Prospects for the elimination of leprosy as a public health problem in the State of Paraná, Brazil

Leprosy, an endemic contagious/infectious disease, is still a public health problem in most States of Brazil, despite an important decrease in the prevalence rate in recent years. The current study aims to analyze the prospects for the elimination of leprosy in the State of Paraná, based on detection and prevalence rates for the years 2000 to 2005, in addition to data on gender, age, clinical form, operational classification, and number of skin lesions. Data were obtained from the Reportable Diseases Information System (SINAN) and the Tabnet software. Leprosy detection and prevalence rates in Paraná remained unaltered during the study period. The leprosy detection rates were high or very high in the majority of the health districts in the State. In terms of prevalence, eight health districts had reached the goal of eliminating the disease. In conclusion, the State of Paraná is close to reaching the goal of eliminating leprosy. Based on the study results, actions are recommended to eliminate the disease as a public health problem.     

Retrospective study of dental trauma in children with autism spectrum disorders: a paired study

The objective was to evaluate the history of traumatic dental injury (TDI) among children with and without autism spectrum disorders (ASD) at the Centro Integrado de Educação Especial (CIES), in Teresina, Brazil. The dental records of 228 children, 114 with ASD (SG = study group) and 114 without ASD (CG = control group), paired by age, gender and socioeconomic characteristics between January 2007 and September 2014 were reviewed. Data were analyzed using chi‐square test and multivariate logistic regression (alpha = 5.0%). Dental trauma in SG was lower than in the CG (24.6% and 41.2%, respectively, p = 0.007). The risk of trauma was lower among males in SG (OR: 0.35; 95%CI: 0.18 to 0.67). The likelihood of TDI in SG was 3.17 higher in females than that of males (p = 0.040). The prevalence of TDI was lower in ASD individuals compared to controls. Dental trauma was higher among ASD girls than ASD boys.     

Evaluation of antiulcer activity of chromanone fraction from Calophyllum brasiliesnse Camb

Ethnopharmacological relevance

Calophyllum brasiliense Camb. (Clusiaceae), popularly known as ‘guanandi’, is found in the tropical areas and swampy lands. The latex exuding from its bark is used in the treatment of gastric ulcer in folk medicine. Several active compounds have been isolated from its stem bark among them, are the chromanone acids. Therefore, this study aimed to evaluate antiulcer activity and probable mechanism(s) of action of a fraction containing a mixture of chromanone acids (BI), derived by column chromatography fractionation of the hexane extract of the stem bark of Calophyllum brasiliense (HECb), using experimental in vitro and in vivo models.

Materials and methods

Ulcer was induced by oral administration of ethanol (75%, v/v) and indomethacin (50 mg/kg). Malondialdehyde, reduced glutathione and catalase activity was measured in stomach tissue after ethanol induced ulcer. In order to evaluate the effect of BI on nitric oxide, ulcer was induced by ethanol in l-NAME pretreated animals. Anti-Helicobacter pylori activity was verified in disk diffusion and broth microdilution in vitro assays, using cagA+ and vacA+ Helicobacter pylori strains.

Results

BI prevented the gastric ulceration caused by ethanol and indomethacin treatments. Its gastroprotective mechanism in ethanol-induced ulcer was partly due to reduction of MDA and CAT levels in the gastric tissue. BI did not affect the GSH levels and its gastroprotective effect was not reversed by pretreatment with l-NAME. BI showed anti-Helicobacter pylori in the both assays.

Conclusion

The results indicate that BI is partly responsible for the HECb antiulcer and anti-Helicobacter pylori effects.     

Efficacy of e‐technologies in improving breastfeeding outcomes among perinatal women: a meta‐analysis

A growing line of research has highlighted that e‐technologies may play a promising role in improving breastfeeding outcomes. The objective of this review was to synthesise the best of available evidence by conducting a meta‐analysis to evaluate whether e‐technologies have had any effect in improving breastfeeding outcomes among perinatal women. The review was conducted using nine electronic databases to search for English‐language research studies from 2007 to 2014. A ‘risk of bias’ table was used to assess methodological quality. Meta‐analysis was performed with the RevMan software. The Q test and I² test was used to assess the heterogeneity. The test of overall effect was assessed using z‐statistics at P < 0.05. Of 1842 studies identified through electronic searches and reference lists, 16 experimental studies were selected after applying the inclusion and exclusion criteria. Half of the selected studies had a low risk of bias, from which a total of 5505 women in six countries in these studies were included. Meta‐analyses revealed that e‐technologies significantly improved exclusive breastfeeding initiation (z = 6.90, P < 0.00001), exclusive breastfeeding at 4 weeks (z = 2.12, P = 0.03) and 6 months (z = 3.2, P = 0.001), breastfeeding attitude (z = 3.01, P = 0.003) and breastfeeding knowledge (z = 4.54, P = < 0.00001) in subgroup analyses. This review provides support for the development of web‐based, texting messaging, compact disc read‐only memory, electronic prompts and interactive computer agent interventions for promoting and supporting breastfeeding.     

Finding FMR1 mosaicism in Fragile X syndrome

OBJECTIVE: Almost all patients with Fragile X Syndrome (FXS) exhibit a CGG repeat expansion (full mutation) in the Fragile Mental Retardation 1 gene (FMR1). Here, the authors report five unrelated males with FXS harboring a somatic full mutation/deletion mosaicism.

METHODS: Mutational profiles were only elucidated by using a combination of molecular approaches (CGG-based PCR, Sanger sequencing, MS-MLPA, Southern blot and mPCR).

RESULTS: Four patients exhibited small deletions encompassing the CGG repeats tract and flanking regions, whereas the remaining had a larger deletion comprising at least exon 1 and part of intron 1 of FMR1 gene. The presence of a 2-3 base pairs microhomology in proximal and distal non-recurrent breakpoints without scars supports the involvement of microhomology mediated induced repair (MMBIR) mechanism in three small deletions.

CONCLUSION: The authors data highlights the importance of using different research methods to elucidate atypical FXS mutational profiles, which are clinically undistinguishable and may have been underestimated.     

Central auditory processing and migraine: a controlled study

Background

This study aimed to verify and compare central auditory processing (CAP) performance in migraine with and without aura patients and healthy controls.

Methods

Forty-one volunteers of both genders, aged between 18 and 40 years, diagnosed with migraine with and without aura by the criteria of “The International Classification of Headache Disorders” (ICDH-3 beta) and a control group of the same age range and with no headache history, were included. Gaps-in-noise (GIN), Duration Pattern test (DPT) and Dichotic Digits Test (DDT) tests were used to assess central auditory processing performance.

Results

The volunteers were divided into 3 groups: Migraine with aura (11), migraine without aura (15), and control group (15), matched by age and schooling. Subjects with aura and without aura performed significantly worse in GIN test for right ear (p = .006), for left ear (p = .005) and for DPT test (p < .001) when compared with controls without headache, however no significant differences were found in the DDT test for the right ear (p = .362) and for the left ear (p = .190).

Conclusions

Subjects with migraine performed worsened in auditory gap detection, in the discrimination of short and long duration. They also presented impairment in the physiological mechanism of temporal processing, especially in temporal resolution and temporal ordering when compared with controls. Migraine could be related to an impaired central auditory processing.

Clinical trial registration

Research Ethics Committee (CEP 0480.10) – UNIFESP