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INTRODUCTION: One of the most common complications of the surgical treatment of breast cancer is limited range-of-motion in the shoulder. Scapular winging is one of the most underdiagnosed shoulder mobility impairments. OBJECTIVE: The main objective of this study was to determine the incidence of scapular winging in patients who underwent breast cancer surgery as the basis for expanding the protocol to patients who have had a sentinel lymph node biopsy. The secondary objective was to determine the risk factors that lead to the development of a winged scapula presented after breast cancer treatment in our sample. METHODS: This was a prospective, observational, and multidisciplinary study. Between 2013 and 2018, 214 consecutive patients who had been diagnosed with breast cancer and treated for it surgically were followed by Rehabilitation Department for 3 years. The patients were evaluated in the 1st, 6th, 12th, 18th, 24th and 36th months following surgery. Scapular winging was evaluated at each visit by means of static and dynamic tests. RESULTS: The cumulative incidence of scapular winging was 3.6% and seven cases of winged scapula were diagnosed. All the cases were diagnosed at the first visit, 1 month after the intervention. In the univariate analysis, the axillary lymph node dissection technique was a more significant risk factor for a winged scapula than sentinel lymph node biopsy. CONCLUSIONS: The axillary lymph node dissection technique is a risk factor for developing a winged scapula. No evidence was found for any other significant risk factor.

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Sediments can be natural archives to reconstruct the history of pollutant inputs into coastal areas. This is important to improve management strategies and evaluate the success of pollution control measurements. In this work, the vertical distribution of organochlorine pesticides (DDTs, Lindane, HCB, Heptachlor, Aldrin and Mirex) was determined in a sediment core collected from the Gulf of Batabanó, Cuba, which was dated by using the (210)Pb dating method and validated with the (239,240)Pu fallout peak. Results showed significant changes in sediment accumulation during the last 40 years: recent mass accumulation rates (0.321 g cm(-2) yr(-1)) double those estimated before 1970 (0.15 g cm(-2) yr(-1)). This change matches closely land use change in the region (intense deforestation and regulation of the Colon River in the late 1970s). Among pesticides, only DDTs isomers, Lindane and HCB were detected, and ranged from 0.029 to 0.374 ng g(-1) dw for DDTs, from<0.006 to 0.05 ng g(-1) dw for Lindane and from<0.04 to 0.134 ng g(-1) dw for HCB. Heptachlor, Aldrin and Mirex were below the detection limits (∼0.003 ng g(-1)), indicating that these compounds had a limited application in the Coloma watershed. Pesticide contamination was evident since the 1970s. DDTs and HCB records showed that management strategies, namely the banning the use of organochlorine contaminants, led to a concentration decline. However, Lindane, which was restricted in 1990, can still be found in the watershed. According to NOAA guidelines, pesticides concentrations encountered in these sediments are low and probably not having an adverse effect on sediment dwelling organisms.

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The vertical activity distribution and inventories of (239+240)Pu profile and Hg were determined in Sagua la Grande estuary, Cuba. The shape of the (239+240)Pu profile in the core column resembled very closely the history of atmospheric nuclear weapons' testing, and the maximum deposition in 1963 was recorded in the sediment core history. The (239+240)Pu activity concentrations in the surface layer sediments varied from 0.163 to 0.611 mBq g(-1). The inventory of (239+240)Pu was 42 ± 5.6 Bq m(-2), a value close to that expected from direct global fallout. Using the (239+240)Pu as a chronomarker the mass sedimentation rate in the area for the last 60 years was calculated, reaching values of 0.173 g cm(-2) y(-1). The mercury profile reflects the history of anthropogenic pollution in the estuary and perfectly describes the operation of the mercury-cell chlor-alkali plant, for production of NaOH, which began operations in 1980. The inventory of Hg was 2.42 ± 0.19 µg cm(-2). These results contribute to the scarce regional database for pollutants and anthropogenic radionuclides in the Caribbean marine environment, particularly in relation to (239+240)Pu.

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Since 1998 the highly polluted Havana Bay ecosystem has been the subject of a mitigation program. In order to determine whether pollution-reduction strategies were effective, we have evaluated the historical trends of pollution recorded in sediments of the Bay. A sediment core was dated radiometrically using natural and artificial fallout radionuclides. An irregularity in the (210)Pb record was caused by an episode of accelerated sedimentation. This episode was dated to occur in 1982, a year coincident with the heaviest rains reported in Havana over the XX century. Peaks of mass accumulation rates (MAR) were associated with hurricanes and intensive rains. In the past 60 years, these maxima are related to strong El Niño periods, which are known to increase rainfall in the north Caribbean region. We observed a steady increase of pollution (mainly Pb, Zn, Sn, and Hg) since the beginning of the century to the mid 90 s, with enrichment factors as high as 6. MAR and pollution decreased rapidly after the mid 90 s, although some trace metal levels remain high. This reduction was due to the integrated coastal zone management program introduced in the late 90 s, which dismissed catchment erosion and pollution.

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The vertical distribution of Hg and Pb were determined in a sediment core collected from the Sagua estuary (North Cuba) that receives input from the Sagua river, one of the most polluted rivers discharging into the Cuban coastal environment. Depth profiles of metal concentrations were converted to time-based profiles using the (210)Pb dating method and confirmed with the (137)Cs fallout peak. The mean mass accumulation rate was estimated to be 0.17+/-0.04 g cm(-2)y(-1) (mean sediment accumulation rate 0.52+/-0.13 cm y(-1)) and the core bottom was estimated to date back about 130 years. The historical sedimentary record showed a strong enrichment of mercury concentrations in the past decades, caused by the incomplete treatment of industrial wastes from a chlor-alkali plant with mercury-cell technology in the Sagua river basin. Lead fluxes to sediments showed a gradual increase from the 1920s to present, which agrees with a population increase in Sagua la Grande City. Fluxes of both metals have increased the past 25 years, with values reaching a maximum of 0.5 and 3.9 microg cm(-2)y(-1) for Hg and Pb, respectively.

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Levels of 137Cs in total atmospheric deposition have been measured in the Cienfuegos region (Cuba) between 1994 and 2002. Samples were collected every three months, evaporated to dryness to obtain residual samples, and measured by gamma spectrometry. The 137Cs mean concentration in total deposition was 0.24 Bq m(-2) and data ranged between < 0.05 and 0.62 Bq m(-2). Precipitation rates and raintime have proved to be the most important factors controlling the concentration and depositional flux of 137Cs in the atmosphere over Cienfuegos, showing a high correlation coefficient (R = 0.93).

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Levels of 137Cs and 7Be in aerosols have been measured in the region of Cienfuegos (Cuba) during the period 1994-1998. 137Cs showed the same seasonal trend as 7Be and the monthly regimes of precipitation seemed to be responsible for the observed pattern. The 137Cs/7Be ratio obtained in Cienfuegos and Miami (FL) in this period was used to calibrate the long-term database of 137Cs concentrations recorded in Miami (250 km from Cienfuegos). The database was then employed to reconstruct the 137Cs monthly concentrations in Cienfuegos since 1957.

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One part of Radiological Monitoring Programme in central Cuba (1991-1995) was dedicated to study the background levels of natural and anthropogenic radioactivity in Cienfuegos Bay in the vicinity of the first Cuban nuclear power station under construction. 210Po and 137Cs concentrations in fish, molluscs and crustaceans collected in Cienfuegos Bay were determined and the committed effective doses (CED) were calculated for two population groups inhabiting this region. The highest values of 210Po concentrations were found in crustaceans, but significant accumulation was also observed in fish and molluscs. The mean 137Cs concentrations in organisms are several times lower with respect to 210Po, a situation that characterises the regions affected by the global fallout only. Values of CED from the consumption of crustaceans and molluscs are very low both from 210Po and 137Cs. The mean individual dose from 210Po in the seafood consumed varies from 39 microSv for general populations to 2802 microSv for the "critical group" consuming 320 kg of fish per year. The dose from 137Cs is negligible.

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During the past decade, interpersonal violence increasingly has become a public health concern. As a result, prevention programs now aim to decrease violence among diverse populations. This article describes the beliefs and rationale for gender-based violence among a cohort of low-income, predominantly second-generation, mainland Puerto Rican adolescents. Based on a three-year (1989-91) ethnographic study, the findings describe how these young people, through the use of gender-based social constructs such as "machos" and "sluts," justify violence by linking it to beliefs about gender roles, sexuality, and biology, and thus perpetuate gender-role conformity, particularly heterosexual male dominance. The findings suggest that if the public health community is going to reduce gender-based violence among Puerto Rican youth, it needs to acknowledge that gender and sexuality are important ingredients that support violence and avoid a simplified and stereotypical model of culture that ignores other social factors and changes in traditional Latino gender roles.

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The dopaminergic and antioxidant properties of pukateine [(R)-11-hydroxy-1,2-methylenedioxyaporphine, PUK], a natural aporphine derivative, were analyzed in the rat central nervous system. At dopamine (DA) D1 ([3H]-SCH 23390) and D2 ([3H]-raclopride) binding sites, PUK showed IC50 values in the submicromolar range (0.4 and 0.6 microM, respectively). When the uptake of tritiated dopamine was assayed by using a synaptosomal preparation, PUK showed an IC50 = 46 microM. In 6-hydroxydopamine unilaterally denervated rats, PUK (8 mg/kg but not 4 mg/kg) elicited a significant contralateral circling, a behavior classically associated with a dopaminergic agonist action. When perfused through a microdialysis probe inserted into the striatum, PUK (340 microM) induced a significant increase in dopamine levels. In vitro experiments with a crude rat brain mitochondrial suspension showed that PUK did not affect monoamine oxidase activities, at concentrations as high as 100 microM. PUK potently (IC50 = 15 microM) and dose-dependently inhibited the basal lipid peroxidation of a rat brain membrane preparation. As a whole, PUK showed a unique profile of action, comprising an increase in extracellular DA, an agonist-like interaction with DA receptors, and antioxidant activity. Thus, PUK may be taken as a lead compound for the development of novel therapeutic strategies for Parkinson disease.

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