Phase angle obtained by bioelectrical impedance analysis independently predicts mortality in patients with cirrhosis

AIM To evaluate the prognostic value of the phase angle(PA)obtained from bioelectrical impedance analysis(BIA) for mortality prediction in patients with cirrhosis. METHODS In total, 134 male cirrhotic patients prospectively completed clinical evaluations and nutritional assessment by BIA to obtain PAs during a 36-mo follow-up period. Mortality risk was analyzed by applying the PA cutoff point recently proposed as a malnutrition marker(PA ≤ 4.9°) in Kaplan-Meier curves and multivariate Cox regression models. RESULTS The patients were divided into two groups according to the PA cutoff value(PA > 4.9°, n = 73; PA ≤ 4.9°, n = 61). Weight, height, and body mass index were similar in both groups, but patients with PAs > 4.9° were younger and had higher mid-arm muscle circumference, albumin, and handgrip-strength values and lower severe ascites and encephalopathy incidences, interleukin(IL)-6/IL-10 ratios and C-reactive protein levels than did patients with PAs ≤ 4.9°(P ≤ 0.05). Forty-eight(35.80%) patients died due to cirrhosis, with a median of 18 mo(interquartile range, 3.3-25.6 mo) follow-up until death. Thirty-one(64.60%) of these patients were from the PA ≤ 4.9° group. PA ≤ 4.9° significantly and independently affected the mortality model adjusted for Model for End-Stage Liver Disease score and age(hazard ratio = 2.05, 95%CI: 1.11-3.77, P = 0.021). In addition, Kaplan-Meier curves showed that patients with PAs ≤ 4.9° were significantly more likely to die. CONCLUSION In male patients with cirrhosis, the PA ≤ 4.9° cutoff was associated independently with mortality and identified patients with worse metabolic, nutritional, and disease progression profiles. The PA may be a useful and reliable bedside tool to evaluate prognosis in cirrhosis.

Prevalence and Incidence of Hand Osteoarthritis and Upper Limb Complaints in Patients with Knee Osteoarthritis. Correlations among Functionality, Grip Strength, Changes in Body Mass Index and Symptoms among Patients in an Educational Osteoarthritis Program

Objective: To evaluate the prevalence of hand osteoarthritis (hOA) in a population with knee osteoarthritis (KOA) at baseline and one year following the administration of a multi-professional OA educational program correlating symptoms and changes in BMI with function questionnaires of the upper limbs and direct grip strength measurements. Design: Epidemiological study of the prevalence of hand OA in patients with knee osteoarthritis. The Stanford Health Assessment Questionnaire instruments (HAQ);Disabilities of the Arm, Shoulder and Hand* (DASH);grip strength;and finger pinch were utilized, and the upper limbs symptoms were verified at baseline and one year following the educational program. Results: The prevalence of hOA was 23.7% at baseline and 47.4% at one year (incidence of 31.8% per year). The HAQ indicated that patients who did not alter or increased their BMI experienced worsened global strength, whereas patients who reduced BMI improved global strength (p = 0.041). Patients with higher initial BMIs experienced less improvement in the HAQ (r = -0.148, p = 0.041). The DASH results improved, but the right and left tripod grip worsened in all patients, irrespective of BMI change (p < 0.05) or symptoms at baseline and reassessment (p < 0.05). Pinch strength (right and left tripod and left pulp-pulp) was higher in patients without symptoms at baseline (p = 0.048, p = 0.045 and 0.033, respectively). Conclusions: The prevalence of hand OA increased for patients with OA undergoing an educational program irrespective of improved upper function and regardless of BMI change. Patients who decreased their BMI improved their global strength.

Gait, posture and transfer assessment among elderly practitioners and non-practitioners of Tai Chi Chuan

Falls may be devastating events among elderly people. Tai Chi Chuan is a type of moderate sports exercise that demonstrates improvements in balance, gait and posture. The aim here was to assess the influence of this method on the balance, gait and posture of healthy active elderly people. A controlled cross-sectional study was conducted on 76 volunteers, divided into two groups: 51 volunteers Tai Chi Chuan group mean age 76.8 years and 25 volunteers control group mean age 70.3 years. Both groups underwent the Modified Clinical Test on Sensory Interaction for Balance (mCTSIB), Walking Test (WT), Sit-to-Stand Transfer Test (SSTT) and Unipedal Assessment Test (UT), using the Neurocom Balance Master system. Result: In conditions Static balance tests: the mCTSIB-Tai-Chi Group had a lower sway velocity (°/s) on a firm surface with eyes open and medio-lateral direction, Foam Surface with eyes open medio-lateral and anteroposterior direction. Unilateral Stance Tai-Chi Group had a lower mean sway velocity (°/s) with open eyes (right and left), but with eyes closed. The Control Group showed a lower sway velocity. Under Dynamic Balance: Walk Across Test Tai-Chi Group presented a walking speed greater than the Control Group. In Sit to Stand Transfer Test, Tai-Chi Group showed a better index rising to lift up and lower oscillation in the final standing position. Conclusion: The Tai Chi Group was shown to be a protection factor for preserving and maintaining the static and dynamic positions of posture and gait.

Analysis of Anthropometric Measurements and Dietary Intake in Patients Undergoing a Multi-Professional Osteoarthritis Education Program (PARQVE-Project Arthritis Recovering Quality of Life by Means of Education)

Background: Osteoarthritis (OA) has a major impact on mobility and the loss of productivity of patients, especially knee OA (KOA). Obesity is one of the main risk factors for the incidence and prevalence of KOA. Weight loss alone decreases pain and improves quality of life and functional scores. Objective: To use BMI, body fat, and calorie intake to measure the effect of a multi-professional educational program on patients with KOA and correlate these measurements with subjective questionnaire results. Methods: A total of 198 patients undergoing standard treatment for KOA were randomized to 4 groups. All groups received written and video information regarding KOA. Three groups (1, 2 and 3) also attended two days of lectures 1, 2 and 3 months apart, respectively, whereas group 4 did not. Each group was divided into subgroups A (bimonthly telephone calls) and B (no telephone calls). All patients were evaluated at baseline and at one year for BMI, waist-hip ratio (WHR), percentage of body fat, and calorie intake and with the WOMAC, LEQUESNE, VAS and SF-36 questionnaires. Results: The WHR showed 89.4% of android obesity at baseline and 87.9% at one year without improvement (p = 0.38). Body fat decreased by 0.44% regardless of group or subgroup. Calorie intake was different between groups (p = 0.019) according to phone calls and follow-up (p = 0.03). BMI and body fat percentage were correlated with the WOMAC, WOMAC pain, VAS and LEQUESNE scores at baseline and at reassessment. Weight was correlated with the baseline results of the WOMAC pain (r = 0.175, p = 0.014), VAS (r = 0.155, p = 0.029), LEQUESNE (r = 0.161, p = 0.023), SF-36-PCS (r = ?0.186, p = 0.009) and SF-36-MCS (r = 0.155, p = 0.029) scores and with the one-year results of the WOMAC (r = 0.155, p = 0.029) and WOMAC pain (r = 0.151, p = 0.034) scores. Conclusion: The multi-professional treatment program had very little impacts on the percentage of body fat. This improvement was independent of classes, telephone calls, or improvements in pain, function and quality of life. Calorie intake improvement was influenced by telephone calls and classes but was not associated with objective measurements of/or changes in weight, BMI, or body fat percentage or with subjective improvements.

A Cost-Benefit Evaluation of the Air Quality and Health Impacts in Sao Paulo,Brazil

The objective was to assess the impact on health due to the exposure to air pollution derived from the renewal of the urban bus fleet in S?o Paulo. The study analyzed the substitution of the bus fleet through the variation of the concentration of atmospheric pollutants such as PM10 in the municipality of S?o Paulo and its associated health’s benefits values compared to the investments performed in the bus fleet renewal. PM10 average annual reduction due to the bus improvement system resulted on 22.3%. A cost-benefit evaluation considered the renewal investments’ costs compared to the obtained valued health benefits and it resulted in 4.31. Although the result may suggest a not viable investment, it must be observed that air pollution reduction favors health impacts and that this relation could be improved if additional investments on sustainable transportation increase.

Musculoskeletal Tuberculosis in Dermatomyositis: Association or Coincidence?

Dermatomyositis is a rare idiopathic inflammatory myopathy characterized by proximal muscle weakness associated with typical skin abnormalities and compatible electromyographic finds. Tuberculosis could determine several clinical manifestations but the classic one is the lung presentation. Among the extra pulmonary manifestations of tuberculosis, the musculoskeletal form is rare and it is usually a direct extension of the bone involvement nearby. In the present study, the authors described two dermatomyositis patients and musculoskeletal tuberculosis. In both cases, there was presence of bilateral tenosynovitis, which is considered atypical for further infectious.

Propofol vs traditional sedatives for sedation in endoscopy:A systematic review and meta-analysis

BACKGROUND Propofol is commonly used for sedation during endoscopic procedures.Data suggests its superiority to traditional sedatives used in endoscopy including benzodiazepines and opioids with more rapid onset of action and improved postprocedure recovery times for patients.However,Propofol requires administration by trained healthcare providers,has a narrow therapeutic index,lacks an antidote and increases risks of cardio-pulmonary complications.AIM To compare,through a systematic review of the literature and meta-analysis,sedation with propofol to traditional sedatives with or without propofol during endoscopic procedures.METHODS A literature search was performed using MEDLINE,Scopus,EMBASE,the Cochrane Library,Scopus,LILACS,BVS,Cochrane Central Register of Controlled Trials,and The Cumulative Index to Nursing and Allied Health Literature databases.The last search in the literature was performed on March,2019 with no restriction regarding the idiom or the year of publication.Only randomized clinical trials with full texts published were included.We divided sedation therapies to the following groups:(1)Propofol versus benzodiazepines and/or opiate sedatives;(2)Propofol versus Propofol with benzodiazepine and/or opioids;and(3)Propofol with adjunctive benzodiazepine and opioid versus benzodiazepine and opioid.The following outcomes were addressed:Adverse events,patient satisfaction with type of sedation,endoscopists satisfaction with sedation administered,dose of propofol administered and time to recovery post procedure.Meta-analysis was performed using RevMan5 software version 5.39.RESULTS A total of 23 clinical trials were included(n=3854)from the initial search of 6410 articles.For Group I(Propofol vs benzodiazepine and/or opioids):The incidence of bradycardia was not statistically different between both sedation arms(RD:-0.01,95%CI:-0.03–+0.01,I2:22%).In 10 studies,the incidence of hypotension was not statistically difference between sedation arms(RD:0.01,95%CI:-0.02–+0.04,I2:0%).Oxygen desaturation was higher in the propofol group but not statistically different between groups(RD:-0.03,95%CI:-0.06–+0.00,I2:25%).Patients were more satisfied with their sedation in the benzodiazepine+opioid group compared to those with monotherapy propofol sedation(MD:+0.89,95%CI:+0.62–+1.17,I2:39%).The recovery time after the procedure showed high heterogeneity even after outlier withdrawal,there was no statistical difference between both arms(MD:-15.15,95%CI:-31.85–+1.56,I2:99%).For Group II(Propofol vs propofol with benzodiazepine and/or opioids):Bradycardia had a tendency to occur in the Propofol group with benzodiazepine and/or opioidassociated(RD:-0.08,95%CI:-0.13–-0.02,I2:59%).There was no statistical difference in the incidence of bradycardia(RD:-0.00,95%CI:-0.08–+0.08,I2:85%),desaturation(RD:-0.00,95%CI:-0.03–+0.02,I2:44%)or recovery time(MD:-2.04,95%CI:-6.96–+2.88,I2:97%)between sedation arms.The total dose of propofol was higher in the propofol group with benzodiazepine and/or opiates but with high heterogeneity.(MD:70.36,95%CI:+53.11–+87.60,I2:61%).For Group III(Propofol with benzodiazepine and opioid vs benzodiazepine and opioid):Bradycardia and hypotension was not statistically significant between groups(RD:-0.00,95%CI:-0.002–+0.02,I2:3%;RD:0.04,95%CI:-0.05–+0.13,I2:77%).Desaturation was evaluated in two articles and was higher in the propofol+benzodiazepine+opioid group,but with high heterogeneity(RD:0.15,95%CI:0.08–+0.22,I2:95%).CONCLUSION This meta-analysis suggests that the use of propofol alone or in combination with traditional adjunctive sedatives is safe and does not result in an increase in negative outcomes in patients undergoing endoscopic procedures.

Endoscopic stenting for inoperable malignant biliary obstruction: A systematic review and meta-analysis

AIM: To analyze through meta-analyses the benefits of two types of stents in the inoperable malignant biliary obstruction.METHODS: A systematic review of randomized clinical trials(RCT) was conducted, with the last update on March 2015, using EMBASE, CINAHL(EBSCO), MEDLINE, LILACS/CENTRAL(BVS), SCOPUS, CAPES(Brazil), and gray literature. Information of the selected studies was extracted in sight of six outcomes: primarily regarding dysfunction, complication and reintervention rates; and secondarily costs, survival, and patency time. The data about characteristics of trial participants, inclusion and exclusion criteria and types of stents were also extracted. The bias was mainly assessed through the JADAD scale. This meta-analysis was registered in the PROSPERO database by the number CRD42014015078. The analysis of the absolute risk of the outcomes was performed using the software Rev Man, by computing risk differences(RD) of dichotomous variables and mean differences(MD) of continuous variables. Data on RD and MD for each primary outcome were calculated using the MantelHaenszel test and inconsistency was qualified and reported in χ2 and the Higgins method(I2). Sensitivity analysis was performed when heterogeneity was higher than 50%, a subsequent assay was done and other findings were compiled. Student's t-test was used for the comparison of weighted arithmetic means regarding secondary outcomes.RESULTS: Initial searching identified 3660 studies; 3539 were excluded through title, repetition, and/or abstract, while 121 studies were fully assessed and were excluded mainly because they did not compare self-expanding metal stents(SEMS) and plastic stents(PS), leading to thirteen RCT selected, with 13 articles and 1133 subjects meta-analyzed. The mean age was 69.5 years old, that were affected mostly by bile duct(proximal) and pancreatic tumors(distal). The preferred SEMS diameter used was the 10 mm(30 Fr) and the preferred PS diameter used was 10 Fr. In the metaanalysis, SEMS had lower overall stent dysfunction compared to PS(21.6% vs 46.8%, P < 0.00001) and fewer re-interventions(21.6% vs 56.6%, P < 0.00001), with no difference in complications(13.7% vs 15.9%, P = 0.16). In the secondary analysis, the mean survival rate was higher in the SEMS group(182 d vs 150 d, P < 0.0001), with a higher patency period(250 d vs 124 d, P < 0.0001) and a lower cost per patient(4193.98 vs 4728.65 Euros, P < 0.0985).CONCLUSION: SEMS are associated with lower stent dysfunction, lower re-intervention rates, better survival, and higher patency time. Complications and costs showed no difference.

Endoscopy vs surgery in the treatment of early gastric cancer:Systematic review

AIM: To report a systematic review,establishing the available data to an unpublished 2a strength of evidence,better handling clinical practice.METHODS: A systematic review was performed using MEDLINE,EMBASE,Cochrane,LILACS,Scopus and CINAHL databases. Information of the selected studies was extracted on characteristics of trial participants,inclusion and exclusion criteria,interventions(mainly,mucosal resection and submucosal dissection vs surgical approach) and outcomes(adverse events,different survival rates,mortality,recurrence and complete resection rates). To ascertain the validity of eligible studies,the risk of bias was measured using the Newcastle-Ottawa Quality Assessment Scale. The analysis of the absolute risk of the outcomes was performed using the software Rev Man,by computingrisk differences(RD) of dichotomous variables. Data on RD and 95%CIs for each outcome were calculated using the Mantel-Haenszel test and inconsistency was qualified and reported in χ2 and the Higgins method(I2). Sensitivity analysis was performed when heterogeneity was higher than 50%,a subsequent assay was done and other findings were compiled.RESULTS: Eleven retrospective cohort studies were selected. The included records involved 2654 patients with early gastric cancer that filled the absolute or expanded indications for endoscopic resection. Threeyear survival data were available for six studies(n = 1197). There were no risk differences(RD) after endoscopic and surgical treatment(RD = 0.01,95%CI:-0.02-0.05,P = 0.51). Five-year survival data(n = 2310) showed no difference between the two groups(RD = 0.01,95%CI:-0.01-0.03,P = 0.46). Recurrence data were analized in five studies(1331 patients) and there was no difference between the approaches(RD = 0.01,95%CI:-0.00-0.02,P = 0.09). Adverse event data were identified in eight studies(n = 2439). A significant difference was detected(RD =-0.08,95%CI:-0.10--0.05,P < 0.05),demonstrating better results with endoscopy. Mortality data were obtained in four studies(n = 1107). There was no difference between the groups(RD =-0.01,95%CI:-0.02-0.00,P = 0.22).CONCLUSION: Three-,5-year survival,recurrence and mortality are similar for both groups. Considering complication,endoscopy is better and,analyzing complete resection data,it is worse than surgery.

Living-donor liver transplantation in Budd-Chiari syndrome with inferior vena cava complete thrombosis:A case report and review of the literature

BACKGROUND Budd-Chiari syndrome(BCS)is a challenging indication for liver transplantation(LT)due to a combination of massive liver,increased bleeding,retroperitoneal fibrosis and frequently presents with stenosis of the inferior vena cava(IVC).Occasionally,it may be totally thrombosed,increasing the complexity of the procedure,as it should also be resected.The challenge is even greater when performing living-donor LT as the graft does not contain the retrohepatic IVC;thus,it may be necessary to reconstruct it.CASE SUMMARY A 35-year-old male patient with liver cirrhosis due to BCS and hepatocellular carcinoma beyond the Milan criteria underwent living-donor LT with IVC reconstruction.It was necessary to remove the IVC as its retrohepatic portion was completely thrombosed,up to almost the right atrium.A right-lobe graft was retrieved from his sister,with outflow reconstruction including the right hepatic vein and the branches of segment V and VIII to the middle hepatic vein.Owing to massive subcutaneous collaterals in the abdominal wall,venovenous bypass was implemented before incising the skin.The right atrium was reached via a transdiaphragramatic approach.Hepatectomy was performed en bloc with the retrohepatic vena cava.It was reconstructed with an infra-hepatic vena cava graft obtained from a deceased donor.The patient remains well on outpatient clinic follow-up 25 mo after the procedure,under an anticoagulation protocol with warfarin.CONCLUSION Living-donor LT in BCS with IVC thrombosis is feasible using a meticulous surgical technique and tailored strategies.

Sodium picosulphate or polyethylene glycol before elective colonoscopy in outpatients?A systematic review and meta-analysis

AIM To determine the best option for bowel preparation [sodium picosulphate or polyethylene glycol(PEG)] for elective colonoscopy in adult outpatients.METHODS A systematic review of the literature following the PRISMA guidelines was performed using Medline, Scopus, EMBASE, Central, Cinahl and Lilacs. No restrictions were placed for country, year of publication or language. The last search in the literature was performed on November 20th, 2017. Only randomized clinical trials with full texts published were included. The subjects included were adult outpatients who underwent bowel cleansing for elective colonoscopy. The included studies compared sodium picosulphate with magnesium citrate(SPMC)and PEG for bowel preparation. Exclusion criteria were the inclusion of inpatients or groups with specific conditions, failure to mention patient status(outpatient or inpatient) or dietary restrictions, and permission to have unrestricted diet on the day prior to the exam. Primary outcomes were bowel cleaning success and/or tolerability of colon preparation. Secondary outcomes were adverse events, polyp and adenoma detection rates. Data on intention-totreat were extracted by two independent authors and risk of bias assessed through the Jadad scale. Funnel plots, Egger's test, Higgins' test(I2) and sensitivity analyses were used to assess reporting bias and heterogeneity. The meta-analysis was performed by computing risk difference(RD) using MantelHaenszel(MH) method with fixed-effects(FE) and random-effects(RE) models.Review Manager 5(RevMan 5) version 6.1(The Cochrane Collaboration) was the software chosen to perform the meta-analysis.RESULTS662 records were identified but only 16 trials with 6200 subjects were included for the meta-analysis. High heterogeneity among studies was found and sensitivity analysis was needed and performed to interpret data. In the pooled analysis,SPMC was better for bowel cleaning [MH FE, RD 0.03, IC(0.01, 0.05), P = 0.003, I2= 33%, NNT 34], for tolerability [MH RE, RD 0.08, IC(0.03, 0.13), P = 0.002, I2 =88%, NNT 13] and for adverse events [MH RE, RD 0.13, IC(0.05, 0.22), P = 0.002,I2 = 88%, NNT 7]. There was no difference in regard to polyp and adenoma detection rates. Additional analyses were made by subgroups(type of regimen,volume of PEG solution and dietary recommendations). SPMC demonstrated better tolerability levels when compared to PEG in the following subgroups:"day-before preparation" [MH FE, RD 0.17, IC(0.13, 0.21), P < 0.0001, I2 = 0%,NNT 6], "preparation in accordance with time interval for colonoscopy" [MH RE,RD 0.08, IC(0.01, 0.15), P = 0.02, I2 = 54%, NNT 13], when compared to "highvolume PEG solutions" [MH RE, RD 0.08, IC(0.01, 0.14), I2 = 89%, P = 0.02, NNT13] and in the subgroup "liquid diet on day before" [MH RE, RD 0.14, IC(0.06,0.22), P = 0.0006, I2 = 81%, NNT 8]. SPMC was also found to cause fewer adverse events than PEG in the "high-volume PEG solutions" [MH RE, RD-0.18,IC(-0.30,-0.07), P = 0.002, I2 = 79%, NNT 6] and PEG in the "low-residue diet"subgroup [MH RE, RD-0.17, IC(-0.27, 0.07), P = 0.0008, I2 = 86%, NNT 6].CONCLUSION SPMC seems to be better than PEG for bowel preparation, with a similar bowel cleaning success rate, better tolerability and lower prevalence of adverse events.

Efficacy and safety of peroral endoscopic myotomy after prior sleeve gastrectomy and gastric bypass surgery

BACKGROUND Per-oral endoscopic myotomy(POEM)is safe and effective for the treatment of achalasia.There is limited data on performance of POEM in patients with altered upper gastrointestinal anatomy,especially after bariatric surgery.Outcomes in patients with prior sleeve gastrectomy have not been reported.AIM To assess the efficacy and safety of POEM in patients with prior bariatric surgery.METHODS A prospective POEM database was reviewed from 3/2017-5/2020 to identify patients who underwent POEM after prior bariatric surgery.Efficacy was assessed by technical success(defined as the ability to successfully complete the procedure)and clinical success[decrease in Eckardt score(ES)to≤3 post procedure].Safety was evaluated by recording adverse events.RESULTS Six patients(50%male,mean age 48 years)with a history of prior bariatric surgery who underwent POEM were included.Three had prior sleeve gastrectomy(SG)and three prior Roux-en-Y gastric bypass(RYGB).Four patients had achalasia subtype II and 2 had type I.Most(4)patients had undergone previous achalasia therapy.Technical success was 100%.Clinical success was achieved in 4(67%)patients at mean follow-up of 21 mo.In one of the clinical failures,EndoFLIP evaluation demonstrated adequate treatment and candida esophagitis was noted as the likely cause of dysphagia.There were no major adverse events.CONCLUSION POEM is technically feasible after both RYGB and SG and offers an effective treatment for this rare group of patients where surgical options for achalasia are limited.

Moral Dilemma Judgment Revisited: A Loreta Analysis

Background: Recent neuroscience investigations on moral judgment have provided useful information about how brain processes such complex decision making. All these studies carried out so far were fMRI investigations and therefore were constrained by the poor temporal resolution of this technique. Recent advances in electroencephalography (EEG) analysis provided by Low Resolution Tomogray (Loreta), Principal Component (PCA), Correlation and Regression Analysis improved EEG spatial resolution and made EEG a very useful technique in decision-making studies. Methods: Here, we reinvestigate previous fMRI study of personal (PD) and impersonal (ID) moral dilemma judgment, taking profit of these new EEG analysis improvements. Results: PCA analysis disclosed three different patterns of brain activity associated with dilemma judgment. These patterns are proposed to disclose the neural circuits involved in benefit and risk evaluation, calculating intention to act and controlling decision-making. Regression analysis showed that activity at some cortical areas favors action implementation by increasing intention to act, while activity at some other areas opposes it by decreasing intention to act. Comparison with Existing Methods: Compared to the previous fMRI results, Loreta and PCA revealed a much greater number of cortical areas involved in dilemma judgment, whose temporal and spatial distribution were different for ID compared to PD. The present paper suggests that whenever final temporal details of the decision making process are desired, EEG becomes the tool of choice as compared with fMRI. Conclusions: The presented results are discussed from the utilitarian point of view that proposes adequacy of human action being dependent upon how much pleasure and fear/pain they are associated.

A Modified Shannon Trap for Use in Forensic Entomology

The objective of this study was to determine the efficacy of a modified Shannon trap to capture adult insects that are involved in cadaveric decomposition processes. The Shannon trap proposed here is composed of a thin fabric tent with a top formed by a transparent bottle containing a compartment filled with alcohol gel on which the captured insects are affixed. The trap was effective both for weather resistance and the quantity, quality and diversity of insects caught.