Perceptions of health managers and facilitators of the Integrated management of childhood illness (IMCI) in Northeastern Brazil and Peru

<p></p><p>The objective of this study was to explore the Integrated Management of Childhood Illness (IMCI) strategy through the perceptions of the health managers and facilitators of strategy. A qualitative study was conducted using semi-structured interviews. Fourteen interviews were carried out, eight in the State of Ceará-Brazil and six in Peru, between May and June 2011. In general, participants expressed a positive perception of the IMCI strategy. Also was observed the predominance of the clinical component, compared with the community or the health services component. In Peru unlike Brazil, the government promoted the adoption of the strategy. In conclusion, this study shows a complex intervention of the IMCI strategy, with a predominance of the clinical component, evidencing the limitations in the integration of the components of the strategy.</p><p></p

Primary non-Hodgkin's lymphoma of the nose and nasopharynx: Clinical features, tumor immunophenotype, and treatment outcome in 113 patients

Purpose: To study the clinical features and outcome for primary non- Hodgkin's lymphomas of the nose/nasopharynx (NNP-NHLs) according to immunophenotype. Patients and Methods: One hundred thirteen Chinese patients with primary NNP-NHLs that belonged to the categories E, F, G, or H according to the Working Formulation (WF), with full immunophenotypic date and complete clinical follow-up data, were analyzed in this retrospective study. Results: Ninety (79.6%) patients had localized (stage I or II) disease, while 23 (20.4%) had stage III or IV disease. The lymphomas in 51 (45.1%), 24 (21.3%), and 38 (33.6%) patients showed natural killer (NK)/T- (CD56-positive), T- cell, and B-cell immunophenotype, respectively. Seventy-three patients (65.8%) achieved a complete remission, of whom 34 (46.6%) subsequently relapsed. The median follow-up time for those alive was 38 months. The 5- year actuarial disease-free and overall survival rates were 34.4% and 37.9%, respectively. Multivariate analysis showed that only stage and immunophenotype were significant for survival. NK/T lymphomas were distinctive among the three immunophenotypes in the following aspects: the highest male-to-female ratio, more frequent involvement of the nasal cavity alone, higher risk of dissemination to the skin, more frequent development of hemophagocytic syndrome, and the worst prognosis (overall median survival, 12.5 months). Conclusion: The three immunophenotypes studied are shown to exhibit different clinical patterns. Since the NK/T phenotype carries the worst prognosis, patients who present with NNP-NHL should have their tumors analyzed for CD56 expression.Link_to_subscribed_fulltex