Detection of Zika virus in Brazilian patients during the first five days of infection - urine versus plasma.

Advantages of testing for Zika virus (ZIKV) in urine have been reported, such as the persistence of ZIKV in this type of specimen for up to 20 days after ZIKV disease onset. We investigate 61 patients in the first 5 days post-symptom onset and find more patients testing positive for ZIKV in plasma samples (n=46), than in corresponding urine samples (n=37). For patients respectively testing positive in both plasma and urine (n=28), respective viral loads appeared similar.

Women's Views on Handling and Managing Their Breast Cancer in Pakistan: A Qualitative Study.

In this study, we examine and analyze the experiences of women and their perceptions on handling and managing their breast cancer. Seven women from Peshawar, Pakistan who had breast cancer and have been cured, were interviewed. Qualitative content analysis of their life stories was performed using a computerized software Atlas.ti. In the coding process, 128 codes were initially developed. These codes were then grouped into 12 categories, which were then further refined into 8 theoretically grounded categories: awareness and education about breast cancer, cultural barriers, early detection, quality of care and treatment, support, side effects, courage and learned to face challenges. The early views of participant's feelings about breast cancer are mostly similar to the general population in Pakistan. Before starting treatment, all participant were unaware of the treatment process and had fear in their mind. They were hesitant in starting their treatment and were worried. However, when they were cured, their attitudes toward breast cancer and even to their whole lives were changed. Comprehensive awareness programs in a culturally acceptable language and facilities for routine breast examinations should be easily accessible to all women in Pakistan in order to promote early detection. In order to eradicate cultural barriers, female staff who are trained to perform routine breast examinations, should be available in all facilities and treatment centers.

[Maternal mortality from hemorrhage in the State of Santa Catarina, Brazil]. / Mortalidade materna por hemorragia no Estado de Santa Catarina, Brasil.

Hemorrhage represents a set of causes that focuses on women during the pregnancy and puerperal period, and that, with improper attention, results in death. The authors aimed to analyze maternal deaths related to hemorrhage that occurred in the state of Santa Catarina, Brazil. The data were obtained from the Mortality Information System and Live Births Information System from the Brazilian Ministry of Health. This was a descriptive study, in which 491 maternal deaths that occurred in the period 1997-2010 were analyzed. Of these, 61 were related to hemorrhage, corresponding to 12.42%; postpartum hemorrhage was the most prevalent cause, with 26 deaths, followed by placental abruption with 15, representing 67.21% of the cases. The maternal mortality from hemorrhage is a public health problem in the state of Santa Catarina, due to its high prevalence and the fact that its underlying causes are preventable.

Mortalidad neonatal en el Estado de Santa Catarina, Brasil / Neonatal mortality in the state of Santa Catarina, Brazil

Objetivo: analizar el perfil de la mortalidad neonatal en el Estado de Santa Catarina, sur de Brasil, de 2001 a 2011. Métodos: estudio descriptivo, utilizando datos secundarios obtenidos del Sistema de Información sobre Mortalidad, del Ministerio de Salud de Brasil, en relación a la mortalidad neonatal en el Estado de Santa Catarina. Se utilizaron las siguientes variables de la declaración de óbitos (DO) relacionadas con el recién nacido: edad, sexo y peso al nacer; relacionado con la madre, las variables fueron: edad, nivel educativo, tipo de embarazo y tiempo de embarazo. Resultados: durante el período de estudio, hubo 8 141 muertes neonatales. La tasa media de mortalidad neonatal fue de 8,69 por mil nacidos vivos. La mortalidad neonatal en Santa Catarina disminuyó a 20,74 por ciento en la década estudiada, con el mayor porcentaje en período neonatal precoz (76,39 por ciento). Conclusiones: la mayoría de los óbitos se produjeron por causas evitables, pudiendo ser enfrentadas principalmente a través de intervenciones que buscan mejorar la atención prenatal desde el acceso, la calidad y el vínculo con la Atención Primaria de Salud, la atención al parto y el nacimiento. Los datos indicaron que sigue habiendo dificultades en la atención de los recién nacidos, ya sea por la falta de pediatra en la sala de partos, por reducido número de camas en la Unidad de Cuidados Intensivos Neonatal, inexistencia de protocolos clínicos, y además porque las mujeres embarazadas no estaban vinculadas con los centros de atención materna(AU)

Objective: Analyze the profile of neonatal mortality in the state of Santa Catarina, southern Brazil, from 2001 to 2011. Methods: A descriptive study was conducted based on secondary data about neonatal mortality in the state of Santa Catarina obtained from the Mortality Information System of the Brazilian Ministry of Health. The variables examined about newborns were sex and birth weight, as reflected in death certificates (DC). The variables about mothers were age, education, pregnancy time and delivery type. Results: There were 8 141 neonatal deaths during the study period. Mean neonatal mortality rate was 8.69 per thousand live births. Neonatal mortality in Santa Catarina decreased 20.74 percent in the decade under study, with the highest percentage in the early neonatal period (76.39 percent). Conclusions: Most deaths were due to preventable causes which could have been dealt with through interventions aimed at improving prenatal care, such as access, quality, liaison with primary health care, and attention to deliveries and births. Data showed that there are still difficulties in the care of newborns. These are due to the absence of a pediatrician in the labor room, the reduced number of beds in the neonatal intensive care unit, especially the non-existence of clinical protocols, and the fact that pregnant women were not linked to maternal care centers(AU)

Maternal mortality due to hemorrhage in Brazil.

OBJECTIVE: to analyze the rates of maternal mortality due to hemorrhage identified in Brazil from 1997 to 2009. METHODS: the time series and population data from the Brazilian Health Ministry, Mortality Information System and Live Birth Information System were examined. From the Mortality Information System, we initially selected all reported deaths of women between 10 and 49 years old, which occurred from January 1, 1997 to December 31, 2009 in Brazil, recorded as a "maternal death". RESULTS: during the research period, 22,281 maternal deaths were identified, among which 3,179 were due to hemorrhage, accounting for 14.26% of the total deaths. The highest rates of maternal mortality were found in the North and Northeast areas of Brazil. CONCLUSIONS: the Brazilian scenario shows regional inequalities regarding maternal mortality. It presents hemorrhaging as a symptom and not as a cause of death.

Investigación cualitativa en enfermería. Metodología y didáctica / Qualitative research in nursing. Methodology and didactics

El libro reúne una serie de artículos realizados por un grupo de profesionales e investigadores en enfermería provenientes de Argentina, Brasil, Canadá, Chile, Colombia, Ecuador, Estados Unidos de América, México, Panamá, Perú y Venezuela, quienes abordan las múltiples posibilidades metodológicas que tiene la investigación cualitativa y su aplicación en las áreas de enfermería y salud. Ofrece una metodología y didáctica de cómo hacer investigación cualitativa en enfermería en diferentes diseños. A través de sus capítulos los autores presentan diferentes diseños de estudios cualitativos y aportan discusiones sobre los aspectos instrumentales dela investigación: organización del trabajo de investigación y técnicas de investigación (entrevista, grupo focal, revisión de la literatura, difusión de los estudios cualitativos en lacomunidad científica, elaboración de manuscritos para publicación). Además, hacen una reflexión sobre el rigor científico y los desafíos de calidad de los estudios cualitativos en salud y enfermería.

El cáncer de cuello de útero: un problema social mundial / O câncer de colo do útero: um problema social mundial

Objetivo: analizar el cáncer de cuello de útero como problema social. Metodos: estudio transversal con datos poblacionales, fundamentado en la epidemiología descriptiva. Los datos fueron recolectados en la base de datos Globocan-2008. En el análisis es aplicada la clasificación de desarrollo de los países, de la Organización de las Naciones Unidas, y los niveles de incidencia y mortalidad por cáncer de cuello uterino, de la Agencia Internacional para la Investigación en Cáncer. Resultados: para el año 2008 fue estimada la ocurrencia de 529.828 casos nuevos y 275.128 muertes en el mundo, de los cuales 85 por ciento y 88 por ciento respectivamente ocurrieron en países en desarrollo, en estos países la tasa de incidencia por CCU fue de 17,8 por 100.000 mujeres, la tasa de mortalidad fue de 9,8 por 100.000 mujeres y el riesgo de una mujer ser afectada por esa neoplasia antes de los 75 años es de 1,87 por ciento y el de morir es de 1,10 por ciento . En los países desarrollados, la tasa de incidencia por CCU es de 9,0 por 100.000 mujeres, la tasa de mortalidad es de 3,2 por 100.000 mujeres y el riesgo de una mujer ser afectada por esa neoplasia antes de los 75 años es de 0,85 por ciento , y el de morir es de 0,33 por ciento . Conclusiones: el CCU es un problema social mundial, que afecta a las mujeres de los países en desarrollo como de los países desarrollados. Las proyecciones de la enfermedad en el período 2010 a 2030 revelan tendencia en el aumento de casos nuevos, siendo mayor el riesgo de enfermar por CCU en mujeres de países en desarrollo(AU)

Objective: to analyze cervical cancer as a social problem. Method: cross sectional study with population data, based in descriptive epidemiology. Data were collected using the Globocan 2008 database. The United Nations classification of countries based on their level of development, the mortality rates due to cervical cancer from the International agency for research on cancer were applied to the analysis. Results: in 2008 the cervical cancer incidence was calculated in 529.828 new cases and 275.128 deaths in the World, from which 85 percent and 88 percent were from developed and developing countries respectively. In the developing countries the incidence rate of CUC was 17,8 percent per 100.000 women, the mortality rate was 9,8 percent per 100.000 women, the risk for a women of being affected by the neoplasia before the age of 75 years old is 1,87 percent and the risk of dying is 1,10 percent. In developed countries the incidence rate of CUC was 9,0 per 100.000 women, the mortality rate was 3,2 percent per 100.000 women and the risk for a women of being affected by the neoplasia before the age of 75 years old is 0,85 percent and the risk of dying is 0,33 percent. Conclusion: CUC is a social problem Worldwide; it affects women from developing countries as well as women from developed countries. Disease projections for the period between 2010 and 2030 reveal a tendency of increasing the number of new cases, being the highest risk of falling ill with CUC for women from developing countries(AU)

Objetivo: analisar o câncer de colo de útero como problema social. Metodologia: estudo transversal com dados populacionais, fundamentado na epidemiologia descritiva. Os dados foram coletados na base de dados Globocan-2008. Na análise são aplicadas a classificação de desenvolvimento dos países, da Organização das Nações Unidas, e os níveis de incidência e mortalidade por câncer do colo uterino, da International Agency for Research on Câncer. Resultados: para o ano de 2008 foi estimada a ocorrência de 529.828 casos novos e 275.128 mortes no mundo dos quais 85 porcento e 88 porcento respectivamente nos países em desenvolvimento, nos quais a taxa de incidência por CCU é de 17,8 por 100.000 mulheres, a taxa de mortalidade é de 9,8 por 100.000 mulheres e o risco de uma mulher ser acometida por essa neoplasia antes dos 75 anos é de 1,87 porcento, e o de morrer é de 1,10 porcento. Nos países desenvolvidos, a taxa de incidência por CCU é de 9,0 por 100.000 mulheres, a taxa de mortalidade é de 3,2 por 100.000 mulheres e o risco de uma mulher ser acometida por essa neoplasia antes dos 75 anos é de 0,85 porcento, e o de morrer é de 0,33 porcento. Conclusões: o CCU é um problema social mundial, que afeta as mulheres em países em desenvolvimento tanto quanto dos países desenvolvidos. As projeções da doença no período 2010 a 2030 revelam tendência de aumento de casos novos, sendo maior o risco de adoecer por CCU m mulheres de países em desenvolvimento(AU)

[Girls from Santa Catarina: losing your life to become a mother]. / Meninas Catarinas: a vida perdida ao ser mãe.

The Maternal Mortality Ratio (MMR) is an indicator that analyses the life conditions and care given to pregnant women, and indicates whether the constitutional rights related to life and health are being complied with. This study shows losses of lives among adolescent women associated with pregnancy, childbirth and the puerperal period, in the state of Santa Catarina between 1994 and 2005. It is an exploratory study of a quantitative nature. There were 72 maternal deaths in adolescents, 67% had a direct obstetric cause, 23% had an indirect obstetric cause and about 9% were classified as accidental or incidental. The Maternal Mortality Ratio in adolescents was high and most could have been prevented and its causes controlled. The identified situation shows an absence of quality health care. To reduce these deaths it is central that nursing action be combined with other professionals and other organized sectors of society.

Investigación cualitativa en enfermería: Contexto y bases conceptuales / Qualitative research in nursing: Context and conceptual bases

El libro reúne una serie de artículos realizados por profesionales expertos en la materia, que ofrecen una mirada de las múltiples posibilidades metodológicas de los estudios cualitativos y su aplicación en las áreas de enfermería y salud. En los siete primeros capítulos, los autores traen discusiones teórico-filosóficas acerca del paradigma cualitativo y sus contribuciones a la producción del conocimiento científico con el objetivo de aproximar al lector las discusiones en este campo y contribuir a la compresiónde sus fundamentos. En los capítulos posteriores se presentan algunos métodos de investigación cualitativa, en especial sus fundamentos teórico-metodológicos y su aplicación en enfermería. En el último capítulo, los autores ofrecen una serie de procedimientos para ayudar a los investigadores con experiencia inicial en esta perspectiva científica y con intéres de desarrollar estudios de esa naturaleza.

Kalanchosine dimalate, an anti-inflammatory salt from Kalanchoe brasiliensis.

This report describes the isolation and characterization of kalanchosine dimalate (KMC), an anti-inflammatory salt from the fresh juice of the aerial parts of Kalanchoe brasiliensis. KMC comprises the new metabolite kalanchosine (1) and malic acid (2) in a 1:2 stoichiometric ratio. Kalanchosine (1), 3,6-diamino-4,5-dihydroxyoctanedioic acid, is the first naturally occurring dimeric bis(gamma-hydroxy-beta-amino acid) and is at least partially responsible for the anti-inflammatory properties of K. brasiliensis.