The fungicide azoxystrobin causes histopathological and cytotoxic changes in the midgut of the honey bee Apis mellifera (Hymenoptera: Apidae).

Apis mellifera is an important bee pollinating native and crop plants but its recent population decline has been linked to the use of pesticides, including fungicides that have been commonly classified as safe for bees. However, many pesticides, in addition to direct mortality cause sublethal effects, including damage to target selective honey bee organs. The midgut is the organ responsible for the digestion and absorption of nutrients and the detoxification of ingested substances, such as pesticides. This study evaluated the histopathological and cytotoxic changes in the midgut of A. mellifera workers caused by the pesticide azoxystrobin. The limit-test was performed, and a 100 µg a.i./bee dose was administered orally and midgut analyzed with light and transmission electron microscopies after 24 h and 48 h of pesticide exposure. The midgut of the control bees has a single layer of digestive cells, with spherical nuclei, nests of regenerative cells, and the lumen coated with the peritrophic matrix. The bees fed on azoxystrobin showed morphological changes, including intense cytoplasm vacuolization and cell fragments released into the gut lumen. The protein detection test showed greater staining intensity in the nests of regenerative cells after 24 h of exposure to azoxystrobin. The occurrence of damage to the midgut in A. mellifera exposed to azoxystrobin indicates that although this fungicide has been classified as low toxicity for bees, it has sublethal effects in the midgut, and effects in other organs should be investigated.

Side-effects of pesticides on non-target insects in agriculture: a mini-review.

Climate change mediated by anthropogenic activity induces significant alterations on pest abundance and behavior and a potential increase in the use of agrochemicals for crop protection. Pesticides have been a tool in the control of pests, diseases, and weeds of agricultural systems. However, little attention has been given to their toxic effects on beneficial insect communities that contribute to the maintenance and sustainability of agroecosystems. In addition to pesticide-induced direct mortality, their sublethal effects on arthropod physiology and behavior must be considered for a complete analysis of their impact. This review describes the sublethal effects of pesticides on agriculturally beneficial insects and provides new information about the impacts on the behavior and physiology of these insects. The different types of sublethal effects of pesticides used in agriculture on pollinators, predators, parasitoids, and coprophagous insects were detailed.

Protein and volatile contents in the mandibular gland of the sugarcane borer Diatraea saccharalis (Lepidoptera: Crambidae).

The sugarcane borer Diatraea saccharalis (Lepidoptera: Crambidae) is an important sugarcane pest and mechanical injuries caused through the mandibles can allow pathogen infections. The mandibles of D. saccharalis, as well as other insects, are associated with mandibular glands with a possible function in food intake and mouthparts lubrication; however, the chemical composition of the secretion is poorly known and its elucidation is important for the comprehensive understanding of plant-insect interactions. This study characterized some proteins and volatiles in the mandibular glands of D. saccharalis larvae. MALDI-TOF/TOF mass spectrometry allowed the identification of 24 predicted proteins within 10 functional classes, including the transport and metabolism of carbohydrates, lipids, amino acids, and nucleotides; Posttranslational protein modifications; energy conversion; intracellular trafficking; transcription; translation; and cytoskeleton function. Metabolites identified from GC/MS analysis revealed the presence of hydrocarbons classified as alcohols, ether, alkanes, and esters with differences in their relative abundance. Linolenic acid, the most abundant metabolite found in this gland, when conjugated with amino acids, can be an elicitor in the plant-herbivore interaction. The results suggest the occurrence of digestive and defensive biochemical components, which may contribute to understanding of the multifunctional roles of the mandibular gland secretion of D. saccharalis larvae during feeding activity.

A new analytical model for the response curve in megavoltage photon beams of the radiochromic EBT3 films measured with flatbed scanners.

PURPOSE: The aim of this work is to study a new analytical model which describes the dose-response curve in megavoltage photon beams of the radiochromic EBT3 film measured with two commercially available flatbed scanners. This model takes into account the different increase of the number of two types of absorbents in the film with absorbed dose and it allows to identify parameters that depend on the flatbed scanner and the film model, and parameters that exclusively depend on the production lot. In addition, the new model is also compared with other models commonly used in the literature in terms of its performance in reducing systematic calibration uncertainties. METHODS AND MATERIALS: The new analytical model consists on a linear combination of two saturating exponential functions for every color channel. The exponents modeling the growing of each kind of absorbent are film model and scanner model-dependent, but they do not depend on the manufacturing lot. The proposed model considers the different dose kinetics of each absorbent and the apparent effective behavior of one of the absorbents in the red color channel of the scanner. The dose-response curve has been measured using EBT3 films, a percentage depth dose (PDD) calibration method in a dose range between 0.5 and 25 Gy, and two flatbed scanners: a Microtek 1000 XL and an EPSON 11000 XL. The PDD calibration method allows to obtain a dense collection of calibration points which have been fitted to the proposed response curve model and to other published models. The fit residuals were used to evaluate the performance of each model compared with the new analytical model. RESULTS: The model presented here does not introduce any systematic deviations up to the degree of accuracy reached in this work. The residual distribution is normally shaped and with lower variance than the distributions of the other published models. The model separates the parameters reflecting specific characteristics of the dosimetry system from the linear parameters which depend only on the production lot and are related to the relative abundance of each type of absorbent. The calibration uncertainty is reduced by a mean factor of two by using this model compared with the other studied models. CONCLUSIONS: The proposed model reduces the calibration uncertainty related to systematic deviations introduced by the response curve. In addition, it separates parameters depending on the flatbed scanner and the film model from those depending on the production lot exclusively and therefore provides a better characterization of the dosimetry system and increases its reliability.

Imidacloprid-mediated alterations on the salivary glands of the Neotropical brown stink bug, Euschistus heros.

The management of the Neotropical brown stinkbug Euschistus heros (Hemiptera: Pentatomidae) in soybean fields has been heavily dependent on the application of neonicotinoid insecticides. Neonicotinoids act primarily by impairing the function of the nicotinic acetylcholine receptors of the nervous system. These compounds also target specific organs (e.g., salivary glands), which may potentiate their insecticidal efficacy. Here, we evaluated whether the exposure to the neonicotinoid imidacloprid would cause cytomorphological changes in the salivary glands of E. heros. First, we determined the lethal concentrations (LCs) of imidacloprid through contact and ingestion. Subsequently, the cytomorphology of the salivary glands were evaluated in insect groups that survived exposure to the LC5 (3.75 mg a.i./L), LC50 (112.5 mg a.i./L), or LC75 (375.0 mg a.i./L, equivalent to the recommended field rate) doses. Imidacloprid induced apoptosis and necrosis in the salivary gland cells according to the insecticide concentration and salivary gland region. All concentrations increased apoptosis and injured cells (e.g., vacuolization, chromatin condensation, swelling of organelles, and plasma membrane rupture) in the principal and accessory salivary glands. Individuals that survived exposure to the highest concentrations (i.e., LC5 and LC50) were more affected, and exhibited several necrotic cells on their main principal salivary glands. Collectively, our results indicate that imidacloprid exerts toxic effects on the non-target organs, such as the salivary glands, which increases the efficacy of this compound in the management of stink bug infestations.

Morphology and composition of the midgut bacterial community of Scaptocoris castanea Perty, 1830 (Hemiptera: Cydnidae).

The burrower bug Scaptocoris castanea is an important soybean and pasture pest in Brazil, with an underground habit feeding directly on the sap of the roots. Underground habit hinders control and knowledge of the biology and physiology of this pest. This study describes the anatomy, histology, ultrastructure and symbionts of the midgut of S. castanea. The midgut of S. castanea is anatomically divided into five regions (ventricles). Ventricles 1-3 are similar between males and females, with cells specialized in digestion and absorption of nutrients, water transport and homeostasis. Ventricle 4 has squamous epithelium forming crypts and harboring bacteria in the lumen. Ventricle 5 of males is small with cells containing apical microvilli and broad basal folds with many openings for hemocoel, while in females, this region of the midgut is well developed and colonized by intracellular bacteria, characterizing bacteriocytes. The main bacteria are Gammaproteobacteria. The results show sexual dimorphism in ventricle 5 of the midgut of S. castanea, with formation of bacteriocytes in the females, while the other regions are involved in digestive processes in both sexes.

Occurrence of virus, microsporidia, and pesticide residues in three species of stingless bees (Apidae: Meliponini) in the field.

Bees are important pollinators whose population has declined due to several factors, including infections by parasites and pathogens. Resource sharing may play a role in the dispersal dynamics of pathogens among bees. This study evaluated the occurrence of viruses (DWV, BQCV, ABPV, IAPV, KBV, and CBPV) and microsporidia (Nosema ceranae and Nosema apis) that infect Apis mellifera, as well as pesticide residues in the stingless bees Nannotrigona testaceicornis, Tetragonisca angustula, and Tetragona elongata sharing the same foraging area with A. mellifera. Stingless bees were obtained from 10 nests (two of N. testaceicornis, five of T. angustula, and three of T. elongata) which were kept in the field for 1 year and analyzed for the occurrence of pathogens. Spores of N. ceranae were detected in stingless bees but were not found in their midgut, which indicates that these bees are not affected, but may be vectors of the microsporidium. Viruses were found in 23.4% of stingless bees samples. APBV was the most prevalent virus (10.8%) followed by DWV and BQCV (both in 5.1% of samples). We detected glyphosate and its metabolites in small amounts in all samples. The highest occurrence of N. ceranae spores and viruses was found in autumn-winter and may be related to both the higher frequency of bee defecation into the colony and the low food resources available in the field, which increases the sharing of plant species among the stingless bees and honey bees. This study shows the simultaneous occurrence of viruses and spores of the microsporidium N. ceranae in asymptomatic stingless bees, which suggest that these bees may be vectors of pathogens.

The fungicide iprodione affects midgut cells of non-target honey bee Apis mellifera workers.

The honey bee Apis mellifera is an important pollinator of agricultural crops and natural forests. Honey bee populations have declined over the years, as a result of diseases, pesticides, and management problems. Fungicides are the main pesticides found in pollen grains, which are the major source of protein for bees. The objective of this study was to evaluate the cytotoxic effects of the fungicide iprodione on midgut cells of adult A. mellifera workers. Bees were fed on iprodione (LD50, determined by the manufacturer) for 12 or 24 h, and the midgut was examined using light and transmission electron microscopies. The expression level of the autophagy gene atg1 was assessed in midgut digestive cells. Cells of treated bees had signs of apoptosis: cytoplasmic vacuolization, apical cell protrusions, nuclear fragmentation, and chromatin condensation. Ultrastructural analysis revealed some cells undergoing autophagy and necrosis. Expression of atg1 was similar between treated and control bees, which can be explained by the facts that digestive cells had autolysosomes, whereas ATG-1 is found in the initial phases of autophagy. Iprodione acts by inhibiting the synthesis of glutathione, leading to the generation of reactive oxygen species, which in turn can induce different types of cell death. The results indicate that iprodione must be used with caution because it has side effects on non-target organisms, such as pollinator bees.

Side effects of Bacillus thuringiensis on the parasitoid Palmistichus elaeisis (Hymenoptera: Eulophidae).

The endoparasitoid wasp Palmistichus elaeisis Delvare & LaSalle (Hymenoptera: Eulophidae) is used to control defoliating lepidopteran pests. Chemical insecticides are not compatible with natural enemies, but bioinsecticides, such as Bacillus thuringiensis Berliner (Bt), have great potential for use in integrated pest management. However, interactions between Bt and P. elaeisis still need to be investigated. This study aimed to evaluate the effects of Bt on parental and first-generation P. elaeisis parasitizing Bt-susceptible and -resistant Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae). An additional aim was to determine the toxicity of Bt to susceptible third-instar S. frugiperda larvae. Larvae were exposed to lethal concentrations (LC50 and LC90) of Bt and then allowed to be parasitized by P. elaeisis. Parasitoid longevity, immature production, reproductive performance, and behavioral responses were evaluated. Bt repelled P. elaeisis and reduced immature production. Parental and first filial generation parasitoids of both sexes emerged from Bt-treated larvae showed lower survivorship than controls. Parasitoids had poorer reproductive performance in Bt-susceptible and -resistant pupae than in untreated pupae. Palmistichus elaeisis emerged from Bt-susceptible and -resistant S. frugiperda showed altered host-searching behavior and reproductive parameters, which indicates low compatibility between the bioinsecticide agent and the parasitoid wasp.

Toxicity and cytotoxicity of the insecticide imidacloprid in the midgut of the predatory bug, Podisus nigrispinus.

The selectivity of insecticides on natural enemies in pest control are an important strategy for Integrated Pest Management. However, insecticides can have side effects on non-target organisms such as natural enemies. This study evaluated the histological and cytological changes mediated by the sublethal concentration of the imidacloprid insecticide on the midgut of non-target predator Podisus nigrispinus (Heteroptera: Pentatomidae), used in the biological control of pests. Imidacloprid was toxic for P. nigrispinus with LC50 = 3.75 mg L-1 and survival of 51.8%. This sublethal concentration of imidacloprid causes histological alterations in the midgut epithelium and cytotoxic features were irregular border epithelium, cytoplasmic vacuolation, and apocrine secretions in the first 6 h after exposure with the insecticide. Apoptosis in the digestive cells occurs after 12 h of exposure in the midgut. These results suggest that imidacloprid may affect the digestive physiology of P. nigrispinus and compromise the effective predation of this insect a biological control agent. The associated use of this insecticide with the predator in pest control should be carefully evaluated.

Chlorantraniliprole-mediated effects on survival, walking abilities, and respiration in the coffee berry borer, Hypothenemus hampei.

Hypothenemus hampei Ferrari (Coleoptera: Curculionidae) is the main pest of coffee crops, and effective methods for pest management are needed urgently. Bioassays were conducted to assess the effects of the insecticide chlorantraniliprole on H. hampei adults. Toxicity, survivorship, larval production, respiration rate, and behavioral responses to six concentrations of chlorantraniliprole were evaluated. Chlorantraniliprole was toxic to H. hampei (LD50 = 0.49 mg mL-1 and LD90 = 1.21 mg mL-1). Survivorship was 98% in adults not exposed to chlorantraniliprole, decreasing to 52% in insects exposed to LD50 and 2% in insects treated with LD90. H. hampei showed reduced mobility on insecticide-treated surfaces. The insecticide promoted a decrease in the respiration rate of H. hampei for up to 3 h after exposure, altering behavioral responses and locomotor activity. Chlorantraniliprole was shown to have lethal and sublethal effects on H. hampei and, thus, can be used rotationally in integrated pest management programs to control of this pest in coffee crops and retard of insect resistance.

Anatomy, Histology, and Ultrastructure of Salivary Glands of the Burrower Bug, Scaptocoris castanea (Hemiptera: Cydnidae).

The burrower bug Scaptocoris castanea Perty, 1830 (Hemiptera: Cydnidae) is an agricultural pest feeding on roots of several crops. The histology and ultrastructure of the salivary glands of S. castanea were described. The salivary system has a pair of principal salivary glands and a pair of accessory salivary glands. The principal salivary gland is bilobed with anterior and posterior lobes joined by a hilus where an excretory duct occurs. The accessory salivary gland is tubular with a narrow lumen that opens into the hilus near the excretory duct, suggesting that its secretion is stored in the lumen of the principal gland. The cytoplasm of the secretory cells is rich in the rough endoplasmic reticulum, secretory vesicles with different electron densities and mitochondria. At the base of the accessory gland epithelium, there were scattered cells that do not reach the gland lumen, with the cytoplasm rich in the rough endoplasmic reticulum, indicating a role in protein production. Data show that principal and accessory salivary glands of S. castanea produce proteinaceous saliva. This is the first morphological description of the S. castanea salivary system that is similar to other Hemiptera Pentatomomorpha, but with occurrence of basal cells in the accessory salivary gland.

Terpenoid constituents of cinnamon and clove essential oils cause toxic effects and behavior repellency response on granary weevil, Sitophilus granarius.

This study evaluated toxic effects, repellency and respiration rate caused by terpenoid constituents of cinnamon and clove essential oils and against Sitophilus granarius L. (Coleoptera: Curculionidae). The lethal concentrations (LC50 and LC90), repellent effect, and behavior repellency response on adults of S. granarius after exposure to six concentrations of each essential oil and terpenoids were evaluated. The chemical composition of the cinnamon oil was also determined and primary compounds were eugenol (10.5%), trans-3-caren-2-ol (10.2%), benzyl benzoate (9.99%), caryophyllene (9.34%), eugenyl acetate (7.71%), α-phellandrene (7.41%), and α-pinene (7.14%). In clove essential oil, the primary compounds were eugenol (27.1%), caryophyllene (24.5%), caryophyllene oxide (18.3%), 2-propenoic acid (12.2%), α-humulene (10.8%), γ-cadinene (5.01%), and humulene oxide (4.84%). Cinnamon and clove essential oil was toxic to S. granarius. In toxic terpenoids compounds, eugenol has stronger contact toxicity in S. granarius than caryophyllene oxide, followed by α-pinene, α-humulene, and α-phellandrene. Insects reduced their respiratory rates after being exposed to essential oil terpenoids and avoided or reduced their mobility on terpenoid-treated surfaces. Cinnamon and clove essential oil, and their terpenoid constituents were toxic and repellent to adult S. granarius and, therefore, have the potential to prevent or retard the development of insecticide resistance.

Squamocin induce histological and ultrastructural changes in the midgut cells of Anticarsia gemmatalis (Lepidoptera: Noctuidae).

Annonaceous acetogenins (Annona squamosa Linnaeus) comprises of a series of natural products which are extracted from Annonaceae species, squamocin proved to be highly efficient among those agents. Squamocin is mostly referred as a lethal agent for midgut cells of different insects, with toxic effects when tested against larva of some insects. In present study, LC50 and LC90 of squamocin for A. gemmatalis Hübner (Lepidoptera: Noctuidae) were calculated using probit analysis. Morphological changes in midgut cells were analyzed under light, fluorescence and transmission electron microscopes when larvae were treated with LC50 and LC90 of squamocin for 24, 48 and 72 h. Results revealed that the maximum damage to midgut cells was found under LC90 where it showed digestive cells with enlarged basal labyrinth, highly vacuolated cytoplasm, damaged apical surface, cell protrusions to the gut lumen, autophagy and cell death. The midgut goblet cells showed a strong disorganization of their microvilli. Likewise, in insects treated with squamocin, mitochondria were not marked with Mitotracker fluorescent probe, suggesting some molecular damage in these organelles, which was reinforced by decrease in the respiration rate in these insects. These results demonstrate that squamocin has potential to induce enough morphological changes in midgut through epithelial cell damage in A. gemmatalis.

Juvenile hormone downregulates vitellogenin production in Ectatomma tuberculatum (Hymenoptera: Formicidae) sterile workers.

In the ant Ectatomma tuberculatum (Olivier 1792), workers have active ovaries and lay trophic eggs that are eaten by the queen and larvae. Vitellogenins are the main proteins found in the eggs of insects and are the source of nutrients for the embryo in the fertilized eggs and for adults in the trophic eggs. In social insects, vitellogenin titres vary between castes and affect reproductive social status, nursing, foraging, longevity, somatic maintenance, and immunity. In most insects, vitellogenin synthesis is mainly regulated by juvenile hormone. However, in non-reproductive worker ants, this relationship is poorly characterized. This study determined the effects of juvenile hormone on vitellogenin synthesis in non-reproductive E. tuberculatum workers. Juvenile hormone was topically applied onto workers, and the effect on vitellogenin synthesis in the fat body and vitellogenin titres in the haemolymph were analysed by ELISA and qPCR. Juvenile hormone downregulated protein synthesis and reduced vitellogenin titres in the haemolymph, suggesting that in workers of E. tuberculatum, juvenile hormone loses its gonadotrophic function.

Interactions Between the Bud Rot Disease of Oil Palm and Rhynchophorus palmarum (Coleoptera: Curculionidae).

Rhynchophorus palmarum (L.) causes great losses to the oil palm plantations, and therefore, the spatial and temporal distribution of this insect should be studied, to manage its populations. Insect sampling was done for 2 yr in an oil palm plantation from Colombia. In total, 60 pheromone traps were used in healthy palm trees and infected ones with the Bud Rot disease. On the other hand, developmental stages of this insect were quantified on healthy and diseased palms for two consecutive years. Number of adult R. palmarum per sampling was higher in the plantation with diseased palm trees, 3.85 and 74.7 insects per trap, than in those with healthy ones, 1.91 and 9.48 insects per trap, in the first and second years, respectively. After the integration of pheromone traps, there was a significant increase in the infestation level at all stages of development of the insect. For the first time, the presence of R. palmarum attracted to diseased palms is reported. The association between R. palmarum and the Bud Rot disease is a cause of death and great loss to the oil palm plantations.

Exploring the effects of the acaricide cyflumetofen on the vital organs of the honey bee Apis mellifera (Hymenoptera: Apidae) workers.

Bees are important for maintaining ecosystems, pollinating crops and producing marketable products. In recent years, a decline in bee populations has been reported, with multifactorial causes, including the intensification of pesticide use in agriculture. Among pesticides, cyflumetofen is an insecticide and acaricide used in apple, coffee and citrus crops, whose main pollinator is the honey bee Apis mellifera. Therefore, this bee is a potential target of cyflumetofen during foraging. This study evaluated the histopathological and cytological damage in the midgut, hypopharyngeal glands and fat body of A. mellifera workers exposed to LC50 of cyflumetofen. The midgut epithelium of exposed bees presented cytoplasmic vacuolization, release of vesicles and cell fragments, which indicate autophagy, increased production of digestive enzymes and cell death, respectively. The cytological analysis of the midgut revealed the dilation of the basal labyrinth and the presence of spherocrystals in the digestive cells. The hypopharyngeal glands produced greater amounts of secretion in treated bees, whereas no changes were observed in the fat body. The results indicate that acute exposure to cyflumetofen negatively affect A. mellifera, causing damage to the midgut and changes in the hypopharyngeal glands, which may compromise the survival and foraging of this pollinator.

Effects of the insecticide flupyradifurone on Anticarsia gemmatalis caterpillar and its predator Podisus nigrispinus.

The caterpillar Anticarsia gemmatalis (Lepidoptera: Noctuidae) is a prevalent pest in soybean plantations, managed using both natural and synthetic chemical products. However, the emergence of resistance in some populations emphasizes the need to explore alternative insecticides. Flupyradifurone, a neurotoxic insecticide, has not been previously used for controlling A. gemmatalis. This study evaluated the potential of flupyradifurone in the management of A. gemmatalis. Initially, the toxicity and anti-feeding effects, as well as histopathological and cytotoxic impacts, of flupyradifurone on A. gemmatalis were evaluated. Subsequently, the indirect effects of flupyradifurone on the midgut and fat body of the predator Podisus nigrispinus (Hemiptera: Pentatomidae) were verified. The results indicate the susceptibility of caterpillars to flupyradifurone, with an LC50 of 5.10 g L-1. Furthermore, the insecticide adversely affects survival, induces an anti-feeding response, and inflicts damage on the midgut of the caterpillars. However, flupyradifurone also leads to side effects in the predator P. nigrispinus through indirect intoxication of the caterpillars, including midgut and fat body damage. While flupyradifurone demonstrates toxicity to A. gemmatalis, suggesting its potential for the chemical control of this pest, the indirect negative effects on the predator indicate the need for its controlled use in integrated pest management programs with the insecticide and the predator.

Effects of chronic oral exposure to insecticide teflubenzuron on the midgut of the honey bee Apis mellifera workers: histopathological insights into pesticide toxicity.

The honey bee Apis mellifera plays a significant role as a pollinator of native and cultivated plants, by increasing the productivity of several cultures, preserving the flora, and producing forest seeds. However, bee populations are declining worldwide, including A. mellifera, due to Colony Collapse Disorder, mainly resulting from the constant use of pesticides in the crops. Teflubenzuron is a physiological insecticide that belongs to the benzoylurea group, which inhibits chitin synthesis, the main component of the insect integument classified as safe for non-target insects, including bees. However, its effect on non-target organs of insects remains unknown. The midgut is the main organ of the digestive tract, which works in digestion and absorption and may be exposed to pesticides that contaminate food resources. The present work aimed to verify if the insecticide teflubenzuron is toxic and has histopathological effects on the midgut of A. mellifera adult workers. Workers exposed orally and chronically to the field-realistic concentration of teflubenzuron present 81.54% mortality. The epithelium of the midgut of these bees presents high vacuolization, spherocrystals, cell fragments released to the organ lumen, apocrine secretion, nuclear pyknosis, loss of cell-cell contact, and damage to regenerative cell nests and to the peritrophic matrix. These results indicate that the chitin synthesis-inhibiting insecticide teflubenzuron is toxic to A. mellifera after chronic oral exposure, at realistic field concentration, although it is classified as non-toxic to adult and non-target insects.

[Clinical practice guideline. Traumatic urethral stenosis in males]. / Guía de práctica clínica. La estenosis de uretra postraumática en el hombre.

The incidence of urethral stenosis in Mexico had not been documented. At the Centro Médico Nacional La Raza, during the year 2010, 629 patients with urethral stenosis were attended as outpatient consultation: 85 % with previous urethral stenosis and 15 % with urethral treatment complication. Urethral stenosis is a chronic illness, with multiple etiological origins and the handling is controversial. It has a great negative impact for the patients and the recurrence reaches 85 %. The treatment consisted of an invasive approach (urethral dilations, endoscopy procedure) and open surgery (urethroplasty). The World Health Organization and World Alliance take the world challenge about the urinary tract infections associated with the attention of patients, focused on urethral stenosis. The objective of the following clinical guide is to offer to the health professional a clinical tool for making decisions in the handling of the hardship or masculine urethral stenosis, based on the best available evidence, carrying out in systematized form with bibliographical research using validated terms of the MeSH: urethral structures, in the databases Trip database, PubMed, Guideline Clearinghouse, Cochrane Library and Ovid.

En México no está documentada la incidencia de la estenosis de uretra en forma consistente. En 2010, en el Centro Médico Nacional La Raza se reportaron 629 pacientes en consulta externa, 85 % de uretra anterior y 15 % de uretra posterior. La estenosis uretral es una enfermedad crónica, de etiología variada y manejo controvertido, con gran impacto negativo para los pacientes y recurrencia hasta de 85 %. El tratamiento puede ser instrumentado (dilataciones, cirugía endoscópica) y por cirugía abierta (uretroplastia). La Organización Mundial de la Salud y Alianza Mundial la consideran un reto de la atención de la salud. El objetivo de la siguiente guía es ofrecer al profesional de la salud, una herramienta clínica para la toma de decisiones en la atención de la estenosis uretral masculina, basada en la mejor evidencia identificada mediante la búsqueda bibliográfica sistematizada en las bases de datos Tripdatabase, PubMed, Guideline Clearinghouse, Cochrane Library y Ovid.