Effect of simulated extreme rainfall on the vegetative phenology of perennial and annual herbaceous plants from a Brazilian dry forest.

Detecting changes in the phenological responses of herbaceous species as a function of predicted climate change is important for forecasting future scenarios for the functioning of dry tropical forests, especially when predicting an increase in the frequency and intensity of extreme droughts. Because of the sensitivity of plants to water availability, our study hypothesizes that if years become drier or wetter, herbaceous plants will synchronously change the onset, duration, and intensity of their vegetative phenophases. We used a historical series of 60 years of precipitation observations for the Caatinga vegetation to define daily average of precipitation for rainy (Twet), median (Tcontrol), and dry (Tdry) years. We simulated past average daily rainfall (Twet, Tcontrol, and Tdry) while growing two herbaceous perennials and two herbaceous annuals. We monitored plant growth and measured the activity (absence or presence) and intensity of vegetative phenophases. We used circular statistical analysis to assess differences between treatments. Our results revealed that leaf production was seasonal but relatively uniform for perennial species and highly seasonal (wet season) for annual species. Simulated dry years induced lower leaf emergence concentrated over a few months in annual species, but this effect was more strongly significant in one of the two perennial species. Both annual and perennial species can experience delayed and less intense leaf abscission during the rainy season in years with below-average precipitation. In contrast, large voluminous rains in years with above-average precipitation can accelerate and intensify the process of leaf renewal. If future precipitation reductions occur, the changes in phenological response indicate that the cover of annual and perennial herbaceous species in this study will likely decrease, altering the landscape and functioning of dry tropical forests. However, the potential trade-offs observed may help populations of these species to persist during years of severe drought in the Caatinga.

Spatial patterns and factors associated with the incidence of tuberculosis-diabetes in Brazil.

OBJECTIVES: The aim of this study was to analyse the spatial patterns and factors associated with the incidence of tuberculosis-diabetes (TB-DM) in Brazil, from 2001 to 2019. STUDY DESIGN: Ecological study. METHODS: Brazilian municipalities were used as the units of analysis. The local empirical Bayesian rate and the spatial autocorrelation test were calculated. Moran and Getis-Ord Gi∗ were used to identify spatial clusters, and spatially weighted regression was conducted. RESULTS: In total, 75,021 new cases of TB associated with DM were reported in Brazil during the study period. Most Brazilian municipalities had an average TB-DM incidence of 1.0-2.0/100,000 inhabitants. The regression showed that the Gini index (ß = 0.85) and family health strategy coverage (ß = -0.26) were the two indicators that had the most influence on TB-DM incidence in Brazil. CONCLUSIONS: This study identified spatial clusters of TB-DM in Brazil. The results also indicated that social inequalities played a key role in the incidence of TB.

The impact of saline and water stress on the agronomic performance of beet crops.

Excessive salts in irrigation water and water stress have a negative impact on the productive yield of agricultural crops. In this regard, the objective was to evaluate the effect of combined saline and water stress on the agronomic performance of the beet crop. The experiment was conducted in a greenhouse located at the Universidade da Integração Internacional da Lusofonia Afro-Brasileira, in Redenção, Ceará. The experimental design used was completely randomized with split-plots arrangement. The main plots were formed by the electrical conductivities of the irrigation water (0.8, 1.5, 3.0, 4.5, and 6.0 dS m-1), while the irrigation depths of 50 and 100% of the crop evapotranspiration (ETc) were the subplots, with 6 replications. Saline stress negatively affected growth, biomass, tuber root length, and productivity, while increasing the soluble solids of the beet crop. Excessive salts in the irrigation water caused reductions in physiological indices of the beet crop, although with less severity under the 100% ETc.

The geographical distribution and socioeconomic risk factors of COVID-19, tuberculosis and leprosy in Fortaleza, Brazil.

BACKGROUND: Fortaleza (Brazil) is high endemic for coronavirus disease 2019 (COVID-19), tuberculosis (TB) and leprosy. These three diseases share respiratory droplets through coughing or sneezing as the main mode of transmission but differ in incubation time, with COVID-19 having a short and leprosy a long incubation time. Consequently, contacts of a patient are at higher risk of infection and developing these diseases. There might be scope for combined preventive measures, but a better understanding of the geographical distribution and relevant socioeconomic risk factors of the three diseases is needed first. This study aims to describe the geographic distribution of COVID-19, TB and leprosy incidence and to identify common socioeconomic risk factors. METHODS: The total number of new cases of COVID-19, TB and leprosy, as well as socioeconomic and demographic variables, were retrieved from official registers. The geographical distribution of COVID-19, TB and leprosy rates per neighbourhood was visualised in Quantum GIS, and spatial autocorrelation was measured with Moran's I in GeoDa. A spatial regression model was applied to understand the association between COVID-19, TB, leprosy rates, and socioeconomic factors. RESULTS: COVID-19 and TB showed a more homogenous distribution, whereas leprosy is located more in the south and west of Fortaleza. One neighbourhood (Pedras) in the southeast was identified as high endemic for all three diseases. Literacy was a socioeconomic risk factor for all three diseases: a high literacy rate increases the risk of COVID-19, and a low literacy rate (i.e., illiteracy) increases the risk of TB and leprosy. In addition, high income was associated with COVID-19, while low income with TB. CONCLUSIONS: Despite the similar mode of transmission, COVID-19, TB and leprosy show a different distribution of cases in Fortaleza. In addition, associated risk factors are related to wealth in COVID-19 and to poverty in TB and leprosy. These findings may support policymakers in developing (partially combined) primary and secondary prevention considering the efficient use of resources.

The ultimate technique for posterior rib fractures: The parascapular sub-iliocostalis plane block – A series of cases / Una técnica fundamental para las fracturas costales posteriores: el bloqueo paraescapular del plano subiliocostal. Una serie de casos

We report retrospectively a series of four cases involving the successful use of the recently described parascapular sub-iliocostalis plane block (PSIP), for lateral-posterior rib fractures. The efficacy of the PSIP block may potentially depend on different mechanisms of action: (1) direct action in the fracture site by craniocaudal myofascial spread underneath the erector spinae muscle (ESM); (2) spread to deep layers through tissue disruption caused by trauma, to reach the proximal intercostal nerves; (3) medial spread below the ESM, to reach the posterior spinal nerves; and (4) lateral spread in the sub-serratus (SS) plane to reach the lateral cutaneous branches of the intercostal nerves; while avoiding significant negative hemodynamic effects and other possible complications associated to other techniques leading that the PSIP may be considered an alternative in some clinical scenarios to the erector spinae plane block or the paravertebral block. (AU)

Presentamos retrospectivamente una serie de 4 casos en los que se utilizó con éxito el bloqueo paraescapular del plano subiliocostal (PSIP), descrito recientemente, para fracturas costales laterales-posteriores. La eficacia del bloqueo PSIP puede depender potencialmente de diferentes mecanismos de acción: (1) acción directa en las fractura por la extensión miofascial craneocaudal por debajo del músculo erector de la columna, (2) diseminación a capas profundas a través de la disrupción tisular causada por el traumatismo, para alcanzar los nervios intercostales proximales, (3) extensión medial por debajo del músculo erector de la columna, para alcanzar los nervios espinales posteriores y (4) extensión lateral en el plano subserrato para alcanzar las ramas cutáneas laterales de los nervios intercostales, evitando al mismo tiempo efectos hemodinámicos negativos y otras posibles complicaciones asociados a otras técnicas, lo que hace que el bloqueo PSIP pueda considerarse en algunos escenarios clínicos una alternativa al bloqueo del plano erector de la columna vertebral o al bloqueo paravertebral. (AU)

The ultimate technique for posterior rib fractures: the parascapular sub-iliocostalis plane block - A series of cases.

We report retrospectively a series of four cases involving the successful use of the recently described parascapular sub-iliocostalis plane block (PSIP), for lateral-posterior rib fractures. The efficacy of the PSIP block may potentially depend on different mechanisms of action: (1) direct action in the fracture site by craniocaudal myofascial spread underneath the erector spinae muscle (ESM); (2) spread to deep layers through tissue disruption caused by trauma, to reach the proximal intercostal nerves; (3) medial spread below the ESM, to reach the posterior spinal nerves; and (4) lateral spread in the sub-serratus (SS) plane to reach the lateral cutaneous branches of the intercostal nerves; while avoiding significant negative hemodynamic effects and other possible complications associated to other techniques leading that the PSIP may be considered an alternative in some clinical scenarios to the Erector Spinae Plane block or the Paravertebral block.

Biology of Glyphepomis dubia Campos & Souza, 2016 (Hemiptera: Pentatomidae) and the parasitoids Telenomus podisi Ashmead, 1893 and Trissolcus basalis (Wollaston, 1858) (Hymenoptera: Platygastridae) on rice / Biologia de Glyphepomis dubia Campos & Souza, 2016 (Hemiptera: Pentatomidae) e dos parasitoides Telenomus podisi Ashmead, 1893 e Trissolcus basalis (Wollaston, 1858) (Hymenoptera: Platygastridae) em arroz

The life cycle of stink bug, Glyphepomis dubia and the development of two egg parasitoids (Telenomus podisi and Trissolcus basalis) were studied at the Federal University of Maranhão, at 26 ± 2oC, relative humidity (RH) of 60 ± 10% and 12h photophase. Individuals used in the study were collected from seven rice fields located around the municipality of Arari, Maranhão, Brazil, and maintained in greenhouse and laboratory for the life cycle studies. From egg to adult, G. dubia took 35.2 days to complete the life cycle. The oviposition period was 37 days, with egg masses of about 12 eggs each and viability of 93.1%. Longevity was 53 and 65 days for females and males, respectively. The egg parasitoids Te. podisi and Tr. basalis parasitized and developed in G. dubia eggs; however, the biological characteristics of Tr. basalis were affected. Emergence of the parasitoids was higher for Te. podisi (83.5%) compared to the records for Tr. basalis (50.4%). Therefore, G. dubia may potentially achieve a pest status and Te. podisi is a promising biological control agent for G. dubia management in Brazil due to its higher longevity and better reproductive parameters.

O ciclo de vida do percevejo, Glyphepomis dubia e a biologia de dois parasitoides de ovos (Telenomus podisi e Trissolcus basalis) foram estudados na Universidade Federal do Maranhão, a 26 ± 2oC, umidade relativa (UR) de 60 ± 10% e fotofase de 12h. Sete indivíduos de G. dubia foram coletados em lavoura de arroz localizada no município de Arari, Maranhão, Brasil e mantidos em casa de vegetação e laboratório para estudos de ciclo de vida. Do ovo ao adulto, G. dubia levou 35.2 dias para completar o ciclo de vida. O período de oviposição foi de 37 dias com massas de ovos com cerca de 12 ovos/massa e viabilidade de 93.1%. A longevidade foi de 53 e 65 dias, respectivamente, para fêmeas e machos. Os parasitoides de ovos, Te. podisi e Tr. basalis parasitaram e se desenvolveram em ovos de G. dubia, no entanto as características biológicas de Tr. basalis foi afetada. A emergência dos parasitoides foi maior para Te. podisi (83.5%) em comparação com o registrado para Tr. basalis (50.4%). Portanto, G. dubia poderá apresentar potencial para atingir o status de praga e Te. podisi é um promissor agente de controle biológico para ser utilizado no manejo de G. dubia no Brasil, pois apresentou maior longevidade e os melhores parâmetros reprodutivos.

Biology of Glyphepomis dubia Campos & Souza, 2016 (Hemiptera: Pentatomidae) and the parasitoids Telenomus podisi Ashmead, 1893 and Trissolcus basalis (Wollaston, 1858) (Hymenoptera: Platygastridae) on rice

Abstract The life cycle of stink bug, Glyphepomis dubia and the development of two egg parasitoids (Telenomus podisi and Trissolcus basalis) were studied at the Federal University of Maranhão, at 26 ± 2oC, relative humidity (RH) of 60 ± 10% and 12h photophase. Individuals used in the study were collected from seven rice fields located around the municipality of Arari, Maranhão, Brazil, and maintained in greenhouse and laboratory for the life cycle studies. From egg to adult, G. dubia took 35.2 days to complete the life cycle. The oviposition period was 37 days, with egg masses of about 12 eggs each and viability of 93.1%. Longevity was 53 and 65 days for females and males, respectively. The egg parasitoids Te. podisi and Tr. basalis parasitized and developed in G. dubia eggs; however, the biological characteristics of Tr. basalis were affected. Emergence of the parasitoids was higher for Te. podisi (83.5%) compared to the records for Tr. basalis (50.4%). Therefore, G. dubia may potentially achieve a pest status and Te. podisi is a promising biological control agent for G. dubia management in Brazil due to its higher longevity and better reproductive parameters.

Resumo O ciclo de vida do percevejo, Glyphepomis dubia e a biologia de dois parasitoides de ovos (Telenomus podisi e Trissolcus basalis) foram estudados na Universidade Federal do Maranhão, a 26 ± 2oC, umidade relativa (UR) de 60 ± 10% e fotofase de 12h. Sete indivíduos de G. dubia foram coletados em lavoura de arroz localizada no município de Arari, Maranhão, Brasil e mantidos em casa de vegetação e laboratório para estudos de ciclo de vida. Do ovo ao adulto, G. dubia levou 35.2 dias para completar o ciclo de vida. O período de oviposição foi de 37 dias com massas de ovos com cerca de 12 ovos/massa e viabilidade de 93.1%. A longevidade foi de 53 e 65 dias, respectivamente, para fêmeas e machos. Os parasitoides de ovos, Te. podisi e Tr. basalis parasitaram e se desenvolveram em ovos de G. dubia, no entanto as características biológicas de Tr. basalis foi afetada. A emergência dos parasitoides foi maior para Te. podisi (83.5%) em comparação com o registrado para Tr. basalis (50.4%). Portanto, G. dubia poderá apresentar potencial para atingir o status de praga e Te. podisi é um promissor agente de controle biológico para ser utilizado no manejo de G. dubia no Brasil, pois apresentou maior longevidade e os melhores parâmetros reprodutivos.

Biology of Glyphepomis dubia Campos & Souza, 2016 (Hemiptera: Pentatomidae) and the parasitoids Telenomus podisi Ashmead, 1893 and Trissolcus basalis (Wollaston, 1858) (Hymenoptera: Platygastridae) on rice / Biologia de Glyphepomis dubia Campos & Souza, 2016 (Hemiptera: Pentatomidae) e dos parasitoides Telenomus podisi Ashmead, 1893 e Trissolcus basalis (Wollaston, 1858 (Hymenoptera: Platygastridae) em arroz

Abstract The life cycle of stink bug, Glyphepomis dubia and the development of two egg parasitoids (Telenomus podisi and Trissolcus basalis) were studied at the Federal University of Maranhão, at 26 ± 2oC, relative humidity (RH) of 60 ± 10% and 12h photophase. Individuals used in the study were collected from seven rice fields located around the municipality of Arari, Maranhão, Brazil, and maintained in greenhouse and laboratory for the life cycle studies. From egg to adult, G. dubia took 35.2 days to complete the life cycle. The oviposition period was 37 days, with egg masses of about 12 eggs each and viability of 93.1%. Longevity was 53 and 65 days for females and males, respectively. The egg parasitoids Te. podisi and Tr. basalis parasitized and developed in G. dubia eggs; however, the biological characteristics of Tr. basalis were affected. Emergence of the parasitoids was higher for Te. podisi (83.5%) compared to the records for Tr. basalis (50.4%). Therefore, G. dubia may potentially achieve a pest status and Te. podisi is a promising biological control agent for G. dubia management in Brazil due to its higher longevity and better reproductive parameters.

Resumo O ciclo de vida do percevejo, Glyphepomis dubia e a biologia de dois parasitoides de ovos (Telenomus podisi e Trissolcus basalis) foram estudados na Universidade Federal do Maranhão, a 26 ± 2oC, umidade relativa (UR) de 60 ± 10% e fotofase de 12h. Sete indivíduos de G. dubia foram coletados em lavoura de arroz localizada no município de Arari, Maranhão, Brasil e mantidos em casa de vegetação e laboratório para estudos de ciclo de vida. Do ovo ao adulto, G. dubia levou 35.2 dias para completar o ciclo de vida. O período de oviposição foi de 37 dias com massas de ovos com cerca de 12 ovos/massa e viabilidade de 93.1%. A longevidade foi de 53 e 65 dias, respectivamente, para fêmeas e machos. Os parasitoides de ovos, Te. podisi e Tr. basalis parasitaram e se desenvolveram em ovos de G. dubia, no entanto as características biológicas de Tr. basalis foi afetada. A emergência dos parasitoides foi maior para Te. podisi (83.5%) em comparação com o registrado para Tr. basalis (50.4%). Portanto, G. dubia poderá apresentar potencial para atingir o status de praga e Te. podisi é um promissor agente de controle biológico para ser utilizado no manejo de G. dubia no Brasil, pois apresentou maior longevidade e os melhores parâmetros reprodutivos.

Therapeutic impact of determination of RAS mutations in the plasma of patient with colorectal cancer.

Stage IV colorectal cancer treatment includes targeted therapy depending on RAS status. During disease progression, loss or gain of RAS mutations could happen, supporting the hypothesis of the evolutionary pressure of therapy. Circulating tumor DNA (ctDNA) are nucleic acids released to the bloodstream by the tumor during its development and may be detected by liquid biopsy. The Idylla© Biocartis, a fully automated real-time-PCR-based molecular diagnostic system, was used in a patient with metastatic colorectal cancer with a NRAS mutation in progression after several therapeutic lines. The ctDNA mutational analysis was performed and revealed the absence of mutations in the KRAS, NRAS, and BRAF genes. The patient started the third line of palliative chemotherapy with irinotecan + cetuximab and achieved a partial response for the first time. The authors describe a case in which liquid biopsy determined the higher progression-free survival achieved.

Biology of Glyphepomis dubia Campos & Souza, 2016 (Hemiptera: Pentatomidae) and the parasitoids Telenomus podisi Ashmead, 1893 and Trissolcus basalis (Wollaston, 1858) (Hymenoptera: Platygastridae) on rice.

The life cycle of stink bug, Glyphepomis dubia and the development of two egg parasitoids (Telenomus podisi and Trissolcus basalis) were studied at the Federal University of Maranhão, at 26 ± 2oC, relative humidity (RH) of 60 ± 10% and 12h photophase. Individuals used in the study were collected from seven rice fields located around the municipality of Arari, Maranhão, Brazil, and maintained in greenhouse and laboratory for the life cycle studies. From egg to adult, G. dubia took 35.2 days to complete the life cycle. The oviposition period was 37 days, with egg masses of about 12 eggs each and viability of 93.1%. Longevity was 53 and 65 days for females and males, respectively. The egg parasitoids Te. podisi and Tr. basalis parasitized and developed in G. dubia eggs; however, the biological characteristics of Tr. basalis were affected. Emergence of the parasitoids was higher for Te. podisi (83.5%) compared to the records for Tr. basalis (50.4%). Therefore, G. dubia may potentially achieve a pest status and Te. podisi is a promising biological control agent for G. dubia management in Brazil due to its higher longevity and better reproductive parameters.

Spatial dynamics of the COVID-19 pandemic in Brazil.

The objective of this study was to analyse the dynamics of spatial dispersion of the coronavirus disease 2019 (COVID-19) in Brazil by correlating them to socioeconomic indicators. This is an ecological study of COVID-19 cases and deaths between 26 February and 31 July 2020. All Brazilian counties were used as units of analysis. The incidence, mortality, Bayesian incidence and mortality rates, global and local Moran indices were calculated. A geographic weighted regression analysis was conducted to assess the relationship between incidence and mortality due to COVID-19 and socioeconomic indicators (independent variables). There were confirmed 2 662 485 cases of COVID-19 reported in Brazil from February to July 2020 with higher rates of incidence in the north and northeast. The Moran global index of incidence rate (0.50, P = 0.01) and mortality (0.45 with P = 0.01) indicate a positive spatial autocorrelation with high standards in the north, northeast and in the largest urban centres between cities in the southeast region. In the same period, there were 92 475 deaths from COVID-19, with higher mortality rates in the northern states of Brazil, mainly Amazonas, Pará and Amapá. The results show that there is a geospatial correlation of COVID-19 in large urban centres and regions with the lowest human development index in the country. In the geographic weighted regression, it was possible to identify that the percentage of people living in residences with density higher than 2 per dormitory, the municipality human development index (MHDI) and the social vulnerability index were the indicators that most contributed to explaining incidence, social development index and the municipality human development index contributed the most to the mortality model. We hope that the findings will contribute to reorienting public health responses to combat COVID-19 in Brazil, the new epicentre of the disease in South America, as well as in other countries that have similar epidemiological and health characteristics to those in Brazil.

Spatiotemporal trends of Chagas disease-related mortality in the Northeast of Brazil, 2007-2017.

Chagas disease (CD) is a neglected disease and endemic in Brazil. In the Brazilian Northeast Region, it affects millions of people. Therefore, it is necessary to identify the spatiotemporal trends of CD mortality in the Northeast of Brazil. This ecological study was designed, in which the unit of analysis was the municipality of the Brazilian northeast. The data source was the Information System of Mortality. It was calculated relative risk from socioeconomic characteristics. Mortality rates were smoothed by the Local Empirical Bayes method. Spatial dependency was analysed by the Global and Local Moran Index. Scan spatial statistics were also used. A total of 11 287 deaths by CD were notified in the study. An expressive parcel of this number was observed among 70-year-olds or more (n = 4381; 38.8%), no schooling (n = 4381; 38.8%), mixed-race (n = 4381; 62.3%), male (n = 6875; 60.9%). It was observed positive spatial autocorrelation, mostly in municipalities of the state of Bahia, Piauí (with high-high clusters), and Maranhão (with low-low clusters). The spatial scan statistics has presented a risk of mortality in 24 purely spatial clusters (P < 0.05). The study has identified the spatial pattern of CD mortality mostly in Bahia and Piauí, highlighting priority areas in planning and control strategies of the health services.

Mortality and survival of COVID-19.

This study aims to identify the risk factors associated with mortality and survival of COVID-19 cases in a state of the Brazilian Northeast. It is a historical cohort with a secondary database of 2070 people that presented flu-like symptoms, sought health assistance in the state and tested positive to COVID-19 until 14 April 2020, only moderate and severe cases were hospitalised. The main outcome was death as a binary variable (yes/no). It also investigated the main factors related to mortality and survival of the disease. Time since the beginning of symptoms until death/end of the survey (14 April 2020) was the time variable of this study. Mortality was analysed by robust Poisson regression, and survival by Kaplan-Meier and Cox regression. From the 2070 people that tested positive to COVID-19, 131 (6.3%) died and 1939 (93.7%) survived, the overall survival probability was 87.7% from the 24th day of infection. Mortality was enhanced by the variables: elderly (HR 3.6; 95% CI 2.3-5.8; P < 0.001), neurological diseases (HR 3.9; 95% CI 1.9-7.8; P < 0.001), pneumopathies (HR 2.6; 95% CI 1.4-4.7; P < 0.001) and cardiovascular diseases (HR 8.9; 95% CI 5.4-14.5; P < 0.001). In conclusion, mortality by COVID-19 in Ceará is similar to countries with a large number of cases of the disease, although deaths occur later. Elderly people and comorbidities presented a greater risk of death.

miRNA signatures in childhood sarcomas and their clinical implications.

Progresses in multimodal treatments have significantly improved the outcomes for childhood cancer. Nonetheless, for about one-third of patients with Ewing sarcoma, rhabdomyosarcoma, or osteosarcoma steady remission has remained intangible. Thus, new biomarkers to improve early diagnosis and the development of precision-targeted medicine remain imperative. Over the last decade, remarkable progress has been made in the basic understanding of miRNAs function and in interpreting the contribution of their dysregulation to cancer development and progression. On this basis, this review focuses on what has been learned about the pivotal roles of miRNAs in the regulation of key genes implicated in childhood sarcomas.

Effect of bone morphogenetic proteins 2 and 4 on survival and development of bovine secondary follicles cultured in vitro.

This study evaluated the effect of bone morphogenetic proteins 2 (BMP2) and 4 (BMP2) on follicle development and mRNA expression for GDF9, Cyclin B1, BMPR1A, BMPR1B, BMPRII, FSHR and SMAD1 in bovine secondary follicles cultured in vitro. Isolated secondary follicles were cultured for 18 days in TCM199+ medium alone or supplemented with BMP2 (10 ng/mL), BMP4 (100 ng/mL) or combination of both BMP2 and 4. Real-time PCR was used to analyze mRNA levels in fresh and cultured follicles. After 18 days of culture, follicles cultured with BMP2 alone or with BMP4 alone had larger diameters when compared to control (P < .05). In addition, all treatments promoted antrum formation and maintained a high viability rate through the growing period. The presence of BMP2, BMP4 or both together did not influence mRNA expression for the tested genes. However, the in vitro culture induces down-regulation for mRNA expression of BMPR1A. In conclusion, the addition of BMP2 or BMP4 alone in cultured medium promotes follicular growth and antrum formation in bovine follicles after 18 days of in vitro culture.

Delirio postoperatorio en pacientes con historial de abuso de alcohol / Postoperative delirium in patients with history of alcohol abuse

Introducción. El delirio postoperatorio (DPO) es un estado confusional agudo caracterizado por cambios fluctuantes en el nivel de consciencia y la función cognitiva, que se desarrolla en un corto período de tiempo. El objetivo de este estudio fue evaluar la relación entre el abuso de alcohol y el desarrollo de DPO. Métodos. Estudio prospectivo incluyendo pacientes programados para cirugía electiva, admitidos en la unidad de cuidados post-anestésicos. Previamente a la cirugía, se preguntó a los pacientes sobre el consumo de alcohol, el cual se evaluó mediante el cuestionario Cutting Down, Annoyance, Guilt and Eye-opener (CAGE); la puntuación ≥2 se definió como abuso de alcohol. Las comparaciones se realizaron utilizando las pruebas exacta de Fischer o de χ2. Los factores de riesgo se analizaron mediante una regresión logística multivariante con razón de momios (RM) e intervalos de confianza del 95% (IC95%). Resultados. Doscientos veintiún pacientes fueron estudiados. El delirio se observó en el 11% de los pacientes. La incidencia del abuso de alcohol fue del 10%. Los pacientes con abuso de alcohol eran más frecuentemente varones (p<0,001) y tenían un mayor grado de riesgo perioperatorio de la ASA (ASAIII/IV) (p=0,021). La edad (RM: 5,9; IC95%: 2,2-15,9; p<0,001 para pacientes mayores de 65años), el estado físico ASAIII/IV (RM: 4,2; IC95%: 1,7-10,7; p=0,002) y el abuso de alcohol (RM: 4,2; IC 95%: 1,4-12,9; p=0,013) resultaron ser factores predictivos independientes del DPO. Conclusiones. Las características más frecuentes en los pacientes con DPO fueron la edad avanzada, una mayor puntuación para el estado físico según la clasificación ASA y el abuso de alcohol. El abuso de alcohol se considera un factor de riesgo independiente para el DPO (AU)

Introduction. Postoperative delirium (POD) is an acute confusional state characterized by changes in consciousness and cognition, which may be fluctuating, developing in a small period of time. The aim of this study was to evaluate the relationship between alcohol abuse and the development of POD. Methods. We prospectively evaluated consecutively all postoperative patients admitted in the Post-anesthesia Care Unit over a 1-month period for delirium, using the Portuguese versions of the the Nursing Delirium Screening Scale. Before surgery, alcohol consumption was inquired and alcohol abuse was assessed by the CAGE (Cutting Down, Annoyance, Guilt and Eye-opener) questionnaire; a score ≥2 defined alcohol abuse. Fischer exact test or chi-square was applied for comparisons. Risk factors were analyzed in a multivariate analysis using a logistic regression with odds ratios (OR) and 95% confidence intervals (95%CI). Results. Two hundred twenty-one patients were enrolled. Delirium was seen in 11% patients. The incidence of alcohol abuse was 10%. Patients with alcohol abuse were more frequently men (P<.001) and had a higher ASA physical status III/IV (P=.021). POD was more frequent in patients with alcohol abuse (30% vs. 9%; P=.002). Age (OR: 5.9; 95%CI: 2.2-15.9; P<.001 for patients ≥65years), ASA physical statusIII/IV (OR: 4.2; 95%CI: 1.7-10.7; P=.002) and alcohol abuse (OR: 4.2; 95%CI: 1.4-12.9; P=.013) were found to be independent predictors for POD. Conclusions. Older patients, higher ASA physical status and alcohol abuse were more frequent in patients with POD. Alcohol abuse was considered an independent risk factor for POD (AU)

Postoperative delirium in patients with history of alcohol abuse. / Delirio postoperatorio en pacientes con historial de abuso de alcohol.

INTRODUCTION: Postoperative delirium (POD) is an acute confusional state characterized by changes in consciousness and cognition, which may be fluctuating, developing in a small period of time. The aim of this study was to evaluate the relationship between alcohol abuse and the development of POD. METHODS: We prospectively evaluated consecutively all postoperative patients admitted in the Post-anesthesia Care Unit over a 1-month period for delirium, using the Portuguese versions of the the Nursing Delirium Screening Scale. Before surgery, alcohol consumption was inquired and alcohol abuse was assessed by the CAGE (Cutting Down, Annoyance, Guilt and Eye-opener) questionnaire; a score ≥2 defined alcohol abuse. Fischer exact test or chi-square was applied for comparisons. Risk factors were analyzed in a multivariate analysis using a logistic regression with odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Two hundred twenty-one patients were enrolled. Delirium was seen in 11% patients. The incidence of alcohol abuse was 10%. Patients with alcohol abuse were more frequently men (P<.001) and had a higher ASA physical status III/IV (P=.021). POD was more frequent in patients with alcohol abuse (30% vs. 9%; P=.002). Age (OR: 5.9; 95%CI: 2.2-15.9; P<.001 for patients ≥65years), ASA physical statusIII/IV (OR: 4.2; 95%CI: 1.7-10.7; P=.002) and alcohol abuse (OR: 4.2; 95%CI: 1.4-12.9; P=.013) were found to be independent predictors for POD. CONCLUSIONS: Older patients, higher ASA physical status and alcohol abuse were more frequent in patients with POD. Alcohol abuse was considered an independent risk factor for POD.