Placental Growth Factor (PlGF) Is a Surrogate Marker in Preeclamptic Hypertension

Objective: To evaluate plasma levels of angiogenic factors and their association with preeclampsia. Methods: Twenty-three women with preeclampsia and nine normotensive pregnant women from the Maternity of Hospital das Clínicas of Belo Horizonte/MG-Brazil were assessed by National High Blood Pressure Education Program Working Group Creteria (NHBPEPWG). The plasma levels of vascular endothelial growth factor (VEGF) and Placental growth factor (PlGF) were determined by ELISA assay. Results: Plasma concentration of PlGF was 12-fold lower in preeclampsia versus non preeclampsia pregnancies. An inverse correlation was observed between PlGF plasma levels and mean arterial pressure (MAP); a decrease in 1pg/mL of PlGF resulted in 6.18 mm Hg increase in MAP. Conclusion: These results indicate that PlGF is related to MAP in pregnant women.     

Patents of drugs extracted from Brazilian medicinal plants

Background: Plants synthesise a vast repertoire of chemicals with various biological activities. Brazilian enormous botanical diversity facilitates the development of novel ethical drugs for the treatment of diseases in humans. Objective: To present therapeutic patent applications comprising Brazilian native plants published in the 2003 – 2008 period in light of legal aspects of patentability of biodiversity and public health concerns. Methods: Therapeutic patent applications related to Brazilian medicinal plants available at both the European Patent Office and the Brazilian National Institute of Industrial Property databases were reviewed. Results/conclusion: Twenty-five patents are presented, most of which concern inflammatory, allergic, parasitic, infectious or digestive diseases, including extracts from Carapa guianensis, Copaifera genus, Cordia verbenacea, Erythrina mulungu, Physalis angulata and other pharmaceutical compositions with antileishmanial, antimalarial or trypanocidal activity. Brazilian research centres and universities are responsible for most of these inventions.     

Three New α-Globin Variants: Hb Itapira [α30(B11)Glu→Val (α1)], Hb Bom Jesus Da Lapa [α30(B11)Glu→Ala (α1)] and Hb Boa Esperança [α16(A14)Lys→Thr (α2)]

Three novel α-globin variants were found during a screening program for hemoglobinopathies in blood donors at the UNICAMP Hematology and Hemotherapy Center, Campinas, State of São Paulo, Southeastern Brazil. They were named for the town of origin of the carrier as Hb Itapira [α30(B11)Glu→Val], Hb Bom Jesus da Lapa [α30(B11)Glu→Ala] and Hb Boa Esperança [α16(A14)Lys→Thr]. Hb Itapira, like Hb Bom Jesus da Lapa, shows an electrophoretic mobility similar to that of Hb S [β6(A3)Glu→Val, GAG→GTG] at alkaline pH; it is associated with a triplicate α-globin allele (ααα^{anti 3.7}) and corresponds to only 5.5% of the total hemoglobin (Hb). Hb Boa Esperança, found in two different individuals, moves faster than Hb A and exhibits an abnormal functional performance.     

Attitudes toward complementary and alternative medicine amongst oncology professionals in Brazil

Complementary and alternative medicines (CAM) are popular amongst cancer patients in the Brazilian context, however little is known about oncology health professionals’ attitudes toward the role of CAM and their perspectives on the potential for integration into oncological care. In this study, drawing on a series of interviews with oncology professionals (i.e. doctors, nurses, nutritionists, pharmacologists and psychologists), we provide insight into their views on the rise, validity, and role of CAM in cancer care. The results reveal two key dynamics in relation to CAM in cancer care in Brazil. First, that doctors, nurses and other allied professionals hold considerably different views on the value and place of CAM, and in turn ascribe it varying levels of legitimacy potentially limiting integration. Second, that while some health professionals may articulate a degree of support for CAM, this is limited by perceptions of CAM as lacking efficacy and intruding on their respective jurisdictional claims. Further research is needed in the Brazilian context to explore patient and professional perspectives on experiences on CAM in cancer care, including how oncology professionals’ varying positions on CAM may influence what patients are prepared to use, or discuss, in the context of cancer care.     

Vacinação em pacientes da Coorte Brasília de artrite reumatoide inicial

IntroductionPatients with a diagnosis of rheumatoid arthritis (RA) are at increased risk of infections. Vaccination is a recommended preventive measure. There are no studies evaluating the practice of vaccination in patients with early RA.ObjectivesTo evaluate the frequency of vaccination and the orientation (by the doctor) about vaccines among patients with early RA diagnosis.MethodsCross‐sectional study including patients from the early RA Brasilia cohort. Demographic data, disease activity index (Disease Activity Score 28 – DAS28), functional disability (Health Assessment Questionnaire – HAQ), and data on treatment and vaccination after diagnosis of RA were analyzed.Results68 patients were evaluated, 94.1% women, mean age 50.7 ± 13.2 years. DAS28 was 3.65 ± 1.64, and HAQ was 0.70. Most patients (63%) had vaccination card. Only five patients (7.3%) were briefed by the doctor about the use of vaccines. Patients were vaccinated for MMR (8.8%), tetanus (44%), yellow fever (44%), hepatitis B (22%), influenza (42%), H1N1 (61.76%), pneumonia (1.4%), meningitis (1.4%), and chickenpox (1.4%). All patients vaccinated with live attenuated virus were undergoing immunosuppressive therapy, and were vaccinated inadvertently, without medical supervision. There was no association between the use of any vaccine and disease activity, functional disability, years of education, lifestyle, and comorbidities.ConclusionPatients were infrequently briefed by the physician regarding use of vaccines, with high frequency of inadvertent vaccination with live attenuated component, while immunization with killed virus was below the recommended level.     

Perfil epidemiológico da espondiloartrite de início juvenil comparada com a espondiloartrite de início na vida adulta em uma grande coorte brasileira

ObjectiveTo analyze the clinical and epidemiologic characteristics of juvenile‐onset spondyloarthritis (SpA) (< 16 years) and compare them with a group of adult‐onset (≥ 16 years) SpA patients.Patients and methodsProspective, observational and multicentric cohort with 1,424 patients with the diagnosis of SpA according to the European Spondyloarthropathy Study Group (ESSG) submitted to a common protocol of investigation and recruited in 29 reference centers participants of the Brazilian Registry of Spondyloarthritis (RBE – Registro Brasileiro de Espondiloartrites). Patients were divided in two groups: age at onset < 16 years (JOSpA group) and age at onset ≥ 16 years (AOSpA group).ResultsAmong the 1,424 patients, 235 presented disease onset before 16 years (16.5%). The clinical and epidemiologic variables associated with JOSpA were male gender (p < 0.001), lower limb arthritis (p = 0.001), enthesitis (p = 0.008), anterior uveitis (p = 0.041) and positive HLA‐B27 (p = 0.017), associated with lower scores of disease activity (Bath Ankylosing Spondylitis Disease Activity Index – BASDAI; p = 0.007) and functionality (Bath Ankylosing Spondylitis Functional Index – BASFI; p = 0.036). Cutaneous psoriasis (p < 0.001), inflammatory bowel disease (p = 0.023), dactylitis (p = 0.024) and nail involvement (p = 0.004) were more frequent in patients with adult‐onset SpA.ConclusionsPatients with JOSpA in this large Brazilian cohort were characterized predominantly by male gender, peripheral involvement (arthritis and enthesitis), positive HLA‐B27 and lower disease scores.     

Psychometric properties of the Brazilian-adapted version of the Ages and Stages Questionnaire in public child daycare centers

Well-designed screening assessment instruments that can evaluate child development in public daycare centers represent an important resource to help improve the quality of these programs, as an early detection method for early developmental delay. The Ages and Stages Questionnaire, 3rd edition (ASQ-3), comprises a series of 21 questionnaires designed to screen developmental performance in the domains of communication, gross motor skills, fine motor skills, problem solving, and personal–social ability in children aged 2 to 66 months. The purpose of the present work was to translate and adapt all of the ASQ-3 questionnaires for use in Brazilian public child daycare centers and to explore their psychometric characteristics with both Classical Test Theory and Rating Scale analyses from the Rasch model family. A total of 18 Ages & Stages Questionnaires — Brazilian translation (ASQ-BR) questionnaires administered at intervals from 6 to 60 months of age were analyzed based on primary caregiver evaluations of 45,640 children distributed in 468 public daycare centers in the city of Rio de Janeiro. The results indicated that most of the ASQ-BR questionnaires had adequate internal consistency. Exploratory factor analyses yielded a one-factor solution for each domain of all of the ASQ-BR questionnaires. The only exception was the personal–social domain in some of the questionnaires. Item Response Theory based on Rating Scale analysis (infit and outfit mean squares statistics) indicated that only 44 of 540 items showed misfit problems. In summary, the ASQ-BR questionnaires are psychometrically sound developmental screening instruments that can be easily administered by primary caregivers.     

3,6‐Dimethoxy‐6″,6″‐Dimethyl‐(7,8,2″,3″)‐Chromeneflavone,a Flavonoid Isolated from Lonchocarpus Araripensis Benth. (Fabaceae), Reduces Nociceptive Behaviour in Mice

Lonchocarpus araripensis Benth. is largely distributed in the northeast region of Brazil. It is popularly known as ‘sucupira’. Recent studies have shown that some species of Lonchocarpus have interesting pharmacological activities. In this study, we evaluated the antinociceptive effect of a flavone isolated from L. araripensis. The chemical examination resulted in the isolation of 3,6‐dimethoxy‐6″,6″‐dimethyl‐(7,8,2″,3″)‐chromeneflavone (DDF). The structure of the compound was established by spectral analysis. Antinociceptive activity of DDF was evaluated by measuring nociception by acetic acid, formalin and hot plate tests. The rota rod test was used to evaluate motor coordination. The results demonstrated that DDF was able to prevent acetic‐acid‐writhing‐induced nociception (p < 0.001) in mice. Furthermore, DDF produced a significant reduction of the nociceptive behaviour at the early and late phases of paw licking in the formalin test. Also, DDF produced an inhibition of the nociceptive behaviour during a hot‐plate test. No alteration in motor coordination was observed. These results confirm the hypothesis that DDF reduces the nociceptive behaviour in mice, probably through central mechanisms, but without compromising the motor coordination of animals. Copyright © 2015 John Wiley & Sons, Ltd.