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The lack of synthesized information regarding biodiversity is a major problem among researchers, leading to a pervasive cycle where ecologists make field campaigns to collect information that already exists and yet has not been made available for a broader audience. This problem leads to long-lasting effects in public policies such as spending money multiple times to conduct similar studies in the same area. We aim to identify this knowledge gap by synthesizing information available regarding two Brazilian long-term biodiversity programs and the metadata generated by them. Using a unique dataset containing 1904 metadata, we identified patterns of metadata distribution and intensity of research conducted in Brazil, as well as where we should concentrate research efforts in the next decades. We found that the majority of metadata were about vertebrates, followed by plants, invertebrates, and fungi. Caatinga was the biome with least metadata, and that there's still a lack of information regarding all biomes in Brazil, with none of them being sufficiently sampled. We hope that these results will have implications for broader conservation and management guiding, as well as to funding allocation programs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: Alveolar bone coverage can be diagnosed through cone beam computed tomography (CBCT) and this information can prevent orthodontic tooth movement beyond the biological limit., Objective: This study evaluated the impact of the bone coverage (BC) diagnosis by CBCT in the orthodontists' planning., Methods: One hundred fifty-nine Brazilian orthodontists suggested treatment plans for six patients at two different times, using two sequential questionnaires. The first questionnaire consisted of extra and intra-oral photographs, one panoramic radiograph; one lateral cephalometric radiograph with Steiner and Tweed analysis, and the patient chief complaint. The second questionnaire included the same presentations of cases with tomographic images and the radiologist's report. The McNemar test assessed the difference between the first and the second treatment plans., Results: In all six cases, most participants changed the treatment plan after evaluating the CBCT images and the radiologist's report (93.7% in case 5, 78.6% in case 4, 74.2% in case 3, 69.8% in case 6, 66% in case 2 and 61% in case 1; p≤0.01)., Conclusion: The evaluation of bone coverage through CBCT images has a substantial impact on the orthodontic diagnosis and planning of the Brazilian orthodontists.

Health literacy, the ability to obtain and comprehend health knowledge, is essential to promote health and reduce disparities. Health communication aims to improve health by ensuring an effective understanding and application of health information. Despite current challenges, there are many opportunities for improving communication in the health literacy practice. Promoting communication in health literacy is essential in empowering individuals, improving outcomes, and reducing healthcare disparities. Effective communication enables access, comprehension, and informed decision-making of individuals and communities regarding their health, strengthening their central role in promoting health literacy. This paper highlights the challenges and opportunities in today's world, especially in a post-pandemic era, dominated by infodemic and social media influencers, while providing solutions, encompassing professional training of health professionals on communication, digital skills, and an overarching strategy across health institutions. Translating knowledge into health-promoting behaviors and well-being can only be effective by accounting for communication in health literacy., Competing Interests: The authors have no conflicts of interest to declare., (© 2024 The Author(s). Published by S. Karger AG, Basel on behalf of NOVA National School of Public Health.)

Background: Decentralization of a health system is a complex and multidimensional phenomenon that demands thorough investigation of its process logistics, predisposing factors and implementation mechanisms, within the broader socio-political environment of each nation. Despite its wide adoption across both high-income countries (HICs) and low-and-middle-income countries (LMICs), empirical evidence of whether decentralization actually translates into improved health system performance remains inconclusive and controversial. This paper aims to provide a comprehensive description of the decentralization processes in three countries at different stages of their decentralization strategies - Pakistan, Brazil and Portugal., Main Body: This study employed a systematic analysis of peer-reviewed academic journals, official government reports, policy documents and publications from international organizations related to health system decentralization. A comprehensive search was conducted using reputable databases such as PubMed, Google Scholar, the WHO repository and other relevant databases, covering the period up to the knowledge cutoff date in June 2023. Information was systematically extracted and organized into the determinants, process mechanics and challenges encountered during the planning, implementation and post-decentralization phases. Although decentralization reforms have achieved some success, challenges persist in their implementation. Comparing all three countries, it was evident that all three have prioritized health in their decentralization reforms and aimed to enhance local decision-making power. Brazil has made significant progress in implementing decentralization reforms, while Portugal and Pakistan are still in the process. Pakistan has faced significant implementation challenges, including capacity-building, resource allocation, resistance to change and inequity in access to care. Brazil and Portugal have also faced challenges, but to a lesser extent. The extent, progress and challenges in the decentralization processes vary among the three countries, each requiring ongoing evaluation and improvement to achieve the desired outcomes., Conclusion: Notable differences exist in the extent of decentralization, the challenges faced during implementation and inequality in access to care between the three countries. It is important for Portugal, Brazil and Pakistan to address these through reinforcing implementation strategies, tackling inequalities in access to care and enhancing monitoring and evaluation mechanism. Additionally, fostering knowledge sharing among these different countries will be instrumental in facilitating mutual learning., (© 2024. The Author(s).)

In this work, we resolve conflicting experimental and theoretical findings related to the dynamical stability and superconducting properties of [Formula: see text]-LuH 3 , which was recently suggested as the parent phase harboring room-temperature superconductivity at near-ambient pressures. Including temperature and quantum anharmonic lattice effects in our calculations, we demonstrate that the theoretically predicted structural instability of the [Formula: see text] phase near ambient pressures is suppressed for temperatures above 200 K. We provide a p-T phase diagram for stability up to pressures of 6 GPa, where the required temperature for stability is reduced to T > 80 K. We also determine the superconducting critical temperature T c of [Formula: see text]-LuH 3 within the Migdal-Eliashberg formalism, using temperature- and quantum-anharmonically-corrected phonon dispersions, finding that the expected T c for electron-phonon mediated superconductivity is in the range of 50-60 K, i.e., well below the temperatures required to stabilize the lattice. When considering moderate doping based on rigidly shifting the Fermi level, T c decreases for both hole and electron doping. Our results thus provide evidence that any observed room-temperature superconductivity in pure or doped [Formula: see text]-LuH 3 , if confirmed, cannot be explained by a conventional electron-phonon mediated pairing mechanism., (© 2024. The Author(s).)

Motivated by the recent report of room-temperature superconductivity at near-ambient pressure in N-doped lutetium hydride, we performed a comprehensive, detailed study of the phase diagram of the Lu-N-H system, looking for superconducting phases. We combined ab initio crystal structure prediction with ephemeral data-derived interatomic potentials to sample over 200,000 different structures. Out of the more than 150 structures predicted to be metastable within ~50 meV from the convex hull we identify 52 viable candidates for conventional superconductivity, for which we computed their superconducting properties from Density Functional Perturbation Theory. Although for some of these structures we do predict a finite superconducting T c , none is even remotely compatible with room-temperature superconductivity as reported by Dasenbrock et al. Our work joins the broader community effort that has followed the report of near-ambient superconductivity, confirming beyond reasonable doubt that no conventional mechanism can explain the reported T c in Lu-N-H., (© 2023. Springer Nature Limited.)

We present structural, electrical, and thermoelectric potential measurements on high-quality single crystals of ZrTe 1.8 grown from isothermal chemical vapor transport. These measurements show that the Te-deficient ZrTe 1.8 , which forms the same structure as the nonsuperconducting ZrTe 2 , is superconducting below 3.2 K. The temperature dependence of the upper critical field (H c 2 ) deviates from the behavior expected in conventional single-band superconductors, being best described by an electron-phonon two-gap superconducting model with strong intraband coupling. For the ZrTe 1.8 single crystals, the Seebeck potential measurements suggest that the charge carriers are predominantly negative, in agreement with the ab initio calculations. Through first-principles calculations within DFT, we show that the slight reduction of Te occupancy in ZrTe 2 unexpectedly gives origin to density of states peaks at the Fermi level due to the formation of localized Zr- d bands, possibly promoting electronic instabilities at the Fermi level and an increase at the critical temperature according to the standard BCS theory. These findings highlight that the Te deficiency promotes the electronic conditions for the stability of the superconducting ground state, suggesting that defects can fine-tune the electronic structure to support superconductivity., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

We estimated comparative primary and booster vaccine effectiveness (VE) of SARS-CoV-2 Omicron BA.5 and BA.2 lineages against infection and disease progression. During April-June 2022, we implemented a case-case and cohort study and classified lineages using whole-genome sequencing or spike gene target failure. For the case-case study, we estimated the adjusted odds ratios (aORs) of vaccination using a logistic regression. For the cohort study, we estimated VE against disease progression using a penalized logistic regression. We observed no reduced VE for primary (aOR 1.07 [95% CI 0.93-1.23]) or booster (aOR 0.96 [95% CI 0.84-1.09]) vaccination against BA.5 infection. Among BA.5 case-patients, booster VE against progression to hospitalization was lower than that among BA.2 case-patients (VE 77% [95% CI 49%-90%] vs. VE 93% [95% CI 86%-97%]). Although booster vaccination is less effective against BA.5 than against BA.2, it offers substantial protection against progression from BA.5 infection to severe disease.

Abstract: Digital papillary adenocarcinoma is a malignant adnexal tumor with a predilection for acral sites. Hidradenoma is a benign solid and cystic sweat gland neoplasm with focal ductal and glandular differentiation and good outcomes. Hidradenomas can occur at acral sites and show papillary structures; for this reason, they are included in the differential diagnosis of digital papillary adenocarcinoma, and immunohistochemistry is a valuable tool in this scenario. We described a case of a 43-year-old man with an epithelial tumor showing papillary structures in the intermediate phalanx of the fourth finger. There was diffuse positivity for p63 and negativity for S100 protein, suggesting that this tumor was an acral hidradenoma with papillary structures., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

In the present work, we demonstrate that C-doped Zr 5 Pt 3 is an electron-phonon superconductor (with critical temperature T C = 3.8 K) with a nonsymmorphic topological Dirac nodal-line semimetal state, which we report here for the first time. The superconducting properties of Zr 5 Pt 3 C 0.5 have been investigated by means of magnetization, resistivity, specific heat, and muon spin rotation and relaxation (μSR) measurements. We find that at low temperatures, the depolarization rate is almost constant and it can be well described by a single-band s -wave model with a superconducting gap of 2Δ(0)/ k B T C = 3.84, somewhat higher than the value of BCS theory. From the transverse field μSR analysis, we estimate the London penetration depth λ L = 469 nm, superconducting carrier density n s = 1.83 × 10 26  m -3 , and effective mass m * = 1.428 m e . The zero field μSR confirms the absence of any spontaneous magnetic field in the superconducting ground state. In order to gain additional insights into the electronic ground state of C-doped Zr 5 Pt 3 , we also performed first-principles calculations within the framework of density functional theory (DFT). The observed homogenous electronic character of the Fermi surface as well as the mutual decrease of T C and density of states at the Fermi level are consistent with the experimental findings of this study. However, the band structure reveals the presence of robust, gapless fourfold-degenerate nodal lines protected by 6 3 screw rotations and glide mirror planes. Therefore, Zr 5 Pt 3 represents a novel, unprecedented condensed matter system to investigate the intricate interplay between superconductivity and topology., (© 2021 IOP Publishing Ltd.)

Objective: The aim of this study was to correlate the absence of BB with skeletal patterns and incisor inclination using cone-beam computed tomography (CBCT)., Methods: The sample comprised CBCT images of 45 patients undergoing orthodontic treatment. BB was classified in each third of the anterior teeth as critical, slender, regular, and thick. The skeletal pattern was determined by the ANB (A point, nasion, B point) angle and the incisor inclination using the 1.NA and 1.NB measurements and the interincisal angle (1:1)., Results: In both analyses, the skeletal pattern of class II revealed better BB in the cervical and middle thirds than classes I and III. A higher proportion of critical BB was found in the middle thirds, and the apical third presented the best regular and thick BB conditions, mainly class I. Less BB was observed in middle and apical thirds in the upper incisors and in cervical thirds in lower incisors, mostly when they were more upright., Conclusions: Knowledge of alveolar bone height and thickness can alter the treatment plan in orthodontics. During orthodontic treatment, more attention should be paid to the lower incisors and vertical teeth because of poor BB conditions, especially in class III skeletal patterns., (© 2021. Japanese Society for Oral and Maxillofacial Radiology and Springer Nature Singapore Pte Ltd.)

Objective: This study aimed to evaluate the effect of isolated vitamin D (VD) supplementation on the metabolic syndrome (MetS) risk profile in postmenopausal women. Methods: In this double-blind, placebo-controlled trial, 160 postmenopausal women aged 50-65 years were randomized into two groups: VD group, supplementation with 1000 IU vitamin D 3 /day ( n  = 80); or placebo group ( n  = 80). The intervention time was 9 months, and the women were assessed at baseline and endpoint. Clinical and anthropometric data were collected. Biochemical parameters, including total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, glucose, and insulin, were measured. The plasma concentration of 25-hydroxyvitamin D (25(OH)D) was measured by high-performance liquid chromatography. Results: After 9 months, there was a significant increase in the 25(OH)D levels for VD group (+45.4%, p  < 0.001), and a decrease (-18.5%, p  = 0.049) in the placebo group. In the VD group, a significant reduction was observed in triglycerides (-12.2%, p  = 0.001), insulin (-13.7%, p  = 0.008), and the homeostasis model assessment of insulin resistance (-17.9%, p  = 0.007). In the placebo group, there was an increase in glucose (+6.2%, p  = 0.009). Analysis of the risk adjusted for age, time since menopause, and body mass index showed that women supplemented with VD had a lower risk of MetS (odds ratio [OR] 0.42; 95% confidence interval [CI] 0.21-0.83), hypertriglyceridemia (OR 0.43; 95% CI 0.22-0.85), and hyperglycemia (OR 0.23; 95% CI 0.10-0.52) compared to the placebo group ( p  < 0.05). Conclusions: In postmenopausal women with VD deficiency, isolated supplementation with 1000 IU vitamin D 3 for 9 months was associated with a reduction in the MetS risk profile. Women undergoing VD supplementation had a lower risk of MetS, hypertriglyceridemia, and hyperglycemia.

Antidepressants, such as venlafaxine (VFX), which are considered emerging environmental pollutants, are increasingly more present in the marine environment, and recent evidence suggest that they might have adverse effects on fish behaviour. Furthermore, altered environmental conditions associated to climate change (e.g. warming and acidification) can also have a determinant role on fish behaviour, fitness and survival. Yet, the underlying interactions between these environmental stressors (pharmaceuticals exposure and climate change) are still far from being fully understood. The aim of this study was to assess behavioural responses (in juvenile meagre (Argyrosomus regius) exposed to VFX via water ([VFX] ~20μgL -1 ) and via dietary sources ([VFX] ~160μgkg -1 dry weight), as well as to increased temperature (ΔT°C=+5°C) and high CO 2 levels (ΔpCO 2 ~1000μatm; equivalent to ΔpH=-0.4units). Overall, VFX bioaccumulation in fish plasma was enhanced under the combination of warming and acidification. VFX triggered fish exploration, whereas fish activity and shoal cohesion were reduced. Acidification alone decreased fish exploration and shoal cohesion, and reversed fish preference to turn leftwards compared to control conditions. Such alterations were further enhanced by VFX exposure. The combination of warming and acidification also reduced shoal cohesion and loss of lateralization, regardless of VFX exposure. The distinct behaviour observed when VFX contamination, acidification and warming acted alone or in combination highlighted the need to consider the likely interactive effects of seawater warming and acidification in future research regarding the toxicological aspects of chemical contaminants., (Copyright © 2018. Published by Elsevier B.V.)

Pharmaceutical drugs, such as diclofenac (DCF), are frequently detected in the marine environment, and recent evidence has pointed out their toxicity to non-target marine biota. Concomitantly, altered environmental conditions associated with climate change (e.g. warming and acidification) can also affect the physiology of marine organisms. Yet, the underlying interactions between these environmental stressors (pharmaceutical exposure and climate change-related stressors) still require a deeper understanding. Comprehending the influence of abiotic variables on chemical contaminants' toxicological attributes provides a broader view of the ecological consequences of climate change. Hence, the aim of this study was to assess the ecotoxicological responses of juvenile seabass Dicenthrachus labrax under the co-exposure to DCF (from dietary sources, 500 ± 36 ng kg -1 dw), warming (ΔTºC = +5 °C) and acidification (ΔpCO 2 ∼1000 μatm, equivalent to ΔpH = -0.4 units), using an "Integrated Biomarker Response" (IBR) approach. Fish were exposed to these three stressors, acting alone or combined, for 28 days in a full cross-factorial design, and blood, brain, liver and muscle tissues were subsequently collected in order to evaluate: i) animal/organ fitness; ii) hematological parameters and iii) molecular biomarkers. Results not only confirmed the toxicological attributes of dietary exposure to DCF in marine fish species at the tissue (e.g. lower HSI), cellular (e.g. increased ENAs and lower erythrocytes viability) and molecular levels (e.g. increased oxidative stress, protein degradation, AChE activity and VTG synthesis), but also showed that such attributes are altered by warming and acidification. Hence, while acidification and/or warming enhanced some effects of DCF exposure (e.g. by further lowering erythrocyte viability, and increasing brain GST activity and Ub synthesis in muscle), the co-exposure to these abiotic stressors also resulted in a reversion/inhibition of some molecular responses (e.g. lower CAT and SOD inhibition and VTG synthesis). IBRs evidenced that an overall higher degree of stress (i.e. high IBR index) was associated with DCF and warming co-exposure, while the effects of acidification were less evident. The distinct responses observed when DCF acted alone or the animals were co-exposed to the drug together with warming and acidification not only highlighted the relevance of considering the interactions between multiple environmental stressors in ecotoxicological studies, but also suggested that the toxicity of pharmaceuticals can be aggravated by climate change-related stressors (particularly warming), thus, posing additional biological challenges to marine fish populations., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Vaccinia virus (VACV), the etiological agent of bovine vaccinia (BV), is widespread in Brazil and present in most of the milk-producing regions. We conducted a horizontal study of BV in Bahia, a state of Brazil in which the production of milk is increasing. During 2011, human and bovine clinical samples were collected during outbreaks for BV diagnosis, virus isolation and molecular analysis. We collected data for epidemiological inferences. Vaccinia virus was detected in 87.7% of the analyzed outbreaks, highlighting the effective circulation of VACV in Bahia. The molecular data showed the spreading of group 1 Brazilian VACV to Bahia. We observed a seasonal profile of BV, with its peak in the drier and cooler season. Manual milking was observed in 96 % of the visited properties, showing its importance to viral spread in herds. Under-notification of BV, ineffective animal trade surveillance, and bad milking practices have contributed to the spread of VACV in Brazil.

For early-stage lung cancer, the treatment of choice is surgery. In patients who are not surgical candidates or are unwilling to undergo surgery, radiotherapy is the principal treatment option. Here, we review stereotactic body radiotherapy, a technique that has produced quite promising results in such patients and should be the treatment of choice, if available. We also present the major indications, technical aspects, results, and special situations related to the technique.

Background: The identification of novel giant viruses from the nucleocytoplasmic large DNA viruses group and their virophages has increased in the last decade and has helped to shed light on viral evolution. This study describe the discovery, isolation and characterization of Samba virus (SMBV), a novel giant virus belonging to the Mimivirus genus, which was isolated from the Negro River in the Brazilian Amazon. We also report the isolation of an SMBV-associated virophage named Rio Negro (RNV), which is the first Mimivirus virophage to be isolated in the Americas., Methods/results: Based on a phylogenetic analysis, SMBV belongs to group A of the putative Megavirales order, possibly a new virus related to Acanthamoeba polyphaga mimivirus (APMV). SMBV is the largest virus isolated in Brazil, with an average particle diameter about 574 nm. The SMBV genome contains 938 ORFs, of which nine are ORFans. The 1,213.6 kb SMBV genome is one of the largest genome of any group A Mimivirus described to date. Electron microscopy showed RNV particle accumulation near SMBV and APMV factories resulting in the production of defective SMBV and APMV particles and decreasing the infectivity of these two viruses by several logs., Conclusion: This discovery expands our knowledge of Mimiviridae evolution and ecology.

Introduction: Fibromyalgia (FM) is a rheumatic condition characterized by a picture of generalized chronic pain, hyperalgesia and allodynia. Symptoms such as fatigue, sleep disorders, morning stiffness, headache and paresthesia can also be present. It is also associated with other comorbidities, such as depression, anxiety, irritable bowel syndrome, myofascial pain syndrome and nonspecific urethral syndrome. Few studies have addressed the evolution of FM, especially regarding medium and long-term evolution, such as why some patients do better than others, despite the fact of being submitted to the same treatment., Objective: To determine whether there is a correlation between demographic and clinical variables and FM severity., Material and Methods: Sixty women who met the classification criteria for FM of the American College of Rheumatology of 1990 were divided into three groups, according to the severity established by the Fibromyalgia Impact Questionnaire (FIQ): severe (70-100), moderate (50 to 70) and mild (0 to 50)., Results: Nine demographic and clinical variables were assessed, with a significant difference (P <0.05) being observed only in the groups showing higher FIQ scores with the presence of depression and workers' compensation interests., Conclusion: The impact of FM measured by the FIQ is directly correlated with the severity of depression and the presence of workers' compensation interests.

Introduction: The purpose of this study was to compare the sensitivity of diagnoses of buccal bone coverage in anterior teeth between axial and sagittal reconstructions using cone-beam computed tomography., Methods: Five dry skulls were clinically evaluated to detect bone defects in the anterior maxilla and mandible to establish a gold standard. The skulls were prepared and placed on a Kodak 9000 3-dimensional scanner (Trophy, Marne La Vallée, France) for image acquisition. The images were processed and reconstructed using Kodak Dental Imaging software 3-dimensional module (version 2.4; Kodak Dental Systems, Atlanta, Ga). All bone defects were identified and recorded., Results: In the sagittal and axial reconstructions, regions without bone coverage were diagnosed in 91.03% of cases as "cortex not seen" or "minimum thickness, fine, without marrow bone.", Conclusions: Cone-beam computed tomography can help in the diagnosis of lack of bone coverage on the buccal surfaces of anterior teeth. There was no difference in the performance of the axial and sagittal reconstructions., (Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Vaccinia virus (VACV) has been associated with several exanthematic outbreaks in bovine, human, and equine species in Brazilian rural areas. Little is known about VACV reservoirs, although it is believed that rodents could be associated with VACV outbreaks. With the goal of filling one more gap in the VACV ecological puzzle, the present work aimed at mimicking a potential transmission route of VACV between cows and rodents, both known as natural VACV hosts. Balb/c mice were exposed to feces of experimentally VACV infected cows for 20 days, and samples from these mice were examined by using molecular and serological tests. VACV DNA was detected in feces and blood samples after several days of exposure; infectious VACV particles were also detected in the feces. The presence of anti-VACV neutralizing antibodies in murine sera further suggested horizontal transmission. If the transmission model described here can be applied to natural environments, exposure to bovine feces could be considered a risk factor for the spread of VACV; consequently, the traditional use of bovine manure as a fertilizer in agricultural activities may be promoting the infection of rodents.

Hand deformities affect aesthetics function of hand severely compromised and also cause psychological disturbances. This report describes the fabrication of a silicone finger prosthesis for a patient after an accident at work. The finger prosthesis was retained by a vacuum effect on the stump. The silicone material Silastic-MDX 44210 was used to provide function and aesthetics. The finger prosthesis offered psychological, functional and rehabilitative advantages for the patient. Restoring the natural appearance with the prosthesis eliminated the trauma generated by the dysfunction and represented an efficient psychological therapy.

Background: Hepatopulmonary syndrome is reported to occur in 4% to 32% of the patients with chronic liver disease and is associated with poor liver function and shortened patient survival before and after liver transplantation., Aims: To assess the frequency of hepatopulmonary syndrome in Brazilian patients with decompensated chronic liver disease and to investigate its impact on patient survival., Methods: One hundred and thirty patients (101 males, mean age 61 +/- 12 years) with decompensated chronic liver disease were evaluated for the presence of hepatopulmonary syndrome. The diagnosis of hepatopulmonary syndrome was considered in the presence of alveolar arterial oxygen gradient of more than 15 mm Hg and of pulmonary vascular dilatation assessed by contrast enhanced echocardiography., Results: Hepatopulmonary syndrome was observed in 21 (16%) patients. The presence of hepatopulmonary syndrome was significantly associated with severity of liver disease assessed by the MELD (Model for End-Stage Liver Disease) score, but not with in hospital mortality after admission due to decompensated chronic liver disease., Conclusions: Hepatopulmonary syndrome occurs in 16% of patients with chronic liver disease and is associated with disease severity according to the MELD score. Short term mortality following decompensation of chronic liver disease was not associated with hepatopulmonary syndrome.

Sinus histiocytosis with massive lymphadenopathy is a benign disorder often characterized by spontaneous remission. Although immunologic abnormalities are common and high Epstein Barr virus titers have been reported, to date no case has been associated with malignant lymphoma. The authors report here the first case of this association.

We have undertaken a perspective study of the prevelance of the central nervous disease in acute granulocytic leukemia (AGL). Thirty-nine newly diagnosed patients with AGL underwent cytocentrifuge examination of cerebral spinal fluid. Seven of the 39 patients had blast cells in their cerebral spinal fluid. All seven of these patients had acute myelomonocytic leukemia (AMML). No patients with other variants of AGL demonstrated blast cells in their cerebral spinal fluid. Other high risk factors associated with meningeal infiltration were elevated serum lysozyme levels, high peripheral white blood cell count, low age, splemomegaly and the presence of infiltration in other organs. The admission rates for patients with meningeal leukemia were lower and the survival time was shorter than in both the 32 noninvolved patients and the noninvolved patients with AMML. We believe that a lumbar puncture is indicated in all patients with newly diagnosed AMML.

We have compared the clinical and laboratory features as well as treatment complications observed in 6 patients with iatrogenic acute myelogenous leukemia (I-AML) with those of 26 patients with idiopathic acute myelogenous leukemia (AML). I-AML patients were significantly younger and their disease appeared less virulent on admission than in the AML patients. Following identical chemotherapy, hemorrhagic complications and the need for platelet support were found to be similar for both groups. Major infections, including systemic candidiasis and Gram-negative septicemias, occurred 3 times more frequently among I-AML than AML patients. More marked suppression and delayed regeneration of the bone marrow also occurred in I-AML patients. These observations and other factors, such as post-splenectomy state and inherent immune deficiency among surgically staged lymphoma patients as well as radiation induced immunologic impairment, may have contributed to the increased propensity to develop infection observed in this group of patients. Five of the 6 I-AML and 17 of the 26 AML patients achieved remission. We attribute the satisfactory outcome in our I-AML patients to treatment in a protective environment and availability of facilities for hematologic supportive care.