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Studies have reported changes in the epidemiological profile of patients with oral cancer in recent decades, especially regarding gender and age. This study aimed to evaluate a historical series of oral malignant lesions prevalence over six decades and define characteristics associated with the occurrence, mainly, of oral squamous cell carcinoma (OSCC). A retrospective review of histopathological records from 1953 to 2019 was conducted in three oral pathology laboratories in South Brazil about age, sex, anatomical site, clinical aspect, and histopathological diagnosis. Descriptive and analytical analyses were performed comparing the histopathological diagnoses with other variables. Multivariable logistic regression was applied to determine the associated predictors of OSCC. Of the 53,065 records available in the institutions, 986 were oral malignant tumors (including all malignant neoplasms), representing 1.86% of all diagnoses. The occurrence of OSCC in the 1960's was 80.0%, decreasing over time reaching the lowest percentage of cases in the 1990's (75.8%) and significantly increasing to 88.7% in the 2010s. Females had a lower chance than males of having OSCC independently of the decade (odds ratio=0.30, p<0.001). This was the same for older individuals compared to those younger than 40 years. No interactions between sex, age, and decade were observed. The number of diagnoses of oral malignant lesions increased over time, and the occurrence of OSCC varied. Older individuals and males had higher chances of having OSCC independently of the decade. Therefore, in this study sample, no changes were observed in the epidemiological profile over the years concerning these predictors.

Objectives: To evaluate the occurrence of plasmid-mediated fos genes among fosfomycin-resistant Escherichia coli isolates collected from patients in Lisbon, Portugal, and characterize the fos-positive strains., Methods: A total of 19 186 E. coli isolates were prospectively collected between April 2022 and January 2023 from inpatients and outpatients at a private laboratory in Lisbon. Fosfomycin resistance was initially assessed by semi-automated systems and further confirmed by the disc diffusion method. Resistant isolates were investigated for plasmid-mediated fos genes (fosA1-fosA10, fosC and fosL1-fosL2) and extended-spectrum beta-lactamases (ESBLs) by PCR and sequencing. Multilocus sequence typing was performed to evaluate the clonal relationship among fos-carrying isolates., Results: Out of the 19 186 E. coli isolates, 100 were fosfomycin-resistant (0.5%), out of which 15 carried a fosA-like gene (15%). The most prevalent fosfomycin-resistant determinant was fosA3 (n = 11), followed by fosA4 (n = 4). Among the 15 FosA-producing isolates, 10 co-produced an ESBL (67%), being either of CTX-M-15 (n = 8) or CTX-M-14 (n = 2) types. The fosA3 gene was carried on IncFIIA-, IncFIB-, and IncY-type plasmids, whereas fosA4 was always located on IncFIB-type plasmids. Most FosA4-producing isolates belonged to a single sequence type ST2161, whereas isolates carrying the fosA3 gene were distributed into nine distinct genetic backgrounds., Conclusion: The prevalence of fosfomycin-resistant E. coli isolates is still low in Portugal. Notably, 15% of fosfomycin-resistant isolates harbour a transferable fosA gene, among which there is a high rate of ESBL producers, turning traditional empirical therapeutical options used in Portugal (fosfomycin and amoxicillin-clavulanic acid) ineffective., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The objective of this study was to evaluate the physicochemical compatibility of mixtures of synthetic and botanical limonoid-based insecticides, as well as the toxicity of these associations, in the management of Spodoptera frugiperda (J.E. Smith) under laboratory and field conditions. For this, the associations of 4 commercial botanical insecticides based on neem registered in Brazil (Azamax, Agroneem, Azact CE, and Fitoneem) were tested with synthetic insecticides from the group of growth regulators (IGRs [triflumuron, lufenuron, methoxyfenozide and tebufenozide]). When mixed, all combinations caused a significant reduction in the pH of the mixture and a significant increase in electrical conductivity. However, all tested combinations showed similar stability behavior to the negative control (distilled water), which demonstrated their physicochemical compatibility. Furthermore, in laboratory and field bioassays, mixtures of IRGs with limonoid-based formulations provided satisfactory effects in the management of S. frugiperda. However, binary mixtures of insecticide Intrepid 240 SC with Azamax or Azact CE (at LC25 previously estimated) showed the highest toxicities on S. frugiperda larvae in laboratory bioassays and damage reduction caused by S. frugiperda in a 2-yr field experiments. Therefore, mixtures of IGRs with limonoid-based botanical insecticides are promising alternatives for the management of S. frugiperda and important component of integrated pest management and insect resistance management programs., (© The Author(s) 2023. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The objective of this study was to evaluate the effects of growth-regulating insecticides of synthetic (e.g., Certero 480 SC, Intrepid 240 SC, Match EC and Mimic 240 SC) and botanical origins (e.g., Azamax 1.2 EC, Agroneem 850 EC, Azact 2.4 EC and Fitoneem 850 EC) on the biological parameters and fertility life table of Spodoptera frugiperda (J.E. Smith) under laboratory conditions. Larvae were fed insecticides that were incorporated into artificial diets. To develop the fertility life table, the following biological parameters were evaluated: survival at 7 days after infestation (d.a.i) and survivorship at adult eclosion, duration of the neonate-to-adult eclosion period, larval and pupal weights and total fecundity (number of total eggs per female). The results indicated that S. frugiperda neonates surviving LC 25 or LC 50 concentrations of the evaluated insecticides showed longer larval and egg-to-adult periods, lower larval and pupal weights and reduced fecundity, when compared to the control treatment. Larvae exposed to Azamax at LC 25 or LC 50 concentrations showed the greatest increase in generation duration (75 d). In addition, S. frugiperda adults emerged from pupae when larvae reared on an artificial diet containing growth regulating insecticides of synthetic and botanical origins produced fewer females per female per generation ( R o ). As well as, lower rates of natural population increase per day ( r m ) compared to insects fed the control diet. Our findings indicated that, neem-derived products and growth-regulating insecticides of synthetic origin may be employed within integrated management strategies that aim to keep populations of S. frugiperda below levels that cause economic damage. Similarly, they offer alternatives for insecticide resistance management programs.

Background: Chagas disease remains a major cause of cardiovascular death in endemic areas. Focused echocardiography (FoCUS) is a point-of-care means of assessing cardiac function which can be useful for the diagnosis of cardiac involvement., Objective: This study aims evaluating the characteristics of validity and reliability of FoCUS applied on Chagas disease patients., Methods: Patients with Chagas disease coming from an endemic area were selected from a large cohort (SaMi-Trop). A simplified echocardiogram with only three images was extracted from the conventional echocardiogram performed in this cohort. The images were evaluated by an observer who was blinded to the clinical and echocardiographic data, to determine the accuracy and reliability of FoCUS for cardiac assessment. The analysis constituted of 5 prespecified variables, dichotomized in absence or presence: left ventricular (LV) size and systolic function, right ventricular (RV) size and systolic function, and LV aneurysm., Results: We included 725 patients with a mean age of 63.4 ± 12.3 years, 483 (67%) female. Abnormal electrocardiogram was observed in 81.5% of the patients. Left and right ventricular dysfunctions were found in 103 (14%) and 49 (7%) of the patients, respectively. Sensitivity, specificity, positive predictive value and negative predictive value were 84%, 94%, 70% and 97% for LV enlargement and 81%, 93%, 68% and 97% for LV systolic dysfunction, respectively, and 46%, 99%, 60% and 98% for RV dilatation, and 37%, 100%, 100% and 96% for RV dysfunction, respectively. Inter and intraobserver agreement were 61% and 87% for LV enlargement and 63% and 92% for LV dysfunction, respectively, and 50% and 49% for RV size and 46% and 79% for RV dysfunction, respectively. LV apical aneurysm was found in 45 patients (6.2%) with the lowest sensitivity of FoCUS study (11%; 95% CI 2-28%)., Conclusions: FoCUS showed satisfactory values of validity and reliability for assessment of cardiac chambers in patients with Chagas disease, except for apical aneurysm. This tool can identify heart disease with potential impact on patient management in the limited-resource setting., Competing Interests: The authors have declared that no competing interests exist.

Anastrepha fraterculus (Wiedemann, 1830) (Diptera: Tephritidae) is a major fruit pest, which is basicaly controlled using insecticides, which represents a risk to beneficial arthropods, human health and food contamination. The sterile insect technique (SIT) is a potential alternative tool for the management of this pest, however, only conflicting data is found regarding the optimal dose to achieve sterility. Thus, this study evaluated the effect of gamma radiation doses (0, 40, 50, 60 and 70 Gy) on male and female reproductive sterility, gonads morphometry, emergence, flight ability, and longevity under nutritional stress of A. fraterculus. Full female sterility was achieved at 50 Gy, while full male sterility was achieved at 70 Gy. Both ovarian and testicular sizes were affected by irradiation, while no influence was observed on the quality parameters evaluated. Our results suggest that 70 Gy applied 48 h before adult emergence can be used to sterilize A. fraterculus in a SIT programme.

The present study evaluated the lethal toxicity and oviposition deterrence of ethanolic extracts of Annona mucosa Jacq., Annona muricata L., and Annona sylvatica A. St.-Hil on Anastrepha fraterculus (Wiedemann) (Diptera: Tephritidae) compared with those of a limonoid-based bioinsecticide (Azamax™ 1.2 EC-azadiractin +3-tigloyl-azadiractol) and a synthetic spinosyn-based insecticide (Delegate™ 250 WG-spinetoram). In addition, the efficacy of the selected toxic bait formulations was evaluated by mixing them with food attractants (Anamed™, 3% Biofruit and 7% sugarcane molasses). In the topical application and ingestion bioassays (2000 mg L -1 ), the aqueous emulsion of the A. mucosa extract caused greater than 80% mortality of A. fraterculus adults in a similar manner to the spinosyn-based synthetic insecticide. Concentration-response curves were performed for the most promising treatments and showed an activity level dependent on the mode of contamination, exposure time, and applied concentration. In bioassays with and without choice, the A. mucosa (77%), A. muricata (51%), A. sylvatica (60%), Azamax™ (74%), and Delegate™ 250 WG (100%) significantly reduced the number of punctures and galleries in grape berries. In combination with the food attractants Anamed™, 3% Biofruit, and 7% sugarcane molasses, the emulsion of the A. mucosa extract had a residual effect similar to that of the spinetoram insecticide, with a mortality rate of over 80% of A. fraterculus adults up to 14 days after application (DAA) in the absence of rain. Thus, acetogenin-rich formulations, especially from A. mucosa seeds, are useful alternatives for the integrated management of A. fraterculus in agricultural orchards.

Bacillus thuringiensis (Berliner) has demonstrated potential use in insect pest management. We evaluated the toxicity and sublethal effects of formulations of toxic baits composed of bacterial isolates (Bt) B. thuringiensis var. oswaldo cruzi (Bto), B. thuringiensis var. israelensis (Bti), B. thuringiensis var. kurstaki (Btk), and B. circulars (Bc) in combination with three food attractants 50% grape juice, 7% sugar cane molasses, and 7% hydrolyzed protein on adults of Zaprionus indianus (Gupta, 1970), the main pest of fig fruit (Ficus carica) in Brazil. Likewise, we evaluated the toxicity on the parasitoids Trichopria anastrephae Lima, 1940 and Pachycrepoideus vindemmiae (Rondani, 1875) in ingestion bioassays. Adults of Z. indianus showed high susceptibility to Bacterial isolates. However, the Bto isolate (1013 CFU. ml-1) caused adult mortality of 100%, in 72 h after exposure, with LT50 values of ≈20 h. By using the lethal concentrations (LC90) of the Bto isolate, estimated via the concentration-response curves with the food attractants, a significant reduction (40 to 50%) in the total fecundity and in the embryonic viability of eggs from females fed with the toxic baits was observed. The food attractants + Bto (80 × 108 CFU. ml-1) did not cause significant mortality of T. anastrephae and P. vindemmiae adults (mortality < 20%). The bacterial isolates Bti, Btk, Bc, and Bto are considered promising for the formulation of toxic baits, because, besides providing toxic effect on adults of Z. indianus, they showed no toxicity on T. anastrephae and P. vindemmiae adults., (© The Author(s) 2019. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives To evaluate the incidence and variability of traditional coronary artery disease (CAD) risk factors in a cohort of lupus patients and to investigate if prednisone use predicts an increase in the number of risk factors. Methods A total of 151 women, 37.8 ± 11.1 (mean ± SD) years old at baseline, were reevaluated after a median period of 39 (interquartile range 36.5-42.0) months. The cumulative incidence of traditional risk factors, the incidence rate (with 95% confidence interval) of hypertension, diabetes, dyslipidemia and hypertriglyceridemia, and the frequency of the risk factors' disappearance were calculated. Metabolic syndrome (MetS) and Framingham risk score (FRS) were computed. Logistic regression was used to investigate if maximum or cumulative prednisone dose used during follow-up predicted an increase in the cardiometabolic risk factors' number. Results The cumulative incidence of risk factors varied from 39.1% (abdominal obesity) to zero (smoking), and the incidence rate varied from 133.2 (87.8-178.6) per 1000 person-years (dyslipidemia) to 10.4 (1.3-19.5) per 1000 person-years (diabetes). The cumulative incidence for MetS was 18.8%, and 11.7% of 143 patients with low FRS at baseline (T 1 ) were classified in the high-risk category at the end of the study (T 2 ). Dyslipidemia was the most variable risk factor, with 43.5% disappearance at T 2 . The maximum prednisone dose used during follow-up was borderline ( p = 0.050) for prediction of an increase in the number of cardiometabolic risk factors in an adjusted model for antimalarial use, modified Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and age. Conclusion The authors described high incidence and variability of CAD risk factors in female lupus patients, with higher prednisone dose being borderline for an increase in the number of cardiometabolic risk factors.

Anastrepha fraterculus (Wiedemann) (Diptera: Tephritidae) is considered to be one of the major pest insects in fruit orchards worldwide. Bacillus thuringiensis Berliner (Bacillales: Bacillaceae) strains are widely used as biological control agents and show high biological activity against different insect species. The objective of this study was to evaluate the biological activity of different strains of B. thuringiensis against A. fraterculus larvae and adults. Bioassays were performed using suspensions of bacterial spores/crystals of B. thuringiensis var. israelensis (Bti), kurstaki (Btk), and oswaldocruzi (Bto) strains at three concentrations [2 × 107, 2 × 108, and 2 × 109 colony-forming units per ml (CFU ml-1)]. At a concentration of 2 × 109 CFU ml-1, a significant larval effect (mortality 60%) was observed when compared with the control treatment. Larvae that ingested spore/crystal suspensions of Bti, Btk, or Bto bacterial strains exhibited significant larval and pupal deformations, leading to a significant decrease (~50%) in the completion of the insects' biological cycle (egg to adult). The B. thuringiensis strains (Bti, Btk, or Bto) at a concentration of 2 × 109 CFU ml-1 in combination with one food attractant (BioAnastrepha 3% or CeraTrap 1.5%) in formulations of toxic baits provided high mortality (mortality > 85%) of A. fraterculus adults 7 d after treatment. However, the Btk strain in combination with CeraTrap 1.5% caused mortality of 40%. On the basis of these results, the native bacterial strains Bti, Btk, and Bto were considered to be promising candidates as biological control agents against A. fraterculus.

Drosophila suzukii (Matsumura, 1931) (Diptera: Drosophilidae) is a widely distributed pest of soft-skinned and stone fruits that is controlled mainly with pesticides. An alternative to the chemical control is the sterile insect technique (SIT), an ecologically friendly method of pest management that could be used against D. suzukii. The objective of the present study was to evaluate the effects of gamma radiation on reproductive sterility, ovarian morphometry, and quality parameters of D. suzukii. Full female sterility was achieved at 75 Gy, while an adequate level of male sterility (99.67%) was obtained at 200 Gy. The ovarian size showed an exponential decay in function of irradiation dose increase. There was no significant influence of irradiation dose on the quality parameters evaluated. Our data suggest that gamma radiation can be recommended to be used in an SIT program for D. suzukii.

Spontaneous bacterial peritonitis (SBP) is a frequent form of decompensation of end-stage liver disease, with an incidence of 15-20% and a short-term mortality of 10-33%. The usual causative agents (90% of SBP) are enteric Gram-negative bacteria-Escherichia coli and Klebsiella pneumoniae. Brucella is known to be a possible, but exceedingly rare, causative agent of SBP. We present the case of a 47-year-old Egyptian man, with hepatitis C cirrhosis, and a 2 week history of ascites, jaundice, encephalopathy, fever and pain on his right shoulder that started while travelling in the Middle East. Laboratory and imaging studies were undertaken and he was diagnosed an SBP that failed to respond to Imipenem. Brucella was identified both in the ascitic fluid and blood; he was started on doxycycline plus rifampin with immediate clinical improvement. The antibiotic regimen was kept for 8 weeks. The patient is currently under evaluation for liver transplantation.