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PubMedDate not supplied

[New formulation of sublingual misoprostol (25 mcg) for induction of labor].

OBJECTIVES: To determine effectiveness and safety of sublingual misoprostol in tablets of 25 mcg, given every 6 hours for induction of labor in high-risk pregnant women hospitalized in two teaching hospitals in the Northeast of Brazil. METHODS: An open, non-randomized clinical trial was conducted, including 40 women with high-risk pregnancies hospitalized at "Maternidade-Escola Assis Chateaubriand" and "Instituto Materno-Infantil de Pernambuco". All of them had gestational age >or= 37 weeks, alive fetus with good vitality and Bishop scores <or= 7. A tablet of 25 mcg of misoprostol was administered every 6 hours, up to a maximum of 4, until active labor. Statistical analysis was performed using the public domain software Epi-Info 3.2.2. RESULTS: Active labor occurred in 100% of cases after misoprostol administration. The mean (+/-SD) induction-to-labor interval was 4.8(+/-3.8 hours. Interval from induction-to-delivery varied from 8 to 31 hours with 95% of the deliveries occurring in the first 24 hours with 75% of vaginal deliveries. The frequency of tachysystole was 12.5%. The women did not present relevant side effects neither were there any neonatal complications. CONCLUSIONS: The sublingual tablet of misoprostol of 25 mcg was shown to be effective for induction of labor in high-risk pregnant women. The efficacy and acceptability of this new route should be compared to vaginal administration of misoprostol in future prospective randomized clinical trials.

Administration, Sublingual↗
PubMedDate not supplied

The poisons and narcotics of the Amazonian Indians.

The indigenous tribes of the Amazonian rainforest have discovered a vast array of poisons and narcotics from the plant species which surround them. Examples are given from the author's personal experience of a variety of arrow poisons, fish poisons and narcotics used by six different tribes. There is a great variety of different plant species used for each category and no two tribes studied employ exactly the same array of plant species. This makes it important to survey a wide range of tribes and to document this information before it is too late as these people are fast losing their traditional culture. Several of the substances used by Amazonian Indians, such as curare and coca, have entered into western medicine and others such as rotenone, an ingredient of their fish poison, has become a useful insecticide. Further useful chemicals are likely to be discovered from ethnobotanical work among indigenous peoples and it is vital that any commercial gain from their knowledge be of direct benefit to these people in accordance with the rules of the Convention on Biological Diversity.

Brazil↗
PubMed2001

Progress of farrowing and early postnatal pig behavior in relation to genetic merit for pig survival.

The objective of this study was to investigate whether pigs with different genetic merit for survival differed in birth weight, progress of farrowing, early postnatal behavior, or rectal temperature within 24 h after birth. On a nucleus farm in Rio Verde, Brazil, information was collected on 280 pigs, originating from 25 litters with known estimated breeding values for pig survival (EBVps). Litters were selected in such a way that a continuous range of EBVps with a maximum genetic contrast was achieved. Birth weight was recorded for all pigs. Indicators for progress of farrowing were birth intervals and duration of farrowing. Behavioral indicators of pig vitality were time until first upright standing (FUS), time until first udder contact (FUC), time until first teat in mouth (FTM), and time until first colostrum uptake (FCU). Rectal temperature was measured within 24 h after birth. Farrowing survival and early postnatal survival (within 3 d after farrowing) were registered. Farrowing survival and early postnatal survival both increased with increasing EBVps (farrowing survival: P = 0.007; early postnatal survival: P = 0.027). Birth weight decreased with increasing EBVps (P = 0.01). Birth intervals tended to increase with increasing EBVps (P = 0.10) and duration of farrowing was not related to EBVps. Time until first teat in mouth increased with increasing EBVps (P = 0.05), but the other behavioral indicators of pig vitality were not related to EBVps. Rectal temperature within 24 h after birth was not related to EBVps. Pigs with a higher genetic merit for survival have a lower birth weight but nevertheless have an increased farrowing survival and early postnatal survival. Their increased survival cannot be explained by differences in progress of farrowing, early postnatal behavior, or rectal temperature within 24 h after birth.

Animals↗
PubMed2002

Molecular genetics of primary congenital glaucoma in Brazil.

PURPOSE: To determine the distribution of CYP1B1 gene mutations in Brazilian patients with primary congenital glaucoma (PCG). METHODS: PCG diagnosis was established by presence of buphthalmos in at least one affected eye and associated high intraocular pressures before the age of 3 years. CYP1B1 mutation screening of 52 patients with PCG was performed by SSCP and direct sequencing of PCR fragments. RESULTS: Eleven mutations, four of which are novel, were observed in 26 (50%) individuals. A new frameshift mutation (4340delG) was observed in 20.2% of all individuals screened. These individuals had early-onset, bilateral glaucoma that necessitated multiple surgical interventions. CYP1B1 mutations were twice as frequent in affected individuals of European descent as in individuals of African descent. Analysis of six intragenic single nucleotide polymorphisms (SNPs) established 5'-C-C-G-G-T-A-3' as the most common haplotype among the affected Brazilian individuals. A nonsense mutation (W57X) previously reported in an individual with Peters anomaly (compound heterozygote) was also observed in two individuals with PCG but combined with different mutations. A newly developed SSCP assay enabled us to detect all DNA mutations and polymorphisms previously detected by direct sequencing. CONCLUSIONS: Our results indicate that CYP1B1 mutations may be responsible for half of cases of PCG in the Brazilian population. The SNP haplotype 5'-C-C-G-G-T-A-3' was associated with the majority of CYP1B1 mutations. This haplotype harbors the high-activity V432 allele, which is emerging as a putative susceptibility factor in several cancers.

Aryl Hydrocarbon Hydroxylases↗
PubMed1976

Ecological affinities of Brazil and the southeastern United States of America. A study in comparative physiological ecology.

Brazil and the southeastern United States have faunistic similarities and differences which are of fundamental interest to the environmental scientist. These similarities and differences provide natural experimental organisms and habitats which can provide answers to basic and applied questions. What are the lethal limits of organisms to environmental changes? How do animals functionally adjust to various ecological parameters? How have basic biological systems evolved in response to new environments? Although the comparative functional attributes of individual species has been stressed in this paper, knowledge of the comparative dynamics os is vitally needed before man can gain an understanding of how systems function, and, equally important, how to manage and manipulate coastal marine environments. This critical area is where man has the potential to exert his greatest influence on the future existence and evolution of specific organisms and ecosystems.

Animals↗
PubMedDate not supplied

[Historical trend in the occurrence of deaths in a municipality from Southern Brazil: 1936-1982].

The authors studied 33,494 deaths occurring in Londrina, State of Paraná, Brazil, from 1936 to 1982. The deaths were divided into two groups: residents and invaders, who lived outside the Londrina municipal limits. Invaders were studied as to origin, place of occurrence, cause, and diagnostic confirmation and compared with residents across proportional mortality. An attempt was made to identify a relationship between invaders' deaths and Londrina's historical development, especially migratory phenomena and health care improvements. Results showed that over the course of the period studied, most of the outsiders who had died in Londrina (over 80%) were from northern Paraná. Identification of the proportion of in-hospital deaths, diagnostic confirmation, and criteria from several chapters of the International Classification of Diseases showed that outsiders had received proportionally more medical care. Londrina's medical care attracted outsiders from the beginning of the period onward, a trend that was further consolidated after 1970.

Adult↗
PubMed2006

[Spirometric reference values in 5 large Latin American cities for subjects aged 40 years or over].

OBJECTIVE: In clinical practice, spirometry is a extremely useful test that requires strict quality control, an appropriate strategy for interpretation, and reliable reference values. The aim of this study was to report spirometric reference values for 5 cities in Latin America. PATIENTS AND METHODS: From data for 5315 subjects who had undergone spirometry in the PLATINO study in Caracas, Mexico City, Santiago, São Paulo, and Montevideo, we selected information for 906 (17%) individuals aged between 40 years and 90 years to provide reference values. The chosen subjects had never smoked, were asymptomatic, had not been diagnosed with lung disease, and were not obese. Multiple regression models were constructed with the following spirometric parameters: forced expiratory volume in 1 second (FEV1) and in 6 seconds (FEV6), peak expiratory flow, forced vital capacity (FVC), FEV1/FEV6, FEV1/FVC, and forced midexpiratory flow rate. Height, sex, and age were also included in the model. RESULTS: Average values for the subjects studied were similar to those for the white North American population and the Mexican-American population of the third National Health and Nutrition Examination Survey, but exceeded those of the black population of the same survey by 20%. CONCLUSIONS: The proposed reference values are an improvement on those currently available for Latin America because the participants were chosen by population sampling methods and standardized up-to-date methodology was used.

Adult↗
PubMed2005

Adolpho Lutz and the origins of medical entomology in Brazil.

Adolpho Lutz (1855-1940) formed a bridge between the Bahian Tropicalist School and post-Mansonian medicine. Before taking over as head of the São Paulo Bacteriological Institute (1893), Lutz traveled through a variety of regions and delved into various disciplines. In the 1880s, he was already arguing that leprosy was transmitted by mosquitoes. Carbuncles, cholera, and typhoid fever were then the accepted models for investigating the etiology of infectious diseases. Following the discovery of how malaria was transmitted, attention turned to hematophagous diptera. Physicians, bacteriologists, zoologists, and veterinarians reshaped the network of actors involved in the 'hunt' for the agents and transmitters of diseases, as they began relying on analogies with malaria and yellow fever. Edwin Ray Lankester, director of the British Museum (Natural History), launched then a worldwide investigation into species that might be linked to human disease. The species described by Lutz and his proposed classification system were vital to Frederick Theobald's fundamental work in medical entomology, published in the early twentieth century. In 1908, Lutz brought with him to the Oswaldo Cruz Institute a remarkable quantity of research and experiments in all branches of the newly created "tropical medicine," devoted especially to entomology.

Animals↗
PubMed1982

The political economy of infant mortality in São Paulo, Brazil.

After the military took power in Brazil in 1964, the government adopted a wide range of policies designed to stimulate economic growth. A central aspect of the Brazilian model of development was the control of wages. From 1964 to 1975 this strategy caused the purchasing power of the minimum wage in the city of Säo Paulo to fall. The decline in the real wage index was associated with a rise in infant mortality during the period. When real wages rose after 1974, the death rate dropped off. The infant mortality trend cannot be explained by other factors that affect the actual or the reported death rate, such as changes in cityward migration, shifts in the distribution of income, and improvements in the quality of vital statistics. The findings of this study indicate a causal relationship between the infant mortality trend and changes in the purchasing power of the urban poor. Additional data on nutrition, changes in household behavior, and shifts in the cause structure of mortality support this conclusion.

Brazil↗
PubMed2001

[Survival of AIDS patients in a city in southeastern Brazil].

OBJECTIVE: To assess survival in patients diagnosed with AIDS in the city of Ribeirão Preto, Brazil, between 1986 and 1997. METHODS: The epidemiological records of 2,214 patients diagnosed during the study period were retrospectively reviewed. From those, 1,231 patients with at least 30 days of follow-up after the date of diagnosis were included in the study. Information concerning deaths was obtained from hospitals and vital-records offices. RESULTS: Survival for the group as a whole was 310 days (10.3 months) over the period of 1986 through 1997. Median survival was 362 days for 1986 to 1990, 260 days for 1991 to 1995, and 864 days for 1996 and 1997. The Kaplan-Meier survival curves and the log-rank test showed significant differences for the following variables: sex, age, period when diagnosis was made, and presence of candidiasis and of cerebral toxoplasmosis. Cox's regression showed an association between reduction of survival and the following variables: age (in comparison to individuals younger than 15 years, hazard ratio = 1.435 for age between 15 and 34 years, and 1.681 for age above 35 years); period of diagnosis (in comparison to the period of 1996 and 1997, hazard ratio = 1.682 for the period from 1986 to 1990, and 2.324 for the period from 1991 to 1995); and presence of candidiasis (hazard ratio = 1.391). The hazard ratio for the presence of cerebral toxoplasmosis was 1.063, with a probability value close to the limit of significance. CONCLUSIONS: Our results show a striking increase in survival in 1996 and 1997, coinciding with the availability and utilization of highly active antiretroviral drugs.

Acquired Immunodeficiency Syndrome↗
PubMed2004

[Extracolonic manifestations of familial adenomatous polyposis: incidence and impact on the disease outcome].

BACKGROUND: Familial adenomatous polyposis is a hereditary disease with autossomic and dominant features, frequently associated to many extracolonic manifestations. AIM: To report extracolonic manifestations incidence and to analyze its impact on the disease's outcome. PATIENTS AND METHODS: Revision of patient charts treated from 1977 to 2001, relating associated extracolonic manifestations and its complications. RESULTS: Among 59 familial adenomatous polyposis patients, 23 (38,9%) presented some extracolonic manifestations at diagnosis or during follow-up. There were registered 37 different extracolonic manifestations (1.6 per patient). The most common manifestations were osteomas and congenital hypertrophy of the retinal pigment epithelium, diagnosed in 25% and 20% of the investigated patients, respectively. Other extracolonic manifestations were represented by upper digestive adenomas, epidermoid cysts, desmoid tumor (seven each), gastric cancer (three) and tireoid cancer (two). Desmoid-associated complications were reported in six patients, being intestinal obstruction in four and hidronephrosis in two; two deaths (28,5%) were registered. CONCLUSIONS: Extracolonic manifestations incidence is high (40%) and may affect disease's outcome and patient's quality of life. For these reasons, the research, prevention and adequate treatment of extracolonic manifestations turn into vital importance in familial adenomatous polyposis patients.

Adenomatous Polyposis Coli↗
PubMed2005

Prevalence of chronic obstructive pulmonary disease and associated factors: the PLATINO Study in São Paulo, Brazil.

Chronic obstructive pulmonary disease (COPD) is now a major public health concern; deaths attributable to COPD in Latin America have increased by 65.0% in the last decade. This study was aimed at evaluating COPD prevalence and associated factors in adults (> 40 years) living in Greater Metropolitan São Paulo, Brazil. The study is part of the Proyecto Latinoamericano de Investigación en Obstrucción Pulmonar (The PLATINO Project), a multi-center survey on COPD burden in Latin America, with São Paulo as the first center where the project has been carried out. A population-based sample was selected in multiple stages. Spirometry tests were performed in each subject pre- and post-bronchodilator and COPD was mainly defined as the ratio of forced expiratory volume to forced vital capacity below 70.0% (fixed ratio definition). Other spirometric criteria were also used for the diagnosis of COPD. COPD prevalence was 15.8% (95%CI: 13.5-18.1) using the fixed ratio definition. COPD was positively associated with age and smoking and inversely with body mass index. Utilization of different COPD spirometry criteria resulted in different percentages of COPD, but similar associated factors.

Adult↗
PubMed2006

Oral magnesium supplementation in asthmatic children: a double-blind randomized placebo-controlled trial.

OBJECTIVE: To investigate the long-term effect of oral magnesium supplementation on clinical symptoms, bronchial reactivity, lung function and allergen-induced skin responses in children and adolescents with moderate persistent asthma. DESIGN: A double-blind randomized parallel placebo-controlled study. SETTING AND SUBJECTS: The patients were recruited from the Pediatric Outpatient Clinic, Division of Pulmonology, Allergy and Immunology, and followed at the Center for Investigation in Pediatrics at State University of Campinas Hospital, Brazil. Thirty-seven out of 72 patients met the study criteria. There were no dropouts. INTERVENTION: The 37 patients (aged 7-19 years, 19 males) were randomized in two groups: magnesium (n=18, 300 mg/day) and placebo (n=19), during 2 months. Both patient groups received inhaled fluticasone (250 microg twice a day) and salbutamol as needed. The primary outcome was bronchial reactivity evaluated with methacholine challenge test (PC20). RESULTS: After a follow-up of 2 months, the methacholine PC20 for testing bronchial reactivity has augmented significantly in the magnesium group only. The skin responses to recognized antigens have also decreased in patients treated with magnesium. The forced vital capacity (FVC), the forced expiratory volume at first second (FEV1), the forced expiratory flow at 25-75 and the FEV1/FVC ratio were similar in both groups. The magnesium group presented fewer asthma exacerbations and used less salbutamol compared to the placebo group. CONCLUSIONS: Oral magnesium supplementation helped to reduce bronchial reactivity to methacholine, to diminish their allergen-induced skin responses and to provide better symptom control in pediatric patients with moderate persistent asthma treated with inhaled fluticasone.

Adolescent↗