Ectoparasitic flies (Diptera: Streblidae) on bats (Mammalia: Chiroptera) from a Private Natural Heritage Reserve in southeastern Brazil

Due to the small number of records of Streblidae on bats, despite extensive study on these mammals in the state of Rio de Janeiro, a survey was carried out in an area of the Atlantic Forest. The present study was carried out at Bom Retiro Farm Natural Heritage Private Reserve. We captured 401 bats of 17 species, 13 genera, and four families; bat flies infested 221 bats of only four species. Carollia perspicillata (Linnaeus, 1758) has the highest fly diversity, with seven fly species: Trichobius joblingi (Wenzel, 1966) (n = 23), Megistopoda proxima (Séguy, 1926) (n = 15), Strebla guajiro (García & Casal, 1965) (n = 15), Aspidoptera falcata (Wenzel, 1976) (n = 6) Paratrichobius longicrus (Miranda Ribeiro, 1907) (n = 8), Paraeuctenodes similis (Wenzel 1976) (n = 3), and Trichobius anducei (Guerrero, 1998) (n = 1). Two species infested Platyrrhinus lineatus (É. Geoffroy, 1810): Aspidoptera falcata (n = 1) and Anastrebla caudiferae (Wenzel, 1996) (n = 1). Paradyschiria parvula (Falcoz, 1931) (n = 11) infested Noctilio leporinus (Linnaeus, 1758) and M. proxima (n = 12) and Trichobius uniformis (Curran, 1935) (n = 1) infested Sturnira lilium (É. Geoffroy, 1842). Sturnira lilium has the highest infestation rate, with ten out of 46 captured individuals parasitized, followed by Carollia perspicillata, with 33 out of 164 captured parasitized, and by P. lineatus with only two parasitized individuals out of ten. Among 97 streblid flies captured, M. proxima was the most abundant (27.83%), followed by T. joblingi (23.71%), and S. guajiro (15.46%). All remaining bat fly species represented 33%. Paradichyria parvula has the first record for Rio de Janeiro State

COGNITION AND FUNCTIONALITY IN BREAST CANCER SURVIVORS UNDERGOING HORMONE THERAPY

O objetivo foi descrever a função cognitiva e a capacidade funcional de sobreviventes de câncer de mama que praticam exercício físico. Oito mulheres diagnosticadas com câncer de mama em estágios I-III participaram deste estudo. Testes cognitivos foram aplicados para avaliar a função cognitiva geral, velocidade de processamento, função executiva e atenção. A capacidade funcional foi determinada por testes de resistência aeróbia, agilidade dinâmica e equilíbrio e testes de força de membros superiores e inferiores. As mulheres do presente estudo tinham 64,5 ± 4,8 anos, índice de massa corporal de 32,6 ± 5,4 kg.m-2 e escolaridade de 10,0 ± 3,5 anos. Os resultados demonstraram desempenho no questionário MSSE e teste de fluência verbal preservados em mulheres idosas diagnosticadas com câncer de mama há quatro anos, com obesidade e que estavam se exercitando por aproximadamente 2,5 anos. Por outro lado, elas apresentaram desempenho inferior no teste cognitivo Trail Making Test e nos testes funcionais do que os valores normativos da literatura, indicando um prejuízo na atenção, velocidade de processamento, flexibilidade cognitiva e baixa capacidade funcional.El objetivo fue describir la función cognitiva y la capacidad funcional de las supervivientes de cáncer de mama que practican ejercicio físico. Ocho mujeres diagnosticadas con cáncer de mama en estadio I-III participaron en este estudio. Se aplicaron pruebas cognitivas para evaluar la función cognitiva general, la velocidad de procesamiento, la función ejecutiva y la atención. La capacidad funcional se determinó mediante pruebas de resistencia aeróbica, agilidad dinámica y equilibrio y pruebas de fuerza superior e inferior. Las mujeres del presente estudio tenían 64,5 ± 4,8 años, el índice de masa corporal 32,6 ± 5,4 kg.m-2 y la escolaridad de 10,0 ± 3,5 años. Los resultados demostraron un desempeño preservado en el cuestionario MSSE y la prueba de fluidez verbal en mujeres mayores diagnosticadas con cáncer de mama hace cuatro años, con obesidad y que hacían ejercicio durante aproximadamente 2,5 años. Por otro lado, ellas presentaron un desempeño más bajo en el Trail Making Test cognitivo y en las pruebas funcionales que los valores normativos de la literatura, indicando un deterioro en la atención, velocidad de procesamiento, flexibilidad cognitiva y baja capacidad funcional.The study aimed to describe the cognitive function and the functional capacity of breast cancer survivors who practice physical exercise. Eight women diagnosed with stages I-III breast cancer participated in this study. Cognitive tests were applied to assess overall cognitive function, processing speed, executive function, and attention. The women in the present study were 64.5 ± 4.8 years old, had a body mass index of 32.6 ± 5.4 kg.m-2, and had 10.0 ± 3.5 years of schooling. The results showed a preserved performance in the MSSE questionnaire and verbal fluency test in older women diagnosed with breast cancer four years ago, with obesity, who have been exercising for approximately 2.5 years. On the other hand, they presented a lower performance in the cognitive Trail Making Test and the functional tests than the normative values in the literature, indicating an impaired attention, processing speed, cognitive flexibility, and low functional capacity

Bilateral asymptomatic fibrous-ankylosis of the temporomandibular joint associated with rheumatoid arthritis: a case report

The American Academy of Orofacial Pain (AAOP) defines ankylosis of the temporomandibular joint (TMJ) as a restriction of movements due to intracapsular fibrous adhesions, fibrous changes in capsular ligaments (fibrous-ankylosis) and osseous mass formation resulting in the fusion of the articular components (osseous-ankylosis). The clinical features of the fibrous-ankylosis are severely limited mouth-opening capacity (limited range of motion during the opening), usually no pain and no joint sounds, marked deflection to the affected side and marked limitation of movement to the contralateral side. A variety of factors may cause TMJ ankylosis, such as trauma, local and systemic inflammatory conditions, neoplasms and TMJ infection. Rheumatoid arthritis (RA) is one of the systemic inflammatory conditions that affect the TMJ and can cause ankylosis. The aim of this study is to present a case of a female patient diagnosed with bilateral asymptomatic fibrous-ankylosis of the TMJ associated with asymptomatic rheumatoid arthritis. This case illustrates the importance of a comprehensive clinical examination and correct diagnosis of an unusual condition causing severe mouth opening limitation

Isolamento e identificação presuntiva de Staphylococcus coagulase positiva e coagulase negativa em queijos minas frescal artesanal comercializados em feiras livres de Ipatinga – MG / Isolation and presucific identification of positive coagulase and negative coagulase Staphylococcus in artisanal minas fresh cheesese marketed at fairs in Ipatinga - MG

Introdução: dentre os diferentes tipos de queijos existentes no Brasil, o Minas Frescal Artesanal destaca-se por ser um produto alimentício bastante consumido e frequentemente fabricado com higiene precária. Por apresentar alto teor de umidade e baixo teor de sal, o queijo Minas Frescal Artesanal é susceptível a contaminações microbianas resultantes, tanto do leite utilizado como matéria-prima, como de contaminações cruzadas na manipulação e no pós-processamento. Os microrganismos contaminantes podem causar deterioração do produto ou até doenças em quem o ingerir, como a intoxicação alimentar. Objetivos: o estudo objetiva verificar de forma presuntiva a existência de Staphylococcus coagulase positiva e negativa por meio do isolamento em uma amostragem de queijos Minas Frescal Artesanal comercializados em feiras livres do Município de Ipatinga, Minas Gerais. Método: foram coletadas amostras de 6 queijos Minas Frescal Artesanal de feiras livres de Ipatinga-MG, sendo cada um deles pertencentes aos seguintes locais: Canaã, Veneza 2, Bom Jardim, Bom Retiro, Ipatingão e Cariru. A partir destas amostras foi isolado o microrganismo Staphylococcus coagulase positiva e negativa por meio de cultura e identificação da bactéria pelo método de Gram e das provas de catalase e coagulase. Resultados: foi constatado que 100% das amostras de queijo Minas Frescal Artesanal apresentaram contaminação em relação à contagem e análise presuntiva de Staphylococcus sp. Conclusão: os produtos analisados obtiveram valores de contaminação por Staphylococcus sp. acima do permitido pela legislação vigente, demonstrando uma precariedade nas boas práticas de fabricação. Dessa forma, entende-se que a fiscalização pelos órgãos competentes precisa ser mais eficaz e rigorosa nas feiras livres do município de Ipatinga.

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI &lt;18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school&#x2;aged children and adolescents, we report thinness (BMI &lt;2 SD below the median of the WHO growth reference) and obesity (BMI &gt;2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

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&nbsp;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&nbsp;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&nbsp; 6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score&nbsp; 652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc&nbsp;= 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&nbsp;= 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&nbsp;Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in&nbsp;Asia&nbsp;and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701