Molecular phylogeny of the Orthalicoidea land snails: Further support and surprises.

The superfamily Orthalicoidea comprises approximately 2,000 species of terrestrial gastropods, mostly concentrated in the Neotropics but also present in southern Africa and Oceania. We provide a multi-marker molecular phylogeny of this superfamily, reassessing its family- and genus-level classification. We exclude two families from the group, Odontostomidae and Vidaliellidae, transferring them to Rhytidoidea based on their phylogenetic relationships as recovered herein. Two new families are recognized herein as members of Orthalicoidea, Tomogeridae and Cyclodontinidae fam. nov. The family Megaspiridae and the subfamily Prestonellinae are paraphyletic but are retained herein for taxonomic stability. The subfamily Placostylinae is synonymized with Bothriembryontinae. The new genera Alterorhinus gen. nov. and Sanniostracus gen. nov. containing some Brazilian species are described here to better reflect the phylogeny. The fossil record and paleobiogeographic history of the group is explored under the new phylogenetic framework.

Effects of Selenium treatment on cardiac function in Chagas heart disease: Results from the STCC randomized Trial.

BACKGROUND: Chagas disease (caused by Trypanosoma cruzi infection) evolves to chronic chagasic cardiomyopathy (CCC) affecting 1.8 million people worldwide. This is the first randomized, placebo-controlled, double-blinded, clinical trial designed to estimate efficacy and safety of selenium (Se) treatment in CCC. METHODS: 66 patients with CCC stages B1 (left ventricular ejection fraction [LVEF] > 45% and no heart failure; n = 54) or B2 (LVEF < 45% and no heart failure; n = 12) were randomly assigned to receive 100 mcg/day sodium selenite (Se, n = 32) or placebo (Pla, n = 34) for one year (study period: May 2014-September 2018). LVEF changes over time and adverse effects were investigated. Trial registration number: NCT00875173 (clinicaltrials.gov). FINDINGS: No significant differences between the two groups were observed for the primary outcome: mean LVEF after 6 (ß= +1.1 p = 0.51 for Se vs Pla) and 12 months (ß= +2.1; p = 0.23). In a subgroup analysis, statistically significant longitudinal changes were observed for mean LVEF in the stage B2 subgroup (ß= +10.1; p = 0.02 for Se [n = 4] vs Pla [n = 8]). Se treatment was safe for CCC patients, and the few adverse effects observed were similarly distributed across the two groups. INTERPRETATION: Se treatment did not improve cardiac function (evaluated from LVEF) in CCC. However, in the subgroup of patients at B2 stage, a potential beneficial influence of Se was observed. Complementary studies are necessary to explore diverse Se dose and/or associations in different CCC stages (B2 and C), as well as in A and B1 stages with longer follow-up. FUNDING: Brazilian Ministry of Health, Fiocruz, CNPq, FAPERJ.

Terrestrial Gastropoda from the caves of Presidente Olegário, southeastern Brazil / Gastrópodes terrestres de cavernas da região de Presidente Olegário no sudeste brasileiro

Abstract: Samples of terrestrial gastropods were collected year-round in seven caves in Presidente Olegário municipality, Minas Gerais state, southeastern Brazil, during several expeditions from 2012 to 2014. Twenty-four taxa (plus a single freshwater species), mainly stylommatophorans, were found in the material. The following species are reported for the first time for Minas Gerais state: Alcadia iheringi Wagner, 1910 and Helicina sordida King, 1831 (Helicinidae); Cecilioides consobrina (d'Orbigny, 1841) (Ferussaciidae); Entodina gionensis Morretes, 1940 and Scolodonta interrupta (Suter, 1900) (Scolodontidae); Megalobulimus sanctipauli (Ihering & Pilsbry, 1900) (Strophocheilidae); Drymaeus coarctatus (Pfeiffer, 1845) (Bulimulidae); Habroconus semenlini (Moricand, 1846) (Euconulidae); and Solaropsis aff. rosaria (Pfeiffer, 1849) (Solaropsidae). Furthermore, the species Drymaeus iracema (Simone, 2015) and Drymaeus terreus (Simone, 2015) are synonymized with Drymaeus coarctatus (L. Pfeiffer, 1845).

Resumo: Amostras de gastrópodes terrestres foram coletadas em sete cavernas na região do município de Presidente Olegário, Minas Gerais, Brasil, durane múltiplas expedições ao longo dos anos de 2012 a 2014. Vinte-e-quatro táxons (mais uma única espécie dulciaquícola) foram encontrados, em sua maioria Stylommatophora. As seguintes espécies são aqui reportadas pela primeira vez para o estado de Minas Gerais: Alcadia iheringi Wagner, 1910 e Helicina sordida King, 1831 (Helicinidae); Cecilioides consobrina (d'Orbigny, 1841) (Ferussaciidae); Entodina gionensis Morretes, 1940 e Scolodonta interrupta (Suter, 1900) (Scolodontidae); Megalobulimus sanctipauli (Ihering & Pilsbry, 1900) (Strophocheilidae); Drymaeus coarctatus (Pfeiffer, 1845) (Bulimulidae); Habroconus semenlini (Moricand, 1846) (Euconulidae); e Solaropsis aff. rosaria (Pfeiffer, 1849) (Solaropsidae). Além disso, as espécies Drymaeus iracema (Simone, 2015) e Drymaeus terreus (Simone, 2015) são aqui sinonimizadas com Drymaeus coarctatus (L. Pfeiffer, 1845).

Volatile Anesthetics versus Total Intravenous Anesthesia for Cardiac Surgery.

BACKGROUND: Volatile (inhaled) anesthetic agents have cardioprotective effects, which might improve clinical outcomes in patients undergoing coronary-artery bypass grafting (CABG). METHODS: We conducted a pragmatic, multicenter, single-blind, controlled trial at 36 centers in 13 countries. Patients scheduled to undergo elective CABG were randomly assigned to an intraoperative anesthetic regimen that included a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or to total intravenous anesthesia. The primary outcome was death from any cause at 1 year. RESULTS: A total of 5400 patients were randomly assigned: 2709 to the volatile anesthetics group and 2691 to the total intravenous anesthesia group. On-pump CABG was performed in 64% of patients, with a mean duration of cardiopulmonary bypass of 79 minutes. The two groups were similar with respect to demographic and clinical characteristics at baseline, the duration of cardiopulmonary bypass, and the number of grafts. At the time of the second interim analysis, the data and safety monitoring board advised that the trial should be stopped for futility. No significant difference between the groups with respect to deaths from any cause was seen at 1 year (2.8% in the volatile anesthetics group and 3.0% in the total intravenous anesthesia group; relative risk, 0.94; 95% confidence interval [CI], 0.69 to 1.29; P = 0.71), with data available for 5353 patients (99.1%), or at 30 days (1.4% and 1.3%, respectively; relative risk, 1.11; 95% CI, 0.70 to 1.76), with data available for 5398 patients (99.9%). There were no significant differences between the groups in any of the secondary outcomes or in the incidence of prespecified adverse events, including myocardial infarction. CONCLUSIONS: Among patients undergoing elective CABG, anesthesia with a volatile agent did not result in significantly fewer deaths at 1 year than total intravenous anesthesia. (Funded by the Italian Ministry of Health; MYRIAD ClinicalTrials.gov number, NCT02105610.).

Volatile Anesthetics versus Total Intravenous Anesthesia for Cardiac Surgery

BACKGROUND: Volatile (inhaled) anesthetic agents have cardioprotective effects, which might improve clinical outcomes in patients undergoing coronary-artery bypass grafting (CABG). METHODS: We conducted a pragmatic, multicenter, single-blind, controlled trial at 36 centers in 13 countries. Patients scheduled to undergo elective CABG were randomly assigned to an intraoperative anesthetic regimen that included a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or to total intravenous anesthesia. The primary outcome was death from any cause at 1 year. RESULTS: A total of 5400 patients were randomly assigned: 2709 to the volatile anesthetics group and 2691 to the total intravenous anesthesia group. On-pump CABG was performed in 64% of patients, with a mean duration of cardiopulmonary bypass of 79 minutes. The two groups were similar with respect to demographic and clinical characteristics at baseline, the duration of cardiopulmonary bypass, and the number of grafts. At the time of the second interim analysis, the data and safety monitoring board advised that the trial should be stopped for futility. No significant difference between the groups with respect to deaths from any cause was seen at 1 year (2.8% in the volatile anesthetics group and 3.0% in the total intravenous anesthesia group; relative risk, 0.94; 95% confidence interval [CI], 0.69 to 1.29; P = 0.71), with data available for 5353 patients (99.1%), or at 30 days (1.4% and 1.3%, respectively; relative risk, 1.11; 95% CI, 0.70 to 1.76), with data available for 5398 patients (99.9%). There were no significant differences between the groups in any of the secondary outcomes or in the incidence of prespecified adverse events, including myocardial infarction. CONCLUSIONS: Among patients undergoing elective CABG, anesthesia with a volatile agent did not result in significantly fewer deaths at 1 year than total intravenous anesthesia. (Funded by the Italian Ministry of Health; MYRIAD ClinicalTrials.gov number, NCT02105610.). (AU)

Role of melanocortin 4 receptor in hypertension induced by chronic intermittent hypoxia.

AIM: We previously demonstrated that central nervous system (CNS) melanocortin 4 receptors (MC4R) play a key role in regulating blood pressure (BP) in some conditions associated with increased SNS activity, including obesity. In this study, we examined whether activation of CNS MC4R contributes to chronic intermittent hypoxia (CIH)-induced hypertension and ventilatory responses to hypercapnia. METHODS: Rats were instrumented with an intracerebroventricular (ICV) cannula in the lateral cerebral ventricle for continuous infusion of MC4R antagonist (SHU-9119) and telemetry probes for measuring mean arterial pressure (MAP) and heart rate (HR). Untreated and SHU-9119-treated rats as well as obese and lean MC4R-deficient rats were exposed to CIH for 7-18 consecutive days. RESULTS: Chronic intermittent hypoxia reduced cumulative food intake by 18 ± 5 g while MAP and HR increased by 10 ± 3 mm Hg and 9 ± 5 bpm in untreated rats. SHU-9119 increased food intake (from 15 ± 1 to 46 ± 3 g) and prevented CIH-induced reduction in food intake. CIH-induced hypertension was not attenuated by MC4R antagonism (average increase of 10 ± 1 vs 9 ± 1 mm Hg for untreated and SHU-9119 treated rats). In obese MC4R-deficient rats, CIH for 7 days raised BP by 11 ± 4 mm Hg. However, when MC4R-deficient rats were food restricted to prevent obesity, CIH-induced hypertension was attenuated by 32%. We also found that MC4R deficiency was associated with impaired ventilatory responses to hypercapnia independently of obesity. CONCLUSION: These results show that obesity and the CNS melanocortin system interact in complex ways to elevate BP during CIH and that MC4R may be important in the ventilatory responses to hypercapnia.

Effects of nalfurafine on the reinforcing, thermal antinociceptive, and respiratory-depressant effects of oxycodone: modeling an abuse-deterrent opioid analgesic in rats.

RATIONALE: Strategies to reduce the misuse of mu opioid agonists are critically needed. Previous work has shown that kappa opioid agonists can diminish the abuse-related effects and augment the antinociceptive effects of mu agonists. However, use of traditional kappa agonists is limited by their dysphoric side effects. OBJECTIVES: The current study examined the effects of nalfurafine, a clinically available atypical kappa agonist, on the reinforcing, thermal antinociceptive, and respiratory-depressant effects of oxycodone in male rats. METHODS: To determine oxycodone/nalfurafine mixture proportions to be examined intravenously across procedures, a progressive ratio (PR) self-administration procedure compared the reinforcing effects of oxycodone (56 µg/kg/inj) available alone or as a mixture with co-administered nalfurafine (0.32, 1, or 3.2 µg/kg/inj), corresponding to oxycodone/nalfurafine proportions of 175:1, 56:1, and 18:1, respectively. Next, PR and thermal antinociception dose-effect functions were each determined for oxycodone, nalfurafine, and the same oxycodone/nalfurafine mixture proportions. Finally, the respiratory-depressant effects of equi-antinociceptive doses of oxycodone, nalfurafine, and the mixtures were compared. RESULTS: Nalfurafine decreased the reinforcing effects of oxycodone, and the 18:1 mixture did not function as a reinforcer. Oxycodone and nalfurafine each produced dose-dependent antinociception, and the mixtures produced additive antinociception. In addition, antinociceptive doses of the 56:1 and 18:1 mixtures did not produce respiratory depression. CONCLUSIONS: These results suggest that nalfurafine may augment the thermal antinociceptive effects while reducing the reinforcing and respiratory-depressant effects of oxycodone.

Psychometric properties of the Brazilian Portuguese versions of the 29- and 13-item scales of the Antonovsky's Sense of Coherence (SOC-29 and SOC-13) evaluated in Brazilian cardiac patients.

AIM AND OBJECTIVES: To assess the construct validity and reliability of the Brazilian Portuguese versions of the 29- and 13-item scales of the Antonovsky's Sense of Coherence Scale (SOC-29 and SOC-13). BACKGROUND: Antonovsky's Sense of Coherence Questionnaire was developed to measure the main construct of the salutogenic theory, the sense of coherence. The use of the sense of coherence by health professionals might help identifying specific coping strategies used by person with chronic illness. DESIGN: Cross-sectional study. METHODS: The SOC-29 has been culturally adapted to Brazilian Portuguese language. In this study, we assessed its psychometric properties (construct validity and internal reliability) tested on 203 cardiac patients. The SOC-13 was tested on another 100 cardiac patients hospitalised in the same hospital. The construct validity of both versions was investigated through Pearson correlation between the measures of sense of coherence and of correlated constructs (self-esteem, depression and age), analysis of the principal components and comparison of distinct groups (male vs. female). The internal reliability for both versions was evaluated by Cronbach's alpha. RESULTS: For both versions, the construct validity assessments showed strong positive correlations between sense of coherence and self-esteem and strong negative correlations between sense of coherence and depression (convergent validity), and weak correlation between sense of coherence and age (divergent validity). Principal component analysis supported in part the presence of a single component (unidimensionality). Differences in sense of coherence were found by sex with SOC-29, but not with SOC-13. Cronbach's alpha coefficients showed satisfactory internal consistency in both versions. CONCLUSIONS: The Brazilian Portuguese versions of SOC-29 and SOC-13 can be considered valid and reliable for the populations studied. More studies need to be performed to assess these proprieties in other Brazilian populations. RELEVANCE TO CLINICAL PRACTICE: This scale can be used in research and clinical practice in Brazil to assess nursing interventions aimed at decreasing stress during cardiac rehabilitation.