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Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world. It causes substantial human health, social, and economic impacts. The illness produces a complex array of gastrointestinal, neurological and neuropsychological, and cardiovascular symptoms, which may last days, weeks, or months. This paper is a general review of CFP including the human health effects of exposure to ciguatoxins (CTXs), diagnosis, human pathophysiology of CFP, treatment, detection of CTXs in fish, epidemiology of the illness, global dimensions, prevention, future directions, and recommendations for clinicians and patients. It updates and expands upon the previous review of CFP published by Friedman et al. (2008) and addresses new insights and relevant emerging global themes such as climate and environmental change, international market issues, and socioeconomic impacts of CFP. It also provides a proposed universal case definition for CFP designed to account for the variability in symptom presentation across different geographic regions. Information that is important but unchanged since the previous review has been reiterated. This article is intended for a broad audience, including resource and fishery managers, commercial and recreational fishers, public health officials, medical professionals, and other interested parties.

This study showed a lower frequency of delayed graft function in kidneys from deceased donors who were randomly assigned to receive mild hypothermia than in those from donors assigned to normothermia. Delayed graft function, which is defined as the requirement for dialysis in the recipient within 7 days after renal transplantation, 1 results in increased health care expenditures and decreased long-term graft function. 2 – 6 Delayed graft function is reported in up to 50% of renal allografts recovered from donors after declaration of death according to neurologic criteria (brain-dead donors). 7 , 8 Randomized, controlled trials to study the effect of therapeutic hypothermic protection in donors on renal-graft function in transplant recipients are lacking. Therapeutic hypothermia, also termed targeted temperature management, is an established intervention that is used to protect neurologic function in patients with . . .

Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.

Hydric forest communities within the Tampa Bay Watershed were inventoried to assess the effect of urbanization on these systems. Based on aerial photography and site visits, 85 hydric plots were assigned a legacy class—remnant (forest, pre-1948), emergent (forest, post 1948), and managed (actively managed grass on plot). On each plot, diameter at breast height (dbh) and canopy width and species were recorded for trees ≥2.5 cm dbh. A hierarchical agglomerative cluster analysis identified community types within a legacy class and one-way AOV (α = .05) was used to compare structural features within and among legacy classes. Remnant plots (43 plots) were composed of six, natural community types as recognized by the Florida Natural Areas Inventory and no novel communities. Emergent plots (23 plots) were composed of four natural community types and one novel community. Managed plots (19 plots) contained only novel communities. Remnants had the highest species richness (41 species) and only one non-native species. Managed had the lowest species richness (33 species) but highest richness of non-native species (17). Remnant and emergent plots had similar densities for trees ≤32 cm dbh, (803 and 820 stems/ha, respectively), whereas managed plots had only 119 stems/ha. For trees >32 cm dbh, remnant plots had a significantly higher density (196 stems/ha) than emergent (99 stems/ha) and managed (40 stems/ha). These results suggest that legacy did not play a key role in differentiating between emergent and remnant plots but did play a key role in identifying managed plots.

The blood-brain barrier is essential to regulating the influx and efflux of biological substances between the blood and the brain. BBB is a highly selective and permeable structure composed of a basement membrane, endothelial cells, pericytes, and astrocyte end feet, protecting the brain from unwanted toxins and molecules while allowing essential nutrients to pass. Vector-borne diseases commonly spread to the central nervous system, presenting an array of neurological consequences. This study explores the mechanisms of how various pathogens cross the BBB and infect the CNS. This study analyzes cellular and molecular components of BBB which facilitate the dissemination of disease-causing pathogens. Here we looked at whether neurological conditions arising from vector-borne disease are due to induced or existing permeability of the BBB, or if a pathogen is able to cross an intact BBB. We hope to provide valuable insights informing the development of potential therapeutics capable of mitigation of infection sequelae or preventing the development of neurological conditions.

Child welfare agencies and family courts have long removed children from allegedly abusive or neglectful parents as an ultimate means of ensuring a child’s safety. The theory that high numbers of removals are necessary to keep children safe, however, had never been tested—there was no mechanism or political will to do so until the onset of the COVID-19 pandemic in March 2020. With the near-complete shutdown of New York City, the child welfare apparatus had no choice but to remove fewer children from their homes. Catastrophe did not ensue. Rather, the numbers tell a different story. Children remained safe across a range of metrics, avoided the trauma of removal from their homes during a global pandemic, and experienced sustained safety as the City began to reopen. This Piece argues that New York’s child welfare system must learn from COVID-19 and significantly curtail its drastic measure of removing children from their families, which can cause substantial, often irreparable trauma to children. It uses the COVID-19 pandemic as a case study to demonstrate the safety and soundness of reserving removals (also known as remands) for only the most extreme circumstances. This Piece focuses on the dramatic reduction of removals specifically during the pandemic; examines the traumatic, racially biased, and overused practice of family separation from a child’s perspective; and calls for specific reforms within the existing system to reduce remands while protecting children’s safety.

Human exposure to naturally occurring marine toxins has been associated with a range of neurobehavioral abnormalities. The toxins are produced by harmful algal blooms (HABs) and are typically contracted through seafood consumption. The primary target of many of the HAB toxins is the neurologic system, and the neurobehavioral symptoms associated with the HAB illnesses have influenced public health policy. The HAB-related illnesses most frequently linked to neuropsychological disturbance are Amnesic Shellfish Poisoning, Ciguatera Fish Poisoning, and Possible Estuarine Associated Syndrome, which is associated with exposure to the Pfiesteria piscicida organism. Although the neurophysiologic mechanisms underlying many of the HAB illnesses have been well delineated, the literature examining the neuropsychological impairments is unclear and needs to be defined. This review is intended to introduce an emerging area of study linking HAB illnesses with neuropsychological changes. (JINS, 2005, 11, 331–338.)

This study assessed the neuropsychological outcome of patients after surgical treatment for third ventricle brain tumors. Neuropsychological consequences of surgical intervention can have a major impact on patients' quality of life and therefore have important implications for treatment planning. A retrospective analysis of 33 patients' neuropsychological data was performed. All patients received a comprehensive neuropsychological evaluation after treatment for a primary brain tumor in the third ventricular region. Twenty-six patients underwent surgery, 14 via the transcallosal approach and 12 via a subfrontal, left transcortical, right pterional, or infratentorial supracerebellar approach. Seven patients were not treated by surgical intervention. There was a significantly elevated frequency of cognitive impairment relative to normative values in memory, executive functioning, and fine manual speed and dexterity. There were no differences in mean neuropsychological scores between patients who underwent surgery and those who did not. There were no differences in mean performance on the basis of surgical approach, tumor infiltration, or history of cranial irradiation. Repeated measures data available for two patients revealed memory impairment before and after surgery, and one patient experienced major improvement after surgery on a measure of mental flexibility and problem solving. Patients with third ventricle tumors are at risk for developing impairments in memory, executive function, and fine manual speed and dexterity, which are domains associated with frontal subcortical functions. In the current study, different types of treatment were not associated with differential cognitive sequelae, and surgical intervention did not account for cognitive deficits.

Natural communities near freshwater hydrological features provide important ecosystem functions and services. As human populations increase, forested landscapes become increasingly fragmented and deforested, which may result in a loss of the functions and services they provide. To investigate the current state of forested natural communities in the rapidly urbanizing Tampa Bay Watershed, this study examined a systematic random sample of fixed radius 0.04 hectare (0.10 acre) plots that were located within 15.2 meters of a hydrologie feature. These 85 plots were further stratified based on site legacy, and were categorized into three groups: remnant (43 plots), emergent (23 plots), and altered (19 plots). A hierarchical agglomerative cluster analysis identified plots that were most similar to one another within each group. These clusters were then compared to Florida Natural Area Inventory (FNAI) descriptions of natural community types. A high degree of clusters in the remnant and emergent groups resembled natural community types, but variations in species composition and dominance also occurred. However, zero clusters in the altered group resembled natural community types, suggesting anthropogenic changes to the landscape have impacted natural plant community assemblages. Findings from this study fill a gap in our current understanding of how natural communities in the Tampa Bay Watershed differ from those in a non-urban context.

Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.