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Various physical demands are placed on soldiers, whose effectiveness and survivability depend on their combat-specific physical fitness. Because sport training programs involving weight-based training have proven effective, this study examined the value of such a program for short-term military training using combat-relevant tests. A male weight-based training (WBT) group (n = 15; mean +/- SD: 27.0 +/- 4.7 years, 173.8 +/- 5.8 cm, 80.9 +/- 12.7 kg) performed full-body weight-based training workouts, 3.2-km runs, interval training, agility training, and progressively loaded 8-km backpack hikes. A male Army Standardized Physical Training (SPT) group (n = 17; mean +/- SD: 29.0 +/- 4.6 years, 179.7 +/- 8.2 cm, 84.5 +/- 10.4 kg) followed the new Army Standardized Physical Training program of stretching, varied calisthenics, movement drills, sprint intervals, shuttle running, and distance runs. Both groups exercised for 1.5 hours a day, 5 days a week for 8 weeks. The following training-induced changes were statistically significant (P < 0.05) for both training groups: 3.2-km run or walk with 32-kg load (minutes), 24.5 +/- 3.2 to 21.0 +/- 2.8 (SPT) and 24.9 +/- 2.8 to 21.1 +/- 2.2 (WBT); 400-m run with 18-kg load (seconds), 94.5 +/- 14.2 to 84.4 +/- 11.9 (SPT) and 100.1 +/- 16.1 to 84.0 +/- 8.4 (WBT); obstacle course with 18-kg load (seconds), 73.3 +/- 10.1 to 61.6 +/- 7.7 (SPT) and 66.8 +/- 10.0 to 60.1 +/- 8.7 (WBT); 5 30-m sprints to prone (seconds), 63.5 +/- 4.8 to 59.8 +/- 4.1 (SPT) and 60.4 +/- 4.2 to 58.9 +/- 2.7 (WBT); and 80-kg casualty rescue from 50 m (seconds), 65.8 +/- 40.0 to 42.1 +/- 9.9 (SPT) and 57.6 +/- 22.0 to 44.2 +/- 8.8 (WBT). Of these tests, only the obstacle course showed significant difference in improvement between the two training groups. Thus, for short-term (i.e., 8-week) training of relatively untrained men, the Army's new Standardized Physical Training program and a weight-based training experimental program can produce similar, significant, and meaningful improvements in military physical performance. Further research would be needed to determine whether weight-based training provides an advantage over a longer training period. [ABSTRACT FROM AUTHOR]

To examine correlates of the speed at which female soldiers carrying loads could cover 3.2 km on foot and traverse an obstacle course, 12 volunteers (mean +/- SD: 25.3 +/- 6 years, 166 +/- 7 cm, 61.3 +/- 7 kg) were timed over 3.2 km while carrying loads of 14, 27, and 41 kg, and while traversing an obstacle course with the two lighter loads. Pearson correlations showed that absolute VO[2max] and 3.2 km run time without a load were the best predictors of 3.2 km load carriage time for all loads. Also, larger subjects with greater muscle mass were able to carry the heaviest load faster than smaller, less muscular subjects, likely because the 41 kg load represented a smaller percentage of the former's bodyweight. Maximum number of sit-ups and push-ups, composite score of the Army Physical Fitness Test as well as body height were positively correlated with the speed at which some course segments were traversed. [ABSTRACT FROM AUTHOR]

Introduction: Catatonia, documented since the 19th century, remains a significant challenge in terms of recognition and treatment. Over the last two decades, ketamine has brought new perspectives to psychiatry, sparking widespread interest. Concurrently, catatonia has attracted heightened scientific attention. Preliminary evidence suggests the therapeutic potential of ketamine for catatonia., Methods: We systematically searched Medline/PubMed, Embase, PsycINFO, Lilacs, and Cochrane Library databases, as well as Google Scholar, for studies with ketamine or its enantiomers as intervention for catatonia, with no restrictions to underlying diagnosis, date, language, or study design., Results: Twenty articles were included, encompassing a total of 25 catatonic patients receiving ketamine or esketamine. Predominantly female (61.9 %), with a mean age of 44.4 years, patients mostly exhibited manifestations compatible with the retarded subtype of catatonia. Mood disorders were the most prevalent underlying diagnoses. Ketamine was primarily administered intravenously over a 40-minute period and in multiple-dosing schemes. Mean response and remission rates of catatonic manifestations for the whole sample were 80 % and 44 %, respectively, with no reports of worsening catatonic features or psychotic symptoms. Only one patient discontinued treatment due to intolerable dissociative effects., Conclusion: Challenging the conventional contraindication of ketamine in psychotic disorders, current evidence highlights its potential efficacy, particularly in treating catatonia. Pending further research, we advocate reevaluating this contraindication, as it may offer a promising therapeutic option, especially for challenging cases. Preliminary evidence suggests potentially greater benefits for catatonic patients with underlying mood disorders compared to primary psychotic disorders., Competing Interests: Declaration of competing interest LCQ reports consulting fees from Allergan, Abbot, Janssen Pharmaceutical and Lundbeck, and research fees from Janssen Pharmaceutical. ALTL has received consulting fees from Hoffmann–La Roche, Genentech, Janssen Pharmaceutical, Daiichi Sankyo, Cristalia Produtos Químicos e Farmacêuticos, Pfizer, Mantecorp Indústria Química e Farmacêutica, Libbs Farmacêutica, FQM Farma, and Sanofi-Aventis over the last 24 months and has received research fees from Janssen Pharmaceutical, Eli Lilly, Novartis, Biophytis, Celltrion, Azidus, H. Lundbeck A/S, Servier Laboratories, Hoffman-La Roche, FQM Farma, and Forum Pharmaceuticals. AG has been a consultant and/or advisor to or has received honoraria from Aché, Daiichi Sankyo, Torrent, Bayer, Cristália, and Janssen. We declare no other conflicts of interest concerning the publication of this article., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: Converging evidence supports the role of the glutamate, an excitatory amino acid neurotransmitter, in the pathophysiology of obsessive-compulsive disorder (OCD). Ketamine and esketamine, both noncompetitive N -methyl- d -aspartate antagonists, have emerged as a promising medication for this psychiatric disorder, given its possible efficacy with faster onset and good tolerability. The purpose of this retrospective chart review is to evaluate whether unbiased clinical documentation supports formal clinical trials of esketamine for an OCD indication., Methods: A retrospective chart review of patients with treatment-resistant OCD receiving a single dose of esketamine (0.5mg/kg) added to standard therapy was conducted. The Yale-Brown Obsessive-Compulsive Scale and the Montgomery-Åsberg Depression Rating Scale were used to evaluate OCD and depressive symptoms respectively at baseline, 24 hours, and 7 days after esketamine administration. Descriptive statistics were used to analyze the data., Results: Eight subjects were identified in this retrospective chart review: esketamine was administered subcutaneously in 7 and intravenously in 1. One week after infusion, 25% of the sample met criteria for treatment response and 50% for partial response. Major depressive disorder was a comorbid diagnosis in 75% of the sample and 2 of these subjects showed a positive antidepressant response., Conclusions: Our findings provide preliminary evidence that esketamine may reduce obsessive-compulsive symptoms in a subset of treatment-resistant OCD patients., Competing Interests: Conflicts of Interest and Source of Funding: This study was supported by a grant from Programa Pesquisa para o SUS (PPSUS/BA—research grant number 003/2017), a public research-funding program, and by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior–Brazil (CAPES)—Finance Code 001. The sponsors had no role in either the study design, the writing of the manuscript, or the decision to submit it for publication. In addition, the University Hospital involved provided hospital structure, medications, and human resources. L.C.Q. reports consulting fees from Abbot, Allergan, Cristalia, Janssen Pharmaceutical, and Lundbeck and research fees from Janssen Pharmaceutical., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Ketamine and esketamine have both shown significant antidepressant effects in treatment-resistant depression (TRD), and conflicting evidence suggests that induced dissociation by these drugs can be a clinical predictor of esketamine/ketamine's efficacy., Methods: This study is a secondary analysis from a bi-center, randomized, controlled trial. Participants were randomly assigned 1:1 to receive an IV infusion of esketamine (.25 mg/kg) or racemic ketamine (.50 mg/kg) over 40 minutes. Dissociative symptoms were assessed using the Clinician-Administered Dissociative State Scale (CADSS) 40 minutes following the beginning of the infusion. The variation in depression scores was measured with the Montgomery-Asberg Depression Rating Scale (MADRS), which was administered before the intervention as a baseline measure and 24 hrs, 72 hrs, and 7 days following infusion., Results: Sixty-one patients were included in the analysis. Examining CADSS scores of 15 or below, for every 1-point increment in the CADSS score, there was a mean change of -0.5 (SD = 0.25; p-value 0.04) of predicted MADRS score from baseline to 24 hrs. The results for 72 hrs and 7 days following infusion were not significant. Limitations: This study was not designed to assess the relationship between ketamine or esketamine-induced dissociation and antidepressant effects as the main outcome, therefore confounding variables for this relationship were not controlled., Conclusion: We suggest a positive relationship between dissociation intensity, measured by CADSS, and antidepressant effect 24 hours after ketamine and esketamine infusion for a CADSS score of up to 15 points., Competing Interests: ALTL reports grants and personal fees from Janssen Pharmaceutical, personal fees from Daiichi Sankyo, Cristalia Produtos Químicos e Farmacêuticos, Libbs, Pfizer, Myralis Farma, Aché Laboratórios, Hypera Pharma, and Sanofi-Aventis, grants from Eli Lilly, H. Lundbeck A/S, Servier Laboratories, Hoffman-La Roche, Forum Pharmaceuticals and from the following public funding programs CNPq and FAPESP. LCQ reports consulting fees from Allergan, Abbott, Cristalia, Janssen Pharmaceutical, and Lundbeck and research fees from Janssen Pharmaceutica and Fundação Baiana de Infectologia. No other conflicts of interest declared concerning the publication of this article.

There are significantly fewer options for the treatment of bipolar depression than major depressive disorder, with an urgent need for alternative therapies. In this pilot study, we treated six subjects with bipolar disorder types I and II (according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria) who had been in a current depressive episode for at least four weeks. Four subjects were female (66.66%), and the mean age was 45.33 (±12.32). Subjects received adjunct treatment with two arketamine intravenous infusions one week apart-0.5 mg/kg first and then 1 mg/kg. The mean baseline Montgomery-Åsberg Depression Rating Scale (MADRS) total score was 36.66, which decreased to 27.83 24h after the first infusion of 0.5 mg/kg of arketamine (p = 0.036). In respect of the 1 mg/kg dose, the mean MADRS total score before the second infusion was 32.0, which dropped to 17.66 after 24h (p < 0.001). Arketamine appears to have rapid-acting antidepressant properties, consistent with previous animal studies on major depression. All individuals tolerated both doses, exhibiting nearly absent dissociation, and no manic symptoms. To the best of our knowledge, this pilot trial is the first to test the feasibility and safety of the (R)-enantiomer of ketamine (arketamine) for bipolar depression., Competing Interests: Declaration of competing interest Dr. Quarantini reports consulting fees from Allergan, Abbott, Janssen Pharmaceuticals and Lundbeck and research fees from Janssen Pharmaceuticals. Dr. Lacerda reports grants and personal fees from Janssen Pharmaceuticals, personal fees from Daiichi Sankyo, Cristalia Produtos Químicos e Farmacêuticos, Libbs, Pfizer, Myralis Farma, Aché Laboratórios, Hypera Pharmaand Sanofi-Aventis, grants from Eli Lilly, H. Lundbeck A/S, Servier Laboratories, Hoffman-La Roche, Forum Pharmaceuticals and from public programs: CNPq and FAPESP., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Racemic ketamine is a mixture of (R)-ketamine (arketamine) and (S)-ketamine (esketamine), with the latter regarded as the main isomer for antidepressant effects. However, preclinical data and one open-label human trial suggest arketamine might exert a more potent and longer-lasting antidepressant effect with fewer side effects. We aimed to explore the feasibility of a randomized controlled trial of arketamine for treatment-resistant depression (TRD) and to assess its efficacy and safety compared to placebo., Methods: This is a, randomized, double-blind, crossover, pilot trial (n = 10). All participants received saline and arketamine (0.5 mg/kg) with a one-week interval. Treatment effects were analyzed with a linear mixed effects (LME) model., Results: Our analysis suggested the presence of a carryover effect, so the main efficacy analysis was limited to the first week, which demonstrated a main effect of time (p = 0.038) but not for treatment (p = 0.40) or their interaction (p = 0.95). This indicates that depression improved over time, but without significant difference between arketamine and placebo. Analyzing the two weeks together, findings were the same. Dissociation and other adverse events were minimal., Limitations: This was a pilot study with a small sample and underpowered., Conclusions: Arketamine was not superior to placebo for TRD but demonstrated to be extremely safe. Our findings reinforce the importance of continuing studies with this drug, with better powered clinical trials, perhaps considering a parallel design with higher or flexible doses and repeated administrations., Competing Interests: Conflict of interest Dr. Lacerda reports grants and personal fees from Janssen Pharmaceutical, Daiichi Sankyo, Cristalia Produtos Químicos e Farmacêuticos, Libbs, Pfizer, Myralis Farma, Aché Laboratórios, Hypera Pharma, Sanofi-Aventis, Eli Lilly, H. Lundbeck A/S, Servier Laboratories, Hoffman-La Roche, and Forum Pharmaceuticals. Dr. Sanacora, in the last 12 months, has provided consulting services to Ancora, Aptinyx, Axsome Therapeutics, Biohaven Pharmaceuticals, Bristol-Myers Squibb, Clexio Biosciences, Denovo Biopharma, EMA Wellness, Engrail, Gilgamesh, Freedom Biosciences, Intra-Cellular Therapies, Janssen, miCure Therapeutics, Merck, Navitor Pharmaceuticals, Neurocrine, Novartis, Noven Pharmaceuticals, Perception Neuroscience, Praxis, Sage Pharmaceuticals, Seelos Pharmaceuticals, and XW Labs. He has received funds for contracted research from Janssen Pharmaceuticals, Merck, and Usona Institute. He holds equity in Biohaven Pharmaceuticals and has received royalties paid from patent licenses with Biohaven Pharmaceuticals. His employer, Yale University, has a financial relationship with Janssen Pharmaceuticals and may receive financial benefits from this relationship. Other authors have no conflicts of interest to report., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objectives: Evidence suggests that ketamine's influence on brain-derived neurotrophic factor (BDNF) might be involved in its mechanism of rapid antidepressant action. We aimed to evaluate the differential impact of ketamine and esketamine on serum BDNF levels and its association with response patterns in treatment-resistant depression (TRD)., Methods: Participants (n = 53) are from a randomized, double-blind clinical trial comparing the efficacy of single-dose ketamine (0.5mg/kg, n = 27) and esketamine (0.25mg/kg, n = 26) in TRD. Depression severity was assessed before and 24 hours, 72 hours, and 7 days after the intervention, using the Montgomery-Åsberg Depression Rating Scale (MADRS). Blood samples were collected before infusion, 24 hours, and 7 days afterwards., Results: There were no significant changes in BDNF levels at post-infusion evaluation points, and no difference in BDNF levels comparing ketamine and esketamine. Both drugs exhibited similar therapeutic effect. There was no association between BDNF levels and response to treatment or severity of depressive symptoms., Conclusion: There was no significant treatment impact on BDNF serum levels - neither with ketamine nor esketamine - despite therapeutic response. These results suggest that ketamine or esketamine intervention for TRD has no impact on BDNF levels measured at 24 hours and 7 days after the infusion., Competing Interests: Acioly L. T. Lacerda reports grants and personal fees from Janssen Pharmaceutical; personal fees from DaiichiSankyo, Cristália, Libbs, Pfizer, Myralis-Farma, Aché Laboratórios, Hypera-Pharma, and Sanofi-Aventis; grants from Eli-Lilly, Lundbeck, Servier-Laboratories, Hoffman-La-Roche, and Forum-Pharmaceuticals. Lucas C. Quarantini reports consulting fees from Allergan, Abbot, Janssen-Pharmaceutical and Lundbeck, and research fees from Janssen-Pharmaceutical. No other conflicts of interest declared concerning the publication of this article.

To analyse the prevalence of dysphagia perception and associated factors among community-dwelling older adults in Pelotas, Brazil. A total of 1447 community-dwelling individuals aged 60 and older participated in a cross-sectional population-based study carried out in 2014. Dysphagia perception was assessed using the following question: "Do you have swallowing difficulties? (Yes/No)". Independent variables included sociodemographic, behavioural and health characteristics. Poisson regression was used to obtain prevalence ratios. Dysphagia perception prevalence was 8.1%, higher among women (PR 1.63, 95% CI 1.07; 2.46) and in subjects older than 80 years (PR 1.88, 95% CI 1.16; 3.03). Older adults with 1-7 years of schooling were more likely to present dysphagia (PR 1.62; 95% CI 1.09; 2.40). Those who did not use dental prosthesis (PR 1.85; 95% CI 1.08; 3.16), who presented dry mouth sensation (PR 4.10; 95% CI 2.59; 6.51) and multimorbidity (PR 30.0; 95% CI 4.09; 219.45) were more likely to present dysphagia perception. The participants who consumed alcohol were 60% less likely to report dysphagia perception (PR 0.43; 95% CI 0.22; 0.86). One out of twelve older adults presented dysphagia perception, and associations with sociodemographic characteristics and other health problems were found. Early identification of dysphagia should be a public health and clinical concern., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purposes/background: The aims of the study were to assess subanesthetic esketamine as an antidepressant for major depressive disorder with psychotic features (PMDD) and to compare posttreatment symptoms among those with PMDD to a sample of nonpsychotic depression (major depressive disorder [MDD])., Methods/procedures: This study is a retrospective chart review of patients with major depression and current psychotic symptoms, treated with a single parenteral 0.5-mg/kg dose of esketamine. Depression symptoms were assessed at baseline and 24-hour posttreatment with the Montgomery-Åsberg Depression Rating Scale. Individuals with PMDD were matched in a 1:2 ratio to nonpsychotic MDD patients from a randomized, noninferiority clinical trial of esketamine., Findings/results: A total of 15 individuals with PMDD were included, which had higher baseline depression scores (PMDD = 40.9, MDD = 33.6, P = 0.004). A statistically significant change in depressive symptoms was found for the PMDD sample (β = -16.20 [95% confidence interval, -23.30 to -9.10], P < 0.001), and no difference between PMDD and MDD groups was observed in the matched-sample analysis (β = -2.2 [95% confidence interval, -9.32 to 4.58], P = 0.537). Treatment-induced dissociative symptoms were present for both groups, self-contained to within 2 hours after treatment, and no exacerbation of psychotic symptoms was found in clinical assessments., Implications/conclusions: Results suggest a single 0.5-mg/kg dose of esketamine may benefit individuals with PMDD, and the symptom reduction may be comparable with esketamine's effects for MDD. Furthermore, esketamine may induce an antidepressant response in those with PMDD without complication of psychotic symptoms. Future research with controlled designs is warranted., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Major depressive disorder (MDD) is a leading cause of disability worldwide and most people do not achieve symptom remission. Treatment-resistant depression (TRD) is characterized by the failure of at least one adequate trial of a major class of antidepressant, with adequate time and dosage. We aimed to identify clinical predictors of depressive symptom remission and response 24 h and 7 days after racemic ketamine and esketamine infusions., Methods: A randomized, double-blind, active-controlled, non-inferiority trial using ketamine and esketamine in TRD. Individuals diagnosed with MDD according to Diagnostic and Statistical Manual of Mental Disorders version IV and fulfilling TRD criteria were recruited from March 2017 to June 2018. Participants received a single subanesthetic dose of ketamine (0.5 mg/kg) or esketamine (0.25 mg/kg) for 40 min. Depressive symptoms were assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) and symptom remission was defined as a MADRS score ≤7 and response defined as ≥50% reduction in depressive symptom severity, 24 h and 7 days after the infusion. Clinical variables were selected based on previous clinical trials. Stepwise backward logistic regression was used, considering a confidence level of 95%., Results: 61 subjects were included: 39 (63.9%) were females with a mean age of 47.2 ± 14.9. Higher number of therapeutic failures (Odds Ratio (OR) = 0.677; 95% confidence interval (CI): 0.47-0.97) and higher severity of illness (OR = 0.912; 95% CI: 0.83-0.99) were associated with fewer remissions of depressive symptoms 7 days after intervention, and with fewer response in 24 h (OR = 0.583; 95% CI: 0,40; 0,84 and OR = 0.909; 95% CI: 0,83; 0,99, respectively)., Conclusion: Number of treatment failures and severity of illness were predictors of fewer remissions and responses of depressive symptoms in this TRD population. Study of predictors of remission may contribute to better selection patients that may benefit from receiving ketamine., (© 2022 John Wiley & Sons Ltd.)

The objective of this study is to evaluate cognition in patients using either ketamine or esketamine to treat TRD. We also evaluate if both ketamine and esketamine as one group influence cognition in patients with TRD. Fifty-four patients with TRD were infused with either ketamine or esketamine and were assessed at three time points: baseline, 24 h, and 7 days after infusion. We applied neuropsychological tests to evaluate executive functions, processing speed, short term memory, and auditory-verbal episodic memory. There is no cognitive difference between ketamine and esketamine, with the exception of one variable. When considered as one group, ketamine and esketamine do not impair cognition; on the contrary, they improve some neuropsychological functions such as visuospatial short-term memory, executive functions, processing speed, and several measures related to episodic verbal memory. Ketamine and esketamine do not present differing cognitive effects when used in antidepressant doses to treat TRD. Furthermore, they rapidly improve many cognitive aspects of patients with TRD at 24 h after the infusion and maintain these effects for at least 7 days., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Dissociative symptoms are common, possibly severe, side effects associated with the use of ketamine and esketamine in depression. We investigated the relationship between trait dissociation and dissociation induced by ketamine and esketamine used as augmentation therapy in treatment-resistant depression (TRD). Adults with TRD were randomly assigned to receive a single intravenous infusion, with a duration of 40 min, of either esketamine 0.25 mg/kg or ketamine 0.5 mg/kg. We assessed trait dissociation with the Dissociative Experience Scale (DES) and, to evaluate induced dissociation, the Clinician-Administered Dissociative States Scale (CADSS) was used. Thirty-two subjects received esketamine and 29 received ketamine. The groups had similar median DES scores (p = 0.26). More than 30% of the patients in both groups had DES scores ≥30 points. The median CADSS score in the esketamine group was equivalent to that in the ketamine group (p = 0.40). Every 5 points increment in the DES was associated with a 10.9% (95% CI 4.5-17.8%) increase in the CADSS, in an exponential fashion when the two groups were pooled together. Subjects with high trait dissociation had a higher risk of induced dissociation state (relative risk [RR] 1.41, 95% CI 1.11-1.78) and very high induced dissociation (RR 3.05, 95% CI 1.14-8.15). Induced dissociation was not a serious adverse effect. The findings suggest that trait dissociation is a predictor of induced dissociation by Ketamine or Esketamine in TRD subjects. Screening for trait dissociation and counseling patients with high trait dissociation on the risks of dissociation by these drugs are recommended., (Copyright © 2021. Published by Elsevier Ltd.)

We aimed to analyze the efficacy and safety of arketamine, the R(-)-enantiomer of ketamine, for treatment-resistant depression (TRD) in humans. Open-label pilot trial, seven subjects with TRD received a single intravenous infusion of arketamine (0.5 mg/kg); primary outcome was change in Montgomery-Åsberg Depression Rating Scale (MADRS) 24 h after. Mean MADRS dropped from 30.7 before infusion to 10.4 after one day, a mean difference of 20.3 points [CI 95% 13.6-27.0; p < 0.001]; dissociation was nearly absent. Arketamine might produce fast-onset and sustained antidepressant effects in humans with favorable safety profile, like previously reported with animals; further controlled-trials are needed.

Background: Ketamine and its enantiomers have recently been highlighted as one of the most effective therapeutic options in refractory depression. However, racemic ketamine and esketamine have not been directly compared. The aim of this study is to assess the efficacy and safety of esketamine compared to ketamine in patients with treatment-resistant depression (TRD)., Methods: This is a randomized, double-blind, active-controlled, bicentre, non-inferiority clinical trial, with two parallel groups. Participants were randomly assigned to a 40-min single intravenous infusion of ketamine 0.5 mg/kg or esketamine 0.25 mg/kg. The primary outcome was the difference in remission rates for depression 24 h following intervention using the Montgomery-Åsberg Depression Rating Scale (MADRS), with a non-inferiority margin of 20%., Results: 63 subjects were included and randomly assigned (29 to receive ketamine and 34 to receive esketamine). At 24 h, 24.1% of participants in the ketamine group and 29.4% of participants in the esketamine group showed remission, with a difference of 5.3% (95% CILB -13.6%), confirming non-inferiority. MADRS scores improved from 33 (SD 9.3) to 16.2 (SD 10.7) in the ketamine group and from 33 (SD 5.3) to 17.5 (SD 12.2) in the esketamine one, with a difference of -5.27% (95% CILB, -13.6). Both groups presented similar mild side effects., Conclusions: Esketamine was non-inferior to ketamine for TRD 24 h following infusion. Both treatments were effective, safe, and well tolerated., Trial Registration: Registered in Japan Primary Registries Network: UMIN000032355., Competing Interests: Declaration of Competing Interest LCQ reports consulting fees from Allergan, Abbot, Janssen Pharmaceutical and Lundbeck and research fees from Janssen Pharmaceutical. ALTL reports grants and personal fees from Janssen Pharmaceutical, personal fees from Daiichi Sankyo, Cristalia Produtos Químicos e Farmacêuticos, Libbs, Pfizer, Myralis Farma, Aché Laboratórios, Hypera Pharmaand Sanofi-Aventis, grants from Eli Lilly, H. Lundbeck A/S, Servier Laboratories, Hoffman-La Roche, Forum Pharmaceuticalsand from public programs: CNPq and FAPESP; LMS received personal fees from Daiichi Sankyo Brasil, Lundbeck Brasil, Moksha8 Brasil, Takeda Brasil, Pfizer, Sanofi Aventis, and Torrent Pharma. The other authors report no conflicts of interest., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Introduction: The use of ketamine as an option in the treatment of depressive disorder is growing rapidly, supported by numerous clinical trials attesting its efficacy and safety. Esketamine, the S (+) enantiomer of ketamine, is the most widely used form in the anesthetic environment in some countries, and new studies have shown that it may also be effective in depression and with better tolerability. However, no study so far has directly compared esketamine with racemic ketamine. Here we propose a protocol of a clinical trial to evaluate esketamine as a noninferior medication when compared to ketamine in the treatment of patients with treatment-resistant depression., Methods/design: This study protocol is for a randomized, controlled, double-blind noninferiority clinical trial. Subjects will be 18 years or older, with major depression characterized as treatment-resistant. Participants will receive a single infusion of either esketamine (0.25 mg/kg) or ketamine (0.5 mg/kg) over 40 minutes. The primary outcome will be the difference in remission rates between the 2 treatment arms at 24 and 72 hours after drug infusion. Secondary outcomes will include other timepoints, measurements of cognition, dissociation, and blood biomarkers., Discussion: A head-to-head study is the best way to evaluate whether the esketamine is in fact comparable to the racemic ketamine in terms of both efficacy and safety, and, if positive, it would be an initial step to increase the access to that type of treatment worldwide., Ethics and Dissemination: The study was approved by the local Institutional Review Board (University Hospital Professor Edgard Santos-Federal University of Bahia-Number: 46657415.0.0000.0049). Subjects will only participate after voluntarily agreeing and signing the Informed Consent Form. The study findings will be published in peer-reviewed journals and presented at national and international conferences., Trial Registration: This trial has been registered in the Japan Primary Registries Network (JPRN): UMIN000032355, which is affiliated with the World Health Organization.

Background: Thyroid remnant ablation (RA) with 30 mCi of radioactive iodine (131I) in patients thyroidectomized for treatment of low-risk differentiated thyroid carcinoma (DTC) has a success rate of 64% to 84%. Lithium increases the residence time of 131I in the thyroid tissue. The aim of this study was to determine if lithium treatment added to 30 mCi 131I would enhance the success rate of this treatment compared with 30 mCi 131I alone in patients who were thyroidectomized for treatment of low-risk DTC., Methods: This was a randomized study with endpoint at one year. Sixty one consecutive patients were enrolled and randomized into two groups: group A (n=32) treated with 30 mCi 131I; group B (n=29) treated with 30 mCi 131I plus an oral dose of lithium 900 mg/day, for 7 days. All patients were evaluated by whole body scan (WBS) with 123I and had serum TSH, thyroglobulin (Tg), and anti-Tg antibodies (TgAb) determined when they were hypothyroid on no thyroid hormone. Patients were reevaluated after one year with serum TSH, Tg, and TgAb determinations and WBS with 123I. The criteria for defining a successful outcome was a negative WBS and a serum Tg of <1., Results: Group A was composed of 28 women and four men (ages 25-71 years) with 2 having follicular thyroid carcinoma (FTC), 22 having papillary thyroid carcinoma (PTC) of 1-4.5 cm, and 8 having micro PTCs (mPTC) of 0.3-0.8 cm. Group B was composed of 26 women and 3 men (ages 20-63 years) with 3 having FTC, 15 having PTC of 1.2-3.5 cm, and 11 having mPTC of 0.2-0.8 cm. All patients had a history of a WBS after their post-therapeutic 131I dose that showed uptake in the cervical region. After one year, 22 patients from group A had a negative WBS (68.75%) and in group B, 27 patients had a negative WBS (93.1%). The successful rates for the follow-up WBS were significantly different (p=0.017). There were 19 patients in group A in whom the initial Tg was positive. Of these, 14 had a negative follow-up Tg (73.7%). Group B had 9 patients with a positive initial Tg and all of them had a negative follow-up Tg (100%)., Conclusion: The addition of lithium to treatment with 30 mCi 131I in thyroidectomized patients with low-risk DTC improved the efficacy of thyroid RA and therefore might be a better alternative than using higher doses of 131I for remnant ablation in these patients.

Background: Invasive and non-invasive tests have been used to identify the risk of ventricular tachycardia (VT) in patients with chronic Chagas' heart disease (CCHD). Cardiac magnetic resonance imaging (CMRI) using the delayed enhancement (DE) technique can be useful to select patients with global or segmentary ventricular dysfunction, with high degree of fibrosis and at higher risk for clinical VT., Objective: To improve the identification of predictors of VT in patients with CCHD., Method: This study assessed 41 patients with CCHD [30 (72%) males; mean age, 55.1 ± 11.9 years]. Twenty-six patients had history of VT (VT group), and 15 had no VT (NVT group). All patients enrolled had DE and segmentary ventricular dysfunction. In each case, the following variables were determined: left ventricular volume; percentage of ventricular wall thickness impairment in each segment; and DE distribution., Results: No statistical difference regarding the DE volume between both groups was observed: VT group = 30.0 ± 16.2%; NVT group = 21.7 ± 15.7%; p = 0.118. The probability of VT was greater in the presence of two or more contiguous transmural fibrosis areas, and that was a predictive factor of clinical VT (RR 4.1; p = 0,04). Agreement between observers was 100% regarding that criterion (p < 0.001)., Conclusion: The identification of two or more segments of transmural DE by use of CMRI is associated with the occurrence of clinical VT in patients with CCHD. Thus, CMRI improved risk stratification in the population studied.

A temporal observational study on culicid entomofauna was conducted in a region characterized as a fragment of the Atlantic Forest that forms the Tinguá Biological Reserve in the State of Rio de Janeiro. This investigation was performed with the aim of analyzing the influence of climatic factors (temperature and relative air humidity) on the activity levels at different times of the day among mosquito species within the ecosystems that form the Tinguá Biological Reserve. The abundance index and dominance coefficient were calculated in relation to 61 mosquito species that were caught at four sampling sites, in the mornings, afternoons, and evenings. The results revealed that culicid species were distributed with greater incidence during the two diurnal periods and that their preference for times of the day was directly influenced by the climatic variables analyzed. The latter acted as limiting factors for occurrences of mosquito species.

Objective: To evaluate the risk of malignancy in thyroid nodules through clinical, laboratory, ultrasonographic and cytological aspects., Patients and Methods: 741 nodules of 407 patients., Results: The cytology was benign (60,5%), indeterminate (23,3%), malignant (8,3%) or nondiagnostic (7,6%). The prevalence of cancer in indeterminate citology was 18,5% (16% in follicular lesions, 44% in suspicious). The diagnosis of malignancy was 17,2% (n = 70). The frequency of cancer in women (15,2%) was lower than in men (27,9%). There was an inverse relation between age and cancer risk. There was no statistical significance in the prevalence of cancer according to number, size of nodules or TSH levels. Hypoechogenicity and microcalcifications on ultrasound were risk factors., Conclusion: The risk of malignancy was higher in men, hypoechoic nodules, with microcalcifications and was inversely related to age. The TSH level was not an independent factor predictive of malignancy.

We report the association between heart disease associated with noncompaction of the left ventricular myocardium (NCLVM) and chronic Chagas' heart disease (CCHD) in a patient with heart failure, ischemic stroke and cardiac arrhythmia. Images typical of NCLVM and CCHD were documented by cardiac magnetic resonance imaging (CMRI).

Objective: In patients with primary hyperparathyroidism, candidates for surgical intervention, the parathyroid pre-operative localization is of fundamental importance in planning the appropriate surgical approach., Materials and Methods: The additional acquisition of SPECT and Technetium-99m images, during parathyroid scintigraphy with Sestamibi, is not common practice. Usually, only planar image acquisition, 15 minutes prior and 2 hours after radiopharmaceutical administration, is performed., Results: In our experience, the complete protocol in parathyroid scintigraphy increases the accuracy of pre-operative parathyroid localization., Conclusion: The complete utilization of all available nuclear medicine methods (SPECT e 99mTc) and image interpretation in a multidisciplinary context can improve the accuracy of parathyroid scintigraphy.

The calyptrate dipterans are the most important decomposers of human cadavers. Knowledge of their species and distribution are of great importance to forensic entomology, especially because of the enormous diversity in Brazil. Carcasses of domestic pigs (Sus scrofa, L) were the experimental models used to attract calyptrates of forensic interest during the winters of 2006 and 2007 and the summers of 2006 and 2008. A total of 24,423 specimens from 44 species were collected (19 Muscidae, 2 Fanniidae and 23 Sarcophagidae), three of which were new records of occurrence and 20 of which were new forensic records for the state of Rio de Janeiro. Fourteen of these species were newly identified as forensically important in Brazil.

The toxicity of tetrahydrofuran lignan grandisin was evaluated against larvae of Chrysomya megacephala F. (Diptera: Calliphoridae). The bioassay involved topical treatment on larvae, topical treatment on egg masses, and incorporation in the larval diet. Grandisin showed inhibition of postembryonic development by ovicidal (30%) and larvicidal (38%) effects and reduced larval weight (4 mg), when topically applied on egg masses and starving larvae (L1) at a concentration of 100 microg/microl. These findings elucidated the effect of grandisin on the C. megacephala life cycle and its potential to control C. megacephala populations.

Forensic entomology is the science that studies the role of insects in decomposing corpses and one of the most common uses is to estimate the post-mortem interval (PMI) based on insect activity on a decomposing body. Usually, flies are the first insects to reach a carcass and are able to oviposit on carrion within a few hours after death. Scanning electron microscopy (SEM) gives detailed information about morphological characters helping to identify the immature forms of flies and consequently serves as a tool in crime scene investigations. Sometimes, only eggs and larvae are found in corpses. Some dipteral species are important because their larvae develop in organic matter. The aim of this study is to identify eggs of species of forensic importance, such as Chrysomya megacephala, Chrysomya putoria, Lucilia cuprina, Lucilia eximia and Ophyra aenescens, using scanning electron microscopy (SEM). C. megacephala had no anastomosis or holes at the top of the islands and C. putoria had few anastomoses and no holes, whereas L. eximia and O. aenescens were found to have anastomoses and holes and L. cuprina had only anastomoses. The median area was bifurcated anteriorly in C. megacephala, L. eximia and O. aenescens and rounded in C. putoria and L. cuprina. Also the sculptures observed in the chorionic cells, the length and the way that median area ends up posteriorly are characteristics of great diagnostic value to identify muscoids of forensic importance.

The record of Pseudolynchia canariensis on two Rufous Crab-Hawk in situ taken care of the Hospital Veterinarian of the RioZoo Foundation. The nineteen collected specimens had been identified in the Laboratory of Diptera, Fundação Instituto Oswaldo Cruz. The findings of P. canariensis out natural host (Columba livia) it represents a contribution to the studies of the family Hippoboscidae considering that it does not have records about native birds of the american continent parasitized by P. canariensis.

Predictive models of battlefield physical performance can benefit the military. To develop models, 32 physically trained men (mean +/- SD: 28.0 +/- 4.7 years, 82.1 +/- 11.3 kg, 176.3 +/- 7.5 cm) underwent (1) anthropometric measures: height and body mass; (2) fitness tests: push-ups, sit-ups, 3.2-km run, vertical jump, horizontal jump; (3) simulated battlefield physical performance in fighting load: five 30-m sprints prone to prone, 400-m run, obstacle course, and casualty recovery. Although greater body mass was positively associated with better casualty recovery performance, it showed trends toward poorer performance on all the other fitness and military performance tests. Regression equations well predicted the simulated battlefield performance from the anthropometric measures and physical fitness tests (r = 0.77-0.82). The vertical jump entered all four prediction equations and the horizontal jump entered one of them. The equations, using input from easy to administer tests, effectively predict simulated battlefield physical performance.

Phytochemicals endowed with hormonal, antihormonal, or toxic activity are potential agents for insect control. The effect of some neolignans on one of the most prevalent flies in urban areas, which constitutes a menace to public health, was investigated.

We report a case of ventricular septal rupture following chest trauma resulting from a car accident. The outcome was relatively favorable despite the extension of the anatomic lesion.

Morphological details are provided for the dorsal and ventral surfaces of both extremities and the micropylar area of eggs of Haemagogus (Haemagogus) capricornii Lutz, captured in the Biological Reserve of Tinguá, State of Rio de Janeiro, Brazil. The eggs were observed by scanning electron microscopy with a morphometrical analysis of the main structures. The outer chorionic cells on the ventral surface were extremely regular, such as those observed in Hg. equinus and Hg. janthinomys. The tubercles present differences in form, size, and distribution. Filaments to attach to the substrate were observed in this species.

The ecology of anopheline species (Diptera, Culicidae) was studied in the vicinity of the Serra da Mesa Reservoir, State of Goiás, Brazil. Climatic factors and frequency of anopheline populations were analyzed. Bimonthly human-bait and Shannon trap captures were conducted for 36 consecutive months (January 1997 through December 1999). A total of 5,205 adult anophelines belonging to five species were collected. Anopheles darlingi was the most frequently collected anopheline (61.4%), followed by An. albitarsis s.l. (35.4%), An. triannulatus. (2.5%), An. oswaldoi (0.4%), and An. evansae (0.2%). The water level and vegetation along the banks of the reservoir were crucial to the frequency of the various anopheline species. Climatic factors had a secondary influence. The reservoir's water-level stability, increased frequency of An. darlingi, and the arrival of gold prospectors were responsible for the increase in malaria cases.

The study was carried out with the purpose of identifying the main parasitoids of Chrysomya megacephala in the city of Rio de Janeiro, Brazil, given the importance of these flies as vectors of pathogenic agents in the urban environment. Samplings were conducted every week from August 1999 to July 2000. The substrate used to grow fly pupae and to trap parasitoids was decomposing meat. It was identified three species of microhimenopterans: Tachinaephagus zealandicus (Encyrtidae), Pachycrepoideus vindemiae (Pteromalidae) and Nasonia vitripennis (Pteromalidae). Further analysis will be performed in order to show the potential of these insects as agents in biological control programs.

Objective: To observe morphological details of the eggs of Haemagogus (Conopostegus) leucocelaenus, seen for the first time via scanning electron microscopy (SEM), with morphometric analysis of the main structures., Methods: Eggs of Hg. leucocelaenus were obtained from females captured in the Biological Reserve of Tinguá, State of Rio de Janeiro. Some of the eggs were kept for hatching and others underwent processing for scanning electron microscopy studies. Three eggs were submitted to morphometric analysis. The material was fixed in 2.5% glutaraldehyde and postfixed in 1% osmium tetroxide, both in 0.1M, pH 7.2 sodium cacodylate buffer, then dehydrated in ethanol and dried using the critical point method. This was then set up on metallic supports, covered with gold and observed using the Jeol 5310 scanning electron microscope. Measurements were made with the aid of the Semafore analysis software coupled to the electron microscope., Results: The eggs presented elliptical outlines of approximately 574 mm in length and 169 mm in width, with an egg index (l/w ratio) of 3.39 mm. The exochorion was extremely regular and had ornamentation that was usually hexagonal but sometimes pentagonal. Tubercles were observed on the chorionic cells, symmetrically arranged in relation to the longitudinal axis. Inside the cells, there were smaller, individualized tubercles, some arranged peripherally and others grouped to a greater or lesser extent in the center. The surface of the chorionic reticulum did not present rugosity. The micropylar apparatus was formed by a prominent continuous collar of 8.32 mm in thickness, with a slightly irregular surface. The micropylar disk was very evident, and was continuous with the collar. The micropyle was seen at the center of this disk, measuring 1.6 mm and with a micropylar apparatus of 27.3 mm in diameter., Conclusions: The ornamentation of the exochorion presents differences in relation to the tubercles of chorionic cells and the external chorionic reticulum between the eggs of Hg. Leucocelaenus, in comparison with the eggs of Hg. janthinomys and Hg. equinus, and also in relation to those of Aedes aegypti, Ae. albopictus and Ae. bahamensis. In various aspects, the eggs of Hg. leucocelaenus have more resemblance to those of Hg. Equinus than those of Hg. janthinomys, with greater differences presented in relation to the eggs of Hg. spegazzinii and Hg. lucifer.

The study was set up to evaluate the impact of two commercial larvicide formulations, Bacillus thuringiensis serovar israelensis base (Bti) at 15 ppm/1 min and temephos at 0.03 ppm of active ingredient, used to control Simulium pertinax populations, on associated non-target entomofauna occupying the same breeding sites. The experiments were carried out on the Pedra Branca and Muricana rivers, on the slopes of Serra do Mar massif, municipality of Paraty, state of Rio de Janeiro, Brazil. Bti was applied to the river Pedra Branca and temephosto theriver Muricana. On both rivers, treatment and control sections were labeled as such, each one with two observation posts: slow moving water and fast water regions respectively. Artificial substrata was used to evaluate the abundance of associated entomofauna. Attached immature stages of arthropods were removed from both of its surfaces fortnightly. Were collected, from the two rivers, 28 477 specimens of the entomofauna associated with S. pertinax. The families Hydropsychidae, Chironomidae, Bactidae, Simuliidae, Blephariceridae and Megapodagrionidae were represented. These was an impact of temephos on the entomofauna associated with S. pertinax only in Simuliidae and Chironomidae, and to Bti only in Simuliidae. However, the reduction in their numbers was not statistically significant.

A study of the mosquito fauna in the Iguaçu National Park focused on population behavior in four biotopes with different types of plant cover inside the Park. Systematic bimonthly diurnal and nocturnal human bait and Shannon trap captures were conducted in both forest and domiciliary environments over the course of 24 months. A total of 20,273 adult mosquito specimens belonging to 44 species were collected: Ochlerotatus serratus (10.3%), Haemagogus leucocelaenus (9.7%), Mansonia titillans (9.6%), and Chagasia fajardoi (8.8%) were the most frequently captured mosquitoes. Anopheles cruzii, Runchomyia theobaldi, Wyeomyia aporonoma, and Wy. confusa were captured almost exclusively in well-preserved areas with dense forest cover. Culex nigripalpus, Oc. pennai, Oc. serratus, Sabethes purpureus, and Sa. albiprivus were captured in three essentially sylvatic biotopes. Species captured in the forest areas around a dam were: An. albitarsis s.l., An. galvaoi, An. evansae, An. fluminensis, Coquillettidia venezuelensis, Cq. juxtamansonia, Wy. quasilongirostris, and Onirion personatum, Ch. fajardoi, Cq. fasciolata, Cq nitens, and Ma. titillans were the most frequently captured species in a residential area.

This study assessed the effect of upper extremity muscle fatigue on shooting performance while in a standing, unsupported firing position. Nine male and three female soldiers fired at targets before and after performing upper extremity exercise to fatigue using both (1) an upper body ergometer and (2) a Military Operations in Urban Terrain obstacle course. Shooting accuracy, assessed by the number of hits, misses, and shot group size, was significantly decreased (p < 0.05) immediately following both types of exercise and recovered to pre-exercise values within 5 minutes for all measures except the number of misses, which returned to pre-exercise values by 10 minutes. There was no relationship between fitness measures and shooting performance, although muscle endurance was a factor in the duration of exercise prior to fatigue. We conclude that shooting accuracy recovers rapidly in fit soldiers following fatiguing lifting, climbing, and pulling activity.

Objective: To assess muscoid dipterae species who are able to carry helminth eggs and larvae and to evaluate the potential contamination of trapped dipterae., Methods: The study was conducted in two different sites of the Zoological Garden of Rio de Janeiro from May 1996 to April 1998. Flies were captured weekly using traps containing putrefied fish, left out in the open for an hour at two sites in the zoo: Site 1 was next to the garbage and Site 2 was near the hippopotamus and birds of prey cages. Of the 41,080 flies captured, Chrysomya megacephala was the most representative species (69.34%), followed by Chrysomya albiceps (11.22%), Musca domestica (7.15%), Chrysomya putoria (4.52%), Fannia sp. ( 3.12%), Ophyra sp. ( 2.53%), and Atherigona orientalis (2.08%). Captured flies had their body surface washed out with distilled water and their gut dissected., Results: Among the species studied, C. megacephala and M. domestica presented higher helminth eggs on their body surface and in their intestinal content. Ascaroidea and Trichinelloidea eggs prevailed in the intestinal content of C. megacephala. The helminth eggs found on the body surface and in the intestinal content were identified as Ascaris sp., Toxascaris sp., Toxocara sp., Trichuris sp., Capillaria sp., Oxyuridae, Trichostrongylidae and Acantocephala. Besides eggs it was also found helminth larvae on the body surface of flies. There were significant differences between the two different capture sites related to the number of helminth eggs found on the flies., Conclusions: Faeces of zoo animals frequently found in their cages and in the zoo garbage contributed to the proliferation of muscoid dipterans who play an important role in spreading helminth eggs, mainly by direct contact of the flies' body with the animals' food.

This study evaluated the arm, trunk, and leg for fat mass, lean soft tissue mass, and bone mineral content (BMC) assessed via dual-energy X-ray absorptiometry in a group of age-matched (approximately 29 yr) men (n = 57) and women (n = 63) and determined their relationship to insulin-like growth factor I (IGF-I) and leptin. After analysis of covariance adjustment to control for differences in body mass between genders, the differences that persisted (P < or = 0.05) were for lean soft tissue mass of the arm (men: 7.1 kg vs. women: 6.4 kg) and fat mass of the leg (men: 5.3 kg vs. women: 6.8 kg). Men and women had similar (P > or = 0.05) values for fat mass of the arms and trunk and lean soft tissue mass of the legs and trunk. Serum IGF-I and insulin-like growth factor binding protein-3 correlated (P < or = 0.05) with all measures of BMC (r values ranged from 0.31 to 0.39) and some measures of lean soft tissue mass for women (r = 0.30) but not men. Leptin correlated (P < or = 0.05) similarly for measures of fat mass for both genders (r values ranging from 0.74 to 0.85) and for lean soft tissue mass of the trunk (r = 0.40) and total body (r = 0.32) for men and for the arms in women (r = 0.56). These data demonstrate that 1) the main phenotypic gender differences in body composition are that men have more of their muscle mass in their arms and women have more of their fat mass in their legs and 2) gender differences exist in the relationship between somatotrophic hormones and lean soft tissue mass.

There are very few reports on the microbiota of the digestive tract of sand flies, an important omission considering that blood is not the only meal ingested. Male and female sand flies obtain sugar meals from several sources, thereby increasing their chance of infection with microorganisms. Chances of contamination are higher when insects are bred in the laboratory, and this may affect the development of Leishmania spp. From the digestive tract of 300 sand fly females separated in two groups we isolated 10 species of bacteria in group 1 and 8 species in group 2. In group 1, Enterobacteriaceae of the following genera were identified: Serratia, Enterobacter, and Yokenella and the non-fermenters: Pseudomonas, Acinetobacter, and Stenotrophomonas. In group 2, the Enterobacteriaceae Enterobacter and Serratia were identified as well as the non-fermenters Acinetobacter, Stenotrophomonas, Burkolderia, and Pseudomonas.

The ecology of mosquito species (Diptera: Culicidae) was studied in areas of the Serra do Mar State Park, State of São Paulo, Brazil. The influence of the lunar cycle and the daily biting rhythms of mosquito populations were analyzed. Systematized biweekly human bait collections were made in a silvatic environment for 24 consecutive months (January 1991 to December 1992). A total of 20,591 specimens of adult mosquitoes belonging to 55 species were collected from 545 catches. Sabethini species were captured exclusively during daylight periods, with the exception of Trichoprosopon digitatum, while members of Anophelinae predominated during nocturnal hours. Members of the subfamily Culicinae that were collected primary during nocturnal periods included Culex nigripalpus, Coquillettidia chrysonotum and Cq. venezuelensis while daytime catches included Psorophora ferox and Ps. albipes. Others members of culicines mosquitoes that were collected during both day and night included: Aedes serratus, Ae. scapularis and Ae. fulvus. Lunar cycles did not appear to influence the daily biting rhythms of most mosquito species in the area, but larger numbers of mosquitoes were collected during the new moon. Ae. scapularis were captured mainly during the full moon.

It has been reported that plasma choline levels decrease following certain types of strenuous exercise. Preliminary findings also suggest that a drop in plasma choline may limit physical performance, while choline supplementation may delay fatigue during prolonged efforts. A double-blind crossover design was used to determine the relationship between plasma choline and performance during and after 4 hr of strenuous exercise. Volunteers (N = 14) received either a placebo or treatment beverage (8.425 g choline citrate) prior to and midway through a 4-hr load carriage treadmill exercise (3% grade at 5.6 km/h 3 20 km) carrying a total load of 34.1 kg. Following the treadmill test, run time-to-exhaustion and squat tests were performed, and perceived exertion, plasma choline, glycerophosphocholine, and phosphatidylcholine were measured. Plasma choline levels increased 128% after the run-to-exhaustion with the choline supplemented beverage but remained unchanged with the placebo beverage. No significant effects were seen with choline supplementation on any outcome performance measure. Consequently, soldiers conditioned to carry heavy loads over long distances do not deplete plasma choline as a result of a prolonged exhaustive exercise under a placebo beverage, nor do they benefit from choline supplementation to delay fatigue under the same conditions.

We dissected the digestive tract of 245 females in pools of 35 flies forming 7 groups. These flies were Lutzomyia longipalpis originating from Lapinha Cave, Lagoa Santa, Minas Gerais. Out of the 8 species of bacteria isolated there was a predominancy of Gram negative bacterias (GNB) in the group of non-fermenters of sugar belonging to the following species: Acinetobacter lwoffii, Stenotrophomonas maltophilia, Pseudomonas putida and Flavimonas orizihabitans. The group of GNB fermenters were: Enterobacter cloacae and Klebsiella ozaenae. In the Gram positive group we isolated the genera Bacillus thuringiensis and Staphylococcus spp.

The ecology of mosquitoes were studied (Diptera: Culicidae) in areas of Serra do Mar State Park, State of São Paulo, Brazil. Systematized monthly human bait collections were made three times a day, for periods of 2 or 3 h each, in sylvatic and rural areas for 24 consecutive months (January 1991 to December 1992). A total of 24, 943 specimens of adult mosquitoes belonging to 57 species were collected during 622 collective periods. Coquillettidia chrysonotum was the most frequent collected mosquito (45.8%) followed by Aedes serratus (6.8%), Cq. venezuelensis (6.5%), Psorophora ferox (5.2) and Ps. albipes (3.1%). The monthly averages of temperature and relative humidity were inserted in the ten-year average limits of maximum and minimum of the previous ten-years. Rainfall accompanied the curve of the ten-year averages. Those climatic factors were influential in the incidence of some species; temperature: Anopheles cruzii, An. mediopunctatus, Ae. scapularis, Ae. fulvus, Cq. chrysonotum, Cq. venezuelensis, Runchomyia reversa, Wyeomyia dyari, Wy. confusa, Wy. shannoni, Wy. theobaldi and Limatus flavisetosus; relative humidity: Ae. serratus, Ae. scapularis, Cq. venezuelensis and Ru. reversa; rainfall: An. cruzii, Ae. scapularis, Ae. fulvus, Cq. venezuelensis Ru. reversa, Wy. theobaldi and Li. flavisetosus.

The mosquito (Diptera: Culicidae) ecology was studied in areas of Serra do Mar State Park, State of São Paulo, Brazil. Systematized biweekly human bait collections were made three times a day, for periods of 2 or 3 h each, in sylvatic and rural areas for 24 consecutive months (January 1991 to December 1992). A total of 24, 943 adult mosquitoes belonging to 57 species were collected during 622 collective periods. Aedes scapularis, Coquillettidia chrysonotum, Cq. venezuelensis, Wyeomyia dyari, Wy. longirostris, Wy. theobaldi and Wy. palmata were more frequently collected at swampy and at flooded areas. Anopheles mediopunctatus, Culex nigripalpus, Ae. serratus, Ae. fulvus, Psorophora ferox, Ps. albipes and the Sabethini in general, were captured almost exclusively in forested areas. An. cruzii, An. oswaldoi and An. fluminensis were captured more frequently in a residence area. However, Cx. quinquefasciatus was the only one truly eusynanthropic. An. cruzii and Ae. scapularis were captured feeding on blood inside and around the residence, indicating that both species, malaria and arbovirus vectors respectively, may be involved in the transmission of these such diseases in rural areas.

The gender differences in peak oxygen uptake (VO2peak) for various modes of exercise have been examined previously; however, no direct gender comparisons have been made during repetitive lifting (RL). In the present study the VO2peak between RL and treadmill running (TR) was compared between 20 men [mean (SD) age, height, body mass and body fat: 21 (3) years, 1.79 (0.06) m, 81 (9) kg, 19 (6)%, respectively] and 20 women [mean (SD) age, height, body mass and body fat: 21 (3) years, 1.63 (0.05) m, 60 (7) kg, 27 (6)%, respectively]. VO2peak (l x min[-1]), defined as the highest value obtained during exercise to volitional fatigue, was determined using discontinuous protocols with treadmill grade or box mass incremented to increase exercise intensity. For RL VO2peak, a pneumatically driven shelf was used to lower a loaded box to the floor, and subjects then lifted the box, at a rate of 15 lifts x min(-1). VO2peak (l x min(-1) and ml x kg(-1) x min[-1]) and minute ventilation (VE, l x min[-1]) were determined using an on-line gas analysis system. A two-way repeated measures analysis of variance revealed significant gender effects, with men having higher values for VO2peak (l x min(-1) and ml x kg(-1) x min[-1]) and VE, but women having higher values of the ventilatory equivalent for oxygen (VE/VO2). There were also mode of exercise effects, with TR values being higher for VO2peak (l x min(-1) and ml x kg(-1) x min[-1]) and VE and an interaction effect for VO2peak (l x min(-1) and ml x kg(-1) x min[-1]) and VE/VO2. The women obtained a greater percentage (approximately 84%) of their TR VO2peak during RL than did the men (approximately 79%). There was a marginal tendency for women to decrease and men to increase their VE/VO2 when comparing TR with RL. The magnitude of the gender differences between the two exercise modalities appeared to be similar for heart rate, VE and R, but differed for VO2peak (l x min(-1) and ml x kg(-1) x min[-1]). Lifting to an absolute height (1.32 m for the RL protocol) may present a different physical challenge to men and women with respect to the degree of involvement of the muscle groups used during lifting and ventilation.