Differential Haematobia irritans infestation levels in beef cattle raised in silvopastoral and conventional pasture systems.

The use of silvopastoral systems (SPS) can be a good alternative to reduce the environmental impacts of livestock breeding in Brazil. One of the reasons for its scarce adoption is the lack of information on health and productivity of cattle raised under these conditions. The experiment reported here was designed to compare the infestation by external parasites - the cattle tick (Rhipicephalus microplus), horn fly (Haematobia irritans), and larvae of the botfly (Dermatobia hominis) - in beef cattle raised in a SPS and a conventional pasture system (CPS), evaluated for 24 months. Data on air and soil temperature, solar radiation, wind incidence and water balance were used to characterize the SPS and CPS. R. microplus adult females and D. hominis larvae were counted on the body of each animal to determine the parasites burdens, but we did not find significant differences between the two systems. Horn flies counts on animals' body, and analysis of the horn fly and its pupal parasitoids associated with the dung pats were obtained in the two systems. Horn fly infestation was significantly lower (p=0.01) in the SPS (13.17±3.46) in comparison with the CPS (24.02±4.43). In SPS and CPS, respectively, the mean densities of pupae of H. irritansin dung pats were 9.8 and 10.7; the mean density of adults of H. irritans, 3.7 and 3.5; and the density of its pupal parasitoids were 20.5 and 5.4. The effect of production system was significant (p<0.05) only for the occurrence of pupal parasitoids of the horn fly, where the greatest occurrences of these natural enemies were in the SPS. These data indicate that natural enemies were able to control, at least partially, the horn fly populations in the cattle.

Three vs twelve months of dual antiplatelet therapy after zotarolimus-eluting stents: the OPTIMIZE randomized trial.

IMPORTANCE: The current recommendation is for at least 12 months of dual antiplatelet therapy after implantation of a drug-eluting stent. However, the optimal duration of dual antiplatelet therapy with specific types of drug-eluting stents remains unknown. OBJECTIVE: To assess the clinical noninferiority of 3 months (short-term) vs 12 months (long-term) of dual antiplatelet therapy in patients undergoing percutaneous coronary intervention (PCI) with zotarolimus-eluting stents. DESIGN, SETTING, AND PATIENTS: The OPTIMIZE trial was an open-label, active-controlled, 1:1 randomized noninferiority study including 3119 patients in 33 sites in Brazil between April 2010 and March 2012. Clinical follow-up was performed at 1, 3, 6, and 12 months. Eligible patients were those with stable coronary artery disease or history of low-risk acute coronary syndrome (ACS) undergoing PCI with zotarolimus-eluting stents. INTERVENTIONS: After PCI with zotarolimus-eluting stents, patients were prescribed aspirin (100-200 mg daily) and clopidogrel (75 mg daily) for 3 months (n = 1563) or 12 months (n = 1556), unless contraindicated because of occurrence of an end point. MAIN OUTCOMES AND MEASURES: The primary end point was net adverse clinical and cerebral events (NACCE; a composite of all-cause death, myocardial infarction [MI], stroke, or major bleeding); the expected event rate at 1 year was 9%, with a noninferiority margin of 2.7%. Secondary end points were major adverse cardiac events (MACE; a composite of all-cause death, MI, emergent coronary artery bypass graft surgery, or target lesion revascularization) and Academic Research Consortium definite or probable stent thrombosis. RESULTS: NACCE occurred in 93 patients receiving short-term and 90 patients receiving long-term therapy (6.0% vs 5.8%, respectively; risk difference, 0.17 [95% CI, -1.52 to 1.86]; P = .002 for noninferiority). Kaplan-Meier estimates demonstrated MACE rates at 1 year of 8.3% (128) in the short-term group and 7.4% (114) in the long-term group (HR, 1.12 [95% CI, 0.87-1.45]). Between 91 and 360 days, no statistically significant association was observed for NACCE (39 [2.6%] vs 38 [2.6%] for the short- and long-term groups, respectively; HR, 1.03 [95% CI, 0.66-1.60]), MACE (78 [5.3%] vs 64 [4.3%]; HR, 1.22 [95% CI, 0.88-1.70]), or stent thrombosis (4 [0.3%] vs 1 [0.1%]; HR, 3.97 [95% CI, 0.44-35.49]). CONCLUSIONS AND RELEVANCE: In patients with stable coronary artery disease or low-risk ACS treated with zotarolimus-eluting stents, 3 months of dual antiplatelet therapy was noninferior to 12 months for NACCE, without significantly increasing the risk of stent thrombosis. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01113372.

Three vs twelve months of dual antiplatelet therapy after Zotarolimus-Eluting Stents the OPTIMIZE andomized trial

The current recommendation is for at least 12 months of dual antiplatelettherapy after implantation of a drug-eluting stent. However, the optimal duration of dualantiplatelet therapy with specific types of drug-eluting stents remains unknown.OBJECTIVE To assess the clinical noninferiority of 3 months (short-term) vs 12 months(long-term) of dual antiplatelet therapy in patients undergoing percutaneous coronaryintervention (PCI) with zotarolimus-eluting stents.DESIGN, SETTING, AND PATIENTS The OPTIMIZE trialwas an open-label, active-controlled, 1:1randomized noninferiority study including 3119 patients in 33 sites in Brazil between April2010 and March 2012. Clinical follow-up was performed at 1, 3, 6, and 12 months. Eligiblepatients were those with stable coronary artery disease or history of low-risk acute coronarysyndrome (ACS) undergoing PCI with zotarolimus-eluting stents.INTERVENTIONS After PCI with zotarolimus-eluting stents, patients were prescribed aspirin(100-200mg daily) and clopidogrel (75mg daily) for 3 months (n = 1563) or 12 months(n = 1556), unless contraindicated because of occurrence of an end point.MAIN OUTCOMES AND MEASURES The primary end pointwas net adverse clinical and cerebralevents (NACCE; a composite of all-cause death, myocardial infarction [MI], stroke, or majorbleeding); the expected event rate at 1 year was 9%, with a noninferiority margin of 2.7%.Secondary end points were major adverse cardiac events (MACE; a composite of all-causedeath, MI, emergent coronary artery bypass graft surgery, or target lesion revascularization)and Academic Research Consortium definite or probable stent thrombosis.RESULTS NACCE occurred in 93 patients receiving short-term and 90 patients receivinglong-term therapy...

Optimized duration of clopidogrel therapy following treatment with the Endeavor zotarolimus-eluting stent in real-world clinical practice (OPTIMIZE) trial: rationale and design of a large-scale, randomized, multicenter study.

BACKGROUND: Current recommendations for antithrombotic therapy after drug-eluting stent (DES) implantation include prolonged dual antiplatelet therapy (DAPT) with aspirin and clopidogrel ≥12 months. However, the impact of such a regimen for all patients receiving any DES system remains unclear based on scientific evidence available to date. Also, several other shortcomings have been identified with prolonged DAPT, including bleeding complications, compliance, and cost. The second-generation Endeavor zotarolimus-eluting stent (E-ZES) has demonstrated efficacy and safety, despite short duration DAPT (3 months) in the majority of studies. Still, the safety and clinical impact of short-term DAPT with E-ZES in the real world is yet to be determined. METHODS: The OPTIMIZE trial is a large, prospective, multicenter, randomized (1:1) non-inferiority clinical evaluation of short-term (3 months) vs long-term (12-months) DAPT in patients undergoing E-ZES implantation in daily clinical practice. Overall, 3,120 patients were enrolled at 33 clinical sites in Brazil. The primary composite endpoint is death (any cause), myocardial infarction, cerebral vascular accident, and major bleeding at 12-month clinical follow-up post-index procedure. CONCLUSIONS: The OPTIMIZE clinical trial will determine the clinical implications of DAPT duration with the second generation E-ZES in real-world patients undergoing percutaneous coronary intervention.

Optimized duration of clopidogrel therapy following treatment with the Endeavor zotarolimus-eluting stent in real-world clinical practice (OPTIMIZE) trial: rationale and design of a large-scale, randomized, multicenter study

Background Current recommendations for antithrombotic therapy after drug-eluting stent (DES) implantation includeprolonged dual antiplatelet therapy (DAPT) with aspirin and clopidogrel ≥12 months. However, the impact of such a regimen for all patients receiving any DES system remains unclear based on scientific evidence available to date. Also, several other shortcomings have been identified with prolonged DAPT, including bleeding complications, compliance, and cost. The second-generation Endeavor zotarolimus-eluting stent (E-ZES) has demonstrated efficacy and safety, despite short durationDAPT (3 months) in the majority of studies. Still, the safety and clinical impact of short-term DAPT with E-ZES in the real world is yet to be determined.Methods The OPTIMIZE trial is a large, prospective, multicenter, randomized (1:1) non-inferiority clinical evaluation of short-term (3 months) vs long-term (12-months) DAPT in patients undergoing E-ZES implantation in daily clinical practice.Overall, 3,120 patients were enrolled at 33 clinical sites in Brazil. The primary composite endpoint is death (any cause),myocardial infarction, cerebral vascular accident, and major bleeding at 12-month clinical follow-up post-index procedure.Conclusions The OPTIMIZE clinical trial will determine the clinical implications of DAPT duration with the secondgeneration E-ZES in real-world patients undergoing percutaneous coronary intervention.

Lesões coronarianas de bifurcação: classificação, estratégias de tratamento e perspectivas: revisão / Coronary bifurcation lesions: classification, strategies of treatment and perspectives: review

A ocorrência de obstruções coronarianas que envolvem ramos laterais, com maior ou menor risco de oclusão, não é um evento raro. O tratamento percutâneo destas lesões de bifurcação tem sido um desafio para a cardiologia intervencionista. A apresentação extremamente variada, seja pela disposição dos ramos, propiciou a descrição de várias classificações. Ainda com a utilização de angioplastia coronária com cateter-balão, muitas técnicas foram escritas. Todas apresentavam resultados tardios poucos satisfatórios. Com o aparecimento dos stents na prática clínica, outras estratégias foram descritas, com a utilização de um e dois stents. No entanto, as taxas de revascularização da lesão-alvo permaneceram altas. O uso de stents com eluição...

Factors affecting colonization and abundance of Aphis gossypii glover (hemiptera: aphididae) on okra plantations

The control of Aphis gossypii Glover (Hemiptera: Aphididae) on okra Abelmoschus esculentus (L.) (Malvaceae) consist primarily in the use of insecticides, due to the lack of information on other mortality factors. The objective of this study was to determine the effects of predators and parasitoids, height of canopy, plant age, leaf areas, organic compounds leaves, levels of leaf nitrogen and potassium, density of leaf trichomes, total rainfall and median temperature on attack intensity of A. gossypii on two successive A. esculentus var. Santa Cruz plantations. Monthly number estimates of A. gossypii and natural enemies (visual inspection) occurred on bottom, middle and apical parts of 30 plants/plantation (one leaf/plant). Plants senescence, leaf areas and natural enemies, mainly Adialytus spp., spiders and Coccinellidae, were some of the factors that most contributed to aphid reduction. A higher number of aphids was found on the bottom part than medium and apical parts of okra plants. Total rainfall can reduce the aphid population. Trichomes non-glandular or low density, organic compounds leaves and levels of N and K were not important for reducing aphid population.

O controle de Aphis gossypii Glover (Hemiptera: Aphididae) em quiabeiro Abelmoschus esculentus (L.) (Malvaceae) consiste principalmente no uso de inseticidas, em virtude da falta de informação sobre outros fatores de mortalidade. Objetivou-se com este estudo determinar os efeitos de predadores e parasitóides, altura de dossel, idade da planta, área foliar, compostos orgânicos foliares, níveis de nitrogênio e potássio, densidade de tricomas, pluviosidade e temperatura na intensidade de ataque de A. gossypii em dois cultivos sucessivos de Abelmoschus esculentus var. Santa Cruz. Estimou-se, mensalmente, o número de A. gossypii e de inimigos naturais (inspeção visual) ocorridos nas folhas (uma folha/planta) localizadas nas partes basal, mediana e apical de 30 plantas/plantação. Os fatores que mais contribuíram com a redução da população de pulgões foram a senescência de plantas, área foliar e inimigos naturais, principalmente Adialytus spp., aranhas e Coccinellidae. Maior número de pulgões foi observado na parte basal que na mediana e apical de plantas de quiabeiro. A pluviosidade total pode reduzir a população de pulgões. Tricomas tectores (não-glandulares) ou baixa densidade destes, compostos orgânicos foliares e níveis de N e de K não foram importantes para a redução da população de pulgões.

Estudo dos defeitos ósseos alveolares em Periodontia: deiscências e fenestrações / Study of defects of the alveolar cortical plate in Periodontics: dehiscences and fenestrations

O objetivo deste trabalho é comparar os resultados encontrados nos diferentes estudos realizados sobre a prevalência, incidência e distribuição das lesões de fenestração e deiscência, relacioná-las com possíveis fatores etiológicos e discutir a importância de seu conhecimento para os CDs. Defeitos ósseos alveolares estão presentes em grande parte da população sendo as fenestrações e deiscências dois de seus exemplos mais comuns. As razões para o aquecimento dessas lesões ainda não foram totalmente definidas; porém, alguns fatores etiológicos têm sido discutidos nos estudos apresentados ao longo dos anos, como tamanho e posição dos elementos dentários, espessura óssea alveolar, dentes que sofreram movimentação ortodôntica, etc.

Seletividade de Inseticidas a Brevicoryne brassicae (L. ) (Hemiptera: Aphididae) e ao Predador Doru luteipes (Scudder) (Dermaptera: Forficulidae) / Insecticide Selectivity to Brevicoryne brassicae (L. ) (Hemiptera: Aphididae) and the Predator Doru luteipes (Scudder) (Dermaptera: Forficulidae)

The objective of this work was to study the selectivity of the insecticides acephate, deltamethrin, dimethoate, methamidophos, methyl parathion, and pirimicarb to first, second, and third instar nymphs and adults of the predator Doru luteipes (Scudder) (Dermaptera: Forficulidae) in comparison with last instar nymphs of the prey Brevicoryne brassicae (L.) (Hemiptera: Aphididae). Pirimicarb and deltamethrin were highly selective to all developmental stages of D. luteipes; the same was observed with acephate except for first instar nymphs to whom it showed median selectivity. Dimethoate showed median selectivity, but methamidophos and methyl parathion were low selective to the predator. Second and third instar nymphs and adults of D. luteipes were more tolerant to acephate, methyl parathion and pirimicarb than first instar nymphs. First and second instar nymphs showed similar tolerance to deltamethrin, dimethoate and methamidophos. Concentration-response curves for dimethoate (to adults and first and second instar nymphs) and methamidophos (to third instar nymphs) showed steeper slopes indicating an homogeneous response of these developmental stages to these insecticides.

Este trabalho teve por objetivo estudar a seletividade dos inseticidas acefato, deltametrina, dimetoato, metamidofós, paratiom metílico e pirimicarbe a ninfas de último estádio de Brevicoryne brassicae (L.) (Hemiptera: Aphididae), em relação a adultos e ninfas de primeiro, segundo e terceiro estádios do predador Doru luteipes (Scudder) (Dermaptera: Forficulidae). Pirimicarbe e deltametrina foram altamente seletivos em favor de todos os estádios de desenvolvimento de D. luteipes, sendo que o mesmo ocorreu para o acefato, com exceção de ninfas de primeiro estádio do predador às quais ele é medianamente seletivo. Dimetoato foi, em geral, medianamente seletivo enquanto metamidofós e paratiom metílico foram pouco seletivos em favor do predador. Adultos e ninfas de segundo e terceiro estádios de D. luteipes foram mais tolerantes ao acefato, paratiom metílico e pirimicarbe do que ninfas de primeiro estádio do predador. Ninfas de primeiro e segundo estádios apresentaram tolerância semelhante a deltametrina, dimetoato e metamidofós. As curvas de concentração-mortalidade do dimetoato (para adultos, ninfas de primeiro e segundo estádios do predador) e metamidofós (para ninfas de terceiro estádio) apresentaram as maiores inclinações, indicando que os estádios estudados apresentam resposta homogênea a esses inseticidas.

Diagnóstico em pediatria pela anamnese / Pediatric diagnosis by anamnesis

Observou-se o poder de resolutividade da anamnese no diagnóstico pediátrico.Um aluno do último período do curso de medicina e dois médicos (um residente em pediatria e outro com pós-graduaçäo além de 10 anos de exercício da profissäo), foram capazes de acertos diagnósticos em respectivamente 62%, 75% e 76% dos casos estudados, a partir exclusivamente da história clínica desses pacientes