The clinical effectiveness of insulin glargine in patients with Type I diabetes in Brazil: findings and implications

Aims: Published studies have challenged the cost-effectiveness of insulin glargine versus NPH insulins in Brazil with limited evidence of increased effectiveness despite considerably higher acquisition costs. However, still a controversy. Consequently, a need to address this. Methods: Retrospective cohort study of type 1 diabetes patients receiving insulin glargine in Brazil following NPH insulin who met the criteria. Results: 580 patients were enrolled. HbA1c varied from 8.80 ± 1.98% in NPH insulin users to 8.54 ± 1.88% after insulin glargine for six months, which is not clinically significant. Frequency of glycemic control varied from 22.6% with NPH insulin to 26.2% with insulin glargine. No statistically significant difference was observed between controlled and still uncontrolled groups for all analyzed factors including type and frequency of insulin use and carbohydrate counting. Conclusions: Limited differences between NPH insulins and insulin analogues in routine clinical care does not justify an appreciable cost difference

Presence of Lutzomyia longipalpis (Diptera: Psychodidae) in the Parque Estadual da Serra da Tiririca, State of Rio de Janeiro, Southeastern Brazil

Abstract INTRODUCTION: The sand fly, Lutzomyia longipalpis, is the main vector of Leishmania infantum in the Americas, primarily occurring in areas of apparent anthropomorphic modifications in several regions of Brazil. METHODS Sand flies were captured using light traps. RESULTS Out of all captured species, Lu. longipalpis numbers had increased within the park. CONCLUSIONS We report the occurrence of Lu. longipalpis in an area of Atlantic Forest, possibly representing the first sylvatic population of Lu. longipalpis in an area absent of peridomestic captures, but with the risk of L. infantum transmission in the areas of Niterói and Maricá

Presence of Lutzomyia longipalpis (Diptera: Psychodidae) in the Parque Estadual da Serra da Tiririca, State of Rio de Janeiro, Southeastern Brazil

Abstract INTRODUCTION: The sand fly, Lutzomyia longipalpis, is the main vector of Leishmania infantum in the Americas, primarily occurring in areas of apparent anthropomorphic modifications in several regions of Brazil. METHODS Sand flies were captured using light traps. RESULTS Out of all captured species, Lu. longipalpis numbers had increased within the park. CONCLUSIONS We report the occurrence of Lu. longipalpis in an area of Atlantic Forest, possibly representing the first sylvatic population of Lu. longipalpis in an area absent of peridomestic captures, but with the risk of L. infantum transmission in the areas of Niterói and Maricá

Efficacy, safety and effectiveness of ondansetron compared to other serotonin-3 receptor antagonists (5-HT₃RAs) used to control chemotherapy-induced nausea and vomiting: systematic review and meta-analysis

<p><b>Introduction</b>: Chemotherapy-induced nausea and vomiting are adverse effects responsible for worsening quality of life in cancer patients. To assess the efficacy, safety and effectiveness of serotonin receptor antagonist in cancer patients undergoing chemotherapy, comparing ondansetron with granisetron, dolasetron, tropisetron and palonosetron.</p> <p><b>Areas covered</b>: Systematic review and meta-analysis. The data were collected using CINAHL; CENTRAL; MEDLINE/PubMed; and LILACS databases; grey literature; and manual search. The methodological quality was assessed using the modified Jadad scale; Cochrane Collaboration’s tool for assessing risk of bias in randomized clinical trials and the Newcastle-Ottawa Scale for observational studies. The search was completed in November, 2015. 26 studies were included in the meta-analysis. Ondansetron exhibited similar efficacy than granisetron and tropisetron, as well as greater efficacy than dolasetron for acute vomiting. Palonosetron exhibited greater efficacy than ondansetron for delayed nausea and acute and delayed vomiting. The comparison of granisetron with ondansetron in the cohort studies showed no difference.</p> <p><b>Expert commentary</b>: In this review, palonosetron had increased efficiency compared with ondansetron, except in the subgroup analysis and acute nausea. Few cohort studies have been published addressing this topic.</p

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora