Interventions about physical activity and diet and their impact on adolescent and young adult cancer survivors: a Prisma systematic review

PURPOSE

Over the past few decades, the incidence of cancer among adolescents and young adults (AYA) has been increasing. The impact of behaviors, such as physical activity (PA) and nutrition, on disease progression, prognosis, and overall health and quality of life for AYA cancer survivors is of significant importance. This systematic review aims to evaluate the effectiveness of PA and diet interventions for AYA cancer survivors and to critically evaluate existing literature, gaps, and limitations.

METHODS

A search of literature was conducted in PubMed, Science Direct, Scopus, and Google Scholar following the PRISMA guidelines. Twenty-two studies were included from online databases from 2012 to 2022, 13 of which were randomized controlled trials.

RESULTS

Most interventions were related to PA, with only four studies including nutrition or Diet interventions. The interventions were generally feasible and acceptable to AYA cancer survivors, and digitally based PA interventions were commonly used. PA interventions mainly comprised aerobic and resistance training and were individualized. Overall, this review found various PA and diet interventions for AYA cancer survivors that were feasible and well-accepted, but gaps in knowledge and design still exist.

CONCLUSIONS

This systematic review underscores the importance of conducting more research on diet interventions for YCS. PROSPERO REGISTRATION: https://www.crd.york.ac.uk/prospero/#aboutregpage.

The genetic landscape of mitochondrial diseases in the next-generation sequencing era: a Portuguese cohort study

Introduction: Rare disorders that are genetically and clinically heterogeneous, such as mitochondrial diseases (MDs), have a challenging diagnosis. Nuclear genes codify most proteins involved in mitochondrial biogenesis, despite all mitochondria having their own DNA. The development of next-generation sequencing (NGS) technologies has revolutionized the understanding of many genes involved in the pathogenesis of MDs. In this new genetic era, using the NGS approach, we aimed to identify the genetic etiology for a suspected MD in a cohort of 450 Portuguese patients. Methods: We examined 450 patients using a combined NGS strategy, starting with the analysis of a targeted mitochondrial panel of 213 nuclear genes, and then proceeding to analyze the whole mitochondrial DNA. Results and Discussion: In this study, we identified disease-related variants in 134 (30%) analyzed patients, 88 with nuclear DNA (nDNA) and 46 with mitochondrial DNA (mtDNA) variants, most of them being pediatric patients (66%), of which 77% were identified in nDNA and 23% in mtDNA. The molecular analysis of this cohort revealed 72 already described pathogenic and 20 novel, probably pathogenic, variants, as well as 62 variants of unknown significance. For this cohort of patients with suspected MDs, the use of a customized gene panel provided a molecular diagnosis in a timely and cost-effective manner. Patients who cannot be diagnosed after this initial approach will be further selected for whole-exome sequencing. Conclusion: As a national laboratory for the study and research of MDs, we demonstrated the power of NGS to achieve a molecular etiology, expanding the mutational spectrum and proposing accurate genetic counseling in this group of heterogeneous diseases without therapeutic options.

Global Protected Areas as refuges for amphibians and reptiles under climate change

Protected Areas (PAs) are the cornerstone of biodiversity conservation. Here, we collated distributional data for >14,000 (~70% of) species of amphibians and reptiles (herpetofauna) to perform a global assessment of the conservation effectiveness of PAs using species distribution models. Our analyses reveal that >91% of herpetofauna species are currently distributed in PAs, and that this proportion will remain unaltered under future climate change. Indeed, loss of species' distributional ranges will be lower inside PAs than outside them. Therefore, the proportion of effectively protected species is predicted to increase. However, over 7.8% of species currently occur outside PAs, and large spatial conservation gaps remain, mainly across tropical and subtropical moist broadleaf forests, and across non-high-income countries. We also predict that more than 300 amphibian and 500 reptile species may go extinct under climate change over the course of the ongoing century. Our study highlights the importance of PAs in providing herpetofauna with refuge from climate change, and suggests ways to optimize PAs to better conserve biodiversity worldwide.

Childbearing intentions after a very preterm delivery: a study among Portuguese mothers and fathers

Background

Adjustments to intended family size are strongly affected by life-course events, but data on childbearing plans after a very preterm delivery are lacking. This study intends to assess the childbearing intentions of mothers and fathers of very preterm infants, regarding the desired and intended number of children, the factors associated with the intention to have more children and the main reasons for not wanting to have more children.

Methods

Between May and July 2017, mothers and fathers of very preterm infants were invited to participate in a structured online questionnaire through the Portuguese association of parents for support to the premature baby, and 231 mothers and 21 fathers were included. The discrepancy between the ideal and intended number of children was assessed by the McNemar-Bowker test. To assess the main factors associated with the plan to have more children in the future, unconditional logistic regression models were fitted to compute odds ratios (OR) and 95% confidence intervals (95%CI), adjusted for age, number of children and time after the very preterm delivery.

Results

Participants intend to have fewer children than they ideally desired (p < 0.001). Although 69.8% of parents would like to have more children, only 25% actually plan to conceive. After adjustment, participants aged above 34 years (OR = 0.27; 95%CI:0.08-0.86), with more than one offspring (OR = 0.34; 95%CI:0.14-0.69) and who experienced a very preterm delivery 5 or more years ago (OR = 0.28; 95%CI:0.09-0.90) were less likely to report the intention to have more children. The main reasons reported for not wanting to have more children were “having the desired number of children” (38.5%), “financial unavailability” (24.2%) and “being too old to have more children” (20.5%).

Conclusions

This study provides a comprehensive assessment of childbearing intentions after a very preterm delivery, advocating for reproductive counselling policies supportive of family planning.

Key messages

Discrepancy between the ideal and actual childbearing intentions support the enhancement of reproductive healthcare services for family planning. Socioeconomic and age-related constraints were the main motives presented by mothers and fathers of very preterm infants for not wanting to have more children.

Portuguese adaptation of the S3-non-invasive ventilation (S3-NIV) questionnaire for home mechanically ventilated patients

Short, valid and easy to use tools are needed to monitor non-invasive ventilation in clinical practice and for organization of home mechanical ventilation services. The aim of this study was to develop a professional translation and cultural adaptation of the Portuguese S³ non-invasive ventilation questionnaire. 234 stable patients (128 male patients, 53.8%) with a mean age of 69.3 years under long-term home non-invasive ventilation were recruited from a single-center outpatient clinic. The most frequent diagnostic groups were obesity hypoventilation syndrome, chronic obstructive pulmonary disease and restrictive chest wall disorders. The Portuguese version of the questionnaire was obtained using translation back-translation process with two professional translators. Internal consistency for the total score was good (Cronbach's α coefficient of 0.76) as well as for the "respiratory symptoms" and the "sleep and side effects" domains (Cronbach's α coefficient=0.68 and Cronbach's α coefficient=0.72, respectively). An exploratory factor analysis was performed leading to an explained variance of 54.6%, and resulted in 3 components. The Portuguese version of the S3-NIV questionnaire is a simple and valid tool for the routine clinical assessment of patients receiving home NIV.

Short communication: Heat stress does not affect induced luteolysis in Holstein cows

Heat stress (HS) has deleterious effects on bovine reproduction, including prolongation of the luteal phase in Holstein cows, perhaps due to compromised luteolysis. The objective was to characterize effects of HS on luteolytic responses of nonlactating Holstein cows given 25 or 12.5 mg of PGF_2α on d 7 of the estrous cycle. Cows were randomly distributed into 2 environments: thermoneutral (n = 12; 25°C) or HS (n = 12; 36°C). In each environment, cows were treated with 2 mL of saline, 25 or 12.5 mg of PGF_2α (n = 4 cows per group). The HS environment induced a significant increase in rectal temperature and respiratory rate compared with the thermoneutral environment. Heat stress did not have significant effects on luteolytic responses or circulating progesterone concentrations. Rapid and complete luteolysis occurred in all cows given 25 mg of PGF_2α and in 4 of 8 cows given 12.5 mg; the other 4 cows given 12.5 mg had partial luteolysis, with circulating progesterone concentrations initially suppressed, but subsequently rebounding. Therefore, we conclude that HS does not change corpus luteum sensitivity to PGF_2α.

A new ‘horned' Stenocercus from the highlands of southeastern Brazil, and redescription of Stenocercus tricristatus (Reptilia: Tropiduridae)

A new species of the lizard genus Stenocercus Duméril & Bibron, 1837 is described based on six specimens from Serra da Canastra, Minas Gerais, southeastern Brazil. Similar to S.tricristatus (Duméril, 1851), S.dumerilii (Steindachner, 1867), S.quinarius Nogueira & Rodrigues, 2006, and S.squarrosus Nogueira & Rodrigues, 2006, the new species has a pyramidal head and an enlarged, dorsally projected post-supraciliary scale, like a small horn. It is most similar to S.tricristatus, from which it differs in having a more elongated head in ventral view; a larger number of scales around midbody; a distinctly enlarged, smooth preauricular scale; and probably a larger body size. Moreover, the new species has distinctly keeled scales, with phylloid and mucronate dorsals; no enlarged supraoculars; no neck folds; a vertebral, and a pair of dorsolateral and (weak) lateral crests. A redescription of S.tricristatus is presented for comparison with the new species.

Long-Term Peritoneal Dialysis Experience in Portugal

Peritoneal dialysis (PD) penetration varies widely. Since the beginning of this therapy, indications have changed and outcomes have improved. In Portugal, PD still remains clearly underutilized.

The results of a 20 year PD programme were evaluated: 312 cumulative patients, 48±16 years, 27% >60 years old, 27% diabetic, 59% with prior hemodialysis (HD). The main reason for admission was vascular access failure (48.7%). Admission due to patient preference has increased significantly between first and second decades of the programme (33% vs 47% (P<0.001)); 98 patients (31.4%) were treated with automated PD but this prescription increased to 43% of the active patients.

A total of 376 Tenckhoff catheters were surgically implanted, recently by the Popovich-Moncrief technique (77 catheters): the cumulative survival was 82%, 64% and 50% at 1, 3 and 5 years, respectively. A better catheter survival was found in the last decade (85.7%, 69.6%, 54.8% versus 77.3%, 55.5%, 40.2%, at 1, 3 and 5 years, respectively (P=0.007).

The patient and technique cumulative survivals were 91, 74, 55% and 85, 67, 41%, at 1, 3, and 5 years, respectively.

The main drop-out was to hemodialysis (35.8%), followed by death (23.7%), and transplantation (21.5%). Peritonitis and access-related infections caused 35% of the transfer to HD. Cardiovascular events caused 58% of deaths. The median PD retention was 35.5 months. The rate of peritonitis has decreased to one episode /30 patient months. Hospital admission has also decreased to 4.8 days/patient year.

This is a first report on long-term PD experience in Portugal. It has been an effective modality of renal replacement therapy, reflected by the growing patient preference in our PD programme. Experience, knowledge and new technical solutions have improved the outcomes.

Molecular picture of cobalamin C/D defects before and after newborn screening era

Objective

Birth prevalence of Cobalamin (Cbl) C or D defects in Portugal is an estimated 1:85,000, one of the highest worldwide. We compared the genotype/phenotype of patients identified with CblC or CblD before and after the implementation of expanded newborn screening.

Methods

Twenty-five Portuguese CblC/D patients, 14 symptomatic and 11 identified through screening, were diagnosed using gas chromatography or tandem mass spectrometry. Molecular characterization was performed through the study of MMACHC and MMADHC genes.

Results

The most common MMACHC mutation, c.271dupA, was present in 100% of MMACHC alleles of all CblC screened patients, in contrast with the 61% identified before expanded newborn screening. All studied cases (except one, who presented a CblD deficiency) presented a CblC defect. More CblC late-onset patients were diagnosed before the introduction of newborn screening than in the post newborn screening era, probably because some early onset patients died without a definitive diagnosis.

Conclusion

The molecular data found in this cohort contribute to the improvement of screening and diagnosis of Cbl defects and would enable a confirmatory diagnosis of these patients, reducing the need for complex, costly, laborious, and time-consuming biochemical/enzymatic tests.

Preliminary safety assessment of C-8 xylitol monoester and xylitol phosphate esters

OBJECTIVES

Most of the cosmetic compounds with preservative properties available in the market pose some risks concerning safety, such as the possibility of causing sensitization. Due to the fact that there are few options, the proper development of new molecules with this purpose is needed. Xylitol is a natural sugar, and the antimicrobial properties of xylitol-derived compounds have already been described in the literature. C-8 xylitol monoester and xylitol phosphate esters may be useful for the development of skincare products. As an initial screen for safety of chemicals, the combination of in silico methods and in vitro testing can aid in prioritizing resources in toxicological investigations while reducing the ethical and monetary costs that are related to animal and human testing. This study was designed to evaluate the safety of C-8 xylitol monoester and xylitol phosphate esters regarding carcinogenicity, mutagenicity, skin and eye irritation/corrosion and sensitization through alternative methods.

METHODS

For the initial safety assessment, quantitative structure-activity relationship methodology was used. The prediction of the parameters carcinogenicity/mutagenicity, skin and eye irritation/corrosion and sensitization was generated from the chemical structure. The analysis also comprised physical-chemical properties, Cramer rules, threshold of toxicological concern and Michael reaction. In silico results of candidate molecules were compared to 19 compounds with preservative properties that are available in the market. Additionally, in vitro tests (Ames test for mutagenicity, cytotoxicity and phototoxicity tests and hen's egg test--chorioallantoic membrane for irritation) were performed to complement the evaluation.

RESULTS

In silico evaluation of both molecules presented no structural alerts related to eye and skin irritation, corrosion and sensitization, but some alerts for micronucleus and carcinogenicity were detected. However, by comparison, C-8 xylitol monoester, xylitol phosphate esters showed similar or better results than the compounds available in the market. Concerning experimental data, phototoxicity and mutagenicity results were negative. As expected for compounds with preservative activity, xylitol-derived substances presented positive result in cytotoxicity test. In hen's egg test, both molecules were irritants.

CONCLUSION

Our results suggested that xylitol-derived compounds appear to be suitable candidates for preservative systems in cosmetics.

Preliminary safety assessment of C-8 xylitol monoester and xylitol phosphate esters

OBJECTIVES

Most of the cosmetic compounds with preservative properties available in the market pose some risks concerning safety, such as the possibility of causing sensitization. Due to the fact that there are few options, the proper development of new molecules with this purpose is needed. Xylitol is a natural sugar, and the antimicrobial properties of xylitol-derived compounds have already been described in the literature. C-8 xylitol monoester and xylitol phosphate esters may be useful for the development of skincare products. As an initial screen for safety of chemicals, the combination of in silico methods and in vitro testing can aid in prioritizing resources in toxicological investigations while reducing the ethical and monetary costs that are related to animal and human testing. This study was designed to evaluate the safety of C-8 xylitol monoester and xylitol phosphate esters regarding carcinogenicity, mutagenicity, skin and eye irritation/corrosion and sensitization through alternative methods.

METHODS

For the initial safety assessment, quantitative structure-activity relationship methodology was used. The prediction of the parameters carcinogenicity/mutagenicity, skin and eye irritation/corrosion and sensitization was generated from the chemical structure. The analysis also comprised physical-chemical properties, Cramer rules, threshold of toxicological concern and Michael reaction. In silico results of candidate molecules were compared to 19 compounds with preservative properties that are available in the market. Additionally, in vitro tests (Ames test for mutagenicity, cytotoxicity and phototoxicity tests and hen's egg test--chorioallantoic membrane for irritation) were performed to complement the evaluation.

RESULTS

In silico evaluation of both molecules presented no structural alerts related to eye and skin irritation, corrosion and sensitization, but some alerts for micronucleus and carcinogenicity were detected. However, by comparison, C-8 xylitol monoester, xylitol phosphate esters showed similar or better results than the compounds available in the market. Concerning experimental data, phototoxicity and mutagenicity results were negative. As expected for compounds with preservative activity, xylitol-derived substances presented positive result in cytotoxicity test. In hen's egg test, both molecules were irritants.

CONCLUSION

Our results suggested that xylitol-derived compounds appear to be suitable candidates for preservative systems in cosmetics.

Vertebral osteoporotic fractures with height loss secondary to Cushing's disease

Cushing's disease is a rare condition which may present with a variety of signs and symptoms. In this report, we present a case of a 37-year-old man referred to our department due to osteoporosis complicated with vertebral and rib fractures and loss of six centimeters in height within the previous year. Study of secondary causes of osteoporosis led to the diagnosis of Cushing's disease. The patient was submitted to transsphenoidal surgery and histological findings confirmed the diagnosis. After surgery, the symptoms improved. Glucocorticoid induced osteoporosis may be reversible, but recovery of bone loss is gradual and may continue for as long as 10 years before bone mineral density normalizes. This case illustrates the need to consider secondary causes of osteoporosis in a young man with bone fractures, namely Cushing's syndrome.

Diversity, natural history, and geographic distribution of snakes in the Caatinga, Northeastern Brazil

The present study is a synthesis on snake diversity and distribution in the Caatinga region of northeastern Brazil, providing an updated species list and data on natural history and geographic distribution. Our study is based on the careful revision of 7,102 voucher specimens, housed in 17 herpetological collections, complemented by data on taxonomic literature. We recorded a total of 112 snake species in the Caatinga, belonging to nine families: Anomalepididae, Leptotyphlopidae, Typhlopidae, Aniliidae, Boidae, Viperidae, Elapidae, Colubridae, and Dipsadidae. Our list includes at least 13 never recorded species for this region, as well as distribution records for all species known from the Caatinga (including expansion and new records of distribution). The snake assemblage of the Caatinga is complex, sharing species with other continental open areas (38.4%), forested areas (27.7%), and both open and forested areas (32.1%). The richest areas were isolated plateaus, followed by contact areas, semi-arid caatinga, and sandy dunes of the São Franscisco River. We identified 22 Caatinga endemic species with the sandy dunes of São Franscico River showing the highest endemism level (12 species, with six endemic species restricted to the area) followed by semi-arid caatinga, and isolated plateaus (eight endemic species each, and six and three endemic species with restricted distribution to each area, respectively). Most species show relatively restricted ranges in parts of the Caatinga. The snake assemblage in Caatinga includes mainly terrestrial species (38.4%), followed by fossorial/cryptozoic (26.8%), arboreal/semi-arboreal (26.8%), and aquatic/semi-aquatic (7.1%) species. Vertebrates are the most important dietary item (80.4%), with 56.6% of species being generalist consumers of this kind of prey; 24.4% are frog-eaters, 7.8% prey on caecilians/amphisbaenians, 6.7% lizard-eaters, 3.3% mammal-eaters, and 1.1% are fish-eaters. Only 18.7% of the snakes eat invertebrate prey, as arthropods, annelids, and mollusks. In relation to time of activity, 35.7% of snakes are both diurnal and nocturnal, 33.0% are strictly nocturnal, and 30.4% are diurnal. The data provided herein increase the list of Caatinga snake species from 50 to 112, and includes detailed maps and information on geographic distribution. The Caatinga snake assemblage shows high richness and endemism levels, and our results highlight the usefulness of basic natural history data and revision of voucher specimens as baseline information for biogeographic studies and conservation strategies. 

Luc's abscess as an unlucky complication of mastoiditis

Luc's abscess is a rare but important complication of acute otitis media (AOM), whereby infection spreads from the middle ear, resulting in a subperiosteal collection beneath the temporal muscle. Unlike other extracranial abscesses relating to AOM, Luc's abscess is not believed to involve the mastoid bone. We present the case of a patient with a Luc's abscess with mastoid involvement and discuss its successful management. We believe that patients presenting with a subperiosteal collection beneath the temporal muscle and mastoiditis may represent a different group of patients to those described originally by Luc. These individuals can be differentiated using computed tomography (CT) of the temporal bones. We advocate CT in patients with Luc's abscess and AOM; this aids preoperative surgical planning.

Diagnosis of sarcoidosis in the endobronchial ultrasound-guided transbronchial needle aspiration era

BACKGROUND

Sarcoidosis is a multisystemic disorder of unknown etiology. Its diagnosis is based on compatible clinical and radiological features and supported by histological demonstration of epithelioid cell noncaseating granulomas with exclusion of other causes. Endobronchial ultrasound combined with transbronchial needle aspiration (EBUS-TBNA) has been proposed as a valuable tool in obtaining suitable tissue sample. The aim of this study was to evaluate the contribution of EBUS-TBNA to the diagnosis of stages I and II thoracic sarcoidosis in a community-based hospital.

METHODS

A prospective study was conducted in patients with suspected stages I and II pulmonary sarcoidosis, based on clinical and radiological data, who were being followed in our Interstitial Lung Disorders Outpatient Clinic or sent from other hospitals to our Respiratory Endoscopy Unit for diagnostic procedures. All suitable and fit patients underwent EBUS-TBNA between March 2010 and June 2013. We assessed demographic characteristics, radiological stages, cytological/histological examination and diagnostic techniques performed.

RESULTS

In the period considered 39 patients underwent EBUS-TBNA for suspected stages I and II thoracic sarcoidosis and adequate samples were obtained in 38 (97.4%). Within this population, 33 (84.6%) patients had a definite diagnosis of sarcoidosis, of which 31 patients (93.9%) were confirmed to have epithelioid noncaseating granulomas by EBUS-TBNA. Four patients were submitted to surgical procedures (three to mediastinoscopy and one to open surgical lung biopsy). Data analysis allowed to calculate a sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of 93.9%, 100%, 100%, 75.0% and 94.8%, respectively. No complications were observed.

CONCLUSIONS

EBUS-TBNA is a valuable tool in the diagnostic workup of patients with suspected stages I and II thoracic sarcoidosis providing a substantial number of pathological confirmations and with few complications. Its high diagnostic accuracy precludes the need for more invasive procedures such as surgical biopsy.

Dehiscence of the posterior and superior semicircular canal presenting in pregnancy

OBJECTIVE

We present an interesting case of superior and posterior semicircular canal dehiscence in pregnancy.

METHOD

We present a case report and a review of the world literature concerning semicircular canal dehiscence.

CASE REPORT

A 34-year-old woman presented with sound and pressure induced vertigo at 22 weeks gestation. A thinly sliced computed tomography (CT) scan of the petrous temporal bones viewed with coronal reconstructions was performed post-partum. This showed the presence of both left superior canal and posterior canal dehiscence.

CONCLUSION

To our knowledge this is the first reported case of semicircular canal dehiscence in pregnancy. The diagnosis of semicircular canal dehiscence should be suspected in pregnant patients with sound induced vertigo.

New locality records, geographical distribution, and morphological variation in Cercosaura parkeri (Ruibal, 1952) (Squamata: Gymnophthalmidae) from western Brazil

The presence of the gymnophthalmid lizard Cercosaura parkeri (Ruibal, 1952) in western Brazil is confirmed, based on vouchered records for localities in the states of Mato Grosso and Mato Grosso do Sul. Morphological variation in a series of 20 males and 17 females is also presented.

Methionine Adenosyltransferase I/III Deficiency in Portugal: High Frequency of a Dominantly Inherited Form in a Small Area of Douro High Lands

Methionine adenosyltransferase deficiency (MAT I/III deficiency) is an inborn error of metabolism resulting in isolated hypermethioninemia, and usually inherited as an autosomal recessive trait, although a dominant form has been reported in several families.During the last 6 years, approximately 520,000 newborns were screened in the Portuguese Newborn Screening Laboratory by MS/MS, and 21 cases of persistent hypermethioninemia were found. One case was confirmed to be a deficiency of cystathionine β-synthase and 20 cases were confirmed by MAT1A gene analysis to have an elevation of methionine due to MAT I/III deficiency, which indicates an incidence for this condition of 1/26,000. Twelve of the MAT I/III deficient newborns, belonging to 11 families, were identified in the northern region of Portugal and sent to the same treatment center, where they are under follow-up. Clinical, biochemical, and genetic characteristics of individuals from these 11 families are presented. Plasma methionine and homocysteine concentrations were found to be moderately increased in all newborns, and molecular analysis revealed that they all were heterozygous for R264H mutation. Normal growth, development, and neurological examination were observed in all cases, and cerebral MRI performed in six cases revealed myelination abnormalities in one case. Plasma methionine concentration for all 12 cases was always below 300 μM, and they are all on a normal diet for their age.

Successful outcome of cochlear implantation in a patient with superficial siderosis

OBJECTIVE

To present the management of a rare case of progressive bilateral sensorineural hearing loss in a patient with superficial siderosis secondary to a cavernoma.

METHOD

A case report and a review of the literature concerning superficial siderosis.

RESULTS

The patient benefited significantly from a cochlear implantation.

CONCLUSIONS

Careful assessment and adequate counselling is necessary to determine the best approach to hearing rehabilitation in patients with superficial siderosis of the central nervous system. Cochlear implantation in patients with superficial siderosis is controversial due to the retrocochlear origin of the hearing loss and, although the case presented had a successful outcome, the results might deteriorate with time.

Répteis do Estado de São Paulo: conhecimento atual e perspectivas

Elaboramos uma lista das espécies de répteis do Estado de São Paulo com base nos registros confirmados de exemplares depositados nas três maiores coleções científicas do estado, complementando esta informação com a bibliografia disponível. Registramos a presença de 212 espécies de répteis no Estado de São Paulo, distribuídas em 23 famílias, incluindo 12 quelônios, três crocodilianos e 197 Squamata (142 serpentes, 44 "lagartos" e 11 anfisbenas). Destas, onze são endêmicas do Estado de São Paulo (Mesoclemmys cf. vanderhaegei, Amphisbaena sanctaeritae, Mabuya caissara, Mabuya macrorhyncha, Liotyphlops caissara, Liotyphlops schubarti, Corallus cropanii, Atractus serranus, Phalotris lativittatus, Bothropoides alcatraz, Bothropoides insularis). Entre os Squamata, quatro lagartos e uma serpente correspondem a espécies ainda não descritas. Destas 212 espécies, 32 estão incluídas na Lista das Espécies Ameaçadas do Estado de São Paulo, enquanto que apenas nove constam na Lista das Espécies Ameaçadas do Brasil. A riqueza de répteis atualmente registrada no Estado de São Paulo representa cerca de 30% da riqueza conhecida para o grupo em todo o território brasileiro, que abrange 721 espécies. Entretanto, concluímos que estudos mais detalhados sobre a taxonomia e a distribuição de espécies bem como os esforços de coleta em áreas com lacunas de amostragem devem ainda aumentar o número de espécies de répteis no estado.

Prostatic carcinomas with neuroendocrine differentiation diagnosed in needle biopsies, a morphologic study of 7 cases among 465 sequential biopsies in a tertiary cancer center

PURPOSE

Neuroendocrine carcinomas (NEC) of the prostate are rare, with only a few series hitherto reported. The objective of this study was to assess in a single institution the clinical and morphologic characteristics of neuroendocrine carcinomas diagnosed in needle core biopsies.

MATERIALS AND METHODS

The current study analyses seven cases diagnosed in needle biopsies at a large tertiary regional cancer center from Northeastern Brazil. Two pathologists reviewed specimens retrospectively, and demographic and morphologic characteristics were compared to 458 acinar tumors diagnosed in the same period.

RESULTS

There were five small cell carcinomas and two low-grade neuroendocrine carcinomas (carcinoid). NEC were associated with an acinar component in 5/7 cases and the Gleason score of the acinar component was always > 6. The number of cores involved in prostates with NEC was greater (65% compared to 24% of acinar tumors, p < 0.05). The mean PSA at diagnosis was 417.7 (range 5.7-1593, SD 218.3), compared to 100.5 (p = 0.1) of acinar tumors (range 0.3-8545, SD 22.7). Prostates harboring NEC were bigger (p < 0.001, mean volume 240 mL vs. 53 mL of acinar tumors). Treatment of NEC included palliative surgery, chemotherapy, and hormonal therapy.

CONCLUSIONS

NEC of the prostate is rare and often associated with a high-grade acinar component. Prostates with NEC tend to be larger and involve a greater number of cores than acinar tumors. PSA at diagnosis does not seem to predict the presence of NE tumors in needle biopsy.

Répteis da Estação Ecológica Serra Geral do Tocantins, Brasil Central

Os Cerrados sul-americanos abrigam alta diversidade de répteis, incluindo elevado número de endemismos. No entanto, o conhecimento desta diversidade é ainda incompleto frente à acelerada transformação das paisagens naturais no Brasil central. Constituem, portanto, uma das regiões prioritárias para estudo e conservação da biodiversidade mundial. Estudos intensivos sobre a fauna de répteis do Cerrado são necessários e urgentes para melhor compreensão dos processos que levaram à sua origem e distribuição e para subsidiar ações de conservação. Por meio de métodos padronizados, amostramos duas regiões ainda inexploradas da Estação Ecológica Serra Geral do Tocantins, situada na região do Jalapão. Registramos 45 espécies de répteis para a EESGT e entorno, o que representa uma riqueza alta e comparável à de outras regiões bem amostradas do Cerrado. Curvas de acumulação e estimadores indicam que a riqueza local de lagartos e anfisbenídeos aproxima-se da riqueza real enquanto a de serpentes é subestimada. A distribuição não-aleatória das espécies na paisagem concorda com evidências anteriores sugerindo utilização diferencial dos hábitats pelos répteis. Reunindo os resultados do presente estudo com os de levantamentos prévios realizados na região, registramos 88 espécies de répteis para o Jalapão sendo oito registros novos que incluem Bachia oxyrhina uma espécie recém descrita da região. As espécies da área apresentam três padrões gerais de distribuição: (1) espécies endêmicas do Cerrado, (2) espécies compartilhadas com domínios da diagonal de formações abertas sul-americanas, e (3) espécies de ampla ocorrência, compartilhadas também com ecossistemas florestais. Prevalecem espécies de ampla distribuição, porém é grande o número de espécies típicas do Cerrado, incluindo cinco possivelmente endêmicas do Jalapão, e há contribuição importante da fauna da Caatinga. A distribuição dos répteis em escala local e regional demonstra a necessidade de considerar a heterogeneidade paisagística para o planejamento de diretrizes visando à conservação em regiões do Cerrado. Por sua grande extensão, posição biogeográfica e complexidade de relevo e tipos de hábitat, a EESGT tem papel fundamental para a preservação e conhecimento da diversidade de répteis do Cerrado.

Anfíbios da Estação Ecológica Serra Geral do Tocantins, região do Jalapão, Estados do Tocantins e Bahia

A porção norte do domínio do Cerrado é uma das áreas historicamente menos conhecidas com relação à sua biodiversidade. Recentemente, alguns estudos tem revelado valores de riqueza comparáveis a outras regiões dentro do domínio. A Estação Ecológica Serra Geral do Tocantins (EESGT) está localizada na região do Jalapão, porção Nordeste do Cerrado, e faz parte do maior bloco de áreas protegidas neste domínio. Neste estudo descrevemos a riqueza e composição de espécies de anfíbios da EESGT, discutindo-as em um contexto biogeográfico, e caracterizamos o uso de sítios reprodutivos pelas espécies de anfíbios registradas em relação às fitofisionomias e aos tipos de corpos d'água. Utilizamos os métodos de busca ativa e armadilhas de queda, no período considerado como o auge da estação reprodutiva para a maior parte das espécies do Cerrado. Foram registradas 36 espécies de anfíbios na EESGT, totalizando 39 espécies conhecidas para a região do Jalapão. Aplicando o estimador Jackknife, sugerimos uma riqueza potencial de 42 espécies para a EESGT. A maior parte das espécies registradas é endêmica ou fortemente associada ao Cerrado, seguidas pelas espécies de ampla distribuição no Brasil ou América do Sul. A maior parte da espécies se reproduz em poças temporárias localizadas em áreas abertas, embora existam espécies que ocorrem exclusivamente em matas de galeria e utilizem corpos d'água lóticos para se reproduzir.

Geologia e geomorfologia da estação ecológica Serra Geral do Tocantins

Este trabalho trata de descrição básica da paisagem existente na Estação Ecológica Serra Geral do Tocantins, localizada na porção oriental do Estado do Tocantins e extremo oeste do Estado da Bahia, Brasil Central. Dois fatores do meio físico são abordados: a geologia, composta por litotipos sedimentares, e as formas de relevo, dada a predominância de chapadões e morros testemunhos na região, famosa pela presença das Dunas do Jalapão ao norte. Tal interação, esculturada sob clima típico de savana, produziu uma série de mosaicos com imensas peculiaridades paisagísticas. A Serra Geral do Tocantins é um planalto sedimentar esculpido na Bacia Sedimentar do Parnaíba. A área da Estação é caracterizada por pacotes de sedimentos predominantemente continentais, posteriores ao derrame basáltico ocorrido durante a Reativação Wealdeniana Juro-Cretácea. São arenitos de colorações brancas a vermelhas, extremamente friáveis, oriundos das acumulações de paleoclimas secos (áridos a semi-áridos) do Mesozóico, possivelmente contemporâneos ao Deserto Botucatu existente na Bacia do Paraná, embora as camadas mais superiores possam estar associadas a ambiente flúvio-lacustre. As formas de relevo envolvem uma seqüência de chapadas e patamares caracterizando formas estruturais com rebordos festonados e rampas escalonadas em formas erosivas. As chapadas são constituídas por sedimentos cretáceos e configuram grandes unidades de relevo em mesa penetradas por vales pedimentados, com bordas escarpadas e anfiteatros largos, que atacados por ciclos de erosão pós-cretáceos resultaram em patamares escalonados e arrasados em pediplanos que descem rumo ao curso do Rio Tocantins. A presença de inúmeros relevos residuais colabora nos contrastes geomorfológicos. Os processos morfogenéticos predominantemente mecânicos podem ser divididos em quatro fases de esculturação que resultaram na dissecação diferenciada. A compartimentação do relevo permite apontar algumas considerações sobre a distribuição geográfica da fauna na área da Estação Ecológica e seu entorno, pois em parte esta relação pode ser determinada pelos escalonamentos topográficos decorrentes do aparecimento das unidades geomorfológicas. A maior barreira geográfica foi criada durante o Neoproterozóico, separando as formas de relevo dos patamares escalonados; os basculamentos mesozóicos produziram os chapadões que, pela erosão mecânica, formaram pedimentos que foram aos poucos coalescidos durante o Cretáceo Superior até o Terciário Superior; tal processo resultou nos relevos residuais que, juntamente com a reativação de falhas antigas, favoreceu o isolamento entre os compartimentos biológicos; este processo continuou durante o Quaternário em razão das alternâncias climáticas de períodos semi-áridos a úmidos, promovendo a retomada da erosão mecânica e a formação de planícies fluviais.

Impactos potenciais das mudanças propostas no Código Florestal Brasileiro sobre os répteis brasileiros

Avaliamos os impactos potenciais sobre a fauna brasileira de répteis (721 espécies descritas até o momento), caso sejam adotadas mudanças propostas por um substitutivo do atual Código Florestal Brasileiro. A possibilidade de compensação ambiental (obrigação legal no caso de degradação de habitats naturais) em bacias ou microbacias distintas daquelas degradadas seria uma das modificações do código vigente que prejudicaria a manutenção da diversidade de répteis. Alguns gêneros de répteis são compostos por espécies que raramente co-ocorrem em uma mesma área. Assim, ações de conservação em escalas reduzidas, em unidades naturais como microbacias, seriam mais adequadas para representar a variação da composição de espécies entre áreas. O substitutivo prevê a exclusão de topos de montanhas como Área de Preservação Permanente (APP), bem como a redução da largura das matas marginais a cursos d´água (que também são APPs). Diversos répteis brasileiros estão restritos a áreas de altitude, ao passo que outros vivem somente ou principalmente em matas de galeria ou áreas ripárias. Assim, a perda de habitat nessas áreas deve tornar alguns répteis vulneráveis a extinção. A proposta também autoriza a recuperação de Reservas Legais (RL) usando espécies de plantas exóticas. Há evidências que muitos répteis brasileiros não conseguem sobreviver em ambientes alterados pelo homem, incluindo as florestas constituídas por espécies exóticas. A proposta também tornará possível compensar RL dentro de unidades de conservação. Entretanto, as unidades de conservação existentes não seriam suficientes para a manutenção da diversidade de répteis no Brasil (principalmente porque muitas espécies têm distribuição restrita). Se adotadas, as mudanças propostas ao Código Florestal Brasileiro terão fortes impactos sobre a fauna de répteis brasileira, um importante componente do patrimônio natural do país. Além disso, moléculas com potencial farmacêutico, presentes nos venenos de muitas espécies, poderão ser perdidas.

Cooperative interactions of PTEN deficiency and RAS activation in melanoma metastasis

Mitogen-activated protein kinase (MAPK) and AKT pathways are frequently co-activated in melanoma through overexpression of receptor tyrosine kinases, mutations in their signaling surrogates, such as RAS and BRAF, or loss of negative regulators such as PTEN. As RAS can be a positive upstream regulator of PI3-K, it has been proposed that the loss of PTEN and the activation of RAS are redundant events in melanoma pathogenesis. Here, in genetically engineered mouse models of cutaneous melanomas, we sought to better understand the genetic interactions between HRAS activation and PTEN inactivation in melanoma genesis and progression in vivo. We showed that HRAS activation cooperates with Pten+/- and Ink4a/Arf-/- to increase melanoma penetrance and promote metastasis. Correspondingly, gain- and loss-of-function studies established that Pten loss increases invasion and migration of melanoma cells and non-transformed melanocytes, and such biological activity correlates with a shift to phosphorylation of AKT2 isoform and E-cadherin down-regulation. Thus, Pten inactivation can drive the genesis and promote the metastatic progression of RAS activated Ink4a/Arf deficient melanomas.

Restricted-range fishes and the conservation of Brazilian freshwaters

BACKGROUND

Freshwaters are the most threatened ecosystems on earth. Although recent assessments provide data on global priority regions for freshwater conservation, local scale priorities remain unknown. Refining the scale of global biodiversity assessments (both at terrestrial and freshwater realms) and translating these into conservation priorities on the ground remains a major challenge to biodiversity science, and depends directly on species occurrence data of high taxonomic and geographic resolution. Brazil harbors the richest freshwater ichthyofauna in the world, but knowledge on endemic areas and conservation in Brazilian rivers is still scarce.

METHODOLOGY/PRINCIPAL FINDINGS

Using data on environmental threats and revised species distribution data we detect and delineate 540 small watershed areas harboring 819 restricted-range fishes in Brazil. Many of these areas are already highly threatened, as 159 (29%) watersheds have lost more than 70% of their original vegetation cover, and only 141 (26%) show significant overlap with formally protected areas or indigenous lands. We detected 220 (40%) critical watersheds overlapping hydroelectric dams or showing both poor formal protection and widespread habitat loss; these sites harbor 344 endemic fish species that may face extinction if no conservation action is in place in the near future.

CONCLUSIONS/SIGNIFICANCE

We provide the first analysis of site-scale conservation priorities in the richest freshwater ecosystems of the globe. Our results corroborate the hypothesis that freshwater biodiversity has been neglected in former conservation assessments. The study provides a simple and straightforward method for detecting freshwater priority areas based on endemism and threat, and represents a starting point for integrating freshwater and terrestrial conservation in representative and biogeographically consistent site-scale conservation strategies, that may be scaled-up following naturally linked drainage systems. Proper management (e. g. forestry code enforcement, landscape planning) and conservation (e. g. formal protection) of the 540 watersheds detected herein will be decisive in avoiding species extinction in the richest aquatic ecosystems on the planet.