Sinonasal Adenocarcinoma: Clinicopathological Characterization and Prognostic Factors

Sinonasal (SN) malignancies are rare. Within SN adenocarcinomas, the most frequent are intestinal-type adenocarcinomas (ITACs). ITAC has been associated with wood and leather dust occupational exposure and TP53 mutations. Not much information is available regarding its characterization and treatment. The aim of this study is to characterize the clinicopathologic and prognostic factors of patients with sinonasal adenocarcinomas (SNACs) treated in our tertiary-level hospital. A retrospective, consecutive study including SNAC patients diagnosed between 2004-2023 was conducted. Clinicopathological data was collected, and p53 status was assessed in the tumor specimens. The association between p53 status and clinicopathological variables, as well as their impact on survival, was evaluated. In total, 35 were included, most of them having ITAC (91.4%) with papillary subtype (37.5%); the majority were subjected to occupational risk exposure (82.9%). Overexpression of p53 was identified in 48.6% of the tumors. Papillary and colonic subtypes were associated with higher median progression-free survival (mPFS) than mucinous and solid subtypes (mPFS 37 months, 95% CI, 20.0-54.0, vs. 9 months, 95% CI, 7.15-10.85, p=0.01); the former was also associated with higher median overall survival (mOS) (mOS 64 months, 95% CI, 37.18-90.81 vs. 14 months, 95% CI, 0-41.58, p=0.02). Histologic grade 1-2 and macroscopic complete resection were associated with higher PFS (PFS of five months of 90.9% vs. 33.3%, p=0.01; mPFS of 37 months, 95% CI, 4.93-69.07 vs. 10 months, 95% CI, 6.43-13.57, p=0.04, respectively). Disease recurrence with distant metastases was associated with lower OS (11 months, 95% CI, 6.1-15.9 vs. 53 months, 95% CI, 22.70-83.30, p=0.04). This study reinforces the importance of protective occupational measures. Future studies will be important to validate the best treatment strategy in the advanced stages of this disease and also to identify new prognostic and/or therapeutic target biomarkers in SNAC.

Heterogeneity in the preferential diet of neotropical bats impacts the pancreatic islet mass and α and β cell distribution

Whether there is a relationship between bats' dietary patterns and evolutionary endocrine pancreas adaptation is not clearly understood. Aiming to contribute to this topic, we evaluated some metabolic and structural parameters in the following adult bats: the frugivorous Artibeus lituratus, the nectarivorous Anoura caudifer, the hematophagous Desmodus rotundus, and the insectivorous Molossus molossus. A. lituratus and A. caudifer diets consist of high amounts of simple carbohydrates, while D. rotundus and M. molossus diets consist of high amounts of proteins or protein and fat, respectively. In our results, A. lituratus and A. caudifer bats exhibited the highest values of relative islet mass (%), islet density (number of islets per pancreas area), and the lowest values of intestinal length among the four species. When adjusted by the body mass (mg/g of body mass), both D. rotundus and A. caudifer bats exhibited the highest islet mass values among the groups. Blood glucose was similar between A. lituratus, D. rotundus, and M. molossus, with the lowest values for the A. caudifer bats. M. molossus bats had the highest plasma cholesterol values among the studied species but exhibited similar plasma triacylglycerol with D. rotundus and A. caudifer bats. β- and α-cell distribution within A. lituratus, A. caudifer, and M. molossus islets achieved an approximate average value of ∼ 66% and ∼ 28%, respectively, a pattern inverted in D. rotundus islets (53% of α cells and 40% of β cells). A. caudifer and D. rotundus exhibited the highest and the lowest β/α-cells ratio per islet, respectively. We conclude that the macronutrient predominance in each bat-eating niche correlates with the morphophysiological pancreas features being the nectarivorous A. caudifer the species with the highest islet mass per body mass and β/α-cells ratio, while the hematophagous D. rotundus showed the highest α-cells apparatus.

Extra-Neural Metastases of Glioblastoma: A Case Series

Glioblastoma (GBM) is the most common brain tumor and has a median survival of less than two years. The current standard of care consists of surgery followed by concomitant radio and chemotherapy with temozolomide. Although it is an aggressive tumor, distant metastases are extremely rare. The dissemination mechanisms are not fully understood and currently there is no standard of care for its treatment. In this study, the authors present a comprehensive analysis of all the existing cases of extra-neural metastases of GBM in a tertiary care center over the last five years, along with the procedures carried out in each case.

Metastatic BRAF V600E-Mutated Thyroid Carcinoma: Molecular/Genetic Profiling Brings a New Therapeutic Option

We describe a case of a 46-year-old woman diagnosed with localized PTC 20 years ago, having already undergone several treatments with iodine-131 and then treatment with lenvatinib for metastatic disease, to which she developed intolerance. In 2020, in addition to pleural, thoracic, and abdominal lymph node metastasis, progression with symptomatic vertebral bone metastasis was detected, which led to the equation of new therapeutic options. In this context, a genetic/molecular test was carried out, which identified the BRAF V600E mutation and enabled the start of treatment with dabrafenib/trametinib since June 2020. This treatment allowed functional gain, symptomatic relief, and stabilization of the disease. It demonstrates how, in rare tumors, the personalized medicine approach can bring new treatment possibilities.

Low energy reserves are associated with fasting susceptibility in Neotropical nectar bats Glossophaga soricina

Neotropical nectar-feeding bats consume large amounts of sugar and use most of their energy-rich diet directly from the bloodstream, suggesting an adaptation towards lower body energy reserves. Here we tested the hypothesis that bats Glossophaga soricina spare the energy costs of storing energy reserves, even if this would represent a risky susceptibility during fasting. Blood glucose concentrations in 18 h fasted bats showed a 40% decrease. Breast muscle and adipose tissue lipids, as well as carcass fatty acids and liver glycogen, were also decreased following fasting. The inability to keep normoglycemia following a short-term fasting (i.e. 28 h) confirm that nectar bats invest little on storing energy reserves and show a severe fasting susceptibility associated to this pattern. Our study also support the general hypothesis that evolutionary specializations towards nectar diets involve adaptations to allow a decreased body mass, which reduces the energy costs of flight while increases foraging time.

CHARACTERIZATION AND PERFORMANCE TESTS OF A NEW OSL/TL PERSONAL DOSEMETER FOR INDIVIDUAL MONITORING

We propose a personal dosemeter based on the combination of thermoluminescence (TL) and optically stimulated luminescence (OSL) detectors employing the advantages of both techniques. The new OSL/TL dosemeter using a badge manufactured in a 3D printer was tested for assessment of photon doses in simulated and actual situations of exposure. Additionally, Brazilian national performance tests adapted to the new dosemeter were run as well as the performance tests of international standards on the passive dosimetry systems. The results showed the advantages of combined OSL and TL techniques when using the three different configurations of detector combination, Al2O3/BeO, BeO/CaSO4 and Al2O3/LiF. The dosemeter allowed corrections for radiation energy without the necessity of attenuation filters, the evaluation of single and accumulated doses and the triple check of the dose values. Further, the performance tests were consistent with national and international requirements, showing the viability of application of the new dosemeter to the assessment of equivalent doses.

Energy reserves of Artibeus lituratus (Chiroptera: Phyllostomidae) in two areas with different degrees of conservation in Minas Gerais, Brazil

Forest fragmentation associated with the expansion of human development is a phenomenon that occurs worldwide. Studies reveal that there have been both a decline in species diversity and a decrease in Neotropical bat population size because of habitat loss. The aim of this study was to investigate whether human action has been affecting the food availability to wildlife species, which could impact the storage of body energy reserves. For this purpose, fruit-eating bats (Artibeus lituratus) were collected in two areas in Minas Gerais state, Brazil. The concentrations of plasma glucose, as well as glycogen, lipids and protein in liver in muscles were performed, in addition to adipose tissue weight and carcass fatty acids. Our results indicate that fat reserves were significantly lower in most tested tissues (muscle of the hindlimbs, breast muscles, adipose tissue and carcass) in animals collected in the region with a higher degree of human disturbance. The other parameters showed no significant differences in the groups collected at different locations. In conclusion, we suggest that human action on the environment may be affecting the storage of body fat energy reserves of this species during the autumn, particularly in metropolitan region areas of Belo Horizonte, MG - Brazil, requiring special attention to the species conservation.

Short-term effects of a spinosyn's family insecticide on energy metabolism and liver morphology in frugivorous bats Artibeus lituratus (Olfers, 1818)

A new class of insecticide derived from fermentation of Sacharopolyspora spinosa - spinosad, has been indicated as being of low toxicity and a natural alternative to classical pesticides. In order to elucidate several aspects related to the morphophysiological changes induced by spinosad in Artibeus lituratus, the effects of a seven-day administration on plasma glucose, glycogen, protein and lipid concentrations were evaluated, and possible changes in liver cells were examined by histological analysis. Animals were fed with spinosyn-contaminated fruit through immersion in a solution. Data reporting on metabolism revealed a decrease in hind limb muscle lipid concentration in the treated group. Morphological analysis indicated a significant increase in liver cell diameter in treated animals compared to the control group. This study indicates that spinosyn, used at its recommended dose, does not affect general energy metabolism in A. lituratus but may affect some ultrastructural characteristics of liver cells.

Seasonal variation and food deprivation in common vampire bats (Chiroptera: Phyllostomidae)

The aim of this study was to investigate the effects of seasonal variation and fasting on fat reserves of the common vampire bat Desmodus rotundus. Plasma free fatty acids (FFA), along with lipid content of the liver and muscles, and fatty acids from the carcass were obtained from bats fed bovine blood and from whom food was subsequently withheld for 24 and 48 h. Animals were caught during both dry and rainy seasons. In general, fat tissue stores were not significantly influenced by seasonal variation. Lipid content of liver, muscles, and carcass decreased during some food deprivation periods, although the concomitant increase expected in plasma FFA was not observed. Lipid metabolism is hypothesized as being continued by the tissues themselves. In addition, free access to food sources (e.g., domestic livestock) throughout the year is believed to contribute to the low seasonal variations in fat reserves observed in the common vampire bat.

Dose measurements in chest diagnostic X rays: adult and paediatric patients

This survey was carried out in the state of São Paulo, Brazil. The health services located in the state perform approximately 321 radiological examinations per 1000 inhabitants. A representative sample of 200 health services was selected using sampling techniques, and a postal dosimetric kit was sent to each one who agreed to participate. The kit evaluates entrance surface dose (ESD), making use of thermoluminescence dosemeters attached to the skin of patients. The radiographic technique employed and some physical data of patients were also gathered. In this stage of the survey, only chest examinations, projections AP, PA and LAT, were evaluated. A total of 917 ESD values were measured, which correspond to 588 patients and 74 examination rooms. The ESD to patients were analysed according to weight and age. Groups of standard patients (children and adults) were selected, and reference doses were determined. Large variations of ESD were observed, indicating that much can be done in order to reduce the patient doses by changing the technical parameters. Moreover, the results of ESD in paediatric radiology point to the necessity of special attention in the practice of radiological examinations in this age group.

Metabolic responses induced by fasting in the common vampire bat Desmodus rotundus

This study explored the effects of fasting on body fuel mobilization in the common vampire bat (Desmodus rotundus) fed a high-protein diet (bovine blood). An uncommon fragility during food deprivation has been reported for this species to the point of untimely deaths after only 2-3 nights of fasting. The immediate biochemical responses to fasting, however, have not been established. Thus, blood glucose, plasma FFA, glycogen, protein, and fat concentrations in the liver and muscles were determined in fed and 24-, 48- and 72 h-fasted individuals. The results indicate that D. rotundus is unable to maintain adequate levels of blood glucose during fasting, probably due to low tissue stores of energy fuels or difficulty in mobilizing them. Other factors may play an important role in this species abundance, such as the previously reported behavior of reciprocal blood regurgitation.

An overview of doses to patients and irradiation conditions of diagnostic chest x ray examinations carried out in hospitals of the City of São Paulo, Brazil

Recently the Brazilian health organisation published information conceming the number of hospitals, details of radiological equipment and frequency of medical examinations in the country. The information concerning the city of São Paulo is compiled here, complemented by a survey of absorbed doses to patients undergoing the most frequent examination: chest radiographs (postero-anterior (PA) and lateral (LAT) projections), as well as the physical parameters employed (tube voltage, current-time product, focus-film distance, field size). To collect the data, a sample of 12 hospitals (a representative sample of the 199 located in the city) was chosen, totalling 27 X ray machines. An anthropomorphic phantom was irradiated to simulate the patient. Absorbed doses were determined with thermoluminescence dosemeters placed in the phantom, externally and internally. Mean values of entrance surface dose (ESD) for PA and LAT projections were 0.22 mGy (from 0.07 to 0.61 mGy) and 0.98 mGy (from (1.30 to 4.01 mGy), respectively. The average organ doses per complete examination (PA and LAT) were 0.15 and 0.24 mGy to thyroid and lung, respectively. The thyroid was thus in the primary beam in many cases. The large variation in the ESD and organ doses indicates that much can be done in order to reduce the patient doses by adequate changes of physical parameters, without loss of image quality.

[The importance of water testing for public health in two regions in Rio de Janeiro: a focus on fecal coliforms, nitrates, and aluminum]

In developing countries, due to poor sanitation conditions and poor quality of drinking water, typical water-borne diseases and more recently diseases caused by drinking water with high concentrations of nitrates and certain metals like aluminum have increased the concern over the health effects of these compounds. Several articles have shown associations between nitrates and methemoglobinemia in children, and aluminum and Alzheimer disease in adults. This study identified water quality with several parameters in non-conformity with Brazilian drinking water standards (Ruling 36/90): more than 50% of all samples from both regions contained fecal coliforms; some 31% of water samples from wells in Duque de Caxias had excessive nitrate concentrations; 100% of all groundwater samples from both regions showed aluminum concentrations not conforming to the norm, with the same result for 100% of samples from the drinking water distribution system in São Gonçalo and 75% of same in Duque de Caxias. This lack of conformity poses several health risks for the local population.