How well does B-type natriuretic peptide predict death and cardiac events in patients with heart failure: systematic review

Objective To assess how well B-type natriuretic peptide (BNP) predicts prognosis in patients with heart failure. Design Systematic review of studies assessing BNP for prognosis m patients with heart failure or asymptomatic patients. Data sources Electronic searches of Medline and Embase from January 1994 to March 2004 and reference lists of included studies. Study selection and data extraction We included all studies that estimated the relation between BNP measurement and the risk of death, cardiac death, sudden death, or cardiovascular event in patients with heart failure or asymptomatic patients, including initial values and changes in values in response to treatment. Multivariable models that included both BNP and left ventricular ejection fraction as predictors were used to compare the prognostic value of each variable. Two reviewers independently selected studies and extracted data. Data synthesis 19 studies used BNP to estimate the relative risk of death or cardiovascular events in heart failure patients and five studies in asymptomatic patients. In heart failure patients, each 100 pg/ml increase was associated with a 35% increase in the relative risk of death. BNP was used in 35 multivariable models of prognosis. In nine of the models, it was the only variable to reach significance-that is, other variables contained no prognostic information beyond that of BNP. Even allowing for the scale of the variables, it seems to be a strong indicator of risk. Conclusion Although systematic reviews of prognostic studies have inherent difficulties, including die possibility of publication bias, the results of the studies in this review show that BNP is a strong prognostic indicator for both asymptomatic patients mid for patients with heart failure at all stages of disease.

Synthesis of (Z)-tributylstannyl enynes: systematic studies of Sonogashira cross-coupling reactions between (E)-1-iodovinyl-1-tributylstannanes and terminal acetylenes using amines or tetrabutylammonium hydroxide (TBAOH) as activator

Sonogashira cross-coupling reactions involving (E)-iodo vinyl stannanes and terminal acetylenes were carried out in the presence of Pd(PPh(3))(4), Cul and several amines, affording (Z)-tributylstannyl enynes in moderate to good yields (62-91%). Utilizing the catalytic system containing Pd(PPh(3))(4) (5%), Cul (10%), and TBAOH (40% in aqueous media) as activator, better yields (72-91%) and lower reaction times were achieved. (C) 2011 Elsevier Ltd. All rights reserved.

Taxonomic revision of Gripopteryx (Pictet, 1841) (Plecoptera: Gripopterygidae)

The genus Gripopteryx is revised and two new species are described, G. japi n. sp. from southeastern Brazil, and G. clemira n. sp. from northeastern Brazil. The male of G. brasiliensis Samal, 1921 and the female of G. flinti Froehlich, 1993 are described. New figures for G. maculosa Jewett, 1960, for the male of G. reticulata Brauer, 1866, and for the female of G. brasiliensis are provided. Keys to adult males and to nymphs are provided.

A revision of Gasteruption Latreille (Hymenoptera: Gasteruptiidae) in the Neotropical Region

The Neotropical species of Gasteruption Latreille are revised, described, diagnosed, and illustrated; a key for females is provided. Twenty six valid species are recognized, thirteen of which are described as new: G. amputatum Townes, G. barnstoni (Westwood), G. bertae n. sp., G. bispinosum Kieffer, G. brachychaetum Schrottky, G. brandaoi n. sp., G. brasiliense (Blanchard), G. floridanum (Bradley), G. glauciae n. sp., G. guildingi (Westwood), G. hansoni n. sp., G. helenae n. sp., G. huberi n. sp., G. kaweahense (Bradley), G. lianae n. sp., G. loiaconoae n. sp., G. masneri n. sp., G. oliveirai n. sp., G. parvum Schrottky, G. rafaeli n. sp., G. sartor Schletterer, G. smithi n. sp., G. tenue Kieffer, G. townesi (Alayo), G. visaliae (Bradley), and G. wahli n. sp. The following new synonymies are proposed: G. maculicorne Cameron, G. macroderum Schletterer, and G. zapotecum Schletterer with G. barnstoni; G. bihamatum Kieffer, G. fallens Kieffer, G. fiebrigi Schrottky, G. leptodomum Kieffer, G. montivagum Kieffer, and G. strandi Kieffer with G. bispinosum; G. annulitarse Schrottky, G. brasiliae Kieffer, G. gracillimum (Schletterer), G. longicauda Kieffer, G. petroselini Schrottky, G. subtropicale Schrottky and G. torridum (Bradley) with G. brasiliense; G. rufipectus (Westwood) with G. guildingi; G. angustatum (Kieffer) with G. kaweahense; G. horni Brethes with G. parvum. The following taxa are considered as species inquirendae: G. albitarse Schletterer, G. austini Jennings and Smith, G. subcoriaceum Kieffer n. stat., and G. tenuicolle Schletterer. As well, G rubrum Taschenberg is synonymized with Pseudofoenus infumatus (Schletterer). In addition, G. tenue Pasteels, 1957a from Australia is a junior homonym of G. tenue Kieffer, 1922 and is renamed G. pasteelsi n. name.

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.

Cochrane systematic reviews of treatments for lung cancer

Morbidity and mortality from lung cancer is a major burden to global health. The integration of expert clinical experience, patient preference and high-quality evidence, including Cochrane systematic reviews, can only help improve outcomes from this highly lethal condition.

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.