Comparative effectiveness of pulsed field ablation and cryoballoon ablation for atrial fibrillation: a systematic review and meta-analysis

BACKGROUND: Cryoballoon ablation (CBA) is a well-established technique for treating atrial fibrillation (AF), with a low complication rate related to cryoenergy-induced lesions. Pulsed Field Ablation (PFA) has emerged as a non-thermal alternative, with promising potential to further reduce complications. PURPOSE: We aim to conduct a systematic review and meta-analysis comparing the efficacy and safety of PFA versus CBA in patients with AF. METHODS: We conducted a systematic search across PubMed, Embase, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials (RCTs) or observational studies published between 2013 and 2024 that compared PFA and CBA ablation techniques in patients with AF. Statistical analysis was carried out utilizing RevMan 5.1.7. Heterogeneity was assessed with I² statistics; p-values inferior to 0.05 and I²>25% were considered as significant heterogeneity. RESULTS: A total of 840 studies were screened in the initial search, and 26 studies were selected for full-text review based on inclusion criteria. Out of these, 8 observational studies involving 3,113 patients were included. Among these, 1,088 (34.9%) underwent PFA, while 2,025 (65.0%) underwent CBA. Periprocedural complications were significantly lower in patients who underwent PFA compared with the CBA group (RR 0.46; 95% CI 0.29 to 0.74; p=0.001; I²=1%; Fig. 1A). Furthermore, there was a significant reduction in procedure time in the PFA group (MD -8.21 min; 95% CI -13.74 to -2.69; p=0.004; I²=96%; Fig. 1B). However, no statistically significant difference was observed among groups regarding fluoroscopy time (MD 1.63 min; 95% CI -0.22 to 3.48; p=0.08; I²=92%; Fig. 2A), or recurrence of atrial arrhythmias after the blanking period (RR 0.84; 95% CI 0.68 to 1.04; p=0.12; I²=6%; Fig. 2B). Additionally, a subgroup analysis involving only propensity score-matched cohorts was conducted but didn't show any statistical difference for any outcomes evaluated. CONCLUSION: In this systematic review and meta-analysis, PFA was associated with a lower risk of periprocedural complications and a shorter procedure duration, compared to CBA in patients with AF. Additionally, it didn't show a potential for reducing the recurrence of atrial arrhythmias, and the data regarding fluoroscopy time were inconclusive.

Bilateral chorioretinopathy in child-onset systemic lupus erythematosus.

Any of the various layers of the eye may suffer injury in systemic lupus erythematosus, ranging from keratoconjunctivitis sicca to retinopathy and optic neuritis. Rheumatologists must always be aware of ocular involvement in those patients since rapid diagnosis and a prompt intervention in those severe cases can prevent visual loss or even irreversible blindness. We present here the case of a 14-year-old girl who, despite a short period of disease, developed chorioretinopathy with transitory visual impairment with a good treatment response.

Description of a New Phlebotomine Species of the Brazilian Cerrado from Sandstone Caves in Tocantins State, Brazil: Lutzomyia (Lutzomyia) elizabethrangelae sp. nov. (Diptera: Psychodidae).

The sand fly Lutzomyia (Lutzomyia) elizabethrangelae sp. nov. is described and illustrated based on the morphological characters of male and female specimens captured in sandstone caves in the municipality of Palmeirópolis, in the southern region of Tocantins state. The samples were collected as part of an entomological vector-monitoring project during the construction of the Peixe Angical Hydroelectric Plant. Based on the morphological characters of the new species, we believe this species can be included in the subgenus Lutzomyia. This species is closely related to two others, Lutzomyia forattinii Galati et al. 1985 and Lutzomyia almerioi Galati and Nunes 1999. The new species can be distinguished from Lutzomyia forattinii and Lutzomyia almerioi by the morphological characteristics of the male genitalia and the female cibarium.

Doctors' awareness concerning primary immunodeficiencies in Brazil.

BACKGROUND: PIDs are a heterogeneous group of genetic illnesses, and delay in their diagnosis is thought to be caused by a lack of awareness among physicians concerning PIDs. The latter is what we aimed to evaluate in Brazil. METHODS: Physicians working at general hospitals all over the country were asked to complete a 14-item questionnaire. One of the questions described 25 clinical situations that could be associated with PIDs and a score was created based on percentages of appropriate answers. RESULTS: A total of 4026 physicians participated in the study: 1628 paediatricians (40.4%), 1436 clinicians (35.7%), and 962 surgeons (23.9%). About 67% of the physicians had learned about PIDs in medical school or residency training, 84.6% evaluated patients who frequently took antibiotics, but only 40.3% of them participated in the immunological evaluation of these patients. Seventy-seven percent of the participating physicians were not familiar with the warning signs for PIDs. The mean score of correct answers for the 25 clinical situations was 48.08% (±16.06). Only 18.3% of the paediatricians, 7.4% of the clinicians, and 5.8% of the surgeons answered at least 2/3 of these situations appropriately. CONCLUSIONS: There is a lack of medical awareness concerning PIDs, even among paediatricians, who have been targeted with PID educational programmes in recent years in Brazil. An increase in awareness with regard to these disorders within the medical community is an important step towards improving recognition and treatment of PIDs.

Severe combined immunodeficiency in Brazil: management, prognosis, and BCG-associated complications.

BACKGROUND: Severe combined immunodeficiency (SCID) is one of the most severe forms of primary immunodeficiency. The objectives of this study were to analyze the diagnosis, treatment, and prognosis of SCID in Brazil and to document the impact of BCG vaccine. METHODS: We actively searched for cases by contacting all Brazilian referral centers. RESULTS: We contacted 23 centers and 70 patients from 65 families. Patients were born between 1996 and 2011, and 49 (70%) were male. More than half (39) of the diagnoses were made after 2006. Mean age at diagnosis declined from 9.7 to 6.1 months (P = .058) before and after 2000, respectively, and mean delay in diagnosis decreased from 7.9 to 4.2 months (P = .009). Most patients (60/70) were vaccinated with BCG before the diagnosis, 39 of 60 (65%) had complications related to BCG vaccine, and the complication was disseminated in 29 of 39 (74.3%). Less than half of the patients (30, 42.9%) underwent hematopoietic stem cell transplantation (HSCT). Half of the patients died (35, 50%), and 23 of these patients had not undergone HSCT. Disseminated BCG was the cause of death, either alone or in association with other causes, in 9 of 31 cases (29%, no data for 4 cases). CONCLUSIONS: In Brazil, diagnosis of SCID has improved over the last decade, both in terms of the number of cases and age at diagnosis, although a much higher number of cases had been expected. Mortality is higher than in developed countries. Complications of BCG vaccine are an important warning sign for the presence of SCID and account for significant morbidity during disease progression.

Nutritional supplementation assessment with whey proteins and TGF-ß in patients with Crohn's disease.

UNLABELLED: Crohn's disease (CD) is a chronic inflammatory disorder that primarily affects the intestines, resulting in breakage of the intestinal barrier, pathological inflammation and nutritional disorders that encompass from trace elements deficiency to severe malnutrition. Nutritional interventions either alone or associated to drug therapy may be effective to achieve and maintain inflammation remission. OBJECTIVE: To evaluate usual food intake as quantitative and qualitatively, in CD patients; and describe the effect of a supplement containing whey proteins and TGF- on their body composition. PATIENTS AND METHODS: Dietary intake was assessed considering 42 consecutive patients, followed in a tertiary center, and by using the 3-day food recall and food intake frequency questionnaire. Body composition was assessed previously and 8 weeks after supplementation with a diet containing whey proteins and TGF-ß (N = 22). RESULTS AND DISCUSSION: Considering carbohydrates and lipids, most patients had adequate dietary intake according recommendations. Protein, saturated fat, B12 vitamin and zinc intakes were higher than the recommended values. The dietary fiber, A, D, C and E vitamins, calcium, iron, folate, potassium and sodium intakes did not reach the recommended requirements in most patients. Patients supplemented with the whey protein and TGF-ß dietary presented a positive increment in their lean body mass, when compared to non-supplemented group. CONCLUSION: CD patients require nutritional orientation. Whey protein intake resulted in significant differences, such as improvement in Lean Body Mass and reduction in Fat percentage.

Circulating concentrations, cerebral output of the CINC-1 and blood­brain barrier disruption in Wistar rats after pneumococcal meningitis induction.

Pneumococcal meningitis is a severe infectious illness of the central nervous system (CNS), with high rates of lethality and morbidity, being that the microorganism and the host's inflammatory response are responsible for cerebral complications. Moreover, the blood­brain barrier (BBB) itself secretes cytokines and, because of the bipolar nature of the BBB, these substances can be secreted into either the CNS compartment or in the blood, so patients with acute bacterial meningitis frequently develop sepsis. Therefore, the aim of this study was to evaluate the cytokine/chemokine levels in different vessels and the BBB integrity after pneumococcal meningitis induction. Wistar rats were infected with Streptococcus pneumoniae, and the BBB integrity was investigated using Evan's blue dye. Also, blood from the carotid artery and jugular vein was collected in order to perform tumour necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1ß), interleukin-6 (IL-60 and cytokine-induced neutrophil chemoattractant-1 (CINC-1) analyses by enzyme-linked immunosorbent assay (ELISA). CINC-1 levels were increased at 6 h in the arterial plasma and at 3 and 6 h in the jugular plasma. We observed BBB breakdown between 12 and 24 h in the hippocampus and at 12 and 18 h in the cortex after pneumococcal meningitis induction. The increase of CINC-1 occurred prior to the BBB breakdown. CINC-1 is a neutrophil chemoattractant and it may be related to early events in the pneumococcal meningitis pathophysiology.

Abnormalities in body composition and nutritional status in HIV-infected children and adolescents on antiretroviral therapy.

This cross-sectional study aimed to compare growth, nutritional status and body composition outcomes between a group of 94 HIV-infected children and adolescents on antiretroviral therapy (ART) and 364 healthy controls, and to evaluate their association with clinical and lifestyle variables within the HIV-infected group. When compared with the control group, HIV patients had higher risk of stunting (odds ratio [OR] 5.33, 95% confidence interval [CI]: 2.83-10.04) and thinness (OR 4.7, 95% CI: 2.44-9.06), higher waist-to-hip ratios (medians 0.89 versus 0.82 for boys and 0.90 versus 0.77 for girls, P < 0.001), and lower prevalence of overweight or obesity (OR 0.33, 95% CI: 0.14-0.78). Protease inhibitor usage was associated with thinness (OR 3.51, 95% CI 1.07-11.44) and lipoatrophy (OR 3.5, 95% CI 1.37-8.95). HIV-infected children on ART showed significant nutritional status and body composition abnormalities, consistent with the severity of vertical HIV infection and the consequences of prolonged ART.

In vivo and in vitro exposures for the evaluation of the genotoxic effects of lead on the Neotropical freshwater fish Prochilodus lineatus.

In the present study, in vivo and in vitro exposures were used to assess the genotoxicity of lead (Pb) to the freshwater fish Prochilodus lineatus. The comet assay using blood, liver and gill cells, and the occurrence of micronuclei (MN) and other erythrocytic nuclear abnormalities (ENA) were used to assess the genotoxic potential of lead in vivo. Metallothionein content (MT) was measured in fish liver in order to evaluate the protection of fish against Pb toxicity. Fish erythrocytes were exposed to Pb in vitro (1, 3 and 6 h) and the number of viable cells, DNA integrity, using the comet assay, and lysosomal membrane stability, measured by the neutral red retention assay (NRRA) were analyzed. The results of the comet assay after in vivo toxicity tests (6, 24 and 96 h) showed that Pb was genotoxic for all the three tissues analyzed after 96 h exposure. A significant increase in liver MT content was observed after 6 and 24 h of Pb exposure. MN frequency did not increase after Pb exposures, but the frequency of the other ENA, such as kidney-shaped nuclei, segmented nuclei and lobed nuclei, showed a significant increase after 24 and 96 h, indicating that ENA is a better biomarker for Pb exposure than MN alone after short-term exposures. The results of the comet assay performed with erythrocytes in vitro exposed to lead confirmed its genotoxic effect and showed that DNA damage increased with increasing exposure time. Moreover, the NRRA clearly indicated that Pb induces a destabilization of the lysosomal membrane. These results demonstrate the potential genotoxicity and cytotoxicity of lead after acute exposures.

Increased levels of glutamate in the central nervous system are associated with behavioral symptoms in experimental malaria

Cerebral malaria (CM) is a severe complication resulting from Plasmodium falciparum infection. This condition has been associated with cognitive, behavioral and motor dysfunctions, seizures and coma. The underlying mechanisms of CM are incompletely understood. Glutamate and other metabolites such as lactate have been implicated in its pathogenesis. In the present study, we investigated the involvement of glutamate in the behavioral symptoms of CM. Seventeen female C57BL/6 mice (20-25 g) aged 6-8 weeks were infected with P. berghei ANKA by the intraperitoneal route using a standardized inoculation of 10(6) parasitized red blood cells suspended in 0.2 mL PBS. Control animals (N = 17) received the same volume of PBS. Behavioral and neurological symptoms were analyzed by the SmithKline/Harwell/Imperial College/Royal Hospital/Phenotype Assessment (SHIRPA) battery. Glutamate release was measured in the cerebral cortex and cerebrospinal fluid of infected and control mice by fluorimetric assay. All functional categories of the SHIRPA battery were significantly altered in the infected mice at 6 days post-infection (dpi) (P ≤ 0.05). In parallel to CM symptoms, we found a significant increase in glutamate levels in the cerebral cortex (mean ± SEM; control: 11.62 ± 0.90 nmol/mg protein; infected at 3 dpi: 10.36 ± 1.17 nmol/mg protein; infected at 6 dpi: 26.65 ± 0.73 nmol/mg protein; with EGTA, control: 5.60 ± 1.92 nmol/mg protein; infected at 3 dpi: 6.24 ± 1.87 nmol/mg protein; infected at 6 dpi: 14.14 ± 0.84 nmol/mg protein) and in the cerebrospinal fluid (control: 128 ± 51.23 pmol/mg protein; infected: 301.4 ± 22.52 pmol/mg protein) of infected mice (P ≤ 0.05). These findings suggest a role of glutamate in the central nervous system dysfunction found in CM.

Increased levels of glutamate in the central nervous system are associated with behavioral symptoms in experimental malaria.

Cerebral malaria (CM) is a severe complication resulting from Plasmodium falciparum infection. This condition has been associated with cognitive, behavioral and motor dysfunctions, seizures and coma. The underlying mechanisms of CM are incompletely understood. Glutamate and other metabolites such as lactate have been implicated in its pathogenesis. In the present study, we investigated the involvement of glutamate in the behavioral symptoms of CM. Seventeen female C57BL/6 mice (20-25 g) aged 6-8 weeks were infected with P. berghei ANKA by the intraperitoneal route using a standardized inoculation of 106 parasitized red blood cells suspended in 0.2 mL PBS. Control animals (N = 17) received the same volume of PBS. Behavioral and neurological symptoms were analyzed by the SmithKline/Harwell/Imperial College/Royal Hospital/Phenotype Assessment (SHIRPA) battery. Glutamate release was measured in the cerebral cortex and cerebrospinal fluid of infected and control mice by fluorimetric assay. All functional categories of the SHIRPA battery were significantly altered in the infected mice at 6 days post-infection (dpi) (P ≤ 0.05). In parallel to CM symptoms, we found a significant increase in glutamate levels in the cerebral cortex (mean ± SEM; control: 11.62 ± 0.90 nmol/mg protein; infected at 3 dpi: 10.36 ± 1.17 nmol/mg protein; infected at 6 dpi: 26.65 ± 0.73 nmol/mg protein; with EGTA, control: 5.60 ± 1.92 nmol/mg protein; infected at 3 dpi: 6.24 ± 1.87 nmol/mg protein; infected at 6 dpi: 14.14 ± 0.84 nmol/mg protein) and in the cerebrospinal fluid (control: 128 ± 51.23 pmol/mg protein; infected: 301.4 ± 22.52 pmol/mg protein) of infected mice (P ≤ 0.05). These findings suggest a role of glutamate in the central nervous system dysfunction found in CM.

Mutations of Bruton's tyrosine kinase gene in Brazilian patients with X-linked agammaglobulinemia

Mutations in Bruton's tyrosine kinase (BTK) gene are responsible for X-linked agammaglobulinemia (XLA), which is characterized by recurrent bacterial infections, profound hypogammaglobulinemia, and decreased numbers of mature B cells in peripheral blood. We evaluated 5 male Brazilian patients, ranging from 3 to 10 years of age, from unrelated families, whose diagnosis was based on recurrent infections, markedly reduced levels of IgM, IgG and IgA, and circulating B cell numbers <2 percent. BTK gene analysis was carried out using PCR-SSCP followed by sequencing. We detected three novel (Ala347fsX55, I355T, and Thr324fsX24) and two previously reported mutations (Q196X and E441X). Flow cytometry revealed a reduced expression of BTK protein in patients and a mosaic pattern of BTK expression was obtained from mothers, indicating that they were XLA carriers.

Seletividade de acaricidas utilizados em cafeeiro para pré-pupas e adultos de Chrysoperla externa (Hagen, 1861) (Neuroptera: Chrysopidae) / Selectivity of pesticides used in coffee crops to pre-pupae and adults of Chrysoperla externa (Hagen, 1861) (Neuroptera: Chrysopidae)

Os ácaros Oligonychus ilicis (McGregor, 1917) (Tetranychidae) e Brevipalpus phoenicis (Geijskes, 1939) (Tenuipalpidae) causam prejuízos econômicos ao cafeeiro e seu controle é feito geralmente por meio do método químico. Dentre os inimigos naturais que regulam as densidades populacionais desses artrópodes-praga, destacam-se os crisopídeos, os quais devem ser preservados por meio do uso de compostos seletivos. Desta forma, objetivou-se avaliar os efeitos de espirodiclofeno (0,12 g i.a./L), fenpropatrina (0,15 e 0,30 g i.a./L), enxofre (4,0 e 8,0 g i.a./L) e abamectina (0,0067 e 0,0225 g i.a./L) sobre as fases de pré-pupa e adulta de Chrysoperla externa. As pulverizações dos compostos foram realizadas diretamente sobre pré-pupas e adultos do crisopídeo por meio de torre de Potter. Em seguida, as pré-pupas foram transferidas para tubos de vidro (2 x 8 cm) e os adultos para gaiolas de PVC (10 x 10 cm), sendo mantidos em sala climatizada (25 ± 2o C, UR de 70 ± 10% e fotofase de 12h). Os compostos foram classificados de acordo com o efeito total no desenvolvimento do predador, seguindo recomendações da IOBC. Constatou-se que espirodiclofeno, fenpropatrina e abamectina foram moderadamente nocivos para C. externa quando aplicados sobre a fase de pré-pupa e enxofre foi levemente nocivo. Quando aplicados sobre adultos, fenpropatrina foi nocivo, espirodiclofeno, abamectina e enxofre na maior dose (8,0 g i.a./L) foram moderadamente nocivos, enquanto que enxofre na menor dose (4,0 g i.a./L) mostrou-se levemente nocivo.

The mites Oligonychus ilicis (McGregor, 1917) (Tetranychidae) and Brevipalpus phoenicis (Geijskes, 1939) (Tenuipalpidae) cause economic losses to coffee and they are usually controlled by means of chemical method. Among the natural enemies that regulate the population densities of arthropod pests, the green lacewings stand out, which must be preserved through the use of selective compounds. For this reason, the present study evaluated the effects of spirodiclofen (Envidor ­ 0.12 g a.i./L), fenpropathrin (Meothrin 300 ­ 0.15 and 0.30 g a.i./L), sulphur (Thiovit Sandoz ­ 4.0 and 8.0 g a.i./L) and abamectin (Vertimec 18 CE ­ 0.0067 and 0.0225 g a.i./L) on pre-pupae and adults of Chrysoperla externa (Hagen). The pesticides were applied directly on pre-pupae and adults of green lacewings, using a Potter's tower. The pre-pupae were then transferred to glass tubes (2 x 8 cm) and the adults to PVC cages (10 x 10cm) and maintained in climatic chambers (25 ± 2o C, RH of 70 ± 10% and 12h photophase). The compounds were classified according to the total effect on the development of the predator, following recommendations of the IOBC. Spirodiclofen, fenpropathrin and abamectin were moderately harmful to C. externa, when applied on the pre-pupae, and sulphur was slightly harmful. When applied on adults, the acaricide fenpropathrin was harmful; spirodiclofen, abamectin and sulphur (8.0 g a.i./L) were moderately harmful, and sulphur (4.0 g a.i./L) was slightly harmful.

Mutations of Bruton's tyrosine kinase gene in Brazilian patients with X-linked agammaglobulinemia.

Mutations in Bruton's tyrosine kinase (BTK) gene are responsible for X-linked agammaglobulinemia (XLA), which is characterized by recurrent bacterial infections, profound hypogammaglobulinemia, and decreased numbers of mature B cells in peripheral blood. We evaluated 5 male Brazilian patients, ranging from 3 to 10 years of age, from unrelated families, whose diagnosis was based on recurrent infections, markedly reduced levels of IgM, IgG and IgA, and circulating B cell numbers <2%. BTK gene analysis was carried out using PCR-SSCP followed by sequencing. We detected three novel (Ala347fsX55, I355T, and Thr324fsX24) and two previously reported mutations (Q196X and E441X). Flow cytometry revealed a reduced expression of BTK protein in patients and a mosaic pattern of BTK expression was obtained from mothers, indicating that they were XLA carriers.

Ação residual de inseticidas para larvas e adultos do predador Cycloneda sanguinea Linnaeus, 1763 (Coleoptera: Coccinellidae) / Residual action of insecticides to larvae and adults of the predator Cycloneda sanguinea Linnaeus, 1763 (Coleoptera: Coccinellidae)

A ação residual dos inseticidas imidacloprido/Beta-ciflutrina, clotianidina e clorfenapir foi avaliada para larvas de terceiro ínstar e adultos do predador Cycloneda sanguinea (Linnaeus). Sementes de algodão da cultivar BRS IPÊ foram semeadas em vasos de PVC e as plantas foram mantidas em casa de vegetação. Ao atingirem 25 dias de idade, as plantas foram pulverizadas com os produtos nas menores dosagens recomendadas pelos fabricantes, utilizando-se pulverizador manual. As concentrações foram em g i.a.L-1 de água: imidacloprido/Beta-ciflutrina (100/12,5 SC -0,25/0,03), clotianidina (500 PM ­ 0,33) e clorfenapir (240 SC ­ 0,80). Água destilada foi utilizada como testemunha. Folhas previamente marcadas em cada planta, de cada tratamento, foram retiradas e levadas ao laboratório e colocadas em placas de Petri contendo solução de ágar bacteriológico. Ovos de Anagasta kuehniella (Zeller) foram colocados sobre as folhas de algodoeiro e, em seguida, liberou-se um espécime por placa. As liberações ocorreram após 1, 12, 23 e 35 dias da pulverização dos compostos. Cada placa de Petri foi imediatamente vedada com filme de plástico PVC. O delineamento foi inteiramente casualizado com quatro tratamentos e doze repetições sendo que, para os testes com larvas, cada parcela foi formada por três espécimes e, para aqueles com adultos, cada repetição correspondeu a um casal. As avaliações de mortalidade foram feitas após 12, 24 e 48 horas das liberações. Os produtos foram classificados de acordo com o proposto pela Organização Internacional para Controle Biológico (IOBC). Todos os produtos foram enquadrados na classe 4 = persistentes, visto que mesmo a partir do trigésimo dia após sua aplicação causaram mais de 30,0% de mortalidade dos predadores.

The residual action of the insecticides imidacloprid/Beta-cyfluthrin, clothianidin and chlorfenapyr was evaluated in regard to third-instar larvae and adults of the predator Cycloneda sanguinea (Linnaeus). Cotton seeds of the cultivar BRS IPÊ were sowed in PVC pots and the plants were maintained in the greenhouse. Upon reaching 25 days of age, the plants were sprayed with the lowest dosages of the products recommended by the manufacturers, using a manual sprayer. The insecticides evaluated in g a.i.L-1 of water were imidacloprid/Beta-cyfluthrin (Imidacloprido/Beta-ciflutrina 100/12.5 CS ­ 0.25/0.03), clothianidin (Clotianidina 500 WP ­ 0.33) and chlorfenapyr (Clorfenapir 240 CS0.80). Distilled water was used as a control. Previously marked leaves, from each treatment, were removed from the plants and taken to the laboratory where they were placed in Petri dishes containing bacteriologic agar solution. Eggs of Anagasta kuehniella (Zeller) were placed on cotton leaves following the release of a Trichogramma specimen per dish after 1, 12, 23 and 35 days from pesticides application. Each Petri dish was immediately closed with plastic PVC film. A completely randomized experimental design was used, with 4 treatments and 12 replicates, each one formed by 3 third-instar larvae or 1 couple of adults. The number of dead larvae and adults in each treatment was examined 12, 24 and 48 hours after exposure to the chemicals. The products were classified according to categories proposed by the International Organization for Biological Control (IOBC). All the compounds tested were evaluated as class 4 = persistent, causing mortality above 30% up to 31 days after application on cotton leaves.

SELETIVIDADE DE ACARICIDAS UTILIZADOS EM CAFEEIRO PARA PRÉ-PUPAS E ADULTOS DE CHRYSOPERLA EXTERNA (HAGEN, 1861) (NEUROPTERA: CHRYSOPIDAE)

ABSTRACT The mites Oligonychus ilicis (McGregor, 1917) (Tetranychidae) and Brevipalpus phoenicis (Geijskes, 1939) (Tenuipalpidae) cause economic losses to coffee and they are usually controlled by means of chemical method. Among the natural enemies that regulate the population densities of arthropod pests, the green lacewings stand out, which must be preserved through the use of selective compounds. For this reason, the present study evaluated the effects of spirodiclofen (Envidor 0.12 g a.i./L), fenpropathrin (Meothrin 300 0.15 and 0.30 g a.i./L), sulphur (Thiovit Sandoz 4.0 and 8.0 g a.i./L) and abamectin (Vertimec 18 CE 0.0067 and 0.0225 g a.i./L) on pre-pupae and adults of Chrysoperla externa (Hagen). The pesticides were applied directly on pre-pupae and adults of green lacewings, using a Potters tower. The pre-pupae were then transferred to glass tubes (2 x 8 cm) and the adults to PVC cages (10 x 10cm) and maintained in climatic chambers (25 ± 2o C, RH of 70 ± 10% and 12h photophase). The compounds were classified according to the total effect on the development of the predator, following recommendations of the IOBC. Spirodiclofen, fenpropathrin and abamectin were moderately harmful to C. externa, when applied on the pre-pupae, and sulphur was slightly harmful. When applied on adults, the acaricide fenpropathrin was harmful; spirodiclofen, abamectin and sulphur (8.0 g a.i./L) were moderately harmful, and sulphur (4.0 g a.i./L) was slightly harmful.

RESUMO Os ácaros Oligonychus ilicis (McGregor, 1917) (Tetranychidae) e Brevipalpus phoenicis (Geijskes, 1939) (Tenuipalpidae) causam prejuízos econômicos ao cafeeiro e seu controle é feito geralmente por meio do método químico. Dentre os inimigos naturais que regulam as densidades populacionais desses artrópodes-praga, destacam-se os crisopídeos, os quais devem ser preservados por meio do uso de compostos seletivos. Desta forma, objetivou-se avaliar os efeitos de espirodiclofeno (0,12 g i.a./L), fenpropatrina (0,15 e 0,30 g i.a./L), enxofre (4,0 e 8,0 g i.a./L) e abamectina (0,0067 e 0,0225 g i.a./L) sobre as fases de pré-pupa e adulta de Chrysoperla externa. As pulverizações dos compostos foram realizadas diretamente sobre pré-pupas e adultos do crisopídeo por meio de torre de Potter. Em seguida, as pré-pupas foram transferidas para tubos de vidro (2 x 8 cm) e os adultos para gaiolas de PVC (10 x 10 cm), sendo mantidos em sala climatizada (25 ± 2o C, UR de 70 ± 10% e fotofase de 12h). Os compostos foram classificados de acordo com o efeito total no desenvolvimento do predador, seguindo recomendações da IOBC. Constatou-se que espirodiclofeno, fenpropatrina e abamectina foram moderadamente nocivos para C. externa quando aplicados sobre a fase de pré-pupa e enxofre foi levemente nocivo. Quando aplicados sobre adultos, fenpropatrina foi nocivo, espirodiclofeno, abamectina e enxofre na maior dose (8,0 g i.a./L) foram moderadamente nocivos, enquanto que enxofre na menor dose (4,0 g i.a./L) mostrou-se levemente nocivo.

AÇÃO RESIDUAL DE INSETICIDAS PARA LARVAS E ADULTOS DO PREDADOR CYCLONEDA SANGUINEA LINNAEUS, 1763 (COLEOPTERA: COCCINELLIDAE)

ABSTRACT The residual action of the insecticides imidacloprid/Beta-cyfluthrin, clothianidin and chlorfenapyr was evaluated in regard to third-instar larvae and adults of the predator Cycloneda sanguinea (Linnaeus). Cotton seeds of the cultivar BRS IPÊ were sowed in PVC pots and the plants were maintained in the greenhouse. Upon reaching 25 days of age, the plants were sprayed with the lowest dosages of the products recommended by the manufacturers, using a manual sprayer. The insecticides evaluated in g a.i.L-1 of water were imidacloprid/Beta-cyfluthrin (Imidacloprido/Beta-ciflutrina 100/12.5 CS 0.25/0.03), clothianidin (Clotianidina 500 WP 0.33) and chlorfenapyr (Clorfenapir 240 CS0.80). Distilled water was used as a control. Previously marked leaves, from each treatment, were removed from the plants and taken to the laboratory where they were placed in Petri dishes containing bacteriologic agar solution. Eggs of Anagasta kuehniella (Zeller) were placed on cotton leaves following the release of a Trichogramma specimen per dish after 1, 12, 23 and 35 days from pesticides application. Each Petri dish was immediately closed with plastic PVC film. A completely randomized experimental design was used, with 4 treatments and 12 replicates, each one formed by 3 third-instar larvae or 1 couple of adults. The number of dead larvae and adults in each treatment was examined 12, 24 and 48 hours after exposure to the chemicals. The products were classified according to categories proposed by the International Organization for Biological Control (IOBC). All the compounds tested were evaluated as class 4 = persistent, causing mortality above 30% up to 31 days after application on cotton leaves.

RESUMO A ação residual dos inseticidas imidacloprido/Beta-ciflutrina, clotianidina e clorfenapir foi avaliada para larvas de terceiro ínstar e adultos do predador Cycloneda sanguinea (Linnaeus). Sementes de algodão da cultivar BRS IPÊ foram semeadas em vasos de PVC e as plantas foram mantidas em casa de vegetação. Ao atingirem 25 dias de idade, as plantas foram pulverizadas com os produtos nas menores dosagens recomendadas pelos fabricantes, utilizando-se pulverizador manual. As concentrações foram em g i.a.L-1 de água: imidacloprido/Beta-ciflutrina (100/12,5 SC -0,25/0,03), clotianidina (500 PM 0,33) e clorfenapir (240 SC 0,80). Água destilada foi utilizada como testemunha. Folhas previamente marcadas em cada planta, de cada tratamento, foram retiradas e levadas ao laboratório e colocadas em placas de Petri contendo solução de ágar bacteriológico. Ovos de Anagasta kuehniella (Zeller) foram colocados sobre as folhas de algodoeiro e, em seguida, liberou-se um espécime por placa. As liberações ocorreram após 1, 12, 23 e 35 dias da pulverização dos compostos. Cada placa de Petri foi imediatamente vedada com filme de plástico PVC. O delineamento foi inteiramente casualizado com quatro tratamentos e doze repetições sendo que, para os testes com larvas, cada parcela foi formada por três espécimes e, para aqueles com adultos, cada repetição correspondeu a um casal. As avaliações de mortalidade foram feitas após 12, 24 e 48 horas das liberações. Os produtos foram classificados de acordo com o proposto pela Organização Internacional para Controle Biológico (IOBC). Todos os produtos foram enquadrados na classe 4 = persistentes, visto que mesmo a partir do trigésimo dia após sua aplicação causaram mais de 30,0% de mortalidade dos predadores.

Disseminated blue naevus and malignant blue naevus associated with excessive aromatase syndrome.

We report a case of a 17-year-old boy who had a giant congenital blue naevus with multiple satellite pigmented lesions. Later the patient developed melanoma arising in the pre-existing lesion. He also had gynaecomastia and was diagnosed as having aromatase excess syndrome. To our knowledge, the association of these two rare conditions has not been previously reported. Further studies should be performed to investigate this unusual combination, which may have a genetic, endocrine or local cutaneous link leading to its occurrence.

Expression of Fc gamma and complement receptors in monocytes of X-linked agammaglobulinaemia and common variable immunodeficiency patients.

Recently we reported that monocyte phagocytosis and chemotaxis are impaired in X-linked agammaglobulinaemia (XLA) and common variable immunodeficiency (CVI) patients. Few data exist on the in vivo expression of receptors for the constant region of immunoglobulin (IgG) (Fc gammaR) and complement receptors (CR) in these patients. The objective of this study was to investigate the expression of Fc gammaR and CR on monocytes from XLA and CVI patients and compare it to that of healthy controls. Whole blood samples were obtained from 10 patients with XLA, 12 with CVI and 18 healthy controls. Monocyte phenotype was determined by flow cytometry with gating on CD14+ cells. Surface expression of Fc gammaRI (CD64), Fc gammaRII (CD32) and Fc gammaRIII (CD16), CR1 (CD35) and CR3 (CD11b and CD18) was measured by determination of the proportion of CD14+ cells positive for each receptor and by receptor density. Compared to controls, a significantly higher percentage of CD16 and CD35+ monocytes from XLA (P = 0.002 and P = 0.007, respectively) were observed. The relative fluorescence intensity (RFI) expression of Fc gammaRII (CD32) and Fc gammaRIII (CD16) were significantly lower on CVI monocytes compared to controls (P = 0.001 and P = 0.035, respectively). XLA patients, who have a reduction of Bruton's tyrosine kinase (Btk), showed normal or increased percentages of monocytes expressing Fc gamma and complement receptors. CVI patients, who have normal expression of Btk, showed reduced expression of CD16 and CD32 on monocytes. Inefficient chemotaxis and phagocytosis, reported previously in XLA patients, could be due to defects of cytoplasmatic transduction mechanisms.