Incidental Diagnosis of Bladder Cancer in a 17-year-old Patient

AbstractBladder cancer is the fourth most common type of cancer among males and the ninth most common cause of cancer death. Bladder cancer can occur at any age. This paper reports the incidental diagnosis of bladder cancer in a 17-year-old female patient. Data on bladder cancer at this age are uncommon in the literature

Effects of grazing pressure on activity and richness of bats in a Portuguese silvo-pastoral system

Background High Nature Value Farmlands (HNVF) harbor species dependent upon habitats maintained by low-intensity farming. Among HNVF, the montado (dehesa in Spain) is a multifunctional system declining due to droughts, pathogens, and increasing grazing pressure. Specifically, grazing pressure leads to compact soils and hinders natural tree regeneration. Regrettably, there is a dearth of information supporting management decisions on the side-effects of high grazing pressure on HNVF-dwelling biodiversity. In particular, little is known about the impact of grazing pressure on bats, a group of species of special conservation concern that may provide key ecosystem services such as biological pest control. Purpose We investigated patterns of activity levels and community composition of insectivorous bats to test the hypothesis that there is a significant relationship between the level of livestock grazing pressure within montado HNVF parcels and patterns of insectivorous bats’ presence and activity. Our specific aims were to (i) assess separately the effects of grazing pressure on bat activity and species composition, (ii) test the predictive significance of key covariates (e.g., insect availability). Methods We conducted this study in 2014 in the Natura 2000 network site “Monfurado”, southern Portugal. This site is specifically acknowledged for its well-preserved montados providing feeding areas for bat species. We quantified acoustically bat flight activity and species richness in farm parcels dominated by cork oak trees. Per parcel, we selected two separate locations (high vs. low grazing pressure) based on landowners’ interviews and grazing pressure indicators, totaling 42 sampling locations. We then used linear mixed-effects modeling to evaluate the effects of grazing pressure and covariates on activity and species richness. Results Bat activity and bat species richness peaked at low grazing pressure locations. Bat activity also increased with tree cover and in locations where livestock grazing signs were old or absent. Conversely, bat activity at low grazing pressure locations decreased with distance to the nearest standing water body. Discussion Our study clearly demonstrated that locations maintained under high grazing pressure within HNVF can have negative consequences for bats, which are acknowledged as good bioindicators of habitat quality. In order to promote better habitat for bats, practitioners should avoid favoring grazing-prone areas (e.g., rotating the location of livestock feeders, drinkers, and gates) across montado HNVF. Broadly, ecosystem services provided by bats for HNVF must be enhanced through sustainability oriented agro-environment schemes under the Economic Community Rural Development Program, including the reduction of stocking density

Comportamento de dois genótipos de milho cultivados em sistema de aléias preestabelecido com diferentes leguminosas arbóreas.

O cultivo em aléias tem sido recomendado como alternativa para a substituição da agricultura de corte e queima, no trópico úmido, devido à grande capacidade de produção de matéria orgânica e de reciclagem de nutrientes, mas algumas dúvidas quanto à sustentabilidade e à competição interespecífica são persistentes. O objetivo no trabalho foi avaliar a viabilidade da cultura do milho em um sistema de cultivo em aléias de leguminosas arbóreas. O delineamento experimental utilizado foi em blocos casualisados, com quatro repetições dos tratamentos: aléias de sombreiro (Clitoria fairchildiana), ingá (Inga edulis), guandu (Cajanus cajan) e leucena (Leucaena leucocephala) e uma testemunha sem aléias. Foram avaliadas a remobilização de carbono e nitrogênio, massa de grãos, massa de mil grãos e competição interespecífica entre as cultivares de milho e as leguminosas. A produção de grãos foi maior nas parcelas com C. fairchildiana e L. leucocephala. A produtividade do híbrido de milho foi superior à da variedade em todos os tratamentos. A produtividade e a massa de mil grãos de milho não são negativamente afetadas pela distância da linha da leguminosa arbórea. Esse estudo conclui que o sistema de aléias com leguminosas arbóreas é uma alternativa importante ao manejo sustentável dos agroecossistemas no tropico úmido. Além disso, nessa região a produtividade em grãos na cultura do milho é favorecida no sistema de aléias preeestabelecidas com as leguminosas arbóreas sombreiro, ingá e leucena e pela utilização de genótipos eficientes no aproveitamento do nitrogênio, cujo sincronismo entre a liberação e a absorção do N aplicado por meio das leguminosas deve ser aprimorado

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.