“Bone-shot fracture” – An unusual iliac wing fracture caused by a projectile of autologous bone fragment. A case report

Case: A young adult male sustained a high-energy crash suffering multiple injuries including a comminuted right femoral shaft fracture and an ipsilateral iliac wing fracture. The iliac fracture was caused by a femoral fragment which was projected and pierced the iliac wing. The patient underwent surgery with retrieval of the femoral fragment and fixation of the iliac and femoral fractures. The lesions healed uneventfully. Conclusion: This is the first reported case of an iliac fracture caused by a projectile of autologous bone. High-energy trauma may present unusual or never seen injury patterns to the trauma surgeon

Medicinal animals used in ethnoveterinary practices of the 'Cariri Paraibano', NE Brazil

<p>Abstract</p> <p>Background</p> <p>Zootherapy is important in various socio-cultural environments, and innumerous examples of the use of animal derived remedies can currently be found in many urban, semi-urban and more remote localities in all parts of the world, particularly in developing countries. However, although a number of ethnobiological inventories concerning the use of medicinal animals in human health care have been compiled in Brazil in recent years, zootherapeutic practices in ethnoveterinary medicine (EVM) are poorly described and neglected in favor of human ethnomedicine. In this sense, the purpose of this study was to describe the local zootherapeutic practices in ethnoveterinary medicine of semi-arid of NE Brazil (Caatinga biome) and to contribute to future research about the validation of the effects and side effects of these animal products</p> <p>Methods</p> <p>The information obtained through semi-structured interviews was complemented by free interviews and informal conversations. A total of 67 people were interviewed (53 men and 14 women) about the use and commercialization of medicinal animals. To determine the relative importance of each local known species, their use-values (UV) were calculated. Diversity of species utilized was compared, between localities, using rarefaction curves and diversity estimate (Chao2)</p> <p>Results and Conclusions</p> <p>A total of 44 animal species (37 vertebrates and 7 invertebrates), distributed among 6 taxonomic categories were found to be used to treat 30 different ailments in livestock and pets. The results of our surveys revealed a rich traditional knowledge of local residents about the use of animals in traditional veterinary medicine. Although it is gradually being discontinued, the perceived efficacy, economic and geographic accessibility were main reasons for popularity of zootherapy in studied areas.</p

Ichthyofauna of the Mata de Itamacaoca, an urban protected area from the upper Munim River basin, Northern Brazilian Cerrado

The Munim River basin is one of the main river drainages of the Hydrological unit Maranhão, but there are few published studies which focus on ichthyological surveys and taxonomic work within this basin. The present study aims to provide a fish species inventory of the Mata da Itamacaoca, one of the few urban protected areas from the upper Munim River basin, comparing the ichthyofauna with other lists by conducted at the upper Munim River basin. A total of 42 collection expeditions were conducted, the sampling was conducted at five collecting sites distributed within the boundaries of Mata de Itamacaoca, upper Munim River basin. Diversity indices were calculated and generalised linear models (GLMs) were employed to assess differences in species richness, diversity and evenness depending on season and location in relation to the reservoir dam wall. In order to visualize fish community differences, non-metric multidimensional scaling (nMDS) and a one-way PERMANOVA was used to understand whether factors of site, season and location to the dam wall had an effect on fish community compositions. A total of six orders, 13 families, and 23 fish species were found, and the order with the highest species richness, considering all reaches, was Characiformes followed by Cichliformes. The most abundant species was Nannostomus beckfordi, while Pimelodella parnahybae and Hoplerythrinus unitaeniatus were the rarer species sampled. There were no alien invasive species collected within the study area. Species richness was significantly higher below the dam wall, but there were no other significant differences in diversity indices with regards to season or location. Fish community composition was significantly different above and below the dam wall and was significantly affected by sampling site. Season did not have an effect on fish community. This study corroborates other studies conducted in the Unidade Hidrológica Maranhão sensu Hubbert and Renno (2006), that the ichthyofaunal composition and taxonomy of species within this region face major data deficits, anthropogenic impacts, this study may be a baseline for comparing similar environments throughout the region

Risk of breast cancer following exposure to tetrachloroethylene-contaminated drinking water in Cape Cod, Massachusetts: reanalysis of a case-control study using a modified exposure assessment

<p>Abstract</p> <p>Background</p> <p>Tetrachloroethylene (PCE) is an important occupational chemical used in metal degreasing and drycleaning and a prevalent drinking water contaminant. Exposure often occurs with other chemicals but it occurred alone in a pattern that reduced the likelihood of confounding in a unique scenario on Cape Cod, Massachusetts. We previously found a small to moderate increased risk of breast cancer among women with the highest exposures using a simple exposure model. We have taken advantage of technical improvements in publically available software to incorporate a more sophisticated determination of water flow and direction to see if previous results were robust to more accurate exposure assessment.</p> <p>Methods</p> <p>The current analysis used PCE exposure estimates generated with the addition of water distribution modeling software (EPANET 2.0) to test model assumptions, compare exposure distributions to prior methods, and re-examine the risk of breast cancer. In addition, we applied data smoothing to examine nonlinear relationships between breast cancer and exposure. We also compared a set of measured PCE concentrations in water samples collected in 1980 to modeled estimates.</p> <p>Results</p> <p>Thirty-nine percent of individuals considered unexposed in prior epidemiological analyses were considered exposed using the current method, but mostly at low exposure levels. As a result, the exposure distribution was shifted downward resulting in a lower value for the 90th percentile, the definition of "high exposure" in prior analyses. The current analyses confirmed a modest increase in the risk of breast cancer for women with high PCE exposure levels defined by either the 90th percentile (adjusted ORs 1.0-1.5 for 0-19 year latency assumptions) or smoothing analysis cut point (adjusted ORs 1.3-2.0 for 0-15 year latency assumptions). Current exposure estimates had a higher correlation with PCE concentrations in water samples (Spearman correlation coefficient = 0.65, p < 0.0001) than estimates generated using the prior method (0.54, p < 0.0001).</p> <p>Conclusions</p> <p>The incorporation of sophisticated flow estimates in the exposure assessment method shifted the PCE exposure distribution downward, but did not meaningfully affect the exposure ranking of subjects or the strength of the association with the risk of breast cancer found in earlier analyses. Thus, the current analyses show a slightly elevated breast cancer risk for highly exposed women, with strengthened exposure assessment and minimization of misclassification by using the latest technology.</p

Spatial heterogeneity of habitat suitability for Rift Valley fever occurrence in Tanzania: an ecological niche modelling approach

Despite the long history of Rift Valley fever (RVF) in Tanzania, extent of its suitable habitat in the country remains unclear. In this study we investigated potential effects of temperature, precipitation, elevation, soil type, livestock density, rainfall pattern, proximity to wild animals, protected areas and forest on the habitat suitability for RVF occurrence in Tanzania. Presence-only records of 193 RVF outbreak locations from 1930 to 2007 together with potential predictor variables were used to model and map the suitable habitats for RVF occurrence using ecological niche modelling. Ground-truthing of the model outputs was conducted by comparing the levels of RVF virus specific antibodies in cattle, sheep and goats sampled from locations in Tanzania that presented different predicted habitat suitability values. Habitat suitability values for RVF occurrence were higher in the northern and central-eastern regions of Tanzania than the rest of the regions in the country. Soil type and precipitation of the wettest quarter contributed equally to habitat suitability (32.4% each), followed by livestock density (25.9%) and rainfall pattern (9.3%). Ground-truthing of model outputs revealed that the odds of an animal being seropositive for RVFV when sampled from areas predicted to be most suitable for RVF occurrence were twice the odds of an animal sampled from areas least suitable for RVF occurrence (95% CI: 1.43, 2.76, p < 0.001). The regions in the northern and central-eastern Tanzania were more suitable for RVF occurrence than the rest of the regions in the country. The modelled suitable habitat is characterised by impermeable soils, moderate precipitation in the wettest quarter, high livestock density and a bimodal rainfall pattern. The findings of this study should provide guidance for the design of appropriate RVF surveillance, prevention and control strategies which target areas with these characteristics

Quem Recorre ao Serviço de Urgência de Pedopsiquiatria de Lisboa?

Introdução: A recorrência de crianças e adolescentes aos serviços de saúde mental em Portugal tem vindo a aumentar. Em contexto de serviço de urgência pedopsiquiátrica também se tem constatado um aumento na frequência e na severidade dos casos. Porém, estas questões não têm sido claramente avaliadas nos últimos anos. Objetivos: O presente estudo pretende, neste contexto, identificar os padrões de acesso e caracterizar a população que recorreu ao serviço de urgência de pedopsiquiatria de Lisboa ao longo do ano de 2013. Métodos: Revisão bibliográfica. Seleção de variáveis (caracterização demográfica, acompanhamento atual por serviços de saúde mental; motivo de admissão; visitas prévias ao serviço de urgência pedopsiquiátrica; tipo de intervenção). Os dados foram recolhidos a partir do sistema de software informático do serviço de urgência (HCIS®), com posterior cruzamento de dados com os da folha de registo de atividade do médico de urgência de pedopsiquiatria. A informação foi submetida a processamento estatístico (em SPSS®), com análise descritiva e correlação de variáveis.Resultados: Os nossos resultados mostram uma maior prevalência de adolescentes a recorrer ao serviço de urgência, predominantemente com idade superior a 15 anos, com alterações de comportamento, problemas de humor e episódios auto-lesivos. Verifica-se uma variabilidade mensal, com maior afluência em maio, outubro e novembro. Conclusões: Este resultados revelam haver uma grande afluência de crianças e adolescentes à urgência pedopsiquiátrica de Lisboa, muito superior a dados pontuais de anos anteriores. Devido à sua prevalência, os adolescentes mais velhos com patologias graves são o foco da nossa preocupação. São necessários mais estudos que permitam compreender as suas causas, consequências e as necessidades de mudança em prol da melhoria dos cuidados de saúde mental infantil.info:eu-repo/semantics/publishedVersio