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The European Union (EU) discard ban, called the landing obligation (LO), was initiated in 2015 to reduce unwanted catches by EU fisheries. To ease the transition to a system where total allowable catches (TACs) refer to catches rather than landings only, the majority of EU TACs was increased to account for the part of the catch that was previously discarded and would now be landed. The analysis shows an average annual upward adjustment of 36% in TACs since 2015, but these percentages were considerably higher in 2019 and 2020 (reaching 43 and 50%, respectively), when the LO was fully applicable to all fisheries, and particularly for TACs of demersal species (reaching 51 and 60%). These results demonstrate the significant impact that the discard ban has had on the quantities of EU fishing opportunities. Since discarding has not declined in EU fisheries at any significant level, the magnitude of these increases may likely have resulted in a substantial widespread increase in fishing mortality being exerted on European stocks, and thus likely lead to an implosion of the EU TAC system, the Common Fisheries Policy central instrument to manage fisheries in the EU.

Fisheries in the European Union (EU) are managed through the Common Fisheries Policy (CFP), which has been revised in 2013 to achieve Maximum Sustainable Yield (MSY) for all commercial exploited stocks and ban discards, amongst other aims. One of its core instruments to achieve stock conservation objectives in the North-East Atlantic are Total Allowable Catches (TACs). These are agreed annually by the Council of the EU, informed by scientific advice but usually based on perceived short-term socioeconomic impacts. The objective of this study was to analyse the influence of major policy decisions and consequent changes in the basis of scientific advice on TAC decisions. TACs set were compared to maximum advised catch levels between 2010 and 2017, in order to determine to what extent the EU adheres to scientific advice. The results show that EU fisheries ministers persistently set fishing opportunities above those given by MSY based scientific advice. Since 2010, 60% of the TACs analysed were constantly set above the advised levels, but departure from the advised tonnes peaked at around 40% in 2013, during the CFP negotiation, and again in 2017 due to the introduction of the landing obligation. More importantly, the observed decreasing trend of overfishing that had been achieved in Europe has been halted since 2011–2012. Finally, there was no impact of ICES’ adoption of the MSY approach in EU TACs decision-making.

In many countries, policies regarding reduction of unwanted catch and discards are crafted in response to concerns regarding accountability, conservation, and waste as well as scientific needs to fully account for all sources of fishing mortality. It is important to note, however, that unwanted catch is minimal and most, or all, of the catch has value in some fisheries. Utilisation rates are very high, and discarding is generally not of concern in such fisheries which occur primarily, but not entirely, in developing countries. Where unwanted catch and discards are a concern, legislation may be prescriptive, as can be seen in the EU Landing Obligation (LO), and programmes established in e.g. Norway, Iceland, Argentina, Chile and New Zealand. Elsewhere, legislative language is intended to minimize unwanted catch but allows for some flexibility in developing strategies and solutions, as in the USA. The effectiveness of these approaches depends on many factors and all require effective cross-sectoral collaboration. Also essential is a comprehensive monitoring and control system which insures regulatory compliance and collection of adequate data to address scientific and management information needs. In this chapter, we evaluate the effectiveness of discard and unwanted catch reduction approaches under diverse legislative systems in different parts of the world, with reference to emerging practices under the LO. We consider the importance of finding the balance between top-down and bottom-up processes and look carefully at different governance/regulatory frameworks (e.g. input controls, output controls, quota management and transferability, cooperative/collaborative management), factors which encourage or discourage innovation and collaborative problem solving, monitoring and accountability. This is accomplished through case studies from selected fisheries around the world. publishedVersion

20 pages, 2 tables.-- This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License, A key requirement for the successful implementation of the Landing Obligation is the need to monitor and regulate unwanted catches at sea. This issue is particularly challenging because of the large number of vessels and trips that need to be monitored and the remoteness of vessels at sea. Several options exist in theory, ranging from patrol vessels to onboard observers and self-sampling. Increasingly though, technology is developing to provide remote Electronic Monitoring (EM) with cameras at lower costs. This chapter first provides an overall synthesis of the pro’s and con’s of several monitoring tools and technologies. Four EM technologies already trialled in EU fisheries are then summarised. We conclude that it is now possible to conduct reliable and cost-effective monitoring of unwanted catches at sea, especially if various options are used in combination. However, effective monitoring is a necessary condition for the successful implementation of the Landing Obligation but insufficient unless it is implemented with a high level of coverage and with the support of the fishing industry, This chapter is largely based on work carried out in the DiscardLess project and the Life iSEAS project. The DiscardLess project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement DiscardLess No 633680. The Life iSEAS project has been co-funded under the LIFE+Environment Program of the European Union (LIFE13 ENV/ES/000131). This support is gratefully acknowledged

This chapter deals with the development of the European Union (EU) discard policy over time. It describes the process from 1992, when the issue of discards was first recognised in the Common Fisheries Policy (CFP) reform process, to the Landing Obligation (LO) adopted in 2013. It analyses the context to which policy choices were made that shaped the present format of the EU LO, how it is being implemented and the impact it is having on associated fisheries management measures. Finally, future possible policy developments are examined.

ResumoAs lesões vasculares poplíteas causadas pela cirurgia de substituição total do joelho (PTJ) são extremamente raras e o seu diagnóstico imagiológico pode ser comprometido pelos artefactos causados pela prótese. Numa era em que a intervenção endovascular domina o tratamento destas lesões, os autores apresentam um caso raro de uma doente que apresentou uma fístula arteriovenosa poplítea, após uma intervenção de PTJ, a qual foi tratada com sucesso por cirurgia convencional.O caso clínico relata uma doente referenciada à consulta externa de cirurgia vascular por queixas de dor e edema da perna esquerda, que surgiram 6 anos após uma intervenção de PTJ. A doente foi submetida a estudo imagiológico por ecodoppler arterial e venoso dos membros inferiores (MI), tomografia computadorizada angiográfica (angio TC) e angiografia digital de subtração, que demonstraram achados consistentes com uma fístula arteriovenosa poplítea. A doente foi submetida a exclusão de fístula por cirurgia convencional e, aos 12 meses de follow‐up, mantém‐se assintomática e sem evidência clínica e imagiológica de recidiva da fístula ou de outras complicações vasculares.AbstractPopliteal vascular lesions following total knee replacement surgery are extremely rare and its radiologic diagnosis may be compromised by the artefact caused by the prosthesis. In an era where the endovascular technique dominates the treatment of these lesions, the authors present a rare case report of a patient presenting with a popliteal arteriovenous fistula, following total knee replacement surgery, who was successfully treated by conventional surgery.The case report refers to a female patient who presented to the Vascular Surgery office complaining of left leg pain and swelling, six years after a total left knee replacement surgery. The patient was studied with arterial and venous lower limb doppler ultrasonography, angiographic computerized tomography and digital subtraction angiography, which demonstrated findings consistent with a popliteal arteriovenous fistula. The patient was then submitted to exclusion of this fistula by conventional surgery. At 12 months follow‐up, the patient remained free of symptoms and of arteriovenous fistula recurrence, as well as of other vascular complications.

Introduction: A systemic inflamatory response is common after EVAR. Its clinical impact is unknown, and although is it usually well tolerated, there is concern it might be associated with increased morbidity and mortality in high risk patients. This study aims to evaluate the occurrence of the post-implantation syndrome (PIS) in patients undergoing EVAR, its characteristics and clinical significance. Methods: This study is a retrospective observational analysis of patients undergoing elective EVAR between November 2012 and November 2014. PIS was defined by fever (>38 ◦C) and leukocytosis (>12,000 µL−1), excluding infectious complications. We evaluated the epidemiological characteristics of the patient, aneurysm and procedure characteristics and their relationship with development of PIS. Results: Fifty-two patients were included, and 21.2% were diagnosed with PIS. The ePTFE grafts were not associated with the occurrence of the syndrome, in contrast with polyester stent grafts (0% vs. 28.2%, p = 0.031). The age and gender of patients, the diameter of the aneurysm, duration and radiation dose and the configuration of the stent graft (aorto-bi-iliac, aorto-uni-iliac or fenestrated) were not associated with PIS. There was no statistically significant difference in the occurrence of major cardiovascular events during hospitalization in both groups. Conclusion: The inflammatory syndrome after EVAR occurs in a significant percentage of patients (21%). Stent grafts constructed by polyester are a significant risk factor. Despite the exuberant inflammatory response, it was not associated with increased occurrence of cardiovascularevents, and it is usually benign, well tolerated and self-limiting. Introdução: É frequente uma resposta inflamatória sistémica após EVAR. O seu impacto clínico é desconhecido, e apesar de habitualmente ser bem tolerado existe o receio de estar associado a maior morbi-mortalidade em doentes de alto risco. Este estudo tem como objectivo a avaliação da ocorrência do síndrome pós implantação (SPI) nos doentes submetidos a EVAR, suas características e relevância clínica. Material e métodos: Estudo observacional retrospectico de doentes submetidos a EVAR electivo entre Novembro de 2012 e Novembro de 2014. O SPI foi definido por febre (>38 ◦C) e leucocitose (>12.000/µL), excluídas complicações infecciosas. O outcome primário foi o diagnóstico de SPI. Foram avaliadas as características epidemiológicas do doente, características do aneurisma e do procedimento e sua relação com o SPI. Resultados: Foram incluídos 52 doentes, dos quais 21,2% desenvolveram SPI. As endopróteses de ePTFE não foram associadas à ocorrência de SPI, comparativamente às de poliéster (0% vs.28,2%, p = 0.031). A idade e o sexo dos pacientes, o diâmetro do aneurisma, o tempo e a dose de radiação e a configuração da endoprótese (aorto-bi-ilíaca, aorto-uni-ilíaca ou fenestrada) não foram associados à ocorrência do síndrome. Não se observaram diferenças estatisticamente significativas na ocorrência de eventos cardiovasculares major durante o internamento em ambos os grupos. Conclusão: O SPI ocorre numa percentagem significativa de doentes (21%). As endopróteses construídas com poliéster são um factor de risco significativo. Apesar da resposta inflamatória exuberante, esta não se associou à ocorrência de eventos cardiovasculares, sendo habitualmente benigna, bem tolerada e auto-limitada.

ResumoOs aneurismas da artéria esplénica são, de todos os aneurismas viscerais, os mais frequentes, com uma taxa de rotura até 10%. Não obstante, o seu diagnóstico é normalmente acidental e o seu tratamento eletivo está preconizado para diâmetros >2,5cm. Outrora tratado exclusivamente por cirurgia aberta, através de resseção de aneurisma com ou sem reconstrução arterial, com ou sem esplenectomia associada, também aqui o tratamento endovascular, através da embolização com coils ou stenting da artéria esplénica, tem sido crescentemente utilizado. Os estudos comparativos reportam eficácia sobreponível, com menor morbimortalidade perioperatória, mas maior taxa de complicações tardias. Dentro destas, estão o enfarte e o abcesso esplénico, que nos propusemos estudar e descrever com este trabalho.AbstractSplenic artery aneurysms are the most common of all visceral artery aneurysms, with a risk of rupture up to 10%. Most patients present asymptomatically and its elective treatment is recommended for diameters>2.5cm. Once treated exclusively by open surgery through aneurysm resection with or without arterial reconstruction, with or without splenectomy associated, nowadays endovascular repair has become increasingly used, by embolization with coils or stenting of the splenic artery. Comparative studies report overlapping efficacy, with lower perioperative morbidity and mortality, but higher rate of late complications. Splenic infarction and abscess is one of them, and the goal of our study was to study and describe this complication.

ResumoIntroduçãoA arterite de Takayasu é uma doença inflamatória crónica, rara e idiopática que afeta a aorta, os seus principais ramos, as artérias pulmonares e as coronárias. A artéria visceral envolvida com maior frequência é a artéria renal, podendo resultar em hipertensão renovascular.Caso clínicoMulher de 58 anos, com antecedentes de arterite de Takayasu e história de hipertensão arterial refratária à terapêutica, motivo pelo qual foi submetida a arteriografia aortovisceral, que revelou estenose superior a 70% da artéria renal direita, procedendo‐se a angioplastia transluminal da mesma.O procedimento decorreu sem complicações, com confirmação arteriográfica de sucesso técnico do mesmo. A doente teve alta no dia seguinte, assintomática, com valores de tensão arterial dentro dos parâmetros normais, sem necessidade de terapêutica anti‐hipertensora, mantendo esta estabilidade clínica aos 10 meses de follow‐up.ConclusãoA angioplastia da estenose da artéria renal secundária a arterite de Takayasu é um procedimento seguro, eficaz, pouco invasivo e associado a uma reduzida taxa de complicações, sendo o método de eleição atual no tratamento desta patologia.AbstractIntroductionTakayasu's arteritis is a chronic, rare and idiopathic inflammatory disease, which affects the aorta, its main branches, the pulmonary and coronary arteries. The visceral artery most frequently involved is the renal artery, which may lead to renovascular hypertension.Case reportA 58‐year old woman, with previous history of Takayasu's arteritis and systemic arterial hypertension refractory to treatment. The patient was submitted to aorto‐visceral angiography, showing a right renal artery stenosis, superior to 70% of the estimated diameter, then being submitted to renal artery transluminal angioplasty.The procedure was technically well‐succeeded and there were no complications related to it. The patient was discharged from hospital in the following day, asymptomatic and presenting arterial blood pressure values within the normal range, with no need for antihypertensive drugs, maintaining this clinical picture at 10 months of follow‐up.ConclusionAngioplasty of Takayasu's arteritis induced renal artery stenosis is a safe, effective and low invasive procedure, related to a low complication rate, reasons why this is actually considered the method of choice in the treatment of this pathology.

ResumoOs autores apresentam um caso clínico bem‐sucedido de técnica híbrida de exclusão endovascular de aneurisma ilíaco comum e revascularização cirúrgica da artéria ilíaca interna (AII).Caso clínico de um homem de 80 anos, previamente submetido a exclusão endovascular de aneurisma aorto‐bi‐ilíaco. A tomografia computadorizada angiográfica de follow‐up revelou, 7 anos depois, extensão do aneurisma ilíaco comum direito à bifurcação ilíaca e oclusão da AII contralateral.O doente foi submetido a intervenção híbrida cirúrgica e endovascular, através de laqueação da AII direita na origem, bypass artéria ilíaca externa – AII com prótese e exclusão endovascular do aneurisma ilíaco comum direito.A intervenção foi bem‐sucedida e, tal como o pós‐operatório, decorreu sem complicações. O doente teve alta ao 4.° dia pós‐operatório e, até à data, permanece assintomático e com evidência imagiológica de exclusão de aneurisma ilíaco, sem endoleak e permeabilidade mantida do bypass AIE‐AII.No tratamento dos aneurismas aorto‐ilíacos complexos, a técnica híbrida é uma alternativa associada a uma elevada taxa de sucesso clínico e imagiológico, com reduzida taxa de complicações.AbstractThe authors present a successful clinical report of endovascular exclusion of a common iliac aneurysm and surgical revascularization of the internal iliac artery (IIA).Case report of an 80‐year‐old man, previously submitted to endovascular repair of an aortoiliac aneurysm. Seven years after this intervention, the follow‐up angiographic computerized tomography showed progression of the right common iliac artery aneurysm to the iliac bifurcation and occlusion of the contralateral IIA.The patient was submitted to a hybrid endovascular and surgical procedure, through right IIA interruption, external iliac artery – IIA bypass graft with prosthesis and endovascular repair of the right common iliac artery aneurysm.The procedure was successful and, as the post‐surgical period, free of any complication. The patient was discharged at the fourth day after surgery and, till this date, remains asymptomatic and with imagiologic evidence of iliac aneurysm exclusion, with no endoleak, and EIA – IIA bypass patency.In the treatment of the complex aorto‐iliac aneurysms, the hybrid technique is an alternative associated to a high rate of imagiologic and clinical success, with a lower rate of complications.

ResumoOs aneurismas verdadeiros da artéria femoral superficial são extremamente raros e, na maioria dos casos, associam‐se a aneurismas arteriais noutras localizações. A raridade desta patologia implica a ausência de estudos clínicos prospetivos randomizados, pelo que a terapêutica gold standard destes aneurismas é a cirurgia convencional.Homem de 58 anos, previamente submetido a revascularização do membro inferior direito por doença arterial aterosclerótica obstrutiva, admitido por tumefação pulsátil e indolor na coxa esquerda, com 24 horas de evolução, sem história de traumatismo, cateterismo ou infeção. O eco‐Doppler arterial e a angio TC revelaram aneurisma verdadeiro da artéria femoral superficial esquerda, com 42mm de diâmetro, em rutura contida, com hematoma adjacente de 90x60mm de diâmetro, sem evidência de aneurismas adicionais.O doente foi submetido a ressecção do aneurisma e interposição femoral superficial proximal – femoral superficial distal com prótese e drenagem de hematoma.A intervenção e o pós‐operatório decorreram sem complicações. A microbiologia revelou‐se negativa e o estudo anatomopatológico confirmou aneurisma degenerativo da artéria femoral superficial.AbstractThe true aneurysms of the superficial femoral artery are extremely rare and, in the majority of cases, they are associated to arterial aneurysms in other territories. The rarity of this pathology is responsible for the absence of prospective randomized clinical trials, so the gold standard therapy for this kind of aneurysms remains open surgery procedures.A 58‐year‐old male, previously submitted to right lower limb bypass surgery for obstructive atherosclerotic arterial disease, presented with an acute painless and pulsatile mass in his left thigh, which had appeared 24hours earlier. The arterial doppler ultrasonography and angio CT showed rupture of a true aneurysm of the superficial femoral artery, with 42mm of diameter and associated haematoma with 90x60mm of diameter, with no evidence of other aneurysms.The patient was submitted to aneurysm resection, superficial femoral artery interposition with prosthesis and haematoma drainage.The intervention and follow‐up were intercurrences free. The microbiology was negative and the anatomopathological report confirmed degenerative aneurysm of the superficial femoral artery.

ResumoO priapismo isquémico é uma ereção persistente, sem relação com estímulo sexual, caracterizada pela redução ou ausência de fluxo sanguíneo intracavernoso. Apresenta‐se um caso clínico de um homem de 30 anos, com priapismo com 48 horas de evolução. Foi submetido noutra instituição à drenagem dos corpos cavernosos, instilação de efedrina e criação de shunt cavernoso‐esponjoso, sem melhoria do quadro. Ao ecoDoppler observou‐se ausência de fluxo nas artérias cavernosas, trombose das veias cavernosas e fluxo venoso dorsal normal. Foi submetido a cirurgia de Grayhack, com construção de pontagens cavernoso‐femoral bilateral por transposição segmentar da veia grande safena. Apresentou boa evolução clínica e resolução do priapismo. No 7.° dia de pós‐operatório apresentou trombose das pontagens, com fluxo de baixa resistência nas artérias cavernosas.AbstractIschemic priapism is a persistent erection unrelated to sexual stimulation characterized by reduced or absent intracavernous blood flow. We present a clinical case of a 30 year old man with priapism with 48hours of progression. He underwent surgical drainage of the corpora cavernosa, instillation of ephedrine, and creation of a cavernous‐spongeous shunt without improvement. On the duplex ultrasound there was no flow in the cavernous arteries, thrombosis of the cavernous veins and normal dorsal venous flow. He underwent Grayhack surgery with creation of cavernous‐femoral bypass with great saphenous vein bilaterally. He underwent a Grayhack surgery with creation of a bilateral cavernous‐femoral bypass with great saphenous vein. There was clinical improvement and resolution of the priapism. On the 7th post‐operative day, it was documented thrombosis of the bypasses and patent cavernous arteries and veins.

Introdução: A diabetes mellitus é responsável por 70% das amputações não traumáticas do membro inferior e 85% destas são precipitadas por úlceras. Objetivo - caracterização epidemiológica e resultado da intervenção dos utentes da consulta multidisciplinar do pé diabético. Materiais e métodos: Estudo observacional retrospetivo das primeiras consultas realizadas no âmbito da consulta multidisciplinar do pé diabético, durante um semestre. Revisão do processo clínico e avaliação das características epidemiológicas, investigação clínica realizada, meios complementares de diagnóstico e o resultado final (cicatrização da lesão, amputação major, não cicatrização em um ano ou morte). Resultados: Realizaram-se 361 primeiras consultas do pé diabético no período em estudo, 82,3% por ulceração (31,3% neuropáticos e 68,7% neuroisquémicos). Dos doentes seguidos, 78% obtiveram cicatrização das lesões (com ou sem amputação minor), 7,7% não obtiveram cicatrização da lesão após um ano de seguimento, 10,1% foram submetidos à amputação major e 4,2% faleceram durante o seguimento. Os doentes com doença arterial periférica apresentaram menor probabilidade de cicatrização (70,6 vs. 89,4%, p = 0,004) e risco aumentado de amputação major (15,7 vs. 1,5%, p = 0,003). A nefropatia diminuiu a probabilidade de cicatrização (50 vs. 82,6%, p = 0,008) e aumentou o risco de amputação major (29,1 vs. 6,9%, p = 0,008). Os doentes com dependência de terceiros apresentaram maior risco de amputação major (22,9 vs. 6,8%, p = 0,008). Conclusões: O tratamento eficaz das úlceras do pé diabético necessita uma abordagem multidisciplinar, intervindo nos vários componentes etiológicos. A doença arterial periférica, a insuficiência renal e a dependência de terceiros são fatores de mau prognóstico das úlceras do pé diabético. © 2014 Sociedade Portuguesa de Angiologia e Cirurgia Vascular. Publicado por Elsevier España, S.L.U. Todos os direitos reservados. Introduction: Diabetes mellitus is responsible for 70% of non-traumatic lower limb amputations and 85% of these are precipitated by ulcers. Objective -epidemiological characterization and revision of the outcome of patients observed in a multidisciplinary outpatient clinic of diabetic foot. Matherials and methods: A retrospective observational study with review of the first consultation of the multidisciplinary outpatient clinic of diabetic foot ulcer, during one semester. Review of the clinical process and evaluation of the epidemiological characteristics, clinical investigation, diagnostic tests, and outcome (healing, major amputation, non-healing after 1 year or death). Results: There were 361 first consultations during the study period, 82.3% due to ulceration (31.3% with neuropathic etiology and 68.7% with neuroischemic foot ulcers). Of the patients followed, 78% achieved complete wound healing (with or without minor amputation), 7.7% did not heal after one year of follow up, 10.1% underwent major limb amputation, and 4.2% died during the follow-up. Patients with peripheral arterial disease were less likely to heal (70.6% vs. 89.4%, p = 0.004) and had greater risk of major amputation (15.7% vs. 1.5%, p = 0.003). Nephropathy decreases the likelihood of healing (50% vs. 82.6%, p = 0.008) and increases the risk of major amputation (29.1% vs. 6.9%, p = 0.008). Non-ambulatory patients have a higher risk of major amputation (22.9% vs. 6.8%, p = 0.008). Conclusions: Successful treatment of diabetic foot ulcers requires a multidisciplinary approach, intervening in all etiological components. Peripheral arterial disease, renal failure and non ambulatory status are factors related to poor prognosis of diabetic foot ulcers. © 2014 Sociedade Portuguesa de Angiologia e Cirurgia Vascular. Published by Elsevier España, S.L.U. All rights reserved.

Ocean sustainability is a widespread public concern in Europe, and the issue of fisheries discards is one that is now widely known. With this increase in public awareness comes the need to adapt fisheries management policies to manage issues like fisheries discards that were not previously taken into account. In this context, this study analyses the evolution of the European Union's discard policy since its inception in 2006 until the present day and the events that shaped its current format. It analyses the policy's advantages and disadvantages, and its political, environmental and scientific consequences. It argues that an increase in public awareness, due to public campaigns against fisheries discards, has focused managers' attention onto a symptom of fisheries mismanagement, rather than on its underlying causes of over-exploitation and lack of fisheries control. This has distorted the discussion of the reform of the Common Fisheries Policy and potentially undermined its provisions relating to discards.

ResumoOs autores apresentam um caso clínico de uma mulher, de 53 anos, com síndrome mielodisplásica, manifestada por trombocitopenia sintomática dependente de corticoterapia em doses elevadas. A doente foi referenciada à consulta de Cirurgia Vascular, pela Hematologia, para ponderação de embolização da artéria esplénica. A doente foi submetida a embolização total da artéria esplénica por coils e esplenectomia laparoscópica no dia seguinte. Os dois procedimentos foram bem sucedidos e decorreram sem complicações. A doente teve alta ao quarto dia pós-operatório, assintomática, clinicamente estável e com hemograma que revelava 208 000 plaquetas/μL.O método combinado de embolização da artéria esplénica e esplenectomia laparoscópica é um procedimento seguro e eficaz, associado a diminuição de incidência de complicações e de tempo de internamento, quando comparado à esplenectomia laparoscópica isolada.AbstractThe authors present a case report of a 53-year old woman, with myelodysplastic syndrome, manifested by symptomatic thrombocytopenia dependent of steroids in high doses. The patient was referenced to Vascular Surgery, by Hematology, for weighing splenic artery embolization. This procedure was performed with total embolization of the artery with coils and the patient was submitted to laparoscopic splenectomy on the next day. Both procedures were well succeeded, with no complications. The patient was discharged from the hospital on the fourth day after surgery, asymptomatic, clinically stable and with 208 000 platelets/μL.The combined method of splenic artery embolization and laparoscopic splenectomy is a safe and effective method, associated with a reduced complications incidence and a shorter hospital stay, when compared to laparoscopic splenectomy alone.

Introdução: Os aneurismas e as fístulas arteriovenosas (FAV) da artéria renal são entidades raras, geralmente assintomáticas, cujas manifestações clínicas podem ser variadas. Os falsos aneurismas da artéria renal estão normalmente associados a traumatismo prévio e apresentam maior tendência a rutura. A indicação de tratamento destas lesões não é consensual, assim como o método a ser utilizado. Material e métodos: Neste trabalho, os autores procederam à análise retrospetiva dos doentes com diagnóstico de falso aneurisma da artéria renal tratados na instituição, no período de 2011-2015, incluindo manifestação clínica, diagnóstico, tratamento e seu resultado. Resultados: Foram tratados 6 doentes, 4 do sexo masculino e 2 do sexo feminino, com idade média de 59 anos. A manifestação clínica inaugural foi hematúria macroscópica em 4 doentes, instabilidade hemodinâmica em um doente e queda do valor de hemoglobina em um doente. Em todos os casos, o diagnóstico foi feito por tomografia computadorizada (TC) e confirmado por angiografia, que foi terapêutica no mesmo ato. Conclusão/Discussão: Em todos os casos havia história recente de algum procedimento urológico, podendo ser consideradas estas lesões iatrogénicas. Com o aumento do número de intervenções urológicas semelhantes às referidas neste trabalho, é expectável um aumento da incidência de lesões da artéria renal ou seus ramos, entre as quais se destacam os falsos aneurismas. Tratando-se na maioria dos casos de lesões intraparenquimatosas, envolvendo vasos de pequeno calibre, a cirurgia convencional tem poucas alternativas terapêuticas além da nefrectomia. Assim, o tratamento endovascular é o único que poderá minimizar a perda de tecido renal, sendo a embolização o mais frequentemente utilizado. Todos os nossos casos foram tratados com sucesso, como demonstrado clinicamente e por TC de controlo. Assim, na nossa experiência, o tratamento endovascular mostrou-se um método de tratamento eficaz dos falsos aneurismas traumáticos renais intraparenquimatosos. Introduction: Renal artery aneurysms and arteriovenous fistulae are rare, generally asymptomatic, whose clinical manifestations can be varied. Renal artery pseudoaneurysms are usually associated with previous trauma and are more likely to rupture. The indication for treatment of these lesions is not consensual, as well as the method to be used. Material and Methods: In this study the authors have made a retrospective analysis of patients with the diagnosis of renal artery pseudoaneurysm treated in the institution in the period between 2011 and 2015, including clinical presentation, diagnosis, treatment and result. Results: Six patients were treated, four male and two female, with an average age of 59 years. The inaugural clinical manifestation was macroscopic haematuria in four patients, hemodynamic instability in a patient and decrease of the hemoglobin value in another patient. In all patients, the diagnosis was made by Computed Tomography (CT) and confirmed by angiography, which was therapeutic in the same act. Conclusion/Discussion: In all cases there was a recent history of a urological procedure, renal artery pseudoaneurysms may be considered iatrogenic lesions. With the rising number of urological interventions similar to those described in this study, it is expected a rising incidence of lesions of the renal artery or its branches, particularly pseudoaneurysms. As it includes in most cases small intra-parenchymal vessels, conventional surgery has few therapeutic alternatives and usually consists in nephrectomy. The endovascular treatment is the only one that can minimize the loss of kidney tissue, embolization is the preferred method. All our cases were successfully treated as clinically proven and on CT control. So in our experience, endovascular treatment was an effective method of treatment of these lesions.

The nuclear hormone receptor farnesoid X receptor (FXR) plays a critical role in the regulation of bile acid, triglyceride (TG), and cholesterol homeostasis. WAY-362450 (FXR-450/XL335) is a potent synthetic FXR agonist as characterized in luciferase reporter assays and in mediating FXR target gene regulation in primary human and immortalized mouse hepatocytes. In vivo, WAY-362450 dose dependently decreased serum TG levels after 7 days of oral dosing in western diet-fed low-density lipoprotein receptor−/− mice and in the diabetic mouse strains KK-Ay and db/db comparable to that achieved with the peroxisome proliferator activated receptor-α agonist, fenofibrate. WAY-362450 treatment also reduced serum cholesterol levels via reductions in LDLc, VLDLc, and HDLc lipoprotein fractions that were not accompanied by hepatic cholesterol accumulation. This cholesterol lowering was dependent on FXR as demonstrated in a hypothyroid-induced hypercholesterolemia setting in FXR−/− mice. In fructose-fed models, WAY-362450 also decreased TG and VLDLc levels in rats and hamsters but significantly increased HDLc levels in rats while reducing HDLc levels in hamsters. The differential effect of WAY-362450 on HDLc is likely due to a murine-specific induction of endothelial lipase and scavenger receptor-BI that does not occur in rats. These studies demonstrate a consistent ability of WAY-362450 to lower both serum TG and cholesterol levels and suggest that synthetic FXR agonists may have clinical utility in the treatment of mixed dyslipidemia.

Borges, L., van Keeken, O. A., van Helmond, A. T. M., Couperus, B., and Dickey-Collas, M. 2008. What do pelagic freezer-trawlers discard? – ICES Journal of Marine Science, 65: 605–611. Estimates of discards by the Dutch pelagic freezer-trawler fleet were derived based on data from observers on board commercial vessels. In all, 27 fishing trips of duration 2–5 weeks each were sampled between 2002 and 2005, covering the North Sea and the western waters of the British Isles. Different methods to estimate discards were compared, and raising these estimates by number of trips or by total landings did not greatly influence the annual estimates of total discards. Some 30 000 t of fish were discarded annually by the fleet, the commercial target species mackerel, herring, and horse mackerel being discarded most, with 41%, 19%, and 15% of the total discards by weight, respectively. The most commonly discarded non-commercial species was boarfish, accounting for 5% of total discards. Slippage accounts for 10% of all discards, and the most common species slipped is herring. There is extensive discarding of juvenile mackerel in the horse mackerel fishery, and to a lesser extent highgrading of mackerel in the same fishery.

The discovery of novel intervention points in the inflammatory pathway has been a focus of drug development in recent years. We have identified pathway selective ligands for the estrogen receptor (ER) that inhibit NF-kappaB mediated inflammatory gene expression causing a reduction of cytokines, chemokines, adhesion molecules and inflammatory enzymes. SAR development of a series of 4-(Indazol-3-yl)-phenols has led to the identification of WAY-169916 an orally active non-steroidal ligand with the potential use in the treatment of inflammatory diseases without the classical proliferative effects associated with non-selective estrogens.

Annual discard ogives were estimated using generalized additive models (GAMs) for four demersal fish species: whiting, haddock, megrim, and plaice. The analysis was based on data collected on board commercial vessels and at Irish fishing ports from 1995 to 2003. For all species the most important factors influencing annual discard ogives were fleet (combination of gear, fishing ground, and targeted species), mean length of the catch and year, and, for megrim, also minimum landing size. The length at which fish are discarded has increased since 2000 for haddock, whiting, and plaice. In contrast, discarded length has decreased for megrim, accompanying a reduction in minimum landing size in 2000.

This paper presents the first estimation of discarding levels by the demersal fishery in the waters around Ireland. The analysis is based on the Irish discard programme, involving observer's onboard commercial vessels that participate on a voluntary basis. The programme started in 1993 and, until 2002, 225 trips were sampled, corresponding to 2189 sampled tows. Approximately one-quarter of the catch of otter trawlers and “Scottish” seiners is discarded, while two-thirds of the catch of beam trawls is discarded. Furthermore, otter trawl fleet components (defined by the area visited, targeted species and gear used) discard between 20 and 60% of their catch. Discards usually comprise 11 fish species per haul in the 3 gears types studied. Whiting (Merlangius merlangus), haddock (Melanogrammus aeglefinus), bluemouth (Helicolenus dactylopterus), megrim (Lepidorhombus whiffiagonis) and dogfish (Scyliorhinus spp.) are the main species discarded by otter trawlers. “Scottish” seiners discard mostly whiting, haddock and grey gurnard (Eutrigla gurnardus). Dab (Limanda limanda) and plaice (Pleuronectes platessa) are the most species discarded by beam trawls. The majority of these discarded species consist of immature fish. Discarding appears to be increasing in recent years, especially in traditionally bycaught species such as haddock and whiting.

The effects of two sampling units (haul and trip) and three auxiliary variables (total landings in weight, effort in hours fished and in numbers of fishing trips) commonly used in discard estimations were compared. Considering the sampling unit at haul level will increase variability in the final estimation. In addition, there was a significant linear relationship between discards per trip with both landings and effort, but not at haul level. The different auxiliary variables used to raise discard samples to population levels give significantly different results, with effort in hours fished giving the highest discard estimates. Fishing trips was the recommended variable to estimate discards in six out of ten fleets studied. These results highlight the importance of preliminary studies to determine the methodology to be used in discard estimations, in order to avoid considerably imprecise estimations.

Previous studies have demonstrated a dramatic induction of inflammatory gene expression in livers from mice fed a high-fat, high-cholesterol diet containing cholate after 3–5 wk. To determine the contribution of cholate in mediating these inductions, C57BL/6 mice were fed a chow diet supplemented with increasing concentrations of cholic acid (CA) for 5 days. A dose-dependent induction in the hepatic levels of TNF-α, VCAM-1, ICAM-1, and SAA-2 mRNA were observed. As positive controls, a dose-dependent repression of cholesterol 7α-hydroxylase and a dose-dependent induction of small heterodimer partner (SHP) expression were also observed, suggesting that farnesoid X receptor (FXR) was activated. In addition, ICAM-1 and SHP mRNA levels were also induced in primary human hepatocytes when treated with chenodeoxycholic acid or GW4064, a FXR-selective agonist. The involvement of FXR in CA-induced inflammatory gene expression was further investigated in the human hepatic cell line HepG2. Both ICAM-1 and SHP expression were induced in a dose- and time- dependent manner by treatment with the FXR-selective agonist GW4064. Moreover, the induction of ICAM-1 by GW4064 was inhibited by the FXR antagonist guggulsterone or with transfection of FXR siRNA. Finally, the activity of FXR was mapped to a retinoic acid response element (RARE) site containing an imbedded farnesoid X response element (FXRE) on the human ICAM-1 promoter and FXR and retinoid X receptor were demonstrated to bind to this site. Finally, FXR-mediated activation of ICAM-1 could be further enhanced by TNF-α cotreatment in hepatocytes, suggesting a potential cooperation between cytokine and bile acid-signaling pathways during hepatic inflammatory events.

Rheumatoid arthritis (RA) is a chronic inflammatory disease that produces synovial proliferation and joint erosions. The pathologic lesions of RA are driven through the production of inflammatory mediators in the synovium mediated, in part, by the transcription factor NF-kappaB. We have identified a non-steroidal estrogen receptor ligand, WAY-169916, that selectively inhibits NF-kappaB transcriptional activity but is devoid of conventional estrogenic activity. The activity of WAY-169916 was monitored in two models of arthritis, the HLA-B27 transgenic rat and the Lewis rat adjuvant-induced model, after daily oral administration. In both models, a near complete reversal in hindpaw scores was observed as well as marked improvements in the histological scores. In the Lewis rat adjuvant model, WAY-169916 markedly suppresses the adjuvant induction of three serum acute phase proteins: haptoglobin, alpha1-acid glycoprotein (alpha1-AGP), and C-reactive protein (CRP). Gene expression experiments also demonstrate a global suppression of adjuvant-induced gene expression in the spleen, liver, and popliteal lymph nodes. Finally, WAY-169916 was effective in suppressing tumor necrosis factor-alpha-mediated inflammatory gene expression in fibroblast-like synoviocytes isolated from patients with RA. Together, these data suggest the utility of WAY-169916, and other compounds in its class, in treating RA through global suppression of inflammation via selective blockade of NF-kappaB transcriptional activity.

This paper presents optimum sampling levels in discard sampling programs considering cost and precision objectives simultaneously and explores their dependence on both variables. The analysis is based on the Irish discard program: an onboard-observer voluntary sampling scheme aimed at estimating discard rates in trawl fisheries. Multi- stage analysis was performed to establish the precision levels achieved in the past, and a cost function was determined to estimate the financial cost of the program. Gear, fishing ground, targeted species, and International Council for the Exploration of the Sea (ICES) divisions were the main factors affecting discarding, together with random effects of the three nested groups considered: haul, trip, and vessel. Reductions in the present budget will imply only marginal de- creases in precision, although changes in cost variables can have an impact on sampling levels. On the other hand, increasing the target precision by one-half will imply a considerable increase in sampling and associated cost, which will be difficult if not impossible to achieve. Finally, the analysis by fleet components suggests a marked increase in sampling levels, which emphasizes the importance of clearly stated discard sampling objectives. Resume : Notre etude determine les intensites optimales d'echantillonnage dans les programmes d'echantillonnage des rejets, afin de tenir compte a la fois des couts et de la precision visee, et elle examine la dependance de ces program- mes des deux variables en question. L'analyse se base sur le programme irlandais des rejets qui comporte un plan d'echantillonnage volontaire par un observateur a bord qui vise a estimer les taux de rejet dans les peches au chalut. Une analyse en plusieurs etapes a permis d'estimer les niveaux de precision atteints dans le passe et une fonction de cout a servi a estimer le cout financier du programme. Les principaux facteurs qui affectent les rejets sont les engins de peche, les aires de peche, les especes recherchees et les divisions du Conseil international pour l'exploration de la mer (ICES); il y a aussi des effets aleatoires des trois groupes emboites considerees, soit le trait de chalut, la sortie et le navire. Des reductions du budget actuel n'entraineront qu'une diminution marginale de la precision, bien que des changements dans les variables reliees au cout peuvent avoir un impact sur l'intensite de l'echantillonnage. D'autre part, pour augmenter la precision visee de moitie, il faudrait accroitre considerablement l'echantillonnage et les couts associes, ce qui sera difficile ou impossible a realiser. Enfin, l'analyse en fonction des composantes des flottes indique un accroissement marque de l'echantillonnage, ce qui met en lumiere l'importance de preciser clairement les objectifs de l'echantillonnage des rejets.

A 48-year-old woman performing peritoneal dialysis for end-stage renal disease presented with a painful leg ulcer. The investigation revealed an elevated parathyroid hormone level and the histological examination of the biopsy tissue from the ulcer revealed medial calcification of the arterioles, consistent with calciphylaxis. The patient developed additional ulcers in the lower limbs and treatment with antibiotics, cinacalcet, sevelamer, sodium thiosulfate, low calcium dialysate and hyperbaric oxygen therapy was instituted. The patient had a favourable outcome and after 9 months the ulcers had healed and the parathyroid hormone level reached the normal range. Calciphylaxis is a rare and life-threatening disorder associated with a mortality of 60-80%. Its pathogenesis is not fully understood hence there is no consensus in the treatment of this pathology.

Age and growth of the snipefish was studied based on samples collected in the Portuguese continental waters between 1996 and 1998. Analysis was conducted for two species, Macrorhamphosus scolopax and M. gracilis and for both species combined. Total length ranged from 5.5 to 18.2 cm for M. scolopax and from 5.4 to 17.3 cm for M. gracilis. Length–weight relationships were described for M. scolopax (a=0.00401; b=3.127), M. gracilis (a=0.00459; b=3.006) and both combined (a=0.00240; b=3.282). Age estimation, based on otolith observations, resulted in six and five years maximum age attributed to M. scolopax and M. gracilis, respectively. Back-calculation analysis based on a polynomial relation of the otolith radius on total length provided significantly smaller lengths-at-age compared with observed lengths. The von Bertalanffy growth curves fitted to observed lengths-at-age provided parameters of L∞=15.7 cm, K=0.654, t0=−1.066 for M. scolopax; L∞=14.2 cm, K=0.694, t0=−0.954 for M. gracilis and L∞=15.8 cm, K=0.470, t0=−1.408 for both species combined.

Background The aim of this study is to evaluate the role of hyperbaric oxygen in the treatment of diabetic foot ulcers. Methods We performed a retrospective observational study of all patients with diabetic foot ulcers treated at the Institution's hyperbaric chamber between January 2010 and August 2012. Patient data was obtained upon patient hospital visit and prospective clinical record consultation. Results Twenty-six foot lesions including 13 foot ulcers Wagner grade 2 or greater and 13 amputation stump ulcers were submitted to hyperbaric oxygen therapy between January 2010 and August 2012 in our Institution. Of these, 23 foot lesions completed treatment and complete epithelialization of the primary lesion was achieved in 15 (65%). The mean healing period since the first hyperbaric oxygen therapy session was 16 weeks. Above-ankle amputations were performed in 3 limbs and transmetatarsal amputations in 2 limbs. Conclusion Hyperbaric oxygen may be associated with ulcer healing in selected diabetic foot ulcers with impaired cicatrization.

Concern about the impact of fishing on ecosystems and fisheries production is increasing (1, 2). Strategies to reduce these impacts while addressing the growing need for food security (3) include increasing selectivity (1, 2): capturing species, sexes, and sizes in proportions that differ from their occurrence in the ecosystem. Increasing evidence suggests that more selective fishing neither maximizes production nor minimizes impacts (4–7). Balanced harvesting would more effectively mitigate adverse ecological effects of fishing while supporting sustainable fisheries. This strategy, which challenges present management paradigms, distributes a moderate mortality from fishing across the widest possible range of species, stocks, and sizes in an eco-system, in proportion to their natural productivity (8), so that the relative size and species composition is maintained. Summary: http://www.sciencemag.org/cgi/content/summary/335/6072/1045?ijkey=cjKQs4eSejTM.&keytype=ref&siteid=sci Full Text: http://www.sciencemag.org/cgi/content/full/335/6072/1045?ijkey=cjKQs4eSejTM.&keytype=ref&siteid=sci

In an effort to develop orally active farnesoid X receptor (FXR) agonists, a series of tetrahydroazepinoindoles with appended solubilizing amine functionalities were synthesized. The crystal structure of the previously disclosed FXR agonist, 1 (FXR-450), aided in the design of compounds with tethered solubilizing functionalities designed to reach the solvent cavity around the hFXR receptor. These compounds were soluble in 0.5% methylcellulose/2% Tween-80 in water (MC/T) for oral administration. In vitro and in vivo optimization led to the identification of 14dd and 14cc, which in a dose-dependent fashion regulated low density lipoprotein cholesterol (LDLc) in low density lipoprotein receptor knockout (LDLR(-/-)) mice. Compound 14cc was dosed in female rhesus monkeys for 4 weeks at 60 mg/kg daily in MC/T vehicle. After 7 days, triglyceride (TG) levels and very low density lipoprotein cholesterol (VLDLc) levels were significantly decreased and LDLc was decreased 63%. These data are the first to demonstrate the dramatic lowering of serum LDLc levels by a FXR agonist in primates and supports the potential utility of 14cc in treating dyslipidemia in humans beyond just TG lowering.

Pathway selective ligands of the estrogen receptor inhibit transcriptional activation of proinflammatory genes mediated by NF-kappaB. Substituted 2-cyanopropanoic acid derivatives were developed leading to the discovery of WAY-204688, an orally active, pathway selective, estrogen receptor dependent anti-inflammatory agent. This propanamide was shown to be orally active in preclinical models of inflammatory diseases, such as rheumatoid arthritis, without the proliferative effect associated with traditional estrogens.

Situs inversus is a rare congenital defect defined by a mirror image anatomic variation of the thoracic and abdominal organs. In this situation, abdominal aortic surgery may become particularly challenging. This is the case of a 51-year-old man, who presented with an incapacitating lower limb claudication. On his workup, a complete occlusion of the infrarenal aorta requiring surgical revascularization was found. Additionally, a situs inversus totalis was identified along with a single horseshoe kidney. The patient underwent uneventfully a surgical aortobifemoral interposition. The sole modification to the standard procedure regarded the graft limbs tunneling, which was performed in a prerenal pathway in the retroperitoneal space, thus avoiding iatrogenic injury to the anteriorly positioned iliac veins. Although challenging, conventional aortic surgery can be safely accomplished in patients with situs inversus totalis.

Inflammation is now recognized as a key component in a number of diseases such as atherosclerosis, rheumatoid arthritis, and inflammatory bowel disease. The transcription factor NF-κB has been shown to be involved in both the early and late stages of the inflammatory-proliferative process. In this report, we describe the identification of the pathway-selective estrogen receptor (ER) ligand, WAY-169916, that inhibits NF-κB transcriptional activity but is devoid of conventional estrogenic activity. This pathway-selective ligand does not promote the classic actions of estrogens such as stimulation of uterine proliferation or ER-mediated gene expression, but is a potent antiinflammatory agent, as demonstrated in the HLA-B27 transgenic rat model of inflammatory bowel disease. Our results indicate the potential utility of pathway-selective ER ligands such as WAY-169916 in the treatment of chronic inflammatory diseases.

Our aim is to present a case of a common iliac artery pseudoaneurysm, which complicated an allograft nephrectomy. A 27-year-old woman presented with acute abdominal pain and a palpable pulsatile mass in the right iliac fossa, 1 year after a right pelvic allograft nephrectomy. An iliac pseudoaneurysm was suspected and confirmed on triplex ultrasound and CT angiography. The patient underwent a pseudoaneurysm resection with direct repair of the previous allograft Carrell patch suture dehiscence. The intervention and recovery were uneventful and after a follow-up of 6 months, the patient remains asymptomatic with no clinical or imaging recurrence of the pseudoaneurysm.Vascular complications following allograft nephrectomy are rare but may present significant morbidity and mortality. Endovascular exclusion is currently the preferred option for the management of pseudoaneurysms following allograft nephrectomy; however, open surgical approach remains an alternative for selected patients.

A 52-year-old man was admitted with a cutaneous rash associated with septic shock and multiorganic failure, 6 days after a dog bite. He was started on empiric antibiotherapy and supportive measures. The patient's condition aggravated, with need for invasive mechanical ventilation and intermittent haemodialysis, and evolution from a petechiae-like rash to purpura and gangrene, culminating in bilateral lower limb amputation. The blood cultures revealed only Pasteurella multocida, after 10 days of incubation. P multocida infection is a rare cause of soft tissue infection that subsides with oral antibiotherapy. Infections causing sepsis are rare and appear in immunocompromised patients. Purpura fulminans induced by sepsis is a rare, life-threatening disorder. This syndrome should be recognised promptly, so early treatment is instituted. We found no case reports of purpura fulminans caused by Pasteurella infections in our literature review.

ResumoIntroduçãoAs malformações arteriovenosas (MAV) podem ter uma apresentação clínica e evolução imprevisíveis. Por isso, o seu tratamento é ainda um desafio entre as várias patologias vasculares. MAV's das extremidades de localização muito periférica podem não ser amenizáveis por emboloterapia devido ao risco elevado de necrose. Os autores apresentam um caso clínico de uma malformação arteriovenosa congénita do membro superior que foi abordado exclusivamente por cirurgia convencional.Caso clínicoMulher de 27 anos sem antecedentes pessoais relevantes, seguida em consulta por malformação do 5° dedo da mão direita, com agravamento progressivo de queixas de dor, impotência funcional, deformidade do dedo da mão e incapacidade laboral. A doente foi submetida a uma ressecção da malformação arteriovenosa e laqueação dos principais ramos aferentes da MAV. Após um seguimento de 8 meses, a doente apresenta a incisão cirúrgica cicatrizada, sem impotência funcional do dedo e sem evidência clínica de recidiva.ConclusõesO tratamento cirúrgico das MAV digitais do membro superior pode ser realizado de forma curativa com conservação do dedo, com resultados estéticos e funcionais favoráveis.AbstractIntroductionArteriovenous malformations (AVM) have a variety of clinical presentations and may evolve in unpredictable ways. Therefore, its management is still challenging. AVM's with very peripheral location on the extremities, embolotherapy may be contraindicated due to the risk of necrosis. The authors present a clinical case in which a finger AVM was treated surgically.Clinical caseA 27 year-old woman with a known AVM affecting the 5th finger of the right hand presented progressive pain, functional and cosmetic impairment of the finger, which significantly interfered with her professional occupation. A surgical procedure consisting of ligation of all the afferent vessels with complete nidus resection was performed. After 8 months of follow-up, the patient had a fully healed surgical incision, and was without any functional limitations or signs of clinical relapse.ConclusionSurgical treatment of AVM affecting the fingers may be accomplished in a curative way with good cosmetic and functional outcomes.

ResumoOs autores apresentam um caso clínico referente a um doente com antecedentes de bypass aorto-femoral esquerdo complicado por infeção, pelo que foi submetido a resseção parcial do mesmo e construção de bypass femoro-femoral, com necessidade de transversostomia subsequente por fistulização entre o cólon descendente, a loca da prótese removida e a parede abdominal. Após episódios de hemorragia gastrointestinal associados a investigação inconclusiva, a última TC abdominopélvica levantou suspeita de fístula aorto-entérica secundária e o doente foi submetido a laparotomia exploradora, laqueação da aorta abdominal e bypass axilo-“cross over” femoro-femoral. Segue-se uma revisão literária das fístulas aorto-entéricas.AbstractThe authors present a case report of a patient with previous history of a left aorto-femoral bypass complicated by infection, then submitted to partial resection of the prosthesis and femoro-femoral bypass, with subsequent transversostomy for fistula between the descendent colon, the loca of the removed prosthesis and the abdominal wall. After a few episodes of gastrointestinal bleeding with no conclusive investigation, a secondary aorto-duodenal fistula was suspected in the last abdominopelvic CT performed. The patient was submitted to laparotomy for abdominal aorta closure suture and axilo-“cross over” bypass. This is followed by a literary review of aorto-enteric fistulae.

Discard bans have been proposed as part of management policies aimed at balanced harvest (BH). Nationwide discard bans exist in several countries, including Chile, the European Union, Norway, and New Zealand. We analysed experiences from these countries to determine whether or not discard bans are in contradiction with BH, based on six aspects: policy objectives, species/sizes applicability, accompanying technical measures, at-sea monitoring and control, and possible impacts. When discard bans are fully implemented, fishing operations change to more selective fishing, typically targeting bigger individuals of main commercial species. This is consistent with the primary objective of many discard policies, i.e. to reduce unwanted catch. In contrast, proponents of BH argue that broader catch diversity, a product of a widespread harvest strategy, should be sought to avoid major impacts on the ecosystem. Our analysis demonstrates that the scope of discard bans is often limited to main commercial species, although usually they can be extended to include more ecosystem components. Some of the policies examined also prohibit the use of unwanted catches for human consumption, thus limiting their effective use. However, the implementation of discard bans requires high levels of at-sea monitoring and effective control, and/or strong incentives to fish more selectively, neither of which applied in most cases examined. We conclude that if discard bans were set differently, they could contribute to fishery management policies aiming at BH. Their goals should be in line with BH, i.e. to reach a wider global harvest pattern, or at least be established within management regimes that promote high compliance. Finally, the extent to which a discard ban contributes to achieve BH depends also on the relative importance of the ecosystem benthic and megafauna components.

A comparison was made between catches from deepwater trawl and longline surveys (1993–2000) in the Northeast Atlantic. Longline catches were dominated by elasmobranchs, particularly squalid sharks and species numbers were low. Trawl catches had higher species numbers, with more teleosts, though elasmobranchs were still an important component. Species composition of the catch was depth dependent. Comparative trawl and longline surveys of the eastern and southern slopes of the Rockall Trough (west and north of Ireland) were used to examine size-selectivity. Trawls and longlines selected for significantly different size frequency distributions of Centroscymnus coelolepis and Deania calceus, though not for Centrophorus squamosus. These data highlight some important aspects of behavior of the species studying relation to fishing gears. Smaller C. coelolepis were selected by longlines than trawls, suggesting that smaller sharks were present at a considerable height above the seabed, out of reach of trawls, but attracted to baited hooks. In the case of D. calceus, larger females were selected by hooks, but were not present in trawl catches, possibly indicating their ability to escape towed gears. Trawl selectivity ogives were constructed for D. calceus and ogives for C. coelolepis and C. squamosus were simulated, using available data. Results suggest that longlines are not as selective for C. coelolepis as trawls. Selectivity ogives for D. calceus were similar in form, but longlines selected bigger individuals. Life history studies suggest that these species cannot sustain high fishing pressures. The implications of these results for the management of fisheries taking elasmobranchs are discussed.