Human toxocariasis: contribution by Brazilian researchers

In the present paper the main aspects of the natural history of human infection by Toxocara larvae that occasionally result in the occurrence of visceral and/or ocular larva migrans syndrome were reviewed. The contribution by Brazilian researchers was emphasized, especially the staff of the Tropical Medicine Institute of São Paulo (IMT)

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Pharmacist services for non-hospitalised patients

Contains fulltext : 200314.pdf (Publisher’s version ) (Open Access)BACKGROUND: This review focuses on non-dispensing services from pharmacists, i.e. pharmacists in community, primary or ambulatory-care settings, to non-hospitalised patients, and is an update of a previously-published Cochrane Review. OBJECTIVES: To examine the effect of pharmacists' non-dispensing services on non-hospitalised patient outcomes. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, two other databases and two trial registers in March 2015, together with reference checking and contact with study authors to identify additional studies. We included non-English language publications. We ran top-up searches in January 2018 and have added potentially eligible studies to 'Studies awaiting classification'. SELECTION CRITERIA: Randomised trials of pharmacist services compared with the delivery of usual care or equivalent/similar services with the same objective delivered by other health professionals. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures of Cochrane and the Effective Practice and Organisation of Care Group. Two review authors independently checked studies for inclusion, extracted data and assessed risks of bias. We evaluated the overall certainty of evidence using GRADE. MAIN RESULTS: We included 116 trials comprising 111 trials (39,729 participants) comparing pharmacist interventions with usual care and five trials (2122 participants) comparing pharmacist services with services from other healthcare professionals. Of the 116 trials, 76 were included in meta-analyses. The 40 remaining trials were not included in the meta-analyses because they each reported unique outcome measures which could not be combined. Most trials targeted chronic conditions and were conducted in a range of settings, mostly community pharmacies and hospital outpatient clinics, and were mainly but not exclusively conducted in high-income countries. Most trials had a low risk of reporting bias and about 25%-30% were at high risk of bias for performance, detection, and attrition. Selection bias was unclear for about half of the included studies.Compared with usual care, we are uncertain whether pharmacist services reduce the percentage of patients outside the glycated haemoglobin target range (5 trials, N = 558, odds ratio (OR) 0.29, 95% confidence interval (CI) 0.04 to 2.22; very low-certainty evidence). Pharmacist services may reduce the percentage of patients whose blood pressure is outside the target range (18 trials, N = 4107, OR 0.40, 95% CI 0.29 to 0.55; low-certainty evidence) and probably lead to little or no difference in hospital attendance or admissions (14 trials, N = 3631, OR 0.85, 95% CI 0.65 to 1.11; moderate-certainty evidence). Pharmacist services may make little or no difference to adverse drug effects (3 trials, N = 590, OR 1.65, 95% CI 0.84 to 3.24) and may slightly improve physical functioning (7 trials, N = 1329, mean difference (MD) 5.84, 95% CI 1.21 to 10.48; low-certainty evidence). Pharmacist services may make little or no difference to mortality (9 trials, N = 1980, OR 0.79, 95% CI 0.56 to 1.12, low-certaintly evidence).Of the five studies that compared services delivered by pharmacists with other health professionals, no studies evaluated the impact of the intervention on the percentage of patients outside blood pressure or glycated haemoglobin target range, hospital attendance and admission, adverse drug effects, or physical functioning. AUTHORS' CONCLUSIONS: The results demonstrate that pharmacist services have varying effects on patient outcomes compared with usual care. We found no studies comparing services delivered by pharmacists with other healthcare professionals that evaluated the impact of the intervention on the six main outcome measures. The results need to be interpreted cautiously because there was major heterogeneity in study populations, types of interventions delivered and reported outcomes.There was considerable heterogeneity within many of the meta-analyses, as well as considerable variation in the risks of bias

Evaluation of platelet function and of serum fibrinogen levels in patients bitten by snakes of the genus Crotalus: preliminary report

Submitted by Guilherme Lemeszenski ([email protected]) on 2013-08-22T19:04:08Z No. of bitstreams: 1 S0036-46651991000300009.pdf: 117928 bytes, checksum: 30abc46c537d441fad2f2fdc2716cbf7 (MD5)Made available in DSpace on 2013-08-22T19:04:08Z (GMT). No. of bitstreams: 1 S0036-46651991000300009.pdf: 117928 bytes, checksum: 30abc46c537d441fad2f2fdc2716cbf7 (MD5) Previous issue date: 1991-06-01Made available in DSpace on 2013-09-30T17:42:46Z (GMT). No. of bitstreams: 2 S0036-46651991000300009.pdf: 117928 bytes, checksum: 30abc46c537d441fad2f2fdc2716cbf7 (MD5) S0036-46651991000300009.pdf.txt: 2 bytes, checksum: e1c06d85ae7b8b032bef47e42e4c08f9 (MD5) Previous issue date: 1991-06-01Submitted by Vitor Silverio Rodrigues ([email protected]) on 2014-05-20T13:38:46Z No. of bitstreams: 2 S0036-46651991000300009.pdf: 117928 bytes, checksum: 30abc46c537d441fad2f2fdc2716cbf7 (MD5) S0036-46651991000300009.pdf.txt: 2 bytes, checksum: e1c06d85ae7b8b032bef47e42e4c08f9 (MD5)Made available in DSpace on 2014-05-20T13:38:46Z (GMT). No. of bitstreams: 2 S0036-46651991000300009.pdf: 117928 bytes, checksum: 30abc46c537d441fad2f2fdc2716cbf7 (MD5) S0036-46651991000300009.pdf.txt: 2 bytes, checksum: e1c06d85ae7b8b032bef47e42e4c08f9 (MD5) Previous issue date: 1991-06-01UNESP Hemocentro do Hospital das Clínicas Divisão de HemostasiaUNESP Faculdade de Medicina de Botucatu Depto. de UrologiaUNESP Faculdade de Medicina de BotucatuUNESP Faculdade de Medicina de Botucatu Departamento de Moléstias Infecciosas e ParasitáriasUNESP Centro de Estudos de Venenos e Animais PeçonhentosUNESP Hemocentro do Hospital das Clínicas Divisão de HemostasiaUNESP Faculdade de Medicina de Botucatu Depto. de UrologiaUNESP Faculdade de Medicina de BotucatuUNESP Faculdade de Medicina de Botucatu Departamento de Moléstias Infecciosas e ParasitáriasUNESP Centro de Estudos de Venenos e Animais Peçonhento