RESUMO
This article consists in an essay that aims, through a review of bibliography, to discuss the relation between a proposal of Bruno Latour about nature-culture and breast feeding. According to his proposal, having as reference an epistemological view, there is an attempt to establish dialogue between different scientific achievements with a view to contribute to the improvement of this subject in the field of public health. Firstly, the paradox of weaning is found in the scenery of knowledge and practices of breast feeding. The analysis is based on the relationship nature-science and culture-society, which are present in the process of breast feeding. Finally, the discussion has the aim of dealing with breast feeding as long as a hybrid between nature and culture, starting a new issue to the continuity in the debate about the thematic in question.
Assuntos
Atitude Frente a Saúde/etnologia , Aleitamento Materno/etnologia , Conhecimentos, Atitudes e Prática em Saúde , Valores Sociais , Brasil , Feminino , Humanos , Conhecimento , Filosofia Médica , Saúde PúblicaRESUMO
Brazil has a young population and areas of endemic mansoni schistosomiasis where Wilson's disease might be easily misdiagnosed in patients erroneously classified as having either the hepatosplenic or the hepatointestinal form of the helminthiasis. Twenty five patients with the "hepatic form" of Wilson's disease (14 males and 11 females) were investigated in Belo Horizonte, MG; the mean age was 13.7 years (3 to 22). Nineteen had hepatomegaly (76%) and nine splenomegaly (36%). Twenty two (88%) had cirrhosis. The Kaiser-Fleisher ring was detected in fifteen (60%). Four (16%) had clear neurological abnormalities. Eleven (44%) had ascitis and/or jaundice. Ninety one point three per cent and 92% had low ceruloplasmin and copper serum levels respectively. Eighty four point two per cent showed an increased 24 hours urinary copper excretion; seven patients in whom hepatic copper was determined had increased values. Six out of nine had at least a ten fold increase in 24 hours urinary copper excretion following penicillamine use ("penicillamine test"). Three out of 19 patients (15.8%) had mansoni schistosoma ova in stools examination, a common prevalence in our population. Their biopsies showed inactive cirrhosis without schistosomiasis-associated alterations. At least fourteen patients (56%) could be misdiagnosed as having hepatointestinal or hepatosplenic schistosomisis when in fact they suffered from Wilson's disease with or without asymptomatic intestinal schistosomiasis, losing the chance of an early treatment. The follow-up time of 22 patients was 52 months (1 to 96); eight (36.3%) died, four from bleeding esphageal varices, three from terminal hepatic failure and one from fulminant liver failure. The majority of the patients, including those who died, had abandomned the use of penicillamine or had taken it irregularly, due mainly to its highly expensive cost. A 17 year old patient underwent a successful liver transplant in 1989.
Assuntos
Degeneração Hepatolenticular/diagnóstico , Hepatopatias/etiologia , Esquistossomose mansoni/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Cobre/urina , Diagnóstico Diferencial , Feminino , Seguimentos , Degeneração Hepatolenticular/etiologia , Degeneração Hepatolenticular/terapia , Humanos , Cirrose Hepática/patologia , Hepatopatias/fisiopatologia , Masculino , Esquistossomose mansoni/diagnósticoRESUMO
With the intention to verify the frequency of intestinal parasites, we have taken the inside digestive system material from three different parts of the intestinal tract while we were doing 135 complete necropsies. The stools were kept in MIF (Formol, iodine and merthiolate mixture) being studied in slides by the direct method. We have found intestinal parasites in 40 cases (29.6%), 11 (27.5%) with two or more kinds of parasites and 29 cases (72.5%) with only one kind of parasite. The most frequent parasites were: S. stercoralis (31,9%), E. hystolytica (23.4%), hook worm (19.1%) and A. lumbricoides (17%). The results are in according with epidemiological research made in this area. Thus, they prove that the parasitological exam made in feces taken during the necroscopy provides further evidence to enrich the anatomo-pathological diagnosis.