G6PD deficiency in Latin America: systematic review on prevalence and variants

Plasmodium vivax radical cure requires the use of primaquine (PQ), a drug that induces haemolysis in glucose-6-phosphate dehydrogenase deficient (G6PDd) individuals, which further hampers malaria control efforts. The aim of this work was to study the G6PDd prevalence and variants in Latin America (LA) and the Caribbean region. A systematic search of the published literature was undertaken in August 2013. Bibliographies of manuscripts were also searched and additional references were identified. Low prevalence rates of G6PDd were documented in Argentina, Bolivia, Mexico, Peru and Uruguay, but studies from Curaçao, Ecuador, Jamaica, Saint Lucia, Suriname and Trinidad, as well as some surveys carried out in areas of Brazil, Colombia and Cuba, have shown a high prevalence (> 10%) of G6PDd. The G6PD A-202A mutation was the variant most broadly distributed across LA and was identified in 81.1% of the deficient individuals surveyed. G6PDd is a frequent phenomenon in LA, although certain Amerindian populations may not be affected, suggesting that PQ could be safely used in these specific populations. Population-wide use of PQ as part of malaria elimination strategies in LA cannot be supported unless a rapid, accurate and field-deployable G6PDd diagnostic test is made available

NATURAL REGENERATION UNDER FOREST PLANTATIONS: "GREEN DESERTS" OR MILIEU FOR BIODIVERSITY?

Although commercial forest plantations have been termed "green deserts", several studies from the last two decades have reported the opposite. These studies suggest that forest plantations can catalyze the natural regeneration in their understory and, thus, contribute to biodiversity conservation. In order to obtain a wide and multi-faceted panorama of forest plantations and their potential contribution to biodiversity conservation and forest restoration, previous studies investigating natural regeneration under forest plantations have been reviewed, highlighting those carried out in Brazil. Methods and environmental conditions are quite variable among studies, making generalizations difficult. Nevertheless, results indicate that historical and environmental factors, such as canopy density and light availability, plantation age, forest species, distance from natural forests, silvicultural practices, and previous land use directly or indirectly affect natural regeneration richness, abundance and community structure under forest plantations. The reviewed studies, as a whole, reinforce the idea that commercial forest plantations can act as environments of biodiversity, at least for some life forms, and, in addition, can facilitate the restoration of native forests. Although the Brazilian studies are abundant, they have been restricted to a few regions and biomes and are mostly descriptive studies. Experimental studies focusing on specific factors that affect the natural regeneration dynamic under forest plantations as well as on management techniques in order to combine high production and biodiversity conservation are desirable. Nonetheless, other biomes and regions rather than those already studied, where forest plantation is a common land use, should be considered.20353355

Experiência de pais e outros familiares no cuidado à criança e ao adolescente após o transplante de medula óssea Experiencia de padres y otros familiares en el cuidado al niño y al adolescente después del transplante de medula ósea Experience of parents and other family members in the care to children and adolescents after bone marrow transplantation

O objetivo deste trabalho é descrever como os pais e outros familiares de crianças e adolescentes submetidos ao Transplante de medula Óssea (TMO) vivenciam esta experiência, especialmente na fase pós operatória. Participaram do estudo treze responsáveis por onze pacientes menores de dezoito anos. Utilizamos como instrumento de coleta de dados a entrevista semi-estruturada com os responsáveis. Para a análise dos dados recorremos a abordagem qualitativa. Através das entrevistas identificamos os seguintes temas: impacto do transplante e cotidiano familiar. Os resultados indicam que pela complexidade do TMO é indispensável o conhecimento da realidade familiar do paciente pois esta tem papel fundamental na sua qualidade de vida. Assim identificar condições, vivências e modo de vida das famílias permite trabalhar com base em suas reais necessidades, respeitando suas possibilidades e limites.<br>El objetivo de este trabajo es describir como los padres y otros familiares de niños y adolescentes sometidos al Transplante de Médula Ósea vivencian esa experiencia, especialmente después del transplante. Participaron del estudio trece responsables por once pacientes con menos de 18 años. Utilizamos como instrumento de recolección de datos la entrevista semi-estructurada con los responsables. Para el análisis de datos fue utilizado el abordaje cualitativo. A través de entrevistas fueron identificados los siguientes temas: impacto del transplante y cotidiano familiar. Los resultados indican que por la complejidad del Transplante de Médula Ósea es indispensable el conocimiento de la realidad familiar del paciente pues esta tiene un papel fundamental en su calidad de vida. Así, identificar condiciones, vivencias y el modo de vida de las familias permite trabajar con base en sus reales necesidades, respetando sus posibilidades y limites.<br>The purpose of this study is to describe how parents and other family members of children and adolescents submitted to Bone Marrow Transplantation, specially in the post operative period. Thirteen subjects responsible to the care of eleven patients under 18 years old participated in the study. Authors used semi-structured interviews to collected data. Data were analyzed through a qualitative approach. The following themes were identified: impact of transplantation and family life. Results indicated that due to the complexity of Bone Marrow Transplantation, the knowledge on the family reality is crucial as family plays a fundamental role in patients' quality of life. Therefore, to identify conditions, experiences and the life style of families enable the work based on their real needs, respecting their possibilities and limitations