Limb body wall complex and amniotic band sequence in sibs

We report on a woman who gave birth consecutively to an infant with limb body wall complex (LBWC) and then to an infant with amniotic band sequence (ABS). This paper reviews the different etiological hypotheses and the classification problems for the amniotic band diseases. No maternal factors were found, but this clinical report suggests further research in this direction, as well as the need to look more closely at the relation between LBWC and ABS.     

Alcohol purchase survey by adolescents in two cities of State of São Paulo, Southeastern Brazil

OBJECTIVE: Alcohol use is a public health problem. Commercial availability is an important factor that encourages the use of alcohol by young people. The aim of the study was to assess how often young people under 18 could buy alcohol in shops METHODS: Adolescents from 13 to 17 attempted to purchase alcoholic beverages at a random sample of shops in the cities of Paulinia (n=108) and Diadema (n=426), Southeastern Brazil. The study was conducted from November to December 2003 in Paulínia, and July 2004 to August 2005 in Diadema. They were told not to lie about their ages when asked and to say that the beverage was for themselves. Statistical tests performed were two-tailed and the significance level considered was p<0.05. RESULTS: Adolescents, under the minimum legal age, were successful in purchasing alcoholic beverages in the first attempt in 85.2% of the surveyed outlets in Paulinia, and 82.4% in Diadema. The adolescents bought alcoholic beverages just as easy in all shops researched. CONCLUSIONS: The data showed almost unanimous easiness of teenagers to obtain alcoholic beverages, suggesting the relevance of this problem in these cities (and probably in Brazil). The urge to adopt specific alcohol policies to this age group is highlighted, in order to reduce alcohol consumption.     

Alcohol-related public policies

The article is a review of studies on alcohol-related problems and public policies for consumption reduction addressing recent national and international scientific evidences. In this way, literature review was carried out on alcohol-related public policies through searches in MEDLINE, SCiELO and LILACS databases. Policies for alcohol consumption reduction have been implemented in different countries to minimize its effects on people's health and safety but only recently such strategies and interventions have been scientifically evaluated. It is discussed better cost-effectiveness policies for reducing harmful effects and socioeconomic costs associated with alcohol use through the development of strategies favoring changes in behavior and harmful consumption contexts that can be applicable to different communities.     

Alcohol and adolescents: study to implement municipal policies

OBJECTIVE: To build students' profile regarding alcohol consumption and risk behavior. METHODS: A total of 1,990 students were included in the study, aged 11 to 21 years old, from both genders, enrolled in public and private schools, in Southeastern Brazil, in 2004. A self-administered questionnaire was answered in the classroom without the presence of the teacher. The questionnaire also assessed the perception of how easy it was to get alcoholic beverages, the contexts where they drunk, and the consequences of drinking. RESULTS: Prevalence of lifetime alcohol use was 62.2%. Regarding consumption in the last 30 days, 17.3% of students reported at least one episode of binge drinking (five or more drinks). Adolescents reported that they had gotten alcoholic drinks very easily from shops, and also in social contexts with relatives and friends. Only 1% of underaged reported that they had tried and could not buy alcoholic beverages. As negative consequences of alcohol use in the last 12 months, students reported feeling sick due to drinking (17.9%), regret for doing something under the influence of alcohol (11%), blackouts (9.8%), and getting involved in a fight after drinking (5%). Over half of the students (55%) reported knowing someone who had been involved in a car accident because of a drunk driver. CONCLUSIONS: Data showed high prevalence of alcohol use among adolescents studied and how easy access to alcoholic beverages is, including to underaged people. Youngsters put themselves at risk and presented negative consequences of alcohol consumption. Prompt actions regarding public alcohol policies in Brazil are needed.     

The effect of restricting opening hours on alcohol-related violence

Objective. We investigated whether limiting the hours of alcoholic beverage sales in bars had an effect on homicides and violence against women in the Brazilian city of Diadema. The policy to restrict alcohol sales was introduced in July 2002 and prohibited on-premises alcohol sales after 11 pm.Methods. We analyzed data on homicides (1995 to 2005) and violence against women (2000 to 2005) from the Diadema (population 360 000) police archives using log-linear regression analyses.Results. The new restriction on drinking hours led to a decrease of almost 9 murders a month. Assaults against women also decreased, but this effect was not significant in models in which we controlled for underlying trends.Conclusions. Introducing restrictions on opening hours resulted in a significant decrease in murders, which confirmed what we know from the literature: restricting access to alcohol can reduce alcohol-related problems. Our results give no support to the converse view, that increasing availability will somehow reduce problems.Restricting alcohol availability may reduce alcohol consumption and associated harm, including violence.1 Conversely, relaxing restrictions on the availability of alcohol may lead to increased consumption and problems.2^–6 Thus, for example, neighborhoods that have more bars and alcohol outlets per capita experience more violence.7^–9 Studies of licensing hours have for the most part investigated only modest changes (e.g., extending closing times from midnight to 1:00 am). Such changes might be expected to have only minimal effects. Moreover, these studies have been limited to North America, Europe, or Australia. No studies have examined the effects of changes in sales hours in developing countries, where the alcohol market is largely unregulated. Going beyond previous research, we report on the effects on assaults on women and homicides of a new law significantly restricting sales hours for bars in the Brazilian city of Diadema.A significant proportion of the Brazilian population (17% of men and 6% of women) report alcohol-related problems.10^,11 During 1988–1999, more than 84% of hospital admissions for addictions related to alcohol.12 Alcohol-related violence is also a serious problem. A 1995 São Paulo study found that alcohol was involved in 18 000 homicides, 15% of the 120 111 studied.13 An analysis of 130 homicides in Curitiba from 1990 to 1995 showed that 54% of the victims and 60% of the perpetrators were under the influence of alcohol during the crime.14 These findings highlight the urgent need for new and effective alcohol control policies in Brazil, yet there are few. There is a minimum age to buy and drink alcohol (18 years), there are time restrictions on advertising liquor, although not beer or wine (no television advertising allowed between 6 am and 9 pm), and the blood alcohol limit for drivers is 0.06 g/L. However these policies are poorly enforced, alcohol is cheap and readily available, and there is a high density of retail outlets that sell alcohol (e.g., 1 for every 16 people in a São Paulo suburb).15Diadema, 20 km from the center of São Paulo, is an industrial city with a population (357 064) of predominantly low socioeconomic status. In 1999, Diadema had one of the highest homicide rates in Brazil (103 per 100 000 inhabitants), of which 65% were alcohol related.16 The mayor was concerned about the high murder rate, and police statistics showed that most murders and assaults on women occurred in or close to bars between 11 pm and 6 am. As a result, in July 2002, a new law was introduced in Diadema that closed all bars at 11 pm. Before the law, most bars remained open 24 hours. To evaluate the effect of the new licensing law, we addressed the questions: do the new restrictions reduce murders or assaults against women or both?     

“Bunch of grapes” in complete hydatidiform mole

Abdominal Radiology - Complete hydatidiform mole is a common cause of gestational bleeding of the first trimester, commonly assessed by ultrasound. It represents an abnormal proliferation of...     

Resistance of Aedes aegypti to organophosphates in several municipalities in the State of Rio de Janeiro and Espírito Santo,Brazil

Chemical insecticides have been widely used in Brazil for several years. This exposes mosquito populations to an intense selection pressure for resistance to insecticides. In 1999, the Brazilian National Health Foundation started the first program designed to monitor the resistance of Aedes aegypti to insecticides. We analyzed populations from 10 municipalities (from 84 selected in Brazil) in the states of Rio de Janeiro and Espírito Santo. Exposure of larvae to a diagnostic dose of temephos showed in alterations in susceptibility in all populations. Mosquitoes from eight municipalities exhibited resistance, with mortality levels ranging from 74% (Campos dos Goytacazes, Rio de Janeiro) to 23.5% (S?o Gon?alo, Rio de Janeiro). The resistance ratios of mosquitoes from three municipalities ranged from 3.59 to 12.41. Adults from only one municipality (Nova Igua?u, Rio de Janeiro) remained susceptible to both fenitrothion and malathion. These results are being used to define new local vector control strategies.