Variability of adenoidectomy/tonsillectomy rates among children of the Veneto Region, Italy

<p>Abstract</p> <p>Background</p> <p>Despite national guidelines in 2003 aimed at limiting the recourse to tonsillectomy and/or adenoidectomy (A/T), the latter are among the most frequent pediatric surgeries performed in Italy. Aim of the study is to investigate variability of A/T rates among children of the Veneto Region, Italy.</p> <p>Methods</p> <p>All discharges of Veneto residents with Diagnosis-Related Groups 57–60 and ICD9-CM intervention codes 28.2 (tonsillectomy), 28.3 (adenotonsillectomy), 28.6 (adenoidectomy) were selected in the period 2000–2006 for a descriptive analysis. A multilevel Poisson regression model was applied to estimate Incidence Rate Ratios (IRR) with 95% Confidence Intervals (CI) for A/T surgery among children aged 2–9 years in 2004–2006, while taking into account clustering of interventions within the 21 Local Health Units.</p> <p>Results</p> <p>Through 2000–2006, the overall number of A/T surgeries decreased (-8%); there was a decline of adenoidectomies (-20%) and tonsillectomies (-8%), whereas adenotonsillectomies raised (+18%). Analyses on children aged 2–9 resulted in an overall rate of 14.4 surgeries per 1000 person-years (16.1 among males and 12.5 among females), with a wide heterogeneity across Local Health Units (range 8.1–27.6). At random intercept Poisson regression, while adjusting for sex and age, intervention rates were markedly lower among foreign than among Italian children (IRR = 0.57, CI 0.53–0.61). A/T rates in the 10–40 age group (mainly tonsillectomies) computed for each Local Health Unit and introduced in the regression model accounted for 40% of the variance at Local Health Unit level of pediatric rates (mainly adenoidectomies and adenotonsillectomies).</p> <p>Conclusion</p> <p>A/T rates in the Veneto Region, especially adenoidectomies among children aged 2–9 years, remain high notwithstanding a decrease through 2000–2006. A wide heterogeneity according to nationality and Local Health Units is evident. The propensity to A/T surgery of each Local Health Unit is similar in different age groups and for different surgical indications.</p

Characterization of Geographically Distinct Bacterial Communities Associated with Coral Mucus Produced by Acropora spp. and Porites spp

ABSTRACT Acropora and Porites corals are important reef builders in the Indo-Pacific and Caribbean. Bacteria associated with mucus produced by Porites spp. and Acropora spp. from Caribbean (Punta Maroma, Mexico) and Indo-Pacific (Hoga and Sampela, Indonesia) reefs were determined. Analysis of pyrosequencing libraries showed that bacterial communities from Caribbean corals were significantly more diverse (H′, 3.18 to 4.25) than their Indonesian counterparts (H′, 2.54 to 3.25). Dominant taxa were Gammaproteobacteria , Alphaproteobacteria , Firmicutes , and Cyanobacteria , which varied in relative abundance between coral genera and region. Distinct coral host-specific communities were also found; for example, Clostridiales were dominant on Acropora spp. (at Hoga and the Mexican Caribbean) compared to Porites spp. and seawater. Within the Gammproteobacteria , Halomonas spp. dominated sequence libraries from Porites spp. (49%) and Acropora spp. (5.6%) from the Mexican Caribbean, compared to the corresponding Indonesian coral libraries (&lt;2%). Interestingly, with the exception of Porites spp. from the Mexican Caribbean, there was also a ubiquity of Psychrobacter spp., which dominated Acropora and Porites libraries from Indonesia and Acropora libraries from the Caribbean. In conclusion, there was a dominance of Halomonas spp. (associated with Acropora and Porites [Mexican Caribbean]), Firmicutes (associated with Acropora [Mexican Caribbean] and with Acropora and Porites [Hoga]), and Cyanobacteria (associated with Acropora and Porites [Hoga] and Porites [Sampela]). This is also the first report describing geographically distinct Psychrobacter spp. associated with coral mucus. In addition, the predominance of Clostridiales associated with Acropora spp. provided additional evidence for coral host-specific microorganisms. </jats:p

Projections of climate conditions that increase coral disease susceptibility and pathogen abundance and virulence

Rising sea temperatures are likely to increase the frequency of disease outbreaks affecting reef-building corals through impacts on coral hosts and pathogens. We present and compare climate model projections of temperature conditions that will increase coral susceptibility to disease, pathogen abundance and pathogen virulence. Both moderate (RCP 4.5) and fossil fuel aggressive (RCP 8.5) emissions scenarios are examined. We also compare projections for the onset of disease-conducive conditions and severe annual coral bleaching, and produce a disease risk summary that combines climate stress with stress caused by local human activities. There is great spatial variation in the projections, both among and within the major ocean basins, in conditions favouring disease development. Our results indicate that disease is as likely to cause coral mortality as bleaching in the coming decades. These projections identify priority locations to reduce stress caused by local human activities and test management interventions to reduce disease impacts

Thermal and Sedimentation Stress Are Unlikely Causes of Brown Spot Syndrome in the Coral Reef Sponge, Ianthella basta

Background: Marine diseases are being increasingly linked to anthropogenic factors including global and local stressors. On the Great Barrier Reef, up to 66% of the Ianthella basta population was recently found to be afflicted by a syndrome characterized by brown spot lesions and necrotic tissue.\ud \ud Methodology/Principal Findings: Manipulative experiments were undertaken to ascertain the role of environmental stressors in this syndrome. Specifically, the effects of elevated temperature and sedimentation on sponge health and symbiont stability in I. basta were examined. Neither elevated temperature nor increased sedimentation were responsible for the brown spot lesions, but sponges exposed to 32°C developed substantial discoloration and deterioration of their tissues, resulting in death after eight days and a higher microbial diversity in those samples. No shifts in the microbial community of I. basta were observed across a latitudinal gradient or with increased sedimentation, with three previously described symbionts dominating the community of all sponges (Alphaproteobacteria, Gammaproteobacteria and Thaumarchaea).\ud \ud Conclusions/Significance: Results from this study highlight the stable microbial community of I. basta and indicate that thermal and sedimentation stress are not responsible for the brown spot lesions currently affecting this abundant and ecologically important sponge species

The Biology and Economics of Coral Growth

To protect natural coral reefs, it is of utmost importance to understand how the growth of the main reef-building organisms—the zooxanthellate scleractinian corals—is controlled. Understanding coral growth is also relevant for coral aquaculture, which is a rapidly developing business. This review paper provides a comprehensive overview of factors that can influence the growth of zooxanthellate scleractinian corals, with particular emphasis on interactions between these factors. Furthermore, the kinetic principles underlying coral growth are discussed. The reviewed information is put into an economic perspective by making an estimation of the costs of coral aquaculture

Coral health on reefs near mining sites in New Caledonia

Coral health data are poorly documented in New Caledonia, particularly from reefs chronically subject to anthropogenic and natural runoff. We investigated patterns of coral disease and non-disease conditions on reefs situated downstream of mining sites off the coast of New Caledonia. Surveys were conducted in March 2013 at 2 locations along the west coast and 2 locations along the east coast of the main island. Only 2 coral diseases were detected: growth anomalies and white syndrome. The most prevalent signs of compromised health at each location were sediment damage and algal overgrowth. These results support earlier findings that sedimentation and turbidity are major threats to inshore reefs in New Caledonia. The Poritidae-dominated west coast locations were more subject to sediment damage, algal overgrowth and growth anomalies compared to the Acroporidae-dominated east coast locations. If growth form and resistance of coral hosts influence these results, differences in environmental conditions including hydro-dynamism between locations may also contribute to these outputs. Our results highlight the importance of combining coral health surveys with measurements of coral cover when assessing the health status of a reef, as reefs with high coral cover may have a high prevalence of corals demonstrating signs of compromised health

Oil pollution on coral reefs: a review of the state of knowledge and management needs

This paper reviews the current state of knowledge of the effects that oil pollution has on scleractinian corals. Areview of results obtained in laboratory as well as in field conditions are given and suitable management tools are discussed. Studies made in the 1970s and 1980s presented conflicting results regarding the impacts of oil on coral physiology, but later results confirmed the detrimental effect of oil on corals. The world's coral reefs are severely threatened by an array of factors, one of which is oil pollution. More laboratory and field work with current oils and dispersants is urgently needed in order to update our knowledge in this field and reduce impacts in case of a major oil spill on coral reefs

Disease outbreaks, bleaching and a cyclone drive changes in coral assemblages on an inshore reef of the Great Barrier Reef

Coral disease is a major threat to the resilience of coral reefs; thus, understanding linkages between disease outbreaks and disturbances predicted to increase with climate change is becoming increasingly important. Coral disease surveys conducted twice yearly between 2008 and 2011 at a turbid inshore reef in the central Great Barrier Reef spanned two disturbance events, a coral bleaching event in 2009 and a severe cyclone (cyclone 'Yasi') in 2011. Surveys of coral cover, community structure and disease prevalence throughout this 4-yr study provide a unique opportunity to explore cumulative impacts of disturbance events and disease for inshore coral assemblages. The principal coral disease at the study site was atramentous necrosis (AtN), and it primarily affected the key inshore, reef-building coral Montipora aequituberculata. Other diseases detected were growth anomalies, white syndrome and brown band syndrome. Diseases affected eight coral genera, although Montipora was, by far, the genus mostly affected. The prevalence of AtN followed a clear seasonal pattern, with disease outbreaks occurring only in wet seasons. Mean prevalence of AtN on Montipora spp. (63.8 % ± 3.03) was three- to tenfold greater in the wet season of 2009, which coincided with the 2009 bleaching event, than in other years. Persistent wet season outbreaks of AtN combined with the impacts of bleaching and cyclone events resulted in a 50–80 % proportional decline in total coral cover. The greatest losses of branching and tabular acroporids occurred following the low-salinity-induced bleaching event of 2009, and the greatest losses of laminar montiporids occurred following AtN outbreaks in 2009 and in 2011 following cyclone Yasi. The shift to a less diverse coral assemblage and the concomitant loss of structural complexity are likely to have long-term consequences for associated vertebrate and invertebrate communities on Magnetic Island reefs

The association between coral communities and disease assemblages in the Wakatobi Marine National Park, south-eastern Sulawesi, Indonesia

The relationship between coral community structure and disease prevalence is poorly understood, particularly in the Coral Triangle. Improved understanding of this relationship will assist in identifying assemblages that might be particularly vulnerable to disease, and in predicting possible future impacts. Here, we report results from the last 2 years (2010 and 2011) of a 4-year coral disease-monitoring program (2005, 2007, 2010, 2011) in the Wakatobi Marine National Park (Indonesia), and evaluate changes in total disease prevalence and coral cover since 2005. A comparison with previously published results from 2005 and 2007 indicates that the number of coral diseases increased from two to eight and total disease prevalence tripled between 2005 and 2011. We observed a dramatic decline in coral cover and an increase in disease prevalence at a site with a unique community of foliose corals. However, because of the 3-year period between surveys (2007, 2010), it is likely that the peak of the disease event was not observed. While multi-year studies provide useful insights into the relationships between community structure and disease, our results emphasise how determining the drivers of change in remote reef locations is especially challenging if events such as disease outbreaks are missed

Morphological changes in polyp structure of massive coral species in clear and turbid waters

We explored variations in polyp morphology of four ecologically important massive coral species, Porites lutea (Milne-Edwards and Haime, 1860), Diploastrea heliopora (Lamarck, 1816), Favia speciosa (Dana, 1846), and Favia matthaii (Vaughan, 1918), across a depth gradient and among sites of differing turbidity within the Wakatobi Marine National Park, Indonesia. Increased polyp area with decreased light availability was found in all target species except F. speciosa, whereas polyp density only varied across sites or depth in D. heliopora, P. lutea, and F. speciosa. Variability in polyp morphology may reflect both an optimization of light capture and an increase in heterotrophic efficiency of the host to compensate for decreased photosynthesis with depth. The morphological variability demonstrated in these key species, which acts to optimize environmental suitability, may be a crucial attribute that has contributed to the success and abundance of these species within the Wakatobi Marine National Park