Validation of the Killip-Kimball Classification and Late Mortality after Acute Myocardial Infarction

Background: The classification or index of heart failure severity in patients with acute myocardial infarction (AMI) was proposed by Killip and Kimball aiming at assessing the risk of in-hospital death and the potential benefit of specific management of care provided in Coronary Care Units (CCU) during the decade of 60. Objective: To validate the risk stratification of Killip classification in the long-term mortality and compare the prognostic value in patients with non-ST-segment elevation MI (NSTEMI) relative to patients with ST-segment elevation MI (STEMI), in the era of reperfusion and modern antithrombotic therapies. Methods: We evaluated 1906 patients with documented AMI and admitted to the CCU, from 1995 to 2011, with a mean follow-up of 05 years to assess total mortality. Kaplan-Meier (KM) curves were developed for comparison between survival distributions according to Killip class and NSTEMI versus STEMI. Cox proportional regression models were developed to determine the independent association between Killip class and mortality, with sensitivity analyses based on type of AMI. Results: The proportions of deaths and the KM survival distributions were significantly different across Killip class >1 (p <0.001) and with a similar pattern between patients with NSTEMI and STEMI. Cox models identified the Killip classification as a significant, sustained, consistent predictor and independent of relevant covariables (Wald χ2 16.5 [p = 0.001], NSTEMI) and (Wald χ2 11.9 [p = 0.008], STEMI). Conclusion: The Killip and Kimball classification performs relevant prognostic role in mortality at mean follow-up of 05 years post-AMI, with a similar pattern between NSTEMI and STEMI patients.

Physa acuta Draparnaud, 1805 (Gastropoda: Physidae): a study of topotypic specimens

A description is given of Physa acuta Draparnaud, 1805, based on topotypic specimens from the Garonne river basin, and additional samples from the environs of the French cities of Montpellier and Perpignan. It proved indistinguishable, in shell and anatomy, from topotypic Physa cubensis Pfeiffer, 1839, thus leading the authors to admit the synonymy of the two nominal species under the older name, P. acuta.

Hemilucilia segmentaria (Fabricius, 1805) (Diptera: Calliphoridae) as new biological vector of eggs of Dermatobia hominis (Linnaeus Jr., 1781) (Diptera: Oestridae) in Reserva Biológica do Tinguá, Rio de Janeiro, Brazil

The aim of this note was to record for the first time the finding of Hemilucilia segmentaria acting as biological vector of Dermatobia hominis, during a study of the diversity of Calliphoridae at Reserva Biológica do Tinguá, Rio de Janeiro, Brazil. The insects were captured using traps baited with chicken vicera, for a period of 28-30 h twice per month. In the period of one year, 1987 insects were collected, 7.5% of which belonged to the H. segmentaria; of these a female was captured in May 2001, carrying a mass of 20 eggs on the left side of its abdomen.

Acute myocardial infarction in elderly patients: comparative analysis of the predictors of mortality. The elderly versus the young

OBJECTIVE: To study the in-hospital evolution of patients aged 65 years and older, with acute myocardial infarction, who were treated by direct coronary angioplasty with no fibrinolytic therapy. METHODS: We studied 885 patients divided into 2 groups as follows: group I (GI) - 293 (33.4%) patients aged ³ 65 years (72±5 years), and group II (GII) - 592 patients aged < 65 years (57±9 years). Multivessel disease was more frequent in GI (63.5% x 49.7%; p=0.001). A greater number of GII patients were class I or II of the clinical Killip-Kimball classification (K) (80.2% x 67.2%; p=0.00002), while a significant number of GI patients were KIII and KIV (24.3% x 12.8%; p=0.00003). RESULTS: Group I had a lower index of success (84.6% x 94%; p=0.0002) and a greater in-hospital mortality (12.2% x 4.7%; p=0.00007). The predictors of mortality in GI were as follows: previous infarction (20.5% x 6.3%; p=0.02), anterior location (13.4% x 6.4%; p=0.03), and male sex (10.4% x 4.4%; p=0.007). CONCLUSION: Elderly patients had more severe acute myocardial infarction and more extensive disease, a lower index of success, and greater in-hospital mortality. Previous infarction, anterior location and male sex were identified as predictors of mortality in the elderly group (GI).

Variações morfológicas em Edessa rufomarginata e revalidação de E. albomarginata e E. marginalis (Heteroptera, Pentatomidae, Edessinae)

Based on the types of Edessa rufomarginata (De Geer, 1773) and its synonyms, on morphology of the paramere and coloration, seven patterns are described for E. rufomarginata. Pentatoma furcata Palisot de Beauvois, 1805, Cimex cruentus Fabricius, 1775, Aceratodes flavovirens Stål, 1855 and A. flavomarginatus Stål, 1855 are mantained as junior synonyms of E. rufomarginata. A. albomarginatus Stål, 1855 and A. marginalis Dallas, 1951 are removed from the synonymy of E. rufomarginata and are reinstated in Edessa. Aceratodes discolor Dallas, 1951 is removed from the synonymy of E. rufomarginata and is considered junior synonym of Edessa abdominalis Erichson, 1848.

Morfologia e biologia dos imaturos de Euschistus hansi (Hemiptera, Heteroptera, Pentatomidae)

São descritos e ilustrados os estágios imaturos de Euschistus hansi Grazia, 1987, com ênfase nos caracteres morfológicos externos do ovo e dos cinco instares. Adultos e ninfas foram alimentados com ramos frescos e frutos maduros de "ligustro", Ligustrum lucidum Ait. (Oleaceae). As ninfas de E. hansi são comparadas com os imaturos já descritos de outras espécies neotropicais de Euschistus Dallas, 1851: E. heros (Fabricius, 1798), E. sulcacitus Rolston, 1971 e E. bifibulus (Palisot de Beauvois, 1805). Dados biológicos também são fornecidos.

Population fluctuations of calliphorid species (Diptera, Calliphoridae) in the Biological Reserve of Tinguá, state of Rio de Janeiro, Brazil

The purpose of this work was to determine the diversity and population fluctuations of calliphorid flies in the Biological Reserve of Tinguá (ReBio-Tinguá), Nova Iguaçu, state of Rio de Janeiro, Brazil and to correlate their occurrence with the environmental variables of temperature, rainfall and relative air humidity. Specimens of Diptera were collected monthly between June 2002 and January 2005 using four traps placed at four points along a trail and exposed for 48 hours. The traps were baited with sardines and the trapped insects were stored in 70% alcohol. It was collected 8,528 calliphorids, thirteen species were identified among the blowflies including Laneela nigripes Guimarães 1977, Chrysomya megacephala (Fabricius, 1794), C. albiceps (Wiedemann, 1819), C. putoria (Wiedemann, 1830), Chloroprocta idioidea (Robineau-Devoidy, 1830), Cochliomyia macellaria (Fabricius, 1775), Hemilucilia semidiaphana (Rondani, 1850), H. segmentaria (Fabricius, 1805), Lucilia eximia (Wiedemann,1819), L. cuprina (Wiedemann, 1830), Paralucilia pseudolyrcea (Mello, 1969), Mesembrinella sp. and Eumesembrinella pauciseta (Aldrich, 1922). No significant correlation was found between the abundance of blowflies and the temperature and relative air humidity. Only C. megacephala and C. albiceps showed a positive and significant correlation with rainfall. An analysis of grouping by month (UPGMA) revealed no seasonal difference in the composition of the community, indicating that the community of calliphorid flies is probably more influenced by the ecological niches occupied by each species than by the seasons of the year.

Differences on allocation of available resources, in growth, reproduction, and survival, in an exotic gastropod of Physidae compared to an endemic one

Physa acuta Draparnaud, 1805 is an invasive gastropod that can affect local species. In Argentina, it is widespread and abundant, even in environments inhabited by the native species Stenophysa marmorata Guilding, 1828. Its predominance raises the question whether this could be explained by a more successful energy allocation in functional requirements (growth, reproduction and survival) compared to S. marmorata. This study was aimed at comparing growth rates, as well as survival and fecundity, between both species under laboratory conditions. Individuals born on the same day were grouped in four per aquaria and kept under controlled conditions of food, light, and temperature. Snails were weekly measured (maximum shell length), and growth rates were calculated using the Von Bertalanffy's equation. The number of eggs and survivors were grouped by week. Stenophysa marmorata was larger at birth than Physa acuta and invested more energy in growth, delaying sexual maturity. This resulted in a disadvantage in fecundity and survival compared to P. acuta, which had a lower growth rate but matured earlier and survived longer. Furthermore, the growth of P. acuta was not affected by reproduction, its reproductive period was longer, consequently with more eggs laid than S. marmorata.

Três espécies novas de Cryptachaea e notas taxonômicas em Theridiidae (Araneae)

Três espécies novas de Cryptachaea Archer, 1946 são descritas e ilustradas, com base em ambos os sexos: Cryptachaea brescoviti sp. nov. de Beni, Bolívia e Bahia e Espírito Santo, Brasil; C. bonaldoi sp. nov. de Minas Gerais, Mato Grosso do Sul e Paraná e C. lisei sp. nov. de São Paulo e Rio Grande do Sul, Brasil. Sinonímias novas são propostas: Chrysso ribeirao Levi, 1962 e C. caraca Levi, 1962 com Chrysso arops Levi, 1962; Cryptachaea diamantina (Levi, 1963) com C. hirta (Taczanowski, 1873) e Cryptachaea maxima (Keyserling, 1884) com C. altiventer (Keyserling, 1884). Theridion altum Levi, 1963 é sinônimo júnior de Theridion soaresi Levi, 1963. Theridion melanosternum Mello-Leitão, 1947 é sinonimizada com Oedothorax bisignatus Mello-Leitão, 1944 e esta última espécie é removida da sinonímia de Theridion calcynatum Holmberg, 1876 e transferida para Theridion Walckenaer, 1805. Theridion tungurahua Levi, 1963 é a fêmea de Theridion fungosum Keyserling, 1884 e a espécie é transferida para Exalbidion Wunderlich, 1995. Theridion antron Levi, 1963 é a fêmea de Theridion filum Levi, 1963. Theridion nesticum Levi, 1963 é sinonimizada com Theridion teresae Levi, 1963. Theridion olaup Levi, 1963 é transferida para Kockiura Archer, 1950 e a fêmea é descrita e ilustrada pela primeira vez. Novas combinações são estabelecidas: Cryptachaea dalana (Buckup & Marques, 1991), C. triguttata (Keyserling, 1891), C. dea (Buckup & Marques, 2006), C. digitus (Buckup & Marques, 2006), C. taim (Buckup & Marques, 2006) e Parasteatoda nigrovittata (Keyserling, 1884), todas são transferidas de Achaearanea Strand, 1929. Cryptachaea rafaeli (Buckup & Marques, 1991) é transferida para Henziectypus Archer, 1946.

Primeira contribuição ao conhecimento da família Rhopalomeridae: (Diptera)

The author studies the genera Rhopalomera Wiedemann, 1824 and Willistoniella Mik, 1895, pointing out the remarkables differentces between them. Describes Rhopalomera stictica (wiedemann, 1828), Rhopalomera clavipes (Fabricius, 1805) and Willistoniella peluropunctata (Wiedemann, 1824).

Planorbidae, Lymnaeidae and Physidae of Ecuador (Mollusca: Basommatophora)

In the course of a trip to Ecuador I had the opportunity of collecting topotypic specimens of the following nominal species of pulmonate molluscs: Biomphalaria cousini Paraense, 1966; Planorbis equatorius Cousin, 1887; P. canonicus Cousin, 1887; Lymnaea cousini Jousseaume, 1887 and P. boetzkesi Miller, 1879. Additional findings were: Helisoma trivolvis (Say, 1817), Biomphalaria peregrina (Orbigny 1835), Drepanotrema anatinum (Orbigny, 1835), D. kermatoides (Orbigny, 1835), D. lucidum (Pfeiffer, 1839), D. surinamense (Clessin, 1884), Lymnaea columella Say, 1817 and Physa acuta Draparnaud, 1805. P. boetzkesi and P. canonicus are considered junior synonyms of Gyraulus hindsianus (Dunker, 1848) and Biomphalaria peregrina (Orbigny, 1835), respectively.

Planorbidae, Lymnaeidae and Physidae of Argentina (Mollusca: Basommatophora)

In the course of several trips to Argentina I had the opportunity of collecting specimens of Acrorbis petricola Odhner,1937, Biomphalaria orbignyi Paraense, 1975, B. peregrina (Orbigny, 1835), B. tenagophila (Orbigny, 1835) Lymnaea viatrix Orbigny, 1835, Antillorbis nordestensis (Lucena, 1954), B. intermedia (Paraense & Deslandes, 1962), B. oligoza Paraense, 1974, B. straminea (Dunker, 1848), Drepanotrema anatinum (Orbigny, 1835), D. cimex (Moricand, 1837), D. depressissimum (Moricand, 1837), D. heloicum (Orbigny, 1835), D. kermatoides (Orbigny, 1835), D. lucidum (Pfeiffer, 1839), L. columella Say, 1817, Physa acuta Draparnaud, 1805, and P. marmorata Guilding, 1828.

Activities of tabanids (Diptera, Tabanidae) attacking domestic duck-Cairina moschata (Linnaeus) (Aves, Anatidae), introduced in a forest area in the Central Amazon, Manaus, Brazil

Presented here are the feeding habits, attack behavior, daily and annual activity of adult of Phorcotabanus cinereus (Wiedeman, 1821), Chrysops laetus (Fabricius, 1805) and Phaeotabanus cajennensis (Fabricius, 1787), while biting a domestic duck, Cairina moschata (Linnaeus, 1758). The last two species were recorded for the first time attacking birds. This study comprehended monthly observations of two consecutive days from April/97 to March/98 between 5:30 a.m. and 6:30 p.m. at the Army Instructional Base ((BI-2/CIGS) near Manaus. Annual occurrence of P. cinereus was from July to September, with a daily occurrence between 9:00 a.m. and 5:00 p.m. and highest activity at 12:00 a.m. and 2:00 p.m. C. laetus ocurred from June to October; with a daily occurrence between 8:00 a.m. and 3 p.m. and highest activity at 11:00 and 12:00 a.m. Occurrence of P. cajennensis with one specimen only, was in July between 10:00 and 11:00 a.m.

Revisão do gênero Antiteuchus Dallas (Heteroptera, Pentatomidae, Discocephalinae)

Revisão do gênero Antiteuchus Dallas (Heteroptera, Pentatomidae, Discocephalinae). O gênero Antiteuchus Dallas, 1851 com 46 espécies descritas é revisado; as espécies são redescritas com base na morfologia externa da genitália do macho e em algumas características da morfologia geral do corpo. Neodine Kirkaldy, 1909 é considerado sinônimo junior de Antiteuchus. As espécies foram subdivididas em seis grupos aqui propostos: A. amplus, A. supinatus, A. peruensis, A. tesselatus, A. marmoratus e A. mixtus. Oito novas espécies são descritas: A. amapensis sp. nov., A. beckerae sp. nov., A. doesburgi sp. nov., A. exiguus sp. nov., A. ledeburi sp. nov., A. marini sp. nov., A. melanicus sp. nov. and A. similis sp. nov. Nove espécies e uma subespécie são sinonimizadas. Antiteuchus varians Ruckes, 1964 é considerada sinônimo júnior de A. pallescens Stål, 1868; A. englemani Rolston, 1993 de A. amplus (Walker, 1867); A. tripterus limbativentris Ruckes, 1964 e A. minor Engleman, 1983 de A. tripterus (Fabricius, 1787); A. fuscus (Ruckes, 1959), A. piceus (Palisot de Beauvois, 1805), A. subgibbus Engleman, 1983, A. subimpunctatus Ruckes, 1964, A. unicolor (Westwood, 1837) e A. variolosus (Westwood, 1837) de A. mixtus (Fabricius, 1787). Antiteuchus tatei (Ruckes, 1958) é considerada species inquirenda. Empicoris marmoreus Spinola, 1837 é colocada em incertae sedis e tratada como species inquirenda. O macho de A. pictus, até agora desconhecido, é descrito. Chaves de identificação para os machos das espécies de Antiteuchus e para os grupos de espécies são apresentadas.

Revision of the New World bee fly genus Heterostylum Macquart (Diptera, Bombyliidae, Bombyliinae)

The genus Heterostylum Macquart and five Neotropical species (H. ferrugineum (Fabricius, 1805), H. hirsutum (Thunberg, 1827), H. rufum (Olivier, 1789), H. haemorrhoicum (Loew, 1863) and H. pallipes Bigot, 1892) are redescribed. The other species, recently redescribed or described are only diagnosed, except for H. deani Painter, 1930, whose spermathecae are described and illustrated for the first time. The main characters of the external morphology were photographed and the male genitalia and female spermathecae illustrated. An identification key to all included species is also presented.