Avaliação do sistema de informação sobre nascidos vivos e o uso de seus dados em epidemiologia e estatísticas de saúde

O Ministério da Saúde, considerando a existência de falhas do ponto de vista quantitativo (cobertura) no registro de nascidos vivos, no Brasil, e a impossibilidade de conhecer a distribuição dos nascidos vivos segundo algumas variáveis importantes sob a óptica clínico/epidemiológica (peso ao nascer, Índice de Apgar, duração da gestação, tipo de parto, paridade, idade e instrução da mãe), implantou em 1990, no Brasil, o Sistema de Informações sobre Nascidos Vivos - SINASC- tendo como documento-base a Declaração de Nascido Vivo - DN - com a finalidade de suprir essas lacunas. Com o objetivo de avaliar a cobertura e a fidedignidade das informações geradas pelo SINASC, foi analisada a distribuição dos nascidos vivos hospitalares segundo características epidcmiológicas relativas ao produto de concepção, à gravidez, ao parto e à mãe. A população de estudo compreendeu 15.142 nascidos vivos hospitalares ocorridos em cinco municípios do Estado de São Paulo, Brasil, no período de janeiro a julho de 1992. Os resultados permitiram reconhecer excelente cobertura do SINASC (emissão de DN acima de 99,5%) e ótima fidedignidade do preenchimento das DNs, para a maioria das variáveis, quando comparadas aos documentos hospitalares. Para algumas características foi observada maior fragilidade (Índice de Apgar, duração da gestação, instrução da mãe, número total de filhos tidos e nome do pai). São apresentadas sugestões para o aperfeiçoamento do SINASC e recomendados treinamentos/reciclagens do pessoal envolvido no preenchimento das DNs. O estudo confirma o fato de os dados permitirem análise válida para o conhecimento de aspectos ligados à saúde materno-infantil. Do ponto de vista epidemiológico, o estudo permitiu detectar proporções elevadas de parto operatório (48,4%), mães adolescentes (17,5%) e o valor estimado para o baixo peso ao nascer foi de 8,5%.The Brazilian Ministry of Health implemented, in 1990, a System of Information of Live Births (SINASC) which introduced a Birth Certificate with a view to obtaining the total number of these events and their distribution according to epidemiological, demographic and clinical characteristics. It was decided to evaluate the System according to its coverage and the quality of information obtained, two years after its initial implementation. The population of this study consists of 15,142 hospital live births which occurred in five cities of the State of São Paulo, Brazil, in 1992. Birth Certificates and the corresponding maternal and child hospital records were examined visually with a view to checking data recorded on the Birth Certificate. It was seen that the system achieved a high degree of completeness (99.5%) and obtained a very accurate report for most of the items, though rather poor reporting for Apgar Score, length of gestation, mother's schooling, parity and father's name. This study allows suggestions to be made for the reformulation of some items and regarding the necessity for retraining the hospital personnel involved in the filling in of the certificates. Overall this study confirms that the Birth Certificate data are adequate for a valid analysis of aspects of maternal and child health research. The data showed high percentages of adolescent mothers (17.5%) and deliveries by cesarian section (48.4%). The percentage of low birth weight was 8.5%

Culturally valuable minority crops provide a succession of floral resources for flower visitors in traditional orchard gardens

Agricultural intensification typically has detrimental effects on pollinator communities, but diverse cropping systems that contain sequentially-flowering crops have the potential to benefit pollinators through the provision of additional floral resources. In this study we investigate the importance of cultivated flora for flower visitors in ten agricultural gardens in South Sinai, Egypt. Insect-flower interactions in gardens and unmanaged plots were surveyed across a four-month period in two environmentally distinct years (pre-flood and post-flood). Despite containing an equal abundance and diversity of wild plants as unmanaged habitat, gardens supported a higher abundance and diversity of flower visitors due to the additional presence of cultivated flora. Visitation networks exhibited dramatic intra-annual changes in composition, with cultivated plants becoming increasingly important in later months. Trends were highly conserved across 2 years despite highly contrasting rainfall. Several key crop species were strongly involved in shaping the structure of the networks, the majority of which were herbs with strong cultural significance (fennel, rosemary, mint) and grown incidentally alongside the primary orchard crops. Minority crops are frequently overlooked in agricultural systems due to their low economic value, but we show that they can have a dramatic influence upon the structure of visitation networks, increasing both pollinator abundance and diversity, and emphasising the link between cultural practices and biodiversity conservation

Platinum resistance in breast and ovarian cancer cell lines

Breast and ovarian cancers are among the 10 leading cancer types in females with mortalities of 15% and 6%, respectively. Despite tremendous efforts to conquer malignant diseases, the war on cancer declared by Richard Nixon four decades ago seems to be lost. Approximately 21,800 women in the US will be diagnosed with ovarian cancer in 2011. Therefore, its incidence is relatively low compared to breast cancer with 207.090 prognosed cases in 2011. However, overall survival unmasks ovarian cancer as the most deadly gynecological neoplasia. Platinum-based chemotherapy is emerging as an upcoming treatment modality especially in triple negative breast cancer. However, in ovarian cancer Platinum-complexes for a long time are established as first line treatment. Emergence of a resistant phenotype is a major hurdle in curative cancer therapy approaches and many scientists around the world are focussing on this issue. This review covers new findings in this field during the past decade

Cell–cell and cell–matrix dynamics in intraperitoneal cancer metastasis

The peritoneal metastatic route of cancer dissemination is shared by cancers of the ovary and gastrointestinal tract. Once initiated, peritoneal metastasis typically proceeds rapidly in a feed-forward manner. Several factors contribute to this efficient progression. In peritoneal metastasis, cancer cells exfoliate into the peritoneal fluid and spread locally, transported by peritoneal fluid. Inflammatory cytokines released by tumor and immune cells compromise the protective, anti-adhesive mesothelial cell layer that lines the peritoneal cavity, exposing the underlying extracellular matrix to which cancer cells readily attach. The peritoneum is further rendered receptive to metastatic implantation and growth by myofibroblastic cell behaviors also stimulated by inflammatory cytokines. Individual cancer cells suspended in peritoneal fluid can aggregate to form multicellular spheroids. This cellular arrangement imparts resistance to anoikis, apoptosis, and chemotherapeutics. Emerging evidence indicates that compact spheroid formation is preferentially accomplished by cancer cells with high invasive capacity and contractile behaviors. This review focuses on the pathological alterations to the peritoneum and the properties of cancer cells that in combination drive peritoneal metastasis

A Case Report of Primary Nasal Natural Killer (NK)/T-cell Lymphoma in an African American Patient Presenting With Hemophagocytic Syndrome

BACKGROUND Extranodal natural killer/T-cell lymphoma, nasal type (ENKTCL) is generally an aggressive and rare non-Hodgkin lymphoma. It is most common in East Asians, Native Americans, and South Americans, but is rarely reported in blacks. CASE REPORT A 55-year-old African American male born in Grenada presented with a left nostril mass with facial swelling and biopsy subsequently confirmed a diagnosis of extranodal NK/T-cell lymphoma, nasal type (ENKTCL). Immunochemistry was positive for CD2, cytoplasmic CD3, CD7, CD 43, CD 56, granzyme B, and TIA-1. In situ hybridization was positive for Epstein-Barr virus encoded ribonucleic acid (EBERs). Bone marrow aspiration did not show lymphoma involvement. The patient had progressive neutropenia upon presentation, with further investigations showing hepatomegaly, hyperferritinemia, and hemophagocytosis in the bone marrow. We reached a diagnosis of hemophagocytic syndrome. He was treated with a high-dose combination chemotherapy and radiation therapy; the neutropenia improved significantly with steroids as treatment for immune activation in the setting of hemophagocytic syndrome. CONCLUSIONS To the best of our knowledge, this is the only second report of extranodal NK/T-cell lymphoma, nasal type in a black patient, and it raises the awareness of early recognition of rare manifestations of NK/T-cell lymphoma such as hemophagocytic syndrome