RESUMO
BACKGROUND: English-speaking Caribbean (ESC) childhood cancer outcomes are unknown. PROCEDURE: Through the SickKids-Caribbean Initiative (SCI), we established a multicenter childhood cancer database across seven centers in six ESC countries. Data managers entered patient demographics, disease, treatment, and outcome data. Data collection commenced in 2013, with retrospective collection to 2011 and subsequent prospective collection. RESULTS: A total of 367 children were diagnosed between 2011 and 2015 with a median age of 5.7 years (interquartile range 2.9-10.6 years). One hundred thirty (35.4%) patients were diagnosed with leukemia, 30 (8.2%) with lymphoma, and 149 (40.6%) with solid tumors. A relative paucity of children with brain tumors was seen (N = 58, 15.8%). Two-year event-free survival (EFS) for the cohort was 48.5% ± 3.2%; 2-year overall survival (OS) was 55.1% ± 3.1%. Children with acute lymphoblastic leukemia (ALL) and Wilms tumor (WT) experienced better 2-year EFS (62.1% ± 6.4% and 66.7% ± 10.1%), while dismal outcomes were seen in children with acute myeloid leukemia (AML; 22.7 ± 9.6%), rhabdomyosarcoma (21.0% ± 17.0%), and medulloblastoma (21.4% ± 17.8%). Of 108 deaths with known cause, 58 (53.7%) were attributed to disease and 50 (46.3%) to treatment complications. Death within 60 days of diagnosis was relatively common in acute leukemia [13/98 (13.3%) ALL, 8/26 (30.8%) AML]. Despite this, traditional prognosticators adversely impacted outcome in ALL, including higher age, higher white blood cell count, and T-cell lineage. CONCLUSIONS: ESC childhood cancer outcomes are significantly inferior to high-income country outcomes. Based on these data, interventions for improving supportive care and modifying treatment protocols are under way. Continued data collection will allow evaluation of interventions and ensure maximal outcome improvements.
Assuntos
Neoplasias/mortalidade , Neoplasias/terapia , Fatores Etários , Região do Caribe/epidemiologia , Criança , Pré-Escolar , Intervalo Livre de Doença , Feminino , Humanos , Contagem de Leucócitos , Masculino , Neoplasias/sangue , Estudos Retrospectivos , Taxa de Sobrevida , Fatores de TempoRESUMO
Suicide and attempted suicide are identified as a serious mental health problem in Suriname, especially in the district of Nickerie. An epidemiological study in the Nickerie catchment area revealed high rates of suicide (48 per 100,000) and attempted suicide (207 per 100,000) on average in the years 2000-2004. Particularly remarkable is the high number of attempted suicides among males (49%), and the use of pesticides in both fatal (55%) and nonfatal suicidal behavior (44%). Probably this high incidence of suicidal behavior reflects the very poor economic situation of the district, poverty of most of the population, high levels of alcohol misuse, domestic violence, the rigidity of Hindustani culture regarding family traditions, the accessibility of pesticides, and the lack of future perspectives. Health care alone will not be sufficient to tackle this problem. One of the most urgent measures to prevent suicides is to stow away pesticides in locked cabinets with the key held by the proprietor.
Assuntos
Praguicidas/intoxicação , Suicídio/estatística & dados numéricos , Adolescente , Adulto , Causas de Morte , Feminino , Hinduísmo , Humanos , Masculino , Pessoa de Meia-Idade , Religião e Psicologia , Distribuição por Sexo , Suicídio/psicologia , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Suriname/epidemiologia , Prevenção do SuicídioRESUMO
Two species of Nasicola Yamaguti, 1968 are described from the nasal cavities of tunas ( Thunnus spp.) from off the coast of Brazil: N. brasiliensis n. sp. from T. obesus (Lowe) and the type-species, N. klawei (Stunkard, 1962), from T. albacares (Bonn.). The new species is differentiated from N. klawei on the basis of the large number of testes and from N. hogansi Wheeler & Beverley-Burton, 1986 by its greater body-size, proportionately smaller haptor and smaller number of marginal spines. The host-specificity of Nasicola spp. is commented upon.
Assuntos
Trematódeos/anatomia & histologia , Atum/parasitologia , Animais , Brasil , Feminino , Masculino , Microscopia Eletrônica de Varredura , Cavidade Nasal/parasitologiaRESUMO
Pseudorhabdosynochus sulamericanus n. sp. from the gills of Epinephelus niveatus has a reniform proximal region of the cirrus-bulb which is divided in four chambers and contains a large, round reservoir of the male accessory glands, a partly sclerotised vagina which is enclosed in a muscular funnel cap and squamodiscs with 15-16 open concentric rows of elements. P. beverleyburtonae (Oliver, 1984) is redescribed from E. marginatus with additional morphological data. These are the first reports of Pseudorhabdosynochus spp. in South American Atlantic waters, where the potentiality for the mariculture of Epinephelus spp. is currently being evaluated. Pseudorhabdosynochus hargisi (Oliver & Paperna, 1984) n. comb. is proposed for Diplectanum hargisi.
Assuntos
Doenças dos Peixes/parasitologia , Brânquias/parasitologia , Perciformes , Trematódeos/classificação , Infecções por Trematódeos/veterinária , Animais , Brasil , Trematódeos/anatomia & histologia , Infecções por Trematódeos/parasitologiaRESUMO
Chalcinotrema thatcheri n. sp. from the intestine of Schizodon knerii is described. It is most closely related in general morphology to C. salobrensis Freitas, 1947 and C. ruedasueltensis Thatcher, 1978, from which it differs, respectively, in: testis-size, the distribution of the vitelline follicles and the distance between the gonads; and body-size, egg-size, the extent of the caeca and the shape of the seminal vesicle. The holotype of C. ruedasueltensis is redescribed with original figures. Chalcinotrema Freitas, 1947, is considered a good genus distinct from Carassotrema Park, 1938, on the basis of the presence of uterine loops between the ovary and testis and its totally different geographical distribution. Carassotrema tilapiae Nasir & Gomez, 1976 is transferred to the former genus as Chalcinotrema tilapiae (Nasir & Gomez, 1976) n. comb.
Assuntos
Peixes/parasitologia , Trematódeos/classificação , Animais , Brasil , Água Doce , Intestinos/parasitologia , Trematódeos/anatomia & histologiaRESUMO
This chapter describes the electromagnetic spectrum with respect to photographic and electronic imaging of the ultraviolet (UV) and infrared (IR). It also describes the techniques of UV, UV fluorescence, IR and IR luminescence photography. These methods are applied to the biomedical sciences and some similar electronic imaging techniques are noted
Assuntos
Espectrofotometria Ultravioleta/métodos , Espectrofotometria Ultravioleta , Espectrofotometria Infravermelho/métodos , Tecnologia BiomédicaRESUMO
The benefits and pitfalls of applying media and communications techniques to the education of health professionals are considered in the context of their use in the classroom, for independent study and for distance education. The difficulties are emphasized for managing learning materials of this kind, and for keeping them up-to-date.
Assuntos
Recursos Audiovisuais , Educação Médica/métodosRESUMO
The response of Fuchsia magellanica Lam. - a shade-tolerant perennial - to white light photon flux density and end-of-day red and far-red light irradiation was studied to evaluate the role that different morphological and functional alterations play in whole-plant acclimation to shade. The estimated relative growth rate of plants growing under a photon flux density of 30µmol m2 s1 was 71 % of that of those growing under 450µmol m-2 s-1 . The proportion of total dry weight allocated to shoots was higher in low light plants, but the proportion of shoot dry weight allocated to leaf blades was not affected by any of the treatments. The estimated relative growth rate, specific leaf area and leaf conductance were not affected by end-of-day irradiation. In low light plants the specific leaf area was higher, and at saturating photon flux density photosynthesis was lower on a leaf area basis, but was not on a leaf dry weight basis. Dark respiration was higher in high light plants when expressed on an area basis, but not when expressed on a dry weight basis. During the normal photoperiod, leaf conductance measured in darkness was higher in high light plants than in low light ones, which is consistent with the higher stomatal density observed in these plants. The cross-sectional area of the petioles was slightly reduced in low light in spite of a large increase in the area of individual leaves. Low irradiance affected the display of leaves, decreased leaf thickness and increased chlorophyll content per unit dry weight. End-of-day far-red resulted in plants with more erect branches. Both low photon flux density and far-red enhanced internode elongation. The effect of end-of-day irradiations was bigger in low light than in high light, which is the opposite to what is observed in shade-avoiders. The relatively small difference in mean growth rate can be explained by changes in specific leaf area, shoot: root dry weight partition ratio, and by the shape of the photosynthetic light response curve. However when comparing photosynthetic rates on a dry weight basis low light plants do not seem to be at a disadvantage under high light.
RESUMO
Proteocephalid cestode hyperparasites are reported from numerous proteocephalids occurring in pimelodid fishes in different regions of Brazil. In addition, three specimens of a nematode hyperparasite are reported from the proteocephalid cestode Choanoscolex abscissus from the pimelodid fish Pseudoplatystoma corruscans in Brazil. Previous records of cestode and nematode hyperparasites of cestodes are listed, and the possible identities of the Brazilian records are discussed.
Assuntos
Cestoides/parasitologia , Peixes/parasitologia , Nematoides/parasitologia , AnimaisRESUMO
To examine the effect of a soybean oil emulsion on essential fatty acid, lipid, and glucose metabolism, preterm infants were randomized to receive 0.5 g/kg/d lipid for 5 days (n = 10, group 1) or 0.5 increased to 2.0 g/kg/d over 5 days (n = 11, group 2). Triene/tetraene ratios did not change in group 1, but decreased in group 2. In both groups, plasma phospholipid linoleate (percent and micrograms per milliliter) increased, the increase being greater in group 2. In both groups, percent content of arachidonate and 5,8,11-eicosatrienoate decreased, and that of oleate remained unchanged. In contrast, absolute content of arachidonate and oleate tended to increase, and that of 5,8,11-eicosatrienoate remained unchanged. At a lipid intake of 0.5 g/kg/d, no infants had hyperlipemia. When lipid intake exceeded 1.0 g/kg/d, the frequency of hypertriglyceridemia (triglycerides greater than 200 mg/dL) and free fatty acidemia, with the free fatty acid/molar albumin ratio exceeding 6:1, increased. Plasma glycerol increased slightly, but was substantially less than the rise in enzymatically determined triglycerides. Hyperglycemia was self-limiting and did not require alteration in dextrose intake. Thus, (1) infusion of a soybean oil emulsion at 0.5 to 2.0 g/kg/d maintains essential fatty acid status and phospholipid arachidonate concentrations; (2) significant hyperlipemia occurs when lipid intake exceeds 1.0 g/kg/d; (3) hyperglycemia associated with lipid infusion tends to be self-limiting and may not require alteration in lipid or dextrose intake; and (4) enzymatically determined triglycerides may be used to monitor lipid tolerance, provided that allowance is made for a small but systematic overestimation resulting from the rise in plasma glycerol.
Assuntos
Emulsões Gordurosas Intravenosas , Ácidos Graxos Essenciais/metabolismo , Glucose/metabolismo , Recém-Nascido Prematuro , Metabolismo dos Lipídeos , Nutrição Parenteral Total , Óleos de Plantas/administração & dosagem , Óleo de Soja/administração & dosagem , Ácido 8,11,14-Eicosatrienoico/sangue , Análise de Variância , Ácido Araquidônico , Ácidos Araquidônicos/sangue , Ácidos Graxos não Esterificados/sangue , Humanos , Recém-Nascido , Recém-Nascido Prematuro/metabolismo , Ácido Linoleico , Ácidos Linoleicos/sangue , Ácido Oleico , Ácidos Oleicos/sangue , Fosfolipídeos/sangue , Análise de Regressão , Triglicerídeos/sangueRESUMO
The usual pattern of onchocercal dermatitis in Africans and Guatemalans is a generalized and symmetrical dermatitis located on legs, arms and trunk. These patients appear to be anergic, with depressed immune responses and numerous microfilariae in the skin. In contrast, "sowda" is an unusual type of onchocercal dermatitis found in Yemenites and in a minority of African patients. Here the dermatitis is localized and asymmetrical - typically confined to one limb or one region of the body. Patients with sowda appear to be hypergic, with active humoral and cellular immune responses; microfilariae are rare or absent. This study describes two Guatemalan patients with sowda-type dermatitis. The diagnosis in these two patients is based on the asymmetrical papular pruritic dermatitis, rare or absent microfilariae, a positive Mazzotti reaction, and histopathologic changes characteristic of the sowda-type onchocercal dermatitis.