostic impact of BB prescription after acute coronary syndrome (ACS), in patients with previous or de novo AF, and in patients with sinus rhythm (SR).

Methods

This was a national multicentre retrospective study of patients hospitalized for ACS between October 2010 and December 2021. A total of 35279 patients was included, and divided in two groups according to the prescription or not of BB. Patients with previous history of ischemic heart disease (myocardial angina, AMI or coronary revascularization) or heart failure, as well as presenting in Killip class IV or submitted to coronary artery bypass graft during admission were excluded. The impact of BB prescription on in-hospital and 1 year mortality rates, in patients with AF versus SR, was compared.

Results

A total of 14906 patients was selected, 82.5% with and 17.5% without BB prescription. Most patients were in SR (90.2%), with 9.8% presenting previous or new-onset AF.

Patients without BB prescription were older (67±14 vs. 63±13 years) and had more comorbidities, namely valvular disease (2.3% vs. 1.2%, p&lt;0.001) and chronic pulmonary obstructive disease (7.1% vs. 3.1%). The mean left ventricular ejection fraction was 53±13% in patients without BB prescription and 52±11 in the group with BB prescription (p&lt;0.001). In-hospital and after discharge BB prescription was less frequent in AF patients (80.2% vs. 82.5% and 74.7% vs. 78.8%, respectively).

The in-hospital mortality rate was 2.2%, 1.3% in the BB group and 6.6% in patients without BB prescription (p&lt;0.001). At 1 year, mortality rate increased to 5.1%.

BB prescription was associated with lower in-hospital mortality rate regardless of the rhythm, with an 81% risk reduction in SR (OR = 0.19, 95% CI 0.14–0.24) and 79% in AF patients (OR = 0.21, 95% CI 0.13–0.35). In a multivariate regression analysis, after adjusting for all the possible confounders, in-hospital BB prescription was associated with 70% of mortality risk (OR = 0.30, 95% CI 0.23–0.35).

Overall, after discharge BB prescription was associated with reduced 1-year mortality risk (HR = 0.57, 95% CI 0.44–0.73), although it didn't reach statistical significance in AF patients (p=0.413). Nevertheless, in a bivariate Cox regression, rhythm showed no impact on BB protective effect (p-interaction = 0.335). As expected, AF had a negative prognostic impact (HR = 3.85, 95% CI 2.66–5.02).

Conclusion

BB prescription was associated with reduced in-hospital and 1 year mortality rates. The prognostic benefit of BB therapy was equivalent in ACS patients in sinus rhythm and with previous or new-onset AF.

Funding Acknowledgement

Type of funding sources: None.

Rabdomiólise em militares: uma missão de reconhecimento para prevenção

O treinamento físico regular faz parte do cotidiano militar, com intuito de aprimorar competências físicas essenciais para tarefas de combate. No entanto, quando executado de forma extenuante ou desenvolvido em condições climáticas adversas pode ocasionar o desenvolvimento da rabdomiólise por esforço físico. A rabdomiólise por esforço físico é definida como uma síndrome decorrente da necrose das células musculares, com sintomas variáveis, como dor muscular, fraqueza e aumento plasmático de enzimas musculares. A severidade da rabdomiólise por esforço físico varia individualmente, porém, pode se tornar clinicamente relevante, contribuindo para a hospitalização, insuficiência renal aguda, incapacidade permanente ou óbito. Sendo assim, o objetivo desta revisão narrativa é apresentar possíveis causas e fatores de risco para rabdomiólise, discutir sua fisiopatologia, seus possíveis diagnósticos e suas principais complicações, enfatizando o contexto militar.

Coronary artery fistulas: a single-center case series

Introduction

Coronary artery fistulas (CAFs) are rare anomalous connections between a coronary artery and a major vessel or cardiac chamber. Currently they are being increasingly encountered due to the more widespread use of various imaging modalities and coronary angiography. Although the vast majority of CAFs are incidentally diagnosed and have no clinical relevance, they can cause significant morbidity such as myocardial infarction, congestive heart failure and endocarditis.

Methods

A consecutive series of 55867 coronary arteriograms performed in our Cardiology Department from 2007 to 2019 was retrospectively investigated for the presence of coronary artery fistulas. Patients clinical, angiographic and therapeutic data up to november 2019 were analyzed. Data were obtained from medical records of hospital stay and subsequent consultations.

Results

We identified 50 patients who were diagnosed with one or more CAFs, with ages between 5 and 85 years (mean 59 years). 62% (n=31) were males.

The great majority of patients had a single fistula (n=34, 68%), 11 patients had two fistulas (22%), 1 patient had 3 fistulas (2%) and 4 patients had multiple fistulas (8%).

CAFs arose more frequently from the left anterior descending artery (n=27), followed by the right coronary (n=18), left circumflex (n=15), left main (n=5) and intermediate artery (n=2). The most frequent drainage site was the pulmonary artery (n=38).

The majority of CAFs were incidentally found (n=32; 64%) and thought to have no significance for the patients' clinical status. As for the rest of the patients, CAFs were diagnosed during evaluation of: a heart murmur (n=7); exertional chest pain with no associated significant atherosclerotic coronary artery disease (n=7); exertional dyspnea (n=2); positive exercise stress test (n=1); NSTEMI and cardiac arrest (n=1).

Regarding treatment, watchful waiting was the main approach (n=40; 80%). 3 patients had their CAFs closed during surgery for another heart condition (CABG/aortic valve replacement). In 1 patient, heart surgery was specifically conducted for fistula closure. 6 patients (12%) underwent fistula transcatheter closure.

Conclusion

CAFs are rare coronary anomalies and the majority has no clinical relevance, so watchful waiting is the commonest approach. When they are hemodynamically significant or symptoms/complications arise, surgical or transcatheter closure should be considered. This study describes the angiographic, clinical and therapeutic data of CAFs detected along the last 12 years in a single tertiary care center catheterization laboratory.

Funding Acknowledgement

Type of funding source: None

Potential of synthetic chalcone derivatives to prevent marine biofouling

Biofouling represents a major economic, environmental and health concern for which new eco-friendly solutions are needed. International legislation has restricted the use of biocidal-based antifouling coatings, and increasing efforts have been applied in the search for environmentally friendly antifouling agents. This research work deals with the assessment of the interest of a series of synthetic chalcone derivatives for antifouling applications. Sixteen chalcone derivatives were synthesized with moderate yields (38-85%). Antifouling bioactivity of these compounds was assessed at different levels of biological organization using both anti-macrofouling and anti-microfouling bioassays, namely an anti-settlement assay using mussel (Mytilus galloprovincialis) larvae, as well as marine bacteria and microalgal biofilms growth inhibition bioassays. Results showed that three compounds (11, 12, and 16) were particularly active against the settlement of mussel larvae (EC₅₀ 7.24-34.63 μM), being compounds 12 and 16 also able to inhibit the growth of microfouling species (EC₅₀ 4.09-20.31 μM). Moreover, the most potent compounds 12 and 16 were found to be non-toxic to the non-target species Artemia salina (<10% mortality at 25 μM). A quantitative structure-activity relationship model predicted that descriptors describing the ability of molecules to form hydrogen bonds and encoding the shape, branching ratio and constitutional diversity of the molecule were implied in the antifouling activity against the settlement of mussel larvae. This work elucidates for the first time the relevance of synthesizing chalcone derivatives to generate new non-toxic products to prevent marine biofouling.

Exposure-safety and efficacy response relationships and population pharmacokinetics of eslicarbazepine acetate

Objectives

Eslicarbazepine acetate (ESL) is a once‐daily (QD) oral antiepileptic drug (AED) for focal‐onset seizures (FOS). Pharmacokinetic (PK) and pharmacodynamic (PD) models were developed to assess dose selection, identify significant AED drug interactions, and quantitate relationships between exposure and safety and efficacy outcomes from Phase 3 trials of adjunctive ESL.

Methods

Eslicarbazepine (the primary active metabolite of ESL) population PK was evaluated using data from 1351 subjects enrolled in 14 studies (11 Phase 1 and three Phase 3 studies) after multiple oral doses ranging from 400 to 1200 mg. Population PK and PD models related individual eslicarbazepine exposures to safety outcomes and efficacy responses.

Results

Eslicarbazepine PK was described by a one‐compartment model with linear absorption and elimination. The probability of a treatment‐emergent adverse event (TEAE; dizziness, headache, or somnolence) was higher with an initial dose of ESL 800 mg than with an initial dose of ESL 400 mg QD. Body weight, sex, region, and baseline use of carbamazepine (CBZ) or lamotrigine were also found to influence the probability of TEAEs. Eslicarbazepine exposure influenced serum sodium concentration, standardized seizure frequency, and probability of response; better efficacy outcomes were predicted in patients not from Western Europe (WE; vs WE patients) and those not taking CBZ (vs taking CBZ) at baseline.

Conclusions

Pharmacokinetic and PK/PD modeling were implemented during the development of ESL for adjunctive treatment of FOS in adults. This quantitative approach supported decision‐making during the development of ESL, and contributed to dosing recommendations and labeling information related to drug interactions.

Accuracy of quick sequential organ failure assessment score to predict mortality in hospitalized patients with suspected infection in an HIV/AIDS reference centre in Rio de Janeiro, Brazil

OBJECTIVES

To compare the discriminatory capacity of the quick sequential organ failure assessment (qSOFA) vs. the systemic inflammatory response syndrome (SIRS) score for predicting 30-day mortality and intensive care unit (ICU) admission in patients with suspicion of infection at an HIV reference centre.

METHODS

We performed a prospective cohort study including consecutive adult patients who had suspected infection and who were subsequently admitted to the medical ward. Variables related to qSOFA and SIRS were measured at admission. The performance (area under the receiver operating curve, AUROC) of qSOFA (score ≥2) and SIRS (≥2 criteria) as a predictor of 30-day mortality and ICU admission was evaluated.

RESULTS

One hundred seventy-three patients (mean ± standard deviation age, 42.6 ± 12.4 years) were included in the analysis; 107 (61.8%) were male, and 111 (64.2%) were HIV positive. Respiratory and gastrointestinal infections occurred in 49 (28.3%) and 23 (13.3%), respectively. The 30-day mortality rate was 9 (5.2%) of 173. The prognostic performance of qSOFA was similar compared to SIRS, with an AUROC of 0.68 (95% confidence interval, 0.55-0.81) and 0.69 (95% confidence interval, 0.53-0.86) (p 0.96). Twenty patients (11%) were admitted to the ICU; qSOFA and SIRS had a similar discriminatory capacity for ICU admission (AUROC 0.63 (95% confidence interval, 0.51-0.75) and 0.63 (95% confidence interval, 0.50-0.76)), respectively).

CONCLUSIONS

We found a poor prognostic accuracy of the qSOFA to predict 30-day mortality in hospitalized patients suspected of infection in a setting with a high burden of HIV infection.

Epidemiology of acute febrile illness in Latin America

Background

The causes of acute febrile illness (AFI) in Latin America are diverse and their complexity increases as the proportion of fever due to malaria decreases, as malaria control measures and new pathogens emerge in the region. In this context, it is important to shed light on the gaps in the epidemiological characteristics and the geographic range for many AFI aetiologies.

Objectives

To review studies on community-acquired fever aetiology other than malaria in Latin America, and to highlight knowledge gaps and challenges needing further investigation.

Sources

PubMed from 2012 to April 2018.

Content

We found 17 eligible studies describing 13 539 patients. The median number of pathogens tested per individual was 3.5 (range 2–17). A causative pathogen could be determined for 6661 (49.2%) individuals. The most frequently reported pathogen during the study periods was dengue virus (DENV) (14 studies), followed by chikungunya virus (nine studies) and Zika virus (seven studies). Among the studies reporting concurrent infections, 296 individuals (2.2%) were found to have co-infections. In-hospital mortality was reported in eight (47%) studies, ranging between 0% and 18%.

Implications

DENV fever is the febrile illness most frequently reported, reflecting its importance, while chikungunya and zika viruses present increasing trends since their emergence in the region. Studies with systematic and harmonized approaches for detection of multiple pathogens are needed and would probably reveal a higher burden of neglected pathogens such as Rickettsia spp. and arenaviruses. The lack of point-of-care tests and harmonized approach limits the care provided by health professionals and the efficacy of surveillance for AFI in the region.

Effects of adjunctive eslicarbazepine acetate on neurocognitive functioning in children with refractory focal-onset seizures

PURPOSE

This was a phase-II, randomized, double-blind (DB), placebo-controlled study aimed to evaluate neurocognitive effects of eslicarbazepine acetate (ESL) as adjunctive therapy in pediatric patients with refractory focal-onset seizures (FOS).

METHODS

Children (6-16years old) with FOS were randomized (2:1) to ESL or placebo. Treatment started at 10mg/kg/day, was up-titrated up to 30mg/kg/day (target dose), and maintained for 8weeks, followed by one-year open-label follow-up. The primary endpoint was change from baseline to the end of maintenance period in the composite Power of Attention assessed with the Cognitive Drug Research (CDR) system. Behavioral and emotional functioning and quality of life (QOL), secondary endpoints, were assessed with Child Health Questionnaire-Parent Form 50 (CHQ-PF50), Child Behavior Checklist (CBCL), and Raven's Standard Progressive Matrices (SPM). Efficacy was evaluated through changes in standardized seizure frequency (SF), responder rate, and proportion of seizure-free patients. Safety was evaluated by the incidence of treatment-emergent adverse events (TEAEs).

RESULTS

One hundred and twenty-three patients were randomized. A noninferiority analysis failed to reject the null hypothesis that the change from baseline in the Power of Attention score in the ESL group was at least 121ms inferior to the placebo group for all age groups. The CDR scores showed no differences between placebo and ESL in Power of Attention (1868.0 vs 1759.5), Continuity of Attention (1.136 vs -1.786), Quality of Working Memory (-0.023 vs -0.024), and Speed of Memory (-263.4 vs -249.6). Nonsignificant differences between placebo and ESL were seen for CHQ-PF50, CBCL scores, and Raven's SPM. Episodic Memory Index showed significant negative effect on ESL. Efficacy results favored the ESL group (SF least square [LS] means 1.98 vs 4.29). The TEAEs had a similar incidence between treatment groups (41.0% vs 47.5%).

CONCLUSIONS

Overall ESL did not produce statistically significant effects on neurocognitive and behavioral functioning in patients with epilepsy aged 6 to 16years. Additionally, ESL was effective in reducing seizure frequency and was well-tolerated.

Primer registro de <em>Phisidia oculata</em> (Langerhans, 1881) (Annelida, Terebellidae) tras la descripción original

El examen de dos ejemplares de Terebellidae depositados en el Museo Nacional de Ciencias Naturales, Madrid, procedentes de las Islas Chafarinas ha revelado su pertenencia a la especie Phisidia oculata (Langerhans, 1881). Este es el primer registro de la especie tras su descripción original, por lo que se realiza una descripción de los mismos, indicando las principales características morfológicas que permiten su reconocimiento frente a otras especies cogenéricas y a otros géneros próximos, incluyendo una tabla sinóptica con las principales características de las especies del género Phisidia.

The effect of sequential information on consumers' willingness to pay for credence food attributes

The use of experimental methods to determine consumers' willingness to pay for "quality" food has been gaining importance in scientific research. In most of the empirical literature on this issue the experimental design starts with blind tasting, after which information is introduced. It is assumed that this approach allows consumers to elicit the real value that they attach to each of the features added through specific information. In this paper, the starting hypothesis is that this technique overestimates the weight of the features introduced by information in consumers' willingness to pay when compared to a real market situation, in which consumers are confronted with all the information at once. The data obtained through contingent valuation in an in-store setting was used to estimate a hedonic model aiming at assessing consumers' willingness to pay (WTP) for the feature "geographical origin of the variety" of pears and apples in different information scenarios: i) blind tasting followed by extrinsic information and ii) full information provided at once. The results show that, in fact, features are more valued when gradually added to background information than when consumers receive all the information from the beginning.

Music Orchestrating Health Feelings and Senses Given to the Music Present at the Hospital During Hemodynamic Procedures: Cardiac Catheterization and Coronary Angioplasty

Several studies indicate that music has soothing effects and is effective for reducing stress and anxiety in coronary patients. The effects of stress on the cardiovascular system have also been proven. However, the meanings assigned to music when used during hemodynamic procedures are unknown, as are the meanings of the experience of these procedures. The aim of this research is to understand the senses and feelings of music for patients undergoing hemodynamic procedures, identify and interpret the fantasies and emotions related to, and study the possibility of deploying in hospitals the “Musical Method for Hemodynamic Procedures”, being developed by the author. This research is based on a clinical-qualitative methodology. The sampling method is the theoretical saturation. The semi-structured interview was used in order to obtain data that was submitted to content analysis. The subjects are patients undergoing hemodynamic procedures in hospital SEMPER, Brazil. We conclude that within the experience of listening to music while undergoing catheterisation 100% of the patients claimed they had overcome the experience of stress and felt calm, tranquillity, peace and happiness. Some patients described the music as a companion, as something that diverts their attention from fear, transporting them to an imaginary place, to another dimension. The episodic memory, the capacity to recognize a musical excerpt for which the spatiotemporal context surrounding its former encounter can be recalled, was also important, with surprising results in the case of patients who underwent catheterisation in the presence of music and, later, angioplasty without the presence of music.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Sexually acquired Zika virus: a systematic review

BACKGROUND

Zika virus (ZIKV) is transmitted to humans primarily by Aedes mosquito bites. However, circumstantial evidence points to a sexual transmission route.

OBJECTIVES

To assess the sexually acquired ZIKV cases and to investigate the shedding of ZIKV in genital fluids.

DATA SOURCES

PubMed, Scopus, Pro-MED-mail and WHO ZIKV notification databases from inception to December 2016.

SELECTION CRITERIA

Reports describing ZIKV acquisition through sex and studies reporting the detection or isolation of ZIKV in the genital fluids were included.

RISK-OF-BIAS ASSESSMENT

The risk of bias was assessed using the National Institute of Health Tool.

RESULTS

Eighteen studies reporting on sex-acquired ZIKV and 21 describing the presence of ZIKV in genital fluids were included. The overall risk of bias was moderate. Sexual transmission was male-female (92.5%), female-male (3.7%) and male-male (3.7%). Modes of sexual transmission were unprotected vaginal (96.2%), oral (18.5%) and anal (7.4%) intercourse. The median time between onset of symptoms in the index partner and presumed sexual transmission was 13 days (range 4-44 days). ZIKV RNA was detected in semen as late as 188 days (range 3-188 days) following symptom onset, and infectious virus was isolated in semen up to 69 days after symptom onset. No study reported ZIKV isolation from female genital samples, but detection did occur up to 13 days after symptom onset.

CONCLUSIONS

ZIKV is potentially sexually transmitted and persists in male genital secretions for a prolonged period after symptom onset. PROSPERO systematic review registration number CRD42016041475.

An In Situ Study of the Influence of Staining Beverages on Color Alteration of Bleached Teeth

The aim of this study was to evaluate overall color change in bovine tooth fragments submitted to dental bleaching treatment performed simultaneously with the ingestion of beverages containing dyes. For this purpose, tooth fragments assembled into intraoral devices were submitted to at-home dental bleaching using 10% carbamide peroxide (CP) for 14 days and to immersion in staining beverages for 10 minutes daily. The specimens were divided into the following study groups according to bleaching treatment and staining substance (n=12): G I (negative control): no bleaching + distilled water; G II (positive control): bleaching + distilled water; G III: bleaching + coffee; and G IV: bleaching + grape juice. Twelve volunteers used the device continually, except during meals, oral hygiene, dental bleaching, and pigment challenge. Color readings were performed using a spectrophotometer both before the bleaching treatment and after each treatment week. The results were submitted to the normality test. The data obtained were submitted to analysis of variance and the Tukey or Kruskal-Wallis and Dunn tests (α=0.05). All bleached groups showed similar ΔE results at the end of treatment. Staining beverages generated negative ΔL mean values, and the lowest result was obtained in the treatment with coffee after 14 days. The Δa values in the groups that received treatment with staining beverages were higher when compared to the control groups. Dental bleaching associated with the consumption of staining substances may not affect overall tooth color change by the end of the treatment, although the consumption of staining substances did influence the different color dimensions.

Divergência genética entre genótipos de frangos tipo caipira

RESUMOObjetivou-se com este trabalho verificar a divergência genética entre sete genótipos de frangos tipo caipira da linhagem Redbro utilizando as características de desempenho por meio de técnicas de análise multivariada. Foram utilizados 840 pintos de um dia, machos, distribuídos em delineamento inteiramente ao acaso, dos seguintes genótipos: Caboclo, Carijó, Colorpak, Gigante Negro, Pesadão Vermelho, Pescoço Pelado e Tricolor. Após a consistência dos dados, foram avaliadas as seguintes variáveis: ganho em peso médio diário, consumo de ração médio diário e conversão alimentar, para os períodos: 1 a 28, 1 a 56, 1 a 70 e 1 a 84 dias de idade; peso corporal ao nascimento, aos 28, 56, 70 e aos 84 dias de idade. O desempenho dos genótipos foi avaliado por meio da análise de variância multivariada e da função discriminante linear de Fisher, usando os testes do maior autovalor de Roy e da união-interseção de Roy para as comparações múltiplas. O estudo da divergência genética foi feito por meio da análise por variáveis canônicas e pelo método de otimização de Tocher. Os genótipos Caboclo e Gigante Negro apresentaram médias canônicas diferentes dos demais genótipos. As duas primeiras variáveis canônicas explicaram 97,41% da variação entre os genótipos. A divergência genética entre os genótipos avaliados permitiu a formação de quatro grupos com os seguintes genótipos: grupo 1 - Colorpak; grupo 2 - Pesadão Vermelho e Pescoço Pelado; grupo 3 - Carijó e Tricolor; e grupo 4 - Caboclo e Gigante Negro.

Community ecology of the metazoan parasites of Brazilian sardinella, Sardinella brasiliensis (Steindachner, 1879) (Actinopterygii: Clupeidae) from the coastal zone of the State of Rio de Janeiro, Brazil

AbstractBetween March 2010 and August 2011 were necropsied 100 specimens of Sardinella brasiliensis (Steindachner, 1879), from the coast of the State of Rio de Janeiro, Brazil (22°51’S, 43°56’W), to study their community of metazoan parasites. All specimens of S. brasiliensis were parasitized by at least one species of metazoan parasite, with mean of 68.7 ± 71.2 parasites/fish. Eleven species were collected: 3 digeneans, 1 monogenean, 2 cestodes, 3 nematodes and 2 copepods. The digenean Myosaccium ecaude Montgomery was the most abundant, prevalent, and dominant species, representing 72.7% of metazoan parasites collected, showing positive correlation between host’s total length and parasite abundance. Total parasite abundance was positively correlated with host’s total length. Three pairs of adult endoparasites showed significant positive association and covariation. The parasite community of S. brasiliensis showed dominance by digeneans. Sardinella brasiliensis represents new host record for most found parasite species.

Sperm Bundles in the Seminal Vesicle of the Crematogaster victima (Smith) Adult Males (Hymenoptera: Formicidae)

This study establishes the presence of spermatodesm in the seminal vesicles of sexually mature males of Crematogaster victima (Smith). In this species, the spermatozoa are maintained together by an extracellular matrix in which the acrosomal regions are embedded. This characteristic has not yet been observed in any other Aculeata. However, the sperm morphology in this species is similar to that described for other ants. The spermatozoa measure on average 100 μm in length, and the number of sperm per bundle is up to 256. They are composed of a head formed by the acrosome and nucleus; this is followed by the flagellum, which is formed by the centriolar adjunct, an axoneme with a 9 + 9 + 2 microtubule pattern, two mitochondrial derivatives, and two accessory bodies. The acrosome is formed by the acrosomal vesicle and perforatorium. The nucleus is filled with compact chromatin with many areas of thick and non-compacted filaments. Both mitochondrial derivatives have the same shape and diameters. The presence of sperm bundles in sexually mature males differentiates C. victima from other ants; however, the similarities in the sperm ultrastructure support the monophyly of this insect group.

Abstract P3-03-02: Na+,HCO3--cotransport is the major mechanism of cellular acid extrusion in human and murine breast cancer

High metabolism and insufficient blood supply are characteristics of cancer tissue, which in combination with biochemical changes favor glycolytic metabolism and result in prominent intracellular acid production. Although extracellular pH at the core of malignant tumors is as low as one unit below normal, intracellular pH (pHi) in tumor cells is typically normal or even slightly alkaline. Thus, cancer cells must possess efficient mechanisms of acid extrusion to eliminate the excess acid load.

We investigated the role of the Na+,HCO3–cotransporter NBCn1 (SLC4A7), which in recent genome-wide association studies has been linked to human breast cancer. Based on immunohistochemistry of tumor slices and immunoblotting of enzymatically isolated epithelial organoids, we found that NBCn1 expression is upregulated in human and murine primary breast carcinomas and metastases compared to normal breast tissue. The upregulation of NBCn1 was of similar or greater magnitude than that observed for the Na+/H+-exchanger NHE1, which has previously been implicated in cell migration, proliferation and malignancy. Measurements of pHi from slices of human and murine breast cancers and from malignant and normal breast epithelial organoids showed that Na+,HCO3–cotransport is the major mechanism of acid extrusion in the near-physiological pHi range. Na+/H+-exchange was important for acid extrusion only at very low pHi values. We furthermore found that Na+,HCO3–cotransport activity was substantially greater in malignant compared to normal breast epithelial organoids of both human and murine origin, while no apparent difference in Na+/H+-exchange activity was detected between cancer and normal breast tissue. Steady-state pHi was higher in the breast cancer tissue compared to normal breast epithelium in the presence of CO2/HCO3- but not in its nominal absence.

We propose that NBCn1 plays a major role for cellular acid extrusion and pHi regulation in human and murine breast cancer. The upregulated expression of NBCn1 and the functional importance of Na+,HCO3–cotransport for pHi regulation support a causative role for NBCn1 in breast cancer development or progression.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-03-02.

Hypodontia: a retrospective study of portuguese population

Short Communication selected from the Oral Presentations of the 56th Congress of the Groupèment International pour la Recherche Scientifique en Stomatologie et Odontologie, Peñafiel (Portugal) May 2012.

Relation between dental anomalies in portuguese population

Short Communication selected from the Oral Presentations of the 56th Congress of the Groupèment International pour la Recherche Scientifique en Stomatologie et Odontologie, Peñafiel (Portugal) May 2012.

Infectious complications among individuals with clinical monoclonal B-cell lymphocytosis (MBL): a cohort study of newly diagnosed cases compared to controls

Although the risk of progression from monoclonal B-cell lymphocytosis (MBL) to chronic lymphocytic leukemia (CLL) has been well characterized, it is unknown whether other common complications associated with CLL, such as increased risk of infection, occurs in individuals with MBL. We used the Mayo CLL database to identify cohorts of individuals with newly diagnosed MBL (n=154) or newly diagnosed CLL (n=174) who resided within 50 miles of Mayo Clinic. A cohort of 689 adult patients seen for a general medical examination who resided within 50 miles of Mayo clinic and who enrolled in a case-control study of non-Hodgkin lymphoma (NHL) was used as a comparison cohort. Hospitalization with infection was more common among individuals with MBL (25/154; 16.2%), and CLL (32/174; 18.4%) than controls (18/689; 2.6%). On pooled multivariable Cox proportional hazards analysis of all 1017 patients (controls, MBL and CLL), male sex (hazards ratio (HR)=2.3; P=0.002), major co-morbid health problems (HR=1.7, P=0.04), the presence of CLL (HR=3.2, P<0.001), treatment for progressive CLL (HR=2.4, P=0.001) and the presence of MBL (HR=3.0, P=0.001) were independently associated with risk of hospitalization for infection. These results suggest the risk of serious infection in clinical MBL is substantially greater than the risk of progression requiring treatment.