Phacoemulsification versus extracapsular extraction: governmental costs

PURPOSE: To evaluate the governmental costs of patients undergoing phacoemulsification and extracapsular cataract extraction at a public hospital in a developing country. METHODS: A prospective study was conduced with 205 patients. The subjects were randomized for cataract surgery using either phacoemulsification or extracapsular cataract extraction techniques. RESULTS: Of the 205 patients, 101 patients were submitted to phacoemulsificationand 104 patients were submitted to extracapsular cataract extraction. Brazilian Health Care System expenditures for the surgery and the postoperative period were US$95.49 more in the phacoemulsification group than in the extracapsular cataract extractiongroup. If we take into account Social Security expenditures, then we estimate that the average difference for the total direct cost for the government for the surgery and the postoperative period for both procedures was US$ 50.91 or approximately half of the initial difference in cost for the phacoemulsification surgery. The total cost of cataract surgery for the government (excluding social security) was estimated at US$258.79 for extracapsular cataract extraction and US$ 309.70 for phacoemulsification per patient. Focusing only on working patients, the total cost was US$342.21 for phacoemulsification and US$ 587.71 for extracapsular cataract extraction, a difference of US$ 245.50. This difference can be considered monetarily and socially justifiable when the benefits of the surgical technique are evaluated. CONCLUSION: Under the conditions of this study, we observed that phacoemulsification was an efficient procedure with regard to the impact on public health care system, when all costs are assessed comprehensively, mainly for subjects with regular jobs

Integrative taxonomy of morphologically indistinguishable species of the genus Psychodopygus (Diptera, Psychodidae), Chagasi series, registered in Brazil

Introdução. A identificação dos flebotomíneos baseia-se principalmente na morfologia do adulto, o que pode ser problemático quando as espécies são morfologicamente muito semelhantes. Psychodopygus é um gênero de flebotomíneos de grande interesse em saúde pública devido ao papel de algumas espécies na veiculação de Leishmania spp. no Brasil. No entanto, este gênero inclui espécies com fêmeas morfologicamente indistinguíveis que pertencem à Série Chagasi, sendo elas: P. chagasi, P. complexus, P. squamiventris maripaensis, P. squamiventris squamiventris e P. wellcomei. Objetivos. Investigar a possibilidade de distinguir essas espécies por meio de análises morfométrica e molecular, além de produzir uma distribuição geográfica atualizada para o grupo analisando a probabilidade de ocorrência das espécies através da análise de modelagem de nicho ecológico. Material e Métodos. Foi realizada a análise discriminante na morfometria geométrica (cabeça e asa) e linear, morfologia (usando microscopia óptica e eletrônica de varredura) e a análise do citocromo c oxidase subunidade 1 (COI), avaliando-se um total de 752 espécimes (460 fêmeas e 292 machos) dos seguintes estados Amapá, Amazonas, Ceará, Mato Grosso, Pará, Rondônia, Roraima e Tocantins. Mapas de distribuição foram produzidos através de dados obtidos do material analisado e de revisão bibliográfica. Resultados. A análise discriminante usando caracteres morfométricos lineares mostrou-se capaz de diferenciar todas as espécies, exceto P. complexus, que apresentou 2,2% de erro de identificação. A morfometria geométrica das asas foi incapaz de separar completamente as espécies através da conformação, mas o tamanho do centróide dos espécimes fêmeas falhou apenas em distinguir P. complexus de P. s. maripaensis. Por outro lado, a morfometria geométrica das cabeças foi capaz de distinguir todas as espécies com grande eficiência ao usar tanto a forma como o tamanho do centróide. A análise morfológica revelou que a coloração torácica, principalmente do pronoto e do pós-noto, pode ser usada para separar as cinco espécies em três grupos: P. chagasi, P. wellcomei / P. complexus e P. s. mariapaensis / P. s. squamiventris. Os resultados da análise de DNA Barcoding, mostraram um agrupamento semelhante ao observado na morfologia; embora os espécimes de P. wellcomei do estado do Ceará mostrem uma grande distância genética da população do estado do Pará, evidenciando que essa espécie possa representar um complexo. Quanto à microscopia eletrônica de varredura, foram avaliadas detalhadamente as estruturas das antenas, tórax e genitália masculina. Salientamos que no anepímero (tórax) foi observada uma escama tipo \"raquete\" modificada apenas em Psychodopygus s. squamiventris. A revisão da distribuição geográfica mostrou que as espécies possuem uma distribuição cis-andina, ocorrendo principalmente no bioma Amazônico. A nítida separação de algumas espécies pelo rio Amazonas, sugere que o surgimento do grupo ocorreu no período que se estende da orogênese dos Andes até a formação deste rio. Conclusões. O estudo possibilitou diferenciar completamente as fêmeas das cinco espécies da Série Chagasi utilizando o conjunto de dados obtidos por morfometria linear e geométrica e análises morfológicas e também apresentar novos caracteres morfológicos e padrões distribucionais que facilitarão a identificação de machos e fêmeas dessas espécies.Introduction. The identification of sand flies is mainly based on adult morphology, which can be problematic when species are morphologically very similar. Psychodopygus is one of the sand fly genera of great interest in public health, due to the role of some species in the transmission of Leishmania spp. in Brazil. However, this genus includes species with morphologically indistinguishable females that belong to the Chagasi series, which includes: P. chagasi, P. complexus, P. squamiventris maripaensis, P. squamiventris squamiventris and P. wellcomei. Objectives. To investigate the possibility of distinguishing among these species by means of morphometric and molecular analyses in addition to producing an updated geographical distribution for the group, analyzing the probability of the occurrence of the species by the analysis of ecological niche modeling. Material and methods. The analyses of the cytochrome c oxidase subunit 1 (COI), geometrical (head and wing) and of linear morphometry and morphology (using optical microscopy and scanning electron microscopy) were carried out using a total of 752 specimens (460 females and 292 males) from the following states: Amapá, Amazonas, Ceará, Mato Grosso, Pará, Rondônia, Roraima e Tocantins. Distribution maps were produced on the basis of data obtained from the material analyzed and a bibliographical review. Results. The discriminant analysis using linear morphometric characters was able to differentiate among all the species, except for P. complexus, which presented a 2.2% error of identification. The geometric morphometry of the wings was unable to completely separate the species by means of the shape analyses, but the centroid size of the female specimens only failed to distinguish P. complexus from P. s. maripaensis. Otherwise, the geometric morphometry of the heads was sufficient to distinguish all the species with great efficiency, when using both the head-shape and the centroid size. The morphological analysis revealed that the thoracic coloration, mainly of the pronotum and the post-notum, can be used to separate the five species into three groups: P. chagasi, P. wellcomei / P. complexus, P. s. mariapaensis / P. s. squamiventris. The results of the Barcoding DNA analyses showed a cluster similar to that observed in the morphology; however, P. wellcomei specimens from the Ceará population showed a great genetic distance from the population of Pará, evidencing that this species may represent a complex. As for the scanning electron microscopy, the structures of the antennae, thorax and male genitalia were evaluated in detail. In the anepimerum (thorax) a modified \"racket\"-type scale was observed only in Psychodopygus s. squamiventris. The review of the geographical distribution showed that the species have a cis-Andean distribution, occurring mainly in the Amazonian biome. The separation of some species from the others by the Amazon river suggests that the appearance of the Chagasi series occurred in the period from the orogenesis of the Andes to the formation of this river. Conclusions. The results clearly differentiate the females of the five species of the Chagasi series using the data set of linear and geometric morphometry and morphological analyses, providing new morphological and distributional data that will facilitate the identification of the males and females of this group

Estudo morfológico e morfométrico comparativo de espécies de flebotomíneos (diptera:psychodidae:phlebotominae) dos gêneros nyssomyia barretto, 1962, bichromomyia artemiev, 1991 e migonemyia galati, 1995, vetores de leishmânias dermotrópicas, no Brasil

Made available in DSpace on 2015-10-21T12:19:30Z (GMT). No. of bitstreams: 2 rodrigo_godoy_ioc_mest_2012.pdf: 4319793 bytes, checksum: 12512310f752b37e87a767cc8d0a9bae (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2015-05-21Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, BrasilPhlebotominae representa um dos grupos de insetos de grande importância médica, especialmente para o Brasil, estando associado à transmissão de agentes das leishmanioses tegumentar e visceral. A geração de conhecimentos sobre a morfologia e morfometria de ambos, machos e fêmeas de flebotomíneos vetores de leishmaniose tegumentar americana (LTA), poderão indicar estruturas diagnósticas importantes como subsídios para estudos filogenéticos que permitam avaliar a relação vetor -patógeno no processo de coevolução. Com isso o trabalho teve como objetivo analisar comparativamente as seguintes espécies de flebotomíneos: Nyssomyia intermedia, Ny. neivai, Ny. whitmani, Migonemyia migonei e Bichromomyia flaviscutellata, importantes vetores de Leishmania spp., causadores da LTA no Brasil. As análises morfométricas foram capazes de separar os gêneros. A análise comparativa dos flebotomíneos por morfometria geométrica e clássica, permitiu aprofundar a discussão sobre a posição taxonômica de Ny. intermedia e Ny. neivai, consideradas por alguns autores como espécies crípticas, onde houve diferença significativa em várias das estruturas analisadas, como no tamanho do centroide das asas e a razão entre os filamentos genitais e a ponta dos filamentos genitais. Através das análises de morfometria clássica e do tamanho dos centróides e as formas médias das asas, as espécies de Nyssomyia se apresentam mais próximas feneticamente de Mg. migonei, vetores de Leishmania (Viannia) braziliensis, do que de Bi. flaviscutellata, vetora de Leishmania (Leishmania) amazonensis, o que também corrobora com a separação dos gêneros Nyssomyia e BichromomyiaPhlebotominae represents one group of insects of medical importance, especially in Brazil being associated with the transmission of agents of cutaneous and visceral leishmanias e s . The generation of knowledge about the morphology and morphometry of both male and female sandfly vectors of American c utaneous l eishmaniasis (ACL) may indicate structures as important diagnostic information for phylogenetic studies to assess the relationship of vector - pathogen coevolution . In this aspect the work was to analyze comparatively the following species of sandflies : Nyss omyia intermedia, Ny. neivai, Ny. whitmani, Migonemyia migonei and Bichromomyia flaviscutellata , important vectors of Leishmania spp ., causing leishmaniasis in Brazil. The morphometric analyzes were able to separate the genders. The comparative analysis of sandflies by classical and geometric morphometr y allowed us to discuss about the taxonomic position of Ny. intermedia and Ny. neivai , considered by some authors as cr yptic species , where significant differences were observed in several structures analyzed as the centroid size of the wings and the ratio between the genital filaments and the tip of the genital filaments . The classical morphometric analysis, size of the centroids of the wings as well as the mean forms of the wings showed Nyssomyia close st phe netically to Mg. migonei , vectors of Leishmania (Viannia) braziliensis , than Bi. flaviscutellata , vector of Leishmania (Leishmania) amazonensis , these results also corroborate with the separation of the genders Nyssomyia and Bichromomyi

leishmaniasis in Brazil

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The phlebotomine fauna (Diptera: Psychodidae) of Guaraí, state of Tocantins, with an emphasis on the putative vectors of American cutaneous leishmaniasis in rural settlement and periurban areas

Phlebotomine sandflies were captured in rural settlement and periurban areas of the municipality of Guaraí in the state of Tocantins (TO), an endemic area of American cutaneous leishmaniasis (ACL). Forty-three phlebotomine species were identified, nine of which have already been recognised as ACL vectors. Eleven species were recorded for the first time in TO. Nyssomyia whitmani was the most abundant species, followed by Evandromyia bourrouli, Nyssomyia antunesi and Psychodopygus complexus. The Shannon-Wiener diversity index and the evenness index were higher in the rural settlement area than in the periurban area. The evaluation of different ecotopes within the rural area showed the highest frequencies of Ev. bourrouli and Ny. antunesi in chicken coops, whereas Ny. whitmani predominated in this ecotope in the periurban area. In the rural settlement area, Ev. bourrouli was the most frequently captured species in automatic light traps and Ps. complexus was the most prevalent in Shannon trap captures. The rural settlement environment exhibited greater phlebotomine biodiversity than the periurban area. Ps. complexus and Psychodopygus ayrozai naturally infected with Leishmania (Viannia) braziliensis were identified. The data identified Ny. whitmani as a potential ACL vector in the periurban area, whereas Ps. complexus was more prevalent in the rural environment associated with settlements

Studies on Phlebotominae (Diptera: Psychodidae) in the Campus FIOCRUZ Mata Atlântica, Jacarepaguá, in the City of Rio de Janeiro, Brazil

INTRODUCTION: The presence of American cutaneous leishmaniasis (ACL) in the communities of the Campus FIOCRUZ Mata Atlântica (CFMA) in the City of Rio de Janeiro initiated the investigation of the Phlebotominae fauna in the Atlantic Forest to determine the occurrence of putative ACL vectors associated with the enzootic cycle. METHODS: For 24 consecutive months, sand flies were captured inside the forest and in the border area near the communities. RESULTS: The following sand fly species were identified: Brumptomyia brumpti, Brumptomyia cunhai, Brumptomyia nitzulescui, Lutzomyia edwardsi, Lutzomyia pelloni, and Lutzomyia quinquefer. Other identified sand fly vectors, such as Lutzomyia intermedia (the predominant species), Lutzomyia migonei, Lutzomyia whitmani, Lutzomyia fischeri, and Lutzomyia hirsuta hirsuta, are associated with ACL transmission, and the vector for American visceral leishmaniases (AVL), Lutzomyia longipalpis, was also found. CONCLUSIONS: All sand fly vectors were found in both studied environments except for Lutzomyia whitmani, which was only identified in the forest. This study represents the first identification of Lutzomyia longipalpis in the CFMA, and the epidemiological implications are discussed

Geometric morphometry of the head in sand flies (Diptera: Psychodidae: Phlebotominae), an alternative approach to taxonomy studies

Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brazil / Fundação Osvaldo Cruz. Instituto Osvaldo Cruz. Laboratório Interdisciplinar de Vigilância Entomológica em Diptera e Hemiptera. Rio de Janeiro, RJ, Brazil.Fundacao Osvaldo Cruz. Instituto René Rachou. Grupo de Estudos Leishmanioses. Coleção Flebotomineos. Belo Horizonte, MG, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Laboratório de Leishmanioses. Ananindeua, PA, Brasil.Fundação Osvaldo Cruz, Instituto Leônidas & Maria Deane. Laboratório Ecologia de Doenças Transmissíveis na Amazônia. Manaus, AM, Brazil.Secretaria Estadual de Saúde de Rondônia. Laboratório Central de Saúde Publica de Rondônia Anita Garibalde. Porto Velho, RO, Brazil.Secretaria da Saúde do Estado Ceará. Laboratório de Entomologia Médica Dr. Thomaz Corrêa Aragão. Fortaleza, CE, Brazil.Fundação Osvaldo Cruz. Instituto Osvaldo Cruz. Laboratório Interdisciplinar de Vigilância Entomológica em Diptera e Hemiptera. Rio de Janeiro, RJ, Brazil.Fundação Osvaldo Cruz. Instituto Osvaldo Cruz. Laboratório Interdisciplinar de Vigilância Entomológica em Diptera e Hemiptera. Rio de Janeiro, RJ, Brazil.Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brazil.Almost 30% of female American sand flies are morphologically indistinguishable from one another. These females belong to species-complexes or groups with closely related species, making species-level identification difficult or even impossible. This fact has implications for public health since several of these groups include species which are vectors of human pathogens. Thus, new tools are needed to minimize species-level identification problems. In this context, our research sought to use geometric morphometry in the study of the head of females of closely related species of the genus Psychodopygus, Chagasi series, which includes the following species: P. chagasi, P. complexus, P. squamiventris maripaensis, P. squamiventris squamiventris, and P. wellcomei. We have used ten landmarks distributed on the head of these species. All species were clearly distinguished using the centroid size and shape together. These results highlight the head analysis as an effective tool for future geometric morphometry studies in sand flies

Scanning electron microscopy of sand flies of the Chagasi series, Psychodopygus (Diptera: Psychodidae) genus, focusing on the genitalia

Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brazil / Instituto Oswaldo Cruz. Laboratório Interdisciplinar de Vigilância Entomológica em Díptera e Hemiptera. Rio de Janeiro, RJ, Brazil.Instituto Oswaldo Cruz. Laboratório Interdisciplinar de Vigilância Entomológica em Díptera e Hemiptera. Rio de Janeiro, RJ, Brazil.Instituto Oswaldo Cruz. Laboratório Interdisciplinar de Vigilância Entomológica em Díptera e Hemiptera. Rio de Janeiro, RJ, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Fundação Oswaldo Cruz. Instituto Leônidas and Maria Deane. Laboratório de Ecologia de doenças transmissíveis na Amazônia. Manaus, AM, Brasil.Secretaria Estadual de Saúde de Rondônia. Laboratório Central de Saúde Pública. Rondônia, RO, Brazil.Instituto Oswaldo Cruz. Laboratório Interdisciplinar de Vigilância Entomológica em Díptera e Hemiptera. Rio de Janeiro, RJ, Brazil.Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brazil.Males of cryptic or closely related species present great morphological variation in their genitalia, whereas females, such as those of the Chagasi Series of the Psychodopygus Mangabeira, 1941 genus, are more similar. Therefore, our aim was to study the fine structure of the male genitalia of five species of the Chagasi Series to better understand the variation in their morphology and its influence on the copulatory process. The sand fly species were captured in the following Brazilian states: Psychodopygus chagasi (Costa Lima, 1941) (Rondônia), Psychodopygus complexus (Mangabeira, 1941) (Tocantins), Psychodopygus squamiventris maripaensis (Floch & Abonnenc, 1946) (Amapá), Psychodopygus squamiventris squamiventris (Lutz & Neiva, 1912) (Amazonas), and Psychodopygus wellcomei Fraiha, Shaw & Lainson, 1971 (Pará and Ceará). Insects were stored in ethanol 70% (then dehydrated) and dry after they were sputtered with gold. The samples were observed under a scanning electron microscope. Microtrichiae, two types of trichoid sensilla, coeloconic and chaetic sensillae, were observed on the antenna of all species, with no difference between them. Only on the anepimeron of P. squamiventris squamiventris a modified ‘racket’-like scale was observed. As for the male genitalia, the setae and structures of each species were fully described, such as the small setae on the paramere apex of the P. squamiventris subspecies, and the grooves present in this region and on the paramere lobe of P. complexus and P. wellcomei, which are impossible to observe with optic microscopy. New information is thus provided on the male genitalia, which can contribute to future bionomic studies of these species

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data