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Quantitative ethnobotany in an atlantic forest fragment of northeastern Brazil: implications to conservation.

An ethnobotanical study was executed in the rural community of the Municipality of "Rio Formoso", starting from the forest inventory accomplished in an Atlantic Forest remnant adjacent to the studied community. Using the methodology of quantitative ethnobotany allied to the ecological parameters (richness, relative frequency, relative density, relative dominance and importance value index) the following results were obtained: 42 inventoried species gathered in 26 families, presented from 1 to 27 means of use for the community. The largest use of the plants is related to obtaining wood in order to be used in house building, firewood production and charcoal. The largest use value was attributed to the Vouacapoua virgilioides (Kunth) Kuntze. The most frequent species were Tapirira guianensis Aubl. (Anacardiaceae), Thyrsodium schomburgkianum Benth. (Anacardiaceae), Schefflera morototoni (Aubl.) Maguire, Steyem. & Frodin (Araliaceae) and Dialium guianense (Aubl.) Sandwith. (Leg-Caesalpinioideae).

Atlantic Ocean↗

[Technologic features in the working process in nurseries].

The relationship established between health professionals and newborns is analysed in this study. The research focuses mainly on the fact that this interaction is mediated by scientific knowledge, technology and the equipment used on the care of babies. This is a exploratory qualitative research. The data was collected in two nurseries in the city of Ribeirão Preto, SP, Brazil. It was verified that the procedures used in these nurseries fulfilled the necessities of newborns regarding the control and maintenance of vital functions (cardio-respiratory, thermoregulation, oxygenation, fluid-electrolyte balance and nutrition), as well as the administration of medicines, and collection of organic material for diagnosis and therapy. It was also observed that nursery professionals prepare, install, control and do the maintenance of the equipment, while doctors are in charge of installing and controlling it in more invasive procedures.

Humans↗

[Power relations and democracy in health councils in Brazil: a case study].

BACKGROUND: Social participation is fundamental for the consolidation of the Brazilian Health Reform, with the aim of promoting equity, universality and democratization of access to health, and the health councils are vital forums for its concretization. However, the authoritarian culture of our institutions makes effective participation in these organizations difficult. The objective of this work was to analyze the power relations which permeate the practices of a health council, seeking to understand discourse as a builder of participation in health. METHODS: A qualitative case study in a municipal health council in a Brazilian town. The discourse analysis was carried out on the minutes of two management terms, legal documents, interviews and observation during meetings. RESULTS: The quantitative presence of the user representatives does not correspond to the quality of their participation. The governmental sector uses most of the speaking turns, establishing monological relations, based on the a lack of symmetry determined by level of education, professional training, social status of the councilors and the relations of knowledge and power present in the health institutions. We identify resistances coming from the user sectors and the health professionals. However, these are scattered, fragile and not very important. CONCLUSIONS: The current practices that exist can, contrarily, go against democracy, for which is necessary to invest in the empowerment of councilors and users in the day-to-day reality of health care.

Brazil↗

[The path taken by social sciences within health in Latin America: review of scientific production].

An analysis was made of the path taken by social sciences within health in Latin America, on the basis of scientific production achieved, especially in Brazil. The work is divided into the following sections: introduction; notes on the origins of the field; scientific reviews; the 1990s and studies on scientific production; previous review articles; and final comments. This study recounts the historical path taken by scientific production, using extensive documentation: bibliographic surveys, bibliographic studies and review articles. The topics surveyed within this field and some data on the professionals who work in these activities are highlighted. In the conclusions, emphasis is given to the great vitality of the field, which in just a few decades has attained importance within the scientific scene.

Biomedical Research↗

Antivenom and biological effects of ar-turmerone isolated from Curcuma longa (Zingiberaceae)

A potent antivenom against snakebite was isolated from Curcuma longa, a plant commonly used in traditional Brazilian medicine. The fraction consisting of ar-turmerone neutralized both the hemorrhagic activity present in Bothrops jararaca venom, and the lethal effect of Crotalus durissus terrificus venom in mice. Immunological studies demonstrated that this fraction also inhibited the proliferation and the natural killer activity of human lymphocytes.

Animals↗

[Validation of an evaluation guide for healthcare training programs in the field of humanitarian efforts].

The training of healthcare professionals working in the field of humanitarian action is of fundamental importance but there have been few procedures for assessing the training programs. A specific guide was produced for the evaluation of healthcare training programs. It uses a three-pronged approach to improve the training of healthcare personnel, encouraging educators to take a fresh look at the way in which they work. The guide seeks to improve the efficiency of training by evaluating programs. The guide was tested on four training programs conducted by three non-governmental organizations in three countries: Handicap International in Cambodia and Mozambique, Médecins Sans Frontières in Cambodia and Action Nord Sud in Brazil. Questionnaires, guides and appraisals were analyzed, and the results suggested that the guide was valid, reproducible and easy to use. However, it is vital to provide external educational assistance during evaluation, to promote the implementation of decisions, thereby improving training practices.

Attitude of Health Personnel↗

Comparison of the effects of losartan and atenolol on common carotid artery intima-media thickness in patients with hypertension: results of a 2-year, double-blind, randomized, controlled study.

BACKGROUND: Hypertension induces progressive pathologic changes in the arterial wall. Experimental findings suggest that these changes, which include intima-media thickening, may be mediated, at least in part, by angiotensin II (AII). OBJECTIVE: The Losartan Vascular Regression Study (LAARS) was a double-blind, parallel-group, randomized, controlled, multicenter study designed to compare the effects of the AII antagonist losartan and the beta-blocker atenolol on ultrasonographically determined intimamedia thickness (IMT) of the common carotid artery (CCA) in patients with mild to moderate essential hypertension. METHODS: The primary end point of the study was the yearly rate of change (YRC) from baseline of the mean IMT of the CCA (CCA-IMT(mean)) averaged over 2 years of treatment. Secondary end points included IMT of the common femoral artery and sitting systolic and diastolic blood pressures (SiSBP/SiDBP). Safety assessments of losartan and atenolol were made by statistical and clinical review of the incidence of adverse experiences as well as review of vital signs and laboratory values. A total of 414 patients with essential hypertension were screened for study inclusion at 36 study centers in Germany and Brazil. Patients received losartan (50 mg once daily) or atenolol (50 mg once daily) for 24 months. Target blood pressure (SiSBP/SiDBP <140/<90 mm Hg) was achieved by adding hydrochlorothiazide 12.5 mg once daily, doubling the dose of study drug, or adding an open-label calcium channel blocker sequentially, as needed. RESULTS: Of the original 414 patients screened, 280 hypertension patients (SiDBP 95-115 mm Hg), aged 35 to 65 years, with an IMT of 0.8 to 1.5 mm of the right or left CCA, were randomized to treatment with either losartan (n = 142) or atenolol (n = 138). Both losartan and atenolol therapy produced comparable reductions in CCA-IMTmean over 24 months compared with baseline; the average YRC was -0.038 +/- 0.004 mm/y (P < or = 0.001) for losartan and -0.037 +/- 0.004 mm/y (P < or = 0.001) for atenolol. There were no significant differences between groups. Losartan showed a greater reduction of femoral artery IMT than did atenolol; the average YRC was -0.024 mm/y (P < or = 0.05) for losartan and -0.017 mm/y for atenolol (P = NS), with no significant difference between groups. Both agents produced similar significant reductions in SiSBP and SiDBP and were generally well tolerated. Approximately 7% of losartan patients had drug-related clinical adverse events, compared with 12% of atenolol patients. CONCLUSIONS: The findings of LAARS, the first large study with an AII antagonist that examined IMT, suggest that AII antagonism reverses the early stages of vascular hypertrophy in patients with hypertension. Further studies are needed to delineate the relative importance of AII antagonism versus blood pressure reduction per se in mediating the beneficial vascular effects of losartan.

Adult↗

Implementation of an expert system to determine eligibility and priorities for bone marrow transplants.

The Bone Marrow Transplant Unit (BMTU) (Serviço de Transplante de Medula Ossea) at HC-UFPR, in Curitiba, Brazil, commonly receives a large number of candidates for bone marrow transplants (BMT). Managing information on the BMTU's waiting list is extremely complex and vital to services as eligibility and priorities are established with implications on both pre and post transplant survival. Consequently, physicians working at the BMTU have to regularly evaluate each candidate to determine his or her eligibility and priority for a BMT. This report describes the implementation of an expert system (ES) in aiding the assessment of candidates for BMT. The ES prototype was created as a means to help healthcare providers define eligibility and priority by using production rules and the Bayesian net (BN). Some factors contributed a lot to test and to validate the systems of this project. Real cases were tested, therefore BMTU presents a database (DB) with all the patients that are awaiting transplant. The system was capable of determining all the patients' eligibility with the diagnosis of Chronic Myeloid Leukemia (CML) and to indicate transplant priority.

Bayes Theorem↗

Immunotherapy for scorpion envenoming in Brazil.

Using the ELISA we have shown that in rats subcutaneously injected with Tityus serrulatus scorpion venom there is a fast absorption rate, a fast and high distribution of venom to tissues, a great affinity of the venom for the tissues and a slow elimination half-life. Because of these experimental data, i.v. immunotherapy should be given to patients stung by scorpions as soon as possible after hospital admission. The severity of scorpion envenoming is related to plasma venom concentration (ELISA). The high levels of plasma scorpion venom antigens (ELISA) were cleared 1 h after the infusion of antivenom (5-30 ml of Fab2 fragment) and high concentrations of circulating antivenom persisted for at least 24 h, confirming the efficacy of immunotherapy to neutralise circulating venom. Some symptoms (e.g. local pain and vomiting) decreased 1 h after the starting of immunotherapy, whereas the other symptoms disappeared from 12-48 h later. Using our tripartite approach of treating scorpion envenoming (symptomatic measures, support of vital functions and serotherapy), the mortality rate was very low (0.28%).

Animals↗

[Estivation of Biomphalaria tenagophila (Pulmonata, Planorbidae)].

This study reports the finding of Biomphalaria tenagophila naturally aestived in two municipalities of the State of S. Paulo (Brazil): Ubatuba and Conchas. This ethological characteristic was discovered in 15 specimens collected in Ubatuba, and in 6 specimens collected in Conchas. The snails aestived showed vitality after being placed in water.

Adaptation, Physiological↗

[Maintenance of armadillos in captivity and results of the inoculation of Mycobacterium leprae].

The authors report their experiences in raising armadillos and the results obtained in inoculating them with M. leprae. They begin by reporting on the origin of the animals, how they were captured, and their efforts until they found the right kind of housing for the armadillos. They also tell of their attempts to develop the correct feeding procedures. The result is the feed used now in their laboratory: chicken feed mixed with bread, eggs, meat and milk. Along with this, they report on the way each animal is registered and the examination it undergoes upon admittance, namely, recording of its weight, rectal temperature, feces examination, hemogram and hemossedimentation. They also tell how animals are immobilized so as to take blood samples for the inoculations. Lastly, they present the results of the inoculations with M. leprae in three armadillos of the Euphractus sexticinctus species and 26 of the Dasypus novemcinctus species, with special reference to an armadillo of the D. novemcinctus species, which had systemic infection 15 months after being inoculated subcutaneously and intravenously. Bacilli were found in large quantities in various organs like the skin, lymph nodes, liver, kidneys and spleen. No bacilli were found in the myocardium, pancreas, thyroid and testicles. The authors are of the opinion that this is the first armadillo of the D. novemcinctus species to present experimental systemic infection with M. leprae in South America. Another armadillo, which has been inoculated with a suspension of 1.2 X 10(8) bacilli by the intracardiac route already showed nodules with bacilli on the abdominal wall 10 months after being inoculated. They believe that the results already obtained indicate that soon they will be able to provide material for institutions in Brazil as well as other countries that are interested in the study of M. leprae and in the preparation of the Mitsuda antigen which is so vital to the control of Hansen's disease.

Animal Feed↗

[Citizen training in nursing: myth or potential utopia?].

The objective of this study is to verify to what extent the concepts of university, citizenship, social compromise and health system influence the nursing practice. These topics were analysed through questionnaires answered by senior nursing students. The pedagogical project of the this course was used as reference to analyse students' speech. The study showed that these prospective professionals didn't have a satisfying advance concerning their view on education, health and conception of the world. This result suggested that this pedagogical proposal has to be constantly reexamined in order to broaden students' view on the aspects mentioned. It was noticed that students' discourses were heterogeneous, and contrasted with the apparent homogeneity in the understanding of specific contents. The research highlights the dialectical movement that affects the teaching practice, which oscillates between a critical formation and Descartes' logic. It was concluded that a continuous evaluation of the educational project is a vital strategy to consolidate a formation compromised with citizenship.

Brazil↗

Clinical diagnosis versus autopsy.

Records from 910 autopsies performed at a university hospital in Salvador, Bahia, Brazil, were examined in order to assess the accuracy of clinical diagnoses of the patients' underlying causes of death. This study found inaccurate clinical diagnoses in 31% of the cases. The overall rate of diagnostic error appeared to remain fairly stable from 1970 to 1982, being highest for older patients. Thirty-six percent of the 263 cancer deaths were incorrectly diagnosed, and a number of pathologies considered relatively easy to diagnose were not always correctly identified. Quite aside from their direct medical implications, diagnostic errors of the magnitude observed in this and other studies seriously jeopardize the quality of vital statistics and such statistics' usefulness for improving public health.

Adolescent↗

U.S. military overseas medical research laboratories.

Many infectious disease threats to U.S. military operations are uncommon in the United States. The advanced development and testing of countermeasures, such as vaccines, drugs, or insect repellents, requires the capability to study militarily important infectious diseases where they occur. With formal agreements between the U.S. and each host country, the U.S. military operates seven overseas medical research laboratories (labs). Six labs conduct infectious disease research and are distributed over three continents: Africa (labs in Egypt and Kenya), Asia (labs in Indonesia and Thailand), and South America (labs in Brazil and Peru). One other lab is located in Germany and conducts psychosocial research related to military personnel and their families. In addition to product development, these labs play vital roles supporting overseas deployments, providing technical training, and promoting international relations. Also, these labs are well positioned to become part of a developing global surveillance and response system to help address the threat posed by emerging infectious diseases. This article will present an overview of this unique medical research capability, describe the history and some of the activities of each lab, and discuss the importance of maintaining these labs in the 21st century.

Communicable Diseases↗