RESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: Participatory research can help to broaden the understanding of medical systems and beliefs of traditional communities. An ethnopharmacological survey in collaboration with local people focused on plants used in quilombos located in Southeast Region in Brazil identified cultural factors that influence plant and recipe choice. AIM OF THE STUDY: To investigate the factors related to the therapeutic efficiency of medicinal plants from the perspective of Quilombo da Fazenda residents. MATERIALS AND METHODS: University researchers collaborated with community residents for both aims and methods of the study. The local partners were trained in the gathering of ethnopharmacological data and then selected and interviewed the residents considered experts on the use of medicinal plants. Data on the use of each species were supported by voucher specimens collected by the local partners and university researchers. Participant observations and field diaries by the university researchers supplemented the data. RESULTS: Eight interviewees mentioned 92 medicinal species with 60 therapeutic uses, applied in 208 recipes or remedies. Asteraceae (13 species), Lamiaceae (5) and Urticaceae (5) contributed most medicinal plant species. Of the 12 etic categories of use, the circulatory system category had the highest number of plants mentioned. Decoction was the most commonly used preparation method (66.8%), and most remedies were administered orally (76.4%). Eighty-six recipes included more than one plant species and/or the addition of other components, such as sugar, salt or animal products. Several cultural factors influence medicinal plant use. Popular beliefs on the quality of blood or the humoral properties of plants and illnesses, characteristics of the plants and other factors determine which plant is used and why. CONCLUSIONS: The participatory method identified a large number of factors that influence medicinal plant use: the patient's blood type; the condition of the plant and the disease (hot-cold system); the route of administration and dosage; the preventive uses of the plants; and the influence of other factors, such as the sun, the moon and dew. The participatory approach is useful for gaining insight on the decision processes of medicinal plant use in traditional societies, and also for those communities wanting to document their knowledge with or without the participation of the academy.
Assuntos
Medicina Tradicional , Plantas Medicinais , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Etnofarmacologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Magnoliopsida , Masculino , Pessoa de Meia-Idade , Fitoterapia , Inquéritos e QuestionáriosRESUMO
To evaluate the impact of chemotherapy and surgery on the outcome of osteosarcoma (OS) of the extremities and to identify prognostic factors in Brazilian patients. A total of 225 patients with metastatic and nonmetastatic OS of the extremities were enrolled and assessed in two consecutive studies designed and implemented by the Brazilian Osteosarcoma Treatment Group. The 5-year survival and event-free survival rates for the 209 assessable patients were 50.1% and 39%, respectively; for the 178 patients with nonmetastatic disease at diagnosis, the rates were 60.5% and 45.5%, respectively. The multivariate analysis showed that the following variables were associated with a shorter survival: metastases at diagnosis (P < .001), necrosis grades 1 and 2 (P = .046), and tumor size (P = .0071). The overall 5- and 10-year survival rates were lower than the rates reported in North American and European trials. A pattern of advanced disease at diagnosis was often present, with a high proportion of patients having metastases (20.8%) and large tumor size (42.9%). However, these features were not necessarily associated with longer duration of prediagnostic symptoms. These findings were considered in the strategic planning of the current Brazilian cooperative study, with the aim of improving survival and quality of life of a large number of patients with OS.
Assuntos
Humanos , Estudos de Casos e Controles , Metástase Neoplásica , Osteossarcoma/diagnóstico , Osteossarcoma/tratamento farmacológicoRESUMO
BACKGROUND: Chemotherapy has dramatically improved the rates of cure and survival of patients with localized and metastatic osteosarcoma. Nonetheless, the number of chemotherapeutic agents active against osteosarcoma is limited to doxorubicin, cisplatin, high-dose methotrexate, and ifosfamide. Carboplatin, a cisplatin analogue, has been tested as a single agent in patients with recurrent osteosarcoma or as part of multiagent chemotherapy in newly diagnosed patients. PROCEDURE: We tested the activity and toxicity of two cycles of intraarterial carboplatin as a "window therapy" (600 mg/m2 per cycle) in 33 consecutive patients with extremity osteosarcoma before the start of multiagent chemotherapy. Response was based on clinical (tumor diameter, local inflammatory signs, and range of motion) and radiological parameters (plain local films and arteriographic studies prior to drug administration). RESULTS: Patients' age ranged between 8 and 18 years (median age 13 years). Primary tumor originated from the femur (15 patients), tibia (10 patients), fibula (4 patients), humerus (3 patients), and calcaneus (1 patient). Only 7 patients (21%) had metastatic disease at diagnosis (5 in the lung and 2 in other bones). A favorable clinical and radiological response was documented in 81% and 73% of the patients, respectively. Clinical and radiological progression occurred in 12% and 9% of the patients, respectively. Seventeen of the patients remain alive and disease-free. Survival and event-free survival at 3 years for nonmetastatic patients are 71% (SE = 9%) and 65% (SE = 9%), respectively; for metastatic patients, the figures are 17% (SE = 15%) and 14% (SE = 13%), respectively. CONCLUSIONS: We conclude that carboplatin is an active agent in the treatment of newly diagnosed extremity osteosarcoma.
Assuntos
Antineoplásicos/administração & dosagem , Neoplasias Ósseas/tratamento farmacológico , Carboplatina/administração & dosagem , Osteossarcoma/tratamento farmacológico , Adolescente , Antineoplásicos/uso terapêutico , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Carboplatina/uso terapêutico , Quimioterapia Adjuvante , Criança , Extremidades , Feminino , Humanos , Infusões Intra-Arteriais , Masculino , Osteossarcoma/diagnóstico por imagem , Osteossarcoma/secundário , Radiografia , Análise de SobrevidaAssuntos
Legislação como Assunto , Política Pública , América , Países em Desenvolvimento , América Latina , América do Sul , VenezuelaRESUMO
Clinical, epidemiological, and laboratory circumstances were the cause of an initially erroneous diagnosis of variola minor in the second half of 1967, when the regional virology laboratory studied an epidemic outbreak of an eruptive disease in a rural community with some industry in which very few smallpox vaccinations had been administered. The disease sharply attacked the adult population and spread to municipalities near the capital of the department of Antioquia, Colombia, which two years earlier, had been protected by a mass vaccination campaign
Recourse to the national reference laboratory and the National Communicable Disease Center of the United States was available in connection with a change in diagnosis, discarding smallpox and adopting chikenpox. This was verified within the framework of the PASB smallpox eradication program, which ensures continous reliability for the diagnosis in the laboratory through dependable tests, and clinically by stressing the different features between smallpox and chickenpox, as shown in photographs used in the continous medical education programs.