Terapia oral como primeira escolha para tratamento de necrose retiniana aguda: um relato de caso/ Oral therapy as the first choice for treating acute retinal necrosis: a case report

A necrose retiniana aguda (NRA) é uma doença inflamatória ocular rara, de etiologia, principalmente viral, que tem como desfecho, em sua maioria dos casos, a cegueira. Esta patologia é tradicionalmente tratada com aciclovir intravenoso seguido de aciclovir oral por um extenso periodo. Porém, o aciclovir oral não atinge concentrações vítreas capazes de inibir a ação dos principais causadores virais da doença. Contudo, antivirais mais recentes, como o valaciclovir e o famciclovir, tem demonstrado boa biodisponibilidade oral, permitindo mudança em direção ao tratamento ambulatorial e diminuindo tratamento hospitalar de alto custo e exposição do paciente a novos patógenos hospitalares

Medical Students’ Awareness About Value-Based Health Care in Brazil: A Cross Sectional Study

Background: Rising healthcare costs demand a transition from the current fee-for-service to a Value-Based Health Care (VBHC) Model. This requires that all future doctors to understand the VBHC Model. We aimed to evaluate the VBHC awareness among Brazilian medical students and to identify it’s associated intrinsic/extrinsic factors through a survey-based, cross-sectional study. Methods: An online survey was sent to students from Brazilian medical schools. A descriptive analysis based on participants' level of awareness about VBHC was performed. The categorical variables included were absolute and relative frequencies using chi-square tests. A multivariate binary logistic regression analysis was performed by calculating the odds ratio (OR) and 95% confidence intervals (95%CI) to compare each response according to VBHC awareness. Results: We collected 3030 responses from 148 Medical Schools across all Brazilian states. Medical students were compared into 2 groups; 1 was familiar with VBHC (14%; 426); 2 were not (86%; 2575). The univariate analysis showed that group 1 was more willing to share clinical outcomes/costs data related to their practice (57.04%) compared to 2 (48.12%), p<0.01. The multivariate analysis showed that internship experience was the most relevant factor associated with VBHC exposure (OR 4.32 [CI 95% 1.82 - 10.24]). Conclusion: We found that few medical students understand VBHC concepts, and that exposure was due to self-education efforts. Our results suggest that medical schools have the potential to reinforce both intrinsic and extrinsic factors related to students with regards to VBHC knowledge in order to prepare future doctors to practice in a value-driven context

The economic costs of biological invasions in Central and South America: a first regional assessment

Invasive alien species are responsible for a high economic impact on many sectors worldwide. Nevertheless, there is a scarcity of studies assessing these impacts in Central and South America. Investigating costs of invasions is important to motivate and guide policy responses by increasing stakeholders’ awareness and identifying action priorities. Here, we used the InvaCost database to investigate (i) the geographical pattern of biological invasion costs across the region; (ii) the monetary expenditure across taxa and impacted sectors; and (iii) the taxa responsible for more than 50% of the costs (hyper-costly taxa) per impacted sector and type of costs. The total of reliable and observed costs reported for biological invasions in Central and South America was USD 102.5 billion between 1975 and 2020, but about 90% of the total costs were reported for only three countries (Brazil, Argentina and Colombia). Costs per species were associated with geographical regions (i.e., South America, Central America and Islands) and with the area of the countries in km2. Most of the expenses were associated with damage costs (97.8%), whereas multiple sectors (77.4%), agriculture (15%) and public and social welfare (4.2%) were the most impacted sectors. Aedes spp. was the hyper-costly taxon for the terrestrial environment (costs of USD 25 billion) and water hyacinth (Eichhornia crassipes) was the hyper-costly taxon for the aquatic environment (USD 179.9 million). Six taxa were classified as hyper-costly for at least one impacted sector and two taxa for at least one type of cost. In conclusion, invasive alien species caused billions of dollars of economic burden in Central and South America, mainly in large countries of South America. Costs caused by invasive alien species were unevenly distributed across countries, impacted sectors, types of costs and taxa (hyper-costly taxa). These results suggest that impacted sectors should drive efforts to manage the species that are draining financial sources.info:eu-repo/semantics/publishedVersio

Análise sobre acidentes em humanos por ofídicos

The aim was to identify the medical conduct against snakebites in the literature. This is a descriptive study of a critical-reflexive nature, with a qualitative approach. Three categories were established for analysis, such as: Ophidian accidents, Medical conducts and Permanent education. It was noted the importance of recognizing snakes and knowledge of clinical management in the establishment of an appropriate medical conduct and that, for this, it is necessary for the professional to have a continuing education in their work environment. It is concluded that their accidents constitute a public health problem, with the highest number of accidents in rural areas, in patients of economically active age; regarding the anatomical part, the lower limbs were the most affected; Regarding seasonality, the months from October to December were more frequent and most patients sought immediate help, up to 3 hours after the accident. Among the accidents, the most frequent local manifestations were pain and edema. Most cases were classified as mild and the number of deaths extremely low. The results showed a lack in the taxonomic description and the scarcity of scientific materials that addressed the medical conduct to be taken in the face of accidents with snakes.Objetivou-se identificar a conduta médica frente aos acidentes ofídicos na literatura. Trata-se de um estudo descritivo de caráter crítico-reflexivo, de abordagem qualitativa. Estabeleceu-se três categorias para análise, tais quais: Acidentes ofídicos, Condutas médicas e Educação permanente. Notou-se a importância do reconhecimento das serpentes e conhecimento do manejo clínico no estabelecimento de uma conduta médica adequada e que, para isso, torna-se necessário que o profissional tenha uma educação continuada em seu ambiente laboral. Conclui-se que seus acidentes constituem um problema de saúde pública, sendo o maior número de acidentes na zona rural, em pacientes com idade economicamente ativa; com relação a parte anatômica, os membros inferiores foram os mais acometidos; com relação a sazonalidade, os meses de outubro a dezembro tiveram maior frequência e a maioria dos pacientes procuraram socorro imediato, até 3 horas após o acidente. Dentre os acidentes, as manifestações locais mais frequentes foram dor e edema. A maioria dos casos foram classificados como leves e o número de óbito extremamente baixos. Os resultados evidenciaram carência na descrição taxonômica e a escassez de materiais científicos que abordavam sobre as condutas médicas a serem tomadas frente aos acidentes com serpentes das serpentes

Análise sobre acidentes em humanos por ofídicos

The aim was to identify the medical conduct against snakebites in the literature. This is a descriptive study of a critical-reflexive nature, with a qualitative approach. Three categories were established for analysis, such as: Ophidian accidents, Medical conducts and Permanent education. It was noted the importance of recognizing snakes and knowledge of clinical management in the establishment of an appropriate medical conduct and that, for this, it is necessary for the professional to have a continuing education in their work environment. It is concluded that their accidents constitute a public health problem, with the highest number of accidents in rural areas, in patients of economically active age; regarding the anatomical part, the lower limbs were the most affected; Regarding seasonality, the months from October to December were more frequent and most patients sought immediate help, up to 3 hours after the accident. Among the accidents, the most frequent local manifestations were pain and edema. Most cases were classified as mild and the number of deaths extremely low. The results showed a lack in the taxonomic description and the scarcity of scientific materials that addressed the medical conduct to be taken in the face of accidents with snakes.Objetivou-se identificar a conduta médica frente aos acidentes ofídicos na literatura. Trata-se de um estudo descritivo de caráter crítico-reflexivo, de abordagem qualitativa. Estabeleceu-se três categorias para análise, tais quais: Acidentes ofídicos, Condutas médicas e Educação permanente. Notou-se a importância do reconhecimento das serpentes e conhecimento do manejo clínico no estabelecimento de uma conduta médica adequada e que, para isso, torna-se necessário que o profissional tenha uma educação continuada em seu ambiente laboral. Conclui-se que seus acidentes constituem um problema de saúde pública, sendo o maior número de acidentes na zona rural, em pacientes com idade economicamente ativa; com relação a parte anatômica, os membros inferiores foram os mais acometidos; com relação a sazonalidade, os meses de outubro a dezembro tiveram maior frequência e a maioria dos pacientes procuraram socorro imediato, até 3 horas após o acidente. Dentre os acidentes, as manifestações locais mais frequentes foram dor e edema. A maioria dos casos foram classificados como leves e o número de óbito extremamente baixos. Os resultados evidenciaram carência na descrição taxonômica e a escassez de materiais científicos que abordavam sobre as condutas médicas a serem tomadas frente aos acidentes com serpentes das serpentes

Fitossociologia de plantas daninhas em cultivos de feijão sobre diferentes manejos de herbicidas

Knowledge on changes in weeds communities caused by weeds management practices is important when effective strategies for the control of these species are set. A field experiment was conducted to assess the effects of herbicides applications with different sprayer boom heights on the weeds dynamics and beans yield. A 3x4+1 factorial arrangement was adopted, comprised of the combination of three herbicides (fomesafen. fluazifop-p-butyl and a mixture of both) and four different boom heights (0.20; 0.30; 0.40 and 0.50 m above target) and one control (non-weeded check). Thirty days after application (DAA), the following phytosociological indices were determined: relative frequency, relative density, relative dominance, and importance value. Sixty days DAA, yield rates were determined. Prior to the experiment installation, 22 species were identified in the entire experimental area. The species Alternanthera tenella, Chelidonium majus, Digitaria horizontalis and Bidens pilosa dominated the area where there was no weed control. Reduced boom heights for application of fomesafen diminished the importance of dicot species. In the plots with fomesafen + fluazifop-p-butyl applications, the number of dicot weeds was greater than the other species, with predominance of A. tenella e B. pilosa. In general, the similarity index between the different herbicides and different boom heights was low, which indicates that the treatments used result in different weeds populations. Bean crops reduces the weeds diversity, and the application of herbicides has a positive effect on weeds infestation, with consequent gains in productivity.O conhecimento das alterações na comunidade infestante provocado pelo manejo de plantas daninhas é importante para definição de estratégias eficientes para o controle destas. Realizou-se um experimento de campo para avaliar os efeitos do uso de herbicidas em diferentes alturas de barra na dinâmica de plantas daninhas e produtividade do feijoeiro. Adotou-se arranjo fatorial em esquema 3x4+1, constituído pela combinação de três herbicidas (fomesafen, fluazifop-p-butil e sua mistura) e quatro alturas de barras do pulverizador (0,20; 0,30; 0,40 e 0,50 m) e mais a testemunha sem capina. Aos 30 dias após aplicação (DAA) determinou-se os seguintes índices fitossociológicos: frequência relativa, densidade relativa, dominância relativa, índice de valor de importância e índice de similaridade. Aos 60 DAA foi determinada a produtividade. Antes da instalação do experimento foram identificadas 22 espécies em toda área experimental. As espécies Alternanthera tenella, Chelidonium majus, Digitaria horizontalis e Bidens pilosa predominaram na área cultivada em que não houve controle. A redução da altura de barras na aplicação do fomesafen reduziu a importância das espécies eudicotiledôneas. Nas parcelas com aplicação de fomesafen + fluazifop-p-butil o número de infestantes eudicotiledôneas foi superior às demais, com predominância de A. tenella e B. pilosa. No geral, o índice de similaridade entre os diferentes herbicidas e as diferentes alturas de barra foi baixo, o que indica que os tratamentos aplicados resultam em diferentes populações de plantas daninhas. O feijoeiro reduz a diversidade de plantas daninhas e a aplicação de herbicidas altera a infestação destas com consequência no ganho em produtividade

TOLERÂNCIA DE PLANTAS JOVENS DE CAFÉ A HERBICIDAS APLICADOS ISOLADAMENTE OU EM MISTURA COM O FERTILIZANTE FERTIACTYL

The control of weeds in the coffee crop is hampered by the scarcity of selective herbicides for the growing crop. An alternative to circumvent the damage caused by herbicides is the use of chemical protectors with the ability to minimize herbicide intoxication. The objective was to evaluate the selectivity of herbicides applied alone or in a mixture in the tank with Fertiactyl Sweet® for recently transplanted coffee plants. The experiment was carried out in pots in a completely randomized design, in a 10x2 factorial scheme, with four replications. The first factor corresponded to nine herbicides: (oxyfluorfen; sulfentrazone; flumioxazin; [isoxaflutole + indaziflam]; isoxaflutole; indaziflam; [metribuzin + indaziflam]; chlorimuron-ethyl; and metsulfuron-methyl) and control without herbicide application; the second factor was the presence or absence of Fertiactyl Sweet. The treatments were applied “over the top” at 30 days after transplanting. From 7 to 172 days after application (DAA), the percentage of intoxication was evaluated. And at 172 DAA, the morphological variables of the plants were measured. The addition of Fertiactyl Sweet next to the herbicide syrup did not change the tolerance of coffee plants to herbicides. The most tolerant herbicides for coffee were oxyfluorfen and sulfentrazone. The commercial mixture indaziflam + metribuzin caused the death of the coffee seedlings. Fertiactyl Sweet® did not reduce the poisoning of Arabica coffee seedlings (Catuaí Vermelho - lineage 44) caused by the studied herbicides. The herbicides metsulfuron-methyl and oxyfluorfen were the most tolerated by recently transplanted coffee plants.O controle de plantas daninhas na cultura do cafeeiro é dificultado pela escassez de herbicidas seletivos para a cultura em fase de implantação. Uma alternativa para contornar os danos causados pelos herbicidas é o uso de protetores químicos com capacidade de minimizar a intoxicação dos herbicidas. Objetivou-se avaliar a seletividade de herbicidas aplicados isoladamente ou em mistura no tanque com o Fertiactyl Sweet® para plantas de café recém-transplantadas. O experimento foi realizado em vasos em delineamento inteiramente casualizado, em esquema fatorial 10x2, com quatro repetições. O primeiro fator correspondeu a nove herbicidas: (oxyfluorfen; sulfentrazone; flumioxazin; [isoxaflutole + indaziflam]; isoxaflutole; indaziflam; [metribuzin + indaziflam]; chlorimuron-etílico; e metsulfuron-metílico) e o controle sem aplicação de herbicida; o segundo fator constou da presença ou ausência do Fertiactyl Sweet. Os tratamentos foram aplicados em “over the top” aos 30 dias após o transplantio. De 7 aos 172 dias após a aplicação (DAA), avaliou-se a porcentagem de intoxicação. E aos 172 DAA, mensurou-se as variáveis morfológicas das plantas. A adição do Fertiactyl Sweet junto à calda dos herbicidas não modificou a tolerância das plantas de café aos herbicidas. Os herbicidas mais tolerantes para o café foram o oxyfluorfen e o sulfentrazone. A mistura comercial indaziflam + metribuzin causou a morte das mudas de café. O Fertiactyl Sweet® não reduziu a intoxicação das mudas de café arábica (Catuaí vermelho - linhagem 44) causada pelos herbicidas estudados. Os herbicidas metsulfuron-metílico e oxyfluorfen foram os mais tolerados pelas plantas de café recém-transplantadas

Fitotoxicidade de herbicidas aplicados em pós transplantio de mudas de maracujá amarelo

Brazil is the world’s leading producer of passion fruit. However, for this crop, there are no records of herbicides for weed control. Thus, the aim of this study was to evaluate the effects of herbicide application after transplanting of yellow passion fruit seedlings during growth and phytotoxicity of the crop. Twenty-one herbicides with different mechanisms of action were tested by application at 35 days after transplanting (DAT). Phytotoxicity of the crop by the herbicides was evaluated at 63 DAT, and assessments of damage to seedlings were held at 70 days DAT. No herbicide caused damage to the root system of the passion fruit plants. The herbicides glyphosate, imazapic, metsulfuron-methyl and glufosinate-ammonium reduced plant height gain. The herbicides atrazine, linuron, metribuzin, diuron, tebuthiuron and bentazon reduced leaf dry matter, stem dry matter and total dry matter of the plants. Fluazifop-p-butyl reduced height gain and leaf dry matter. Herbicides that caused the greatest damage to seedling growth also caused the greatest phytotoxicity. The herbicides oxadiazon, fenoxaprop-ethyl, tembotrione, chlorimuron-ethyl and isoxaflutole did not hinder growth and did not intoxicate the seedlings; they were the most promising for use in the total area.O Brasil é o principal produtor de maracujá do mundo, todavia, para esta cultura não existe registro de herbicidas no controle de plantas daninhas. Sendo assim, o objetivo deste experimento foi avaliar os efeitos da aplicação de herbicidas após o transplantio de mudas de maracujá amarelo no crescimento e intoxicação da cultura. Foram testados 21 herbicidas de diferentes mecanismos de ação aplicados aos 35 dias após transplantio (DAT). Aos 63 dias DAT foram avaliadas as intoxicações causadas pelos herbicidas na cultura, e aos 70 dias DAT foram realizadas as avaliações dos danos causados às mudas. Nenhum herbicida causou danos ao sistema radicular das plantas de maracujá. Os herbicidas glifosate, imazapic, metsulfuron-methyl e amonio-glufosinate, causaram reduções no ganho em altura das plantas. Os herbicidas atrazine, linuron, metribuzin, diuron, tebuthiuron e bentazon reduziram a matéria seca da folha, caule e total das plantas. O fluazifop-p-butil reduziu o ganho em altura e a matéria seca de folhas. Os herbicidas que causaram os maiores danos no crescimento das mudas, também causaram maiores intoxicações. Os herbicidas oxadiazon, fenoxaprop-ethyl, tembotrione, chlorimuron-ethyl e isoxaflutole não prejudicaram o crescimento e não intoxicaram as mudas, sendo os mais promissores para aplicação em área total

Indicators species of saflufenacil residue in soils

Um dos métodos, eficientes e de baixo custo, para estimar a presença de herbicidas no solo é o biológico. Entretanto, antes de se utilizar este método é necessário identificar espécies que apresentam alta sensibilidade ao herbicida em estudo. Esta pesquisa teve como objetivo selecionar espécies que apresentem alta sensibilidade ao saflufenacil para posteriores estudos da dinâmica desse herbicida no solo. Foram avaliadas a sensibilidade de sete espécies de plantas ao saflufenacil (Curcubita pepo, Beta vulgaris, Daucus carota, Citrullus lanatus, Cucumis sativus, Sorghum bicolor e Solanum lycopersicum). Para isso, estas espécies foram cultivadas em substrato inerte (areia lavada) tratado com doses crescentes do saflufenacil (0,0; 0,625; 1,25; 2,50; 5,0; 10,0 e 20,0 g ha-1). As espécies B. vulgaris, S. lycopersicum e S. bicolor foram as mais sensíveis ao saflufenacil. Dentre estas espécies, B. vulgaris é de fácil cultivo, crescimento rápido e permite rápida visualização dos sintomas de intoxicação. Concluiu-se que B. vulgaris pode ser considerada como indicadora da presença do saflufenacil na solução do solo para estudos da dinâmica desse herbicida em solos.One of the methods, efficient and low cost, to estimate the presence of herbicides in the soil is the biological. However, before using this method it is necessary to identify species that have high sensitivity to the herbicide under controlled conditions. This research aimed to select species that show high sensitivity to saflufenacil for later studies of the dynamics of this herbicide in soil. The sensitivity of seven plants species to saflufenacil (Curcubita pepo, Beta vulgaris, Daucus carota, Citrullus lanatus, Cucumis sativus, Sorghum bicolor and Solanum lycopersicum) were evaluated. For this, these species were cultivated on an inert substrate (washed sand) treated with increasing doses of saflufenacil (0.0, 0.625, 1.25, 2.50, 5.0, 10.0 and 20.0 g ha-1). The species B. vulgaris, S. lycopersicum and S. bicolor were the most sensitive to saflufenacil. Among these species, B. vulgaris is easy to grow, fast growing and allows rapid visualization of the symptoms of intoxication. It was concluded that B. vulgaris can be considered as an indicator of the presence of saflufenacil in the soil solution to study the dynamics of this herbicide in soils

Non-English languages enrich scientific knowledge : The example of economic costs of biological invasions

We contend that the exclusive focus on the English language in scientific researchmight hinder effective communication between scientists and practitioners or policymakerswhose mother tongue is non-English. This barrier in scientific knowledge and data transfer likely leads to significant knowledge gaps and may create biases when providing global patterns in many fields of science. To demonstrate this, we compiled data on the global economic costs of invasive alien species reported in 15 non-English languages. We compared it with equivalent data from English documents (i.e., the InvaCost database, the most up-to-date repository of invasion costs globally). The comparison of both databases (similar to 7500 entries in total) revealed that non-English sources: (i) capture a greater amount of data than English sources alone (2500 vs. 2396 cost entries respectively); (ii) add 249 invasive species and 15 countries to those reported by English literature, and (iii) increase the global cost estimate of invasions by 16.6% (i.e., US$ 214 billion added to 1.288 trillion estimated fromthe English database). Additionally, 2712 cost entries - not directly comparable to the English database - were directly obtained frompractitioners, revealing the value of communication between scientists and practitioners. Moreover, we demonstrated how gaps caused by overlooking non-English data resulted in significant biases in the distribution of costs across space, taxonomic groups, types of cost, and impacted sectors. Specifically, costs from Europe, at the local scale, and particularly pertaining to management, were largely under-represented in the English database. Thus, combining scientific data from English and non-English sources proves fundamental and enhances data completeness. Considering non-English sources helps alleviate biases in understanding invasion costs at a global scale. Finally, it also holds strong potential for improving management performance, coordination among experts (scientists and practitioners), and collaborative actions across countries. Note: non-English versions of the abstract and figures are provided in Appendix S5 in 12 languages. (c) 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/ by/4.0/).Peer reviewe