São Paulo medical journal = Revista paulista de medicina
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Brazilian infant and child mortality levels are not compatible with the country's economic potential. In this paper, we provide a description of levels and trends in infant mortality due to perinatal causes and malformations and assess the likely impact of changing intermediate-level determinants, many of which are amenable to direct interventions through the health or related sectors. ⋯ A first priority for the further reduction in infant mortality in Brazil is to improve equality among regions, since the North and Northeast, and particularly rural areas, still show very high death rates. Further reductions in infant mortality will largely depend on decreasing deaths due to perinatal causes. Improvements in the coverage and particularly in the quality of antenatal and delivery care are urgently needed. Another intervention with a potential important impact on infant mortality is the promotion of family planning. Improving birth weight might lead to an 8 % reduction in infant mortality but the efficacy of available interventions is low.
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Breast cancer is the most important neoplasm in adult women, and its worldwide incidence is growing. The tumoral stroma is very important for modulating the growth and invasion of the tumor itself. The relationship between these two components is not completely understood. Schirrous carcinoma is a variant of ductal invasive carcinoma in which the stroma is very desmoplastic, and the importance of this finding still a motive for debate in the literature. ⋯ The intense stromal reaction in invasive ductal carcinoma may modulate the expression of p53. Further investigations should be made with the aim of understanding how this expression determines the proliferative activity in schirrous carcinoma, and whether this overexpression is secondary to mutation of the p53 gene or due to modulation of other molecules of the stroma.
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Identification of Philadelphia chromosome or BCR/ABL gene rearrangement in chronic myeloid leukemia is important at diagnosis as well as after treatment. ⋯ The applicability of FISH is clear, particularly for residual disease detection. Classical and molecular cytogenetics are complementary methods.
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The literature shows an association between several ultrasound markers and chromosome abnormality. Among these, measurement of nuchal translucency has been indicated as a screening method for aneuploidy. The trisomy of chromosome 21 has been most evaluated. ⋯ The measurement of nuchal translucency was found to be fairly accurate as an ultrasound marker for fetal abnormalities and measurements equal to or higher than 2.5 mm were the best fixed cutoff points.