The emitted dose of drug from a valved holding chamber using five pressurized metered dose inhalers.

Background. The dose available at the mouth from a pressurised metered-dose inhaler (pMDI) cannot stay the same if it is used with a valved holding chamber (VHC). A different aerosol drug delivery system is created when the pMDI is used with the VHC and therefore the dose delivered to the patients is no longer that released from the pMDI alone, but the one emitted by the new system. This study aims to verify the emitted dose of five pMDI drugs when used with a VHC. Methods. The emitted dose was expressed as the amount of drug within the respirable fraction available at the end of the VHC, i.e. the drug output (measured by high performance liquid chromatography) multiplied by the percentage of FDF determined using a laser diffraction analyser. Results. the emitted doses were drastically reduced in comparison with the nominal doses (Beclomethasone from 250 to 90.5 µg, Budesonide from 200 to 100 µg, Ciclesonide from 160 to 102 µg Fluticasone from 250 to 116 µg, Salbutamol from 100 to 54 µg). Conclusions. When pMDIs are employed with a VHC, the emitted dose drastically changes; it is more or less halved. In order to facilitate prescription by the physician, both the nominal and the emitted doses should be reported in the VHC package

Degree of infestation of red belt thrips in cashew clones intercropped with fruit trees / Grau de infestação do tripes-da-cinta-vermelha em clones de cajueiro consorciados com fruteiras

Among the species of phytophagous thrips that attack the cashew tree (Anacardium occidentale), the red belt thrips (Selenotripes rubrocinctus) is the species of greatest economic importance due to the damage it causes, the wide geographical distribution, and the attack of the cashew tree in all ages of the plant, This work aimed to evaluate the degree of infestation of red belt thrips in dwarf cashew clones CCP 76, BRS 226, BRS 189, in field conditions, intercropped with three different fruit trees, at the Experimental Field of Embrapa Agroindústria Tropical, in the municipality of Pacajus-CE, Brazil. The evaluation of the attack in the three genotypes was based on a system that recommends using grades that varied from one to five when it was verified in the plant. The cashew clones were arranged in four blocks where each clone was intercropped with banana, watermelon, and papaya, in addition to the control treatment (single cashew). Five consecutive evaluations were carried out during the period from September 29 to December 19, 2017. The study showed that pest infestations were more intense in cashew trees intercropped with fruit trees, whereas in the consortium with banana trees, the intensity of the attack was higher than in consortia with other fruit trees. This result is probably due to the environmental conditions imposed by the greater shade of the banana trees. Over the evaluation period, infestations showed a slight downward trend for the three clones evaluated. The BRS 226 clone proved to be the most preferred by thrips in conditions of intercropping with banana

Avaliação de métodos para estimar a infestação da Traça-da-castanha em estudo sobre a resposta de clones de cajueiro ao ataque da praga: Evaluation of methods to estimate chestnut moth infestation in a study on the response of cashew tree clones to pest attack

A traça-da-castanha (Anacampsis phytomiella Busck, Lepidoptera: Gelechiidae) é considerada a principal praga dos frutos do cajueiro devido aos elevados prejuízos que causa por destruir completamente a amêndoa da castanha-de-caju. Este trabalho teve como objetivos: 1) comparar a eficiência de dois métodos de amostragens do ataque da traça-da-castanha; 2) avaliar o grau de infestação da praga em duas épocas do período produtivo de clones de cajueiro-anão. O trabalho foi realizado no segundo semestre de 2015 na Estação Experimental da Embrapa Agroindústria Tropical em Pacajus, CE. Para avaliações dos graus de infestação da traça-da-castanha na planta e no solo, foram adotados dois procedimentos de amostragem. No primeiro, o grau de infestação foi calculado amostrando-se cinco castanhas no estágio de máximo desenvolvimento (castanhas verdes na planta), em cada quadrante, totalizando 20 castanhas por planta. No segundo, o grau de infestação foi determinado por meio de uma amostra de 200 castanhas coletadas no solo, debaixo das copas dos cajueiros. Para os dois métodos, as avaliações foram feitas em 20 plantas dos cinco clones CCP 1001, CCP 76, CCP 09, BRS189 e CCP 06, e o grau de infestação foi dado pelo percentual de castanhas de caju com perfurações, as quais são normalmente observadas na ponta da castanha.  Assumindo-se que o cálculo do percentual de castanhas furadas colhidas no solo (debaixo da copa) representa a perda econômica real causada pela praga e considerando que esse valor não difere estatisticamente do obtido por meio da avaliação amostral na planta, conclui-se a partir dos dados obtidos que este último procedimento é suficientemente preciso na determinação do grau de infestação ocasionado pela traça-da-castanha e que, pela rapidez e facilidade na execução, esse método pode ser utilizado para dar suporte a decisões de controle dentro das premissas do manejo integrado de pragas. O clone CCP 1001, seguido do clone CCP 76, foi o genótipo que apresentou o maior grau de infestação, em que mais da metade das castanhas colhidas tiveram suas amêndoas destruídas pela praga. O percentual de castanhas furadas apresentou uma tendência de redução ao longo do ciclo produtivo do cajueiro; ou seja, o grau da infestação decresce do início para o fim da safr

Manejo de Tuta absoluta em tomate cereja em cultivo protegido na Serra da Ibiapaba, no Ceará: Management of Tuta absoluta in cherry tomato in protected cultivation in Serra da Ibiapaba, Ceará

Com os objetivos de melhorar a viabilidade do cultivo do tomateiro na região da Serra da Ibiapaba, reduzir o uso de defensivos agrícolas, aumentar a produtividade e melhorar a qualidade do produto para o consumidor, foi proposto um sistema de produção inovador para a região, que combinou o cultivo protegido em estufa e o plantio do tomateiro em vaso com substrato de fibra de coco fertirrigado com o uso de técnicas de manejo integrado da traça-do-tomateiro (Tuta absoluta). O plantio foi realizado na região da Serra da Ibiapaba, na cidade de Guaraciaba do Norte, em estufa com dimensões de 52 m x 50 m, com 3.600 plantas de tomate cereja da variedade Sweet Heaven. O monitoramento da praga foi feito com armadilha tipo delta com feromônio específico para a espécie. Os índices de infestação estabelecidos para determinar as ações de controle foram o número de insetos adultos nas armadilhas, o número de larvas e pupas vivas em folhas com minas e o percentual de frutas atacadas. Durante o período de colheita, deu-se preferência aos produtos biológicos à base da bactéria Bacillus thuringiensis, do parasitoide Trichogramma pretiosum e de óleos vegetais e calda de sabão neutro. A eficiência do manejo adotado foi comprovada pelo percentual médio de 1,66% de frutos atacados com sintomas apenas superficiais, sem comprometer a parte interna dos frutos. Além de ser um nível de ataque considerado baixo, não foram encontradas larvas em 100% dos tomates avaliados, o que preservou a qualidade do produto para outra finalidade que não o consumo in natura, como, por exemplo, para a confecção de polpas

Health burden and economic impact of measles-related hospitalizations in Italy in 2002–2003

Background: A large measles outbreak occurred in Italy in 2002 - 2003. This study evaluates the health burden and economic impact of measles- related hospitalizations in Italy during the specified period. Methods: Hospital discharge abstract data for measles hospitalizations in Italy during 2002 - 2003 were analysed to obtain information regarding number and rates of measles hospitalizations by geographical area and age group, length of hospital stay, and complications. Hospitalization costs were estimated on the basis of Diagnosis- Related Groups. Results: A total of 5,154 hospitalizations were identified, 3,478 ( 67%) of which occurred in children < 15 years of age. Most hospitalizations occurred in southern Italy ( 71 %) and children below 1 year of age presented the greatest hospitalization rates ( 46.2/ 100,000 and 19.0/ 100,000, respectively in 2002 and 2003). Pneumonia was diagnosed in 594 cases ( 11.5%) and encephalitis in 138 cases ( 2.7%). Total hospital charges were approximately (sic) 8.8 million. Conclusion: The nationwide health burden associated with measles during the 2002 - 2003 outbreak was substantial and a high cost was incurred by the Italian National Health Service for the thousands of measles- related hospitalizations which occurred. By assuming that hospital costs represent 40 - 50% of the direct costs of measles cases, direct costs of measles for the two years combined were estimated to be between (sic)17.6 - 22.0 million, which equates to the vaccination of 1.5 - 1.9 million children ( 3 - 4 birth cohorts) with one dose of MMR. The high cost of measles and the severity of its complications fully justify the commitment required to reach measles elimination

Omega-3 supplementation from pregnancy to postpartum to prevent depressive symptoms: a randomized placebo-controlled trial

Background: Low n-3 polyunsaturated fatty acids (PUFAs) has been linked to depression, but the preventive effect of n-3PUFAs supplementation on maternal depression needs further investigation. We aimed to evaluate the efficacy of a daily dose of n-3 PUFAs supplementation (fish oil) on the prevention of postpartum depression (PPD). Methods: A randomized, placebo-controlled, double blind trial was designed and nested into a cohort study conducted in Rio de Janeiro, Brazil. Sixty pregnant women identified as being at risk for PPD were invited and randomly assigned to receive fish oil capsules [1.8 g (1.08 g of Eicosapentaenoic (EPA) and 0.72 g of Docosapentaenoic (DHA) acids)] or placebo (control). The Edinburgh Postnatal Depression Scale (EPDS) was scored at 5–13 (T0, baseline), 22–24 (T1), 30–32 weeks of gestation (T2) and 4–6 weeks’ postpartum (T3). Supplementation started at week 22–24 of gestation (T1) and lasted for 16 weeks. Serum fatty acids were assayed to evaluate compliance. Prevalence of EPDS ≥11 was the primary outcome, and mean and changes in EPDS score, length of gestation, and birth weight the secondary outcomes. Linear mixed-effect (LME) and random-intercept logistic regression models were performed to test the effect of fish oil supplementation on prevalence of EPDS ≥11 and EPDS scores variation. Results: In intention-to-treat (ITT) analysis, at 30–32 weeks’ gestation women in the fish oil presented higher serum concentration of EPA, DHA and lower n-6/n-3 ratio comparing to the control group. There were no differences between intervention and control groups in the prevalence of EPDS ≥11, EPDS scores over time, or in changes in EPDS scores from pregnancy to postpartum in either the ITT or per-protocol analyses. Women in the fish oil group with previous history of depression presented a higher reduction on the EPDS score from the second to the third trimester in the fish oil comparing to the control group in the ITT analyses [−1.0 (−3.0–0.0) vs. -0.0 (−1.0–3.0), P = 0.038). These results were confirmed on the LME model (β = −3.441; 95%CI: -6.532– -0.350, P = 0.029). Conclusion: Daily supplementation of 1.8 g of n-3 PUFAs during 16 weeks did not prevent maternal depressive symptoms in a sample of Brazilian women