Feeding preference and intraguild interactions between the parasitoid Trichogramma achaeae and the predator Macrolophus pygmaeus, two biological agents of Tuta absoluta.

BACKGROUND: Tuta absoluta is an exotic species and a major pest of tomato crops in Europe. Macrolophus pygmaeus and Trichogramma achaeae are two biocontrol agents widely used in integrated pest management programs of the South American tomato pinworm Tuta absoluta. In this study, we evaluated under laboratory conditions the (i) voracity of M. pygmaeus females fed on single diets of Tuta absoluta eggs parasitized or unparasitized by Trichogramma achaeae, (ii) voracity and feeding preference of M. pygmaeus females provided with mixed diets of Tuta absoluta eggs unparasitized and parasitized by Trichogramma achaeae and (iii) effect of competitive and intraguild interactions between M. pygmaeus and Trichogramma achaeae on the number of Tuta absoluta eggs consumed and/or parasitized. Lastly, we assessed under field conditions the effect of interspecific and intraspecific interactions between natural enemies on the number of Tuta absoluta eggs consumed and/or parasitized. RESULTS: Macrolophus pygmaeus consumed more unparasitized than parasitized eggs of Tuta absoluta. Under mixed diet regimes, Manly indices revealed a feeding preference for unparasitized eggs, and a decrease in the total number of eggs consumed, as the proportion of available parasitized eggs increased, whereas the unparasitized eggs were consumed in direct proportion to their availability. Conspecific interactions between M. pygmaeus, in contrast to Trichogramma achaeae, revealed the possible occurrence of intraspecific competition. For intraguild heterospecific interactions, the number of Tuta absoluta eggs consumed by M. pygmaeus and parasitized by Trichogramma achaeae was lower than that predicted for additive and non-interactive scenarios. Under field conditions, a significant difference between the conspecific treatment and heterospecific treatments revealed a slightly higher success rate in controlling Tuta absoluta when both M. pygmaeus and Trichogramma achaeae were used simultaneously. CONCLUSION: Macrolophus pygmaeus prefers unparasitized eggs of Tuta absoluta but inflicts intraguild predation on Trichogramma achaeae. In conspecific experiments, mutual interference between M. pygmaeus predators intensifies as the number of individuals increases, but for Trichogramma achaeae, it occurs in an unpredictable manner. Adding Trichogramma achaeae could significantly increase the level of control of Tuta absoluta compared to what could be achieved when only M. pygmaeus is present in glasshouse tomatoes. © 2023 Society of Chemical Industry.

Economic and financial model to the mass-rearing of Macrolophus pygmaeus (Rambur) (Heteroptera: Miridae), a biological control agent against the tomato moth Tuta absoluta (Meyrick) (Lepidoptera: Gelechiidae) in protected culture.

BACKGROUND: Tuta absoluta (Meyrick) is a major pest of tomato produced in glasshouses and open field, causing severe damages to crops, reducing the quality of tomato fruits. The current maintenance of the pest populations below the economic threshold is not achieved by natural and classical control, thus requiring the continuous application of biological control agents (BCAs), under an augmentative or inoculative approach. The present study aims to develop an economic and financial model to evaluate the commercial viability of a continuous mass production of Macrolophus pygmaeus (Rambur), a BCA commonly used against the tomato moth, Tuta absoluta, in protected culture. The estimations for our model were based on two approaches: the farm-level impact analysis and the benefit-cost analysis. RESULTS: The results of the farm-level analysis show that the adoption of a more sustainable biological control approach is profitable for farmers and the benefit-cost analysis provides evidence that the investment on a new factory dedicated to the mass rearing of M. pygmaeus to control tomato moth populations generates a positive net present value (NPV) of 7.2 million euros, corresponding to an internal rate of return (IRR) of 28.4% per year. CONCLUSION: Our results are in line with (i) the more recent European Commission proposals for a new Regulation on sustainable use of plant protection products, which includes the reduction of 50% the use and risk of chemical pesticides by 2030 and (ii) most of the existing literature which conclude that new projects on BCA production are worth investments. © 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

A roadmap for ladybird conservation and recovery.

Ladybirds (Coleoptera: Coccinellidae) provide services that are critical to food production, and they fulfill an ecological role as a food source for predators. The richness, abundance, and distribution of ladybirds, however, are compromised by many anthropogenic threats. Meanwhile, a lack of knowledge of the conservation status of most species and the factors driving their population dynamics hinders the development and implementation of conservation strategies for ladybirds. We conducted a review of the literature on the ecology, diversity, and conservation of ladybirds to identify their key ecological threats. Ladybird populations are most affected by climate factors, landscape composition, and biological invasions. We suggest mitigating actions for ladybird conservation and recovery. Short-term actions include citizen science programs and education, protective measures for habitat recovery and threatened species, prevention of the introduction of non-native species, and the maintenance and restoration of natural areas and landscape heterogeneity. Mid-term actions involve the analysis of data from monitoring programs and insect collections to disentangle the effect of different threats to ladybird populations, understand habitat use by taxa on which there is limited knowledge, and quantify temporal trends of abundance, diversity, and biomass along a management-intensity gradient. Long-term actions include the development of a worldwide monitoring program based on standardized sampling to fill data gaps, increase explanatory power, streamline analyses, and facilitate global collaborations.

Las catarinas (Coleoptera: Coccinellidae) proporcionan servicios que son críticos para la producción de alimento, y juegan un papel ecológico como fuente de alimento para depredadores. Sin embargo, la riqueza, abundancia y distribución de catarinas están en peligro debido a muchas amenazas antropogénicas. La carencia de conocimiento sobre el estatus de conservación de la mayoría de las especies y los factores que inciden en su dinámica poblacional dificulta el desarrollo e implementación de estrategias de conservación para las catarinas. Realizamos una revisión de la literatura sobre la ecología, diversidad y conservación de catarinas para identificar sus amenazas ecológicas clave. Las poblaciones de catarinas fueron afectadas mayormente por factores climáticos, composición del paisaje e invasiones biológicas. Proponemos acciones de mitigación para la conservación y recuperación de catarinas. Acciones a corto plazo incluyen programas de ciencia y educación ciudadana, medidas de protección para la recuperación de hábitat y de especies amenazadas, prevención de la introducción de especies no nativas y el mantenimiento y restauración de áreas naturales y la heterogeneidad del paisaje. Acciones a mediano plazo implican el análisis de datos obtenidos de programas de monitoreo y colecciones de insectos para desenmarañar el efecto de las diferentes amenazas a las poblaciones de catarinas, comprender el uso del hábitat por taxa de los que se tiene conocimiento limitado y cuantifica las tendencias temporales de la abundancia, diversidad y biomasa a lo largo de un gradiente de intensidad de manejo. Acciones a largo plazo incluyen el desarrollo de un programa de monitoreo a nivel mundial basado en muestreos estandarizados para subsanar la falta de datos, incrementar el poder explicativo, optimizar los análisis y facilitar colaboraciones globales.

Association of Newly Diagnosed Hypertension and Polypharmacy with Frailty in a Tertiary Hospital Patients from Maracaibo City, Venezuela.

BACKGROUND: As a syndrome of physiological vulnerability and multifactorial progressive decline tightly related to age, frailty has been associated with several illnesses, and in particular cardiovascular disease. OBJECTIVE: To assess the factors associated with the frailty syndrome in older adults evaluated in the outpatient clinic of a tertiary hospital from Maracaibo city, Venezuela. MATERIALS AND METHODS: An observational, analytical, cross-sectional study was performed on subjects of both genders, over 60 years old that went to the Internal Medicine outpatient clinic of the Hospital General del Sur "Dr. Pedro Iturbe" from Maracaibo city, Venezuela. Sampling was performed via a non-probabilistic, intentional method. For each subject with frailty or pre-frailty, a control subject was selected in a 1:1 ratio according to gender; several risk factors were interrogated. The state of frailty was determined through the FRAIL scale. RESULTS: Of the 201 assessed patients, 49.3% (n=99) were non-frail, 19.9% (n=40) were pre-frail and 30.8% (n=62) were frail. The population's overall age was 68.8±6.8 in non-frails, 69.1±7.7 in pre-frails, and 68.6±7.1 in frails. In the multivariate analysis, subjects with frailty and pre-frailty were most likely to be receiving polypharmacy (OR: 2.36, CI95%: 1.05-5.37; P=0.04) and have hypertension during the study (OR: 10.19, CI95%: 3.86-26.89; P<0.01). CONCLUSION: The newly diagnosed hypertension and presence of polypharmacy were the factors most associated with frailty and pre-frailty in older adults evaluated in a tertiary hospital from Maracaibo city, Venezuela.

An updated checklist of Azorean arthropods (Arthropoda).

Background: The Azores is a remote oceanic archipelago of nine islands which belongs to the Macaronesia biogeographical region hosting a unique biodiversity. The present Azorean landscape is strongly modified by the presence of man and only in small areas, where the soil or climate was too rough, have primitive conditions remained unchanged. Despite the fact that most of the Azorean native habitats are now lost, a large number of endemic species are still present and need urgent conservation. The present checklist of terrestrial and freshwater arthropods of the Azores Archipelago is based on all known published literature. The main goal of this work is to list, as rigorously as possible, all the known terrestrial and freshwater arthropods of the Azores. In this way, we are contributing to solve the 'Linnaean' shortfall, i.e. an incomplete taxonomic description of species-level diversity and the Wallacean Biodiversity Shortfall, the incomplete species distribution knowledge. New information: The checklist includes new records of arthropods at island and archipelago levels that were published in the last twelve years. Compared to the last checklist of Azorean arthropods (Borges et al. 2010b), a total of 217 taxa (species and subspecies) are added.Currently, the total number of terrestrial and freshwater arthropod species and subspecies in the Azores is estimated to be 2420 taxa belonging to 14 classes, 53 orders, 440 families, 1556 genera, 2400 species and 149 individual subspecies.The most diverse orders of Azorean arthropods are: Coleoptera (585 taxa), Diptera (423 taxa), Hemiptera (338 taxa), Hymenoptera (163 taxa), Lepidoptera (159 taxa) and Araneae (133 taxa).A total of 276 endemic taxa are currently known (232 species and 44 subspecies), belonging to eight classes and 22 orders. São Miguel, Terceira and Pico are the islands with higher number of endemic species and subspecies. In the Azores, the number of native non-endemic taxa is 793 taxa, totalling 1069 indigenous taxa. Compared to the other nearest Macaronesian archipelagos (Madeira and Canaries), the Azorean arthropod fauna is characterised by a lower percentage of endemism (endemics/indigenous: 26% in Azores, 47% in Madeira Archipelago and 42% in Canary Islands) and a high proportion of exotic introduced taxa (39% in Azores, 19% in Madeira Archipelago and 8% in Canary Islands).Based on recent IUCN Red-listing of Azorean arthropods, a large fraction of the endemic taxa is under high threat.

Diversity of Lepidoptera (Insecta) recorded in a forest nursery of Nordeste County on São Miguel Island (Azores).

Background: The diversity of moth species (Insecta, Lepidoptera) recorded in the forest nursery of Nordeste County on São Miguel Island (Azores) is given. Adults were sampled between March and December 2019 using three methods: (i) light trap to catch Noctuidae species, (ii) open-sided delta trap baited with a synthetic female sex pheromone lure to attract Epiphyaspostvittana (Walker) males and (iii) entomological net to collect microlepidopteran moths. This contribution focuses mainly on the diversity of moths present in one forest nursery of Nordeste County of São Miguel Island (Azores), especially on the species associated with endemic and native plant species. It also contributes to better plan strategies for integrated protection and conservation measures, since nurseries host a great diversity of plants from the Laurel Forest, which may attract many lepidopteran species. New information: A total of 10160 adults belonging to 33 lepidopteran species were recorded and listed by families, including: Argyresthiidae, one species (3%), Crambidae, four species (12%), Erebidae, one species (3%), Geometridae, five species (15%), Noctuidae, 18 species (55%), Sphingidae, one species (3%), Tineidae, one species (3%) and Tortricidae, two species (6%). The families Noctuidae, Geometridae and Crambidae were the most diverse. Those with the highest abundance of adults were the Noctuidae family, followed by the Geometridae, Crambidae, Tortricidae and Tineidae. The number of caught adults was consistently higher during spring and summer, decreasing sharply in late autumn. For 13 species caught in the light trap, the adult sex ratio was favourable to females. An analysis of the colonisation status, feeding and primary hosts of these endemic, native or exotic moth species contributes to our understanding of the factors that may lead to their establishment in Laurel Forest environments and to what extent there is a need to monitor and control them mainly with biological control agents.

An updated checklist to the biodiversity data of ladybeetles (Coleoptera: Coccinellidae) of the Azores Archipelago (Portugal).

BACKGROUND: A recently-published review from 2021 presents a comprehensive checklist of ladybeetles of Portugal, including the Azores and Madeira Archipelagos. Until then, the available information was very scattered and based on a single revision dating back to 1986, a few international catalogues and databases, individual records and studies on communities of agroecosystems. However, no information was available on faunal composition across the Azorean islands and their habitats, using standardised inventories. Here, we present data about the biodiversity of ladybeetles and their distribution and abundance in five Islands of the Azores (Faial, Graciosa, Pico, São Jorge and São Miguel). Surveys included herbaceous and arboreal habitats from native to anthropogenic-managed habitats: ruderal road vegetation, vegetable garden, mixed forest of endemic and non-native host plants, coastal prairies, coastal mixed vegetation, cornfields and urban areas. We aimed to contribute to the ongoing effort to document the terrestrial biodiversity of Portugal, including the Archipelago of the Azores, within the research project AZORESBIOPORTAL-PORBIOTA (ACORES-01-0145-FEDER-000072). NEW INFORMATION: In this study, a total of 1,487 specimens of Coccinellidae belonging to 19 species are reported for several habitats. The listed species are from one single sub-familiy (Coccinellinae) and six tribes; Chilocorini (one species), Coccidulini (three species), Coccinellini (six species), Noviini (one species), Scymnini (seven species), Stethorini (one species). The number of species collected per island differed; Faial (10 species), Graciosa (four species), Pico (seven species), São Jorge (seven species) and São Miguel (12 species). For six species, new island records are given. Currently, the number of species known to occur in the Azores are 32, including two doubtful records. The majority of species are Scymnini, being Scymnus (Scymnus) interruptus (Goeze, 1777) and Scymnus (Scymnus) nubilus Mulsant, 1850, the most abundant species (relative abundance 71.1%). This database will be the baseline of a long-term monitoring project allowing assessment of the impact of ongoing global changes in the distribution and abundance of ladybeetles.

An annotated checklist of ladybeetle species (Coleoptera, Coccinellidae) of Portugal, including the Azores and Madeira Archipelagos.

A comprehensive annotated checklist of the ladybeetle species of Portugal, including the Azores and Madeira archipelagos, is presented. The Coccinellidae fauna comprises a total of 101 species: 83 from the Mainland, 39 from Madeira, and 32 from the Azores. The listed species are distributed among 2 sub-families and 13 tribes: within the subfamily Microweiseinae, Madeirodulini (1 species), Serangiini (2 species), and within the subfamily Coccinellinae, Azyini (1 species), Chilocorini (4 species), Coccidulini (7 species), Coccinellini (30 species), Epilachnini (4 species), Hyperaspidini (7 species), Noviini (2 species), Platynaspini (1 species), Scymnini (37 species), Stethorini (3 species), and Sticholotidini (2 species). The Portuguese fauna comprises 10 exotic species: 5 present in the Mainland, 7 in Madeira, and 6 in the Azores. Harmoniaaxyridis (Pallas, 1773) from Madeira, Propyleaquatuordecimpunctata (Linnaeus, 1758) from the Azores, Delphastuscatalinae (Horn, 1895) from the Azores and Madeira, Nephus (Geminosipho) reunioni (Fürsch, 1974) and Nephus (Nephus) voeltzkowi Weise, 1910 from Madeira and Microserangium sp. from the Mainland, are reported for the first time. Some species are considered doubtful records, as explained in the text. These results were obtained by compiling information on the available literature regarding ladybeetle species on the Portuguese mainland and insular territories, and original data.

Transvaginal Resection of a Rectal Gastrointestinal Stromal Tumor: A Case Report.

Gastrointestinal stromal tumors (GISTs) are a type of mesenchymal tumors. They are rare in rectum. This location is a surgical challenge due to the high morbidity after aggressive surgeries. We present the case of an 81-year-old female with a high-grade GIST treated with transvaginal excision and adjunctive therapy with imatinib. The postoperative period was uneventful without anal dysfunction. Within the types of surgical treatment available, transvaginal excision is an acceptable procedure in lesions located in the rectovaginal region.

Costs and Benefits of Wax Production in the Larvae of the Ladybeetle Scymnus nubilus.

BACKGROUND: Larvae of the minute aphidophagous Scymnus nubilus Mulsant (Coleoptera: Coccinellidae) are common predators in apple orchards, covered by a wax layer that might act as a defense mechanism against natural enemies. However, the costs and benefits of protection conferred by wax remain to be assessed. We tested the following hypothesis: there is a trade-off in wax producing ladybeetles between the protection conferred by wax cover and the physiological or behavioral costs associated with its production. We predict that: (1) wax production is an efficient defensive mechanism (against intraguild predation), (2) wax production is associated with detrimental physiological (growth, reproduction) or behavioral effects (behavioral compensation: increased biomass consumption). RESULTS: Tests were carried out in the laboratory with wax and waxless larvae of S. nubilus, with and without lacewing larvae of Chrysoperla agilis (Neuroptera: Chrysopidae) being used as a potential intraguild predator of the coccinellid. Waxless individuals were more susceptible to intraguild predation by lacewing larvae. Adults originating from waxless larvae were lighter than the ones originating from wax larvae, suggesting a metabolic cost resulting from a constant need of wax production. Body-weight gain and conversion efficiency were lower in waxless larvae. Biomass consumption was similar, showing that waxless larvae did not compensate for the physiological cost by eating more aphid biomass. CONCLUSION: The results indicate the potential existence of a trade-off between growth and protection associated with wax production.

Hemoperitoneum secondary to mesenteric laceration after abdominal trauma - Case report.

Mesenteric laceration is an uncommon cause of hemoperitoneum, with nonspecific signs and symptoms and frequently is camouflaged by the signs of other traumatic lesions. There is a high risk to go unnoticed increasing morbidity and mortality. We report a case of a 43-year-old man, who was involved in a motorcycle accident, with thoraco-abdomino-pelvic trauma, but without evidence of intra-abdominal lesions on exams, with exception of hemoperitoneum. Due to hemodynamic instability, it was performed an exploratory laparotomy. Intraoperative findings were mesenteric lacerations affecting a small bowel segment. This case demonstrates that a high index of suspicion is necessary to diagnose and treat lesions like mesenteric laceration, not visible early on imaging but potentially fatal, with high risk of complications.

Standardised arthropod (Arthropoda) inventory across natural and anthropogenic impacted habitats in the Azores archipelago.

BACKGROUND: In this paper, we present an extensive checklist of selected arthropods and their distribution in five Islands of the Azores (Santa Maria. São Miguel, Terceira, Flores and Pico). Habitat surveys included five herbaceous and four arboreal habitat types, scaling up from native to anthropogenic managed habitats. We aimed to contribute to the ongoing effort to document the terrestrial biodiversity of the world, in particular the Portuguese archipelago of the Azores, as islands harbour a significant portion of unique terrestrial biodiversity. Selection of Arthropoda groups for the current checklist was based on their known richness and abundance (Arachnida, Collembola, Hemiptera, Neuroptera, Coleoptera, Hymenoptera), in almost all terrestrial ecosystems, as well as their importance in current Integrated Pest Management and alternative Biocontrol protocols at large (i.e. hymenopteran parasitoids and beneficial Coleoptera). In addition, we include the list of Dermaptera, Orthoptera, Psocoptera and Thysanoptera species. These assembled groups represent part of the monitoring programme EDEN Azores (2008-2014), where all Arthropod fauna, at all strata, within nine representative habitats of the abovementioned five Islands of the Azores was recorded. NEW INFORMATION: In this study, a total of 116,523 specimens, belonging to 483 species and subspecies of selected groups of arthropods, are reported by order, family and, when possible, genus and species. Hymenopteran, mostly parasitoids, accounted for the most represented taxa across all the monitoring and sampling phase of EDEN Azores (193 species and mophospecies), followed by Coleoptera (95 species); Collembola (89 species); and Araneae (72 species).A total of 37 non-native species are reported for the first time in the Azores. Coleoptera: Asaphidion flavipes (Linnaeus, 1761) (Carabidae); Tachyporus dispar (Paykull, 1789) (Staphylinidae). Hemiptera: Acrosternum heegeri Fieber, 1861 (Pentatomidae). Collembola: Entomobrya regularis Stach, 1963 (Entomobryidae); Lepidocyrtus lusitanicus piezoensis (Simón-Benito, 2007) (Entomobryidae); Jordanathrix articulata (Ellis, 1974) (Sminthuridae); Sminthurinus quadrimaculatus (Ryder, 1879) (Katiannidae); Himalanura sp. (Entomobryidae); Protophorura sp. (Onychiuridae). Hymenoptera, parasitoids: Aphidius colemani Viereck, 1912 (Braconidae); Aphidius ervi Haliday, 1834 (Braconidae); Aphidius matricariae Viereck, 1912 (Braconidae); Aphidius rhopalosiphi Stefani-Perez, 1902 (Braconidae); Aphidius rosae (Haliday, 1834) (Braconidae); Aphidius urticae Haliday, 1834 (Braconidae); Centistidea ectoedemiae Rohwer, 1914 (Braconidae); Meteorus unicolor (Wesmael, 1835) (Braconidae); Meteorus collaris (Spin.) Hal. - Ruschka, Fulmek, 1915 (Braconidae); Orthostigma cratospilum (Thomson, 1895) (Braconidae); Orthostigma latriventris Ratzeburg, 1844 (Braconidae); two other species of Orthostigma sp.; Pseudopezomachus bituberculatus (Marshall, 1905) (Braconidae); Tanycarpa punctata (van Achterberg, 1976) (Braconidae); Gonatopus clavipes (Thunberg, 1827) (Dryinidae). New genera not previously recorded for the Azores include: Pycnetron sp. (Chalcidoidea: Pteromalidae); four species of Aspilota sp. (Braconidae: Alysiinae); four species of Chorebus sp. (Braconidae: Aphidiinae: Alysiinae); Microgaster sp. (Braconidae: Microgastrinae); Homolobus sp. (Braconidae: Homolobinae); Lodbrokia sp. (Braconidae: Alysiinae).These 37 taxa were found in several Islands and five are new species for Flores Island, 10 species are new for Pico Island, 12 species are new for Terceira Island, 19 species are new for S. Miguel Island and five species are new for S. Maria Island.Additional species records for the Islands included: Flores (5 Collembola, 9 Araneae; 2 Hemiptera; 8 Coleoptera, 8 Hymenoptera), Pico (4 Collembola; 7 Araneae; 4 Hemiptera; 11 Coleoptera; 9 Hymenoptera), Terceira (4 Collembola; 1 Araneae; 3 Hymenoptera), S. Miguel (1 Araneae; 2 Coleoptera; 3 Hymenoptera), S. Maria (5 Collembola; 3 Araneae; 2 Hemiptera; 2 Hymenoptera).

Undiagnosed Risk of Obstructive Sleep Apnea in Obese Individuals in a Primary Health Care Context.

INTRODUCTION: Obstructive sleep apnea is a clinical entity that is associated with an increase in morbidity and mortality and it is estimated that it is significantly undiagnosed. The objective of this study was to assess the risk of undiagnosed obstructive sleep apneain obese individuals. MATERIAL AND METHODS: A descriptive and analytical cross-sectional study; the risk of obstructive sleep apnea's was assessed over a period of 11 months by applying the STOP-Bang questionnaire to all individuals who attended a family health unit who were aged ≥ 18 years and had body mass index of ≥ 30 kg/m2 and who had not yet been diagnosed with obstructive sleep apnea and agreed to participate; the risk of an undiagnosed moderate to severe obstructive sleep apnea was considered for any STOP-Bang score of ≥ 3. RESULTS: The risk of undiagnosed obstructive sleep apnea was assessed in 888 individuals (59.3% females) with an average age of 59.6 ± 14.68 years and a mean body mass index 33.6 ± 3.43 kg/m2; the mean STOP-Bang score was 3.5 ± 1.74, 70.9% scored ≥ 3; the frequency of all STOP-Bang questionnaire parameters was higher (p < 0.004) within the group with score ≥ 3. DISCUSSION: The studied population is one of the main strengths, since it is in obese people that the incidence of this disease is higher. There are some limitations related to this sample coming from a single family health unit, as well as the patients' follow-up being carried out throughout routine appointments for diseases that are closely related with obstructive sleep apnea. CONCLUSION: The level of underdiagnosis of obstructive sleep apnea's in obese individuals can be significantly high and a large proportion of them may have the disease at a moderate to severe stage; Family Physicians can have a very important role in screening and diagnosis.

Introdução: A apneia obstrutiva do sono é uma entidade clínica que condiciona aumento da morbimortalidade e estima-se que exista um elevado subdiagnóstico. Foi objetivo deste estudo avaliar o risco de apneia obstrutiva do sono não diagnosticada em indivíduos obesos. Material e Métodos: Estudo transversal descritivo e analítico; durante um período de 11 meses foi avaliado o risco de apneia obstrutiva do sono aplicando o questionário STOP-Bang a todos os indivíduos com idade ≥ 18 anos e índice de massa corporal ≥ 30 kg/m2 que frequentaram uma unidade de saúde familiar, sem o diagnóstico de apneia obstrutiva do sono e que aceitaram participar; considerou-se risco de apneia obstrutiva do sono não diagnosticada para score STOP-Bang ≥ 3. Resultados: Foi avaliado o risco de apneia obstrutiva do sono não diagnosticada em 888 indivíduos (59,3% do género feminino), com idade média de 59,6 ± 14,68 anos e índice de massa corporal médio de 33,6 ± 3,43 kg/m2; o score STOP-Bang médio foi de 3,5 ± 1,74, 70,9% apresentaram score ≥ 3; a frequência de todos os parâmetros do questionário STOP-Bang foi superior (p < 0,004) no grupo com score ≥ 3. Discussão: A população estudada é uma das principais forças, pois é nas pessoas obesas que a incidência dessa doença é maior. Existem algumas limitações relacionadas com a amostra ser de uma única unidade de saúde, bem como o seguimento dos pacientes ser por doenças relacionadas com a apneia obstrutiva do sono. Conclusão: O subdiagnóstico da apneia obstrutiva do sono nos indivíduos obesos pode ser muito elevado e uma grande parte destes pode apresentar doença moderada a grave; os médicos de Medicina Geral e Familiar podem ter um papel muito importante no rastreio e diagnóstico.

Evaluation of Scymnus nubilus (Coleoptera: Coccinellidae) as a biological control agent against Aphis spiraecola and Cinara juniperi (Hemiptera: Aphididae).

BACKGROUND: Aphids are a major insect pest of forestry systems. In this study, we evaluate the potential of the ladybeetle Scymnus nubilus Mulsant (Coleoptera: Coccinellidae) as a biological control agent against Aphis spiraecola Patch and Cinara juniperi (De Geer) (Hemiptera: Aphididae) infesting Azorean endemic plants reared in forestry nurseries. RESULTS: Aphis spiraecola, infesting Viburnum treleasei Gand. (Dipsacales: Adroxaceae), was the most abundant aphid; however, a higher proportion of Juniperus brevifolia (Seub.) Antoine (Pinales: Cupressaceae) was infested by C. juniperi. Scymnus nubilus fourth instar larvae were able to complete development on both aphid species. Voracity was significantly higher when S. nubilus was fed on A. spiraecola but biomass consumption was significantly lower. The relative growth rate and conversion efficiency of the fourth instar larvae were similar. Field experiments indicated that S. nubilus can contribute to the decrease in pest population densities. However, the fourth instar larvae proved to be more efficient when released onto A. spiraecola; this outcome can be attributed to the distribution patterns of the aphids on the host plant and to the aphid or host plant morphology. Predator density and sleeve cage effect are apparently critical factors in reaching an efficient control. CONCLUSION: The obtained results provide the essential preliminary information required to establish future programs of biological control against aphids infesting Azorean endemic plants. Developmental and feeding performances, as well as the immediate impact of the predator when released onto A. spiraecola colonies, indicate that S. nubilus could be a useful candidate for reducing aphid populations. © 2019 Society of Chemical Industry.

Chimeric NANOG repressors inhibit glioblastoma growth in vivo in a context-dependent manner.

Targeting stemness promises new therapeutic strategies against highly invasive tumors. While a number of approaches are being tested, inhibiting the core transcription regulatory network of cancer stem cells is an attractive yet challenging possibility. Here we have aimed to provide the proof of principle for a strategy, previously used in developmental studies, to directly repress the targets of a salient stemness and pluripotency factor: NANOG. In doing so we expected to inhibit the expression of so far unknown mediators of pro-tumorigenic NANOG function. We chose NANOG since previous work showed the essential requirement for NANOG activity for human glioblastoma (GBM) growth in orthotopic xenografts, and it is apparently absent from many adult human tissues thus likely minimizing unwanted effects on normal cells. NANOG repressor chimeras, which we name NANEPs, bear the DNA-binding specificity of NANOG through its homeodomain (HD), and this is linked to transposable human repressor domains. We show that in vitro and in vivo, NANEP5, our most active NANEP with a HES1 repressor domain, mimics knock-down (kd) of NANOG function in GBM cells. Competition orthotopic xenografts also reveal the effectiveness of NANEP5 in a brain tumor context, as well as the specificity of NANEP activity through the abrogation of its function via the introduction of specific mutations in the HD. The transcriptomes of cells expressing NANEP5 reveal multiple potential mediators of pro-tumorigenic NANEP/NANOG action including intercellular signaling components. The present results encourage further studies on the regulation of context-dependent NANEP abundance and function, and the development of NANEP-based anti-cancer therapies.

Long-Lasting WNT-TCF Response Blocking and Epigenetic Modifying Activities of Withanolide F in Human Cancer Cells.

The WNT-TCF signaling pathway participates in adult tissue homeostasis and repair, and is hyperactive in a number of human diseases including cancers of the colon. Whereas to date there are no antagonists approved for patient use, a potential problem for their sustained use is the blockade of WNT signaling in healthy tissues, thus provoking potentially serious co-lateral damage. Here we have screened a library of plant and microorganism small molecules for novel WNT signaling antagonists and describe withanolide F as a potent WNT-TCF response blocker. This steroidal lactone inhibits TCF-dependent colon cancer xenograft growth and mimics the effects of genetic blockade of TCF and of ivermectin, a previously reported WNT-TCF blocker. However, withanolide F is unique in that it imposes a long-lasting repression of tumor growth, WNT-TCF targets and cancer stem cell clonogenicity after drug treatment. These findings are paralleled by its modulation of chromatin regulators and its alteration of overall H3K4me1 levels. Our results open up the possibility to permanently repress essential signaling responses in cancer cells through limited treatments with small molecules.

[Efficacy of the Vaccines Against Human Papillomavirus in Women Older than 24 Years in the Cervix Cancer Prevention]. / Eficácia das Vacinas Contra o Vírus do Papiloma Humano nas Mulheres com mais de 24 Anos na Prevenção do Cancro do Colo do Útero.

INTRODUCTION: Cervix cancer is the fourth most common female cancer and the second most frequent in women aged 15 to 44 years. The infection by the human papillomavirus is a necessary condition in almost all of cervix cancer cases; it is a sexually transmitted disease and all women sexually active are at risk of being infected. There are currently three vaccines against human papillomavirus, and despite of the efficacy being well proven in woman aged up to 25 years, it is not well established in older ages. MATERIAL AND METHODS: It was performed a literature review of the current evidence about the efficacy of the vaccines against human papillomavirus in women older than 24 years in the cervix cancer prevention, and was assessed the evidence quality by the GRADE system. RESULTS: Two randomized controlled trials were identified with a total of 9,571 participants - 4,792 vaccinated and 4,779 at the control group and reported data of 48 months period follow-up. The relative risk reduction was 41% (95% CI: 29 a 50%) - for the vaccinated group. There were no differences in safety and tolerability between the two groups - vaccine and control. CONCLUSION: The actual evidence shows that the vaccines against human papillomavirus 16 and/or 18 in women older than 24 until 45 years have an important efficacy at reducing the risk of having persistent infection and/or to acquire cervix cancer precursor lesions.

Introdução: O cancro do colo do útero é o quarto tipo de cancro feminino mais comum e o segundo mais frequente nas mulheres entre os 15 e os 44 anos. A infeção pelo vírus do papiloma humano é condição necessária na quase totalidade dos casos de cancro do colo do útero; trata-se de uma doença sexualmente transmissível e todas as mulheres sexualmente ativas estão em risco de contrair infeção. Atualmente existem três vacinas contra o vírus do papiloma humano, e apesar da sua eficácia estar bem comprovada nas mulheres até aos 25 anos, não está totalmente estabelecida em idades superiores.Material e Métodos: Realizou-se uma revisão da literatura sobre a evidência atual relativa à eficácia das vacinas contra o vírus do papiloma humano nas mulheres com mais de 24 anos na prevenção do cancro do colo do útero e foi avaliada a qualidade da evidência segundo o sistema GRADE.Resultados: Foram identificados dois estudos controlados randomizados relevantes para a análise que envolveram um total de 9 571 participantes ­ 4 792 no grupo vacinado e 4 779 no grupo controlo ­ e reportaram dados relativos a 48 meses de follow-up. A redução do risco relativo foi de 41% (95% CI: 29 a 50%), ­ favorável para o grupo vacinado. Não existiram diferenças entre a segurança e tolerabilidade das vacinas nos grupos vacina e controlo.Conclusão: A evidência atual demonstra que as vacinas contra o vírus do papiloma humano 16 e/ou 18 nas mulheres com mais de 24 e até aos 45 anos apresentam uma eficácia importante na redução do risco de desenvolver infeção persistente e/ou adquirir lesões precursoras de cancro do colo do útero.

The river blindness drug Ivermectin and related macrocyclic lactones inhibit WNT-TCF pathway responses in human cancer.

Constitutive activation of canonical WNT-TCF signaling is implicated in multiple diseases, including intestine and lung cancers, but there are no WNT-TCF antagonists in clinical use. We have performed a repositioning screen for WNT-TCF response blockers aiming to recapitulate the genetic blockade afforded by dominant-negative TCF. We report that Ivermectin inhibits the expression of WNT-TCF targets, mimicking dnTCF, and that its low concentration effects are rescued by direct activation by TCF(VP16). Ivermectin inhibits the proliferation and increases apoptosis of various human cancer types. It represses the levels of C-terminal ß-CATENIN phosphoforms and of CYCLIN D1 in an okadaic acid-sensitive manner, indicating its action involves protein phosphatases. In vivo, Ivermectin selectively inhibits TCF-dependent, but not TCF-independent, xenograft growth without obvious side effects. Analysis of single semi-synthetic derivatives highlights Selamectin, urging its clinical testing and the exploration of the macrocyclic lactone chemical space. Given that Ivermectin is a safe anti-parasitic agent used by > 200 million people against river blindness, our results suggest its additional use as a therapeutic WNT-TCF pathway response blocker to treat WNT-TCF-dependent diseases including multiple cancers.

Câncer colorretal em pacientes jovens / Colorectal carcinoma in young patients

Introdução: O câncer colorretal costuma ser pouco frequente em indivíduos abaixo dos 50 anos, persistindo ainda controvérsias quanto ao seu comportamento e prognóstico. Objetivo: Avaliar as características epidemiológicas, clínicas, histopatológicas e terapêuticas de pacientes com câncer colorretal, comparando os grupos de faixa etária até 50 anos e idade superior a 50 anos. Método: Trata-se de um estudo descritivo, em que foram analisados prontuários de 505 pacientes com câncer colorretal, atendidos de janeiro de 1998 a dezembro de 2008. Parâmetros clínicos e histopatológicos foram coletados. Resultados: Os indivíduos com idade até 50 anos corresponderam a 26,53 por cento da amostra e não houve predileção por gênero. Alteração no hábito intestinal como queixa inicial e anemia ao exame físico foram significativamente mais comuns no grupo mais jovem. Os pacientes até 50 anos exibiram também estadiamento linfonodal mais avançado, maior ocorrência de carcinoma espinocelular ou neuroendócrino e pior diferenciação histopatológica, bem como maior recorrência local, apesar de maior índice de tratamento cirúrgico e quimioterápico. Conclusão: O câncer colorretal em pacientes com idade até 50 anos mostrou-se mais agressivo e indiferenciado. As queixas, mesmo dos pacientes jovens, devem ser prontamente investigadas, a fim de possibilitar o diagnóstico precoce e maior chance de cura ao paciente com câncer colorretal.