Establishment and cryptic transmission of Zika virus in Brazil and the Americas.

Transmission of Zika virus (ZIKV) in the Americas was first confirmed in May 2015 in northeast Brazil. Brazil has had the highest number of reported ZIKV cases worldwide (more than 200,000 by 24 December 2016) and the most cases associated with microcephaly and other birth defects (2,366 confirmed by 31 December 2016). Since the initial detection of ZIKV in Brazil, more than 45 countries in the Americas have reported local ZIKV transmission, with 24 of these reporting severe ZIKV-associated disease. However, the origin and epidemic history of ZIKV in Brazil and the Americas remain poorly understood, despite the value of this information for interpreting observed trends in reported microcephaly. Here we address this issue by generating 54 complete or partial ZIKV genomes, mostly from Brazil, and reporting data generated by a mobile genomics laboratory that travelled across northeast Brazil in 2016. One sequence represents the earliest confirmed ZIKV infection in Brazil. Analyses of viral genomes with ecological and epidemiological data yield an estimate that ZIKV was present in northeast Brazil by February 2014 and is likely to have disseminated from there, nationally and internationally, before the first detection of ZIKV in the Americas. Estimated dates for the international spread of ZIKV from Brazil indicate the duration of pre-detection cryptic transmission in recipient regions. The role of northeast Brazil in the establishment of ZIKV in the Americas is further supported by geographic analysis of ZIKV transmission potential and by estimates of the basic reproduction number of the virus.

6-Dimethylaminopurine and cyclohexamide are mutagenic and alter reproductive performance and intrauterine development in vivo.

The compounds 6-dimethylaminopurine (6-DMAP) and cyclohexamide (CHX) are currently used to stimulate the development of embryos produced by nuclear transfer in the production of cloned mammals with a great deal success. This study investigated the effects of 6-DMAP and CHX in vivo using biological assays to evaluate reproductive performance in females, teratogenesis, and mutagenesis. The results of this study demonstrated that the activating agents of oocyte cytoplasm, 6-DMAP and CHX, altered the reproductive performance of the experimental animals, as well as increased the rate malformations. In addition to these adverse effects, the administration of these compounds in pregnant females resulted in genotoxic and mutagenic toxicity, as determined by comet and micronucleus assays carried out in peripheral blood samples, respectively. Based on these findings and that alterations in DNA are important, morpho-functional teratogenesis and diminished embryonic viability, suggesting that 6-DMAP and CHX, which are utilized during the cloning of mammals, are responsible for the fact that embryos produced by nuclear transfer show low viability after implantation in utero or after birth because of congenital malformations and/or alterations in their DNA.

Avaliação farmacognostica e da rotulagem das drogas vegetais boldo-do-chile (Peumus boldus Molina) e camomila (Matricaria recutita L. ) comercializadas em Fortaleza, CE / Pharmacognostic evaluation and analysis of labels of the medicinal plants Boldo-do-Chile (Peumus boldus Molina) and Chamomile (Matricaria recutita L. ), commercialized in Fortaleza, Ceará State, Brazil

RESUMO Boldo-do-chile (Peumus boldus) e camomila (Matricaria recutita) são plantas empregadas na fitoterapia principalmente para o tratamento de desordens hepáticas e intestinais, atuando também como anti-inflamatório e antiespasmódico, respectivamente. Por isso, o presente trabalho objetivou avaliar a qualidade farmacognostica dessas drogas vegetais comercializadas em Fortaleza (CE), além das informações de suas rotulagens. Quarenta e duas amostras de boldo, e quarenta e cinco amostras de camomila, procedentes de farmácias, de lojas de produtos naturais e de bancas de raizeiros, foram analisadas quanto à autenticidade, à pureza e às informações contidas na rotulagem desses produtos conforme legislação vigente. Na verificação de impurezas, 35,7% das amostras de boldo e 57,7% das amostras de camomila excederam o teor máximo de matéria estranha; no teor de cinzas totais, 33,3% das amostras de boldo foram reprovadas; rotulagens das amostras de boldo (100%) e de camomila (96,6%) apresentaram erros ou ausência de informações. Os resultados das análises confirmam, portanto, a necessidade urgente de melhor fiscalização e intervenção na produção e venda dessas e de outras drogas vegetais para adequação às normas vigentes.

ABSTRACT Boldo (Peumus boldus) and chamomile (Matricaria recutita) plants are mainly used in herbal medicine to treat hepatic and gastrointestinal diseases, having also anti-inflammatory and antispasmodic properties. This study aimed to evaluate the pharmacognostic quality of these herbal drugs sold in Fortaleza (CE), besides analyzing the information on their labeling. Forty-two samples of boldo, and forty-five samples of chamomile, brought from pharmacies, health food stores and newsstands were analyzed regarding their authenticity, purity, and the information contained in the labeling of the industrial products, to assure that it was in accordance with the current legislation. When verifying the impurities, 35.7% of the boldo samples and 57.7% of the chamomile ones exceeded the maximum level of strange organic matter allowed. Concerning the total ash content, 33.3% of boldo samples were rejected. The labels on the packages of boldo (100%) and chamomile (96,6%) contain errors or lack of information. The test results confirm the need for better surveillance and intervention in the production and sale of these and other drugs plants in order to meet the current standards.

Método Dáder de seguimento farmacoterapêutico, terceira edição (2007): Um estudo piloto / The Dader method of pharmacotherapy follow-up, third edition (2007): A pilot study

As doenças cardiovasculares acarretam elevado custo médico-social, sobretudo devido a suas complicações clínicas. Dentre elas, a hipertensão arterial sistêmica é a que apresenta maior prevalência e mortalidade entre os idosos. As doenças crônicas estão relacionadas à utilização de um elevado número de medicamentos, o que predispõe ao maior risco de problemas farmacoterapêuticos. O estudo visou avaliar a influência do serviço de Atenção Farmacêutica na otimização dos resultados terapêuticos em 10 pacientes hipertensos na Farmácia Escola da Universidade Federal de Pernambuco. No processo, seguiu-se o Método Dáder de Seguimento Farmacoterapêutico, Terceira Edição. Entre os dados obtidos, identificaram-se 36 resultados negativos associados à medicação. Foram realizadas 69 intervenções farmacêuticas visando a resolução destes problemas, das quais 84,1% foram realizadas pelo farmacêutico, sem a participação do médico. No início da pesquisa, todos os usuários apresentaram hipertensão arterial não controlada apesar da terapia medicamentosa prescrita. Após as intervenções farmacêuticas, todos os pacientes tiveram redução da pressão arterial, e apenas quatro (40%) não alcançaram os níveis pressóricos normais. O estudo mostra a importância e a necessidade do serviço de atenção farmacêutica aos usuários de medicamentos, conduzindo à melhora dos resultados clínicos do tratamento da hipertensão arterial sistêmica.

Cardiovascular diseases entail high medical-social costs, mainly due to the clinical complications. Among these, arterial hypertension is the most prevalent and incurs the highest mortality among the elderly. Chronic diseases involve the use of a large number of drugs, which predisposing the patient to pharmacotherapeutic problems. The aim of this study was to evaluate the influence of the pharmaceutical care service in the improvement of therapeutic results in 10 hypertensive patients at the School of Pharmacy, Federal University of Pernambuco, Brazil. To this end, the Dader Method of Pharmacotherapeutic Monitoring (3rd Edition) was used. In all, 36 negative results associated with the medication were identified; 69 pharmaceutical interventions were made in attempts to resolve these problems, 84.1% by the pharmacist, without the participation of the doctor. At the beginning of the study, all users had uncontrolled hypertension, despite the prescribed medication. After the pharmaceutical interventions, all patients had reduced blood pressure and only 4 (40%) failed to reach normal blood pressure levels. The study demonstrates the importance of and need for the pharmaceutical care service to users of medicines, which led to an improvement of clinical results in the treatment of arterial hypertension.

The opinion of Brazilian women regarding vaginal labor and cesarean section.

OBJECTIVES: The opinions of Brazilian women regarding vaginal delivery and cesarean sections was studied. METHODS: Six hundred and fifty-six women who had given birth in seven hospitals in São Paulo and Pernambuco, using the Public Health Service, were interviewed. The opinions of women who had delivered only by cesarean section was compared with those of women who had had at least one vaginal delivery. RESULTS: Significantly more women who had experienced at least one vaginal delivery considered this to be the best way of giving birth (90.4% vs. 75.9% among C-section-only women). Similar proportions in both groups (45.5% and 42.8%) stated that vaginal labor is better because it causes less pain and suffering for the woman. Significantly more women who had experienced a vaginal labor (47.1% vs. 30.3%) reported that it had no disadvantage. More women who had only had cesarean sections referred not having contractions/pain as an advantage of this method (56.7% vs. 41.7%). CONCLUSIONS: Apparently, pain and women's perception of pain were the characteristics which differentiated women with history of vaginal delivery from those with cesarean sections in the sample studied. However, the opinion that vaginal delivery is better than cesarean section was expressed independently of the recognition that pain could be its main disadvantage.

The opinion of Brazilian women regarding vaginal labor and cesarean section.

OBJECTIVES: The opinions of Brazilian women regarding vaginal delivery and cesarean sections was studied. METHODS: Six hundred and fifty-six women who had given birth in seven hospitals in São Paulo and Pernambuco, using the Public Health Service, were interviewed. The opinions of women who had delivered only by cesarean section was compared with those of women who had had at least one vaginal delivery. RESULTS: Significantly more women who had experienced at least one vaginal delivery considered this to be the best way of giving birth (90.4% vs. 75.9% among C-section-only women). Similar proportions in both groups (45.5% and 42.8%) stated that vaginal labor is better because it causes less pain and suffering for the woman. Significantly more women who had experienced a vaginal labor (47.1% vs. 30.3%) reported that it had no disadvantage. More women who had only had cesarean sections referred not having contractions/pain as an advantage of this method (56.7% vs. 41.7%). CONCLUSIONS: Apparently, pain and women's perception of pain were the characteristics which differentiated women with history of vaginal delivery from those with cesarean sections in the sample studied. However, the opinion that vaginal delivery is better than cesarean section was expressed independently of the recognition that pain could be its main disadvantage.

Clinical and laboratorial correlation of postoperative hypocalcemia after extensive thyroidectomy.

The medical records of 84 patients submitted to extensive thyroidectomy from January 1991 to April 1995 were reviewed and the data was analyzed in order to verify a correlation between postoperative laboratories results and physical findings suggestive of hypocalcemia. It was verified that there was hypocalcemia in 51.2 percent of the patients, of which only 18.6 percent presented symptoms. It was concluded that asymptomatic hypocalcemia is frequent in extensive thyroidectomy and a routine screening for serum calcium in the postoperative period following thyroidectomy and calcium reposition must be systematic.

Factors associated with the acceptance of Norplant or IUD among women with similar socio-demographic characteristics.

The purpose of this study was to identify factors that explain why women who consulted at the same clinic, went through the same counseling procedure and who had no contraindications for using Norplant decided to use another long-acting method, the IUD. Subjects were women who consulted at the Family Planning Clinic, State University of Campinas Hospital. One hundred Norplant acceptors and 100 IUD acceptors were interviewed at home, by trained interviewers who were not related to the clinic. Four out of five Norplant acceptors and all IUD acceptors had learned about the method chosen before attending the clinic. Results suggest that among IUD users there were more women who did not like the idea of taking a hormone or medicine to prevent pregnancy, while Norplant acceptors were more willing to try new experiences. Half the Norplant acceptors had learned about the method through TV, compared to 12% of IUD acceptors. Counseling at the clinic was not a determining factor, though it is important to clarify clients' doubts.