Historical analysis of the Brazilian cervical cancer screening program from 2006 to 2013: a time for reflection

BACKGROUND: The Cervical Cancer Database of the Brazilian National Health Service (SISCOLO) contains information regarding all cervical cytological tests and, if properly explored, can be used as a tool for monitoring and managing the cervical cancer screening program. The aim of this study was to perform a historical analysis of the cervical cancer screening program in Brazil from 2006 to 2013. MATERIAL AND METHODS: The data necessary to calculate quality indicators were obtained from the SISCOLO, a Brazilian health system tool. Joinpoint analysis was used to calculate the annual percentage change. RESULTS: We observed important trends showing decreased rates of low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and an increased rate of rejected exams from 2009 to 2013. The index of positivity was maintained at levels below those indicated by international standards; very low frequencies of unsatisfactory cases were observed over the study period, which partially contradicts the low rate of positive cases. The number of positive cytological diagnoses was below that expected, considering that developed countries with low frequencies of cervical cancer detect more lesions annually. CONCLUSIONS: The evolution of indicators from 2006 to 2013 suggests that actions must be taken to improve the effectiveness of cervical cancer control in Brazil

Host-parasite co-metabolic activation of antitrypanosomal aminomethyl-benzoxaboroles

<div><p>Recent development of benzoxaborole-based chemistry gave rise to a collection of compounds with great potential in targeting diverse infectious diseases, including human African Trypanosomiasis (HAT), a devastating neglected tropical disease. However, further medicinal development is largely restricted by a lack of insight into mechanism of action (MoA) in pathogenic kinetoplastids. We adopted a multidisciplinary approach, combining a high-throughput forward genetic screen with functional group focused chemical biological, structural biology and biochemical analyses, to tackle the complex MoAs of benzoxaboroles in <i>Trypanosoma brucei</i>. We describe an oxidative enzymatic pathway composed of host semicarbazide-sensitive amine oxidase and a trypanosomal aldehyde dehydrogenase TbALDH3. Two sequential reactions through this pathway serve as the key underlying mechanism for activating a series of 4-aminomethylphenoxy-benzoxaboroles as potent trypanocides; the methylamine parental compounds as pro-drugs are transformed first into intermediate aldehyde metabolites, and further into the carboxylate metabolites as effective forms. Moreover, comparative biochemical and crystallographic analyses elucidated the catalytic specificity of TbALDH3 towards the benzaldehyde benzoxaborole metabolites as xenogeneic substrates. Overall, this work proposes a novel drug activation mechanism dependent on both host and parasite metabolism of primary amine containing molecules, which contributes a new perspective to our understanding of the benzoxaborole MoA, and could be further exploited to improve the therapeutic index of antimicrobial compounds.</p></div

55Mn NMR observation of colossal magnetoresistance effect in Sm0.55Sr0.45MnO3

Temperature dependent 55Mn NMR study of Sm0.55Sr0.45MnO3 is reported. Previous bulk magnetization measurements have shown that below T C ~ 125 K the sample is ferromagnetic metallic (FMM) and above TC it is charge ordered and insulating. In present report, we show that from zero-field NMR a single line double-exchange (DE) signal is observed at temperatures up to 139 K, which is due to a presence of FMM clusters also above T C. The intensity of the DE line follows the temperature dependence of the magnetization measured at 0.01 T. When a magnetic field up to 2 T is applied at 139 K (i.e. 14 K above T C), a strong increase in NMR intensity of the DE line is observed indicating that content of FMM regions increases. This reveals that metallicity is induced in the material by the applied magnetic field and explains the observed colossal magnetoresistance (CMR) effect at the microscopic level. The observation agrees with previous results, which confirm that the percolation of the FMM clusters is responsible for the CMR effect. The shift of the resonant frequency in the applied field is three times smaller compared to decrease expected from gyromagnetic ratio, which indicates an antiferromagnetic coupling between the FMM clusters.This research was supported by the Polish Ministry of Science and Higher Education (MNiSzW), the Spanish Ministry of Science (through Project No. MAT2014-51982-C2-R, including European social fund) and the Aragón Regional government (Project No.E26).Peer reviewe

Perfil social das gestantes em unidades de saúde da família do município de Teresópolis Pregnants' social profile in family health unities from the county of Teresópolis, Rio de Janeiro

Estudo descritivo de mulheres gestantes, com o objetivo de caracterizar as mulheres em relação às condições sociais e à assistência à gestação. As observações pertencem a um estudo transversal, a partir de uma amostra de 69 gestantes, inscritas nas unidades de saúde da família de Beira Linha, Araras e Rosário, residentes em Teresópolis (RJ). A análise comparativa entre gestantes adolescentes x não adolescentes considerou o teste exato de Fisher para mensurar possíveis significâncias estatísticas. No período considerado, 31,9% eram mães adolescentes. Entre essas, 72,7% estavam em sua primeira gestação, e 31,9% das não adolescentes encontravam-se nessa situação (p-valor < 0,01). O papel da família na orientação quanto ao sexo é mais marcante entre as gestantes adolescentes (59,1%) do que entre as não adolescentes (25,5%) (p-valor <0,01). Cerca de 70% das mulheres engravidaram do primeiro parceiro sexual, apesar de não ter planejado a gravidez, e de 25% estar utilizando algum método contraceptivo. Embora a mãe das gestantes adolescentes possuam, em média, um número superior de filhos, quando comparadas às mães das gestantes não adolescentes, essa tendência não se repetiu entre suas filhas, o que pode estar relacionado a melhores condições sociais observadas na população estudada.<br>Descriptive study of pregnants, aiming the characterization of women in relation to social condition and pregnancy assistance. The observations are part of a transversal study, considering a sample of 69 pregnants, registered in the Family Health Unities of Beira Linha, Araras and Rosário, residing in the county of Teresópolis, Rio de Janeiro, Brazil. The comparative analysis among adolescent and non-adolescent pregnants considered the exact test of Fisher to measure statistical significance. In the considered period, 31,9% were found adolescent mothers. Among then, 72,7% were in their first gestation, and 31,9 % from the non-adolescent mothers were found in this situation (p-value< 0,01). The family role in the sexual orientation is stronger among adolescent pregnants (59,1%) than among the non-adolescent ones (25,5%) (p-value < 0,01). Near 70% of the women got pregnant from their first sexual partner, although pregnancy have not been planned before, and 25% of them were making use of a king of contraceptive method. Although the adolescent pregnants' mothers have an average of a superior number of children, when compared to the non-adolescent pregnants' mothers, this tendency was not followed by their daugthers, and this maybe related to better social conditions, observed in the researched population