Spesifisitas Substrat Dinoflagellata Epibentik Penyebab Ciguatera Fish Poisoning Berdasarkan Analisis Aku dan Afk di di Perairan Pulau Harapan, Kepulauan Seribu

Ciguatera Fish Poisoning (CFP) yang disebabkan oleh Ciguatoksin, dihasilkan oleh beberapa jenis Dinoflagellata epibentik yang umumnya menempel pada makroalga. Dinoflagellata epibentik juga dapat menempel pada substrat lain, seperti pada sedimen atau pecahan karang. Penelitian mengenai Dinoflagellata epibentik telah dilakukan di Pulau Harapan, Kepulauan Seribu pada bulan Maret 2013, di empat stasiun yang terletak di sisi timur, utara, selatan, dan barat pulau. Penelitian ini bertujuan untuk mengetahui spesifisitas substrat Dinoflagellata epibentik pada berbagai macam tipe substrat.Penelitian dilakukan dengan mengoleksi berbagai substrat di rataan terumbu setiap stasiun yaitu pasir, karang mati, lamun Thallasia, dan makroalga Padina, untuk kemudian dimasukkan ke dalam wadah plastik berisi air laut. Setelah itu, untuk melepaskan Dinoflagellata bentik dari substrat, dilakukan proses pengocokan. Sampel kemudian disaring dengan saringan bertingkat (125µm dan 20µm) dan diamati di bawah mikroskop. Data hasil penelitian dianalisis menggunakan Analisis Faktorial Koresponden (AFK) dan Analisis Komponen Utama (AKU).Berdasarkan hasil penelitian, diperoleh dua belas spesies Dinoflagellata epibentik yang tujuh diantaranya merupakan spesies yang berpotensi toksik. Berdasarkan hasil analisis AFK dan AKU diketahui bahwa spesifisitas substrat dari Gambierdiscus toxicus adalah makroalga; Amphidiniopsis hirsutum, Prorocentrum concavum, Coolia sp., dan Amphidinium sp. adalah substrat pasir; Ostreopsis ovata, Ostreopsis lenticularis, dan Prorocentrum rhatymum adalah substrat lamun, karang, dan pasir; Ostreopsis siamensis, Prorocentrum lima, Prorocentrum emarginatum, dan Sinophysis microcephalus adalah substrat lamun, karang, dan makroalga

Dome-shaped macula in premature infants visualized by handheld spectral-domain optical coherence tomography

PURPOSE: To describe dome-shaped macula and associated clinical findings in premature infants. METHODS: This prospective, observational cohort study included a consecutive sample of premature infants screened for retinopathy of prematurity (ROP) with 9-month follow-up. Handheld spectral domain optical coherence tomography (SD-OCT) was performed at the time of ROP screening. Images were assessed for dome-shaped macula, cystoid macular edema, epiretinal membrane, vitreous bands, and punctate hyperreflective vitreous opacities. Dome height measurements were performed in a subset of images. Teller visual acuity and cycloplegic refraction were performed at an adjusted age of 8-10 months. RESULTS: Of 37 infants (74 eyes; 49% male; mean gestational age 27.8 ± 3.2 weeks; mean birth weight 949 ± 284 g), 24/37 (65%) demonstrated dome-shaped macula in at least one eye (13 both eyes, 5 right eye only, and 6 left eye only). Of the 74 eyes, 26 (35%) could be reliably measured, with a mean dome height of 139.0 ± 72.3 μm (range, 54-369 μm). Presence of dome-shaped macula was associated with a diagnosis of ROP (P = 0.02; OR, 3.03; 95% CI, 1.18-7.82) and pre-plus or plus disease (P = 0.02; OR, 4.20; 95% CI, 1.05-16.78). Infants with dome-shaped macula had lower birth weight compared with those without (877 vs 1081 g; P = 0.04). No associations with other demographics, OCT findings, and 9-month refractive outcomes were found. CONCLUSIONS: Dome-shaped macula was frequently identified by handheld SD-OCT in premature infants, especially those with lower birth weight and severe ROP. The long-term clinical significance of this finding is unknown

Recurrence and Mortality Risk of Merkel Cell Carcinoma by Cancer Stage and Time From Diagnosis.

Importance: Merkel cell carcinoma (MCC) often behaves aggressively; however, disease-recurrence data are not captured in national databases, and it is unclear what proportion of patients with MCC experience a recurrence (estimates vary from 27%-77%). Stage-specific recurrence data that includes time from diagnosis would provide more precise prognostic information and contribute to risk-appropriate clinical surveillance. Objective: To estimate risk of stage-specific MCC recurrence and mortality over time since diagnosis. Design, Setting, and Participants: This prospective cohort study included 618 patients with MCC who were prospectively enrolled in a Seattle-based data repository between 2003 and 2019. Of these patients, 223 experienced a recurrence of MCC. Data analysis was performed July 2019 to November 2021. Main Outcomes and Measures: Stage-specific recurrence and survival, as well as cumulative incidence and Kaplan-Meier analyses. Results: Among the 618 patients included in the analysis (median [range] age, 69 [11-98] years; 227 [37%] female), the 5-year recurrence rate for MCC was 40%. Risk of recurrence in the first year was high (11% for patients with pathologic stage I, 33% for pathologic stage IIA/IIB, 30% for pathologic stage IIIA, 45% for pathologic stage IIIB, and 58% for pathologic stage IV), with 95% of recurrences occurring within the first 3 years. Median follow-up among living patients was 4.3 years. Beyond stage, 4 factors were associated with increased recurrence risk in univariable analyses: immunosuppression (hazard ratio [HR], 2.4; 95% CI, 1.7-3.3; P \u3c .001), male sex (HR, 1.9; 95% CI, 1.4-2.5; P \u3c .001), known primary lesion among patients with clinically detectable nodal disease (HR, 2.3; 95% CI, 1.4-4.0; P = .001), and older age (HR, 1.1; 95% CI, 1.0-1.3; P = .06 for each 10-year increase). Among 187 deaths in the cohort, 121 (65%) were due to MCC. The MCC-specific survival rate was strongly stage dependent (95% at 5 years for patients with pathologic stage I vs 41% for pathologic stage IV). Among patients presenting with stage I to II MCC, a local recurrence (17 arising within/adjacent to the primary tumor scar) did not appreciably diminish survival compared with patients who had no recurrence (85% vs 88% MCC-specific survival at 5 years). Conclusions and Relevance: In this cohort study, the MCC recurrence rate (approximately 40%) was notably different than that reported for invasive melanoma (approximately 19%), squamous cell carcinoma (approximately 5%-9%), or basal cell carcinoma (approximately 1%-2%) following definitive therapy. Because more than 90% of MCC recurrences arise within 3 years, it is appropriate to adjust surveillance intensity accordingly. Stage- and time-specific recurrence data can assist in appropriately focusing surveillance resources on patients and time intervals in which recurrence risk is highest