Investigation of Rhodnius prolixus head anatomy using microtomography.

In the last years, microtomography has proved to be a powerful technique on insects' studies, allowing a detailed view of the structures' internal with a high resolution. One of the most important advantages about the use of microtomography in these studies is the fact that the dissection is not necessary, which decreases considerably the number of samples used on the insects' research. Some insects are used constantly in studies about morphology, metamorphosis, and reproduction, because they work as a model for others, and Rhodnius prolixus is one of the most studied in this group. This insect is also one of the main insect vectors of Chagas disease that kills around 12,000 people every year in Latin America. Some studies using laboratory microtomography conventional scanners combining with the correct staining methods have proved that it could be a powerful tool in biological research, allowing the visualisation of low-density tissues. The main goal of the present work was to use staining protocols to study Rhodnius prolixus with laboratory microtomography conventional scanners. The experiments were carried out at the imaging lab in the Theoretical Biology Department, University of Vienna, using an Xradia MicroXCT and at the University of Oslo, using a Skyscan 2211.

Ureteroscopia flexible sin vaina de acceso ureteral / Flexible ureteroscopy without ureteral access sheath

Introducción: La vaina de acceso ureteral (VAU) se utiliza ampliamente en la ureteroscopia flexible con litotricia con láser (URSF) por sus mejores tasas de estado libre de cálculos, menor presión intrarrenal y menos complicaciones. Sin embargo, también aumenta los costes quirúrgicos y puede lesionar la pared ureteral. El objetivo principal de nuestro estudio es comparar la seguridad y la eficacia de la URSF con y sin VAU para evaluar la justificación de su uso en todos los casos.Materiales y métodos: Hemos llevado a cabo un estudio analítico observacional retrospectivo con una base de datos prospectiva. Se incluyeron para el análisis un total de 241 pacientes consecutivos que se sometieron a URSF para el tratamiento de cálculos renales y de uréter superior entre enero de 2018 y mayo de 2020 y se dividieron en dos grupos según el uso dela VAU. Se compararon los datos demográficos, las características de los cálculos, la presentación, el tiempo operatorio, la necesidad de catéter ureteral, la infección urinaria posoperatoria, el cólico renal y la necesidad de procedimientos adicionales.Resultados: Un total de 198 pacientes (82,2%) conformaron el grupo sin VAU. El tiempo operatorio fue significativamente menor en el grupo de pacientes sin VAU que en los tratados con VAU (64,6 minutos ± 29,5 vs. 89,9 minutos ±2,8, respectivamente; p 0,010). Ambos grupos presentaron tasas similares de dolor renal e infección del tracto urinario. Los procedimientos auxiliares fueron más frecuentes en el grupo con VAU (37,2 vs. 21,2%; p 0,026), pero no hubo significación en el análisis multivariante.Conclusión: La URSF sin VAU parece ser tan segura como la URSF con VAU, pero requiere menos procedimientos adicionales. Otra de las ventajas es un menor tiempo operatorio (AU)

Introduction: Ureteral access sheath (UAS) is widely used in flexible ureteroscopy and laser lithotripsy (FURS) based on better stone-free rates, lower intrarenal pressure and fewer complications. However, it also rises surgical costs and may injure the ureteral wall. The main objective of our study is to compare safety and efficacy of FURS with and without UAS to evaluate whether its use is justified in all cases.Materials and methods: We performed a retrospective observational analytic study based on a prospective database. A total of 241 consecutive patients who underwent FURS for upper ureter and renal stones between January 2018 and May 2020 were included for analysis and divided into two groups upon UAS use. We compared demographic data, stone characteristics, prestenting, operative time, need for ureteral stent, postoperative urinary tract infection, renal colic and need for ancillary procedures.Results: A total of 198 patients (82.2%) were included in the group without UAS. Operative time was significantly shorter in the group of patients without UAS than those with UAS (64.6 minutes ± 29.5 vs. 89.9 minutes ± 2.8 respectively; p 0.010). Both groups had similar rates of colic pain and urinary tract infection. Ancillary procedures were more frequent in the UAS group (37.2 vs. 21.2%; p 0.026), but significance was lost in multivariate assessment.Conclusion: FURS without UAS seems to be as safe as FURS with UAS but requires less ancillary procedures. An additional advantage is shorter operative time (AU)

Flexible ureteroscopy without ureteral access sheath.

INTRODUCTION: Ureteral access sheath (UAS) is widely used in flexible ureteroscopy and laser lithotripsy (FURS) based on better stone-free rates, lower intrarenal pressure and fewer complications. However, it also rises surgical costs and may injure the ureteral wall. The main objective of our study is to compare safety and efficacy of FURS with and without UAS to evaluate whether its use is justified in all cases. MATERIALS AND METHODS: We performed a retrospective observational analytic study based on a prospective database. A total of 241 consecutive patients who underwent FURS for upper ureter and renal stones between January 2018 and May 2020 were included for analysis and divided into two groups upon UAS use. We compared demographic data, stone characteristics, prestenting, operative time, need for ureteral stent, postoperative urinary tract infection, renal colic and need for ancillary procedures. RESULTS: A total of 198 patients (82.2%) were included in the group without UAS. Operative time was significantly shorter in the group of patients without UAS than those with UAS (64.6 minutes ± 29.5 vs. 89.9 minutes ± 2.8 respectively; p 0.010). Both groups had similar rates of colic pain and urinary tract infection. Ancillary procedures were more frequent in the UAS group (37.2 vs. 21.2%; p 0.026), but significance was lost in multivariate assessment. CONCLUSION: FURS without UAS seems to be as safe as FURS with UAS but requires less ancillary procedures. An additional advantage is shorter operative time.

Medicamentos de alto impacto económico y sanitario en la prestación farmacéutica hospitalaria / Medicines with high economic impact in the hospital setting

Objetivos: Los medicamentos de alto impacto económico (MAIE) constituyen un reto para los servicios de salud públicos de los países europeos. Sin embargo, no existe consenso sobre qué constituye un MAIE. El objetivo del estudio fue configurar una lista de MAIE dispensados por los servicios de farmacia hospitalarios y analizar la situación respecto a estos fármacos en España.Métodos: Se consideraron MAIE aquellos fármacos con un coste >10.000 €/año (MAC) o con un elevado volumen de consumo (MEC). Se estimaron los precios (PVL) por dosis diaria definida o dosis diaria prescrita.Resultados: Un total de 147 principios activos fueron considerados MAC, correspondiendo mayoritariamente con los grupos: L (69,4%), J (10,9%) y A (10,2%). El PVL medio diario de los MAC fue 218,6 € (28,6-2.892,5). El 38,8% de los MAC fueron innovadores, 26,5% huérfanos y 34,0% biológicos. Dieciséis medicamentos tuvieron un coste >10.000 €/envase. Los MEC pertenecieron principalmente al grupo L (45,0%) y J (35,0%). El PVL medio diario de los MEC fue 154,4 € (1,1-1.629,3). El 35,5% fueron innovadores, 5,0% huérfanos y 60,0% biológicos.Conclusiones: Un elevado número de MAIE son dispensados por los servicios de farmacia hospitalarios, principalmente antineoplásicos y antiinfecciosos. Aunque el PVL mínimo diario para considerar un medicamento de alto impacto es 27,4 €, el PVL medio diario de los MAC fue >200 €. Sin embargo, el elevado consumo de algunos fármacos, hace que medicamentos con un coste tan bajo como 1,1 € puedan ser considerados MAIE. Se puede establecer una nueva categoría de MAC para aquellos con un coste >10.000 €/envase. (AU)

Objetivos: Los medicamentos de alto impacto económico (MAIE) constituyen un reto para los servicios de salud públicos de los países europeos. Sin embargo, no existe consenso sobre qué constituye un MAIE. El objetivo del estudio fue configurar una lista de MAIE dispensados por los servicios de farmacia hospitalarios y analizar la situación respecto a estos fármacos en España.Métodos: Se consideraron MAIE aquellos fármacos con un coste >10.000 €/año (MAC) o con un elevado volumen de consumo (MEC). Se estimaron los precios (PVL) por dosis diaria definida o dosis diaria prescrita.Resultados: Un total de 147 principios activos fueron considerados MAC, correspondiendo mayoritariamente con los grupos: L (69,4%), J (10,9%) y A (10,2%). El PVL medio diario de los MAC fue 218,6 € (28,6-2.892,5). El 38,8% de los MAC fueron innovadores, 26,5% huérfanos y 34,0% biológicos. Dieciséis medicamentos tuvieron un coste >10.000 €/envase. Los MEC pertenecieron principalmente al grupo L (45,0%) y J (35,0%). El PVL medio diario de los MEC fue 154,4 € (1,1-1.629,3). El 35,5% fueron innovadores, 5,0% huérfanos y 60,0% biológicos.Conclusiones: Un elevado número de MAIE son dispensados por los servicios de farmacia hospitalarios, principalmente antineoplásicos y antiinfecciosos. Aunque el PVL mínimo diario para considerar un medicamento de alto impacto es 27,4 €, el PVL medio diario de los MAC fue >200 €. Sin embargo, el elevado consumo de algunos fármacos, hace que medicamentos con un coste tan bajo como 1,1 € puedan ser considerados MAIE. Se puede establecer una nueva categoría de MAC para aquellos con un coste >10.000 €/envase. (AU)

Imatinib en leucemia mieloide crónica: resultados en práctica clínica habitual / Imatinib in chronic myeloid leukemia: outcomes in routine clinical practice

Objetivos: Imatinib cambió el paradigma de la leucemia mieloide crónica (LMC), tras lograr en los ensayos clínicos frente a interferón mejor tasa de respuestas y supervivencia libre de progresión, con un aceptable perfil de toxicidad. El objetivo del presente estudio fue evaluar la efectividad, seguridad y adherencia de imatinib en LMC en la práctica clínica habitual.Métodos: Estudio observacional retrospectivo en pacientes con LMC en fase crónica tratados con imatinib. Objetivos principales: respuesta completa hematológica (RCH), respuesta completa citogenética (RCyC), respuesta mayor molecular (RMM), adherencia (ADH) y efectos adversos (EA). Las tasas de respuesta fueron definidas según criterios de The European LeukemiaNet y la ADH como dosis totales dispensadas x 100/dosis totales prescritas. Se consideraron adherentes aquellos pacientes con ADH ≥85%. Variables secundarias: supervivencia libre de progresión (SLP) y global (SG).Resultados: Se incluyeron un total de 39 pacientes. Tasas de respuesta: RCH 100%, RCyC 84,6% y RMM 66,7%. La ADH media al tratamiento fue de 94,9%, con un 92,3% de pacientes adherentes. Las tasas de SLP y SG estimadas a los 8 años fueron 94,4% (IC95%: 86,9-100,0) y 94,4% (IC95%: 87,3-100,0) respectivamente. EA no hematológicos más frecuentes: edemas (53,8%), dolor músculo-esquelético (43,6%) y calambres (38,5%). Se encontró neutropenia y trombocitopenia grado 3-4 en el 10,3% y 5,1% de los pacientes respectivamente.Conclusiones: Imatinib induce respuestas duraderas en una notable proporción de pacientes, consiguiendo mantener la enfermedad bajo control. Este estudio confirma el beneficio de imatinib en práctica clínica habitual. El perfil de seguridad es consistente con los resultados obtenidos en estudios previos. (AU)

Objectives: Imatinib changed the treatment paradigm of chronic myeloid leukemia (CML) after yielding better response rates and progression free survival than interferon-α, with an acceptable safety profile. The aim of this study was to evaluate the effectiveness, safety and adherence of imatinib in the treatment of CML in clinical practice.Methods: Retrospective study carried out in patients with CML in chronic phase treated with imatinib. Primary endpoints: complete hematological response (CHR), complete cytogenetic response (CCyR), major molecular response (MMR), treatment adherence (ADH) and adverse events (AE). Response rates were defined according to the criteria of The European LeukemiaNet and ADH was estimated as number of dosage units dispensed x 100/ number of dosage units prescribed. Patients were adherent if their ADH was ≥85%. Secondary endpoints: progression free survival (PFS) and overall survival (OS).Results: 39 patients were included. Response rates: CHR 100% (39/39); CCyR 84.6% (33/39); and MMR 66.7% (26/39). The mean ADH was 94.9% (59.0%-100%), with a 92.3% of patients considered adherents. PFS and OS rates estimated at 8 years were: 94.4% (95% CI: 86.9-100.0) and 94.4% (95% CI: 87.3-100.0), respectively. Most frequent non-hematological AE: edema 53.8% (21/39), musculoskeletal pain 43.6% (17/39) and muscle cramps 38.5% (15/39). Grade 3-4 neutropenia and thrombocytopenia were found in 10.3% (4/39) and 5.1% (2/39) of patients, respectively.Conclusions: Imatinib induced sustainable responses in a remarkable proportion of real world patients, managing to keep the disease under control. This study confirms the benefits of imatinib in clinical practice. The safety profile was consistent with earlier reports. (AU)

Late effects of Beauveria bassiana on larval stages of Aedes aegypti Linneo , 1762 (Diptera: Culicidae) / Efeitos tardios de Beauveria bassiana nos estágios larvais de Aedes aegypti Linneo, 1762 (Diptera: Culicidae)

Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104 , 1.5× 105 , 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values with 63% in the highest concentration i.e., 1.5 × 107 , while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.

O Aedes aegypti é um culicida que vem ganhando relevância ao longo dos anos devido à sua capacidade de transmitir diversos vírus causadores de doenças em humanos que ao longo dos anos ocasionam altas taxas de mortalidade na população mundial. O principal problema é que Ae. aegypti tem conseguido estabelecer e manter uma relação próxima com o homem e seu habitat, por isso a busca por alternativas para o controle das populações de vetores torna-se imperativa. O objetivo do presente trabalho foi estudar os efeitos de duas cepas de Beauveria bassiana sobre Ae. aegypti. Larvas de terceiro instar de Ae. aegypti em recipientes plásticos de 250 mL foram inoculados com as cepas GHA e NB3 em diferentes concentrações (1.5 × 104, 1.5 × 105, 1.5 × 106 e 1.5 × 107 conídios/mL). A cepa NB3 apresentou os maiores valores de mortalidade com 63% na concentração mais alta, ou seja, 1.5 × 107, enquanto para a cepa GHA o maior valor de mortalidade foi 30.7% na mesma concentração. Os resultados mostraram diferença significativa na mortalidade com relação à cepa e dias pós-tratamento (P = 0.0001), mas não com relação à concentração de conídios (P = 0.634). A mortalidade média de larvas por dia para o NB3 para diferentes concentrações variou de 20 a 25 larvas por dia, enquanto para o GHA a mortalidade diária variou de 5 a 12 larvas. Na mortalidade pós-tratamento, a maior mortalidade foi registrada nas larvas de terceiro estágio para o NB3, enquanto para o GHA o maior percentual de mortalidade foi observado em indivíduos que conseguiram atingir o estado adulto. Os resultados da pesquisa atual retratam o papel notável de B. bassiana no manejo de um importante vetor de doenças humanas.

Late effects of Beauveria bassiana on larval stages of Aedes aegypti Linneo, 1762 (Diptera: Culicidae) / Efeitos tardios de Beauveria bassiana nos estágios larvais de Aedes aegypti Linneo, 1762 (Diptera: Culicidae)

Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104, 1.5× 105, 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values with 63% in the highest concentration i.e., 1.5 × 107, while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.

O Aedes aegypti é um culicida que vem ganhando relevância ao longo dos anos devido à sua capacidade de transmitir diversos vírus causadores de doenças em humanos que ao longo dos anos ocasionam altas taxas de mortalidade na população mundial. O principal problema é que Ae. aegypti tem conseguido estabelecer e manter uma relação próxima com o homem e seu habitat, por isso a busca por alternativas para o controle das populações de vetores torna-se imperativa. O objetivo do presente trabalho foi estudar os efeitos de duas cepas de Beauveria bassiana sobre Ae. aegypti. Larvas de terceiro instar de Ae. aegypti em recipientes plásticos de 250 mL foram inoculados com as cepas GHA e NB3 em diferentes concentrações (1.5 × 104, 1.5 × 105, 1.5 × 106 e 1.5 × 107 conídios/mL). A cepa NB3 apresentou os maiores valores de mortalidade com 63% na concentração mais alta, ou seja, 1.5 × 107, enquanto para a cepa GHA o maior valor de mortalidade foi 30.7% na mesma concentração. Os resultados mostraram diferença significativa na mortalidade com relação à cepa e dias pós-tratamento (P = 0.0001), mas não com relação à concentração de conídios (P = 0.634). A mortalidade média de larvas por dia para o NB3 para diferentes concentrações variou de 20 a 25 larvas por dia, enquanto para o GHA a mortalidade diária variou de 5 a 12 larvas. Na mortalidade pós-tratamento, a maior mortalidade foi registrada nas larvas de terceiro estágio para o NB3, enquanto para o GHA o maior percentual de mortalidade foi observado em indivíduos que conseguiram atingir o estado adulto. Os resultados da pesquisa atual retratam o papel notável de B. bassiana no manejo de um importante vetor de doenças humanas.

Late effects of Beauveria bassiana on larval stages of Aedes aegypti Linneo, 1762 (Diptera: Culicidae)

Abstract Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104, 1.5× 105, 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values with 63% in the highest concentration i.e., 1.5 × 107, while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.

Resumo O Aedes aegypti é um culicida que vem ganhando relevância ao longo dos anos devido à sua capacidade de transmitir diversos vírus causadores de doenças em humanos que ao longo dos anos ocasionam altas taxas de mortalidade na população mundial. O principal problema é que Ae. aegypti tem conseguido estabelecer e manter uma relação próxima com o homem e seu habitat, por isso a busca por alternativas para o controle das populações de vetores torna-se imperativa. O objetivo do presente trabalho foi estudar os efeitos de duas cepas de Beauveria bassiana sobre Ae. aegypti. Larvas de terceiro instar de Ae. aegypti em recipientes plásticos de 250 mL foram inoculados com as cepas GHA e NB3 em diferentes concentrações (1.5 × 104, 1.5 × 105, 1.5 × 106 e 1.5 × 107 conídios/mL). A cepa NB3 apresentou os maiores valores de mortalidade com 63% na concentração mais alta, ou seja, 1.5 × 107, enquanto para a cepa GHA o maior valor de mortalidade foi 30.7% na mesma concentração. Os resultados mostraram diferença significativa na mortalidade com relação à cepa e dias pós-tratamento (P = 0.0001), mas não com relação à concentração de conídios (P = 0.634). A mortalidade média de larvas por dia para o NB3 para diferentes concentrações variou de 20 a 25 larvas por dia, enquanto para o GHA a mortalidade diária variou de 5 a 12 larvas. Na mortalidade pós-tratamento, a maior mortalidade foi registrada nas larvas de terceiro estágio para o NB3, enquanto para o GHA o maior percentual de mortalidade foi observado em indivíduos que conseguiram atingir o estado adulto. Os resultados da pesquisa atual retratam o papel notável de B. bassiana no manejo de um importante vetor de doenças humanas.

Diagnostico de Chagas Congénito en el Hospital de Niños "Sor María Ludovica" / Diagnosis of Congenital Chagas in the Children's Hospital "Sor María Ludovica"

Introducción:La transmisión congénita de Trypanosoma cruzi constituye, en la actualidad, la vía que genera mayor cantidad de nuevos casos de infección aguda. El diagnóstico y tratamiento temprano aseguran una elevada probabilidad de cura parasitológica. El objetivo del trabajo fue evaluar el seguimiento de potenciales casos de Chagas Congénito, estimar la tasa de transmisión materno-fetal y la capacidad diagnóstica del microhematocrito. Materiales y métodos: Se realizó un estudio descriptivo transversal sobre hijos de mujeres con Chagas, que concurrieron al Laboratorio Central del H.I.A.E.P. Sor María Ludovica durante abril 2013-febrero 2019. Los niños fueron estudiados por microhematocrito y pruebas serológicas. Los resultados se obtuvieron del Sistema Informático de Laboratorio de Wiener®. Resultados: En el período de tiempo evaluado, fueron estudiados por microhematocrito un total de 268 niños (edad promedio= 2,35 meses), obteniéndose 16 resultados positivos. De los 252 niños con microhematocrito negativo, 58 fueron seguidos por pruebas serológicas hasta el año de vida, obteniéndose 3 resultados positivos. Se evidenció una pérdida de seguimiento serológico del 77%. La tasa de transmisión congénita estimada fue del 6,9% y el porcentaje de detección diagnóstica de la técnica directa, del 84,2%. Conclusión: La búsqueda de infección congénita en hijos de mujeres con Chagas, y su seguimiento hasta el año de vida, resulta esencial para lograr la detección y tratamiento temprano de nuevos casos. Sin embargo, la pérdida de seguimiento de potenciales casos de Chagas Congénito resulta alarmante. Esto enfatiza la necesidad de plantear estrategias sólidas para mejorar la aplicación del algoritmo diagnóstico

Introduction:Congenital Trypanosoma cruzi transmission is currently the route that generates the largest number of new cases of acute infection. Early diagnosis and treatment ensure a high probability of parasitological cure. The aim of this article was to evaluate the follow-up of possible cases of Congenital Chagas, to estimate the maternal-fetal transmission rate and the diagnostic capacity of microhematocrit. Materials and methods: A cross-sectional descriptive study was carried out on children born from Chagasic women, who attended the Central Laboratory of the H.I.A.E.P Sor María Ludovica during April 2013-February 2019. The children were studied by microhematocrit and serological tests. The results were obtained from the Wiener® Laboratory Information System. Results: In the evaluated time period, a total of 268 children (mean age = 2.35 months) were studied by microhematocrit, obtaining 16 positive results. Among the 252 children with negative microhematocrit, 58 were followed by serological tests up to one year of life, obtaining 3 positive results. A 77% loss of serological follow-up was evidenced. The estimated congenital transmission rate was 6.9% and the percentage of diagnostic detection of the direct technique was 84.2%. Conclusion: The search for congenital infection in children born from Chagasic women, and its follow-up until one year of life, is essential to achieve the early detection and treatment of new cases. However, the loss of follow-up of potential cases of Congenital Chagas is alarming. This emphasizes the need to propose solid strategies to improve the application of the diagnostic algorithm

Late effects of Beauveria bassiana on larval stages of Aedes aegypti Linneo , 1762 (Diptera: Culicidae).

Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104, 1.5× 105, 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values ​​with 63% in the highest concentration i.e., 1.5 × 107, while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.

The effects of microstructure, Nb content and secondary Ruddlesden-Popper phase on thermoelectric properties in perovskite CaMn1-x Nb x O3 (x = 0-0.10) thin films.

CaMn1-x Nb x O3 (x = 0, 0.5, 0.6, 0.7 and 0.10) thin films have been grown by a two-step sputtering/annealing method. First, rock-salt-structured (Ca,Mn1-x ,Nb x )O thin films were deposited on 11̄00 sapphire using reactive RF magnetron co-sputtering from elemental targets of Ca, Mn and Nb. The CaMn1-x Nb x O3 films were then obtained by thermally induced phase transformation from rock-salt-structured (Ca,Mn1-x Nb x )O to orthorhombic during post-deposition annealing at 700 °C for 3 h in oxygen flow. The X-ray diffraction patterns of pure CaMnO3 showed mixed orientation, while Nb-containing films were epitaxially grown in [101] out of-plane-direction. Scanning transmission electron microscopy showed a Ruddlesden-Popper (R-P) secondary phase in the films, which results in reduction of the electrical and thermal conductivity of CaMn1-x Nb x O3. The electrical resistivity and Seebeck coefficient of the pure CaMnO3 film were measured to 2.7 Ω cm and -270 µV K-1 at room temperature, respectively. The electrical resistivity and Seebeck coefficient were reduced by alloying with Nb and was measured to 0.09 Ω cm and -145 µV K-1 for x = 0.05. Yielding a power factor of 21.5 µW K-2 m-1 near room temperature, nearly eight times higher than for pure CaMnO3 (2.8 µW K-2 m-1). The power factors for alloyed samples are low compared to other studies on phase-pure material. This is due to high electrical resistivity originating from the secondary R-P phase. The thermal conductivity of the CaMn1-x Nb x O3 films is low for all samples and is the lowest for x = 0.07 and 0.10, determined to 1.6 W m-1 K-1. The low thermal conductivity is attributed to grain boundary scattering and the secondary R-P phase.

Rhodnius prolixus: from physiology by Wigglesworth to recent studies of immune system modulation by Trypanosoma cruzi and Trypanosoma rangeli.

This review is dedicated to the memory of Professor Sir Vincent B. Wigglesworth (VW) in recognition of his many pioneering contributions to insect physiology which, even today, form the basis of modern-day research in this field. Insects not only make vital contributions to our everyday lives by their roles in pollination, balancing eco-systems and provision of honey and silk products, but they are also outstanding models for studying the pathogenicity of microorganisms and the functioning of innate immunity in humans. In this overview, the immune system of the triatomine bug, Rhodnius prolixus, is considered which is most appropriate to this dedication as this insect species was the favourite subject of VW's research. Herein are described recent developments in knowledge of the functioning of the R. prolixus immune system. Thus, the roles of the cellular defences, such as phagocytosis and nodule formation, as well as the role of eicosanoids, ecdysone, antimicrobial peptides, reactive oxygen and nitrogen radicals, and the gut microbiota in the immune response of R. prolixus are described. The details of many of these were unknown to VW although his work gives indications of his awareness of the importance to R. prolixus of cellular immunity, antibacterial activity, prophenoloxidase and the gut microbiota. This description of R. prolixus immunity forms a backdrop to studies on the interaction of the parasitic flagellates, Trypanosoma cruzi and Trypanosoma rangeli, with the host defences of this important insect vector. These parasites remarkably utilize different strategies to avoid/modulate the triatomine immune response in order to survive in the extremely hostile host environments present in the vector gut and haemocoel. Much recent information has also been gleaned on the remarkable diversity of the immune system in the R. prolixus gut and its interaction with trypanosome parasites. This new data is reviewed and gaps in our knowledge of R. prolixus immunity are identified as subjects for future endeavours. Finally, the publication of the T. cruzi, T. rangeli and R. prolixus genomes, together with the use of modern molecular techniques, should lead to the enhanced identification of the determinants of infection derived from both the vector and the parasites which, in turn, could form targets for new molecular-based control strategies.

[Management of malignant ureteral obstruction.] / Manejo de la obstrucción ureteral maligna.

OBJECTIVE: To describe the different therapeutic alternatives in malignant ureteral obstruction (MUO), and to analyze short and long-term results. METHODS: We conducted a bibliographic search about MUO in Spanish and English languages in PubMed and Google Scholar. We examined the most relevant reviews, original manuscripts and their respective citations. Last search was on April 2016. RESULTS: Polymeric double J stent is the cheapest and most accessible internal urinary diversion, but has also the shortest duration. Early and late failure rates were 0-35% and 14-49% respectively. Mean time to late failure was 3-12 months. Percutaneous nephrostomy is the safest alternative in terms of failure rates, though it has frequent complications such as tube dislodgement, and may have a negative effect on quality of life. The only metallic double J stent with enough bibliographic background is the Resonance® stent. Early failure was 0-15% and late failure 4-41%, with a mean time to late failure of 2.6-13 months. Regarding metallic stents, Memokath 051® has obtained the best results, with 0-5% early failure rates, 19-49% late failures and mean time to late failure of 7-11 months. In patients with polymeric double J stent failure, patients benefited from tandem double J stents, metallic double J catheters or metallic stents, avoiding the need of a percutaneous nephrostomy. The evidence level was low in all cases. CONCLUSIONS: Results in MUO are very heterogeneous and have a low evidence level. Factors that influence results include stent characteristics, status and prognosis of the obstructive condition and probably patient and physician's preferences. Polymeric double J stents seem to have higher early and late failure rates than metallic double J catheters and metallic stents. Even though, the difference is not clearly evident. Prospective, multicenter, multidisciplinary trials are necessary to elucidate convenience and adequate selection of each type of stent.

Ecdysis period of Rhodnius prolixus head investigated using phase contrast synchrotron microtomography.

Microtomography using synchrotron sources is a useful tool in biological imaging research since the phase coherence of synchrotron beams can be exploited to obtain images with high contrast resolution. This work is part of a series of works using phase contrast synchrotron microtomography in the study of Rhodnius prolixus head, the insect vector of Chagas' disease, responsible for about 12,000 deaths per year. The control of insect vector is the most efficient method to prevent this disease and studies have shown that the use of triflumuron, a chitin synthesis inhibitor, disrupted chitin synthesis during larval development and it's an alternative method against insect pests. The aim of this work was to investigate the biological effects of treatments with triflumuron in the ecdysis period (the moulting of the R. prolixus cuticle) using the new imaging beamline IMX at LNLS (Brazilian Synchrotron Light Laboratory). Nymphs of R. prolixus were taken from the Laboratory of Biochemistry and Physiology of Insects, Oswaldo Cruz Foundation, Brazil. Doses of 0.05mg of triflumuron were applied directly to the abdomen on half of the insects immediately after feeding. The insects were sacrificed 25days after feeding (intermoulting period) and fixed with glutaraldehyde. The results obtained using phase contrast synchrotron microtomography in R. prolixus showed amazing images of the effects of triflumuron on insects in the ecdysis period, and the formation of the new cuticle on those which were not treated with triflumuron. Both formation and malformation of this insect's cuticle have never been seen before with this technique.

Low thermal conductivity and improved thermoelectric performance of nanocrystalline silicon germanium films by sputtering.

Si x Ge1-x alloys are well-known thermoelectric materials with a high figure of merit at high temperatures. In this work, metal-induced crystallization (MIC) has been used to grow Si0.8Ge0.2 films that present improved thermoelectric performance (zT = 5.6 × 10(-4) at room temperature)--according to previously reported values on films--with a relatively large power factor (σ · S (2) = 16 µW · m(-1) · K(-2)). More importantly, a reduction in the thermal conductivity at room temperature (κ = 1.13 ± 0.12 W · m(-1) · K(-1)) compared to other Si-Ge films (∼3 W · m(-1) · K(-1)) has been found. Whereas the usual crystallization of amorphous SiGe (a-SiGe) is achieved at high temperatures and for long times, which triggers dopant loss, MIC reduces the crystallization temperature and the heating time. The associated dopant loss is thus avoided, resulting in a nanostructuration of the film. Using this method, we obtained Si0.8Ge0.2 films (grown by DC plasma sputtering) with appropriate compositional and structural properties. Different thermal treatments were tested in situ (by heating the sample inside the deposition chamber) and ex situ (annealed in an external furnace with controlled conditions). From the studies of the films by: x-ray diffraction (XRD), synchrotron radiation grazing incidence x-ray diffraction (SR-GIXRD), micro Raman, scanning electron microscopy (SEM), x-ray photoemission spectroscopy (XPS), Hall effect, Seebeck coefficient, electrical and thermal conductivity measurements, we observed that the in situ films at 500 °C presented the best zT values with no gold contamination.

Análisis de los pacientes que reconsultaron a un servicio de emergencias pediátricas de un hospital materno infantil como indicador de calidad asistencial / Analysis of patients who consulted for a second time at a pediatric emergency department at a mother-and-child hospital as a marker of quality of care

Objetivos: 1) Analizar las reconsultas (RC) de pacientes a las 72 horas de su primera consulta en el Servicio de Emergencias Pediatría (SEP) de un hospital materno infantil del conurbano bonaerense. 2) Comparar las reconsultas entre dos periodos, luego de implementar mejoras en los procesos asistenciales y de contrarreferencia. Materiales y Metodos: Diseño: retrospectivo, observacional y transversal. Criterios de inclusión: pacientes de 30 días a 15 años de edad, que reconsultaron en el SEP del 01/01 al 31/03 de los años 2010 y 2014. Resultados: Las consultas que se atendieron en el periodo de estudio fueron: 14.003 en 2010 y 13.011 en 2014. Los diagnósticos más frecuentes fueron: infección respiratoria aguda alta (19.2%), fiebre (13%) y diarrea/ gastroenteritis (13.3%). Hubo 7.11% (n=966) de RC en el 2010 y 12.21% (n=1589) en el 2014. La mediana de edad de los pacientes con RC fue 24 meses en ambos años. Los motivos de RC más frecuentes fueron: persistencia de los síntomas (41% y 53.67%); progresión de la enfermedad (25% y 11.43%); otros diagnósticos nuevos (14.07% y 19.5%) y control (14% y 8.3%). Las RC de los domiciliados en San Isidro fueron 72.97% (n=694) en el 2010 y 69.32% (n=1071) en el 2014 del total de RC. La disminución de las RC observada al comparar ambos períodos es estadísticamente no significativa. (Pearson chi2 2.4506, p = 0.117). Conclusiones: 1) Los principales motivos de consulta fueron fiebre, diarrea y patología de la vía aérea superior. 2) Las RC dentro de las primeras 72 horas fueron 7% en 2010 y 12.9% en 2014. 3) La mayoría de los niños que concurren por RC lo hacen por la persistencia de síntomas de procesos que revisten poca gravedad. 4) Hubo una leve disminución, estadísticamente no significativa, de la RC de los pacientes domiciliados en San Isidro (AU)

Aims: 1) To analyze second consultations (SC) in patients within 72 hours of the first consultation at the Pediatric Emergency Department (PED) of a mother-and-child hospital in Greater Buenos Aires. 2) To compare SC between two time periods, after implementing a program of care and counter-referral. Material and Methods: Study design: a retrospective, observational, and cross-sectional study was conducted. Inclusion criteria: patients between 30 days of life and 15 years of age, who consulted at the PED between 01/01 and 31/03 from 2010 to 2014. Results: Patients seen during the study period were: 14,003 in 2010 and 13,011 in 2014. The most common diagnoses were: Acute upper respiratory infection (19.2%), fever (13%) and diarrhea/gastroenteritis (13.3%). SC were 7.11% (n=966) in 2010 and 12.21% (n=1589) in 2014. Median age of patients with a SC was 24 months in both years. Most common reasons for SC were persistent symptoms (41% and 53.67%); disease progression (25% and 11.43%); new diagnosis (14.07% and 19.5%) and control (14% and 8.3%). Home visits for SC in San Isidro were 72.97% (n=694) in 2010 and 69.32% (n=1071) in 2014 of all SC. The decrease in SC when comparing both periods was not statistically significant (Pearson chi2 2.4506, p = 0.117). Conclusions: 1) The main reasons for consult were fever, diarrhea, and upper airway infections. 2) SC within 72 hours were 7% in 2010 and 12.9% in 2014. 3) The majority of childrenwho were seen in a SC had persistent symptoms that were not severe. 4) A slight decrease, that was not statistically significant, was observed in SC of patients seen in the area of San Isidro (AU)

Zanthoxylum caribaeum (Rutaceae) essential oil: chemical investigation and biological effects on Rhodnius prolixus nymph.

A chemical investigation and bioassays against fifth-instar nymphae of the hematophagous insect Rhodnius prolixus, vector of Chagas disease, were conducted with the essential oil from Zanthoxylum caribaeum. The main results may be summarized as follows: (i) 54 components were identified, corresponding to 90.4% of the relative composition; sesquiterpenes (47.3%) and monoterpenes (41.2%) are the major constituents; (ii) muurola-4,5-trans-diene and isodaucene are described for the first time as chemical constituents of the essential oil from leaves of this species; (iii) topical treatment with the crude essential oil induced high levels of paralysis (from 18.88 to 33.33%) and mortality (from 80 to 98.9%) depending on the dose applied (0.5 to 5.0 µl per insect); (iv) feeding treatment with the crude essential oil also induced high levels of mortality (from 48.8 to 100%) but low levels of paralysis (from 2.22 to 7.77%) depending on the dose applied (0.5 to 5.0 µl/ml of blood); (v) in the continuous treatment, only the dose of 5.0 µl/cm(2) was able to promote statistical significant levels of mortality (63.3%) but no paralysis were detected. However in this group, occasionally, only few insects displayed malformations of legs and wings after treatment; and (vi) any treatment was able to disrupt the metamorphosis process since the low adult stage emergence observed to all groups was due the high insect mortality. These observations suggest the interference of Z. caribaeum compounds on the triatomine neuroendocrine system. The significance of these results in relation to the relevant biological events in R. prolixus as well as the possible use of insect growth regulators present in Z. caribaeum oil in integrated vector control programs against hematophagous triatomine species is herein discussed.

Advances in the synthesis of calystegines and related products and their biochemical properties.

The revision of the structures and properties of Calystegines shows that they can be regarded as carbohydrate mimics, with related biological activities and peculiar characteristics. Not only they can be isolated from food plants, but they can be obtained from a variety of monosaccharide derivatives and of non-carbohydrate products. Although several synthetic calystegine analogs have been reported as glycosidase inhibitors, new, more potent and effective inhibitors are required.

Trypanosoma cruzi: effects of azadirachtin and ecdysone on the dynamic development in Rhodnius prolixus larvae.

The effects of azadirachtin and ecdysone on the Trypanosoma cruzi population in the Rhodnius prolixus gut were investigated. T. cruzi were rarely found in the gut compartments of azadirachtin-treated larvae. High parasite numbers were observed in the stomach of the control and ecdysone groups until 10 days after treatment and in the small intestine and rectum until 25 days after treatment. High percentages of round forms developed in the stomachs of all groups, whereas azadirachtin blocked the development of protozoan intermediate forms. This effect was counteracted by ecdysone therapy. In the small intestine and rectum, epimastigotes predominated for all groups, but more of their intermediates developed in the control and ecdysone groups. Azadirachtin supported the development of round forms and their intermediates into trypomastigotes. In the rectum, trypomastigotes did not develop in the azadirachtin group and developed much later after ecdysone therapy. The parallel between the effects of azadirachtin and ecdysone on the host and parasite development is discussed on the basis of the present results because ecdysone appears to act directly or indirectly in determining the synchronic development of T. cruzi forms from round to epimastigotes, but not metacyclic trypomastigotes, in the invertebrate vector.