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The Brazilian Merganser (Mergus octosetaceus) is one of the rarest birds in South America, and it is a critically endangered Anatidae species with an estimated population of less than 250 adult individuals in the Brazilian Cerrado. A captive population was established a few years ago at Zooparque Itatiba (São Paulo state) where 46 individuals were kept, and the founding population (progenitors derived from nature) was composed of 19 of the ex situ birds, derived from the four remaining localities with wild populations in Brazil. To characterize the genetic diversity and the genealogical relationships of the captive population, it is essential to conduct appropriate ex situ management and to assist future reintroduction projects. Thus, we have identified 425 SNPs by massively parallel sequencing of ddRAD libraries that allowed us to genotype individuals of the captive population. We observed a close relatedness between 70% of the captive population and founding individuals of Jalapão and Alto Paranaiba localities, indicating the need for supplementation with individuals from other areas of Canastra and Veadeiros. Even though many captives present a high level of inbreeding, we have identified some individuals with a high genetic value (less inbred) that can be selected for the breeding program to generate individuals for a future pilot reintroduction project.

Purpose This study was performed to investigate the convergent validity, discriminative validity, and reliability of the Brazilian version of the low anterior resection syndrome (LARS) score in a population with low educational and socioeconomic levels. Methods The LARS score was translated into the Portuguese language by forward- and back-translation procedures. In total, 127 patients from a public hospital in Brazil completed the questionnaires. The convergent validity was tested by comparing the LARS score with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core Module 30 (QLQ-C30) and with patients’ self-reported quality of life. For the discriminative validity, we tested the ability of the score to differentiate among subgroups of patients regarding neoadjuvant radiotherapy, type of surgery, and tumor distance from the anal verge. The test-retest reliability was investigated in a subgroup of 36 patients who responded to the survey twice in 2 weeks. Results The LARS score demonstrated a strong correlation with 5 of 6 items from the EORTC QLQ-C30 (P

Abstract Pseudolaelia is a genus endemic to the eastern Brazilian Atlantic Forest, consisting of 12 accepted species. Some Pseudolaelia species, such as P. vellozicola, P. aguadocensis, P. oliveirana, and P. regentii, referred to here as the PV complex, present extensive intra‐ and interpopulation morphological polymorphism, raising uncertainty regarding their circumscriptions. Although previous morphological analyses were used to solve the generic boundaries in the PV complex, persuasive genetic evidence is lacking. In order to test the hypothesis that the group under investigation contains only one taxon, amplification profiles of five intersimple sequence repeat (ISSR) markers were used to evaluate genetic diversity, genetic structure, and the relationships among the PV complex species. A total of 134 reproductive individuals were sampled in eight insular populations. Intrapopulation genetic analysis indicated low levels of genetic diversity. Analysis of genetic structure revealed that each of the eight sample locations can be considered unique biological populations as they are highly differentiated from each other. The Mantel test showed a high and positive correlation between genetic and geographic distance (r = .841, p

Abstract The Cerrado, the largest Neotropical savanna, and the Brazilian Atlantic Forest form large ecotonal areas where savanna and forest habitats occupy adjacent patches with closely related species occurring side by side, providing opportunities for hybridization. Here, we investigated the evolutionary divergence between the savanna and forest ecotypes of the widely distributed tree Plathymenia reticulata (n = 233 individuals). Genetic structure analysis of P. reticulata was congruent with the recognition of two ecotypes, whose divergence captured the largest proportion of genetic variance in the data (FCT = 0.222 and FST = 0.307). The ecotonal areas between the Cerrado and the Atlantic Forest constitute a hybrid zone in which a diversity of hybrid classes was observed, most of them corresponding to second‐generation hybrids (F2) or backcrosses. Gene flow occurred mainly toward the forest ecotype. The genetic structure was congruent with isolation by environment, and environmental correlates of divergence were identified. The observed pattern of high genetic divergence between ecotypes may reflect an incipient speciation process in P. reticulata. The low genetic diversity of the P. reticulata forest ecotype indicate that it is threatened in areas with high habitat loss on Atlantic Forest. In addition, the high divergence from the savanna ecotype suggests it should be treated as a different unit of management. The high genetic diversity found in the ecotonal hybrid zone supports the view of ecotones as important areas for the origin and conservation of biodiversity in the Neotropics.

Purpose: This article aims to present a standardization of the technique of transanal therapeutic irrigation, which is an old technique that has passed through history and is now used as a medical procedure to assist in the treatment of defecation disorders. Methods: This protocol was developed in patients with myelomeningocele submitted to the standard transanal therapeutic irrigation technique, in accordance with the protocol established at the Clinic of defecation disorders at a public university hospital in Brazil. The presented standard technique highlights the following topics: preparation of the patient before the treatment; interdisciplinary approach; training of the patient or the family member responsible for the patient and the step-by-step technique itself. The research ethics committee at the university approved this study. Discussion: Transanal therapeutic irrigation is indicated in neurogenic bowel dysfunctions and functional disorders of defecation. Training the patient or a family member responsible for irrigation is performed on three consecutive days, all of them supervised by the nurse. This technique aims to re-establish control over defecation and bowel function, and consists in an infusion of warm tap water through the anus, which allows the patient to evacuate daily the stool and keep the colon empty for longer periods. This avoids fecal incontinence and increases the quality of life of patients with defecation disorders. Conclusion: Transanal therapeutic irrigation is an effective, well-tolerated and safe procedure, which is better compared to the standard clinical care. Resumo: Objetivo: Este artigo tem como objetivo apresentar uma padronização da técnica de irrigação transanal terapêutica, uma técnica antiga que passou pela história e tem sido utilizada como procedimento médico para auxiliar no tratamento de distúrbios de defecação. Métodos: Este protocolo foi desenvolvido em pacientes com mielomeningocele submetidos à técnica de irrigação terapêutica transanal padrão, de acordo com o protocolo estabelecido na Clínica de Distúrbios da Defecação de um hospital universitário público no Brasil. A técnica padrão apresentada destaca os seguintes tópicos: preparação do paciente antes do tratamento; Abordagem interdisciplinar; treinamento do paciente ou do membro da família responsável pelo paciente e a técnica passo a passo em si. O comitê de ética em pesquisa da universidade aprovou este estudo. Discussão: A irrigação transanal terapêutica está indicada nas disfunções intestinais neurogênicas e nos distúrbios funcionais da defecação. O treinamento do paciente ou de um familiar responsável pela irrigação é realizado em três dias consecutivos, todos supervisionados por uma enfermeira. Esta técnica visa restabelecer o controle sobre a evacuação e a função intestinal, e consiste em uma infusão de água da torneira quente através do ânus, que permite ao paciente evacuar diariamente as fezes e manter o cólon vazio por períodos mais longos. Isso evita a incontinência fecal e aumenta a qualidade de vida dos pacientes com distúrbios de defecação. Conclusão: A irrigação terapêutica transanal é um procedimento efetivo, bem tolerado e seguro, o qual é melhor quando comparado ao tratamento clínico padrão. Keywords: Spinal cord injuries, Fecal incontinence, Constipation, Quality of life, Stomas, Therapeutic irrigation, Palavras-chave: Traumatismos da medula espinhal, Incontinência fecal, Constipação, Qualidade de vida, Estomas, Irrigação terapêutica

Identifying the environmental factors that shape intraspecific genetic and phenotypic diversity of species can provide insights into the processes that generate and maintain divergence in highly diverse biomes such as the savannas of the Neotropics. Here, we sampled Qualea grandiflora, the most widely distributed tree species in the Cerrado, a large Neotropical savanna. We analyzed genetic variation with microsatellite markers in 23 populations (418 individuals) and phenotypic variation of 10 metamer traits (internode, petiole and corresponding leaf lamina) in 36 populations (744 individuals). To evaluate the role of geography, soil, climate, and wind speed in shaping the divergence of genetic and phenotypic traits among populations, we used Generalized Dissimilarity Modelling. We also used multiple regressions to further investigate the contributions of those environmental factors on leaf trait diversity. We found high genetic diversity, which was geographically structured. Geographic distance was the main factor shaping genetic divergence in Qualea grandiflora, reflecting isolation by distance. Genetic structure was more related to past climatic changes than to the current climate. We also found high metamer trait variation, which seemed largely influenced by precipitation, soil bulk density and wind speed during the period of metamer development. The high degree of metamer trait variation seems to be due to both, phenotypic plasticity and local adaptation to different environmental conditions, and may explain the success of the species in occupying all the Cerrado biome.

Introduction: Acute appendicitis is the most common surgical disease of the abdomen in clinical practice, affecting mainly young adults. It has a wide variety of clinical presentations, due to the anatomical variation of the cecal appendix. Its presentation as acute scrotum and scrotal abscess is quite rare and atypical, occurring mainly in young male patients with patent processus vaginalis. Case presentation: An 18-years-old male patient attended the emergency unit complaining of diffuse abdominal pain, fever and hyporexia for four days followed by inflammatory signs in the scrotum. He was taken to the operation room after diagnosis of scrotal and abdominal sepsis. During scrotum exploration, pus was found inside the right hemiscrotum coming down from the groin and communicating with the abdominal cavity. The laparotomy found perforated appendicitis and peritonitis leading to the scrotal abscess. The abscess was drained, appendectomy was performed and the scrotal and abdominal cavity were washed with saline solution. Despite postoperative complications such as pneumonia and intra-abdominal abscess, the reported patient recovered and was discharged in the 44th postoperative day. Conclusion: Acute appendicitis can mimic acute scrotum and surgeons must have a high index of suspicion of this complication for diagnosing. This unusual clinical presentation may be challenging and can delay the diagnosis leading to perforated peritonitis. Resumo: Introdução: A apendicite aguda é a doença cirúrgica mais comum do abdome na prática clínica, afetando principalmente adultos jovens. Tem uma grande variedade de apresentações clínicas, devido à variação anatômica do apêndice cecal. Sua apresentação como escroto agudo e abscesso escrotal é bastante rara e atípica, ocorrendo principalmente em pacientes jovens do sexo masculino com túnica vaginalis patente. Apresentação do caso: um paciente do sexo masculino de 18 anos de idade compareceu à unidade de emergência queixando dor abdominal difusa, febre e hiporexia por quatro dias que se seguiram de sinais inflamatórios no escroto. Ele foi levado para centro cirúrgico após o diagnóstico de sepse de origem escrotal e abdominal. Durante a exploração da bolsa escrotal, secreção purulenta foi encontrada do lado direito oriunda do canal inguinal e comunicando-se com a cavidade abdominal. Durante a laparotomia observou-se sinais de apendicite aguda perfurada e peritonite levando ao abscesso escrotal. O abscesso foi drenado, a apendicectomia foi realizada e as cavidades escrotal e abdominal foram lavadas com solução salina. Apesar de complicações pós-operatórias como pneumonia e abscesso intra-abdominal, o paciente recuperou-se bem, recebendo alta hospitalar no 44° dia pós-operatório. Conclusão: A apendicite aguda pode simular o escroto agudo e os cirurgiões devem ter um alto grau de suspeição dessa complicação para o diagnóstico. Esta apresentação clínica incomum pode ser desafiadora e retardar o diagnóstico levando à peritonite por perfuração. Keywords: Acute appendicitis, Appendectomy, Acute abdomen, Spermatic cord torsion, Acute scrotum, Palavras-chave: Apendicite, Apendicectomia, Abdomen agudo, Torção do cordão espermático, Escroto agudo

Background: Fecal incontinence causes a big impact on patient's quality of life. Our study analyzed the main questionnaires about fecal incontinence available internationally, aiming to delineate vantages and limitations of these instruments and their application, to mention the cultural aspects involved in the process of development and validation, as well as to suggest a reflection about the complexity of this matter. Results: Four of the instruments (Pescatori score, FISI, MSKCC bowel function instrument, and LARS score) do not include quality of life, working only as diagnostic tools. Two others, ‘Jorge and Wexner Fecal Incontinence score’, and ‘St Marks’ Fecal incontinence grading system’ can diagnose and grade fecal incontinence, however they are very subtle in assessing quality of life. The ‘EORTC Colorectal Cancer-specific’, on the other hand, focuses exclusively on quality of life. Although the ‘FIQL’ questionnaire assesses quality of life related to fecal incontinence, it does not measure leakage. Lastly, the ‘RAFIS’ assesses both aspects but too superficially. Conclusion: None of the questionnaires analyzed were able to simultaneously assess both fecal incontinence and quality of life successfully. Furthermore, the concepts related to fecal incontinence have different meanings depending on the cultural and psychosocial context. These differences are even greater when individuals of developed countries like the ones where these questionnaires were developed are compared to the ones of developing countries, such as Brazil, which makes its very hard for these instruments to be used universally. Resumo: Contexto: A incontinência anal acarreta grande impacto na qualidade de vida (QV) dos pacientes. Nosso estudo analisou os principais questionários sobre o tema disponíveis na literatura internacional, visando delinear vantagens e limitações desses instrumentos e de sua correta aplicação, bem como citar os aspectos culturais envolvidos no processo de sua criação e validação, e sugerir uma reflexão sobre a complexidade do tema. Métodos: Nessa revisão assistemática, utilizamos três bases de dados eletrônicas (MEDLINE, LILACS, e DeCS) para encontrar os 9 questionários mais utilizados no mundo, e palavras-chave relacionadas. Resultados: Quatro dos instrumentos estudados (Pescatori score, FISI, MSKCC bowel function instrument, e o LARS score) não abordam QV, funcionando apenas para diagnóstico. Outros dois, o ‘Jorge and Wexner FI score’, e o ‘St Marks’ FI grading system’ diagnosticam e graduam bem a incontinência, porém apenas avaliam brevemente a QV. O ‘EORTC Colorectal Cancer-specific’, por sua vez, foca exclusivamente na QV. O questionário ‘FIQL’ apesar de conseguir avaliar a QV relacionada à função intestinal, não avalia vazamentos. Por fim, o ‘RAFIS’ avalia de forma muito simplificada esses aspectos. Conclusão: Nenhum dos questionários analisados se mostrou eficiente na avaliação simultânea da incontinência e da QV. Além disso, os conceitos que envolvem incontinência anal apresentam significados diferentes dependendo do contexto cultural e psicossocial. Essas diferenças são ainda maiores quando se comparam indivíduos dos países desenvolvidos onde esses questionários foram desenvolvidos, com os de países subdesenvolvidos como o Brasil, dificultando sua aplicação de forma universal. Keywords: Fecal incontinence, Quality of life, Signs and symptoms, Outcome assessment (health care), Fecal Incontinence Score, Evaluation of results of therapeutic interventions, Palavras-chave: Incontinência fecal, Qualidade de vida, Sinais e sintomas, Avaliação de resultados (cuidados de saúde), Índice de Incontinência Fecal, Avaliação de resultados de intervenção terapêutica

Abstract Duddingtonia flagrans has been tested as an alternative parasite control, but data from in vitro experiments based on in vivo calculations describing nematophagous fungi predation in nematodes are restricted. The objective of this work was to determine the efficacy of D. flagrans against sheep nematode larvae in vitro using in vivo calculations. Fecal samples were introduced to fungi in different concentrations: 0.0/control; 0.05; 0.1; 0.2; 0.4; 0.8; 1.6; 3.2; and 6.4 g corresponding, respectively, to 583.000; 1.166.000; 2.332.000; 4.664.000; 9.328.000; 18.656.000; 37.312.000 and 74.624.000 chlamydospores/kg of body weight. The material was incubated for 14 days, before the larvae recovery (Assay 1). Assay 2 was carried out with the doses of 0.00625; 0.0125; and 0.025 g. The results showed a negative correlation between fungal concentrations and larval numbers for both assays. The fungus demonstrated an efficacy above 89% in both assays. Thus, we consider that the data from in vitro studies based on in vivo calculations may optimize the fungi quantities for field experiments.

Purpose: Anal incontinence is a very stigmatizing condition, which affects biopsychosocially the patient. It is a neglected, but quite common complication of obstetric and anorectal surgery, however it has treatment options. None of the treatment options have exceptional efficacy rates and still associated with risk of recurrence. The surgery techniques known are: anterior and posterior shortening procedure; post-anal repair; anterior elevator plasty and external sphincter plication; total pelvic floor repair and sphincter repair. None of them use a flap rotation of adipose tissue. The purpose is to propose a new surgery technique of anal sphincteroplasty, which uses flap rotation, for severe perineal deformity associated with anal incontinence. Methods: Patient with severe perineal deformity and anal incontinence treated with a new surgery technique of sphincteroplasty with flap rotation. Results: The severe perineal deformity was corrected with both esthetic and functional results. Anal continence measured by Wexner and Jorge assessment in a follow-up period of 2 years after the intervention. Pictures and video show esthetic and functional aspects. Conclusion: This is the first time that a flap rotation is used to treat a severe perineal deformity. And the technique presented promising outcomes, which allows perineum reconstruction that is similar to the original anatomy. Therefore, this technique is justified to better evaluate its efficiency and the impact on patients’ prognosis. Resumo: Objetivo: A incontinência anal é uma condição muito estigmatizante, que afeta biopsicossocialmente o paciente. É uma complicação negligenciada, mas bastante comum da cirurgia obstétrica e anorretal, no entanto, tem opções de tratamento. Nenhuma das opções de tratamento tem taxas de eficácia excepcionais e ainda está associada ao risco de recorrência. As técnicas cirúrgicas conhecidas são: procedimento de encurtamento anterior e posterior; reparação pós-anal; plástica do elevador anterior e plicatura externa do esfíncter; reparo total do assoalho pélvico e reparo do esfíncter. Nenhum deles utiliza uma rotação de retalho de tecido adiposo. O objetivo é propor uma nova técnica cirúrgica de esfincteroplastia anal, que utiliza a rotação de retalho, para deformidade perineal grave associada à incontinência anal. Métodos: Paciente com deformidade perineal grave e incontinência anal tratada com nova técnica cirúrgica de esfincteroplastia com rotação de retalho. Resultados: A deformidade perineal grave foi corrigida com resultados estéticos e funcionais. Continência anal medida pela avaliação de Wexner & Jorge em um período de seguimento de 2 anos após a intervenção. Imagens e vídeo mostram aspectos estéticos e funcionais. Conclusão: Esta é a primeira vez que uma rotação de retalho é usada para tratar uma deformidade perineal grave. E a técnica apresentou resultados promissores, o que permite a reconstrução do períneo semelhante à anatomia original. Portanto, esta técnica é justificada para melhor avaliar sua eficiência e o impacto no prognóstico dos pacientes. Keywords: Colorectal surgery, Surgical flaps, Fecal incontinence, Treatment outcome, Palavras chave: Cirurgia colorretal, Retalhos cirúrgicos, Incontinência fecal, Resultado do tratamento

Introduction: Odontomas are one of the most common odontogenic tumours and are classified as benign odontogenic tumours. According to radiographic, microscopic and clinical features there are two main types of odontomas: compound and complex. Aim: To analyse the prevalence of benign odontogenic tumours compatible with odontomas in digital panoramic radiographs in a Brazilian population. Materials and Methods: This retrospective study was conducted from January 2015 to December 2015 and analysed 2,167 digital panoramic radiographs from the database of a Specialised Dental Radiological Clinic in Belo Horizonte, Brazil. Results: Seven images presented lesions compatible with odontomas, resulting in a prevalence rate of 0.32%. Three images (42.9%) were compatible with compound odontomas and 4 (57.1%) with complex odontomas. Regarding gender, the majority of odontomas were found in female patients (71.4%). The age of the patients diagnosed with odontomas ranged from 7 to 37 years and the main clinical manifestation observed was their association with non-erupted teeth. Regarding the location of the lesions, compound odontomas were mainly observed in the incisor region (66.6%), whereas complex odontomas were found in the posterior region of the molars (50.0%). Conclusion: Data presented in this study reinforce the importance of panoramic digital radiographic images during dental practice for incidental diagnoses of odontogenic tumours, such as odontomas, since these lesions are in most cases, asymptomatic.

RESUMO Objetivo: avaliar os fatores associados ao não fechamento de ileostomia protetora após ressecção anterior do reto com excisão total do mesorreto por câncer retal, a morbidade associada ao fechamento destas ileostomias e a taxa de estomia permanente em pacientes com adenocarcinoma retal. Métodos: estudo retrospectivo de 174 pacientes consecutivos com diagnóstico de tumores retais, dos quais 92 foram submetidos à ressecção anterior do reto com intenção curativa, anastomose coloanal ou colorretal e ileostomia de proteção. Foi realizada análise multivariada visando a determinar os fatores associados à permanência definitiva da estomia, assim como o estudo da morbidade nos que se submeteram à reconstrução do trânsito. Resultados: no período de seguimento de 84 meses, 54 dos 92 pacientes avaliados (58,7%) tiveram a ileostomia fechada e 38 (41,3%) permaneceram com a estomia. Entre os 62 pacientes que tiveram a ileostomia fechada, 11 (17,7%) apresentaram algum tipo de complicação pós-operatória: três com deiscência de anastomose ileal, cinco com obstrução intestinal, dois com infecção de ferida operatória e um com pneumonia. Oito destes pacientes necessitaram de um novo estoma. Conclusão: de acordo com a análise multivariada, os fatores associados à permanência da estomia foram fístula de anastomose, presença de metástases e fechamento da ileostomia durante quimioterapia.

Se evaluó la acción del Albendazol y el Triclabendazol en 12 ovinos adultos de raza Pelibuey infectados por Fasciola hepatica, en la provincia de Camagüey, Cuba. Se empleó de un test de reducción y conteo de huevos en las heces (HPG). Para el estudio crítico se distribuyeron los animales en 2 grupos. En el día 0 (D0) los animales del grupo 1 recibieron Albendazol vía oral y los del grupo 2 Triclabendazol. Se colectaron las muestras de heces (vía retal) los días 0 (D0), 14 (D14) y 28 (D28) después del tratamiento. Para el conteo de huevos de F. hepatica se empleó la técnica de McMaster, con una solución de ZnCl2 (1,5 g/ml) a una sensibilidad de 10 huevos por gramos de heces. Se calculó la media de los resultados por grupo y, posterior-mente, el por ciento de reducción de huevos. El D14 se observó 98,17 % de reducción de huevos para el grupo 1 y 79,58 % para el grupo 2; sin embargo, en el D28 el grupo 1 alcanzó 33 % de reducción de huevos, mientras que el grupo 2 alcanzó 90,39 %. El tratamiento con Triclabendozol se mostró más efectivo para F. hepatica.