Performance of cotton expressing Cry1Ac, Cry1F and Vip3Aa19 insecticidal proteins against Helicoverpa armigera, H. zea and their hybrid progeny, and evidence of reduced susceptibility of a field population of H. zea to Cry1 and Vip3Aa in Brazil.

The genetically modified cotton DAS-21023-5 × DAS-24236-5 × SYN-IR102-7 expressing Cry1Ac, Cry1F and Vip3Aa19 from Bacillus thuringiensis Berliner (Bt) has been cultivated in Brazil since the 2020/2021 season. Here, we assessed the performance of DAS-21023-5 × DAS-24236-5 × SYN-IR102-7 cotton expressing Cry1Ac, Cry1F and Vip3Aa19 against Helicoverpa armigera (Hübner), Helicoverpa zea (Boddie), and their hybrid progeny. We also carried out evaluations with DAS-21023-5 × DAS-24236-5 cotton containing Cry1Ac and Cry1F. In leaf-disk bioassays, DAS-21023-5 × DAS-24236-5 × SYN-IR102-7 was effective in controlling neonates from laboratory colonies of H. armigera, H. zea and the hybrid progeny (71.9%-100% mortality). On floral bud bioassays using L2 larvae, H. zea presented complete mortality, whereas H. armigera and the hybrid progeny showed <55% mortality. On DAS-21023-5 × DAS-24236-5 cotton, the mortality of H. armigera on leaf-disk and floral buds ranged from 60% to 73%, whereas mortality of hybrids was <46%. This Bt cotton caused complete mortality of H. zea larvae from a laboratory colony in the early growth stages, but mortalities were <55% on advanced growth stages and on floral buds. In field studies conducted from 2014 to 2019, DAS-21023-5 × DAS-24236-5 × SYN-IR102-7 cotton was also effective at protecting plants against H. armigera. In contrast, a population of H. zea collected in western Bahia in 2021/2022 on Bt cotton expressing Cry1 and Vip3Aa proteins, showed 63% mortality after 30 d, with insects developing into fifth and sixth instars, on DAS-21023-5 × DAS-24236-5 × SYN-IR102-7 cotton. We conclude that H. armigera, H. zea, and their hybrid progeny can be managed with DAS-21023-5 × DAS-24236-5 × SYN-IR102-7 cotton; however we found the first evidence in Brazil of a significant reduction in the susceptibility to DAS-21023-5 × DAS-24236-5 × SYN-IR102-7 cotton of a population of H. zea collected from Bt cotton in Bahia in 2021/2022.

Low-cost transcriptional diagnostic to accurately categorize lymphomas in low- and middle-income countries.

Inadequate diagnostics compromise cancer care across lower- and middle-income countries (LMICs). We hypothesized that an inexpensive gene expression assay using paraffin-embedded biopsy specimens from LMICs could distinguish lymphoma subtypes without pathologist input. We reviewed all biopsy specimens obtained at the Instituto de Cancerología y Hospital Dr. Bernardo Del Valle in Guatemala City between 2006 and 2018 for suspicion of lymphoma. Diagnoses were established based on the World Health Organization classification and then binned into 9 categories: nonmalignant, aggressive B-cell, diffuse large B-cell, follicular, Hodgkin, mantle cell, marginal zone, natural killer/T-cell, or mature T-cell lymphoma. We established a chemical ligation probe-based assay (CLPA) that quantifies expression of 37 genes by capillary electrophoresis with reagent/consumable cost of approximately $10/sample. To assign bins based on gene expression, 13 models were evaluated as candidate base learners, and class probabilities from each model were then used as predictors in an extreme gradient boosting super learner. Cases with call probabilities < 60% were classified as indeterminate. Four (2%) of 194 biopsy specimens in storage <3 years experienced assay failure. Diagnostic samples were divided into 70% (n = 397) training and 30% (n = 163) validation cohorts. Overall accuracy for the validation cohort was 86% (95% confidence interval [CI]: 80%-91%). After excluding 28 (17%) indeterminate calls, accuracy increased to 94% (95% CI: 89%-97%). Concordance was 97% for a set of high-probability calls (n = 37) assayed by CLPA in both the United States and Guatemala. Accuracy for a cohort of relapsed/refractory biopsy specimens (n = 39) was 79% and 88%, respectively, after excluding indeterminate cases. Machine-learning analysis of gene expression accurately classifies paraffin-embedded lymphoma biopsy specimens and could transform diagnosis in LMICs.

Field efficacy of Bt cotton containing events DAS-21023-5 × DAS-24236-5 × SYN-IR102-7 against lepidopteran pests and impact on the non-target arthropod community in Brazil.

The efficacy and non-target arthropod effects of transgenic DAS-21023-5 × DAS-24236-5 × SYN-IR102-7 Bt cotton, expressing proteins Cry1Ac, Cry1F and Vip3Aa19, was examined through field trials in Brazil. Fifteen field efficacy experiments were conducted from 2014 through the 2020 growing season across six different states in Brazil to evaluate performance against key lepidopteran pests through artificial infestations of Chrysodeixis includens (Walker), Spodoptera frugiperda (J.E. Smith,1797), Spodoptera cosmioides (Walker, 1858) and Chloridea virescens (F., 1781), and natural infestations of Alabama argillacea (Hübner) and S. frugiperda. The impact of this Bt cotton technology on the non-target arthropod community in Brazilian cotton production systems was also assessed in a multi-site experiment. DAS-21023-5 × DAS-24236-5 × SYN-IR102-7 cotton significantly reduced the feeding damage caused by S. frugiperda, S. cosmioides, C. includens, C. virescens and A. argillacea, causing high levels of mortality (greater than 99%) to all target lepidopteran pests evaluated during vegetative and/or reproductive stages of crop development. Non-target arthropod community-level analyses confirmed no unintended effects on the arthropod groups monitored. These results demonstrate the value of transgenic Bt cotton containing event DAS-21023-5 × DAS-24236-5 × SYN-IR102-7 for consideration as part of an integrated approach for managing key lepidopteran pests in Brazilian cotton production systems.

Classic Hodgkin lymphoma in Guatemalan children of age less than six years: analysis of immune regulatory pathways and the tumor microenvironment.

Classic Hodgkin lymphoma (cHL) in young children (ages 0-6) is rare in high income countries (HICs) but is more prevalent in low- and middle-income countries (LMICs) like Guatemala. Given that the majority of cHL studies have evaluated adolescent/adults, and the immune system changes with age, we sought to characterize Epstein-Barr virus (EBV) expression, immune regulatory pathway markers and the tumor microenvironment in 42 children ages 0-6 with cHL from Guatemala. We found a very high frequency of EBV expression (97.5%). Hodgkin cells showed increased expression of PD1 ligands and CD137, indicative of shared immune regulatory mechanisms with adult cHL. Pediatric cHL also showed an increase in CD8+ tumor infiltrating lymphocytes and tumor associated macrophages within the tumor microenvironment. Despite 25 having high risk disease, only 4 patients died from progressive disease, relapse or infection.

Assessing the Efficacy of Bacillus thuringiensis (Bt) Pyramided Proteins Cry1F, Cry1A.105, Cry2Ab2, and Vip3Aa20 Expressed in Bt Maize Against Lepidopteran Pests in Brazil.

Field studies across four states in maize-producing areas of Brazil were conducted to characterize the efficacy of a new pyramided Bacillus thuringiensis (Bt) Berliner technology in maize, Zea mays L., and compare it to existing single and pyramided commercial Bt technologies, to control Helicoverpa zea Boddie (Lepidoptera: Noctuidae), Elasmopalpus lignosellus Zeller (Lepidoptera: Pyralidae), Agrotis ipsilon (Hufnagel) (Lepidoptera: Noctuidae), and Diatraea saccharalis F. (Lepidoptera: Crambidae). Bt maize expressing Vip3Aa20 protein and pyramided Bt maize expressing proteins Cry1F + Cry1A.105 + Cry2Ab2 + Vip3Aa20 provided excellent protection against kernel feeding by H. zea compared to Bt technologies expressing only Cry1F or Cry1A.105 + Cry2Ab2. Bt maize expressing Cry1F, Cry1A.105 + Cry2Ab2, Cry1F + Cry1A.105 + Cry2Ab2, and Cry1F + Cry1A.105 + Cry2Ab2 + Vip3Aa20 resulted in less than 5% of plants injured by E. lignosellus, significantly less than Bt maize expressing only Vip3Aa20 and a non-Bt maize iso-hybrid with and without a thiamethoxam seed treatment. The highest protection against plant cutting injury caused by A. ipsilon was observed in the pyramid Bt maize technology expressing Cry1F + Cry1A.105 + Cry2Ab2 + Vip3Aa20. However, it did not differ statistically from the Bt maize expressing Vip3Aa20, Cry1F, or Cry1F + Cry1A.105 + Cry2Ab2. All Bt maize hybrids evaluated in our study were highly effective in reducing tunneling injury caused by D. saccharalis. These results show that a new maize technology expressing pyramided Bt proteins Cry1F + Cry1A.105 + Cry2Ab2 + Vip3Aa20 offers a higher level of protection from feeding by the above lepidopteran pest complex compared to maize with a single Bt protein or double pyramided Bt proteins.

Knowledge, Attitudes, and Practices on Infection Control Measures in Stomatology Students in Lima, Peru.

Introduction: The level of knowledge, attitudes, and practices with respect to infection control measures in undergraduate stomatology students is not well understood; that is why these variables were evaluated in the students of the Universidad Privada San Juan Bautista between September and November of 2017. Methods: A cross-sectional study was carried out. A total of 347 students from the Ica, Lima Norte, and Chorrillos campuses were evaluated. The sample was calculated using the statistical formula of comparison of means. The questionnaire of the CDC (Center of Contagious Diseases) was used to measure the variables described. Results: It was observed that 72.05% of the students preferred to use oral rinsing before starting a treatment, 72.62% used the autoclave as the primary equipment to sterilize their instruments in the dental clinic, 95.10% considered that isolation is important in the control of the infection, 46.40% affirmed that tuberculosis is the most infectious disease, and only 26.51% considered it to be hepatitis B. On the other hand, it was found that the scores of knowledge, attitudes, and practices were 2.74 ± 2.16, 3.59 ± 0.88, and 3.59 ± 1.73, respectively. Conclusions: The level of knowledge was low among the students evaluated; however, as far as the level of practices and attitudes was high, even so, this topic must be reinforced so that stomatology students reflect on the importance of the risks that exist to get infected with any disease inside the dental office, as outside of it.

Susceptibility of Grapholita molesta to insecticides in Brazil / Suscetibilidade de Grapholita molesta a inseticidas no Brasil

The use of insecticides has been the main tool for Grapholita molesta (Busck) control in Brazil, which is considered one of the most important pests in apple and peach orchards. In order to implement an Insect Resistance Management (IRM) program, studies were conducted to characterize the baseline susceptibility of G. molesta to major insecticides for its control. Then, we conducted an insecticide susceptibility monitoring in thirteen field-collected populations of the pest. Neonates (0-24h old) were exposed to insecticides applied on surface of artificial diet. A high susceptibility was verified when neonates of the Laboratory population of G. molesta were exposed to insecticides with LC50 values (µg a.i./cm2) of 0.1 (spinetoram), 1.0 (metaflumizone), 1.2 (chlorantraniliprole), 4.8 (novaluron), 5.1 (tebufenozide), 11.3 (phosmet) and 222.5 (pyriproxyfen). Based on the LC99 (µg a.i./cm2), the diagnostic concentrations of 0.6 (spinetoram), 5.5 (metaflumizone), 5.6 (chlorantraniliprole), 19.6 (tebufenozide), 37.4 (phosmet), 37.8 (novaluron) and 2011 pyriproxyfen) caused high mortality (>95%) of neonates from field populations. These diagnostic concentrations will be used in resistance monitoring programs of G. molesta in Brazil.(AU)

O uso de inseticidas tem sido a principal ferramenta para o controle da Grapholita molesta (Busck) no Brasil, considerada uma das mais importantes pragas em pomares de macieira e pessegueiro. Para implementar um programa de Manejo de Resistência a Insetos (MRI), estudos foram conduzidos para estabelecer uma linha básica de suscetibilidade de G. molesta a inseticidas utilizados para o seu controle. Posteriormente, foi realizado o monitoramento da suscetibilidade a inseticidas em treze populações da praga provenientes do campo. Lagartas (0-24 horas de idade) foram expostas a inseticidas aplicados na superfície da dieta artificial. Verificou-se alta suscetibilidade de lagartas neonatas de G. molesta (população de laboratório) quando foram expostas aos inseticidas, com valores de CL50 (µg i.a./cm2) de 0,1 (espinetoram), 1,0 (metoxifenozida), 1,2 (clorantraniliprole), 4,8 (novaluron), 5,1 (tebufenozida), 11,3 (fosmete) e 222,5 (piriproxifem). Com base na CL99 (µg i.a./cm2), as concentrações diagnósticas de 0,6 (espinetoram), 5,5 (metaflumizona), 5,6 (clorantraniliprole), 19,6 (tebufenozida), 37,4 (fosmete), 37,8 (novaluron) e 2.011 (piriproxifem) ocasionaram alta mortalidade (> 95%) de neonatas provenientes de populações de campo. Essas concentrações diagnósticas poderão ser utilizadas em programas de monitoramento da resistência de G. molesta no Brasil.(AU)

Susceptibility of Grapholita molesta to insecticides in Brazil / Suscetibilidade de Grapholita molesta a inseticidas no Brasil

ABSTRACT: The use of insecticides has been the main tool for Grapholita molesta (Busck) control in Brazil, which is considered one of the most important pests in apple and peach orchards. In order to implement an Insect Resistance Management (IRM) program, studies were conducted to characterize the baseline susceptibility of G. molesta to major insecticides for its control. Then, we conducted an insecticide susceptibility monitoring in thirteen field-collected populations of the pest. Neonates (0-24h old) were exposed to insecticides applied on surface of artificial diet. A high susceptibility was verified when neonates of the Laboratory population of G. molesta were exposed to insecticides with LC50 values (µg a.i./cm2) of 0.1 (spinetoram), 1.0 (metaflumizone), 1.2 (chlorantraniliprole), 4.8 (novaluron), 5.1 (tebufenozide), 11.3 (phosmet) and 222.5 (pyriproxyfen). Based on the LC99 (µg a.i./cm2), the diagnostic concentrations of 0.6 (spinetoram), 5.5 (metaflumizone), 5.6 (chlorantraniliprole), 19.6 (tebufenozide), 37.4 (phosmet), 37.8 (novaluron) and 2011 pyriproxyfen) caused high mortality (>95%) of neonates from field populations. These diagnostic concentrations will be used in resistance monitoring programs of G. molesta in Brazil.

RESUMO: O uso de inseticidas tem sido a principal ferramenta para o controle da Grapholita molesta (Busck) no Brasil, considerada uma das mais importantes pragas em pomares de macieira e pessegueiro. Para implementar um programa de Manejo de Resistência a Insetos (MRI), estudos foram conduzidos para estabelecer uma linha básica de suscetibilidade de G. molesta a inseticidas utilizados para o seu controle. Posteriormente, foi realizado o monitoramento da suscetibilidade a inseticidas em treze populações da praga provenientes do campo. Lagartas (0-24 horas de idade) foram expostas a inseticidas aplicados na superfície da dieta artificial. Verificou-se alta suscetibilidade de lagartas neonatas de G. molesta (população de laboratório) quando foram expostas aos inseticidas, com valores de CL50 (µg i.a./cm2) de 0,1 (espinetoram), 1,0 (metoxifenozida), 1,2 (clorantraniliprole), 4,8 (novaluron), 5,1 (tebufenozida), 11,3 (fosmete) e 222,5 (piriproxifem). Com base na CL99 (µg i.a./cm2), as concentrações diagnósticas de 0,6 (espinetoram), 5,5 (metaflumizona), 5,6 (clorantraniliprole), 19,6 (tebufenozida), 37,4 (fosmete), 37,8 (novaluron) e 2.011 (piriproxifem) ocasionaram alta mortalidade (> 95%) de neonatas provenientes de populações de campo. Essas concentrações diagnósticas poderão ser utilizadas em programas de monitoramento da resistência de G. molesta no Brasil.

Spanish Adaptation and Validation of the Outcome Questionnaire OQ-30.2.

This study assessed the psychometric properties of a Spanish version of the Shortened Outcome Questionnaire (OQ-30.2, Lambert et al., 2004) validated with a sample of 546 patients in an outpatient mental health clinic and 100 non-clinical adults in Chile. Our results show that this measure has similar normative data to the original measure, with a cutoff score for the Chilean population set at 43.36, and the reliable change index at 14. This Spanish OQ-30.2 has good internal consistency (α = 0.90), has concurrent validity with the Depressive, Anxious, and Somatoform disorders measuring scale (Alvarado and Vera, 1991), and is sensitive to change during psychotherapy. Consistent with previous studies, factorial analyses showed that both, the one-factor solution for a general scale and the three-factor solution containing three theoretical scales yielded poor fit estimates. Overall, our results are similar to past research on the OQ-45 and the OQ-30. The short version has adequate psychometric properties, comparable to those of the OQ-45, but provides a gain in application time that could be relevant in the setting of psychotherapy research with large samples, frequent assessments over time, and/or samples that may require more assistance completing items (e.g., low-literacy). We conclude that this measure will be a valuable instrument for research and clinical practice.

Susceptibility of Bonagota salubricola (Lepidoptera: Tortricidae) to Insecticides in Brazilian Apple Orchards: Implications for Resistance Management.

The Bonagota salubricola (Meyrick) is a major pest in apple orchards in Brazil, and chemical control has been the primary tool for insect management. To support the development of an insect resistance management (IRM) program, baseline studies of the susceptibility of a reference (laboratory) B. salubricola population were conducted; seven wild B. salubricola populations were monitored for susceptibility to insecticide; and the toxicity of some new chemicals to third-instar larvae and adults was evaluated by a leaf dip and ingestion bioassay, respectively. Neonates from the susceptible (laboratory) population exposed to insecticide showed an LC50 ranging from 0.34 (spinetoram) to 30.19 (novaluron) µg of a.i. ml(-1) (88.8-fold variation), so the diagnostic concentrations for an IRM program in Brazil based on the LC99 were as follows: 19.0 µg of a.i./ml chlorantraniliprole, 510.0 novaluron, 72.0 phosmet, 4.1 spinetoram, 12.8 spinosad, and 110.0 tebufenozide. Based on the LC99, significant differences were not observed in the susceptibility of the field and laboratory populations to chlorantraniliprole, phosmet, spinetoram, spinosad, and tebufenozide insecticides, but there were significant differences in the survival rates of the two populations to novaluron insecticide (3.3%). All insecticides at the diagnostic concentrations showed high toxicity to third-instar larvae (mortality rates between 73 to 97%). Phosmet, spinetoram, and spinosad insecticides were toxic to B. salubricola adults (mortality >85%), while chlorantraniliprole, novaluron, and tebufenozide insecticides caused mortality below 5%. The evaluated insecticides showed high toxicity to different developmental stages of B. salubricola, so the diagnostic concentrations may be used in IRM programs in Brazil.

Genotyping-by-sequencing approach indicates geographic distance as the main factor affecting genetic structure and gene flow in Brazilian populations of Grapholita molesta (Lepidoptera, Tortricidae).

The oriental fruit moth Grapholita molesta is one of the major pests of stone and pome fruit species in Brazil. Here, we applied 1226 SNPs obtained by genotyping-by-sequencing to test whether host species associations or other factors such as geographic distance structured populations of this pest. Populations from the main areas of occurrence of G. molesta were sampled principally from peach and apple orchards. Three main clusters were recovered by neighbor-joining analysis, all defined by geographic proximity between sampling localities. Overall genetic structure inferred by a nonhierarchical amova resulted in a significant ΦST value = 0.19109. Here, we demonstrate for the first time that SNPs gathered by genotyping-by-sequencing can be used to infer genetic structure of a pest insect in Brazil; moreover, our results indicate that those markers are very informative even over a restricted geographic scale. We also demonstrate that host plant association has little effect on genetic structure among Brazilian populations of G. molesta; on the other hand, reduced gene flow promoted by geographic isolation has a stronger impact on population differentiation.

Biological characteristics of Grapholita molesta (Lepidoptera: Tortricidae) induced to diapause in laboratory.

In southern Brazil, Grapholita molesta (Busck) (Lepidoptera: Tortricidae) uses diapause as survival strategy during the winter (May-August). In our study, we evaluated the effect of diapause on biological characteristics of the species for 4 months in laboratory. Newly hatched larvae of G. molesta were induced to diapause changing the photoperiod and temperature (T) (12 ± 1°C), relative humidity (RH) (70 ± 10%), and a photophase of 12 h and, when they started diapause in the prepupal stage, the conditions were kept for 4 months. Afterwards, the insects were induced to finalize the diapause process at T 25 ± 1°C, RH 70 ± 10%, and a photophase of 16 h. We evaluated the duration and viability of the larval stages and pupae, pupae weight at 24 h and sex ratio (sr), periods of preoviposition, oviposition, and postoviposition; adult life span (males and females); fecundity (daily and total); embryonic period duration and eggs viability, comparing the data with insects nondiapause. The results show that diapause greatly affected the viability of pupal-adult stages of the population (21.8%) when compared with insects' nondiapause (80.0%). Total fecundity (83.0 eggs) and mean life span (12.0 d) of insects diapause was significantly lower compared with insects nondiapause (173.0 and 17.0), respectively. However, these differences were not observed in the sr, which was similar to insects diapause (sr = 0.41) and insects nondiapause (sr = 0.49). The diapause induced for 4 months negatively affects reproduction and life span of adults of G. molesta.

Hidrodinámica aplicada a la gestión y la conservación de ecosistemas marinos y costeros: Isla Gorgona, Océano Pacífico Colombiano / Hydrodynamics applied to the management and conservation of marine and coastal ecosystems: Gorgona Island, Colombian Pacific Ocean

Palmeras (Gorgona National Park) is one of the most important sites for sea turtle nesting in South and Central America. Because of the morphological processes affecting the beach, the turtle nests are increasingly exposed to the impact of waves and tides, threatening conservation. A study was made to determine the hydrodynamical processes of the zone adjacent to Playa Palmeras, which affects directly the morphodynamical behavior of the beach and thus the preservation of the nests. Field measurements and numerical modeling were used to obtain the general circulation patterns and thermohaline structure behavior in the area in order to determine the spatial and temporal variability of waves and its effects on the beach. A marked seasonality was found, both in the waves and the currents, influenced mainly by the meridional displacement of the ITCZ (Inter-Tropical Convergence Zone) and an interannual variability of the waves, associated with ENSO (El Niño Southern Oscillation). The flooding levels of the beach were determined and flooding probability maps were made, where safer sites to locate the turtle nests could be identified. These maps serve the officials responsible of monitoring the turtles as a tool to take decisions on moving the nests, since they have flood risk information for any point on the beach. The results show that the middle zone north of the beach is the one with the lowest risk of flooding, therefore the most appropriate zone to relocate nests that are in high risk areas. Rev. Biol. Trop. 62 (Suppl. 1): 133-147. Epub 2014 February 01.

Playa Palmeras (En el Parque Nacional Isla Gorgona) es uno de los sitios más importantes para la anidación de tortugas marinas en América del Sur y Centroamérica. Debido a procesos morfológicos que afectan la playa, los nidos de las tortugas se han visto cada vez más expuestos al impacto del oleaje y la marea, poniendo en riesgo la conservación de éstas especies. Se llevó a cabo un estudio para conocer los procesos hidrodinámicos de la zona costera en Playa Palmeras, de los cuales depende el comportamiento morfodinámico de la playa y la preservación de los nidos. Se usó modelación numérica y mediciones en campo para conocer la variabilidad espacio-temporal del oleaje y obtener los patrones generales de circulación y la estructura termohalina de la zona. Se encontró un marcado ciclo anual, tanto en el oleaje como en las corrientes, influenciado por la Zona de Convergencia Intertropical (ZCIT) y una variabilidad interanual del oleaje, asociada a El Niño Oscilación del Sur (ENSO). Se estimó la cota de inundación de la playa y se crearon mapas de probabilidad de inundación, identificando los sitios potencialmente más seguros para la anidación. Los resultados muestran que hacia el norte de la playa está la zona de menor riesgo.

Estudio piloto de medidas antropométricas de la mano y fuerzasde prensión: aplicables al diseño de herramientas manuales / Pilot study of anthropometric measurements of the hand and grip strengths: applicable to manual tool design

Objetivo: El objetivo de este artículo es presentar resultados de un estudio no experimental, descriptivo y transversal: este estudio describe fuerzas de prensión dígito-palmar completa (agarre) y dimensiones antropométricas de mano de una muestra de trabajadores de mantención. Método: Muestra de 36 trabajadores de áreas de mantención, de 3 complejos hospitalarios del sector sur de Santiago y trabajadores de la Facultad de Medicina de la Universidad de Chile. Se evaluó, en cada sujeto, 13 dimensiones antropométricas de mano y fuerzas de prensión máxima en 5 distancias de agarre previamente determinadas. Para la medición de las variables se utiliza cinta métrica de medición y dinamómetro Dynatronics. Resultados: La distancia de agarre de 4,76 cm representa la medida donde se ejecuta la mayor fuerza prensión dígito-palmar completa (posición 2 de dinamómetro Dynatronics). La caracterización de las 13 medidas antropométricas de mano se representa mediante medidas de tendencia central.Conclusión: Los resultados de este estudio constituyen una base preliminar para proveer información relevante respecto a antropometría de mano y fuerzas de prensión dígito-palmar (agarre) para el diseño y selección de herramientas de uso manual, a fin y efecto de obtener sistemas más seguros para las personas y eficientes en la ejecución de tareas específicas.

Objective: The aim of this article is to present results of a nonexperimental,descriptive, cross-sectional study. Full digital palmar grip strengths and hand anthropometric measurements of a sample of maintenance personnel are described in this study. Method: Sample is composed of 36 maintenance workers from 3 hospital centers located in the southern part of Santiago and workers from the Medical School of the Universidad de Chile. In each subject, 13 hand anthropometric measurements were taken and then maximum grip strengths in 5 previously determined grip distances were measured. A tape measurer and Dynatronics dynamometer were used for measuring variables. Results: The highest full digital palmar grip strength was registered in a grip distance of 4,76 cm (position 2 of the Dynatronics dynamometer). The 13 hand anthropometric measurements were represented by measures of central tendency. Conclusion: Results of this study constitute a preliminary base to provide significant information regarding hand anthropometry and digital palmar grip strengths for the design and selection of manual tools, thus obtaining more secure and efficient systems for workers in specific tasks.

Inter-rater concordance study of the PASI (Psoriasis Area and Severity Index).

BACKGROUND: Developed in 1978, the PASI (Psoriasis Area and Severity Index) is a method to rate psoriasis severity. Since then, it has been criticized for being extremely long, complex and for yielding significantly divergent interpretations. OBJECTIVE: To determine the PASI inter-rater reliability among three independent evaluators examining the same patients. METHODS: Cross-sectional study conducted in 2007 at a psoriasis treatment center, where 20 patients were selected. The patients were evaluated by three postgraduate students of Dermatology who independently determined the PASI of each patient. The inter-rater reliability coefficient was determined by employing intraclass correlation coefficients (ICC) and Bland & Altman plots. RESULTS: An ICC of 0.729 (IC 95%: 0.440 - 0.882) showed a significant degree of concordance among evaluators. By graphic means, the Bland & Altman plot method presents concordance gap ranges. As shown in this study, narrow gap ranges indicate a good concordance degree. It was also observed that for high PASI values, wider concordance gap ranges predominate. CONCLUSION: Based on this analysis, we may conclude that the PASI is a reliable indicator of psoriasis severity because it shows significant concordance when independent evaluations are performed.

Importância da variação do PASI realizado por diversos observadores / Inter-rater concordance study of the PASI (Psoriasis Area and Severity Index)

FUNDAMENTO: O índice da área e gravidade da psoríase foi método desenvolvido em 1978, para quantificar a gravidade da psoríase. Desde então, têm recebido algumas críticas, por ser longo, complexo e apresentar divergências na sua interpretação. OBJETIVO: Demonstrar o grau de concordância do índice da área e gravidade da psoríase aplicado em pacientes de psoríase por três avaliadores isoladamente. MATERIAL E MÉTODO: Estudo observacional, transversal, realizado no ambulatório de psoríase, no ano de 2007, onde foram selecionados 20 pacientes. Os pacientes foram avaliados por três pós-graduandos de dermatologia, que determinaram o índice da área e gravidade da psoríase, isoladamente. A fidedignidade interobservador foi avaliada pelo coeficiente de correlação intraclasses (ICC) e os gráficos de Bland & Altman. RESULTADOS: O ICC de 0,729 (IC 95 por cento: 0,440 - 0,882) demonstrou que existe boa concordância entre os observadores. Pela análise dos gráficos de Bland e Altman, no máximo, duas diferenças estão fora dos limites de concordância, expressando boa concordância. Observou-se também que existe comportamento sistemático nas diferenças do índice da área e gravidade da psoríase em relação a sua média, segundo o qual mostrou para valores altos do índice da área e gravidade da psoríase, ou seja, um predomínio de diferenças maiores. CONCLUSÃO: Notamos, através deste estudo, que o índice da área e gravidade da psoríase apresenta bons critérios de confiabilidade quando houve a avaliação da gravidade da psoríase, mesmo que realizado por diferentes avaliadores.

BACKGROUND: Developed in 1978, the PASI (Psoriasis Area and Severity Index) is a method to rate psoriasis severity. Since then, it has been criticized for being extremely long, complex and for yielding significantly divergent interpretations. OBJECTIVE: To determine the PASI inter-rater reliability among three independent evaluators examining the same patients. METHODS:Cross-sectional study conducted in 2007 at a psoriasis treatment center, where 20 patients were selected. The patients were evaluated by three postgraduate students of Dermatology who independently determined the PASI of each patient. The inter-rater reliability coefficient was determined by employing intraclass correlation coefficients (ICC) and Bland & Altman plots. RESULTS: An ICC of 0.729 (IC 95 percent: 0.440 - 0.882) showed a significant degree of concordance among evaluators. By graphic means, the Bland & Altman plot method presents concordance gap ranges. As shown in this study, narrow gap ranges indicate a good concordance degree. It was also observed that for high PASI values, wider concordance gap ranges predominate. CONCLUSION: Based on this analysis, we may conclude that the PASI is a reliable indicator of psoriasis severity because it shows significant concordance when independent evaluations are performed.

Tratamento clinico da hiperplasia benigna da prostata / Clinical treatment of benign prostatic hyperplasia

Os autores fazem uma revisao do tratamento clinico da hiperplasia benigna da prostata (HBP). As drogas utilizadas foram divididas em dois grupos: agentes que reduzem o tamanho da glandula e os que reduzem o tonus do tecido prostatico. O tratamento mais indicado atualmente para a HBP continua sendo a cirurgia, entretanto a abordagem farmacologica tem mostrado uma eficacia crescente com os novos medicamentos recentemente introduzidos

Duplicaçao uretral / Urethral duplication

Os autores relatam um caso de duplicaçao uretral em um homem com vinte anos de idade. A duplicaçao estava associada com um meato epispadico. O paciente foi submetido a uretroplastia para correçao de jato urinario bifido

Ressecçao hepatica por metastase de cancer colorretal: analise de sete casos / Hepatic resection of metastases from colorretal cancer: an analysis of seven cases

Analisamos sete casos de pacientes submetidos a resseçao hepatica de metastases de cancer colorretal.A apresentaçao das metastases foi metacronica em seis casos e sincronica em um. As lesoes situavam-se no lobo direito em seis oportunidades e no lobo esquerdo em uma. A dosagem previa de antigeno carcinoembrionico (CEA) serico estava elevada em quatro pacientes. O diagnostico foi realizado atraves de queixas clinicas em quatro pacientes e por exame de controle em outros tres. Todos tiveram suas lesoes ressecadas com margem cirurgicas adequadas e nao foram constatadas metastases extra-hepaticas intra-abdominais durante a ressecçao. Nao houve mortalidade operatoria. Cinco pacientes faleceram durante o seguimento, com sobrevivencia de 23,4 meses. Tres destes pacientes morreram por recidiva neoplasica. Dois permaneceram vivos assintomaticos e livres de doença ha cerca de sete meses em um caso e 37 meses em outro, apos a resseçao de suas metastases hepaticas. O prognostico do pacinete portador de metastase hepaticas de cancer colorretal esta na dependencia do numero de metastases, da margem cirurgica adequada, do intervalo de tempo entre a ressecçao do cancer colorretal primario e o aparecimento das lesoes hepaticas e principalmente da presença de metastases extra-hepaticas. A opçao pela hepatectomia deve ser realizada apos a avaliaçao individual dse cada paciente.