Predictors of weight reduction in a Nigerian family practice setting

Objectives: This study identified the predictors of weight reduction among adult obese patients in a Family Practice Setting and developed a statistical model to predict weight reduction. Design: A prospective cohort design. Setting: The Family Practice Clinic, University College Hospital, Ibadan, Nigeria Participants and study tools: Obese adults were recruited into a three-month weight reduction program. Patient Information Leaflets were used for counselling, while questionnaires were administered to obtain socio-demographic and lifestyle factors. Potential predictors were assessed using the Multidimensional Scale of Perceived Social Support, Zung Depression Scale, Rosenberg Self-Esteem scale, Garner's Eating Attitude Test-26 (EAT-26), 24-hour dietary recall and International Physical Activity Questionnaire-short form. Anthropometric indices, blood pressure and Fasting Lipid Profile were assessed. Descriptive and inferential statistics were used for analysis with a significance set at α0.05. Results: Most 99(76.2%) of the 130 participants achieved weight reduction and had a median weight change of -2.3kg (IQR-4, -0.5), with 66 (66.7%) out of 99 attaining the weight reduction target of 10%. The regression model showed predictors of weight reduction to be Total Cholesterol [TC] (p=0.01) and Low-Density Lipoprotein Cholesterol [LDLC] (p=0.03). The statistical model derived for Weight reduction = 0.0028 (LDL-C) -0.029 (TC)-0.053 (EAT-26) +0.041(High-Density Lipoprotein Cholesterol). The proportion of variance of the model tested was R 2 = 0.3928 (adjusted R2 = 0.2106). Conclusion: Predictors of weight reduction among patients were eating attitude score, Total Cholesterol, Low-Density Lipid and High-Density Lipoprotein Cholesterol levels. A statistical model was developed for managing obesity among patients

Challenges and opportunities in the science of research to practice: lessons learned from a randomized controlled trial of a sexual risk-reduction intervention for psychiatric patients in a public mental health system

Objective: Human immunodeficiency virus (HIV) prevention efficacy trials with psychiatric patients have been conducted in research settings in high-resourced countries, establishing short-term efficacy for reducing sexual risk behavior. None has been implemented within systems of care. In the last decade, overcoming this research-to-practice gap has become a focus of implementation science. This paper describes the first and only HIV Prevention intervention trial for psychiatric patients conducted in real-world outpatient psychiatric settings facilitated by trained clinic-based providers. Methods: The HIV Prevention intervention, which uses the Information-Motivation-Behavioral Skills model to achieve sexual risk-reduction, was rigorously adapted to the local context and clinic services' needs. Participants from eight clinics were randomized to HIV Prevention or Health Promotion conditions. Results: HIV Prevention participants showed significant improvement in Information-Motivation-Behavioral domains; in this group, behavioral intentions were associated with significantly fewer unprotected sex occasions, but reduction of unprotected sex occasions was similar in both conditions. Conclusion: Our trial was conducted before implementation studies became widely funded. Transporting an intervention to a new culture or into real-world practice settings may require adaptations. Our results demonstrate that clear guidelines are needed regarding whether to conduct efficacy, effectiveness, and/or implementation research as the most appropriate next step. Clinical trial registration: NCT00881699

Los biomarcadores cardiacos e inflamatorios se asocian con un empeoramiento en los outcomes renales en pacientes con diabetes mellitus tipo 2: observaciones del estudio SAVOR-TIMI 53 / Cardiac and inflammatory biomarkers are associated with worsening renal outcomes in patients with type 2 diabetes mellitus: observations from SAVOR-TIMI 53

Antecedentes: Las enfermedades cardiaca y renal se manifiestan comunmente con interacciones bidireccionales. Nuestra hipotesis es que los biomarcadores cardiacos e inflamatorios pueden ser utiles en la identificacion de pacientes con diabetes mellitus tipo 2 (DM2) de alto riesgo de deterioro de la funcion renal. Métodos: En el presente analisis exploratorio del estudio SAVOR-TIMI 53, las concentraciones de troponina T cardiaca de alta sensibilidad (TnT-us), propeptido natriuretico cerebral N-terminal (NT-proBNP) y proteina C-reactiva de alta sensibilidad (PCR-us) fueron medidas en muestras basales de suero de 12.310 pacientes. El punto final primario para este analisis fue una disminucion mayor al 40% en la tasa de filtracion glomerular estimada (TFGe) al final del tratamiento (FdT) en una mediana de seguimiento de 2,1 anos. Las relaciones entre los biomarcadores y el punto final se modelaron utilizando regresion logistica ajustada y regresion de Cox. Resultados: Despues de la regresion logistica ajustada, incluyendo la funcion renal basal, cada biomarcador se asocio independientemente con mayor riesgo de una disminucion mayor o igual al 40% en la TFGe al FdT [Cuartil (Q) Q4 vs Q1: cociente de probabilidades (CP) ajustado de TnT-us fue 5,63 (IC 95%, 3,49-9,10); para NTproBNP CP ajustado, 3,53 (IC 95%, 2,29-5,45); OR ajustado para PCR-us, 1,84 (IC 95%, 1,27-2,68); todos los valores con p≤0,001]. Ademas, cada biomarcador se asocio de manera independiente con mayor riesgo de empeoramiento en la categoria de la relacion albumina/ creatinina urinaria (RACu) (p≤0,002 en todos los casos). Los analisis de sensibilidad en pacientes sin insuficiencia cardiaca y TFGe >60 mL/min demostraron resultados similares. En un modelo ajustado de marcadores multiples (multi-marcador), TnT-us y NT-proBNP se mantuvieron significativamente asociados con ambos puntos finales renales (p<0,01 en todos los casos). Conclusiones: TnT-us, NT-proBNP y PCR-us se asociaron con el empeoramiento de la funcion renal [reduccion de la TFGe (≥40%) y deterioro en la categoria de RACu] en pacientes con DM2 de alto riesgo. Los pacientes con biomarcadores cardiacos o inflamatorios elevados deben ser tratados no solo por su riesgo de resultados cardiovasculares, sino tambien monitoreados en cuanto a su deterioro renal.

Background: Cardiac and renal diseases commonly occur with bidirectional interactions. We hypothesized that cardiac and inflammatory biomarkers may assist in identification of patients with type 2 diabetes mellitus (T2DM) at high risk of worsening renal function. Methods: In this exploratory analysis from SAVOR-TIMI 53, concentrations of high-sensitivity cardiac troponin T (hs-TnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hs-CRP) were measured in baseline serum samples of 12310 patients. The primary end point for this analysis was a ≥40% decrease in estimated glomerular filtration rate (eGFR) at end of treatment (EOT) at a median of 2.1 years. The relationships between biomarkers and the end point were modeled using adjusted logistic and Cox regression. Results: After multivariable adjustment including baseline renal function, each biomarker was independently associated with an increased risk of ≥40% decrease in eGFR at EOT [Quartile (Q) Q4 vs Q1: hs-TnT adjusted odds ratio (OR), 5.63 (3.49-9.10); NT-proBNP adjusted OR, 3.53 (2.29-5.45); hs-CRP adjusted OR, 1.84 (95% CI, 1.27-2.68); all P values ≤0.001]. Furthermore, each biomarker was independently associated with higher risk of worsening of urinary albumin-to-creatinine ratio (UACR) category (all P values ≤0.002). Sensitivity analyses in patients without heart failure and eGFR >60 mL/min provided similar results. In an adjusted multimarker model, hs- TnT and NT-proBNP remained significantly associated with both renal outcomes (all P values <0.01). Conclusions: hs-TnT, NT-proBNP, and hs-CRP were each associated with worsening of renal function [reduction in eGFR (≥40%) and deterioration in UACR class] in high-risk patients with T2DM. Patients with high cardiac or inflammatory biomarkers should be treated not only for their risk of cardiovascular outcomes but also followed for renal deterioration.

Evaluation of prescription pattern of analgesic use among ambulatory elderly in South-Western Nigeria

Inappropriate prescribing of analgesics has a global impact on the health of elderly patients and the society. Empirical evidence on the prescription of analgesics among elderly Nigerians is scarce. Objectives: The objective of the study was to evaluate the prescription pattern of analgesics and describe the co-prescribing of gastroprotective agents with non-steroidal anti-inflammatory drugs (NSAIDs) among elderly patients at the geriatric center, University College Hospital, Ibadan. Methods: A retrospective cross-sectional, hospital-based study was carried out among elderly patients (≥60 years) who were prescribed analgesics. Using a data extraction sheet, information on demographic characteristics, drug utilization pattern, and morbidities was obtained from patients' case files via electronic health records. Results: A total of 337 patients case files were reviewed, the mean age was 72 ± 8.8 years, and 210 (62.3%) were females. There were a total of 2074 medications prescribed, with 733 (35.3%) being analgesics. Majority of the elderly patients (259, 76.9%) were on nonopioids, with 252 (74.8%) on NSAIDs. Paracetamol was the most commonly prescribed analgesics (181, 24.6%), followed by diclofenac/misoprostol (177, 24.1%), opioid analgesic prescribed was 88 (12.0%), with paracetamol/codeine 58 (65.9%), and tramadol 16 (18.2%) being the most prescribed opioid. A significant proportion of the hypertensive elderly patients (160, 78.8%; P < 0.036) were on NSAIDs. The oral route of administration (302, 89.6%) was the most common route of administration. Majority (310, 92%) of elderly patients taking NSAIDs had a co-prescription for gastroprotective agents. Conclusions: Majority of hypertensive patients were on NSAIDs. This calls for prompt awareness of rational analgesic use among the elderly to improve management and their survival

Frailty and mortality among older patients in a tertiary hospital in Nigeria

Background: This study determined the frailty status and its association with mortality among older patients. Design: A prospective cohort design. Setting: Study was conducted at the medical wards of University College Hospital, Ibadan, Nigeria. Participants and study tools: Four hundred and fifty older patients (>60 years) were followed up from the day of admission to death or discharge. Information obtained includes socio-demographic characteristics and clinical frailty was assessed using the Canadian Study of Health and Aging (CSHA) scale. Bivariate and multivariate analyses were carried out using SPSS version 21 at a p <0.05. Results: Overall, frailty was identified in 285 (63.3%) respondents. Mortality was significantly higher among frail respondents (25.3%) than non-frail respondents (15.4%) p=0.028. Logistic regression analysis showed factors associated with frailty were: male sex (OR=1.946 [1.005­3.774], p=0.048), non-engagement in occupational activities (OR=2.642 [1.394­5.008], p=0.003), multiple morbidities (OR=4.411 [1.944­10.006], p<0.0001), functional disability (OR=2.114 [1.029­4.343), p=0.042], malnutrition (OR=9.258 [1.029­83.301], p=0.047) and being underweight (OR=7.462 [1.499­37.037], p=0.014). Conclusion: The prevalence of frailty among medical in-hospital older patients is very high and calls for its prompt identification and management to improve their survival

A Pilot Study of the Effect of Daikenchuto on Rectal Sensation in Patients with Irritable Bowel Syndrome

BACKGROUND/AIMS: Daikenchuto (TU 100), a botanical agent that modulates gastrointestinal nerves, is used in the treatment of motility and functional disorders. Our aim was to study the effects of TU-100 on rectal compliance and sensation in patients with irritable bowel syndrome (IBS). METHODS: In 20 patients per treatment arm, we conducted a single-center, randomized, parallel-group, double-blind, placebo-controlled, single-dose pharmacodynamics study evaluating the effects of TU-100, 15 g (5 g t.i.d. [means 3 times a day]), for 14-16 consecutive days on rectal compliance and rectal sensation (thresholds and sensation ratings), all measured at baseline and on the last day of medication treatment. The primary endpoint was rectal sensation thresholds and sensation ratings in response to balloon distension at 32 mmHg. Secondary endpoints were rectal compliance, sensation thresholds, ratings and tone (fasting and postprandial), bowel pattern, abdominal pain (average and worst severity) and bloating scores, IBS quality of life and safety profile. RESULTS: Rectal sensation ratings post-treatment were significantly associated with baseline (pre-treatment) ratings and with level of anxiety or stress recorded at the time of the sensation testing. There were no effects of TU-100 treatment on rectal sensation ratings, sensation thresholds, rectal fasting or postprandial tone, rectal compliance, bowel function, abdominal pain or bloating scores, or IBS quality of life. CONCLUSIONS: TU-100 did not significantly affect rectal compliance and sensation in patients with IBS in this study.

Criança com Síndrome de Apert: diagnóstico clínico-radiográfico, manifestações orofaciais e qualidade de vida / Child with Apert Syndrome: clinical and radiographic diagnosis, orofacial manifestations and quality of life

Este relato de caso mostra o diagnóstico de uma patologia congênita rara: Síndrome de Apert. Paciente do sexo feminino, 12 anos, melanoderma, apresentou aos exames clínico e radiográfico: acrobraquicefalia, sindactilia em mãos e pés, acne facial, nariz disforme, retrusão maxilar, pseudoprognatismo, hipertelorismo, proptose ocular, depressão das fissuras palpebrais laterais, lábios em forma trapezoidal, lábio superior protruso, pseudomacroglossia, mordida aberta anterior, mordida cruzadaposterior, palato em arco bizantino, múltiplas anomalias dentárias de posição (apinhamento dental maxilar e giroversões) e forma (ponte de esmalte pronunciada em incisivos laterais e taurodontismo em segundos molares), e alongamento do processo estilóide bilateral. A qualidade de saúde bucal da paciente era insatisfatória, com excesso de biofilme oral, cárie, doença periodontal e comprometimento endodôntico. O teste AUQEI apontou que a criança possuía baixa a moderada qualidade de vida. Este caso destaca a importância do diagnóstico precoce para intervenções clínico-cirúrgicas mais eficazes e o valor da equipe multidisciplinar no acompanhamento contínuo e na melhora da qualidade de vida de pacientes infantis portadores de anomalias congênitas severas.

This case report shows the diagnosis of a rare congenital pathology: Apert syndrome. A 12-year-old female patient, melanoderm, presented in clinical and radiographic examinations: acrobraquicephalia, syndactilia in hands and feet, facial acne, unshapely nose, maxillary retrusion, pseudoprognatism, hypertelorism, ocular proptosis, depression of the lateral palpebral fissures, trapezoid shaped appearance to the lips, upper lip protrusion, pseudomacroglossia, anterior open bite, posterior crossbite,Byzantine-arch palate, multiple dental anomalies of position (maxillary dental crowding and dental rotation) and shape (pronounced enamel bridge in lateral incisors and taurodontism in second molar teeth) and bilateral elongated styloid process. The quality of oral health was unsatisfactory in the patient, with excessive oral biofilm, carie lesion, periodontal disease and endodontic involvement. The AUQEI test showed that the child had a low to moderate quality of life. This case highlight the importance of an early diagnosis for more effective clinical and surgical interventions and the value of a multidisciplinary team in the continuousmonitoring and improvement of quality of life in pediatric patients with severe congenital abnormalities.

Percepção de vulnerabilidade ao HPV e câncer de cabeça e pescoço: comportamentos sexuais e de risc oem jovens de Niterói, RJ / Perception of vulnerability to HPV and head and neck cancer: sexual and risk behaviors in youths from Niteroi, RJ

A associação do papilomavírus humano (HPV) ao carcinoma de células escamosas em região de cabeça e pescoço representa um problema de saúde pública, em especial para os jovens que são mais sujeitos às doenças sexualmente transmissíveis (DST). Objetivo: avaliar a vulnerabilidade à transmissão do HPV e ao câncer de cabeça e pescoço em população jovem do município de Niterói. Métodos: um estudo exploratório descritivo foiconduzido por meio de questionários com 450 participantes. Os dados obtidos foram divididos em características sociodemográficas, comportamento sexual, fatores de risco para o câncer bucal, associação entre sintomas orais, regiões orais e história patológica pregressa e educação e prevenção no contexto do HPV. A análise estatística foi realizada com o teste qui-quadrado e considerando p < 0,05. Resultados: em comparação ao sexo feminino,jovens do sexo masculino apresentaram maior vulnerabilidade ao HPV, devido a início sexual precoce, múltiplas parcerias sexuais e sexo oral desprotegido,e ao câncer bucal mediado por álcool, além de menor conhecimento geral sobre o HPV. Em ambos os sexos, verrugas genitais figuraram como as doenças prévias mais prevalentes (5% do total), havendo associação em homens para a sintomatologia de garganta e as demais DST. Conclusão: a população jovem de Niterói apresenta comportamentos sexuais e de risco, como vulnerabilidade à infecção por HPV e grande consumo de álcool, que aumentam asuscetibilidade à carcinogênese em cabeça e pescoço. Deve existir maior articulação das políticas públicas de Saúde para a promoção de ações educativa se preventivas no campo de DST e de combate ao etilismo precoce.

The association of human papillomavirus (HPV) to squamous cell carcinoma in the region of head and neck represents a public health problem, especially to young people who are more prone to sexually transmited diseases (STD). Objective: to assess the vulnerability to transmission of HPV and head and neck cancer in young population from the city of Niteroi. Methods: an exploratory and descriptive study was conducted using questionnaires with 450 participants. The data were divided into socio-demographic characteristics, sexual behavior, risk factors for oral cancer, association between oral symptoms, oral regions and medical history and education and prevention in the context of HPV. Statistical analysis was performed usingchi-squared test and considering p < 0.05. Results: in comparison to females, young males were more vulnerable to HPV due to early sexual debut,multiple sexual partners and unsafe oral sex, and to oral cancer mediated by alcohol, and lower general knowledge about HPV. In both sexes, genital wartspre-figured as the most prevalent diseases (5% of total), with association in men to the symptoms of throat and the other STD. Conclusion: the young population from Niteroi presents risky sexual behaviours such as vulnerability to HPV infection and high alcohol consumption which increase suscetibilityto carcinogenesis in head and neck. There should be greater coordination of public health policies to promote educational preventive actions in the of STD and to combat early alcohol abuse.

Morbidity pattern amongst elderly patients presenting at a primary care clinic in Nigeria

Background: The elderly comprise the fastest-expanding age group globally, with the greatest increase occurring in developing countries. Disease and deteriorating health are implicitly assumed to be associated with ageing, as chronic medical illnesses mostly present with increasing age. Objectives: To describe the morbidity pattern of elderly patients presenting at the General Outpatients Clinic of the University College Hospital, Ibadan, Nigeria. Method: This was a cross-sectional descriptive study of 500 elderly respondents who presented at the clinic between September 2004 and April 2005. They were interviewed according to the format of the electronic, second revision of the International Classification of Primary Care (ICPC-2-E) questionnaire. Main outcome measurements were the prevalence of various morbidities, self-reported health status and socio-demographic characteristics. Body mass index (BMI) was used to assess respondents' nutritional status. Results: Respondents were found to under-report their actual health problems. The mean ± s.d of self-reported health problems was 1.7 ± 0.9 (range 1­6), while the mean ± s.d of diagnosed morbidities was 2.7 ± 1.4 (range 1­8). The most prevalent morbidities were hypertension (40.0%), cataracts (39.4%) and osteoarthritis (26.8%). The prevalence of anaemia was 8.0%(females = 11.2%; males = 2.6%), and it was significantly associated with gender (p = 0.001). Nutritional status indicated a high prevalence of overweight and obesity (51.8%), which was significantly higher amongst the female respondents than the males (p = 0.001). Conclusion: The prevalence of chronic medical illnesses was high amongst the elderly in this setting. In addition, the elderly under-reported their actual health problems. The high prevalence of overweight and obesity amongst the elderly in this setting calls for public health action that advocates lifestyle changes to manage the health of the elderly

Familial isolated pituitary adenomas experience at a single center: clinical importance of AIP mutation screening / Experiência de um único centro em adenoma hipofisário familiar isolado: importância clínica do rastreio de mutação do AIP

We present four FIPA kindred discussing clinical and molecular data and emphasizing the differences regarding AIP status, as well as the importance of genetic screening. Family 1 consists of five patients harboring somatotropinomas with germline E24X mutation in AIP. In one of the patients, acromegaly was diagnosed through active screening, being cured by surgery. Families 2 and 3 are composed of two patients with non-functioning pituitary adenomas. Family 4 comprises patients harboring a prolactinoma and a somatotropinoma. No mutations in AIP were found in these families. No patient in Family 1 was controlled with octreotide treatment, while the acromegalic patient in Family 4 was controlled with octreotide LAR. In conclusion, FIPA is a heterogeneous condition, which may be associated with AIP mutation. Genomic and clinical screening is recommended in families with two or more members harboring pituitary adenomas, allowing early diagnosis and better outcome.

Apresentamos dados clínicos e moleculares de quatro famílias com adenoma hipofisário familiar isolado (FIPA) enfatizando as diferenças na presença ou não de mutação do AIP e a importância da triagem genética. A Família 1 é composta por cinco pacientes portadores de somatotropinomas com mutação germinativa E24X no AIP. Um dos pacientes foi diagnosticado por meio de rastreio ativo, com cura cirúrgica. As Famílias 2 e 3 apresentam em sua composição dois pacientes com adenomas hipofisários não funcionantes. A Família 4 compreende dois pacientes, um com prolactinoma e outro com somatotropinoma. Não foi encontrada mutação no AIP nessas famílias. Na Família 1, não houve resposta ao octreotide, enquanto o paciente acromegálico da Família 4 foi controlado com a medicação. Em conclusão, a FIPA é uma condição heterogênea que pode estar associada à mutação do AIP e o rastreio genético/clínico é recomendado nas famílias com dois ou mais membros portadores de adenoma hipofisário. Isso permite um diagnóstico precoce, com melhor prognóstico.

Effect of db-camp on embryonic development of bovine oocytes fertilized with sex sorted semen. / Efecto del db-cAMP Sobre el Desarrollo Embrionario de Ovocitos Bovinos Fecundados con Semen Sexado.

The objective of this study was to improve sexed bovine embryo production with sorted sperm in chemically defined conditions by supplementing the IVF medium with db-cAMP. Cumulus-oocyte complexes (COCs) were matured for 18 h in supplemented TCM-199 and fertilized with X- or Y-bearing sperm in the presence of heparin (10 µg/ml), db-cAMP (1 µM) or no treatment (control). Presumptive zygotes were cultured 54 h in g-SOF. From 72 to 144 h post- insemination (hpi) embryos were cultured in c-SOF+NEA and from 144 to 192 hpi embryos were placed in maturation medium without hormones. No significant differences were found among treatments for Y-sperm when compared to controls. A significant (P<0.01) improvement in the proportion of cleaved oocytes was found for X-sperm treated with db-cAMP (70.83%) compared to the Y-sperm inseminated oocytes treated wit db-cAMP (46.37%). Treatment with db-cAMP enabled a better (P<0.05) blastocyst formation rate (19.29%) compared to control (8.47%) and heparin (10.44%). Treatment of db-cAMP significantly increased the rate of blastocysts in X-sperm inseminated oocytes (30.77%) compared to Y-sperm inseminated oocytes treated the same (9.68%) and compared to X- and Y-sperm treated with heparin (5.88% and 15.15%, respectively) and not treated (9.68% and 7.14%, respectively, P<0.05). These results suggest that db-cAMP may prove to be an effective treatment of sorted sperm for in vitro production of female bovine embryos under chemically defined conditions.

El objetivo de este estudio fue mejorar la producción de embriones bovinos con semen sexado bajo condiciones químicamente definidas mediante la suplementación del medio de fecundación con db-cAMP. Los complejos ovocitos cumulus (COCs) fueron madurados por 18 horas en TCM-199 suplementado y fueron fecundados con espermatozoides X o Y en presencia de heparina (10 g/ml), db-cAMP (1 µM) o sin tratamiento alguno (control). Los presuntivos cigotos fueron cultivados por 54 horas en g-SOF. Desde las 72 a las 144 horas post-inseminación (hpi) los embriones se cultivaron en c-SOF+NEA y desde 144 a 192 hpi fueron colocados en medio de maduración pero sin hormonas. No se observaron diferencias entre tratamientos para los oocitos fecundados con espermatozoides Y cuando se compararon a los controles. Se observó una mejora significativa (P<0,01) en la proporción de ovocitos que se dividieron cuando fueron fecundados con espermatozoides X tratados con db-cAMP (70,83%) en comparación con los fecundados con espermatozoides Y tratados con db-cAMP (46,37%). El tratamiento con db-cAMP fue capaz de inducir una mayor (P<0,05) tasa de formación de blastocistos (19.29%) en comparación a los tratamientos control (8,47%) y heparina (10,44%). El tratamiento con db-cAMP incrementó (P<0,05) la tasa de embriones de cuatro células alcanzando el estadio de blastocisto cuando los oocitos fueron fecundados con espermatozoides X (30,77%) en comparación a cuando la fecundación se realizó con espermatozoides Y (9,68%) y en comparación a cuando se llevó a cabo con espermatozoides X o Y en presencia de heparina (5,88% y 15,15%, respectivamente) o en el tratamiento control (9,68% y 7,14%, respectivamente). Estos resultados sugieren, que el db-cAMP puede ser un tratamiento efectivo para el semen sexado, a fin de incrementar la producción in vitro de embriones bovinos hembra bajo condiciones químicamente definidas.

Microbial control of arthropod pests of tropical tree fruits

A multitude of insects and mites attack fruit crops throughout the tropics. The traditional method for controlling most of these pests is the application of chemical pesticides. Growing concern on the negative environmental effects has encouraged the development of alternatives. Inundatively and inoculatively applied microbial control agents (virus, bacteria, fungi, and entomopathogenic nematodes) have been developed as alternative control methods of a wide variety of arthropods including tropical fruit pests. The majority of the research and applications in tropical fruit agroecosystems has been conducted in citrus, banana, coconut, and mango. Successful microbial control initiatives of citrus pests and mites have been reported. Microbial control of arthropod pests of banana includes banana weevil, Cosmopolites sordidus Germar (Coleoptera: Curculionidae) (with EPNs and fungi) among others Oryctes rhinoceros (L.) is one of the most important pests of coconut and one of the most successful uses of non-occluded virus for classical biological control. Key pests of mango that have been controlled with microbial control agents include fruit flies (Diptera: Tephritidae) (with EPNs and fungi), and other pests. Also successful is the microbial control of arthropod pests of guava, papaya and pineapple. The challenge towards a broader application of entomopathogens is the development of successful combinations of entomopathogens, predators, and parasitoids along with other interventions to produce effective and sustainable pest management.

Muitos insetos e ácaros atacam fruteiras nos trópicos. O método tradicional para controlar a maioria dessas pragas é a aplicação de inseticidas químicos. A crescente preocupação sobre os efeitos negativos desses produtos vem encorajando o desenvolvimento de alternativas. Agentes do controle biológico aplicados de forma inundativa ou inoculativa têm sido pesquisados como método de controle alternativo para uma variedade de pragas em grande número de culturas, incluindo fruteiras tropicais. A maioria das pesquisas e aplicações em fruteiras tropicais tem sido feita em citros, banana, côco e manga. Especificamente, há vários casos de sucesso em citros para diferentes ácaros e insetos. Em banana, o controle do moleque-da-bananeira, Cosmopolites sordidus Germar (Coleoptera: Curculionidae) com nematóides e fungus também é considerado de sucesso. Oryctes rhinoceros (L.) (Coleoptera: Scarabaeidae) é uma das principais pragas em côco e um dos mais importantes exemplos de controle biológico clássico por vírus não-ocluso. As pragas-chave em manga que têm sido controladas com diferentes agentes de controle microbiano são as moscas-das-frutas (Diptera: Tephritidae), com nematóides e fungos, o gorgulho-da-manga, Sternochetus mangiferae (Fabricius) (Coleoptera: Curculionidae), com fungos, e vários hemípteros com fungo. O controle microbiano de pragas tem sido bem sucedido também em goiaba, mamão e abacaxi. O desafio que se vislumbra para a maior aplicabilidade dessas tecnologias é o desenvolvimento de combinações compatíveis entre entomopatógenos, predadores e parasitóides juntamente com outras técnicas de controle.

Bridging the knowledge-behaviour gap through HIV/AIDS surveillance in four markets in Ogbomoso and Ibadan, Nigeria

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Modulation of Pituitary Somatostatin Receptor Subtype (sst1-5) mRNA Levels by Growth Hormone (GH) -Releasing Hormone in Purified Somatotropes

We have previously reported that expression of the somatostatin receptor subtypes, sst1-5, is differentially regulated by growth hormone (GH) -releasing hormone (GHRH) and forskolin (FSK), in vitro. GHRH binds to membrane receptors selectively located on pituitary somatotropes, activates adenylyl cyclase (AC) and increases sst1 and sst2 and decreases sst5 mRNA levels, without significantly altering the expression of sst3 and sst4. In contrast FSK directly activates AC in all pituitary cell types and increases sst1 and sst2 mRNA levels and decreases sst3, sst4 and sst5 expression. Two explanations could account for these differential effects: 1) GHRH inhibits sst3 and sst4 expression in somatotropes, but this inhibitory effect is masked by expression of these receptors in unresponsive pituitary cell types, and 2) FSK inhibits sst3 and sst4 expression levels in pituitary cell types other than somatotropes. To differentiate between these two possibilities, somatotropes were sequentially labeled with monkey anti-rat GH antiserum, biotinylated goat anti-human IgG, and streptavidin-PE and subsequently purified by fluorescent-activated cell sorting (FACS). The resultant cell population consisted of 95% somatotropes, as determined by GH immunohistochemistry using a primary GH antiserum different from that used for FACS sorting. Purified somatotropes were cultured for 3 days and treated for 4 h with vehicle, GHRH (10 nM) or FSK (10micrometer). Total RNA was isolated by column extraction and specific receptor mRNA levels were determined by semi-quantitative multiplex RT-PCR. Under basal conditions, the relative expression levels of the various somatostatin receptor subtypes were sst2> sst5> sst3=sst1> sst4. GHRH treatment increased sst1 and sst2 mRNA levels and decreased sst3, sst4 and sst5 mRNA levels in purified somatotropes, comparable to the effects of FSK on purified somatotropes and mixed pituitary cell cultures. Taken together, these results demonstrate that GHRH acutely modulates the expression of all somatostatin receptor subtypes within GH-producing cells and its actions are likely mediated by activation of AC.

Adult-onset foveomacular dystrophy associated with full-thickness macular hole: report of 5 cases / Distrofia viteliforme foveomacular de início na vida adulta associada a buraco macular: relato de 5 casos

Objetivo: Relatar uma série de 5 casos de distrofia viteliforme foveomacular de início na vida adulta, uma das distrofias padrão da mácula, em associação com o desenvolvimento de buraco macular. Local: Manhattan Eye, Ear & Throat Hospital, New York, NY, USA. Métodos: Relato de uma série de casos. Resultados: Cinco casos de distrofia viteliforme foveomacular de início na vida adulta, uma das distrofias padrão da mácula, desenvolveram buraco macular. Todos os 5 casos, ou 7 olhos, evoluíram com perda de visão, e em um olho foi realizada cirurgia para buraco macular e obtido sucesso anatômico (fechamento do buraco). Conclusão: Distrofia viteliforme foveomacular de início na vida adulta pode associar?se ao desenvolvimento de buraco macular e esta associação pode resultar em perda de visão.