Medicinal animals used in ethnoveterinary practices of the 'Cariri Paraibano', NE Brazil

<p>Abstract</p> <p>Background</p> <p>Zootherapy is important in various socio-cultural environments, and innumerous examples of the use of animal derived remedies can currently be found in many urban, semi-urban and more remote localities in all parts of the world, particularly in developing countries. However, although a number of ethnobiological inventories concerning the use of medicinal animals in human health care have been compiled in Brazil in recent years, zootherapeutic practices in ethnoveterinary medicine (EVM) are poorly described and neglected in favor of human ethnomedicine. In this sense, the purpose of this study was to describe the local zootherapeutic practices in ethnoveterinary medicine of semi-arid of NE Brazil (Caatinga biome) and to contribute to future research about the validation of the effects and side effects of these animal products</p> <p>Methods</p> <p>The information obtained through semi-structured interviews was complemented by free interviews and informal conversations. A total of 67 people were interviewed (53 men and 14 women) about the use and commercialization of medicinal animals. To determine the relative importance of each local known species, their use-values (UV) were calculated. Diversity of species utilized was compared, between localities, using rarefaction curves and diversity estimate (Chao2)</p> <p>Results and Conclusions</p> <p>A total of 44 animal species (37 vertebrates and 7 invertebrates), distributed among 6 taxonomic categories were found to be used to treat 30 different ailments in livestock and pets. The results of our surveys revealed a rich traditional knowledge of local residents about the use of animals in traditional veterinary medicine. Although it is gradually being discontinued, the perceived efficacy, economic and geographic accessibility were main reasons for popularity of zootherapy in studied areas.</p

Genome of the Avirulent Human-Infective Trypanosome—Trypanosoma rangeli

Background: Trypanosoma rangeli is a hemoflagellate protozoan parasite infecting humans and other wild and domestic mammals across Central and South America. It does not cause human disease, but it can be mistaken for the etiologic agent of Chagas disease, Trypanosoma cruzi. We have sequenced the T. rangeli genome to provide new tools for elucidating the distinct and intriguing biology of this species and the key pathways related to interaction with its arthropod and mammalian hosts.  Methodology/Principal Findings: The T. rangeli haploid genome is ,24 Mb in length, and is the smallest and least repetitive trypanosomatid genome sequenced thus far. This parasite genome has shorter subtelomeric sequences compared to those of T. cruzi and T. brucei; displays intraspecific karyotype variability and lacks minichromosomes. Of the predicted 7,613 protein coding sequences, functional annotations could be determined for 2,415, while 5,043 are hypothetical proteins, some with evidence of protein expression. 7,101 genes (93%) are shared with other trypanosomatids that infect humans. An ortholog of the dcl2 gene involved in the T. brucei RNAi pathway was found in T. rangeli, but the RNAi machinery is non-functional since the other genes in this pathway are pseudogenized. T. rangeli is highly susceptible to oxidative stress, a phenotype that may be explained by a smaller number of anti-oxidant defense enzymes and heatshock proteins.  Conclusions/Significance: Phylogenetic comparison of nuclear and mitochondrial genes indicates that T. rangeli and T. cruzi are equidistant from T. brucei. In addition to revealing new aspects of trypanosome co-evolution within the vertebrate and invertebrate hosts, comparative genomic analysis with pathogenic trypanosomatids provides valuable new information that can be further explored with the aim of developing better diagnostic tools and/or therapeutic targets

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Guidelines for management of ischaemic stroke and transient ischaemic attack 2008

This article represents the update of the European Stroke Initiative Recommendations for Stroke Management. These guidelines cover both ischaemic stroke and transient ischaemic attacks, which are now considered to be a single entity. The article covers referral and emergency management, Stroke Unit service, diagnostics, primary and secondary prevention, general stroke treatment, specific treatment including acute management, management of complications, and rehabilitation

Periodontal outcomes and social, racial and gender inequalities in Brazil: a systematic review of the literature between 1999 and 2008 Condições periodontais e desigualdades sociais, raciais e de gênero no Brasil: revisão sistemática da literatura do período de 1999 a 2008

The objective of this study was to review the Brazilian epidemiologic literature on periodontal outcomes and socio-demographic factors, assessing bibliographic and methodological characteristics of this scientific production, as well as the consistency and statistical significance of the examined associations. A systematic review was carried out in six bibliographic sources. The review was limited to the period between 1999 and 2008, without any other type of restriction. Among the 410 papers identified, 29 were included in the review. An increasing number of articles, specifically in the last four years of study, was observed. However, there is a concentration of studies in the South and Southeast regions of Brazil, and many of them are not closely connected to theoretical formulations in the field. In spite of these shortcomings, the review findings corroborate the idea that poor socioeconomic conditions are associated with periodontal outcomes, as demonstrated primarily by income and schooling indicators.<br>O objetivo deste trabalho foi revisar a literatura epidemiológica brasileira sobre condições periodontais e aspectos sociodemográficos, avaliando características bibliográficas e metodológicas dessa produção, bem como a consistência e a significância estatística das associações examinadas. Foi conduzida uma revisão sistemática, por meio de consulta eletrônica, a seis fontes bibliográficas. A revisão foi restrita ao período de 1999 a 2008, sem a imposição de quaisquer outros limites de pesquisa. Entre os 410 artigos identificados, 29 foram incluídos na revisão. Observa-se crescimento da produção, especialmente no último quadriênio. Entretanto, há uma concentração dos estudos nas regiões Sul e Sudeste do país, e os trabalhos não se apoiam explicitamente em elaborações teóricas pertinentes ao tema. Apesar dessas limitações, os resultados dessa revisão sugerem que há uma relação inversa entre indicadores socioeconômicos e desfechos periodontais, demonstrada especialmente por indicadores de renda e escolaridade

Hunting strategies used in the semi-arid region of northeastern Brazil

<p>Abstract</p> <p>Hunting for wild animals is stimulated by the many different human uses of faunal resources, and these animals constitute important subsistence items in local communities in the Caatinga region. In order to gain access to these resources, hunters have developed a series of techniques and strategies that are described in the present work. The principal hunting techniques encountered were: waiting, especially directed towards hunting diurnal birds; calling ("arremedo"), a technique in which the hunters imitate the animal's call to attract it to close range; hunting with dogs, a technique mostly used for capturing mammals; tracking, a technique used by only a few hunters who can recognize and follow animal tracks; and "facheado", in which the hunters go out at night with lanterns to catch birds in their nests. Additionally, many animal species are captured using mechanical traps. The types of traps used by the interviewees were: dead-fall traps ("quixó"), iron-jaw snap traps ("arataca"), wooden cages with bait ("arapuca"), iron-cage traps ("gaiola'), "visgo", multi-compartment bird cages ("alçapão"), buried ground traps with pivoted tops ("fojo"), and nooses and cages for carnivorous. The choice of which technique to use depends on the habits of the species being hunted, indicating that the hunters possess a wide knowledge of the biology of these animals. From a conservation perspective, active hunting techniques (waiting, imitation, hunting with dogs, and "facheado") have the greatest impact on the local fauna. The use of firearm and dogs brought greater efficiency to hunting activities. Additional studies concerning these hunting activities will be useful to contribute to proposals for management plans regulating hunting in the region – with the objective of attaining sustainable use of faunal resources of great importance to the local human communities.</p