Abstract Lemmel syndrome is a rare entity, characterized by the presence of obstructive jaundice secondary to the presence of a periampular duodenal diverticulum. Periampular are the most common, in 75%; of these, those located 2-3 cm from Vater’s ampulla are known as juxtapapillary diverticula, most of which are extraluminal and acquired. Currently the diagnosis is made using endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography, since both can confirm the diagnosis. Endoscopic sphincterotomy and biliary stent placement is the treatment of choice in case of biliary or pancreatic complications. We report the case of a 67-year-old patient with Lemmel syndrome.

Resumen El síndrome de Lemmel es una entidad poco frecuente que se caracteriza por la presencia de ictericia obstructiva secundaria a la presencia de un divertículo duodenal periampular. Los periampulares son los más comunes, se presentan en un 75%; de estos, los que se localizan a 2-3 cm del ámpula de Vater se conocen como divertículos yuxtapapilares y la mayoría son extraluminales y adquiridos. Actualmente el diagnóstico se realiza utilizando colangiopancreatografía retrógrada endoscópica o ultrasonografía endoscópica, ya que con ambas se logra confirmar el diagnóstico. La esfinterotomía endoscópica y colocación de prótesis biliar es el tratamiento de elección en caso de complicación biliar o pancreática. Reportamos el caso de una paciente de 67 años con síndrome de Lemmel.

The control of malaria vector mosquitoes in South Africa's affected provinces is primarily based on indoor spraying of long-lasting residual insecticides. The primary vectors in South Africa are Anopheles arabiensis and An. funestus. South Africa's National Malaria Control Programme has adopted a malaria elimination agenda and has scaled up vector control activities accordingly. However, despite these plans, local transmission continues and is most likely because of outdoor feeding by populations of An. arabiensis. An outdoor Anopheles surveillance system has been set up in three sections of the Mamfene district in northern KwaZulu-Natal in order to assess the extent of outdoor resting An. arabiensis in Mamfene and to assess the current insecticide susceptibility status of this population. According to WHO criteria, the An. arabiensis samples tested showed evidence of resistance to deltamethrin (pyrethroid), DDT (organochlorine) and bendiocarb (carbamate), and full susceptibility to the organophosphates pirimiphos-methyl and fenitrothion. Pre-exposure to piperonyl butoxide completely nullified the deltamethrin resistance otherwise evident in these samples, supporting previous studies implicating monooxygenase-based detoxification as the primary mechanism of pyrethroid resistance. The data presented here affirm the presence of pyrethroid and DDT resistance previously detected in this population and also indicate the comparatively recent emergence of resistance to the carbamate insecticide bendiocarb. These data show that special attention and commitment needs to be given to the principles of insecticide resistance management as well as to investigations into alternative control techniques designed to target outdoor-resting An. arabiensis in northern KwaZulu-Natal.

O presente trabalho teve como objetivo avaliar a tolerância de cultivares de cana-de-açúcar à erradicação de soqueiras com diferentes doses de glyphosate por meio de respostas fisiológicas. Para isso, um ensaio foi desenvolvido no delineamento experimental de blocos ao acaso em esquema fatorial 4 x 4 (cultivares x doses), totalizando 16 tratamentos com quatro repetições. Foram utilizados os cultivares IAC91-5155, IACSP93-3046, IAC86-2480 e IAC87-3396 tratados com as doses de glyphosate 0, 1.920, 2.400, e 2.880gha-1. As variáveis analisadas foram porcentagem de perfilhos mortos, eficiência quântica do FSII (Fv/Fm) e índice SPAD. Há diferenças entre cultivares de cana-de-açúcar quanto à eliminação de perfilhos e a respostas fisiológicas a diferentes doses de glyphosate. A dose de 2.880gha-1 foi a mais eficiente em eliminar perfilhos de cana-de-açúcar. Os cultivares IAC86-2480, IAC87-3396 e IACSP93-3046 foram os mais sensíveis, e o IAC91-5155 tolerou por mais tempo os danos promovidos no aparato fotossintético à dessecação das soqueiras pelo glyphosate. Devido às respostas diferenciadas, manejos distintos devem ser considerados para a eliminação das soqueiras de diferentes cultivares.

This study aimed to evaluate the tolerance of sugarcane cultivars to ratoon eradication under different glyphosate rates by means of physiological responses. Therefore, a trial was carried out in randomized complete blocks with 4 x 4 factorial design (cultivars x rates) totaling 16 treatments with four replicates. The cultivars IAC91-5155, IACSP93-3046, and IAC86-2480 and IAC87-3396 and the glyphosate rates 0 g ha-1; 1,920 g ha-1; 2,400 g ha-1; 2,880 g ha-1 were tested. The variables analyzed were percentage of tiller mortality, quantum efficiency of PSII (Fv/Fm) and SPAD index. The results showed that there are differences among sugarcane cultivars for tiller eradication and for physiological responses with glyphosate different rates. The rate of 2,880 g ha-1 was the most efficient in eliminating sugarcane tillers. The cultivars IAC86-2480, IAC87-3396 and IACSP93-3046 were the most sensitive and the IAC91-5155 tolerated, for a longer period of time, the damage to the photosynthetic apparatus of the ratoons caused by glyphosate desiccation. Due to different responses, different managements should be considered for eliminating ratoons of different cultivars.