Cancer in children: the diagnostic itinerary

This study aims to describe the trajectory children and adolescents experience from the beginning of cancer signs and symptoms until the confirmation of the diagnosis, based on their parents' report. A total of eight mothers and two fathers participated in the study. Data were collected through semi structured interviews, and data were subject to qualitative analysis. We found that this period is significant for parents, who are capable of recognizing that something wrong started to happen to their children, expressed through signs and symptoms. They precisely reported the chronological time of this trajectory. The challenges they mentioned refer to the different diagnostic hypotheses, the difficulty to performing specific diagnostic exams and to be referred to specialized care services. This search for health service care revealed to be a difficult journey, which permits to identify that the Brazilian Basic Health System's principles of accessibility and problem-solving capacity are jeopardized.     

Oral health care and health decentralization in Brazil: two case studies in Bahia State

A comparative case study was performed in two selected municipalities in the State of Bahia, Brazil, to discuss the relationship between health system decentralization and characteristics of oral health services. A logical model was developed and submitted to an expert panel. Data were gathered through in-depth interviews, field observation, and analysis of secondary data from the national Health System database. The results point to the influence of municipal government characteristics on oral health practice. One municipality was classified as having an intermediate standard of oral health system implementation (50%), while the other showed only 11% implementation. The study showed that the decentralization process has not been accompanied by an effort to improve management capacity in the local oral health services, despite the transfer of funds to this area.     

The rights of criminally insane individuals

The Psychiatric Reform Movement has supported proposals to reorient the hegemonic mental health care model. In Brazil, a facility for the criminally insane was created, called the Custody and Psychiatric Treatment Hospital (CPTH). The maintenance of such a structure, known as total institutionalization, has reinforced individual exclusion, limiting the patients' social rehabilitation. This article discusses the right to health in the CPTH from a human rights perspective. The advances achieved in Brazil under the National Mental Health Policy have failed to include reorientation of the care provided in such facilities for the criminally insane. The institution has remained an isolationist asylum, reflecting a historical denial of human rights. Progress in policy, per se, does not guarantee the materialization of recent strides gained through the Psychiatric Reform, particularly in relation to criminals with mental disorders. The state, through shared responsibility with society, should promote the effective reorientation of the health care model for these individuals, whose criminal responsibility should be acknowledged, while providing simultaneously for specialized care. Respect for human rights is not synonymous with impunity.     

Anxiety during pregnancy, prematurity, and low birth weight: a systematic literature review

The purpose of this systematic literature review was to examine publications that had investigated the effect of anxiety on prematurity and/or low birth weight. The PubMed, BVS, CINAHL, and HEALTHSTAR databases, published from 1966 to 2006, were tracked using the following key words: "anxiety", "pregnancy", "low birth weight", and "prematurity". Thirteen studies were found: 11 cohorts, 1 cross-sectional, and 1 case-control. Most studies (7/13) were conducted in the United States. The most reliable results came from four studies, whose strengths were: exclusion of adolescents and/or women older than 34 years, studies that analyzed anxiety during the second and/or third trimester of pregnancy, used validated scales to measure anxiety, kept loss-to-follow-up rates below 30%, and applied adequate control of confounders. Anxiety during pregnancy was associated with prematurity and/or low birth weight in eight studies. Odds ratios and relative risks varied from 1.08 to 2.31. Carefully designed and well-conducted studies are still needed to clarify the relationship between anxiety during pregnancy, prematurity, and low birth weight considering that the accumulated evidence remains controversial.     

Synthesis of amphiphilic galactopyranosyl diamines and amino alcohols as antitubercular agents

Mono- and diacylated derivatives of galactopyranosyl amines were obtained from d-galactose, via aminated intermediates prepared by reaction of 6-deoxy-6-iodo-1,2:3,4-di-O-isopropylidene-alpha-d-galactopyranose with 1,3-propanediamine, 1,2-ethanediamine or ethanolamine. Monoacylated derivatives displayed antitubercular activity.     

Intranasal delivery of naked DNA encoding the LACK antigen leads to protective immunity against visceral leishmaniasis in mice

We previously showed that intranasal (i.n.) vaccination with pCIneo plasmid encoding the leishmanial LACK gene (pCIneo-LACK) induces long-lasting protective immunity against cutaneous leishmaniasis in mice. In this work, we proposed to investigate whether the efficacy of i.n. pCIneo-LACK is extensive to visceral leishmaniasis. BALB/c mice received two i.n. doses of 30 microg pCIneo-LACK prior to intravenous (i.v.) infection with Leishmania chagasi. Vaccinated mice developed significantly lower parasite burden in the liver and spleen than control mice receiving empty pCIneo or saline. The spleen cells of vaccinated mice produced significantly increased IFN-gamma and IL-4 concomitant with decreased IL-10 production during infection. Serum levels of specific IgG were elevated whereas TNF-alpha were decreased as compared with controls. These results show that the practical needle-free i.n. pCIneo-LACK vaccine displays potential broad-spectrum activity against leishmaniasis.     

Breast feeding and mental and motor development at 12 months in a low-income population in northeast Brazil

The aim of this prospective study was to investigate the association between breast feeding and mental and motor development at age 12 months, controlling for comprehensive measures of the child's socio-economic, maternal and environmental background, and nutritional status. A cohort of 205 infants born during May-August 2001 in a poor area in the interior of the State of Pernambuco was enrolled, of whom 191 were tested at age 12 months with the Bayley Scales of Infant Development II, and in whom breast-feeding status was measured at days 1, 10, 30, 60, 90, 120, 150, 180, 270 and 360. After adjusting for potential confounders, full breast feeding (i.e. exclusive or predominant) at 1 month was associated with a small but significant benefit in mental development (+3.0 points, P = 0.02) compared with partial or no breast feeding. No additional advantage in mental development was found with longer durations of full breast feeding. Full breast feeding at 1 month was associated with improved behaviour for two of 10 ratings tested: initiative with tasks (P = 0.003) and attention (P = 0.02). No association between breast feeding and motor development was found.     

Analysis of sports‐relevant polymorphisms in a large Brazilian cohort of top‐level athletes

In recent years, there have been an increasing number of genetic variants associated with athletic phenotypes. Here, we selected a set of sports‐relevant polymorphisms that have been previously suggested as genetic markers for human physical performance, and we examined their association with athletic status in a large cohort of Brazilians. We evaluated a sample of 1,622 individuals, in which 966 were nonathletes, and 656 were athletes: 328 endurance athletes and 328 power athletes. Only the AGT M268T minor allele was nominally associated with the endurance status. Conversely, we found that seven polymorphisms are more frequent in power athletes (MCT1 D490E, AGT M268T, PPARG P12A, PGC1A G482S, VEGFR2 Q472H, NOS3 C/T, and ACTN3 R577X). For all of these polymorphisms, power athletes were more likely than nonathletes or endurance athletes to carry the major allele or the homozygous genotype for the major allele. In particular, MCT1 D490E, AGT M268T, NOS3 C/T, and ACTN3 R577X showed stronger associations. Our findings support a role for these variants in the achievement of power athletic status in Brazilians: MCT1 D490E (T allele), AGT M268T (G allele), PPARG (C allele), PGC1A G482S (C allele), VEGFR2 Q472H (T allele), NOS3 C/T (T allele), and ACTN3 R577X (R allele).     

Dispersion and infectivity of Toxocara canis eggs after passage through chicken intestine

Parasitology Research - Toxocariasis is an important, but neglected, worldwide zoonosis. It is considered a primarily soil-transmitted disease, but food-borne transmission has been associated with...