Misdosing of Non-Vitamin K Antagonist Oral Anticoagulants in Primary Care.

PURPOSE: Prescription patterns of non-vitamin K antagonist oral anticoagulants (NOACs) are unknown among primary care physicians, where most patients with nonvalvular atrial fibrillation (NVAF) are diagnosed and followed up. The goal of this study was to evaluate overdosing and underdosing of NOACs in patients with NVAF followed up in primary care and determine their clinical predictors. METHODS: This multicenter cross-sectional study included all patients with NVAF followed up in 13 primary care units in the center region of Portugal. Patients receiving antithrombotic regimens other than NOACs and patients with missing data were excluded. FINDINGS: The study included 858 patients with NVAF on an NOAC regimen. Overall, 30.3% were prescribed an off-label dosage (25.4% with infratherapeutic dosing [ITD] and 4.9% with supratherapeutic dosing). Chronic kidney disease (odds ratio, 14.0; 95% CI, 5.4-36.5; P < 0.001) and female sex (odds ratio, 2.6; 95% CI, 1.2-5.7; P < 0.001) were independent predictors of supratherapeutic dosing. We also found a significant effect of chronic kidney disease on ITD (odds ratio, 0.22; 95% CI, 0.258-0.678; P < 0.001). IMPLICATIONS: In primary care, NOACs are frequently prescribed with unadjusted dosages, generally infratherapeutic. Attention should be paid to women and patients with chronic kidney disease.

[Determination of LC 90 and LT 90 of IBCB66 Beauveria bassiana (Ascomycetes: Clavicipitaceae) isolate for Rhipicephalus (Boophilus) microplus (Acari: Ixodidae) control]. / Determinação da CL90 e TL90 do isolado IBCB66 de BEauveria bassiana (Ascomycetes: Clavicipitaceae) para o controle de Rhipicephalus (Boophilus) microplus (ACari: Ixodidae).

The objective of this research was to evaluate the pathogenicity and the virulence of the IBCB66 isolate of Beauveria bassiana on infected larvae of Rhipicephalus (Boophilus) microplus. The IBCB66 fungus strain was used as standard isolates of B. bassiana against R. (B.) microplus larvae. The larval bioassay tests using the IBCB66 isolate were carried out to determine the (Lethal Concentration) LC50, LC90, (Lethal Time) LT50 and LT90. The IBCB66 fungus strain was tested at six different concentrations (5x10(6), 10(7), 5x10(7), 10(8), 5x10(8) and 10(9) conidia.mL(-1)) to determine the percentage of larval mortality. In addition, a Probit analysis was also performed. Total larval mortality was observed eighteen days after the beginning of the test in the group treated with 5x10(9) conidia.mL(1). The LC50 and LC90 were 3x10(7) and 5x10(8) respectively and the LT50 and LT90 were 10 and 16 days.

[Selection of isolates of entomopathogenic fungus Beauveria bassiana (Ascomycetes: Clavicipitaceae) for control of Rhipicephalus (Boophilus) microplus (Acari: Ixodidae)]. / Seleção de isolados do fungo entomopatogênico Beauveria bassiana (Ascomycetes: Clavicipitaceae) para o controle de Rhipicephalus (Boophilus) microplus (Acari: Ixodidae)

This study was carried out to select isolates of the entomopathogenic fungus Beauveria bassiana with pathogenic potential to control the Rhipicephalus (Boophilus) microplus tick. The effectiveness of thirty isolates was first tested at a concentration of 5 x 108 conidia.mL(-1). Of these, eight were evaluated (IBCB01, IBCB02, IBCB07, IBCB17, IBCB21, IBCB74, IBCB149, IBCB165) and showed an effectiveness between 90 and 99%; thirteen (IBCB03, IBCB14, IBCB16, IBCB24, IBCB95, IBCB97, IBCB102, IBCB141, IBCB146, IBCB147, IBCB150, IBCB154, IBCB157) between 80 and 89,5%; six (IBCB47, IBCB75, IBCB84, IBCB145, IBCB161, IBCB164) between 70 and 79%, and only two (IBCB13 and IBCB143) had lower pathogenicity (70% or below). In the second step of the study, the five more effective strains in the first phase of the experiment (IBCB01, IBCB07, IBCB21, IBCB66, IBCB165) were analyzed comparatively. Based on in vitro results, it can be concluded that IBCB66 and IBCB21 are the isolates with higher potential for field control of R. (B.) microplus. IBCB01, IBCB07, IBCB21, IBCB66 e IBCB165 isolates were submitted to a conidial production test using a rice-based substrate. The best mass production of the entomopathogenic fungus was obtained with the IBCB66 strain.

[Compatibility of Beauveria bassiana (Ascomycetes: Clavicipitaceae) with chemicals acaricides used in the control of cattle tick]. / Compatibilidade de isolados de Beauveria bassiana (Ascomycetes: Clavicipitaceae) com carrapaticidas químicos utilizados no controle do carrapato dos bovinos.

The purpose of the present study was to assess compatibility between IBCB66 and IBCB21 isolates of Beauveria bassiana and acaricides: Flumethrin+Coumaphos, Deltamethrin, Dichlorvos+Cypermethrin, Dichlorvos+Chlorpyrifos, Cypermethrin High Cis, Dichlorvos+Cypermethrin High Cis, Cypermethrin and Amitraz, utilized on the control of Rhipicephalus (Boophilus) microplus in our country. The effect of commercial products on the isolates was assayed according to observation of vegetative growth, conidia production, and viability of strains of B. bassiana fungus. With concerning about IBCB66 isolate, products Deltamethrin, Cypermethrin High Cis and Amitraz were compatible, not affecting the entomopathogen development. Product Cypermethrin was toxic, and products Flumethrin+Coumaphos, Dichlorvos+Cypermethrin, Dichlorvos+Chlorpyrifos and Dichlorvos+Cypermethrin High Cis were very toxic. In regard to IBCB21 isolate, products Flumethrin+Coumaphos, Dichlorvos+Cypermethrin, Dichlorvos+Chlorpyrifos, Cypermethrin High Cis, Dichlorvos+Cypermethrin High Cis and Cypermethrin were very toxic and product Amitraz was toxic. From the acaricides evaluated, product Deltamethrin was the single agent that did not produce toxic effect on the entomopathogen.

Determinação da CL90 e TL90 do isolado IBCB66 de Beauveria bassiana (Ascomycetes: Clavicipitaceae) para o controle de Rhipicephalus (Boophilus) microplus (Acari: Ixodidae) / Determination of LC 90 and LT 90 of IBCB66 Beauveria bassiana (Ascomycetes: Clavicipitaceae) isolate for Rhipicephalus (Boophilus) microplus (Acari: Ixodidae) control

O presente trabalho teve por objetivo avaliar a patogenicidade e a virulência do isolado IBCB66 de Beauveria bassiana para larvas de Rhipicephalus (Boophilus) microplus. O isolado IBCB66 foi utilizado como padrão, com a finalidade de determinar a CL50 (Concentração Letal), CL90, TL50 (Tempo Letal) e TL90. O isolado IBCB66 foi testado em seis concentrações diferentes (5 × 10(6), 10(7), 5 × 10(7), 10(8), 5 × 10(8) e 10(9)) para determinar a porcentagem de mortalidade. A mortalidade total de larvas foi observada 18 dias após o início do teste no grupo tratado com 5 × 10(9) conídios.mL-1. A análise de Probit dos dados consignados apontou a CL50 e CL90 concentrações de 3 × 10(7) e 5 × 10(8) conídios.mL-1 e para TL50 e TL90, foram 10 e 16 dias, respectivamente.

The objective of this research was to evaluate the pathogenicity and the virulence of the IBCB66 isolate of Beauveria bassiana on infected larvae of Rhipicephalus (Boophilus) microplus. The IBCB66 fungus strain was used as standard isolates of B. bassiana against R. (B.) microplus larvae. The larval bioassay tests using the IBCB66 isolate were carried out to determine the (Lethal Concentration) LC50, LC90, (Lethal Time) LT50 and LT90. The IBCB66 fungus strain was tested at six different concentrations (5 × 10(6), 10(7), 5 × 10(7), 10(8), 5 × 10(8) and 10(9) conidia.mL-1) to determine the percentage of larval mortality. In addition, a Probit analysis was also performed. Total larval mortality was observed eighteen days after the beginning of the test in the group treated with 5 × 10(9) conidia.mL-1. The LC50 and LC90 were 3 × 10(7) and 5 × 10(8) respectively and the LT50 and LT90 were 10 and 16 days.

Seleção de isolados do fungo entomopatogênico Beauveria bassiana (Ascomycetes: Clavicipitaceae) para o controle de Rhipicephalus (Boophilus) microplus (Acari: Ixodidae) / Selection of isolates of entomopathogenic fungus Beauveria bassiana (Ascomycetes: Clavicipitaceae) for control of Rhipicephalus (Boophilus) microplus (Acari: Ixodidae)

O presente estudo foi conduzido com o objetivo de selecionar isolados do fungo entomopatogênico Beauveria bassiana com potencial patogênico para utilização no controle do carrapato Rhipicephalus (Boophilus) microplus. Numa primeira etapa, foi avaliada a eficiência de trinta isolados na concentração de 5 × 10(8) conídios.mL-1. Destes, oito (IBCB01, IBCB02, IBCB07, IBCB17, IBCB21, IBCB74, IBCB149, IBCB165) apresentaram eficiência entre 90 e 99%; treze (IBCB03, IBCB14, IBCB16, IBCB24, IBCB95, IBCB97, IBCB102, IBCB141, IBCB146, IBCB147, IBCB150, IBCB154, IBCB157), indicaram percentuais de eficiência entre 80 e 89,5%; seis (IBCB47, IBCB75, IBCB84, IBCB145, IBCB161, IBCB164), entre 70 e 79% e apenas dois, (IBCB13 e IBCB143) revelaram-se pouco virulentos com porcentagens abaixo de 70%. Na segunda etapa do trabalho, foram analisados comparativamente dados de mortalidade acumulada dos cinco melhores isolados obtidos na primeira fase (IBCB01, IBCB07, IBCB21, IBCB66, IBCB165). Analisando-se os resultados obtidos in vitro, pode-se imputar que os isolados IBCB21 e IBCB66 são os que apresentam maior potencial para utilização a campo, tendo em vista o controle de R. (B.) microplus. Os isolados selecionados, na primeira fase, também foram testados quanto à potencialidade de produção massal em meio de arroz pré-cozido. A melhor produção massal foi obtida com o isolado IBCB66.

This study was carried out to select isolates of the entomopathogenic fungus Beauveria bassiana with pathogenic potential to control the Rhipicephalus (Boophilus) microplus tick. The effectiveness of thirty isolates was first tested at a concentration of 5 × 10(8) conidia.mL-1. Of these, eight were evaluated (IBCB01, IBCB02, IBCB07, IBCB17, IBCB21, IBCB74, IBCB149, IBCB165) and showed an effectiveness between 90 and 99%; thirteen (IBCB03, IBCB14, IBCB16, IBCB24, IBCB95, IBCB97, IBCB102, IBCB141, IBCB146, IBCB147, IBCB150, IBCB154, IBCB157) between 80 and 89,5%; six (IBCB47, IBCB75, IBCB84, IBCB145, IBCB161, IBCB164) between 70 and 79%, and only two (IBCB13 and IBCB143) had lower pathogenicity (70% or below). In the second step of the study, the five more effective strains in the first phase of the experiment (IBCB01, IBCB07, IBCB21, IBCB66, IBCB165) were analyzed comparatively. Based on in vitro results, it can be concluded that IBCB66 and IBCB21 are the isolates with higher potential for field control of R. (B.) microplus. IBCB01, IBCB07, IBCB21, IBCB66 e IBCB165 isolates were submitted to a conidial production test using a rice-based substrate. The best mass production of the entomopathogenic fungus was obtained with the IBCB66 strain.

Compatibilidade de isolados de Beauveria bassiana (Ascomycetes: Clavicipitaceae) com carrapaticidas químicos utilizados no controle do carrapato dos bovinos / Compatibility of Beauveria bassiana (Ascomycetes: Clavicipitaceae) with chemicals acaricides used in the control of cattle tick

O presente trabalho teve como escopo avaliar a compatibilidade dos isolados IBCB66 e IBCB21 de Beauveria bassiana com os carrapaticidas a base de Flumetrina + Coumafós, Deltametrina, Diclorvós + Cipermetrina, Diclorvós + Clorpirifós, Cipermetrina High Cis, Diclorvós + Cipermetrina High Cis, Cipermetrina e Amitraz utilizados no controle do carrapato Rhipicephalus (Boophilus) microplus em nosso país. O efeito dos produtos comerciais sobre os isolados foi verificado por meio da observação do crescimento vegetativo, produção de conídios e viabilidade das estirpes do fungo B. bassiana. Com referência ao isolado IBCB66, os produtos Deltametrina, Cipermetrina High Cis e Amitraz foram classificados como compatíveis, não interferindo no desenvolvimento do entomopatógeno. O produto Cipermetrina foi classificado como tóxico e os produtos Flumetrina + Coumafós, Diclorvós + Cipermetrina, Diclorvós + Clorpirifós e Diclorvós + Cipermetrina High Cis, muito tóxicos. Em relação ao isolado IBCB21, os produtos Flumetrina + Coumafós, Diclorvós + Cipermetrina, Diclorvós + Clorpirifós, Cipermetrina High Cis, Diclorvós + Cipermetrina High Cis e Cipermetrina foram classificados como muito tóxicos e o produto Amitraz como tóxico. Entre os carrapaticidas avaliados, o produto Deltametrina foi o único que não produziu efeito tóxico sobre o entomopatógeno.

The purpose of the present study was to assess compatibility between IBCB66 and IBCB21 isolates of Beauveria bassiana and acaricides: Flumethrin + Coumaphos, Deltamethrin, Dichlorvos + Cypermethrin, Dichlorvos + Chlorpyrifos, Cypermethrin High Cis, Dichlorvos + Cypermethrin High Cis, Cypermethrin and Amitraz, utilized on the control of Rhipicephalus (Boophilus) microplus in our country. The effect of commercial products on the isolates was assayed according to observation of vegetative growth, conidia production, and viability of strains of B. bassiana fungus. With concerning about IBCB66 isolate, products Deltamethrin, Cypermethrin High Cis and Amitraz were compatible, not affecting the entomopathogen development. Product Cypermethrin was toxic, and products Flumethrin + Coumaphos, Dichlorvos + Cypermethrin, Dichlorvos+ Chlorpyrifos and Dichlorvos + Cypermethrin High Cis were very toxic. In regard to IBCB21 isolate, products Flumethrin + Coumaphos, Dichlorvos + Cypermethrin, Dichlorvos + Chlorpyrifos, Cypermethrin High Cis, Dichlorvos + Cypermethrin High Cis and Cypermethrin were very toxic and product Amitraz was toxic. From the acaricides evaluated, product Deltamethrin was the single agent that did not produce toxic effect on the entomopathogen.