FITOTERAPIA NO CONTROLE DE PARASITOS GASTRINTESTINAIS DE RUMINANTES: ÊNFASE NO GÊNERO MENTHA E SEUS COMPONENTES BIOATIVOS

Essa revisão apresenta considerações acerca da relevância das infecções de parasitos gastrintestinais (PGI) em ruminantes, abordando a importância de fármacos antiparasitários no controle das helmintoses e demais alternativas. Foi realizada uma abordagem conceitual e histórica sobre o controle de PGI e o processo de desenvolvimento da resistência parasitária. Como alternativa da baixa eficácia de medicamentos, foi feita uma descrição detalhada sobre o uso de óleos essenciais (OE) e de componentes bioativos no controle das PGI em ruminantes. A produção de OE de plantas, passa pela composição química, técnicas de extração dos componentes, mecanismo de ação e ensaios para validação da sua atividade terapêutica, incluindo sua ação anti-helmíntica. Este artigo traz, na sua segunda parte, uma descrição detalhada de duas espécies do gênero Mentha, com foco em sua biologia, composição química e mecanismos de ação de seus OE. Dentro desse tópico, as espécies Mentha vilosa e M. piperita são as mais estudadas, bem como os seus componentes majoritários e bioativos; carvone e limoneno. Ao final do documento, discutimos sobre a técnica de cromatografia gasosa e espectrometria de massas, que se faz obrigatória para a identificação de compostos presentes em OE. Incluímos ainda, o detalhamento sobre tecnologias de nanoemulsão e suas vantagens na confecção de formulações mais estáveis, menos tóxicas aos hospedeiros e com potencial de aumentar a eficácia de fármacos contra as PGI, para o desenvolvimento de novos compostos fitoterápicos ecosustentáveis.This review presents considerations about the relevance of gastrointestinal parasite (GIP) infections in ruminants, covering also the importance of antiparasitic drugs in the control of helminth infections and some other alternatives. This document describes a conceptual and historical view of the development of routine GIP control and the process of development of drug resistance. As an alternative to the low efficacy of some products, a detailed description was made of the use of essential oils (EO) and their bioactive compounds in the control of GIP in ruminants. The production of EO from plants, goes through the chemical composition, techniques of extraction of components, mechanism of action and assays for the validation of their activity, including the anthelmintic activity. The present document brings, in its second part, a more detailed description of two species of the genus Mentha, focusing on their biology, chemical composition and the mechanism of action of their EO. Within this topic, the species of Mentha vilosa and M. piperita are better studied, as well as their chemical composition and bioactive components carvone and limonene. At the end, it is discussed the gas chromatography and mass spectrometry techniques that are useful to identify compounds present in EO. It was also included the details about nanoemulsion technologies and their advantages in obtaining a more stable formulation, less toxic to the host, with a great potential to increase anthelmintic efficacy against GIP, for the development of new herbal bioactive and ecofriendly compounds

ICAR: endoscopic skull‐base surgery

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The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS