Exploring Neotropical anuran parasites: a morphological, life cycle and phylogenetic study of Catadiscus marinholutzi (Trematoda: Diplodiscidae)

Amphistome species belonging to the genus Catadiscus are poorly studied intestinal trematodes found primarily in Neotropical anurans. Herein, developmental stages of an amphistome species found during herpetological and malacological surveys in a temporary marsh pond from Brazil were subjected to morphological (light and scanning electron microscopy) and molecular analyses. Adult parasites recovered from anurans were identified as Catadiscus marinholutzi. Amphistome cercariae found in the planorbid snails Drepanotrema depressissimum and Drepanotrema lucidum from the same waterbody were used for experimental and molecular studies. Immature parasites, morphologically compatible with members of Catadiscus, were experimentally obtained in laboratory-reared tadpoles. Sequencing of a partial region of 28S rDNA gene of both adult and cercariae revealed 100% similarity between these developmental stages, confirming their conspecificity. Phylogenetic analyses were attempted for the first time to reveal the position of a species of Catadiscus in the superfamily Paramphistomoidea. Catadiscus marinholutzi falls in a virtual polytomy together with other paramphistomoids, which leaves its phylogenetic relationships within the group unclear. Moreover, the high genetic divergence to Diplodiscus spp. (10.06–10.84%) cast doubts on the placement of Catadiscus within Diplodiscidae. Hence the species composition of the Diplodiscidae should be re-evaluated in further studies using a broader spectrum of related taxa.

Sex-specific associations of variants in regulatory regions of NADPH oxidase-2 (CYBB) and glutathione peroxidase 4 (GPX4) genes with kidney disease in type 1 diabetes

Oxidative stress is involved in the pathophysiology of diabetic nephropathy. The superoxide-generating nicotinamide adenine dinucleotide phosphate-oxidase 2 (NOX2, encoded by the CYBB gene) and the antioxidant enzyme glutathione peroxidase 4 (GPX4) play opposing roles in the balance of cellular redox status. In the present study, we investigated associations of single nucleotide polymorphisms (SNPs) in the regulatory regions of CYBB and GPX4 with kidney disease in patients with type 1 diabetes. Two functional SNPs, rs6610650 (CYBB promoter region, chromosome X) and rs713041 (GPX4 3'untranslated region, chromosome 19), were genotyped in 451 patients with type 1 diabetes from a Brazilian cohort (diabetic nephropathy: 44.6%) and in 945 French/Belgian patients with type 1 diabetes from Genesis and GENEDIAB cohorts (diabetic nephropathy: 62.3%). The minor A-allele of CYBB rs6610650 was associated with lower estimated glomerular filtration rate (eGFR) in Brazilian women, and with the prevalence of established/advanced nephropathy in French/Belgian women (odds ratio 1.75, 95% CI 1.11-2.78, p = 0.016). The minor T-allele of GPX4 rs713041 was inversely associated with the prevalence of established/advanced nephropathy in Brazilian men (odds ratio 0.30, 95% CI 0.13-0.68, p = 0.004), and associated with higher eGFR in French/Belgian men. In conclusion, these heterogeneous results suggest that neither CYBB nor GPX4 are major genetic determinants of diabetic nephropathy, but nevertheless, they could modulate in a gender-specific manner the risk for renal disease in patients with type 1 diabetes.

Prevalence of celiac disease in Brazilian children of short stature

The aim of the present study was to determine the prevalence of celiac disease in children of short stature and to assess whether some of the routine laboratory examinations performed to determine the cause of short stature could suggest the presence of celiac disease. A total of 106 children of short stature and no gastrointestinal symptoms were studied. An extensive endocrine work-up had been negative for all of them and an additional investigation was performed by measuring the concentration of antiendomysial antibody. Patients who were positive for antiendomysial antibody (> or =1:10) or who exhibited IgA deficiency (less than 5 mg/dl) were referred for an endoscopic intestinal biopsy. We detected a pathological titer of antiendomysial IgA in six of these patients. Five of them showed histological abnormalities compatible with celiac disease and one had normal histology and was considered to have potential celiac disease. The prevalence of celiac disease in the population studied was 4.7% (with another 0.9% of the subjects being considered to have potential celiac disease). The children with celiac disease did not differ in any of the parameters tested when compared to those without celiac disease, though they showed an improvement in growth velocity after treatment with a gluten-free diet. We conclude that it is important to test all children with short stature for celiac disease by measuring antiendomysial IgA.

[The trajectory towards alternative medicines: an analysis of health professionals' social representations]

This article focuses on social representations of alternative medicines by a group of professors from the School of Medicine and health professionals from the public health system in the city of Campinas, São Paulo, basically physicians and nurses. The article also emphasizes personal trajectories by which these health professionals opted for a dissident theoretical and practical perspective vis-à-vis the hegemonic positivist scientific medical paradigm. The research methods were mainly ethnographic, from a phenomenological perspective. The article concludes by sustaining (in theoretical terms) the importance of these dissident perspectives for scientific development.

[Present status of traffic accidents in the age of speed: an overview]

This article takes an interdisciplinary perspective to studies on traffic accidents on a national and international scale. It begins by analyzing the great increase in the manufacturing and use of motor vehicles worldwide and the resulting social transformations. Particular attention is given to the degradation of the urban environment and the enormous social costs represented by traffic accidents. The author follows with an epidemiological perspective on the victims of traffic accidents. The relationship between personality and traffic accidents deserved special attention, mainly in that it relates to the consumption of alcohol and other drugs, in addition to other law breaking behavior. The article concludes by emphasizing the need for government to implement specifically consistent public policies to control the problem.

[People with leprosy in Campinas, Brazil: an anthropological perspective]

This article studies the life experiences of people with leprosy and their intra-domiciliary families in Campinas, Brazil, based on an analysis of their representations concerning health, disease, and treatment. Taking their living and working conditions as the background, the study sheds light on the strategies that allow them to adapt to social and family life, to obtain a livelihood, and to establish familiarity with the disease process. The article focuses particularly on the way such individuals deal with the problems of regaining their health, in addition to evaluating governmental and nongovernmental health services.

Saúde pública, rede básica e o sistema de saúde brasileiro

Este artigo focaliza o desenvolvimento da saúde pública no Brasil com o intuito de analisar os problemas com os quais se depara o processo atual de municipalização dos serviços de saúde. Argumenta-se que a postura neoliberal ou conservadora tornou-se incapaz de articular uma proposta viável para o sistema de saúde. Por outro lado, a proposta reformista concentra sua atenção no sistema de saúde e sua administração, tendo como modelo a postura positivista das ciências naturais e administrativas. Argumenta-se que apenas uma mudança radical no paradigma da medicina, na qual a dimensão coletiva e social predomina sobre a dimensão biológica e individual, permitiria conciliá-la com as necessidades de saúde da população.