Birth prevalence and characteristics of congenital toxoplasmosis in Sergipe, North-east Brazil.

OBJECTIVES: To estimate, by neonatal screening, the birth prevalence of congenital toxoplasmosis among live-born infants in Sergipe state, Brazil, and to investigate the clinical features of affected infants. METHODS: Dried blood spot specimens obtained from 15 204 neonates were assayed for the presence of anti-T. gondii IgM antibodies. Duplicate retesting was done in infants with positive and borderline results. Confirmatory testing in peripheral blood samples consisted of testing for anti-T. gondii IgG and IgM in infants and mothers. Those with possible congenital toxoplasmosis were evaluated and followed up to a median age of 20 months. Congenital infection was confirmed in the presence of persisting anti-T. gondii IgG antibodies beyond 12 months of age. All infants with confirmed infection were treated with pyrimethamine, sulfadiazine and folinic acid for 1 year. RESULTS: Fifty-three infants had detectable IgM in dried blood spot specimens. Confirmatory testing was reactive in 39/50, of which, 38 completed follow-up. Six of 15 204 newborns were diagnosed with congenital toxoplasmosis, resulting in an estimated birth prevalence of four per 10 000 [CI 95% 1.4-8.0]. Four infants (67%) showed signs of congenital toxoplasmosis in their first year of life; three (75%) had retinochoroidal scars, and one had cerebral calcifications. Two infants remained asymptomatic until 20 months of age. CONCLUSIONS: The birth prevalence of congenital toxoplasmosis is high in the Brazilian state of Sergipe, with most of the infants showing ocular lesions. Preventive measures are strongly warranted.

Modulatory activity of Brazilian red propolis on chemically induced dermal carcinogenesis.

PURPOSE: To evaluate modulatory effects of a hydroalcoholic extract of Brazilian red propolis (HERP) on dermal carcinogenesis using a murine model. METHODS: The HERP was used at concentrations of 10, 50 and 100 mg/kg (PROP10, PROP50 and PROP100, respectively) to modulate dermal carcinogenesis induced by the application of 9,10-dimetil-1,2-benzatraceno (DMBA) on the backs of animals. RESULTS: The chemical compounds identified in HERP included propyl gallate, catechin, epicatechin and formononetin. PROP100 treatment resulted in significantly decreased tumor multiplicity throughout the five weeks of tumor promotion (p<0.05), and this concentration also resulted in the highest frequency of verrucous tumors (p<0.05). All of the tumors that developed in DMBA-treated animals were regarded as squamous cell carcinomas and were either diagnosed as non-invasive verrucous carcinomas or invasive squamous cell carcinomas (SCCs). The average score for malignancy was significantly lower in the PROP100-treated group than the non-treated group (p<0.05), but there was no difference between the other groups (p>0.05). CONCLUSION: The oral administration of hydroalcoholic extract of Brazilian red propolis at a dose of 100 mg/kg had a significant modulatory effect on the formation, differentiation and progression of chemically induced squamous cell carcinoma in a murine experimental model.

[Ethical issues in a market dispute between clinical laboratories and a health plan: case report]. / Aspectos éticos em uma disputa de mercado entre laboratórios clínicos e um plano de saúde: relato de caso.

In Brazil the private health plans appear as an alternative to the public health assistance. This segment suffered great intensification in the seventies and eighties, culminating in the entry of large insurance company in the scenario of supplementary medicine. Quickly, the service providers associated with these insurance companies, consolidating them in the market and triggering a relationship of dependency. This article analyzed, in the form of a case report, a marketing dispute between clinical laboratories and a health plan, emphasizing the moral and ethical aspects involved in this episode.

Modulatory activity of brazilian red propolis on chemically induced dermal carcinogenesis

To evaluate modulatory effects of a hydroalcoholic extract of Brazilian red propolis (HERP) on dermal carcinogenesis using a murine model. METHODS: The HERP was used at concentrations of 10, 50 and 100 mg/kg (PROP10, PROP50 and PROP100, respectively) to modulate dermal carcinogenesis induced by the application of 9,10-dimetil-1,2-benzatraceno (DMBA) on the backs of animals. RESULTS: The chemical compounds identified in HERP included propyl gallate, catechin, epicatechin and formononetin. PROP100 treatment resulted in significantly decreased tumor multiplicity throughout the five weeks of tumor promotion (p<0.05), and this concentration also resulted in the highest frequency of verrucous tumors (p<0.05). All of the tumors that developed in DMBA-treated animals were regarded as squamous cell carcinomas and were either diagnosed as non-invasive verrucous carcinomas or invasive squamous cell carcinomas (SCCs). The average score for malignancy was significantly lower in the PROP100-treated group than the non-treated group (p<0.05), but there was no difference between the other groups (p>0.05). CONCLUSION: The oral administration of hydroalcoholic extract of Brazilian red propolis at a dose of 100 mg/kg had a significant modulatory effect on the formation, differentiation and progression of chemically induced squamous cell carcinoma in a murine experimental model.

[Seroprevalence of antibodies for toxoplasmosis, rubella, cytomegalovirus, syphilis and HIV among pregnant women in Sergipe]. / Soroprevalência de anticorpos para toxoplasmose, rubéola, citomegalovírus, sífilis e HIV em gestantes sergipanas.

The seroprevalence of antibodies for HIV, syphilis, toxoplasmosis, cytomegalovirosis and rubella and its association with age and origin was investigated among pregnant women in Sergipe, northeastern Brazil. A total of 9,550 pregnant women (2,112 from the state capital and 7,438 from other municipalities) were enrolled in the study and consecutively tested during their first antenatal care visit in 2007. The following serum prevalences were found: syphilis (0.9%; 95% CI 0.7%-1.6%), HIV (0.14%; 95% CI 0.08%-0.2%), toxoplasmosis (IgG 69.3%; 95% CI 68.3%-70.2%; IgM 0.4%, 95% CI 0.3%-0.6%), cytomegalovirosis (IgG 76.6%, 95% CI 75.7%-77.5%; IgM 0.2%, 95% CI 0.09%-0.3%) and rubella (IgG 71.6%, 95% CI 70.7%-72.6%; IgM 0.1%, 95% CI 0.04%-0.2%). Toxoplasmosis seropositivity increased with age. The prevalences of IgG antibodies for toxoplasmosis, cytomegalovirus and rubella were higher in Aracaju (state capital) than in other municipalities in the State of Sergipe. The results showed that a large proportion of the pregnant women, particularly in municipalities other than the state capital, were susceptible to toxoplasmosis, rubella and cytomegalovirus, with a risk for their infants.

Aspectos éticos em uma disputa de mercado entre laboratórios clínicos e um plano de saúde: relato de caso / Ethical issues in a market dispute between clinical laboratories and a health plan: case report

Como alternativa à assistência em saúde pública, surgem no Brasil os planos privados. Esse segmento sofreu grande intensificação nas décadas de setenta e oitenta, culminando com a entrada das grandes seguradoras no cenário da medicina suplementar. Rapidamente, os prestadores de serviço se associaram a elas, solidificando-as no mercado e desencadeando uma relação de dependência. O presente artigo analisou, em forma de relato de caso, uma disputa mercadológica entre laboratórios clínicos e um plano de saúde, enfatizando os aspectos éticos e morais envolvidos nesse episódio.

In Brazil the private health plans appear as an alternative to the public health assistance. This segment suffered great intensification in the seventies and eighties, culminating in the entry of large insurance company in the scenario of supplementary medicine. Quickly, the service providers associated with these insurance companies, consolidating them in the market and triggering a relationship of dependency. This article analyzed, in the form of a case report, a marketing dispute between clinical laboratories and a health plan, emphasizing the moral and ethical aspects involved in this episode.

Soroprevalência de anticorpos para toxoplasmose, rubéola, citomegalovírus, sífilis e HIV em gestantes sergipanas / Seroprevalence of antibodies for toxoplasmosis, rubella, cytomegalovirus, syphilis and HIV among pregnant women in Sergipe

Averiguou-se a soroprevalência para HIV, sífilis, toxoplasmose, citomegalovirose e rubéola em gestantes de Sergipe, nordeste do Brasil, verificando-se a associação com idade e procedência. Selecionaram-se 9.550 gestantes (2.112 da capital e 7.438 do interior) testadas consecutivamente durante o primeiro atendimento pré-natal em 2007. Foram encontradas as seguintes frequências de soropositividade: sífilis (0,9 por cento; IC95 por cento 0,7 por cento-1,6 por cento), HIV (0,14 por cento; IC95 por cento 0,08 por cento-0,2 por cento), toxoplasmose (IgG 69,3 por cento; IC95 por cento 68,3 por cento-70,2 por cento; IgM 0,4 por cento, IC95 por cento 0,3 por cento-0,6 por cento), citomegalovirose (IgG 76,6 por cento, IC95 por cento 75,7 por cento-77,5 por cento; IgM 0,2 por cento, IC95 por cento 0,09 por cento-0,3 por cento) e rubéola (IgG 71,6 por cento, IC95 por cento 70,7 por cento-72,6 por cento; IgM 0,1 por cento, IC95 por cento 0,04 por cento-0,2 por cento). A soropositividade para toxoplasmose incrementou com a idade. A prevalência de anticorpos IgG para toxoplasmose, CMV e rubéola foi maior na capital, Aracaju, que nos demais municípios do Estado de Sergipe. Foi encontrada associação entre a idade e soropositividade para a toxoplasmose. Os achados revelam grande proporção de gestantes susceptíveis a toxoplasmose, rubéola e citomegalovirose, principalmente no interior do estado, com risco para seus filhos.

The seroprevalence of antibodies for HIV, syphilis, toxoplasmosis, cytomegalovirosis and rubella and its association with age and origin was investigated among pregnant women in Sergipe, northeastern Brazil. A total of 9,550 pregnant women (2,112 from the state capital and 7,438 from other municipalities) were enrolled in the study and consecutively tested during their first antenatal care visit in 2007. The following serum prevalences were found: syphilis (0.9 percent; 95 percent CI 0.7 percent-1.6 percent), HIV (0.14 percent; 95 percent CI 0.08 percent-0.2 percent), toxoplasmosis (IgG 69.3 percent; 95 percent CI 68.3 percent-70.2 percent; IgM 0.4 percent, 95 percent CI 0.3 percent-0.6 percent), cytomegalovirosis (IgG 76.6 percent, 95 percent CI 75.7 percent-77.5 percent; IgM 0.2 percent, 95 percent CI 0.09 percent-0.3 percent) and rubella (IgG 71.6 percent, 95 percent CI 70.7 percent-72.6 percent; IgM 0.1 percent, 95 percent CI 0.04 percent-0.2 percent). Toxoplasmosis seropositivity increased with age. The prevalences of IgG antibodies for toxoplasmosis, cytomegalovirus and rubella were higher in Aracaju (state capital) than in other municipalities in the State of Sergipe. The results showed that a large proportion of the pregnant women, particularly in municipalities other than the state capital, were susceptible to toxoplasmosis, rubella and cytomegalovirus, with a risk for their infants.