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Rhipicephalus (Boophilus) microplus is one of the parasites that has an impact on livestock farming in Brazil. Bioassays using the larval packet test (LPT) impregnated with cypermethrin and diazinon at different concentrations were performed to characterize phenotypic resistance (resistance level, RL), molecular resistance (mutation in domain III - S6 T2134A) and enzymatic metabolism of diazinon and cypermethrin in some populations of R. microplus that were collected in different regions of the state of São Paulo. Among the 40 farms analyzed, 18 of them presented resistance factors for cypermethrin, with RL I (53%) and RL II (47%). Mutation of domain III T2134A was found for the first time in Brazil, on seven farms. Heterozygous larvae were found on six of them and resistant homozygous larvae on four. No differences (p>0.05) in enzymatic activity of α-esterase and ß-esterase were found in tests with live and dead larvae at a cypermethrin concentration of 409.6µg/cm2. Ninety percent of the farms showed resistance to the active agent diazinon: RL I in 6%, RL II in 30% and RL III in 64%. There were significant differences (p<0.05) in enzymatic activity at the highest concentration (3.2µg/cm2).

Rhipicephalus (Boophilus) microplus (Canestrini) é um dos parasitas que mais impactam a pecuária de países tropicais e subtropicais, incluindo o Brasil, com perdas em torno de US$ 3,24 bilhões por ano. Ocorrências de populações resistentes a diferentes classes de acaricidas e suas associações têm sido amplamente diagnosticadas em todo o Brasil. Para isso, bioensaios utilizando o teste de pacote larval (LPT) impregnado com cipermetrina e diazinon em diferentes concentrações foram realizados para caracterizar a resistência fenotípica (nível de resistência, RL), a resistência molecular (mutação no domínio III - S6 T2134A) e o metabolismo enzimático do diazinon e da cipermetrina em algumas populações de R. (Boophilus) microplus coletadas em diferentes regiões do estado de São Paulo. Dentre as 40 propriedades analisadas, 18 delas apresentaram fatores de resistência à cipermetrina, sendo RL I (53%) e RL II (47%). A mutação do domínio III T2134A foi encontrada pela primeira vez no Brasil, em sete fazendas. Larvas heterozigotas foram constatadas em seis delas, e larvas homozigotas resistentes em quatro. Nenhuma diferença (P>0,05) na atividade enzimática de α-esterase e ß-esterase foi observada em testes com larvas vivas e mortas em uma concentração de cipermetrina de 409,6µg/cm2. Noventa por cento das propriedades apresentaram resistência ao agente ativo diazinon: RL I em 6%, RL II em 30% e RL III em 64%. Houve diferenças significativas (P<0,05) na atividade enzimática na concentração mais elevada (3,2µg/cm2) entre os grupos de larvas vivas e mortas.

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OBJECTIVES: To perform a systematic review and meta-analysis of the diagnostic test accuracy of ultrasound and magnetic resonance imaging (MRI) and compare the performance of the two modalities in the diagnosis of placenta accreta spectrum (PAS). METHODS: This was a systematic review conducted following the Cochrane Diagnostic Test Accuracy Reviews guideline. A literature search was performed in five databases: PubMed, EMBASE, PMC, The Cochrane Library and BVS-Bireme between 27 July and 4 August 2020. The search was updated on 18 August 2021. We included observational studies evaluating diagnostic accuracy in women with risk factors for PAS who had undergone both ultrasound and MRI examinations, published in English between 2011 and 2021. Quality Assessment of Diagnostic Accuracy Studies-2 was used to evaluate the quality of the studies. Forest plots for sensitivity and specificity with 95% CIs and receiver-operating-characteristics curves for ultrasound and MRI were constructed. RESULTS: The literature search identified 266 studies. After reviewing the titles and abstracts of the articles, 51 were selected for full-text review and 17 studies including 1301 women with MRI and ultrasound data available were selected for the meta-analysis. The study population included 457 cases with PAS diagnosed using the gold standard method (intraoperative or histopathological analysis). The overall quality of the evaluated studies was considered satisfactory according to QUADAS-2. The meta-analysis revealed a sensitivity of 0.833 (95% CI, 0.776-0.878) and specificity of 0.834 (95% CI, 0.746-0.897) for ultrasound. For MRI, sensitivity was 0.838 (95% CI, 0.786-0.879) and specificity was 0.831 (95% CI, 0.770-0.878). There was no statistically significant difference between the two modalities. The Cochran's Q values indicated a high level of heterogeneity of sensitivity and specificity of ultrasound and MRI across studies. CONCLUSIONS: Ultrasound and MRI have similar accuracy in the diagnosis of PAS. These results suggest that, in a setting with a high prevalence of risk factors, the choice of imaging modality for initial screening for PAS should depend on the availability of equipment and the examiner's expertise. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

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Pesticides are used worldwide to control arthropod parasites in cattle herds. The indiscriminate and/or inappropriate use of pesticides without veterinary guidance is a reality in several countries of South America. Improper pesticide use increases the chances of contamination of food and the environment with chemical pesticides and their metabolites. Reduction of these contamination events is an increasing challenge for those involved in livestock production. The horn fly, Haematobia irritans (Linnaeus) (Diptera: Muscidae), is one of the most economically important parasites affecting cattle herds around the world. As such, horn fly control efforts are often required to promote the best productive performance of herds. Pesticide susceptibility bioassays revealed that pyrethroid resistance was widespread and reached high levels in horn fly populations in the Brazilian state of Rondônia. The knockdown resistance (kdr) sodium channel gene mutation was detected in all horn fly populations studied (n = 48), and the super kdr sodium channel gene mutation was found in all homozygous resistant kdr individuals (n = 204). Organophosphate resistance was not identified in any of the fly populations evaluated.

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The levels of infection by Babesia bovis and Babesia bigemina were estimated by absolute quantification through the quantitative PCR technique (qPCR). Fifty-one contemporaneous Angus cattle were evaluated on two occasions. The number of standard female Rhipicephalus microplus ticks present on the left side of the body was counted and blood samples were drawn from the tail vein into tubes containing the anticoagulant EDTA. The blood samples were submitted to DNA extraction and used to quantify the number of copies (NC) of DNA from B. bovis and B. bigemina by qPCR. The data on tick count and number of DNA copies were transformed for normalization and analyzed by a mixed model method. A multivariate model with repeated measures of the same animal, including the effects of collection, parasite species and their interaction, was used. The repeatability values were obtained from the matrix of (co)variances and were expressed for each species. The correlations between the counts of different species on the same animal, in the same collection or different collections, were also estimated. The results showed the qPCR could distinguish the two between infection by the two Babesia species. Infection levels by B. bovis and B. bigemina were detected in 100% and 98% of the animals, respectively. Significant differences were found (P<0.05) between the NC of the two Babesia species, B. bovis 1.49±0.07 vs. B. bigemina 0.82±0.06. Low repeatabilities were found for the counts of R. microplus and NC of B. bovis and B. bigemina: 0.05, 0.10 and 0.02, respectively. The correlations between R. microplus count and NC of B. bovis and B. bigemina were both very near zero. However, an association was observed between the NC of the two species, with a correlation coefficient of 0.30 for measures from the same collection. The absence of associations between the quantity of DNA from B. bovis and B. bigemina and the tick counts suggests that the variation of parasitemia by the hemoparasites did not depend on the tick infestation levels at the moment of each collection. The repeatability values estimated indicate that under the study conditions, the variations in the tick infestation levels and of parasitemia by B. bovis and B. bigemina depend more on factors related to each collection than on intrinsic factors of the animal.

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We present a case of a 45-year-old woman who presented with irregular vaginal bleeding and menorrhagia for two months, with an episode of massive bleeding initiating 24 hours before with hemodynamic shock. Vaginal inspection showed a soft, rounded, friable mass in vaginal introitus. After hospitalization, blood transfusion and hydration, she was submitted to vaginal myomectomy with the withdrawal of a 12-cm white, solid, huge, pedunculated, leiomyoma; however, hysterectomy was performed due to persistent uterine bleeding. The postoperation period had no complications. Macroscopy showed a retraction of the myoma pedicle. Gynecologists should prioritize clamping of a pedicle before surgery, reducing its size if the tumor is large.

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The effect of four extracts from neem seeds (Azadirachta indica) containing 2000, 5000, 9000 and 10,000 ppm of azadirachtin A (AZA), quantified by high-performance liquid chromatography (HPLC) and diluted to 1.25%; 2.5%; 5.0%; 10.0% and 12.8% was verified by in vitro tests with engorged females and larvae of the cattle tick Rhipicephalus microplus. The results from the bioassays with the engorged females showed that the main toxic effect of the extracts was reduction of the reproductive parameters, with a sharp drop in the number of eggs laid and the hatching rate, mainly when the extracts were diluted to 10.0% and 12.8%. The product effectiveness (PE) calculations for all the solutions tested showed that the AZA solution at 10,000 ppm (N10) was the most effective. However, statistical analysis of the PE data obtained for the proportional AZA concentrations in the different diluted extracts showed significance (P<0.05) of the effects included in the model (extract dilution, principle effect (classificatory) of the assay (extract) and the interaction between the two), indicating significant variations due to the dilution, the test and the interaction between the two factors in the tests with engorged females. For solutions N2, N5, and N9, it was not possible to estimate LC(90) values in the dilution range tested. The lowest LC(50) was observed for extract N5, and although extract N10 was the only extract for which the LC(90) could be estimated within the range tested, the LC(50) was higher than for N5 and N9. These results suggest that substances other than AZA present in the extracts influenced the efficacy, especially up to a certain LC range. In the tests with larvae, no mortality was observed, indicating zero effectiveness of all the extracts tested. The results of the tests with engorged females showed that the neem extracts had acaricide activity, inhibiting egg laying and the larval hatching rate. Complementary studies are necessary to develop new methods to isolate and/or identify other substances besides AZA contained in this plant, to enable using products made from it as acaricides.

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Primary fallopian tube carcinoma (PFTC) is a rare gynecologic neoplasm and is usually diagnosed late and presents classically with a characteristic group of symptoms. We describe a case of a 76-year-old woman who underwent TVS requested by the family physician due to unspecific pelvic pain. An adnexal mass was found with morphology associated with high levels of CA125 suggestive of a malignant tumor. During laparotomy, a mass located in the left tube was found. Histopathology confirmed PFTC. Total hysterectomy, salpingo-oophorectomy and adjuvant chemotherapy with carboplatin/paclitaxel were performed. The patient has not yet presented any signs of recurrence.

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The postoperative complications observed in a group of 27 patients with hematological diseases that underwent splenectomy are reported: 21 patients had a non-malignant hematological condition, whereas the rest had a hematological malignancy. Seven complications presented in 6 patients (two wound infections, two severe post-operative hemorrhages, one incisional hernia, one sepsis by capsulated bacteria and one fatal hemophagocytic syndrome). The overall complication rate was 27%, whereas the fatal complication rate was 3%. The complication rate in patients with malignant diseases was 83%, whereas that in benign conditions was 9%. The size of the spleen was related with the complication rate (median weight of patients with complications was 990 g versus 132 g in those without complications; p < 0.01). The two patients that underwent splenectomy before age six months had complications, in one case related to parental negligence. In splenectomies performed for hematological disease the benefits must be balanced carefully against the risks.

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