Hagenulopsis Ulmer (Ephemeroptera: Leptophlebiidae): re-description, morphological notes and a new species from South America, Brazil.

Hagenulopsis diptera Ulmer, type species of the genus Hagenulopsis, was originally described based on imagos from Santa Catarina State, Southern Brazil. Misconceptions of H. diptera circumscription led to erroneous attribution of material from Minas Gerais and Esprito Santo, Southeastern Brazil, to H. diptera. Despite the increase in the number of species attributed to Hagenulopsis, little attention has been given to the type species. After comparative examination of photographs of the holotype and fresh material of H. diptera from Southeastern Brazil, we conclude that many specimens previously assigned to H. diptera represent a new species. Thus, we redescribe H. diptera and describe a new species Hagenulopsis perere sp. nov. based on eggs, nymphs and imagos. Diagnostic features of Hagenulopsis perere sp. nov. include cross veins between C and RP1 strongly clouded with brown and outer surface of mid femur with a brown spot at midlength. Finally, comments and new records are presented for Hagenulopsis minuta Spieth.

[Thyroid hormone prescription patterns in a Colombian population]. / Patrones de prescripción de hormonas tiroideas en una población colombiana.

OBJECTIVE: Determine thyroid hormone prescription patterns in the population covered by the Colombian Social Security Health System. METHODS: Descriptive study using a database of 6.2 million people. The selected patients, men and women of all ages, received continuous thyroid hormone treatment from April to June 2013. A database on medication use was designed, using data obtained by the company that dispenses these drugs. RESULTS: It was found that 29 947 patients in 82 Colombian cities had been treated for hypothyroidism. The majority (79.1%) were women, with an average age of 63.2 ± 16.1 years. The most common prescription was for levothyroxine in 50 µg tablets (85.7%) at higher-than-recommended daily dosages, especially as monotherapy. Significant differences between age groups and cities of residence were found for the combined use of thyroid hormone and co-medication. The most frequently prescribed concomitant drugs were antiulcer agents (44%), hypoglycemics (17.4%), and iron salts (16.1%). CONCLUSIONS: There are significant differences in prescribing practices in the cities studied. Clinical management guidelines that standardize dosages and physicians' practices are needed, since a lack of guidelines has likely had an impact on patients' health. The clinical efficacy of the prescriptions studied should be explored.

Patrones de prescripción de hormonas tiroideas en una población colombiana / Thyroid hormone prescription patterns in a colombian population

OBJETIVO: Determinar los patrones de prescripción de hormonas tiroideas en personas afiliadas al Sistema General de Seguridad Social en Salud de Colombia. MÉTODOS: Estudio descriptivo a partir de una base de datos poblacional de 6,2 millones de personas. Se seleccionaron los pacientes medicados con hormonas tiroideas, de uno y otro sexo y todas las edades, con tratamiento continuo de abril a junio de 2013. Se diseñó una base de datos sobre consumo de medicamentos, obtenidos por la empresa que dispensa dichos fármacos. RESULTADOS: Se hallaron 29 947 pacientes tratados para hipotiroidismo en 82 ciudades colombianas. La mayoría (79,1%) eran mujeres, con una edad media de 63,2 ± 16,1 años. La presentación prescrita con mayor frecuencia fue levotiroxina en tabletas de 50 µg (85,7%) a dosis diarias definidas mayores de las recomendadas, sobre todo como monoterapia. Se detectaron diferencias significativas entre los grupos etarios y las ciudades de residencia para el uso combinado de hormona tiroidea y de comedicación. Los medicamentos prescritos de manera concomitante con mayor frecuencia fueron los antiulcerosos (44%), hipoglucemiantes (17,4%) y sales de hierro (16,1%). CONCLUSIONES: Existen diferencias significativas en las recetas de los médicos en las ciudades estudiadas. Hacen falta guías de manejo clínico que estandaricen las dosis y conductas médicas, pues es probable que su ausencia tenga impacto en la salud de los pacientes. Es necesario explorar la efectividad clínica de las prescripciones estudiadas.

OBJECTIVE: Determine thyroid hormone prescription patterns in the population covered by the Colombian Social Security Health System. METHODS: Descriptive study using a database of 6.2 million people. The selected patients, men and women of all ages, received continuous thyroid hormone treatment from April to June 2013. A database on medication use was designed, using data obtained by the company that dispenses these drugs. RESULTS: It was found that 29 947 patients in 82 Colombian cities had been treated for hypothyroidism. The majority (79.1%) were women, with an average age of 63.2 ± 16.1 years. The most common prescription was for levothyroxine in 50 µg tablets (85.7%) at higher-than-recommended daily dosages, especially as monotherapy. Significant differences between age groups and cities of residence were found for the combined use of thyroid hormone and co-medication. The most frequently prescribed concomitant drugs were antiulcer agents (44%), hypoglycemics (17.4%), and iron salts (16.1%). CONCLUSIONS: There are significant differences in prescribing practices in the cities studied. Clinical management guidelines that standardize dosages and physicians' practices are needed, since a lack of guidelines has likely had an impact on patients' health. The clinical efficacy of the prescriptions studied should be explored.