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Liver abscesses are a common complication in patients with amebiasis. Rarely, these will rupture across the diaphragm causing life-threatening empyemas. Evidence justifies performing surgical debridement or decortication for their treatment, given the better overall performance in comparison to open surgeries. However, no current guideline specifies which is the best approach. This report presents the case of a 39-year-old male with clinical, radiographical and microbiological evidence of an amebic empyema secondary to an amebic liver abscess, who received treatment by video-assisted thoracoscopy. The case description highlights the surgical technique, findings and operative outcomes that could be taken into consideration by other physicians to timely manage similar cases. The latter is especially relevant in underdeveloped and developing countries, where the burden of amebiasis appears to be greater. To the best of the authors' knowledge, this is the first description of a transdiaphragmatic amebic infection treated in a minimally invasive fashion.

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PURPOSE: The artificial urinary sphincter (AUS) is one of the most effective surgical treatments for male urinary incontinence regardless of its severity. Current knowledge comes from high-volume centers, but little is known about the performance of this surgery from community practices. This study aims to report contemporary AUS performance in a nationwide observational study in Colombia. METHODS: Male patients who underwent AUS surgery with AMS 800™ between 2000 and 2020 in more than 17 centers and four cities were identified. Pre, intra, and postoperative characteristics were evaluated, mainly addressing patient reported outcomes measurements in the postoperative period. Retrospective and prospective data collection and descriptive analysis were completed. Kaplan-Meier analysis was used to determine AUS survival rate. RESULTS: Out of an initial 667 cases, a total of 215 patients met inclusion and exclusion criteria and were included. Mean age was 67 ± 9.4 years, and mean follow-up was 6.0 ± 4.4 years with maximum range of 14 years. The etiology of urinary incontinence was prostate cancer surgery in 141 (81%) of the cases. The rest of the cases were related to benign prostatic disease or spinal cord injury. It is noteworthy that out of 115 patients, only 59 (51.3%) reported previous formal pelvic floor rehabilitation. Subjective severity of urinary incontinence determined by a visual analog scale showed a decrease in 4.5 points after sphincter implantation. Sphincter removal was required in 50 (23.2%) cases. The main reasons for implant removal were urethral erosion and infection. The sphincter survival rate at 2, 5, 8, 10, and 14 years was 76%, 70%, 60%, 57%, and 17%, respectively. Of the subjects at the last follow-up with the device still in place, 80.7% defined their urinary condition as "does not cause or causes minor discomfort," and 99% would recommend the device to a friend or relative in the same condition. CONCLUSIONS: This series from a community-based practice shows the lack of adherence to clinical practice guidelines and the lack of standardized data collection. In contrast, this study provides real-world data on explantation and revision rates, allows physicians to inform patients and to have clear metrics for a shared decision-making process before the procedure.

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OBJECTIVE: COVID-19 diagnosis is a critical problem, mainly due to the lack or delay in the test results. We aimed to obtain a model to predict SARS-CoV-2 infection in suspected patients reported to the Brazilian surveillance system. METHODS: We analysed suspected patients reported to the National Surveillance System that corresponded to the following case definition: patients with respiratory symptoms and fever, who travelled to regions with local or community transmission or who had close contact with a suspected or confirmed case. Based on variables routinely collected, we obtained a multiple model using logistic regression. The area under the receiver operating characteristic curve (AUC) and accuracy indicators were used for validation. RESULTS: We described 1468 COVID-19 cases (confirmed by RT-PCR) and 4271 patients with other illnesses. With a data subset including 80% of patients from Sao Paulo (SP) and Rio Janeiro (RJ), we obtained a function which reached an AUC of 95.54% (95% CI: 94.41-96.67%) for the diagnosis of COVID-19 and accuracy of 90.1% (sensitivity 87.62% and specificity 92.02%). In a validation dataset including the other 20% of patients from SP and RJ, this model exhibited an AUC of 95.01% (92.51-97.5%) and accuracy of 89.47% (sensitivity 87.32% and specificity 91.36%). CONCLUSION: We obtained a model suitable for the clinical diagnosis of COVID-19 based on routinely collected surveillance data. Applications of this tool include early identification for specific treatment and isolation, rational use of laboratory tests, and input for modelling epidemiological trends.

OBJECTIF: Le diagnostic du COVID-19 est un problème critique, principalement dû au manque ou au retard dans les résultats du test. Nous visions à obtenir un modèle pour prédire l'infection par le SRAS-CoV-2 chez les patients suspects signalés au système de surveillance brésilien. MÉTHODES: Nous avons analysé les patients suspects signalés au Système National de Surveillance qui correspondaient à la définition de cas suivante: patients présentant des symptômes respiratoires et de la fièvre, qui se sont rendus dans des régions à transmission locale ou communautaire ou qui ont eu des contacts étroits avec un cas suspect ou confirmé. Sur la base de variables collectées en routine, nous avons obtenu un modèle multiple en utilisant la régression logistique. L'aire sous la courbe caractéristique de fonctionnement du récepteur (AUC) et les indicateurs de précision ont été utilisés pour la validation. RÉSULTATS: Nous avons décrit 1.468 cas de COVID-19 (confirmés par RT-PCR) et 4.271 patients atteints d'autres maladies. Avec un sous-ensemble de données comprenant 80% de patients de Sao Paulo (SP) et de Rio de Janeiro (RJ), nous avons obtenu une fonction qui atteignait une AUC de 95,54% (IC95%: 94,41% - 96,67%) pour le diagnostic de COVID- 19 et une précision de 90,1% (sensibilité 87,62% et spécificité 92,02%). Dans un ensemble de données de validation incluant les 20% restants de patients de SP et de RJ, ce modèle présentait une AUC de 95,01% (92,51% - 97,5%) et une précision de 89,47% (sensibilité 87,32% et spécificité 91,36%). CONCLUSION: Nous avons obtenu un modèle adapté au diagnostic clinique du COVID-19 sur la base des données de surveillance collectées en routine. Les applications de cet outil comprennent l'identification précoce pour un traitement et un isolement spécifiques, l'utilisation rationnelle des tests de laboratoire et des données pour modéliser les tendances épidémiologiques.

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PURPOSE: High-intensity interval resistance training (HIIRT) is an increasingly popular exercise program that provides positive results with short sessions. This study aimed to evaluate whether an HIIRT session causes muscle and kidney damage. METHODS: Fifty-eight healthy volunteers (median age 24 years, 50% women) participated in this study and performed a HIIRT session. The Borg CR10 scale for pain (CR10P) and blood and urine samples were collected before (baseline) and 2 and 24 hours after the HIIRT session. Blood samples were analyzed for serum creatinine (SCr), creatine kinase (CK) and myoglobin. Urine samples were assessed for creatinine, neutrophil gelatinase-associated lipocalin, interleukin 18, calbindin, microalbuminuria, trefoil factor-3 and ß-2 microglobulin. RESULTS: CR10P had a significant increase at 2 and 24 hours post-workout, and CK increased significantly at 2 hours and increased further at 24 hours. Myoglobin increased significantly at 2 hours and remained elevated at 24 hours. SCr increased modestly but significantly at 24 hours only in men. Three men met the KDIGO diagnostic criteria for acute kidney injury. The urinary kidney injury biomarkers increased significantly at 2 hours and returned to the baseline values 24 hours after HIIRT. CONCLUSIONS: A single HIIRT session caused early and significant elevations in CK, myoglobin, SCr, microalbuminuria and urinary biomarkers indicative of kidney tubular injury, suggesting the occurrence of muscle and kidney damage.

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The aim of this study was to assess the role of physical activity in blood pressure (BP) in individuals with knee osteoarthritis. We compared 136 participants under treatment for primary knee osteoarthritis (age=67.6±9.6 years) allocated to the sedentary-sedentary, active-sedentary, sedentary-active, and active-active groups depending on their levels of daily physical activity before and after follow-up. Their BP, BMI, and endurance performance (6-min walking test) were compared during 12 months of follow-up. The sedentary-sedentary group had increased systolic BP (11±3 mmHg), and the active-sedentary group had increased systolic (12±4 mmHg) and diastolic BP (5±1 mmHg) during follow-up. By contrast, the sedentary-active group maintained systolic BP and showed reduced diastolic BP (5±2 mmHg), and the active-active group maintained both systolic and diastolic BP. Positive effects on BP were accompanied by improvements in endurance performance and BMI in the sedentary-active group (endurance performance=8.5±2.7%; BMI=9.3±3.6%) and the active-active group (endurance performance=2.9±0.9%; BMI=3.8±2.0%), which did not occur in the sedentary-sedentary and active-sedentary groups. These results suggest a positive role of high levels of daily living physical activity in the prevention/management of hypertension in individuals with knee osteoarthritis.

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BACKGROUND: The Brazilian Amazon is the world's largest rainforest regions and plays a key role in biodiversity conservation as well as climate adaptation and mitigation. The government has created a network of protected areas (PAs) to ensure long-term conservation of the region. However, despite the importance of and positive advances in the establishment of PAs, natural resource depletion in the Brazilian Amazon is pervasive. METHODS: We evaluated a total of 4,243 official law enforcement records generated between 2010 and 2015 to understand the geographical distribution of the illegal use of resources in federal PAs in the Brazilian Amazon. We classified illegal activities into ten categories and used generalized additive models (GAMs) to evaluate the relationship between illegal use of natural resources inside PAs with management type, age of PAs, population density, and accessibility. RESULTS: We found 27 types of illegal use of natural resources that were grouped into 10 categories of illegal activities. Most infractions were related to suppression and degradation of vegetation (37.40%), followed by illegal fishing (27.30%) and hunting activities (18.20%). The explanatory power of the GAMs was low for all categories of illegal activity, with a maximum explained variation of 41.2% for illegal activities as a whole, and a minimum of 14.6% for hunting activities. DISCUSSION: These findings demonstrate that even though PAs are fundamental for nature conservation in the Brazilian Amazon, the pressures and threats posed by human activities include a broad range of illegal uses of natural resources. Population density up to 50 km from a PA is a key variable, influencing illegal activities. These threats endanger long-term conservation and many efforts are still needed to maintain PAs that are large enough and sufficiently intact to maintain ecosystem functions and protect biodiversity.

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This paper records the first report of Megastigmus transvaalensis Hussey (Hymenoptera: Torymidae) in Brazilian peppertree, Schinus terebinthifolius Raddi (Anacardiaceae) drupes in Sorocaba, state of São Paulo, Brazil. This wasp is an invasive species and was found damaging S. terebinthifolius drupes in urban areas (35.0 ± 15.8%), natural forests (21.5 ± 10.2%) and restoration areas (15.8 ± 8.4%). The bio-ecology and damage caused by M. transvaalensis in the S. terebinthifolius drupes warrants further study focused upon the management of this phytophagous wasp. Megastigmus transvaalensis has a potential to be disseminated throughout Brazil and is posing a threat to the natural regeneration of S. terebinthifolius in the native forests and restoration areas and ecological regions of this country.

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Practices for endo and ectoparasite control in beef cattle were evaluated in two independent experiments. First, the effects of rotenone on Rhipicephalus (Boophilus) microplus ticks were evaluated in vitro and in experimentally infected calves. In the second trial, the effects of grazing systems associated with endo and ectoparasite treatments on parasite burden and weight gain of naturally parasited animals were evaluated. Rotenone showed acaricide action on larvae and engorged ticks during in vitro tests and on larvae in experimentally infected calves. Three treatments with endectocide decreased (P < .05) the number of EPG and ticks and increased (P < .05) the weight gain in the dry season. Animals treated with only one application of levamisole showed EPG intermediate and different (P < .05) from the groups treated with endectocide (lower) and control (higher) in the dry season, but the weight gain obtained with this treatment did not differ from the control group. During the raining season the animals treated with fipronil were significantly less parasited by horn fly, tick and larvae of Dermatobia hominis and the group treated with rotenone were significantly less parasited by horn fly in relation to control. Animals under rotational grazing showed significantly higher EPG than those under continuous grazing. Three treatments with endectocide in the dry season plus three acaricide treatments with fipronil in the raining season reduced EPG, tick, and screw worm larva counts, and provided a significant increase (23 kg) of live weight gain in relation to untreated animals.

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Foram realizados dois experimentos para avaliar o controle de endo e ectoparasitos de bovinos. No primeiro avaliou-se in vitro e, em animais experimentalmente infestados, o efeito da rotenona no carrapato Rhipicephalus(Boophilus) microplus e, no segundo, avaliou-se o efeito do pastejo rotacionado e de tratamentos contra endo e ectoparasitos na carga parasitária e no desenvolvimento de animais naturalmente parasitados. In vitro a rotenona mostrou ação acaricida nas larvas e nas teleóginas, e nas larvas nos animais estabulados. Três tratamentos com endectocida, no período seco, diminuiram significativamente a contagem de ovos por grama de fezes (OPG) e o número de teleóginas, e, aumentou significativamente o ganho médio de peso. Os animais tratados com uma aplicação de levamisol estavam nesse período com médias de OPG intermediárias e significativamente diferentes dos grupos controle e tratados com endectocida. O ganho de peso, entretanto, não diferiu significativamente do grupo controle. No período das águas, os animais tratados com fipronil estavam significativamente menos parasitados por teleóginas, mosca-dos-chifres e por larvas de Dermatobia hominis; e os tratados com rotenona. menos parasitados por mosca-dos-chifres que os animais controle. Diferentemente do esperado, os animais sob pastejo rotacionado estavam no período seco com OPG significativamente maior que os em sistema contínuo. Três tratamentos com endectocida, no período seco, e três tratamentos acaricida com fipronil, na estação chuvosa, diminuíram significativamente o OPG, o número de teleóginas e o de larvas de berne, e proporcionou um aumento significativo de 23 kg de peso vivo em relação aos animais não tratados.

Practices for endo and ectoparasite control in beef cattle were evaluated in two independent experiments. First, the effects of rotenone® on Rhipicephalus (Boophilus) microplus ticks were evaluated in vitro and in experimentally infected calves. In the second trial, the effects of grazing systems associated with endo and ectoparasite treatments on parasite burden and weight gain of naturally parasited animals were evaluated. Rotenone showed acaricide action on larvae and engorged ticks during in vitro tests and on larvae in experimentally infected calves. Three treatments with endectocide decreased (P < .05) the number of EPG and ticks and increased (P < .05) the weight gain in the dry season. Animals treated with only one application of levamisole showed EPG intermediate and different (P < .05) from the groups treated with endectocide (lower) and control (higher) in the dry season, but the weight gain obtained with this treatment did not differ from the control group. During the raining season the animals treated with fipronil were significantly less parasited by horn fly, tick and larvae of Dermatobia hominis and the group treated with rotenone were significantly less parasited by horn fly in relation to control. Animals under rotational grazing showed significantly higher EPG than those under continuous grazing. Three treatments with endectocide in the dry season plus three acaricide treatments with fipronil in the raining season reduced EPG, tick, and screw worm larva counts, and provided a significant increase (23 kg) of live weight gain in relation to untreated animals.

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