Post-pubertal functional outcomes of one-stage anatomical reconstruction of the corpus spongiosum, bulbo-spongiosus muscle and dartos in 46 children with proximalhypospadias.

INTRODUCTION: Anatomical studies of hypospadias show failure of zipping-up of histologically normal urethral plate and corpus spongiosum. With the commonly utilized substitution urethroplasties for proximal hypospadias, a reconstructed urethra of just an "epithelial-lined tube" with no spongiosal support, is apt to long-term urinary and ejaculatory dysfunctions. We completed a one-stage anatomical reconstruction in children with proximal hypospadias whenever the ventral curvature could be reduced to <30° and evaluated the post-pubertal outcomes. METHOD: This is a retrospective analysis of prospectively maintained data on one-stage anatomical repair of proximal hypospadias between 2003 and 2021. In children with proximal hypospadias, the corpus spongiosum, bulbo-spongiosus muscle (BSM), Bucks', and Dartos' layers of the shaft were anatomically re-aligned prior to assessing the ventral curvature visually. When the curvature was >30°, the urethral plate was divided at the glans for a 2-stage procedure, and those patients were excluded from the study. Otherwise, the anatomical repair was continued (this series). The Hypospadias Objective Scoring Evaluation (HOSE) and the Paediatric Penile Perception Score (PPPS) were used for post-pubertal assessment. RESULTS: Prospective records provided details of 105 patients with proximal hypospadias who had complete primary anatomical repair. The median age at surgery was 1.6 years, and 15.9 years at the post-pubertal assessment. Forty-one (39%) had complications that necessitated re-operations. Thirty-five (33.3%) patients had complications involving the urethra. For fistula and diverticula, eighteen cases required only one corrective procedure, while one required two. Other 16 patients required an average of 1.78 corrective operations for severe chordee and/or breakdown, with 7 requiring Bracka's 2-stage procedure. RESULTS OF PUBERTAL REVIEW: Fifty patients (47.6%) were over 14 years old; 46 (92.0%) had pubertal reviews and scoring, while four were lost to follow-up. The mean HOSE score was 14.8/16, and the mean PPPS score was 17.8/18. Five patients had residual curvature of >10°. 17 and 10 patients, respectively, were unable to comment on glans firmness and ejaculation quality. During erections, 26/29 (89.7%) patients reported a firm glans, and 36/36 (100%) reported normal ejaculations. CONCLUSION: This study proves the need for reconstruction of normal anatomy for normal post-pubertal function. In all proximal hypospadias, we strongly recommend anatomical reconstruction (zipping up) of the corpus spongiosum and BSM. When the curvature can be reduced to <30°, a complete one-stage reconstruction is possible; otherwise, anatomical reconstruction of the bulbar and proximal penile urethra is recommended, reducing the length of the epithelial-lined substitution tube for the distal shaft and glans.

Sandflies (Diptera: Psychodidae) in rural and urban environments in an endemic area of cutaneous leishmaniasis in southern Brazil.

The high proportion of cases of cutaneous leishmaniasis reported amongst residents in the city of Bandeirantes, in the state of Paraná, Brazil, led the authors to investigate the phlebotomine fauna in both urban and rural environments. The sandflies were captured with automatic light traps from 07:00 pm-07:00 am fortnightly in 11 urban peridomiciles from April 2008-March 2009 and monthly in three ecotopes within four rural localities from April 2009-March 2010. In one of these latter localities, sandfly capture was conducted with white/black Shannon traps during each of three seasons: spring, summer and fall. A total of 5,729 sandflies of 17 species were captured. Nyssomyia neivai (46.7%) and Nyssomyia whitmani (35.3%) were the predominant species. In this study, 3,865 specimens were captured with automatic light traps: 22 (0.083 sandflies/trap) in the urban areas and 3,843 (26.69 sandflies/trap) in the rural areas. Ny. neivai was predominant in urban (68.2%) and rural (42.8%) areas. A total of 1,864 specimens were captured with the white/black Shannon traps and Ny. neivai (54.5%) and Ny. whitmani (31.4%) were the predominant species captured. The small numbers of sandflies captured in the urban areas suggest that the transmission of Leishmania has occurred in the rural area due to Ny. neivai and Ny. whitmani as the probable vectors.

Sandflies (Diptera: Psychodidae) in rural and urban environments in an endemic area of cutaneous leishmaniasis in southern Brazil

The high proportion of cases of cutaneous leishmaniasis reported amongst residents in the city of Bandeirantes, in the state of Paraná, Brazil, led the authors to investigate the phlebotomine fauna in both urban and rural environments. The sandflies were captured with automatic light traps from 07:00 pm-07:00 am fortnightly in 11 urban peridomiciles from April 2008-March 2009 and monthly in three ecotopes within four rural localities from April 2009-March 2010. In one of these latter localities, sandfly capture was conducted with white/black Shannon traps during each of three seasons: spring, summer and fall. A total of 5,729 sandflies of 17 species were captured. Nyssomyia neivai (46.7%) and Nyssomyia whitmani (35.3%) were the predominant species. In this study, 3,865 specimens were captured with automatic light traps: 22 (0.083 sandflies/trap) in the urban areas and 3,843 (26.69 sandflies/trap) in the rural areas. Ny. neivai was predominant in urban (68.2%) and rural (42.8%) areas. A total of 1,864 specimens were captured with the white/black Shannon traps and Ny. neivai (54.5%) and Ny. whitmani (31.4%) were the predominant species captured. The small numbers of sandflies captured in the urban areas suggest that the transmission of Leishmania has occurred in the rural area due to Ny. neivai and Ny. whitmani as the probable vectors.

Lavagem gástrica realmente efetiva? / Gastric lavage - effective?

Método descrito pela primeira vez há pouco menos de 200 anos, a lavagem gكstrica é atual- mente utilizada na terapêutica de intoxicaçمo por grande variedade de substâncias, Este pro- cedimento visa à remoçمo da substância ingerida antes que esta atinja o intestino delgado, local de maior absorçمo; e vem sendo realizado de maneira bastante indiscriminada pelos profissionais da saْde. A técnica deve ser realizada em ambiente que ofereça adequadas condiçُes de suporte ao paciente frente às possيveis complicaçُes. Este artigo tem a intençمo de motivar a discussمo acerca da real eficكcia desta prكtica, além de trazer informaçُes ْteis sobre os reais benefيcios e desvantagens advindas da realizaçمo da lavagem gكstrica e de outras técnicas de descontaminaçمo do estômago...(AU)

Described for the first time less than 200 years ago, the gastric lavage method is performed nowadays in the therapeutics for intoxication by severa I kinds of substances. This procedure, which aims to remove the ingested substance before it reaches the small bowel, ploce of highest leveI of absortion; has been conducted in a fairly indiscriminate way by health professionals. It must be performed by well trained personnel in o proper facility, able to manage possible complications. This article is intended to encourage discussion about the real effectiveness of this practice, and provide useful information concerning real benefits and disadvantages arising from the performance of gastric lavage and other techniques for decontamination of the stomach, and, therefore, of the patient...

Description of two new sand fly species related to Nyssomyia antunesi (Diptera, Psychodidae, Phlebotominae).

Both sexes of two new Brazilian phlebotomine sand flies of the genus Nyssomyia Barretto 1962 [= Lutzomyia (Nyssomyia) sensu Barretto], Nyssomyia delsionatali n. sp. and Nyssomyia urbinattii n. sp., presenting close affinity with Nyssomyia antunesi (Coutinho), are described and illustrated. N. delsionatali n. sp was captured on the edge of a riparian Amazonian forest on the Juruena river in the northwest of Mato Grosso state and N. urbinattii n. sp in a riparian Amazonian forest on the Teles Pires river between Mato Grosso and Pará states. Some measurements of both sexes of N. antunesi and illustration of the male genitalia and the female spermathecae as well as an identification key for males and females of the genus Nyssomyia are provided.

Review of American fossil Phlebotominae (Diptera: Psychodidae) with a description of two new species.

The objective of this study was to carry out a taxonomic review of fossil American phlebotomine sand flies and describe two new species found in amber in the Dominican Republic. The gonostyle of one of these, Micropygomyia dorafeliciangeliae nov. sp., (= Lutzomyia dorafeliciangeliae, species group oswaldoi), has five spines, similar to that of Micropygomyia paterna (Quate, 1963) (= Lutzomyia paterna, species group oswaldoi), but they may be distinguished by the alpha/gamma ratio, which is < 1.0 in the new species and > 1 in the latter. Pintomyia dominicana nov. sp. (= Lutzomyia dominicana, species group verrucarum) has four spines on the gonostyle and presents a long bristle on the apex of the paramere, which distinguishes it from the other fossil species. With the description of these two new species, a total of 14 species of the American fossil phlebotomine sand flies has been described, 10 of which belong to the genus Pintomyia. An identification key for male fossil species is presented.

Description of Micropygomyia brandaoi sp. n. (Diptera: Psychodidae: Phlebotominae), a fossil phlebotomine from the Dominican Republic.

The description of Micropygomyia brandaoi, a new species of fossil phlebotomine sand fly, is based on one male specimen obtained from Dominican amber of the Miocene period (20 million years). In this new species, the fifth palpal segment is long, the coxite lacks a setal tuft and the style shows four well-developed spines. This set of characters allowed us to place the new species in the genus Micropygomyia Barretto.

Description of Micropygomyia brandaoi sp. n. (Diptera: Psychodidae: Phlebotominae), a fossil phlebotomine from the Dominican Republic

The description of Micropygomyia brandaoi, a new species of fossil phlebotomine sand fly, is based on one male specimen obtained from Dominican amber of the Miocene period (20 million years). In this new species, the fifth palpal segment is long, the coxite lacks a setal tuft and the style shows four well-developed spines. This set of characters allowed us to place the new species in the genus Micropygomyia Barretto.

Description of Pintomyia (Pifanomyia) paleotrichia, a Miocene period new species from the Dominican Republic (Diptera: Psychodidae: Phlebotominae)

A new fossil species of phlebotomine sandflies is described from Dominican amber based in one specimen. Pintomyia (Pifanomyia) paleotrichia sp. nov. is distinguished from the other extant and extinct species by aspects of paramere and the basal tuft of bristles in the gonocoxite.

Description of Micropygomyia (Sauromyia) vonatzingeni sp. nov. (Diptera, Psychodidae, Phlebotominae) from the states of Pará and Tocantins, Brazil

Both sexes of a new phlebotomine sandfly species Micropygomyia (Sauromyia) vonatzingeni sp. nov. (Diptera, Psychodidae), captured in the Serra das Andorinhas, São Geraldo do Araguaia municipality, Pará state, and Cavalcante municipality, Tocantins state, Brazil, are described and illustrated. This new species belongs to the oswaldoi series and its distinction from the other extant species of the series was made by male and female identification keys. The specific geographical distribution of the oswaldoi series by country and department (or state) is presented.

Ambos os sexos de uma nova espécie de flebotomíneos Micropygomyia (Sauromyia) vonatzingeni sp. nov. (Diptera, Psychodidae) capturada na Serra das Andorinhas, município de São Geraldo do Araguaia, Estado do Pará e no município de Cavalcante, Estado de Tocantins, Brasil são descritos e ilustrados. Esta nova espécie pertence a série oswaldoi e a sua distinção das demais espécies não fósseis da série foi feita por meio de chave de identificação para machos e fêmeas. Apresenta-se a distribuição geográfica das espécies da série oswaldoi, por país e estado (ou departamento).

Description of Pintomyia (Pifanomyia) paleotrichia, a miocene period new species from the Dominican Republic (Diptera: Psychodidae: Phlebotominae).

A new fossil species of phlebotomine sandflies is described from Dominican amber based in one specimen. Pintomyia (Pifanomyia) paleotrichia sp. nov. is distinguished from the other extant and extinct species by aspects of paramere and the basal tuft of bristles in the gonocoxite.

Description of Micropygomyia (Micropygomyia) ancashensis sp. nov. and the female of Lutzomyia (Helcocyrtomyia) chavinensis Pérez & Ogusuku (Diptera, Psychodidae, Phlebotominae) from Ancash department, Peru

A male of a new species Micropygomyia (Micropygomyia) ancashensis sp. nov. and a female of the Lutzomyia (Helcocyrtomyia) chavinensis Pérez & Ogusuku, 1999 captured in the Antonio Raymondi province, department of Ancash, Peru are described and illustrated. The new species belongs to the cayennensis series, being closest to Mi. lewisi (Feliciangeli Ordoñez & Férnandez) though presenting highly sclerotized pseudotracheae on the labella that seem to constitute an autapomorphy among American Phlebotominae, and a clypeus almost completely covered with setae, as in Warileya. The female of Lu. chavinensis is close to those of Lu. blancasi Galati & Cáceres 1990, Lu. noguchii (Shannon, 1929), and Lu. pallidithorax Galati & Cáceres 1994.

Brumptomyia angelae, a new species of Phlebotominae (Diptera, Psychodidae) of the Atlantic forest of the state of Paraná, Brazil.

The male of Brumptomyia angelae, sp. nov., a new species of Phlebotominae (Diptera, Psychodidae) of the Atlantic forest of the state of Paraná, Brazil, is described and illustrated. This new taxon is closely related to Brumptomyia ortizi Martins, Silva & Falcão 1971, Brumptomyia nitzulescui (Costa Lima, 1932), and Brumptomyia troglodytes (Lutz, 1922). The male genitalia of these three latter species have also been drawn.

Brumptomyia angelae, a new species of Phlebotominae (Diptera, Psychodidae) of the Atlantic forest of the state of Paraná, Brazil

The male of Brumptomyia angelae, sp. nov., a new species of Phlebotominae (Diptera, Psychodidae) of the Atlantic forest of the state of Paraná, Brazil, is described and illustrated. This new taxon is closely related to Brumptomyia ortizi Martins, Silva & Falcão 1971, Brumptomyia nitzulescui (Costa Lima, 1932), and Brumptomyia troglodytes (Lutz, 1922). The male genitalia of these three latter species have also been drawn.

The subgenus Migonemyia Galati 1995 (Diptera, Psychodidae, Phlebotominae), with description of a new species Migonemyia vaniae: a review.

The capture of a new species of the subgenus Migonemyia Galati, 1995 (Diptera, Psychodidae, Phlebotominae), Migonemyia vaniae sp. nov. in the Ribeira Valley, state of São Paulo, Brazil, together with the other two species: Mg. migonei (França, 1920) and Mg. rabelloi (Galati & Gomes, 1992) lead us to review this subgenus. The new species was described and illustrated. The genitalia of the two other species were also illustrated and some genital characteristics (number of setae on the gonocoxite tuft, ejaculatory ducts and pump and ducts/pump ratio; and number of setae on the tergite VIII of the females) considered important to differentiate the three species, including five populations of Mg. migonei (from Northeastern, Southeastern, and Southern Brazilian regions and of Peru) were submitted to variance analyses. The Mg. migonei population of Northeastern Brazilian region showed distinct smaller values (P < 0.05) than the other Brazilian populations studied as regarding these characteristics. The capture of both sexes of these three species in sympatry confirms the association between the sexes of Mg. rabelloi, recognised as doubtful when this species was originally described. Identification keys for male and female of the three species are presented.

The subgenus Migonemyia Galati 1995 (Diptera, Psychodidae, Phlebotominae), with description of a new species Migonemyia vaniae: a review

The capture of a new species of the subgenus Migonemyia Galati, 1995 (Diptera, Psychodidae, Phlebotominae), Migonemyia vaniae sp. nov. in the Ribeira Valley, state of São Paulo, Brazil, together with the other two species: Mg. migonei (França, 1920) and Mg. rabelloi (Galati & Gomes, 1992) lead us to review this subgenus. The new species was described and illustrated. The genitalia of the two other species were also illustrated and some genital characteristics (number of setae on the gonocoxite tuft, ejaculatory ducts and pump and ducts/pump ratio; and number of setae on the tergite VIII of the females) considered important to differentiate the three species, including five populations of Mg. migonei (from Northeastern, Southeastern, and Southern Brazilian regions and of Peru) were submitted to variance analyses. The Mg. migonei population of Northeastern Brazilian region showed distinct smaller values (P < 0.05) than the other Brazilian populations studied as regarding these characteristics. The capture of both sexes of these three species in sympatry confirms the association between the sexes of Mg. rabelloi, recognised as doubtful when this species was originally described. Identification keys for male and female of the three species are presented.

Nyssomyia intermedia (Lutz & Neiva, 1912) and Nyssomyia neivai (Pinto, 1926) (Diptera: Psychodidae: Phlebotominae) geographical distribution and epidemiological importance.

Nyssomyia intermedia (Lutz & Neiva 1912) and N. neivai (Pinto 1926) are possible vectors of tegumentary leishmaniasis in some regions of Brazil. Further, the latter was until recently, considered a junior synonym of the former. This study has the purpose of updating our knowledge of the geographical distribution of these species, based on specimens deposited at the collection of the Centro de Pesquisas René Rachou-Fiocruz, Faculdade de Saúde Pública-Universidade de São Paulo, and on data presented by literature as also to associate this distribution with the cutaneous leishmaniasis cases reported. It has been reported that N. intermedia occurs in the states of the Northeastern Region, in Rio de Janeiro, Espírito Santo, on the northern coast of São Paulo, in eastern Minas Gerais, Mato Grosso do Sul, and Goiás, close to the border with Minas Gerais and Bahia. N. neivai occurs in the Southern Region, southern coast and in western São Paulo, southern and western Minas Gerais, southern Goiás, and southern Pará, beyond Argentina, Bolivia, and Paraguay. It is important to highlight that N. intermedia and N. neivai occur in sympatry in Minas Gerais and São Paulo. N. intermedia or N. neivai are predominant or are captured abundantly in several cutaneous leishmaniasis foci in the Southeastern and Southern regions of Brazil.

Nyssomyia intermedia (Lutz & Neiva, 1912) and Nyssomyia neivai (Pinto, 1926) (Diptera: Psychodidae: Phlebotominae) geographical distribution and epidemiological importance

Nyssomyia intermedia (Lutz & Neiva 1912) and N. neivai (Pinto 1926) are possible vectors of tegumentary leishmaniasis in some regions of Brazil. Further, the latter was until recently, considered a junior synonym of the former. This study has the purpose of updating our knowledge of the geographical distribution of these species, based on specimens deposited at the collection of the Centro de Pesquisas René Rachou-Fiocruz, Faculdade de Saúde Pública-Universidade de São Paulo, and on data presented by literature as also to associate this distribution with the cutaneous leishmaniasis cases reported. It has been reported that N. intermedia occurs in the states of the Northeastern Region, in Rio de Janeiro, Espírito Santo, on the northern coast of São Paulo, in eastern Minas Gerais, Mato Grosso do Sul, and Goiás, close to the border with Minas Gerais and Bahia. N. neivai occurs in the Southern Region, southern coast and in western São Paulo, southern and western Minas Gerais, southern Goiás, and southern Pará, beyond Argentina, Bolivia, and Paraguay. It is important to highlight that N. intermedia and N. neivai occur in sympatry in Minas Gerais and São Paulo. N. intermedia or N. neivai are predominant or are captured abundantly in several cutaneous leishmaniasis foci in the Southeastern and Southern regions of Brazil.

Description of Micropygomyia (Micropygomyia) ancashensis sp. nov. and the female of Lutzomyia (Helcocyrtomyia) chavinensis Pérez & Ogusuku (Diptera, Psychodidae, Phlebotominae) from Ancash department, Peru.

A male of a new species Micropygomyia (Micropygomyia) ancashensis sp. nov. and a female of the Lutzomyia (Helcocyrtomyia) chavinensis Pérez & Ogusuku, 1999 captured in the Antonio Raymondi province, department of Ancash, Peru are described and illustrated. The new species belongs to the cayennensis series, being closest to Mi. lewisi (Feliciangeli Ordoñez & Férnandez) though presenting highly sclerotized pseudotracheae on the labella that seem to constitute an autapomorphy among American Phlebotominae, and a clypeus almost completely covered with setae, as in Warileya. The female of Lu. chavinensis is close to those of Lu. blancasi Galati & Cáceres 1990, Lu. noguchii (Shannon, 1929), and Lu. pallidithorax Galati & Cáceres 1994.

Pintomyia (Pifanomyia) paleotownsendi, a new sand fly from the Miocene amber of Dominican Republic (Diptera: Psychodidae: Phlebotominae)

Phlebotominae includes some vector species, mainly that of leishmaniases, with a very old host-parasite relationship. Some species fossils of this subfamily have been recently described and this paper presents the description of a new sand fly Pintomyia (Pifanomyia) paleotownsendi sp. nov in amber. The gonostyle present four spines, being one apical, one external superior implanted close to the apical third, one external inferior in the middle of the structure and one internal implanted in the basal third. This disposition of the spines may separate the new species from others in the sub genus.