Congenital anomalies in low- and middle-income countries: the unborn child of global surgery.

Surgically correctable congenital anomalies cause a substantial burden of global morbidity and mortality. These anomalies disproportionately affect children in low- and middle-income countries (LMICs) due to sociocultural, economic, and structural factors that limit the accessibility and quality of pediatric surgery. While data from LMICs are sparse, available evidence suggests that the true human and financial cost of congenital anomalies is grossly underestimated and that pediatric surgery is a cost-effective intervention with the potential to avert significant premature mortality and lifelong disability

Perspectives of marine biodiversity studies in Argentina

This paper provides an overview of the research being carried out at the moment by a group of Argentinean scientists working on the subjects of marine biodiversity and oceanography. When the idea of the Census of Marine Life (CoML)was proposed following the Symposium held during the IAPSO-IABO conference in Mar del Plata in October 2001, there was a wide response from the marine scientific community. Information about current research projects, as well as plans for future work in the context of the CoML, were then obtained from about 70 scientists (Appendix I) belonging to 12 institutions located along the Argentinean coast (Appendix II, Figure 1). This has been used to illustrate what is currently being pursued in marine biodiversity in Argentina and which subjects are considered as priority for future research in the area. This paper is, thus, not an historical update of the knowledge of marine biodiversity, but it attempts to give an idea of the current situation and what is planned for the future. The development of an extensive database of what is known on marine biodiversity in the region is considered to be a necessity, but it constitutes a complete project on its own; as such it is included in the proposals for future work (see Future Work in this paper). It is emphasised that this synthesis is not exhaustive in the content of the topics being studied or in the number of researchers working in marine biodiversity in the country. It is, though, considered to be a representative sample of the knowledge in marine science in Argentina today. This is a starting point for the CoML project in South America and it is hoped that, as it develops, it will be improved by the active participation, advice and experience of many other scientists in the region

Development and validation of a simple questionnaire for the identification of hereditary breast cancer in primary care

<p>Abstract</p> <p>Background</p> <p>Breast cancer is a significant public health problem worldwide and the development of tools to identify individuals at-risk for hereditary breast cancer syndromes, where specific interventions can be proposed to reduce risk, has become increasingly relevant. A previous study in Southern Brazil has shown that a family history suggestive of these syndromes may be prevalent at the primary care level. Development of a simple and sensitive instrument, easily applicable in primary care units, would be particularly helpful in underserved communities in which identification and referral of high-risk individuals is difficult.</p> <p>Methods</p> <p>A simple 7-question instrument about family history of breast, ovarian and colorectal cancer, FHS-7, was developed to screen for individuals with an increased risk for hereditary breast cancer syndromes. FHS-7 was applied to 9218 women during routine visits to primary care units in Southern Brazil. Two consecutive samples of 885 women and 910 women who answered positively to at least one question and negatively to all questions were included, respectively. The sensitivity, specificity and positive and negative predictive values were determined.</p> <p>Results</p> <p>Of the 885 women reporting a positive family history, 211 (23.8%; CI95%: 21.5–26.2) had a pedigree suggestive of a hereditary breast and/or breast and colorectal cancer syndrome. Using as cut point one positive answer, the sensitivity and specificity of the instrument were 87.6% and 56.4%, respectively. Concordance between answers in two different applications was given by a intra-class correlation (ICC) of 0.84 for at least one positive answer. Temporal stability of the instrument was adequate (ICC = 0.65).</p> <p>Conclusion</p> <p>A simple instrument for the identification of the most common hereditary breast cancer syndrome phenotypes, showing good specificity and temporal stability was developed and could be used as a screening tool in primary care to refer at-risk individuals for genetic evaluations.</p