Revision of the South American species of Hagenulopsis Ulmer and Askola Peters (Ephemeroptera: Leptophlebiidae) with description of six new species

The South American species of the genera Askola and Hagenulopsis are revised. Three new species of Askola from Brazil are described based on male imagos. Askola emmerichi sp. nov. and A. paprockii sp. nov. present spotted wings, but differ in general coloration and details of genitalia; Askola cipoensis sp. nov. is easily distinguished because the male eyes being widely separated on meson of head. Three new species of Hagenulopsis are also described: H. lipeo (from Argentina and Bolivia) and H. zunigae (from Colombia), both described from imagos and nymphs, can be recognized by details of coloration and male genitalia. H. esmeralda sp. nov. from Ecuador, described from imagos, shows a distinct male genitalia and translucent male abdomen. A key to species for the the male and female imagos of Askola and Hagenulopsis species is provided.

A revision of the genus Lycomorphon (Coleoptera: Lycidae)

The Neotropical genus Lycomorphon Pic, 1922 is revised. Eleven species are classified in the genus, six of them are redescribed, five species (Lycomorphon brasiliense sp. n., L. amazonicum sp. n., L. bimaculatum sp. n. L. bolivianum sp. n., L. fulvohumeralis sp. n.) are proposed as new to science. Lycomorphon elongaticolle v. diversicolle Pic, 1926 is raised to species status, and Idiopteron irregularis is transferred to the genus Lycomorphon. The new subgenus Spinolycus sg. n. is proposed within Lycomorphon.

The systematic use of intraoperative vascular Doppler ultrasound during microsurgical subinguinal varicocelectomy improves precise identification and preservation of testicular blood supply

Objective: To evaluate the impact of systematic use of intraoperative Doppler ultrasound during microsurgical subinguinal varicocele repair. Design: Prospective clinical study. Setting: Andrology laboratory and male infertility section of the urology department of a tertiary care hospital. Patient(s): Two hundred and thirteen men with clinical varicocele. Intervention(s): Subinguinal microsurgical varicocele ligation using an intraoperative vascular Doppler flow detector. Main Outcome Measure(s): Number of veins ligated, lymphatic spared, arteries identified or accidentally ligated. Result(s): A statistically significant greater number of arteries were identified and preserved when intraoperative vascular Doppler was used. In addition, the average number of internal spermatic veins ligated was statistically significantly greater in the same group. Accidental artery ligation occurred in two cases (1.1%) in which the Doppler was not applied. There was no statistically significant difference in number of lymphatics spared between groups. Conclusion(s): Our findings showed that concomitant use of intraoperative vascular Doppler during microsurgical varicocelectomy allows more arterial branches to be preserved, and more internal spermatic veins are likely to be ligated. This device should be considered an attractive tool to improve surgical outcomes and safety. (Fertil Steril (R) 2010; 93: 2396-9. (C)2010 by American Society for Reproductive Medicine.)

Bladder irrigation with amphotericin B and fungal urinary tract infection-systematic review with meta-analysis

Background: Candiduria is a hospital-associated infection and a daily problem in the intensive care unit. The treatment of asymptomatic candiduria is not well established and the use of amphotericin B bladder irrigation (ABBI) is controversial. The aim of this systematic review was to determine the best place for this therapy in practice. Methods: The databases searched in this study included MEDLINE, EMBASE, Web of Science, and LILACS (January 1960-June 2007). We included manuscripts with data on the treatment of candiduria using ABBI. The studies were classified as comparative, dose-finding, or non-comparative. Results: From 213 studies, nine articles (377 patients) met our inclusion criteria. ABBI showed a higher clearance of the candiduria 24 hours after the end of therapy than fluconazole (odds ratio (OR) 0.57, 95% confidence interval (CI) 0.32-1.00). Fungal culture 5 days after the end of both therapies showed a similar response (OR 1.51, 95% CI 0.81-2.80). The evaluation of ABBI using an intermittent or continuous system of delivery showed an early candiduria clearance (24 hours after therapy) of 80% and 82%, respectively (OR 0.87, 95% CI 0.52-1.36). Candiduria clearance at >5 days after the therapy showed a superior response using continuous bladder irrigation with amphotericin B (OR 0.52, 95% CI 0.29-0.94). The use of continuous ABBI for more than 5 days showed a better result (88% vs. 78%) than ABBI for less than 5 days, but without significance (OR 0.55, 95% CI 0.34-1.04). Conclusion: Although the strength of the results in the underlying literature is not sufficient to allow the drawing of definitive conclusions, ABBI appears to be as effective as fluconazole, but it does not offer systemic antifungal therapy and should only be used for asymptomatic candiduria. (C) 2008 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Massage for Low Back Pain An Updated Systematic Review Within the Framework of the Cochrane Back Review Group

Study Design. Systematic Review. Objectives. To assess the effects of massage therapy for nonspecific low back pain. Summary of Background Data. Low back pain is one of the most common and costly musculoskeletal problems in modern society. Proponents of massage therapy claim it can minimize pain and disability, and speed return to normal function. Methods. We searched MEDLINE, EMBASE, CINAHL from their beginning to May 2008. We also searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, issue 3), HealthSTAR and Dissertation abstracts up to 2006. There were no language restrictions. References in the included studies and in reviews of the literature were screened. The studies had to be randomized or quasi-randomized trials investigating the use of any type of massage (using the hands or a mechanical device) as a treatment for nonspecific low back pain. Two review authors selected the studies, assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group, and extracted the data using standardized forms. Both qualitative and meta-analyses were performed. Results. Thirteen randomized trials were included. Eight had a high risk and 5 had a low risk of bias. One study was published in German and the rest in English. Massage was compared to an inert therapy (sham treatment) in 2 studies that showed that massage was superior for pain and function on both short- and long-term follow-ups. In 8 studies, massage was compared to other active treatments. They showed that massage was similar to exercises, and massage was superior to joint mobilization, relaxation therapy, physical therapy, acupuncture, and self-care education. One study showed that reflexology on the feet had no effect on pain and functioning. The beneficial effects of massage in patients with chronic low back pain lasted at least 1 year after the end of the treatment. Two studies compared 2 different techniques of massage. One concluded that acupuncture massage produces better results than classic (Swedish) massage and another concluded that Thai massage produces similar results to classic (Swedish) massage. Conclusion. Massage might be beneficial for patients with subacute and chronic nonspecific low back pain, especially when combined with exercises and education. The evidence suggests that acupuncture massage is more effective than classic massage, but this need confirmation. More studies are needed to confirm these conclusions, to assess the impact of massage on return-to-work, and to determine cost-effectiveness of massage as an intervention for low back pain.

Post-craniotomy headache: A proposed revision of IHS diagnostic criteria

Seventy-nine patients with intracranial aneurysms were evaluated in the presurgical period, and followed up to 6 months after surgery. We compare patients who fulfilled with those that did not post-craniotomy headache (PCH) diagnostic criteria, according to the International Classification of Headache Disorders. Semistructured interviews, headache diaries, Short Form-36 and McGill Pain Questionnaire were used. Seventy-two patients (91%) had headaches during the follow-up period. The incidence of PCH according to the International Headache Society diagnostic criteria was 40%. Age, sex, type of surgery, temporomandibular disorder, vasospasm, presence and type of previous headaches, and subarachnoid haemorrhage were not related to headache classification. There were no differences in the quality of life, headache frequency and characteristics or pain intensity between patients with headache that fulfilled or not PCH criteria. We proposed a revision of the diagnostic criteria for PCH, extending the headache outset after surgery from 7 to 30 days, and including the presence of headaches after surgery in patients with no past history of headaches, or an increase in headache frequency during the first 30 days of the postsurgical period followed by a decrease over time. Using these criteria we would classify 65% of our patients as having PCH.

Adenosine deaminase and tuberculous meningitis-A systematic review with meta-analysis

Tuberculous meningitis (TBM) is a severe infection of the central nervous system, particularly in developing countries. Prompt diagnosis and treatment are necessary to decrease the high rates of disability and death associated with TBM. The diagnosis is often time and labour intensive; thus, a simple, accurate and rapid diagnostic test is needed. The adenosine deaminase (ADA) activity test is a rapid test that has been used for the diagnosis of the pleural, peritoneal and pericardial forms of tuberculosis. However, the usefulness of ADA in TBM is uncertain. The aim of this study was to evaluate ADA as a diagnostic test for TBM in a systematic review. A systematic search was performed of the medical literature (MEDLINE, LILACS, Web of Science and EMBASE). The ADA values from TBM cases and controls (diagnosed with other types of meningitis) were necessary to calculate the sensitivity and specificity. Out of a total of 522 studies, 13 were included in the meta-analysis (380 patients with TBM). The sensitivity, specificity and diagnostic odds ratios (DOR) were calculated based on arbitrary ADA cut-off values from 1 to 10 U/l. ADA values from 1 to 4 U/l (sensitivity > 93% and specificity < 80%) helped to exclude TBM; values between 4 and 8 U/l were insufficient to confirm or exclude the diagnosis of TBM (p = 0.07), and values > 8 U/l (sensitivity < 59% and specificity > 96%) improved the diagnosis of TBM (p < 0.001). None of the cut-off values could be used to discriminate between TBM and bacterial meningitis. In conclusion, ADA cannot distinguish between bacterial meningitis and TBM, but using ranges of ADA values could be important to improve TBM diagnosis, particularly after bacterial meningitis has been ruled out. The different methods used to measure ADA and the heterogeneity of data do not allow standardization of this test as a routine.

Quantitative myocardial contrast echocardiography during pharmacological stress for diagnosis of coronary artery disease: a systematic review and meta-analysis of diagnostic accuracy studies

Aims We conducted a meta-analysis to evaluate the accuracy of quantitative stress myocardial contrast echocardiography (MCE) in coronary artery disease (CAD). Methods and results Database search was performed through January 2008. We included studies evaluating accuracy of quantitative stress MCE for detection of CAD compared with coronary angiography or single-photon emission computed tomography (SPECT) and measuring reserve parameters of A, beta, and A beta. Data from studies were verified and supplemented by the authors of each study. Using random effects meta-analysis, we estimated weighted mean difference (WMD), likelihood ratios (LRs), diagnostic odds ratios (DORs), and summary area under curve (AUC), all with 95% confidence interval (0). Of 1443 studies, 13 including 627 patients (age range, 38-75 years) and comparing MCE with angiography (n = 10), SPECT (n = 1), or both (n = 2) were eligible. WMD (95% CI) were significantly less in CAD group than no-CAD group: 0.12 (0.06-0.18) (P < 0.001), 1.38 (1.28-1.52) (P < 0.001), and 1.47 (1.18-1.76) (P < 0.001) for A, beta, and A beta reserves, respectively. Pooled LRs for positive test were 1.33 (1.13-1.57), 3.76 (2.43-5.80), and 3.64 (2.87-4.78) and LRs for negative test were 0.68 (0.55-0.83), 0.30 (0.24-0.38), and 0.27 (0.22-0.34) for A, beta, and A beta reserves, respectively. Pooled DORs were 2.09 (1.42-3.07), 15.11 (7.90-28.91), and 14.73 (9.61-22.57) and AUCs were 0.637 (0.594-0.677), 0.851 (0.828-0.872), and 0.859 (0.842-0.750) for A, beta, and A beta reserves, respectively. Conclusion Evidence supports the use of quantitative MCE as a non-invasive test for detection of CAD. Standardizing MCE quantification analysis and adherence to reporting standards for diagnostic tests could enhance the quality of evidence in this field.

One-Stage Revision of Infected Total Hip Arthroplasty with Bone Graft

There are many different opinions in the literature regarding the best procedure for revision of infected hip arthroplasty and hence in achieving long-term stabilization of a new implant. Thirty-two patients with 32 loose and infected total hip arthroplasties underwent revision with a bone graft in a 1-stage procedure. The bone graft was used in the acetabulum and femure in 25 patients, in the acetabulum alone in 4 patients and in the femur alone in 3 patients. A metal mesh was necessary in 15 patients to contain the morselized bone graft. At the time of surgical revision, 9 patients had a draining sinus, 6 had a closed sinus, and 17 had never had sinuses in the surgical wound. Antibiotic therapy was administered intravenously and orally for 6 months. Mean follow-up was 103 months (range, 63-183 months), and infection recurred in 2 (6.2%) cases. Further studies are necessary, and continuation of this method is justified.

Alcantarea (Bromeliaceae) leaf anatomical characterization and its systematic implications

Alcantarea (Bromeliaceae) has 26 species that are endemic to eastern Brazil, occurring mainly on gneiss-granitic rock outcrops (`inselbergs`). Alcantarea has great ornamental potential and several species are cultivated in gardens. Limited data is available in the literature regarding the leaf anatomical features of the genus, though it has been shown that it may provide valuable information for characterizing of Bromeliaceae taxa. In the present work, we employed leaf anatomy to better characterize the genus and understand its radiation into harsh environments, such as inselbergs. We also searched for characteristics potentially useful in phylogenetic analyses and in delimiting Alcantarea and Vriesea. The anatomical features of the leaves, observed for various Alcantarea species, are in accordance with the general pattern shown by other Bromeliaceae members. However, some features are notable for their importance for sustaining life on rock outcrops, such as: small epidermal thick-walled cells, uneven sinuous epidermal walls, hypodermis often differentiated into lignified layers with thick-walled cells, aquiferous hypodermis bearing collapsible cells, and the presence of well developed epicuticular stratum. Alcantarea leaves tend to show different shapes in the spongy parenchyma, and have chlorenchymatous palisade parenchyma arranged in more well-defined arches, when compared to Vriesea species from the same habitat.

A new species of Potamotrygonocestus Brooks & Thorson, 1976 (Eucestoda : Tetraphyllidea) from Plesiotrygon iwamae Rosa, Castello & Thorson (Mylliobatoidea : Potamotrygonidae) and a redescription of Potamotrygonocestus chaoi Marques, Brooks & Araujo, 2003

Potamotrygonocestus Brooks & Thorson, 1976 is currently represented by six recognised species of tetraphyllidean cestodes inhabiting Neotropical freshwater stingrays. Potamotrygonid stingrays examined to date have included only a single specimen of Plesiotrygon iwamae. Only one species of tetraphyllidean, Potamotrygonocestus chaoi Marques, Brooks & Araujo, 2003, has been described from this host, and this description was based on limited material. New efforts to document the diversity in this host species resulted in the collection of eight additional specimens of P. iwamae, one of these from the upper Rio Solimoes, at Sao Paulo de Olivenca Amazonas during September, 2003, and seven from the Baia do Marajo, Para, during November, 2003. The specimen from the upper Solimoees was found to be infected with P. chaoi. Voucher material from this stingray was used for the redescription of this cestode, which is characterized by strobila 8.78-22.83 mm long and a great number of proglottides, 58-93; the new material provided strobilar length and proglottis counts for complete worms. Potamotrygonocestus marajoara n. sp. is the second species of this genus reported from Plesiotrygon iwamae, although it appears to be restricted to the lower Amazon. This new species resembles P. chaoi in possessing filitriches and blade-like spinitriches on the scolex, cephalic peduncle and cirrus, but differs from other species of the genus in the number of testes, which is 44 on average per proglottis, and by having apical sucker measuring 95-175 mu m in length. Additional data on the distribution and morphology of the microtriches and a detailed description of the female reproductive system are also provided in this study.

Revision of the new wandering spider genus Ohvida and taxonomic remarks on Celaetycheus Simon, 1897 (Araneae: Ctenidae)

The new ctenid genus Ohvida is proposed to include eight species: Ohvida fulvorufa (Franganillo, 1931) comb. nov. (type species) (=Celaetycheus cabriolatus Franganillo, 1930 syn. nov.; = C. cabriolatus pardosiformis Franganillo, 1930 syn. nov.; = C. fulvorufus afoliatus Franganillo, 1931 syn. nov.), O. isolata (Bryant, 1940) comb. nov., O. vernalis (Bryant, 1940) comb. nov., O. brevitarsus (Bryant, 1940) comb. nov., O. coxanus (Bryant, 1940), comb. nov., and three new species, O. turquino sp. nov. (all species from Cuba), and O. andros sp. nov. and O. bimini sp. nov. (both species from The Bahamas). Species of Ohvida differ from all other ctenid spiders by the presence of a retrodorsal projection on the cymbium of the male pedipalp and by a basal position of the lateral spurs on the female epigyne. The genus Celaetycheus Simon, 1897 is reviewed to only include its type species, C. flavostriatus Simon, 1897 from Brazil. We propose the following synonyms and new combinations: Ctenus ottleyi (Petrunkevitch, 1930) (= Celaetycheus strenuus Bryant, 1942 syn. nov. and C. modestus Bryant, 1942 syn. nov.); Ctenus delesserti (Caporiacco, 1947) comb. nov., and Leptoctenus paradoxus (F.O. P.-Cambridge, 1900) comb. nov. Celaetycheus modestus Bryant, 1942 is considered incertae sedis.

Revision and cladistic analysis of Isoctenus and description of a new neotropical genus (Araneae, Ctenidae, Cteninae)

A cladistic analysis was applied to test the monophyly of the genus Isoctenus. The data matrix comprised 28 taxa scored for 53 morphological and two behavioural characters. The analysis resulted in two equally parsimonious trees of 89 steps. The strict consensus was used to discuss the relationships of Isoctenus and related Cteninae genera. Ctenopsis Schmidt is synonymized with Isoctenus. Isoctenus foliifer Bertkau, I. strandi Mello-Leitao, I. eupalaestrus Mello-Leitao, I. janeirus (Walckenaer), I. coxalis (Pickard-Cambridge), I. corymbus Polotow, Brescovit & Pellegatti-Franco and I. malabaris Polotow, Brescovit & Ott are maintained in Isoctenus. Four species currently included in Ctenus are transferred to Isoctenus: I. griseolus (Mello-Leitao) comb. nov., I. taperae (Mello-Leitao) comb. nov., I. herteli (Mello-Leitao) comb. nov. and I. minusculus (Keyserling) comb. nov. The following specific names are synonymized: Ctenus sanguineus Walckenaer, C. semiornatus Mello-Leitao and Ctenopsis stellata Schmidt with Isoctenus janeirus (Walckenaer), Ctenus mourei Mello-Leitao with Isoctenus herteli (Mello-Leitao) and Ctenus pauper Mello-Leitao with Isoctenus strandi Mello-Leitao. Isoctenus sigma Schenkel, described from French Guiana, is transferred to Ctenus. Four species are newly described: Isoctenus areia sp. nov. from Paraiba, Brazil, I. charada sp. nov. and I. segredo sp. nov. from Parana, Brazil, and I. ordinario sp. nov. from south and south-eastern Brazil and north-eastern Argentina. Isoctenus latevittatus Caporiacco is considered species inquirenda. Parabatinga gen. nov. is proposed to include Ctenus brevipes Keyserling. The following synonymies are established: Ctenus taeniatus Keyserling, C. tatarandensis Tullgren, C. anisitsi Strand, C. atrivulvus Strand, C. mentor Strand, C. brevipes brevilabris Strand, Isoctenus masculus Mello-Leitao and Ctenus birabeni Mello-Leitao with Parabatinga brevipes (Keyserling) comb. nov. (C) 2009 The Linnean Society of London, Zoological Journal of the Linnean Society, 2009, 155, 583-614.

Croton laceratoglandulosus (Euphorbiaceae s.s.), a new glandular-stipulate species from Brazil and Bolivia, and its systematic position based on molecular analysis

Croton laceratoglandulosus, a new species from the dry forests of the Brazilian states of Piaui, Ceara, Bahia and Minas Gerais, and the Bolivian department of Santa Cruz, is described and illustrated here. Molecular sequence data demonstrate that it is most closely related to the taxa of Croton section Cascarilla, and not to sections Medea or Barhamia, which also have glandular calyces and laciniate stipules. (C) 2008 The Linnean Society of London, Botanical Journal of the Linnean Society, 2008, 158, 493-498.

Revalidation and revision of the genus Magulla Simon 1892 (Araneae, Mygalomorphae, Theraphosidae)

The genus Magulla Simon 1892 is revalidated and redescribed. The female of the type species M. obesa Simon 1892 is redescribed and the male is described for the first time. Magulla janeirus (Keyserling 1891) is considered a valid species. Magulla symmetrica Bucherl 1949 is transferred to Plesiopelma Pocock 1901, and considered a junior synonym of P. insulare (Mello-Leitao 1923). Additionally, two new species are described from Brazil: M. buecherli n. sp. from Ilhabela, Sao Paulo and M. brescoviti n. sp. from Sao Francisco de Paula, Rio Grande do Sul.