Lack Of Recent Studies Research Articles

Intestinal transport of organic food compounds and drugs: a scoping review on the alterations observed in chronic kidney disease

Background and aimsAround 850 million people worldwide are affected by chronic kidney disease (CKD). Patients with CKD often develop malnutrition and sarcopenia and changes in the pharmacokinetics of drugs. A reduced kidney function partially explains the prolonged half-life of certain drugs due to decreased renal clearance, which leads to an increased risk of adverse effects. While the intestine plays a fundamental role in this context, a systematic review of the effects of CKD on intestinal transport is lacking. We aimed to systematically summarize all the available evidence on intestinal transport of organic food components (carbohydrates/sugar, proteins/amino acids, fats, vitamins) and drugs (including drug transporters) in chronic kidney disease. MethodsWe conducted a systematic search of all the articles published until the 1st of April 2024, on five databases i.e. Embase, PubMed, Web of Science Core Collection, Cochrane Library, and Scopus. This systematic review was registered on the Open Science Framework (OSF) (osf.io/5e6wb) and was carried out according to the PRISMA 2020 guidelines. ResultsFrom 9205 articles identified, 68 met the inclusion criteria. Absorption of organic food compounds seems to be altered, in general, and reduced for vitamins. The expression of intestinal efflux drug transporters may be altered in CKD. ConclusionsDespite alterations in intestinal transport is suggested to be altered in CKD, the lack of recent studies, the paucity of human data and the heterogeneity of the methodologies used underscore the need for more research on the effect of CKD and uremia on intestinal transport.

Complications after fine-needle aspiration cytology and core-needle biopsy in benign head & neck neoplasms

IntroductionBenign neck masses are one of the most common causes of clinical consultation in head & neck (H&N) clinics. Fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) have become among the main strategies for the diagnostic work-up of palpable and non-palpable neck lumps. Moreover, numerous studies have established the safety, high diagnostic yield, and added value of image-guided H&N biopsies, which play an important role in diagnosis, staging, and treatment planning, and can obviate the need for surgery for many patients. Nonetheless, despite the success of both techniques, there is a lack of recent studies regarding their safety and associated complication rates. Material & methodA retrospective analysis was performed of prospective data on patients undergoing ultrasound-guided FNAC or CNB for benign H&N disease (e.g., salivary gland benign tumors, branchial cleft cyst, thyroglossal duct, cyst, lipoma, or neurinoma) between June 2016 and June 2021 in a tertiary university hospital. ResultsOverall, 192 patients were included (105 [54.7%] men and 87 [45.3%] women). The Kolmogorov-Smirnov test indicated that our data were normally distributed (p = 0.452). The mean age of enrolled patients was 54 ± 10 (range: 18–87). The anatomical site most commonly affected was a major salivary gland (74%). Regarding incidence and type of complications, nine (4.7%) patients experienced complications, infection being the most common problem. The risk of complications was highest in patients with branchial cleft cysts who had undergone FNAC (p = 0.028). Overall, the risk of complications was not associated with the type of technique (p = 0.603; OR: 0.942; 95% confidence interval = 0.245–3.624). ConclusionAccording to our results, FNAC and CNB are generally safe and reliable procedures in the diagnostic work-up of H&N lumps. Nevertheless, physicians should be aware of certain risks associated with these procedures.

Can industry 4.0 work together with lean? An investigation from Malaysian lean manufacturing sector

An examination of Industry 4.0 (I4.0) and its impact on lean manufacturing (LM) is not yet detailed, properly evaluated or validated. Notably, there is a lack of recent studies that evaluated I4.0 technology mapping and prioritization in the LM industrial context in Malaysia. The study aims to evaluate how I4.0 technology enablers influence the use of lean tools. Moreover, this study evaluates the correlation between company type and I4.0 implementation maturity, familiarity, and sources exhibiting an inclination to advance skills. The study evaluated 208 respondents belonging to several LM enterprises in Malaysia. Self-administered questionnaires were used and association analysis, based on the independence test, was used to assess the consensus based on the devised hypothesis. The outcomes were obtained using correspondence assessment of the asymptotic significant correlation coefficient (p) in which to draw conclusions using the p determined during hypothesis evaluation, a 0.05 significance level indicates all null hypotheses must be accepted. Moreover, the three elements; I4.0, LMP, and LMSs are significant with 0.897, 0.980, and 0.876 values, respectively. The outcomes indicate a strongly positive correlation between I4.0 and LM system (LMS). This observation is expected to help Malaysian LM practitioners to anticipate the future lean landscape based on the boundless innovation provided by these Technologies as the anticipated outcome is a strong positive correlation between I4.0 and LM systems (LMS). This finding would empower Malaysian LM practitioners to anticipate the future of lean manufacturing, shaped by the boundless innovation potential of I4.0 technologies. By embracing this convergence, companies can unlock a future of enhanced productivity driven by autonomous operations and data-driven decision making. Therefore, using lean in the context of I4.0 is a promising combination for improving future productivity through autonomous operations.

Chandelier-Assisted Scleral Buckling: A Literature Review.

The treatment of retinal detachment (RD) has seen numerous advancements in the last decades. Scleral buckling (SB) is a surgical procedure introduced in the 1950s that has seen a drastic reduction with the advent of vitrectomy. However, due to the new surgical visualization systems, SB has evolved and continues to be an extremely useful procedure in certain conditions. The presence of different case reports or interventional studies with comparable outcomes, as well as the lack of recent studies with direct comparison, may result in an underestimation of its potential nowadays. The aim of this review is to provide a comprehensive update on chandelier-assisted scleral bucking (CSB), with an overview of the surgical evolution, outcomes, advantages, and complications.

On the turbulent boundary layer over a flat plate at moderate Reynolds numbers

Two separate experimental campaigns of a spatially developing turbulent boundary layer under approximately zero-pressure-gradient at moderate Reynolds numbers (1700<Reθ<3400) are conducted with stereoscopic Particle Image Velocimetry (PIV) and one component Hot Wire Anemometry. This range of Reynolds numbers is found to be of particular interest for turbulent boundary layer control investigations. The motivations behind this work rely on the lack of recent studies that provide a rigorous experimental database on a flat plate turbulent boundary layer, openly available online. This is critical as, in most of the cases, the modification of the statistics resulting from turbulent boundary layer control strategies are compared with a smooth baseline reference. The statistics of the velocity fields, obtained with the two techniques, show a good match with the direct numerical simulation in literature results. We focused on the skin friction evaluation by means of Clauser's chart technique. The near wall turbulence activity and the associated coherent structures are investigated by means of the Variable Interval Time Averaging technique using the hot wire signal. The influence of the acquisition and algorithm parameters as well as the effect of the Reynolds number are reported. The logarithmic and outer structures are investigated by applying the Uniform Momentum Zones technique to the PIV dataset. The hierarchical distribution of the uniform momentum zones as a function of the wall distance as well as their variation with the Reynolds number confirm the validity of the attached eddy model even at the moderate Reynolds numbers of the current investigation.

Evaluating the knowledge and training of forensic pathologists and registrars performing forensic radiography at a forensic pathology mortuary in the Free State province, South Africa.

Forensic radiography is an important component in forensic sciences. There seems to be a lack of recent studies in the literature on the knowledge and training of forensic pathologists and registrars performing forensic radiography at forensic pathology mortuaries in South Africa. To evaluate the knowledge and training of forensic pathologists (consultants) and registrars performing forensic radiography at a forensic pathology mortuary in the Free State province, South Africa. A prospective study was conducted at a conveniently selected forensic pathology mortuary located in the Free State province of South Africa. Personnel performing forensic radiography at the selected mortuary were invited to participate in the study. An exploratory quantitative study design was used. The research tool was a self-administered questionnaire comprising open- and closed-ended questions. Four registrars and four consultants (n = 8) completed the questionnaire. Training was only received on computed tomography (n = 1; 12.5%), the C-arm machine (n = 1; 12.5%) and the digital X-ray mobile machine (n = 1; 12.5%) Lodox on corpse positioning (n = 7; 87.5%) and setting of exposure factors (n = 2; 25%). Lack of training of the personnel performing forensic radiography, at the selected mortuary was identified. Training is required in image acquisition protocols, quality control tests of the X-ray machines, setting technical factors and operation of various X-ray machines. Training of registered radiation workers who perform forensic radiography in mortuaries is essential to produce high-quality ionising radiation images and ensure their own and other staff members' safety.

The Role of Methods and Applications of Artificial Intelligence Tools in the Field of Medicine to Diagnose and Discover Various Diseases

The use of AI in healthcare has increased. It is now used in diagnosis, drug production, and improving hospital workflow between medical departments. The ability to examine large numbers of patients quickly is also a major use of artificial intelligence. Indeed, this field has made remarkable advances in early diagnosis and discovery of diseases through data, information, and radiograph analysis. The ability to predict disease outbreaks using AI analytics is dependent on data analysis and disease prediction. The current study aimed to assess the validity of previous research on artificial intelligence applications and their role in diagnosing and discovering diseases. This is to fill several gaps, such as the lack of recent studies in this field, especially Arab studies. The study also seeks to understand how artificial intelligence tools can help diagnose and discover diseases. The study yielded several findings. It is necessary to design systems and algorithms, as well as mechanisms and methods, to fully utilize artificial intelligence in this field. Neural networks, deep learning, fuzzy logic and others were addressed in previous studies, for their adoption and possible application because of their great impact according to the results of previous studies. Artificial intelligence can simultaneously monitor and process an unlimited number of inputs, revealing complex correlations that cannot be easily reduced. Finally, the researcher believes that artificial intelligence will increase efficiency, save time and effort, and reduce errors. Also, AI does not replace doctors because it lacks human qualities like empathy and compassion. The use of artificial intelligence in medicine will thus contribute to an approved and unprecedented scientific approach in this field to achieve the desired goals and objectives.

Effects of Suckling on the Udder Health of Foster Cows

In a foster cow system, one or more calves are reared by a foster cow. With regard to the growing rejection towards the early separation of cow and calf after calving, such alternative rearing methods with prolonged cow–calf contact are coming more into focus. Nevertheless, there is a lack of recent studies investigating the effects of suckling multiple calves on the udder health of a foster cow. The present study aimed to initially describe the status and development of the udder condition and the microbial colonisation during the foster period. Thereby, the objectives were to determine whether suckling multiple calves was associated with an increase in intramammary infections (IMI) and a deterioration of udder constitution. A total of 99 Holstein Friesian foster cows from a large organic dairy farm in eastern Germany were included in this pilot study. Each foster cow was suckled by 3–4 calves and not additionally milked. Quarter milk samples were taken for cytomicrobiological examination at the beginning and end of the approximately 3.5 months suckling period. At the same time, the udders of 91 of these foster cows were clinically examined by visual assessment and manual palpation. In both the first and second examination (E1 and E2, respectively), Corynebacterium ssp. and non-aureus staphylococci (NaS) constituted the most frequently detected pathogen species in the 385 examined udder quarters. Classifying the quarters into mastitis categories was significantly different between the two examinations (p = 0.001). The number of quarters considered as healthy increased from E1 to E2 by 8.5%. At the same time, the number of quarters with mastitis decreased by 2.6%, the number of quarters with non-specific mastitis by 11.4% and the number of quarters with a latent infection increased by 5.4%. In total, 69.4% of the 121 infected udder quarters in E1 were bacteriologically cured in E2. A cytological cure was achieved in 28.1% of the 385 quarters. Both the bacteriological and cytological cure rate were spontaneous. A new infection occurred in 23.1% of the 385 examined udder quarters and was mainly attributable to infections with Corynebacterium spp. and NaS. During the suckling period, mainly new infections occurred and amounted to 73% in relation to presumed persistent infections (18.9%). The new infections were mainly attributable to infections with Corynebacterium spp. and NaS. Pasteurella spp. were also found in high percentages. A total of 10.1% of the quarters showed an increase in somatic cell count (SCC) above the threshold of 100,000 cells/mL from E1 to E2, indicating a new subclinical mastitis. Regarding udder condition, significant changes during the foster period were an increase in udder skin and teat lesions, a decrease in udder oedema, an increased amount of udder quarters with a consistency considered as normal and an increase in the number of udders showing no sign of udder cleft dermatitis. Moreover, teat length, circumference, and diameter increased significantly (p < 0.05). In conclusion, there is a possibility that suckling multiple calves improves udder health in terms of mastitis but leads to an increased pathogen transmission at the same time, resulting in an increase in latent infections. Additionally, pathogens as Pasteurella spp., which are usually located in the upper respiratory system, could be detected in the mammary gland. The changes concerning the udder condition were manifold. However, it has not yet been conclusively clarified whether all these changes are exclusively due to calf suckling. Further investigations with a non-suckled control group are required.

Study of the Etiology of Acute Respiratory Infections in Children Under 5 Years at the Dr. Agostinho Neto Hospital, Praia, Santiago Island, Cabo Verde.

Background: Acute respiratory infections are one of the major causes of morbidity and mortality in children under 5 years in developing countries and are a challenge for the health system of these countries. In Cabo Verde, despite the lack of recent studies, data indicate that it affects thousands of children, being the fourth leading cause of infant mortality in 2013. The aim of this study was to identify and describe the etiological agents associated with acute respiratory tract infections in children under 5 years old, and their associated risk factors, such as clinical symptoms or socio-demographic characteristics.Methods: Naso-pharyngeal samples were collected from children under 5 years attending at Dr. Agostinho Neto Hospital (Praia, Santiago Island, Cabo Verde) with suspected ARI at different time-points during 2019. Samples were analyzed using FilmArray® Respiratory Panel v. 2.0 Plus to identify etiological agents of ARI. A questionnaire with socio-demographic information was also collected for each participant. Data analyses were carried out using the IBM SPSS version 25 (IBM Corporation, Armonk, NY) and R 3.5.1 statistical software.Results: A total of 129 naso-pharyngeal samples were included in the study. Seventeen different etiologic agents of respiratory infections were identified. HRV/EV was the most frequent agent detected, followed by FluA H3 and RSV. Coinfection with two or more pathogens was detected in up to 20% of positive samples. The results were analyzed in terms of age-group, sex, period of the year and other social and demographic factors.Conclusion: Viruses are the main causative agents of ARI in children <5 years attending at the pediatrics service at the Dr. Agostinho Neto Hospital in Praia city, Santiago Island, Cabo Verde. Some factors are described in this study as statistically associated with the presence of an infectious agent, such as having one or more children sharing the bedroom with an adult and the presence of some clinical symptoms. The data addresses the need for studies on respiratory tract infections in Cabo Verde.

Interest rate setting in Egypt: a NARDL approach for estimating backward-looking monetary policy reaction function

ABSTRACT The role of inflation versus output and exchange rate in designing monetary policy in Egypt has been subject to considerable debate in literature, even after the proclamation of price stability as the monetary policy objective in 2004 and the adoption of flexible exchange rate system in 2016. This study aims to investigate the main drivers of interest rate setting in Egypt throughout the period from 2005 to 2019. In this context, both an ARDL and NARDL econometric techniques are employed to estimate the backward-looking augmented Taylor monetary policy reaction function. The estimated equation estimates policy rate as a function in lagged inflation, lagged output gap, lagged policy rate, change in real effective exchange rate, in addition to other variables. The importance of this study arises from the lack of recent studies assessing interest rate setting in Egypt. The study concludes that monetary policy in Egypt has been accommodative to inflation and that Central Bank of Egypt responds asymmetrically to shocks in inflation, output and exchange rate.

A Taxonomic Revision of the Genus Poeppigia (Fabaceae: Dialioideae)

Poeppigia is a Neotropical genus of legumes that occurs from Mexico and Cuba to eastern Brazil and is considered until now to be monospecific with two varieties. Being one of the 17 genera in the subfamily Dialioideae, Poeppigia stands out as one of the few genera with not reduced perianth and androecium, representing a possible link between this subfamily and the other Fabaceae. The genus was never revised since several taxa were described in the XIX century and lack of recent studies and proper typification. Here we revised the genus taxonomically with the analysis of more than 400 specimens and proposed the acceptance of two species: P. procera, distributed on tropical forests from Mexico to Amazon and Southeast Brazil and P. densiflora, endemic of Brazilian Caatinga. The two species are distinct for many characters as habitus, size of branch, leaf and fruits, number of leaflets, stipules and bracts and form of inflorescence. Seed, embryo, pollen and seedling descriptions, conservation assessments, illustrations, maps of distribution and an identification key are presented. Nomenclatural, biogeographical, and ecological comments and three new lectotypifications are made.

Challenges to Reporting the Global Trends in the Epidemiology of ICU-Treated Sepsis and Septic Shock

It is widely believed that the epidemiology of sepsis and septic shock treated in the intensive care unit (ICU) is changing. However, quantifying changes in occurrence and outcomes of ICU-treated sepsis and septic shock are challenged by a number of factors related to study designs as well as varied local resource availability and practices. The authors conducted a structured literature review to examine contemporary studies reporting trends in the prevalence, incidence and case-fatality rates of ICU-treated sepsis and septic shock around the world and further attempted to extrapolate the recent epidemiological trends. During 2015–2020, 13 observational studies with heterogenous methodologies were published from predominantly high-income countries that examined selected cohorts with ICU-treated sepsis, sepsis with end-organ failure (previously known as severe sepsis) and septic shock. The prevalence of sepsis and sepsis-related diagnoses ranged widely from 4.7–42.2% of ICU admissions. The population incidence varied widely between 88 and 370 cases per 100,000 for sepsis and 19 and 79 cases per 100,000 for septic shock. Mean case-fatality rates (deaths per number of cases, %) reported primarily as in-hospital deaths reduced from approximately 40–50% reported in previous years, to 30–40% in the past 5 years. There was a lack of recent studies specifically examining mortality at the population level. Contemporary studies have observed wide variation in prevalence and incidence of sepsis and septic shock along with reports of static or decreasing case-fatality rates, but we are not able to make generalised commentary on global trends from the results of existing studies. Further data from ICUs in low-income and middle-income countries is needed, and well-designed, consistent population-based studies are required in order to establish whether the burden of sepsis and septic shock is changing.

International medical student’s mental health: psychological distress and socio-cultural adaptation

Abstract Background The greater academic mobility and globalization have introduced a substantial number of foreign students to more universities. The lack of recent studies about their adaptation and signs of psychological distress arose an interest about this relevant issue. Recognizing the factors involved in the adaptation process are vital for international students, especially medical, as they are considered the future health-care workforce. Ensuring their well-being is essential for consumers safety, satisfaction and raising quality at lower costs. Thus, the aim of this research was to explore the predictors of psychological distress including socio-demographic variables and socio-cultural adaptation Methods A cross-sectional study was conducted at the University of Belgrade School of Medicine, where 124 (65 males and 59 females) international students from 32 countries were interviewed using a socio-demographic questionnaire and psychometric tools such as Revised Socio-cultural Adaptation Scale (SCAS-R) and Depression, Anxiety, Stress Scale (DASS-21). Statistical analysis included prevalence data and multiple linear regression. Results The prevalence of depression, anxiety and stress was found to be 39%, 55% and 41%, respectively. Maladaptation to a new environment by lack of participation in the community and focus on own interests were significant predictors of depression (β = −.39, p&amp;lt; .01) and stress (β = −.36, p&amp;lt; .05), while anxiety was associated with both female gender (β = −.30, p&amp;lt;.05), self-centration and absence of community involvement (β = −.37, p&amp;lt; .01). Conclusions There is a high prevalence of anxiety followed by stress and depression among international medical students. The results highlighted the importance of cultural adaptation for psychological distress. This shows a requirement for developing an adequate, accessible professional counselling and peer support services for foreign students that are necessary to achieve sustainable development goals. Key messages Encouraging researchers to further investigate the needs of international medical students. The development and implementation of health policies addressing student’s mental health.

TL 18177 - Epidemiological profile of sesamoid disorders of the first metatarsophalangeal joint

Introduction: The sesamoid bones are part of the hallux metatarsophalangeal (MTTF) joint complex and are an important factor in the normal biomechanics of gait. Abnormalities of the sesamoid bones are not rare but are often underestimated and include acute fractures, osteochondral lesions, bipartite sesamoids, recurrent traumatic sesamoiditis or infection, in addition to osteoarthritis. Given the lack of recent studies on the epidemiological profile of sesamoid-related diseases, the objective of this study is to identify the epidemiological characteristics of patients with these disorders. Methods: The study was approved by the research ethics committee and registered in the Brazil Platform (Plataforma Brazil). This retrospective study was performed by reviewing the electronic charts of foot and ankle outpatients diagnosed with sesamoiditis and acute or stress fractures between February 1, 2013 and January 31, 2018. The exclusion criterion used was the presence of incomplete records in the electronic chart. The following variables were analyzed: sex, age, occupation, participation in sports, laterality and affected sesamoid bone (medial or lateral). The data collected were tabulated and saved in an Excel spreadsheet and analyzed using descriptive statistics. Results: Data on 108 patients were collected after reviewing the charts. Based on these data, we report the epidemiological characteristics of patients with sesamoid disorders in a sample of orthopedic patients from a reference hospital of the Unified Health System (Sistema Único de Saúde – SUS) in a city in southern Brazil. Among the various occupations reported, the 3 most common were cleaner (29), student (23) and salesperson (16). Among the subjects who participated in sports, only 22 were involved in competitive sports (professional or amateur).

El agua residual como generadora del espacio de la actividad agrícola en el Valle del Mezquital, Hidalgo, México

Objetivo: determinar, mediante un estudio empírico, cómo el uso del agua residual que recibe la región del Valle del Mezquital en Hidalgo, desde hace más de cien años, proveniente de la Zona Metropolitana del Valle de México, sin un tratamiento previo, configuró el espacio agrícola en esta región no apta para esta actividad por sus condiciones geográficas y climáticas. Metodología: se realizó una revisión de la literatura con respecto a la problemática del agua residual en combinación con información cuantitativa de diferentes instituciones para realizar un análisis desde la disciplina de economía ecológica que identifique los factores que la convierten en el detonante de importantes problemáticas sociales y ambientales. Resultado: se identificó que el uso de este tipo de agua en el sector agrícola de la región, contiene una alta carga contaminante compuesta por material orgánico, algunos metales, bacterias y detergentes, lo cual permitió el desarrollo del sector aunado a severos problemas de salud pública y degradación de suelos. Limitaciones: faltan estudios recientes que documenten las implicaciones en la salud de los habitantes de la región y en los ecosistemas. Conclusiones: la reconfiguración de los espacios para determinar regiones no necesariamente conlleva un beneficio social y ambiental, muchas veces implica el detrimento de la calidad de vida y degradación de los ecosistemas. No obstante, para parte de los habitantes de la región el uso de este tipo de aguas les has permitido salir de las condiciones de marginalidad en las cuales vivían.

Religion and ethnicity at work: a study of British Muslim women’s labour market performance

The literature on British Muslim women’s labour market experience suffers from four lacunae: the inadequate analysis of the multi-layered facets of their identities and the disadvantages they face; the narrow range of labour market outcomes studied (primarily labour market participation and unemployment); a lack of recent studies on the integration of Muslim women, educated in the UK and with English as their first language, into the labour market; and the absence of material on several sub-groups due to the lack of data, notably Arab, Christian Indian and White-British Muslim women. Using a large sample of data from the 2011 British census, the analyses presented here suggest that most non-White women face significant labour market penalties, with religion having a greater impact on labour market outcomes than race/ethnicity; Muslim women were the most disadvantaged, compared to other religious minorities, more so in relation to unemployment levels, part-time jobs and out of employment history, than in relation to occupational class and over-qualification. The results also suggest that the penalties facing Muslim women shaped by their ethnicity; not all Muslim women were similarly disadvantaged.

Schema therapy for emotional dysregulation in personality disorders: a review.

To give an update on the most recent studies regarding the role of schema therapy in the treatment of emotion dysregulation related to personality disorders. In personality disorders, a lack of emotion regulation can be found. Schema therapy treats emotion dysregulation with a series of techniques, such as imagery rescripting, limited reparenting, chairwork, and cognitive restructuring to remove dysregulatory mechanism. Schema therapy is one of the most efficient therapies for personality disorders. However, there is a lack of recent studies on how it treats emotion dysregulation. Although the treatment of emotional dysregulation is not the core of schema therapy, it is certainly important inside this theoretical framework. The mode model helps clinicians address their work toward the reduction of dysfunctional modes, whereas fostering functional modes.

Diversidad taxonómica y funcional en la comunidad de peces sujetos al arrastre de camarón en el norte del Golfo de California, México

The Northern Gulf of California (NGC) is a mega diverse area of high endemism with major economic interest because of the multi-specific fisheries developed, mainly shrimp. There is a lack of recent studies on bycatch fish assemblages, so during the fishing seasons from 2009-2010 and 2010-2011, on board 13 shrimp boats, 14 commercial fishing trips were performed from 5 m - 90 m in depth with a total of 119 catches. The 119 catches were analyzed to assess fish community structure using taxonomic diversity indices to detect changes in the community following the taxonomic distinctness average Δ+ and the diversity index Δ* (TAXDEST of the PRIMER v6 program). To confirm the structure of functional groups, we considered similarities of ecologic and morphologic traits among species. The results showed that the indices Δ+ and Δ* were within the expected average and confidence intervals at 95%, finding significant differences between the indices. The analyses showed a well-structured community because of the great variety of forms and functions of the species within the community. In the community of the functional groups, reproduction was the ecological attribute that contributed the most to their structure. The community structure was represented by intermediate trophic levels (3-3.9), preferably primary and secondary carnivores within the trophic categories of predators of benthic ichthyo-fauna that belong to demersal species of soft bottoms and mostly fusiform body. To conclude, the NGC showed high functional redundancy according to the estimated functional groups, thus the ecosystem was considered stable and with great diversity. This type of studies should be followed using fishing and environmental effort due to the great biological and ecologic importance in the area.

Genitourinary trauma in geriatric patients.

The geriatric population is the fastest growing segment of the population, and geriatric trauma patients are increasingly common. Caring for this population has unique challenges. The goal of the review is to identify factors that may help in the care of geriatric patients suffering from genitourinary trauma. Multiple factors lead to inferior outcomes in patients with geriatric trauma including failure to rescue, treatment in lower volume trauma centers, and undertriage of geriatric patients. Improvement in geriatric trauma outcomes occurs with the use of dedicated geriatric consult teams. The surgical management of genitourinary injuries in the geriatric population remains unchanged. Interventions for geriatric patients differ from younger populations. Direct changes in overall management of the geriatric population lead to improved outcomes. The treatment of geriatric trauma patients with genitourinary injuries is similar to a younger cohort. The lack of recent studies in clinical outcomes in this population has been identified as a gap in knowledge that will require future research to answer.

Septic cavernous sinus thrombosis secondary to acute bacterial sinusitis: a retrospective study of seven cases.

Septic cavernous sinus thrombosis (SCST) is a rare but severe complication of acute bacterial sinusitis. Evaluations of advances in imaging techniques as well as in medical and surgical treatment are hampered by the lack of recent studies. We aim to report our experience in the management of SCST in patients with acute bacterial sphenoid sinusitis over the past 10 years and to discuss the initial work-up and treatment strategies. We performed a retrospective study of patients admitted for SCST related to acute sinusitis at a tertiary care center between 2003 and 2013. Clinical charts were reviewed for demographics, clinical presentations, imaging and microbiologic findings, medical and surgical treatments, and outcomes. Seven patients were treated for SCST. Sphenoid sinus was involved in all cases. The most frequent presenting signs included headache (100%), cranial nerve impairment (86%), fever (71%), and orbital symptoms (71%). Diagnosis was confirmed by a cerebral contrast-enhanced CT scan in all cases. Four patients (57%) had an additional intracranial complication. The average time between clinical onset and diagnosis was 13.7 days. All patients were treated by high-dose i.v. antibiotics, anticoagulation therapy, and surgical endoscopic drainage of the infected sinuses. This treatment strategy resulted in a mortality rate of 0%, but four out of the seven patients developed transient or permanent neurologic deficits, including one with permanent unilateral visual loss. The combination of high-dose i.v. antibiotics, anticoagulation therapy, and endoscopic drainage of the infected paranasal sinus is an effective strategy for the treatment of SCST, but long-term sequelae remain frequent.