Understanding the clinical spectrum of complicated Plasmodium vivax malaria: a systematic review on the contributions of the Brazilian literature

The resurgence of the malaria eradication agenda and the increasing number of severe manifestation reports has contributed to a renewed interested in the Plasmodium vivax infection. It is the most geographically widespread parasite causing human malaria, with around 2.85 billion people living under risk of infection. The Brazilian Amazon region reports more than 50% of the malaria cases in Latin America and since 1990 there is a marked predominance of this species, responsible for 85% of cases in 2009. However, only a few complicated cases of P. vivax have been reported from this region. A systematic review of the Brazilian indexed and non-indexed literature on complicated cases of vivax malaria was performed including published articles, masters' dissertations, doctoral theses and national congresses' abstracts. The following information was retrieved: patient characteristics (demographic, presence of co-morbidities and, whenever possible, associated genetic disorders); description of each major clinical manifestation. As a result, 27 articles, 28 abstracts from scientific events' annals and 13 theses/dissertations were found, only after 1987. Most of the reported information was described in small case series and case reports of patients from all the Amazonian states, and also in travellers from Brazilian non-endemic areas. The more relevant clinical complications were anaemia, thrombocytopaenia, jaundice and acute respiratory distress syndrome, present in all age groups, in addition to other more rare clinical pictures. Complications in pregnant women were also reported. Acute and chronic co-morbidities were frequent, however death was occasional. Clinical atypical cases of malaria are more frequent than published in the indexed literature, probably due to a publication bias. In the Brazilian Amazon (considered to be a low to moderate intensity area of transmission), clinical data are in accordance with the recent findings of severity described in diverse P. vivax endemic areas (especially anaemia in Southeast Asia), however in this region both children and adults are affected. Finally, gaps of knowledge and areas for future research are opportunely pointed out

Identificação de indivíduos vulneráveis no entorno de um hospital universitário: conectando vulnerabilidade, solidariedade e saúde Identification of vulnerable individuals in the area surrounding a university hospital: connecting vulnerability, solidarity and healthcare

No entorno de um hospital universitário do interior do estado de São Paulo há pessoas dormindo, se alimentando ou descansando nos gramados e arredores, permanecendo nestes locais durante horas. Este estudo objetivou identificar e caracterizar indivíduos vulneráveis em área externa deste hospital, oferecendo ajuda. A coleta dos dados foi realizada no período de novembro de 2007 a outubro de 2008, semanalmente, em dias e horários sorteados. Identificaram-se pessoas que permaneciam nesses locais, sendo entrevistados 52 sujeitos. Esses indivíduos são, predominantemente, do sexo feminino (67,3%), brancos (51,9%), casados (59,6%), com escolaridade de até quatro anos de estudo (44,2%) e sem profissão definida (84,6%). A maioria aguardava o horário do ônibus da prefeitura de seu município de origem; o tempo médio de espera foi de aproximadamente 90 minutos e grande parte dos sujeitos apresentou necessidades durante os períodos de espera. Foi oferecida ajuda a 15 pessoas que referiram necessidades no momento da entrevista. Concluiu-se que esses indivíduos se encontram em situação de vulnerabilidade individual, social e programática, destacando-se a vulnerabilidade sócio-econômica, apresentam capacidade de autodeterminação reduzida, submetendo-se a condições desfavoráveis por dependerem dos serviços públicos.<br>In the area around a university hospital in the interior of São Paulo state people are found sleeping, eating or resting on the lawns and surrounding areas, and they linger in such sites for hours. This study sought to identify and characterize vulnerable individuals in the area around the hospital by offering help. Data were collected from November 2007 to October 2008, on a weekly basis and on randomly selected days and times. The people found in these places were identified, and 52 subjects were interviewed. The individuals were, predominantly, females (67.3%), white (51.9%), married (59.6%), had attended school for up to four years (44.2%) and did not have a defined profession (84.6%). Most of them were waiting for bus transportation provided by their hometown administration; the mean waiting time was approximately 90 minutes and most of the subjects had certain needs during the waiting period. Help was offered to 15 individuals who reported specific needs at the moment of the interview. It was concluded that these individuals were in a situation of individual, social and systematic vulnerability, especially in terms of socio-economic vulnerability. They showed reduced self-determination ability and submitted themselves to unfavorable conditions due to their dependence on public services

Paradoxical sleep deprivation: neurochemical, hormonal and behavioral alterations. Evidence from 30 years of research

Sleep comprises approximately one-third of a person's lifetime, but its impact on health and medical conditions remains partially unrecognized. The prevalence of sleep disorders is increasing in modern societies, with significant repercussions on people's well-being. This article reviews past and current literature on the paradoxical sleep deprivation method as well as data on its consequences to animals, ranging from behavioral changes to alterations in the gene expression. More specifically, we highlight relevant experimental studies and our group's contribution over the last three decades.<br>O sono ocupa cerca de um terço de nossas vidas, entretanto seu impacto na saúde e sua influência nas condições patológicas ainda não foi completamente elucidado. A prevalência dos distúrbios de sono é cada vez maior, sobretudo nas regiões mais industrializadas, repercutindo diretamente no bem-estar da população. Este artigo tem como objetivo sintetizar e atualizar a literatura a respeito do método de privação de sono paradoxal e seu panorama de conseqüências desde comportamentais até genéticas em animais. Ainda, destacamos a contribuição e relevância dos estudos experimentais realizados por nosso grupo nas ultimas três décadas

Trichodinidae in commercial fish in South America.

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