Impacto de la trombosis venosa cerebral durante embarazo y puerperio: revision sistematica

Introducción: La trombosis venosa cerebral es una entidad que se presenta más a menudo en gestantes especialmente durante el puerperio debido a que tanto el embarazo como el puerperio se consideran estados procoagulantes. Desafortunadamente al ser la cefalea el síntoma más común, hace que el diagnóstico sea difícil por ser un síntoma común e inespecífico, tan solo en el 40% de los casos hay déficit neurológico focal. Metodología: Se realizó una revisión sistemática de literatura, evaluando la incidencia, curso clínico, factores de riesgo, principales complicaciones de esta patología con el fin de medir el impacto en lasgestantes. Los artículos fueron clasificados por nivel de evidencia y se calculó un componente meta-analítico. Resultados: Se encontraron un total de 40 artículos que cumplieron criterios de inclusión, el 27.5% fueron evidencia III y 72.5% fueron evidencia IV. Su cuadro clínico fue más común durante el puerperio, estando la cefalea presente en el 90% de los casos. El impacto es alto debido al riesgo de complicarse (OR 13.9, IC95% 2.8 – 69.3) y presentar secuelas neurológicas a largo plazo e incluso muerte materno fetal. Resultados significativos. Discusión: La gran variedad de signos y síntomas en la presentación clínica de la trombosis cerebral sumado a la baja frecuencia y poca conciencia de esta patología en la comunidad médica, hacen que la TVSC tenga un nivel bajo de sospecha clínica, con un alto impacto tanto en la morbilidad como la mortalidad materna.

La influencia del tabaquismo en la actividad de la artritis reumatoide y progresión de erosiones articulares: Una revision sistemática y meta-análisis.

Objetivos: Sintetizar a través de una revisión sistemática y un meta-análisis los datos disponibles en la literatura sobre el tabaquismo y la artritis reumatoide (AR), teniendo en cuenta su efecto sobre la actividad de la enfermedad y la progresión radiográfica de erosiones. Métodos: Se realizo una revisión sistemática usando las guías PRISMA en las bases de datos de MEDLINE hasta Julio 2013. Los términos de búsqueda incluían tabaquismo, tabaco, humo, cigarrillo y artritis reumatoide. Se consideró incluir cualquier tipo de de estudio realizado con casos de AR, definida por criterios aceptados de clasificación y que incluyeran información que indicara la relación entre tabaquismo y DAS28 o por lo menos un puntaje de erosión. Un tamaño común del efecto se calculó usando un modelo de efectos aleatorios. Resultados: De un total de 2215 artículos obtenidos, 45 cumplían los criterios de inclusión. De estos 27 fueron incluidos en el meta-análisis. Doce contenían información sobre la relación con DAS28 y 17 acerca del efecto en progresión radiográfica. Se encontró una asociación negativa entre tabaquismo y respuesta EULAR (OR: 0.72; 95% CI:0.57-0.91; p=0.005) y Remisión definida por DAS28 (OR:0.78; 95%CI:0.63-0.96; p=0.023). EL puntaje de DAS28 era significativamente mas alto en fumadores actuales (MD:0.29; 95% CI:0.12-0.44;p<0.001) de igual forma el puntaje de erosión era mas alto en fumadores actuales (SMD:0.38;95% CI:0.04-0.72; p=0.028). Los datos para progresión de erosiones eran ambiguos (OR: 0.93; 95% CI: 0.72-1,2; p=0.59). Un análisis de sensibilidad confirmo que los resultados no eran sensibles a la restricción de los datos incluidos. El sesgo de publicación fue mínimo. Conclusiones: El tabaquismo se encuentra asociado a una respuesta disminuida a tratamiento (definido por criterios EULAR) y un puntaje de erosión, pero no se logro demostrar una mayor progresión radiográfica en los pacientes fumadores.

Revision sistemática: Factores asociados a colonización e infección por bacterias gram negativas resistentes a carbapenemicos

INTRODUCCIÓN: Los carbapenémicos (CP) son una de las últimas líneas de tratamiento para infecciones por microorganismos multirresistentes (MDR), especialmente Gram-negativos productores de betalactamasas de espectro extendido. Es creciente la preocupación a nivel mundial por el aumento de aislamientos resistentes a CP, en EEUU hasta 60% de las infecciones nosocomiales son causadas por bacterias MDR. En la Unión Europea, cerca de 25.000 pacientes mueren anualmente por esta causa. En Latinoamérica hay una tendencia creciente en las tasas de resistencia.OBJETIVO: Identificar y describir factores protectores o de riesgo, relacionados con colonización o infección por Gram negativos resistentes a CP en pacientes adultos hospitalizados, mediante una revisión sistemática de la literatura.MÉTODOS: Revisión sistemática de literatura, búsqueda de estudios observacionales analíticos en las bases de datos PubMed, Embase, Scopus, BVS, Scielo y búsqueda de literatura gris, publicados desde el 01/01/2004 al 15/04/2015. Se evalúo la calidad de los estudios con escala Newcastle-Ottawa y FLC Osteba. RESULTADOS: Se seleccionaron 36 estudios de alta calidad, diseño de casos y controles. Los factores de riesgo estadísticamente significativos observados son estancia en UCI OR:36.46, insuficiencia renal aguda OR:6.23, diálisis OR:10.80 ventilación mecánica OR:17.5, cateterismo vesical OR:14.3, uso de carbapenémicos OR:18,52,quinolonas OR17.30, cefepime OR:28.05, glicopéptidos OR:19.1; metronidazol OR:4.17, p:0.03, colistina OR:12.1, linezolid OR:7 CONCLUSIÓN: Pese a que hay alta heterogeneidad en las variables incluidas en los estudios, se encontró que los factores de riesgo principales para adquirir GNR-CP en pacientes hospitalizados son: antecedente de insuficiencia renal aguda y diálisis, ventilación mecánica, cateterismo vesical, estancia en UCI y uso previo de antibióticos carbapenémicos, quinolonas, cefepime, glicopéptidos, metronidazol, linezolid y colistina. No se hallaron factores protectores. factores de riesgo

Revision of the Neotropical ant subfamily Leptanilloidinae

The rare Neotropical ant subfamily Leptanilloidinae is revised and its internal phylogeny and biogeography discussed. A new genus, Asphinctanilloides gen.n., including three new species, A, amazona, A. anae and A. manauara, and three new species of Leptanilloides, L. improvisa, L. legionaria and L. sculpturata are described. The only previously known species of the subfamily, L. biconstricta Mann (1923), is redescribed, and the larva of L, legionaria sp.n, is described. Keys to the genera and the species, and a phylogeny of the group are provided. Emphasis has been placed on the study of abdominal and sting characters.

Systematic and historical biogeography of the Bryconidae (Ostariophysi: Characiformes) suggesting a new rearrangement of its genera and an old origin of Mesoamerican ichthyofauna

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Phylogeny and revision of the Neotropical bee genus Rhectomia s.l. Moure (Hymenoptera, Apidae, Augochlorini)

This paper revises the bees currently considered to belong to the genus Rhectomia s.l. and proposes a species phylogeny based on morphological characters, using other Corynurina as outgroups. The results indicate that Rhinocorynura Schrottky renders Rhectomia s.l. paraphyletic. Consequently, Corynurella is removed from synonymy with Rhectomia s.s., and Paracorynurella gen.n. is proposed. The topology among these genera is: outgroup [(Rhectomia s.s. + Rhinocorynura) (Paracorynurella gen.n. + Corynurella)]. Nine species are assigned to Corynurella: C. brokopondoi sp.n., C. caerulea sp.n., C. cognata sp.n., C. decora sp.n., C. harrisoni (Engel), C. mourei Eickwort, C. nigra sp.n., C. singularis sp.n. and C. triangulata sp.n. Three new species are described in Paracorynurella gen.n.: type species P. betoi sp.n., P. excavata sp.n., P. reticulata sp.n.; P. difficillima (Ducke) comb.n. is transferred from Rhinocorynura. Three species are recognized in Rhectomia s.s.: R. catarina sp.n., R. liebherri Engel and R. pumilla Moure. The male of R. liebherri is described for the first time. Keys for the identification of the genera and species are provided.

New systematic assignments in Gonyleptoidea (Arachnida, Opiliones, Laniatores)

As part of an ongoing revision of the family Gonyleptidac, we have identified many species that are synonyms of previously described species or misplaced in this family. This article summarizes these findings, adding previously unavailable information or correcting imprecise observations to justify the presented taxonomic changes. The following new familial or subfamilial assignments are proposed: Nemastygnus Roewer, 1929 and Taulisa Roewer, 1956 are transferred to Agoristenidae, Agoristeninae; Napostygnus Roewer, 1929 to Cranaidae; Ceropachylinus peruvianus Roewer, 1956 and Pirunipygus Roewer, 1936 are transferred to Gonyleptidae, Ampycinae; Gyndesops Roewer, 1943, Haversia Roewer, 1913 and Oxapampeus Roewer, 1963 are transferred to Gonyleptidae, Pachylinae. The following generic synonymies are proposed for the family Gonyleptidae: Acanthogonyleptes Mello-Leitao, 1922 = Centroleptes Roewer, 1943; Acrographinotus Roewer, 1929 = Unduavius Roewer, 1929; Gonyleptes Kirby, 1819 = Collonychium Bertkau, 1880; Mischonyx Bertkau, 1880 = Eugonyleptes Roewer, 1913 and Gonazula Roewer, 1930; Parampheres Roewer, 1913 = Metapachyloides Roewer, 1917; Pseudopucrolia Roewer, 19 12 = Meteusarcus Roewer, 1913; Haversia Roewer, 19 13 = Hoggellula Roewer, 1930. The following specific synonymies are proposed for the family Gonyleptidae: Acanthogonyleptes singularis (Mello-Leitao, 1935) = Centroleptes flavus Roewer, 1943, syn. n.; Geraeocormobius sylvarum Holmberg, 1887 = Discocyrtus serrifemur Roewer, 1943, syn. n.; Gonyleptellus bimaculatus (Sorensen, 1884) = Gonyleptes cancellatus Roewer, 1917, syn. n.; Gonyleptes atrus Mello-Leitao, 1923 = Weyhia brieni Giltay, 1928, syn. n.; Gonyleptes fragilis Mello-Leitao, 1923 = Gonyleptes banana Kury, 2003, syn. n.; Gonyleptes horridus Kirby, 1819 = Collonychium bicuspidatum Bertkau, 1880, syn. n., Gonyleptes borgmeyeri Mello-Leitao, 1932, syn. n., Gonyleptes curvicornis Mello-Leitao, 1932, syn. n., Metagonyleptes hamatus Roewer, 1913, syn. n. and Paragonyleptes simoni Roewer, 1930, syn. n.; Gonyleptes pustulatus Sorensen, 1884 = Gonyleptes guttatus Roewer, 1917, syn. n.; Haversia defensa (Butler, 1876) = Sadocus vallentini Hogg, 1913, syn. n.; Liogonyleptoides minensis (Piza, 1946) = Currala bahiensis Soares, 1972, syn. n.; Megapachylus grandis Roewer, 1913 = Metapachyloides almeidai Soares & Soares, 1946, syn. n.; Mischonyx cuspidatus (Roewer, 1913) = Gonazula gibbosa Roewer, 1930 syn. n.; Mischonyx scaber (Kirby, 1819) = Xundarava holacantha Mello-Leitao, 1927, syn. n.; Parampheres tibialis Roewer, 1917 = Metapachyloides rugosus Roewer, 1917, syn. n.; Parapachyloides uncinatus (Sorensen, 1879) = Goyazella armata Mello-Leitao, 1931, syn. n.; Pseudopucrolia mutica (Perry, 1833) = Meteusarcus armatus Roewer, 1913, syn. n. The following new combinations are proposed: Acrographinotus ornatus (Roewer, 1929), comb. n. (ex Unduavius); Gonyleptellus bimaculatus (Sorensen, 1884), comb. n. (ex Gonyleptes); Gonyleptes perlatus (Mello-Leitao, 1935), comb. n. (ex Moojenia); Mischonyx scaber (Kirby, 1819), comb. n. (ex Gonyleptes); and Neopachyloides peruvianus (Roewer, 1956), comb. n. (ex Ceropachylus). The following species of Gonyleptidae, Gonyleptinae are revalidated: Gonyleptes atrus Mello-Leitao, 1923 and Gonyleptes curvicornis (Roewer, 1913).

A Revision of Hortia (Rutaceae)

A taxonomic revision of the genus Hortia (Rutaceae) is presented. Hortia is a Neotropical genus with most of the species occurring in the Amazonian region. The species are woody, nearly all trees, with simple leaves crowded near the apices of the branches, showy broad corymbose terminal inflorescences, reddish to pink flowers, and berries with abundant oil glands. Ten species are recognized here, most of them occurring in Brazil. A key to the species, descriptions, synonyms, illustrations, as (yell as comments on the geographic distribution, ecology, and economic uses of each species are presented.

Neotropical termites: revision of Armitermes Wasmann (Isoptera, Termitidae, Syntermitinae) and phylogeny of the Syntermitinae

We present a comprehensive phylogenetic analysis of Syntermitinae, including representatives of all genera of the subfamily, along with all 12 species assigned formerly to the genus Armitermes Wasmann (Termitidae, Syntermitinae), and 4 new species described herein. Syntermitinae was recovered as a natural group and the hypothesis that the frontal tube indicates convergence between Syntermitinae and Nasutitermitinae was corroborated. Also, several diagnostic characters proposed in the original description of Syntermitinae are discussed. Alongside the phylogenetic study, a taxonomic revision of the Neotropical genus Armitermes was carried out, resulting in division of the genus into four genera. Taxonomic novelties are: Armitermes now includes A. armiger (Motschulsky), A. bidentatus Rocha & Cancello sp.n. and A. spininotus Rocha & Cancello sp.n.; Silvestritermes Rocha & Cancello gen.n. includes S. euamignathus (Silvestri) comb.n., S. lanei (Canter) comb.n., S. gnomus (Constantino) comb.n., S. duende Rocha & Cancello sp.n., S. minutus (Emerson) comb.n., S. almirsateri Rocha & Cancello sp.n. and S. holmgreni (Snyder) comb.n.; Uncitermes Rocha & Cancello gen.n. includes U. teevani (Emerson) comb.n.; Mapinguaritermes Rocha & Cancello gen.n. includes M. peruanus (Holmgren) comb.n. and M. grandidens (Emerson) comb.n. A new synonymy is proposed for A. cerradoensis Mathews under S. euamignathus. All soldiers are described and illustrated, as are the mandibles and digestive tract of the worker and the imago caste, when available. We provide a dichotomous key, based on soldiers, for all genera of Syntermitinae, and distribution maps and dichotomous keys, based on soldiers, for the species of Armitermes and all the new genera described herein.

Is characterization of a single isolate sufficient for valid publication of a new genus or species? Proposal to modify recommendation 30b of the Bacteriological Code (1990 Revision)

From 1990 to 2000, the number of published named taxa based upon new isolates at species and genus levels in International Journal of Systematic and Evolutionary Microbiology, formerly International Journal of Systematic Bacteriology, have increased by approximately four- and sevenfold, respectively. New taxa based upon characterization of only a single isolate remained at around 40% for both categories. The Bacteriological Code (1990 Revision) has no recommendations on the number of strains required for definition of new taxa. For a few groups, a minimum number of 5-10 strains has been suggested in minimal standards. Since an exponential increase in new taxa can be expected in the future, the authors discuss problems related to naming new species and genera based upon descriptions of a single isolate and suggest that this practice is re-evaluated. It is proposed that the following should be added to Recommendation 30b of the Bacteriological Code: 'Descriptions should be based on as many strains as possible (minimum five), representing different sources with respect to geography and ecology in order to be well characterized both phenotypically and genotypically, to establish the centre (from which the type strain could be chosen) and the extent of the cluster to be named. In addition, comparative studies should be performed, including reference strains that represent neighbouring species and/or genera, in order to give descriptions that are sufficiently detailed to allow differentiation from these neighbours.'

Attention-deficit hyperactivity disorder symptoms and lead exposure in children: A systematic review of literature

Blood lead levels > 10 µg/dL are known to affect various areas of the brain that influence behavior and cause many other health problems in children. As a result, the Centers for Disease Control and Prevention (CDC) set the blood lead action level at 10 µg/dL. However, recent research provides evidence that blood lead levels <10 µg/dL also may lead to behavioral problems in children. With the recent increase in diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD) in children in the U.S. it is important to determine possible environmental toxins such as lead that may play a role in causing ADHD symptoms. The aim of this systematic review of the literature was to identify recent published studies that examine an association between blood lead levels < 10 µg/dL and ADHD symptoms in children in order to summarize their findings and describe major gaps in the literature. Although available research is limited, the articles reviewed indicate that blood lead at levels much below the CDC action level of 10 µg/dL may affect a child's level of attention, hyperactivity, impulsivity and ADHD diagnosis. Additional prospective research is warranted in order to inform the revision of current blood lead action levels as well as better elucidate the relationship between lead and ADHD diagnoses.^

Systematic review of Late Jurassic sauropods from the Museu Geológico collections (Lisboa, Portugal)

The Museu Geológico collections house some of the first sauropod references of the Lusitanian Basin Upper Jurassic record, including the Lourinhasaurus alenquerensis and Lusotitan atalaiensis lectotypes, previously considered as new species of the Apatosaurus and Brachiosaurus genera, respectively. Several fragmentary specimens have been classical referred to those taxa, but the most part of these systematic attributions are not supported herein, excluding a caudal vertebra from Maceira (MG 8804) considered as cf. Lusotitan atalaiensis. From the material housed in the Museu Geológico were identified basal eusauropods (indeterminate eusauropods and turiasaurs) and neosauropods (indeterminate neosauropods, diplodods and camarasaurids and basal titanosauriforms). Middle caudal vertebrae with lateral fossae, ventral hollow border by pronounced ventrolateral crests and quadrangular cross-section suggest for the presence of diplodocine diplodocids in north area of the Lusitanian Basin Central Sector during the Late Jurassic. A humerus collected from Praia dos Frades (MG 4976) is attributed to cf. Duriatitan humerocristatus suggesting the presence of shared sauropod forms between the Portugal and United Kingdom during the Late Jurassic. Duriatitan is an indeterminate member of Eusauropoda and the discovery of new material in both territories is necessary to confirm this systematic approach. The studied material is in according with the previous recorded paleobiodiversity for the sauropod clade during the Portuguese Late Jurassic, which includes basal eusauropods (including turiasaurs), diplodocids and macronarians (including camarasaurids and basal titanosauriforms).

Health-related And Socio-demographic Factors Associated With Frailty In The Elderly: A Systematic Literature Review.

Frailty is a syndrome that leads to practical harm in the lives of elders, since it is related to increased risk of dependency, falls, hospitalization, institutionalization, and death. The objective of this systematic review was to identify the socio-demographic, psycho-behavioral, health-related, nutritional, and lifestyle factors associated with frailty in the elderly. A total of 4,183 studies published from 2001 to 2013 were detected in the databases, and 182 complete articles were selected. After a comprehensive reading and application of selection criteria, 35 eligible articles remained for analysis. The main factors associated with frailty were: age, female gender, black race/color, schooling, income, cardiovascular diseases, number of comorbidities/diseases, functional incapacity, poor self-rated health, depressive symptoms, cognitive function, body mass index, smoking, and alcohol use. Knowledge of the complexity of determinants of frailty can assist the formulation of measures for prevention and early intervention, thereby contributing to better quality of life for the elderly.

Cervical Spine Involvement In Rheumatoid Arthritis--a Systematic Review.

Rheumatoid arthritis (RA) is a systemic chronic inflammatory disorder that can compromise the cervical spine in up to 80% of the cases. The most common radiological presentations of cervical involvement are atlantoaxial subluxation (AAS), cranial settling and subaxial subluxation (SAS). We performed a systematic review in the PubMed Database of articles published later 2005 to evaluate the prevalence, progression and risk factors for cervical spine involvement in RA patients. Articles were classified according to their level of evidence. Our literature review reported a wide range in the prevalence of cervical spine disease, probably explained by the different studied populations and disease characteristics. Uncontrolled RA is probably the main risk factor for developing a spinal instability. Adequate treatment with DMARD and BA can prevent development of cervical instabilities but did not avoid progression of a pre-existing injury. MRI is the best radiological method for diagnosis cervical spine involvement. AAS is the most common form of RA. Long term radiological follow-up is necessary to diagnosis patients with late instabilities and monitoring progression of diagnosed injuries.

Influence Of Cyclosporine On The Occurrence Of Nephrotoxicity After Allogeneic Hematopoietic Stem Cell Transplantation: A Systematic Review.

Cyclosporine, a drug used in immunosuppression protocols for hematopoietic stem cell transplantation that has a narrow therapeutic index, may cause various adverse reactions, including nephrotoxicity. This has a direct clinical impact on the patient. This study aims to summarize available evidence in the scientific literature on the use of cyclosporine in respect to its risk factor for the development of nephrotoxicity in patients submitted to hematopoietic stem cell transplantation. A systematic review was made with the following electronic databases: PubMed, Web of Science, Embase, Scopus, CINAHL, LILACS, SciELO and Cochrane BVS. The keywords used were: bone marrow transplantation OR stem cell transplantation OR grafting, bone marrow AND cyclosporine OR cyclosporin OR risk factors AND acute kidney injury OR acute kidney injuries OR acute renal failure OR acute renal failures OR nephrotoxicity. The level of scientific evidence of the studies was classified according to the Oxford Centre for Evidence Based Medicine. The final sample was composed of 19 studies, most of which (89.5%) had an observational design, evidence level 2B and pointed to an incidence of nephrotoxicity above 30%. The available evidence, considered as good quality and appropriate for the analyzed event, indicates that cyclosporine represents a risk factor for the occurrence of nephrotoxicity, particularly when combined with amphotericin B or aminoglycosides, agents commonly used in hematopoietic stem cell transplantation recipients.