Chronic kidney disease in children: the global perspective

In contrast to the increasing availability of information pertaining to the care of children with chronic kidney disease (CKD) from large-scale observational and interventional studies, epidemiological information on the incidence and prevalence of pediatric CKD is currently limited, imprecise, and flawed by methodological differences between the various data sources. There are distinct geographic differences in the reported causes of CKD in children, in part due to environmental, racial, genetic, and cultural (consanguinity) differences. However, a substantial percentage of children develop CKD early in life, with congenital renal disorders such as obstructive uropathy and aplasia/hypoplasia/dysplasia being responsible for almost one half of all cases. The most favored end-stage renal disease (ESRD) treatment modality in children is renal transplantation, but a lack of health care resources and high patient mortality in the developing world limits the global provision of renal replacement therapy (RRT) and influences patient prevalence. Additional efforts to define the epidemiology of pediatric CKD worldwide are necessary if a better understanding of the full extent of the problem, areas for study, and the potential impact of intervention is desired

Effect of garlic on cardiovascular disorders: a review

Garlic and its preparations have been widely recognized as agents for prevention and treatment of cardiovascular and other metabolic diseases, atherosclerosis, hyperlipidemia, thrombosis, hypertension and diabetes. Effectiveness of garlic in cardiovascular diseases was more encouraging in experimental studies, which prompted several clinical trials. Though many clinical trials showed a positive effect of garlic on almost all cardiovascular conditions mentioned above, however a number of negative studies have recently cast doubt on the efficary of garlic specially its cholesterol lowering effect of garlic. It is a great challenge for scientists all over the world to make a proper use of garlic and enjoy its maximum beneficial effect as it is the cheapest way to prevent cardiovascular disease. This review has attempted to make a bridge the gap between experimental and clinical study and to discuss the possible mechanisms of such therapeutic actions of garlic

Os indicadores da hanseníase e as estratégias de eliminação da doença, em município endêmico do Estado do Rio de Janeiro, Brasil The impact of leprosy elimination strategy on an endemic municipality in Rio de Janeiro State, Brazil

As estratégias de controle da hanseníase no mundo vêm sofrendo mudanças na última década, com finalidade de alcançar a meta de eliminação da doença recomendada pela Organização Mundial da Saúde. Atualmente, países mais endêmicos ainda encontram dificuldades de atingir essa meta. O objetivo deste estudo foi descrever as estratégias de eliminação realizadas em Duque de Caxias, município do Estado do Rio de Janeiro, Brasil, com alta endemicidade, e analisar os principais indicadores epidemiológicos e operacionais da doença e sua tendência evolutiva nos últimos 14 anos, a partir do banco de dados oficial de notificação: Sistema de Informação de Agravos de Notificação (SINAN). Estratégias como descentralização do atendimento ao paciente e campanhas localizadas foram associadas ao aumento da detecção de casos mais precoces, e à redução da taxa de prevalência e do tempo de permanência dos pacientes no registro ativo. Um incremento na taxa de detecção anual pode estar relacionado à existência de prevalência oculta ou de indivíduos com infecção assintomática. Novas estratégias complementares necessitam ser formuladas para o alcance da eliminação da doença no município.<br>Various strategies for eliminating leprosy as a public health problem have evolved in the last 20 years. In some countries, especially highly endemic ones, the WHO target rate for leprosy elimination fell far short. The current study aimed to analyze the impact of different strategies for reducing leprosy prevalence in Duque de Caxias, a highly endemic municipality in Rio de Janeiro State, Brazil. The study observed the evolution of traditional operational indicators for the disease and their trends in the last 14 years. The indicators were calculated using the National Communicable Diseases Database (SINAN). Strategies that focused on decentralization of patient care and/or localized campaigns were associated with earlier case detection, reduction in prevalence, and shorter patient time in the active registry. An increase in the annual detection rate could be related to the existence of hidden prevalence or individuals with asymptomatic infection. New complementary strategies are needed to eliminate the disease in Duque de Caxias