Dimensions of youth psychopathy differentially predict concurrent pro- and antisocial behavior

Objective: To investigate the unique contribution of narcissism and impulsivity, in addition to callous-unemotional (CU) traits, in explaining concurrent prosocial and antisocial behavior. Method: Two hundred and forty-nine schoolchildren (53% female; age 9-12 years) completed the self-report Strengths and Difficulties Questionnaire (SDQ) and the Antisocial Process Screening Device (APSD). Two statistical models were tested, predicting conduct problems (CP) and prosocial behavior (PB). In the first one, CU traits and gender were entered into the equation. The second model added narcissism and impulsivity. Results: Gender, narcissism and impulsivity, but not CU, were statistically significant predictors of CP in the second model (F3,226 = 45.07, p < 0.001, R2 = 43.7%; betas: gender = -0.20, narcissism = 0.29, impulsivity = 0.36, CU = 0.06). PB was significantly predicted by all domains except gender (F3,226 = 42.57, p < 0.001, R2 = 42.4%; betas: gender = 0.08, narcissism = -0.16, impulsivity = -0.23, CU = -0.41). Conclusion: Our results confirmed that CU traits refer to a distinct manifestation of psychopathy in youth, but we also found that narcissism and impulsivity are equally important when predicting CP. Previous reports of sex differences on APSD and SDQ domains were also corroborated.

Indução de endividamento hospitalar na compra de medicamento em situação de monopólio: o caso do mesilato de imatinibe / Induction of hospital indebtedness due to medicine purchases under monopoly conditions: the case of imatinib mesylate / Inducción de la deuda hospitalaria en la compra de medicamentos en monopolio: el caso de mesilato de imatinib

Os gastos com medicamentos correspondem a uma grande parcela do orçamento em saúde. Sendo assim, a produção de conhecimento sobre o uso desses recursos é essencial na tomada de decisão em saúde pública e melhoria da assistência farmacêutica. Este estudo teve como objetivo analisar o processo de endividamento em um hospital universitário de alta complexidade devido ao gasto crescente com a aquisição de mesilato de imatinibe. Por meio de análise documental e registros no Sistema de Informações Hospitalares (SIH) entre 2002 e 2010, realizou-se um estudo descritivo. A partir do caminho da incorporação do medicamento, foram mapeadas as estratégias da indústria farmacêutica e do governo, assim como as respostas governamentais de redução do preço. A sistematização e publicação de informações guardadas em arquivos e na memória podem contribuir para o acompanhamento dos resultados dos programas mantidos pelo Ministério da Saúde.

Medicine expenditures consume a large share of the health budget, so knowledge on the use of these funds is essential for decision-making in public health and improvement of pharmaceutical care. This study analyzed the indebtedness of a high-complexity university hospital due to increased spending on imatinib mesylate. The descriptive study was based on analysis of documents and records in the Hospital Information System (SIH) from 2002 to 2010. Starting with inclusion of the medicine in the budget, the study mapped strategies by the pharmaceutical industry and government, as well as government responses to reduce the product's price. The systematization and publication of information stored in files and electronic databases can help monitor the results of programs funded by the Brazilian Ministry of Health.

Los gastos en medicamentos representan una gran proporción del presupuesto de salud, por lo que la producción de conocimiento sobre el uso de estos recursos es esencial en la toma de decisiones en salud pública y la mejora de la atención farmacéutica. Este estudio tuvo como objetivo analizar el proceso de endeudamiento en un hospital universitario de alta complejidad, debido al aumento de los gastos en la adquisición de mesilato de imatinib. A través del análisis de los documentos y registros en el Sistema de Información Hospitalaria (SIH) entre 2002 y 2010, se realizó un estudio descriptivo. A partir de la incorporación del medicamento, se mapearon las estrategias de la industria farmacéutica y del gobierno, así como las respuestas del gobierno para reducir el precio. La sistematización y publicación de la información almacenada en los archivos y su memoria puede contribuir para el seguimiento de los resultados de los programas mantenidos por el Ministerio de Salud.

Caracterización clínica de la incontinencia urinaria y factores asociados en usuarias de la Unidad de la Mujer del Centro de Salud Familiar “Ultraestación” en la ciudad de Chillán, Chile / Prevalence and risk factors for urinary incontinence among women consulting in primary care

Background: It is important to determine the relative importance of urinary incontinence in terms of its prevalence and how it affects the quality of life of women. Aim: To characterize urinary incontinence and factors associated with it in women aged over 30 years. Material and Methods: A survey about urinary incontinence and associated factors was answered by 289 women aged 30 to 81 years, attending a public primary care clinic. Results: The prevalence of urinary incontinence was 62.2%, and it was significantly associated with obesity, diabetes and a history of episiotomy. Conclusions: The high prevalence of urinary incontinence should prompt the implementation of public health measures to prevent and treat it effectively.

Studies on Phlebotominae (Diptera: Psychodidae) in the Campus FIOCRUZ Mata Atlântica, Jacarepaguá, in the City of Rio de Janeiro, Brazil

INTRODUCTION: The presence of American cutaneous leishmaniasis (ACL) in the communities of the Campus FIOCRUZ Mata Atlântica (CFMA) in the City of Rio de Janeiro initiated the investigation of the Phlebotominae fauna in the Atlantic Forest to determine the occurrence of putative ACL vectors associated with the enzootic cycle. METHODS: For 24 consecutive months, sand flies were captured inside the forest and in the border area near the communities. RESULTS: The following sand fly species were identified: Brumptomyia brumpti, Brumptomyia cunhai, Brumptomyia nitzulescui, Lutzomyia edwardsi, Lutzomyia pelloni, and Lutzomyia quinquefer. Other identified sand fly vectors, such as Lutzomyia intermedia (the predominant species), Lutzomyia migonei, Lutzomyia whitmani, Lutzomyia fischeri, and Lutzomyia hirsuta hirsuta, are associated with ACL transmission, and the vector for American visceral leishmaniases (AVL), Lutzomyia longipalpis, was also found. CONCLUSIONS: All sand fly vectors were found in both studied environments except for Lutzomyia whitmani, which was only identified in the forest. This study represents the first identification of Lutzomyia longipalpis in the CFMA, and the epidemiological implications are discussed. .

Influence of surgical technique in the peritoneal carcinomatosis surgical wound implant: experimental model in mice / Influência da técnica cirúrgica na implantação da carcinomatose peritoneal em ferida operatória: modelo experimental em camundongos

BACKGROUND: The number of malignancies increased alarmingly. Surgery constitutes one of the most efficient therapeutic modalities for the treatment of solid tumors. The neoplastic implant in surgical wound is a complication whose percentage of occurrence reported in the literature is variable, but sets with high morbidity and therapeutic difficulties. Protecting the wound is one of the recommended principles of oncologic surgery. AIM: To evaluate the influence of wound protection in the development of tumor implantation. METHODS: Sarcoma 180 tumor cells were used, with intraperitoneal inoculation in Swiss mice. After the establishment of neoplastic ascites, animals were randomized into two groups of 10, each group consisting of five males and five females. In both groups, laparotomy and manipulation of intra-abdominal organs was performed. In a group laparotomy was performed using the protection of the abdominal wound and the other group without it. On the 9th postoperative day macroscopic evaluation of the operative scar was performed, which was later removed for microscopic evaluation. RESULTS: There was microscopic infiltration of tumor cells in the wound of all animals. However, the group that held the protection, infiltration was less intense when compared to the group without it. The infiltration was also more severe in females than in males of the same group. CONCLUSION: Tumor infiltration into the wound was more intense in the group in which the protection of the surgical site was not performed, and in females when compared to males of the same group. .

RACIONAL: O número de neoplasias vem aumentando de maneira preocupante. O tratamento cirúrgico constitui-se em uma das modalidades terapêuticas mais eficientes para os tumores sólidos. O implante neoplásico em ferida operatória é complicação cujo percentual de ocorrência relatado na literatura é variável, porém configura alta morbidade e grande dificuldade terapêutica. A proteção da ferida operatória é um dos princípios de cirurgia oncológica recomendados, entretanto pouco estudado. OBJETIVO: Avaliar a influência da proteção de ferida operatória no desenvolvimento de implante tumoral na ferida operatória. MÉTODOS: Foram utilizadas linhagens de células tumorais do Sarcoma 180, com inoculação intraperitoneal em camundongos Swiss. Após o estabelecimento da ascite neoplásica, os animais foram randomizados em dois grupos de 10, cada grupo composto por cinco machos e cinco fêmeas. Nos dois grupos foi realizada laparotomia e manipulação de órgãos intra-abdominais. Em um grupo a laparotomia foi realizada utilizando a proteção da ferida abdominal e no outro grupo sem proteção. No 9º dia pós-operatório foi realizada avaliação macroscópica da cicatriz operatória, sendo esta removida posteriormente para avaliação microscópica. RESULTADOS: Houve infiltração microscópica de células tumorais na ferida operatória em todos animais. Porém, no grupo em que se realizou a proteção da ferida a infiltração foi menos intensa quando comparado ao grupo sem proteção. A infiltração também foi mais intensa nas fêmeas do que nos machos do mesmo grupo. CONCLUSÃO: A infiltração tumoral na ferida operatória foi mais intensa no grupo em que não foi realizada a proteção da ferida operatória e nas fêmeas quando comparadas aos machos do mesmo grupo. .

Pregnancy and birth complications in patients with schizophrenia in Trinidad and London

It has been shown that an excess of pregnancy and birth complications (PBCs) does not contribute to the excess rates of schizophrenia reported for the population of Caribbean origin in Britain compared with the native Caucasian British population. We therefore attempted to compare the rate of PBCs between a sample of schizophrenics in Britain with that of a sample from Trinidad where some of the Caribbean migrants to Britain originated. First contact patients with schizophrenia according to the CATEGO system diagnosis were identified in Trinidad and London. Their mothers, where available, were interviewed using the Lewis-Murray scale for pregnancy and birth complications. Data from Trinidad and Tobago concerning 56 patients were compared with those of the Caucasian (n = 61) and African-Caribbean (n = 50) patients in London. The rate of PBCs was similar for the Caucasian British patients (24.6) and the patients in Trinidad and Tobago (21.7). The rates were lowest in the African-Caribbean patients in London (14.0), though this difference was not statistically significant. These findings suggest that pregnancy and birth complications are a risk factor for a substantial minority of patients with schizophrenia in Trinidad and London. It also confirms that the excess rates of schizophrenia reported for the Caribbean population in Britain are not due to these complications

BCG, tuberculin skin-test results and asthma prevalence in school children in North London.

OBJECTIVE: To test whether there is any relationship between asthma prevalence and BCG immunization or tuberculin skin text reaction. DESIGN: Cross-sectional survey. SETTING: Secondary school in Haringey, North London, U.K. SUBJECTS: 780 children aged 11-18 years (median 13.35 years). INTERVENTIONS: Administration of tuberculin skin text and questionnaire. MAIN OUTCOME MEASURES: Diagnosis of asthma, presence of nocturnal cough, exercise-induced wheeze or wheeze with viral respiratory infections; diameter of induration with tuberculin skin text; history of BCG immunization. RESULTS: 57 of 629 children (8.5%) had a significantly positive Mantoux reaction (>or=15 millimeters of induration). Children with and without a history of BCG immunization did not differ significantly in prevalence of asthma diagnosis (11.8% vs 14.1%, p > 0.6), exercise-induced wheeze (16.9% vs 21.2%, p>0.4), viral induced wheeze (15.4% vs 7%, p>0.6) or nocturnal cough (32.3% vs 32.7%, p> 0.6). We also found no significant correlation of the prevalence of asthma diagnosis or symptoms with diameter of Mantoux test reaction. CONCLUSION: There is no evidence of an effect of BCG immunization or tuberculin reactivity on the incidence of asthma in secondary school children in Haringey, North London and the exposure to tuberculosis is high in these children.

Comparison of methods to assess coronary heart disease prevalence in South Asians.

BACKGROUND: Migrants from the Indian subcontinent (South Asian migrants) in the United Kingdom have high mortality from coronary heart disease (CHD) in comparison to the indigenous population. Few studies have assessed the prevalence of CHD in South Asians, and the applicability of conventional survey methods in this population is not known. In this pilot random population survey of South Asian men and women living in West London, the prevalence of CHD as judged by the Rose questionnaire, past cardiac history, cardiologist and resting electrocardiogram were compared. METHODS: Subjects aged 30-64 years from randomly selected households were invited for a cardiological assessment. A lay person administered the Rose questionnaire and recorded the past cardiac history. A cardiologist also made an independent assessment and a 12-lead electrocardiogram was recorded and analysed according to the Minnesota code. RESULTS: Three hundred and seventy-six individuals (192 men and 184 women) were assessed. The prevalence of angina in men and women, respectively, was 3.1% and 4.9% by the Rose questionnaire; 2.6% and 2.2% by past cardiac history; and 4.2% and 0.5% according to the cardiologist. The prevalence of myocardial infarction in men and women, respectively, was 5.2% and 2.2% by the Rose questionnaire, 3.6% and zero by past cardiac history and 3.6% and 0.5% by the cardiologist. Q/QS codes were present in 1.6% men and 0.5% women and ischaemic codes in 13% men and 14% women. Ischaemic changes were not associated with any cardiac history in 72% of men and 92% of women. For a diagnosis of CHD in men, there was poor agreement between the Rose questionnaire and either the past cardiac history or the cardiologist's assessment, but moderate agreement between the past cardiac history and the cardiologist. Agreement was poor between all three methods for a positive diagnosis of CHD in women. CONCLUSION: Current accepted epidemiological methods for assessing CHD prevalence may be inaccurate in South Asians, especially women. Electrocardiogram abnormalities suggestive of ischaemia are common in South Asians and are usually not associated with evidence of CHD. Thus, their value as indicators of CHD is questionable.