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Further characterization of genetic structural variations should strongly focus on small and endangered local breeds given their role in unraveling genes and structural variants underlying selective pressures and phenotype variation. A comprehensive genome-wide assessment of copy number variations (CNVs) based on whole-genome re-sequencing data was performed on three Brazilian locally adapted cattle breeds (Caracu Caldeano, Crioulo Lageano, and Pantaneiro) using the ARS-UCD1.2 genome assembly. Data from 36 individuals with an average coverage depth of 14.07× per individual was used. A total of 24 945 CNVs were identified distributed among the breeds (Caracu Caldeano = 7285, Crioulo Lageano = 7297, and Pantaneiro = 10 363). Deletion events were 1.75-2.07-fold higher than duplications, and the total length of CNVs is composed mostly of a high number of segments between 10 and 30 kb. CNV regions (CNVRs) are not uniformly scattered throughout the genomes (n = 463), and 105 CNVRs were found overlapping among the studied breeds. Functional annotation of the CNVRs revealed variants with high consequence on protein sequence harboring relevant genes, in which we highlighted the BOLA-DQB, BOLA-DQA5, CD1A, β-defensins, PRG3, and ULBP21 genes. Enrichment analysis based on the gene list retrieved from the CNVRs disclosed over-represented terms (p < 0.01) strongly associated with immunity and cattle resilience to harsh environments. Additionally, QTL associated with body conformation and dairy-related traits were also unveiled within the CNVRs. These results provide better understanding of the selective forces shaping the genome of such cattle breeds and identify traces of natural selection pressures by which these populations have been exposed to challenging environmental conditions., (© 2023 Stichting International Foundation for Animal Genetics.)

Although the order Rodentia does not present a high risk of extinction compared to mammals as a whole, several families demonstrate high levels of threat and/or data deficiency, therefore highlighting the need for targeted research and the application of ecological and reproductive data to the development of conservation actions. The order Rodentia, the largest among mammals, includes 9 families, and the family Cricetidae is the most diverse of the Brazilian rodents. In Brazil, 12 of the 16 genera of Oecomys are found. Oecomys bicolor is known in Brazil as the 'arboreal rat' and is, found in dry, deciduous and tropical forests. The mean body weight of Oecomys bicolor was 35.8 g and the gonadal, tubular and epithelial somatic indexes were, 0.53%, 0.47% and 0.37%, respectively. Seminiferous tubules volume density was 89.72% and the mitotic and meiotic indexes corresponded to 8.59 and 2.45 cells, respectively, and the yield of spermatogenesis was 23.83 cells. The intertubular compartment represented 10.28% of the testis parenchyma and around 5% of the interstitial space was occupied by Leydig cells, whose number per gram of testis was 11.10 × 10 7 cells. By evaluating the biometric and histomorphometric characteristics of the testis, there is evidence that this species has a high investment in reproduction. Due to the high contribution of the seminiferous epithelium and the intertubular compartment in this species, compared to the others of the same family, it is possible to infer that the species Oecomys bicolor has a promiscuous reproductive behaviour., (© 2024 Wiley‐VCH GmbH. Published by John Wiley & Sons Ltd.)

Aim: This study aims to (1) describe trends in explanations provided for racial/ethnic inequities in dental caries and periodontitis, and (2) explore the patterns of relatedness among explanations for these inequities., Materials and Methods: Highly cited publications based on studies indexed in the Scopus database were retrieved and assessed for eligibility. Explanations for racial/ethnic inequities were classified into eight different, but interrelated domains. We assessed trends and examined the relations among explanations using multiple correspondence analysis., Results: A total of 200 articles among the most cited publications were selected. The proportion of studies invoking racism as an explanation for racial inequities in oral health increased from 0% to 14.3%, from 1937 to 2020. The proportions of individual socio-economic factors increased from 52.0% to 82.9%, and dental care from 28.0% to 62.9%. The remaining explanations were stable: psychological/behavioural processes (62.5%), biological factors (49.5%), contextual/area-level effects (24.0%) and immigrant paradox (4.0%). Multiple correspondence analysis revealed a smaller axial distance between racism and the following categories: studies from Brazil, recent publications and Blacks/Hispanics/mixed-race groups. Publications about immigrants were axially closer to the high-income countries category., Conclusions: Our findings call on dental researchers to consider racism as a cause for existing racial/ethnic inequities in oral health., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Sensitive skin is related to environmental factors., Objectives: We aimed to investigate the roles of poorly known associated and triggering factors on sensitive skin in a large global population., Methods: A survey was administrated to a representative sample of the adult population aged 18-75 years in five different countries (Brazil, China, France Russia, and the United States). All participants answered a web-based questionnaire on sociodemographic characteristics, sensitive skin and environmental factors., Results: Among the 10 743 included individuals (5285 men and 5458 women), 48.2% declared that they had sensitive skin. The group with sensitive skin reported significant increases in fatigue, dust or sweating and to a lesser extent food or tobacco consumption. The members of this group also declared that they experienced more sleep disorders than individuals without sensitive skin. Sensitive skin was very frequent in pregnant women, women with painful menstruations or women using contraceptive pills., Conclusions: This large cohort study identified new factors, including female hormonal status, fatigue, sleep disorders and food, associated with sensitive skin. These associations suggest that sensitive skin is not restricted to an epidermal disorder but may be included in a larger context. The identified factors are potential upstream drivers of neurogenic inflammation in sensitive skin., (© 2021 European Academy of Dermatology and Venereology.)

During the colonial period in South America, many autochthonous populations were affected by relocation by European missionary reductions and other factors that impacted and reconfigured their genetic makeup. Presently, the descendants of some "reduced" and other isolated groups are distributed in the Amazonian areas of Peru, Bolivia, and Brazil, and among them, speakers of Takanan and Panoan languages. Based on linguistics, these peoples should be closely related, but so far no DNA comparison studies have been conducted to corroborate a genetic relationship. To clarify these questions, we used a set of 15 short tandem repeats of the non-recombining part of the Y-chromosome (Y-STRs) and mitochondrial DNA (mtDNA) control region sequence data. Paternal line comparisons showed the Takanan-speaking peoples from Peru and Bolivia descended from recent common ancestors; one group was related to Arawakan, Jivaroan, and Cocama and the other to Panoan speakers, consistent with linguistics. Also, a genetic affinity for maternal lines was observed between some Takanan speakers and individuals who spoke different Amazonian languages. Our results supported a shared ancestry of Takanan, Panoan, Cocama, and Jivaroan-speaking communities who appeared to be related to each other and came likely from an early Arawak expansion in the western Amazonia of South America., (© 2023 The Authors. Annals of Human Genetics published by University College London (UCL) and John Wiley & Sons Ltd.)

Introduction: Brazil has experienced transformations in higher education and health services, including launching more inclusive public policies focused on these two areas., Objective: To evaluate the profile of final-year dental students from a Brazilian public university from 2010 to 2019, accompanied by changes in public health and higher education policies., Methods: A prospective observacional study was carried out with final-year dental students. A self-applicable semi-structured questionnaire was applied., Result: Six-hundred and seventy-seven students participated, of which 71.5% were women, 72.9% aged between 21 and 25 years, 96.2% single, and 96.4% were without children. Over ten years, it was possible to identify trends in the profile explained by implementing public policies toward more inclusive access to Brazilian higher education by socioeconomically disadvantaged individuals. Students who completed the course between 2018 and 2019 did not have the state capital city (the wealthiest area) as their origin city and had lower parental education and income levels than dental students graduating between 2010 and 2011. Moreover, working as a primary care dentist in the Brazilian National Health System was considered a professional possibility by 61.4% of the students, and has gained prominence significantly over time, ranging from 21.1% in 2010 to 72.9% in 2019 (p < .05)., Conclusion: Over the study period, concomitantly to advances in public health and higher education policies in Brazil, more diverse access to public dental education was observed, allowing students from low socioeconomic positions to take the education. Changes have also impacted the students' perspectives regarding the need for postgraduate training and a career in public health dentistry. However, these trends need to be consolidated, and public policies continued and strengthened., (© 2022 The Authors. European Journal of Dental Education published by John Wiley & Sons Ltd.)

Purposes: This study aimed to assess the current status of cone-beam computed tomography (CBCT) education in Brazilian undergraduate Endodontic programs., Methods: One hundred program directors were emailed. The questionnaire asked whether the CBCT topic was included in the program, the availability of a CBCT machine, and, the total length of the dental program. For the group that does not teach, seven questions discussed the reasons for not teaching and whether another subject included this topic. For the programs that included CBCT, seven questions discussed the number of hours included, and the impression of the program directors with the quality of the teaching. The chi-square test was used for the correlation between the availability of the CBCT machine and the length of the dental program with the inclusion of the topic., Results: Thirty-five program directors replied to the questionnaire. Twenty-six (74.3%) reported that the topic of CBCT is not included in their programs. There was no impact of the availability of a CBCT machine on the inclusion of the topic (p > 0.05). The increased length of the dental program decreased the inclusion of the topic (p < 0.05). Fifty percent of the directors replied that lack of time is the reason for not including the topic. Among the programs that include CBCT, the majority (55.6%) deliver 3-5 h of lectures. The practical activities range from 1 to 5 h or more. The majority (77.8%) of the directors are satisfied with the content delivered and 44.4% understand that the students are competent in the interpretation of CBCT images., Conclusions: The majority of the Endodontic undergraduate programs in Brazil do not include CBCT in the program. The availability of a CBCT machine does not impact the inclusion of the topic, the increased duration of the dental program decreases the inclusion of the CBCT topic., (© 2022 American Dental Education Association.)

Issues: Cannabis use and related health/social outcome indicator data for Brazil-where non-medical cannabis is generally illegal-are limited., Approach: Towards a comprehensive overview of relevant indicators, we searched primary databases by combining MeSH-index terms related to cannabis, geographic location and subtopic terms (e.g., use, health, mortality) focusing on cannabis use and key outcome indicators in Brazil since 2010. In addition, relevant 'grey literature' (e.g., survey reports) was identified. Key indicator data were mainly narratively summarised., Key Findings: Overall, cannabis use has increased somewhat since pre-2010, with (past-year) use rates measured at 2-3% for general population adults, yet 5% or higher among youth and/or (e.g., post-secondary) student populations. For key risk behaviours, the presence of tetrahydrocannabinol-positivity among motor-vehicle drivers has been measured at <2%. While the prevalence of cannabis use disorder appears to have decreased, the relative proportion of treatment provided for cannabis-related problems increased. National- and local-based studies indicated an association of cannabis use with mental health harms, including depression and suicidality. Although some non-representative and/or local studies contain information, other monitoring data, including cannabis-related risks and harms (e.g., cannabis-related driving, mortality, hospitalisations), are limited in availability., Implications and Conclusion: The prevalence of cannabis use in Brazil is comparably low (e.g., relative to elsewhere in the Americas). Data on numerous key cannabis-related indicators is absent, or limited in scope for Brazil. Considering ongoing evolutions in cannabis control and its status as the most common illicit drug, more comprehensive surveillance of cannabis use and related outcomes is advised., (© 2022 Australasian Professional Society on Alcohol and other Drugs.)

Keloids (K) and hypertrophic scars (HS) are abnormal responses to wound healing that occur as the result of dermal inflammation. Despite the advances on their treatment, many patients still suffer from the negative effects of excessive scarring; its approach is impaired by the lack of objective data on different treatments and the large genetic variability among patients and the difficulties in producing multicentre studies. Their incidence among the Brazilian population is high, as the result of an admixture of Amerindians, Europeans and Africans ancestral roots. With the aim of producing multicentre studies on K and HS, a panel of senior Brazilian dermatologists focused on their treatment was invited to contribute with the K and HS Treatment Brazilian Guidelines. In the first part of this study, different treatment modalities for keloids and HS are fully reviewed by the panel. The second part of the study presents a consensus recommendation of treatment for different types of lesions. More than a literature review, this article aims to show the pitfalls and pearls of each therapeutic option, as well as a therapeutic approach by the Panel of Experts on keloids and Scars on a highly mixed population, providing simple guidelines., (© 2021 European Academy of Dermatology and Venereology.)

Aim: To investigate the agreement between the 2018 EFP/AAP periodontitis case classification and the 2012 CDC/AAP criteria., Materials and Methods: This cross-sectional study assessed a population-based sample from a rural area in southern Brazil. A complete periodontal examination was performed at six sites/tooth. The periodontitis case definition was estimated and compared according to the 2018 EFP/AAP classification and the 2012 CDC/AAP criteria (reference). Diagnostic tests included sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and area under ROC curve (AUC)., Results: Five hundred and eighty-eight subjects with ≥6 teeth each were included. Based on the 2018 EFP/AAP classification, 71.1% of the subjects were classified as stage III/IV showing 100% agreement with 2012 CDC/AAP criteria for the severe category. For the moderate and severe classification, the 2018 EFP/AAP SN was 99.8% and 100%, SP 13.6% and 43.6%, PPV 83.4% and 47.4%, and NPV 93.7% and 100%, respectively. The AUC was 0.9059 (95% CI = 0.879-0.933) and the optimal cut-off based on the curve was stage III., Conclusions: The 2018 EFP/AAP periodontitis case classification showed high agreement with the 2012 CDC/AAP criteria in a rural sample with high periodontitis occurrence., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The importance of movement behaviors for health is well known, although few studies have examined the adherence to movement guidelines in low-income preschoolers from a middle-income country, as Brazil. This study reports the proportion of preschoolers meeting the 24-hour movement guidelines and investigates its associations with demographic correlates in Brazilian low-income preschoolers., Methods: Two hundred and seventy preschoolers (132 boys, means age = 3.97 ± 0.80) provided physical activity (PA) data (Actigraph wGT3X). Sleep duration, screen time, and social correlates were parent-reported. Preschoolers were classified as compliant/not compliant with the 24-hour movement guidelines. Relationships between compliance with movement behaviors guidelines and demographic correlates were calculated using a network analysis (Mplus 8.0; Rstudio)., Results: Preschoolers were active (273.52 ± 62.08 minutes/day of total PA), though moderate-to-vigorous physical activity (MVPA) time was below the guideline (58.68 ± 22.51 minutes/day); spent more than the recommended 60 minutes/day on screen time (169.91 ± 97.07 minutes/day); and slept less than 10 hours per night (9.44 ± 1.12 hours/day). Only 3% of the sample complied with the guidelines. PA showed the highest compliance (43%), compared to sleep duration (35%) and screen time (15%). Male sex was related to adherence to MVPA recommendations, while female sex, with adherence to total PA recommendations. Child's primary caregiver was the most important centrality indicator in the network., Conclusion: Only 3% of the assessed preschoolers are compliant with the 24-hour movement behaviors guidelines. Strategies to promote adherence to movement behaviors among low-income preschoolers should consider child's primary caregivers to support movement behaviors., (© 2020 Wiley Periodicals LLC.)

Background: It is important to clarify the association of lean and fat mass between children and adolescents considering the rising prevalence of overweight and obesity in this age group. The aim of this study was to verify the association between the body adiposity index (BAI) and dual-energy X-ray absorptiometry (DXA) methods for analyzing body composition, as well as analyzing the validity of BAI to verify the percentage of fat in children and adolescents., Methods: The sample was composed of 106 children and adolescents, 44 females (age: 11.5 ± 1.8 years) and 62 evils (13.6 ± 2.6 years). The body fat (%F) was measured using DXA and the doubly indirect BAI body fat estimation technique., Results: The BAI and DXA estimates of %F were strongly correlated (boys: r = .71, P < .0001; girls: r = .72, P < .0001). The linear regression analyses showed that BAI is significant to estimate the %F in total sample (P < .0001). For boys, the %F analyzes performed by BAI and DXA did not show any differences when compared (P = .2). In addition, BAI pointed out a significant proportion bias for both sexes (P < .0001), which suggests its inefficiency in the analysis of %F., Conclusions: BAI and DXA correlate; however, there is low reliability and a high proportion bias for the analysis of %F by BAI., (© 2020 Wiley Periodicals LLC.)

Rationale, Aims, and Objectives: The growth of clinical pharmacy services (CPS) has positively impacted clinical, economic, and humanistic health outcomes. However, detailed studies on the process of implementing CPS in healthcare systems are incipient. Thus, the present study aimed to evaluate the CPS implementation in certain public health units in a metropolis in northeast Brazil., Methods: A quasi-experimental before-and-after study was carried out in Recife City, from July 2015 to March 2016. The study was carried out using the Methodology of Problematization with Maguerez Arc and was divided into: initial evaluation (before), planning, interventions, and preliminary evaluation (after). The participants were pharmacists, patients, health professionals, and local health managers. Descriptive statistics were used to report data. The statistical significance of the comparison between variables was evaluated using the Wilcoxon test (95% CI; P ≤ .05)., Results: Initial evaluation: Identified incipient CPS, a lack of structure and work process of pharmacists. Planning: Sixteen brainstorming meetings were held with the different actors resulting in a strategic plan., Intervention: Twenty-two political-administrative meetings were held with managers and health teams and 768 hours of theoretical and practical training with mentoring for pharmacists. Preliminary evaluation: Structure indicators presented a statistically significant difference, differently from the process indicators. Pharmacists attended 842 patients and performed 1465 pharmaceutical consultations in 6 months. Regarding the outcome indicators, it was possible to identify changes in the clinical status of the most prevalent diseases among those patients who attended three pharmaceutical consultations., Conclusions: It was possible to evaluate the CPS implementation in certain public health units in a metropolis in Brazil, through the Methodology of Problematization with Maguerez Arc. This methodology may be part of models for future implementations of CPS in health systems., (© 2020 John Wiley & Sons Ltd.)

There are two principal types of nickel (Ni) deposits: sulfide and laterite ores. Interest in low-grade Ni-laterite ores has increased in recent years as high-grade Ni-sulfide deposits are being quickly depleted. However, processing of Ni laterites has proven technically difficult and costly, and the development of alternative low-cost biotechnologies for Ni solubilization has been encouraged. In this context, by the first time, a sample of Brazilian Ni-laterite ore was analyzed mineralogically and subjected to bioleaching tests using a heterotrophic Bacillus subtilis strain. SEM-analysis indicated that the primary Ni carrier mineral is goethite. Chemical analysis of different grain size fractions indicated a homogeneous distribution of Ni. XRF-analysis showed that the ore consists mainly in lizardite (32.6% MgO) and contains1.0% NiO (0.85% Ni). Bioleaching batch experiments demonstrated that about 8.1% Ni (0.7 mg Ni/g ore) were solubilized by the B. subtilis after 7 days. Application of microwave heating as a Ni-laterite pretreatment was also tested. This pretreatment increased the bioextraction of Ni from 8% to 26% (2.3 mg Ni g -1 ore)., (© 2019 American Institute of Chemical Engineers.)

Aim: This scoping review aimed to identify and appraise the effectiveness and impact of breastfeeding promotion interventions conducted across Portuguese-speaking sovereign countries., Methods: Using the PRISMA-ScR guidelines, we searched 14 electronic databases for publications published through 31 July 2023. The search terms were designed to find studies promoting breastfeeding or exclusive breastfeeding in pre-defined Portuguese-speaking countries., Results: Of the 5263 papers initially retrieved, 30 interventional studies on breastfeeding met the inclusion criteria across three countries: Brazil (N = 26), Portugal (N = 2) and Guinea Bissau (N = 2). Participants ranged from pregnant women, mothers, mother-infant pairs, healthcare professionals, and school children. Overall, the interventions increased exclusive breastfeeding and better breastfeeding practices, such as a higher duration of breastfeeding. The interventions positively affected maternal breastfeeding self-efficacy, knowledge and perception. Only four studies used a theoretical framework., Conclusion: While the results were often statistically significant, no study had an outcome close to the recommended UNICEF and WHO goal of 70% breastfeeding at six months. The need to determine what works for the recommended six months postpartum period is critical for maximising children's health in Portuguese-speaking countries., (© 2024 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Objective: The aim of this paper is to provide an overview of the major quality assurance strategies, accreditation and licensure, in health professions education. It explores the nature of these regulatory processes using Brazil and the United States as examples because these large systems are at different ends of the developmental continuum. For each, it describes the tensions that arise, offers a critical synthesis of the evidence and maps out future directions., Results: Given wide variability among operating medical schools in curricular design, length of study, resources and facilities for clinical training and supervision, the nature of regulatory bodies varies considerably. Nonetheless, they share tensions related purpose and process including quality assurance versus quality improvement, outcomes versus process and continuous versus episodic evaluations and assessments. Clear evidence of effectiveness, especially for accreditation, is scarce and difficult to obtain, particularly as it relates to health outcomes., Conclusions: Regulatory processes need to be built around clear definitions of the goals for each stage of professional development, the current movement towards competency-based education and the variable durations of medical education. These changes must motivate revisions in the content and process of programmes for accreditation and licensure, complimentary efforts towards quality of care, and stimulate a significant research effort., (© 2022 Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Aim: This study evaluated medication poisoning in paediatric patients through a systematic review and a retrospective documentary analysis in a Brazilian toxicological centre., Methods: The data were systematically collected on PubMed, Scopus and SciELO databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We included epidemiologic and prevalence studies that were published in English or Portuguese from 2013 to 2017 and covered paediatric patients. The retrospective incidence study was carried out in a Brazilian toxicological centre and was a documentary analysis of paediatric medication poisoning cases from 2005 to 2015., Results: The systematic review comprised 13 papers covering 895 206 poisoning cases from six different countries. The main agents of intoxication were analgesics and antihistamines. The eight papers that explored the reasons for the poisonings showed that 93% of those 762 863 cases were accidental. The Brazilian toxicological centre recorded 443 paediatric patients poisoned by medication such as benzodiazepines, analgesics and antibiotics and found that 63.2% were accidental. However, it agreed with the global findings in many other aspects., Conclusion: The systematic review showed a sustained number of paediatric medication toxicity cases worldwide and the key findings were broadly reflected by the retrospective study carried out in the Brazilian toxicological centre., (© 2020 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

A new disease called coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) virus, was discovered in the city of Wuhan in China in December 2019, and has reached, quickly and progressively, several countries on different continents. Even before the World Health Organization recognized the COVID-19 epidemic as a pandemic, the Brazilian Ministry of Health had already declared COVID-19 a national public health emergency due to the confirmation of cases in Brazil. In this scenario, the educational sector was one of the first to suffer the effects of the pandemic soon after the announcement of social distancing as a way to prevent the collapse of the Unified Health System. The aim of this paper is to report how Brazilians dental schools are leading with the new coronavirus pandemic., (© 2020 American Dental Education Association.)

Aims: This paper presents updated prevalence estimates of awareness, ever-use, and current use of nicotine vaping products (NVPs) from 14 International Tobacco Control Policy Evaluation Project (ITC Project) countries that have varying regulations governing NVP sales and marketing., Design, Setting, Participants and Measurements: A cross-sectional analysis of adult (≥ 18 years) current smokers and ex-smokers from 14 countries participating in the ITC Project. Data from the most recent survey questionnaire for each country were included, which spanned the period 2013-17. Countries were categorized into four groups based on regulations governing NVP sales and marketing (allowable or not), and level of enforcement (strict or weak where NVPs are not permitted to be sold): (1) most restrictive policies (MRPs), not legal to be sold or marketed with strict enforcement: Australia, Brazil, Uruguay; (2) restrictive policies (RPs), not approved for sale or marketing with weak enforcement: Canada, Malaysia, Mexico, New Zealand; (3) less restrictive policies (LRPs), legal to be sold and marketed with regulations: England, the Netherlands, Republic of Korea, United States; and (4) no regulatory policies (NRPs), Bangladesh, China, Zambia. Countries were also grouped by World Bank Income Classifications. Country-specific weighted logistic regression models estimated adjusted NVP prevalence estimates for: awareness, ever/current use, and frequency of use (daily versus non-daily)., Findings: NVP awareness and use were lowest in NRP countries. Generally, ever- and current use of NVPs were lower in MRP countries (ever-use = 7.1-48.9%; current use = 0.3-3.5%) relative to LRP countries (ever-use = 38.9-66.6%; current use = 5.5-17.2%) and RP countries (ever-use = 10.0-62.4%; current use = 1.4-15.5%). NVP use was highest among high-income countries, followed by upper-middle-income countries, and then by lower-middle-income countries., Conclusions: With a few exceptions, awareness and use of nicotine vaping products varied by the strength of national regulations governing nicotine vaping product sales/marketing, and by country income. In countries with no regulatory policies, use rates were very low, suggesting that there was little availability, marketing and/or interest in nicotine vaping products in these countries where smoking populations are predominantly poorer. The higher awareness and use of nicotine vaping products in high income countries with moderately (e.g. Canada, New Zealand) and less (e.g. England, United States) restrictive policies, is likely due to the greater availability and affordability of nicotine vaping products., (© 2019 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

We compared Brazilian oral cleft (OC) frequencies between the population-based Brazilian System of Live Birth (SINASC) and the hospital-based Latin American Collaborative Study of Congenital Malformations (ECLAMC), trying to understand the paucity of cleft of lip and palate (CLP) in the first system. SINASC uses the International Classification of Disease version 10 (ICD-10) for congenital defects coding, ECLAMC uses ICD-8 with modifications. In SINASC, the CLP frequency was 1.7 per 10,000 (95% confidence limits 1.7-1.8), cleft lip (CL) 1.6 (1.5-1.7), and cleft palate (CP) 2.0 (1.9-2.1). In ECLAMC, the CLP frequency was 10.4 per 10,000 (9.0-12.1), CL 5.5 (4.5-6.7), and CP 4.4. (4.5-6.7). In SINASC, only 33% of the oral clefts were CLP, versus 51% in ECLAMC. Part of this discrepancy may have been due to the relative excess of CP and CL cases. Although congenital defect frequencies are usually lower in population than in hospital-based registries, differences in the proportion of the main OC categories are not expected and are probably due to ICD-10 coding issues, such as lumping of unilateral CL and CL without other specifications. ICD-10 codes, whose deficiency for oral clefts is fully explained in the literature, lack modifiers for severity, or clinical subtypes. This paper shows the practical aspect of the ICD-10 system deficiency in capturing cleft lip and palate (CLP) subtypes, as demonstrated in SINASC covering three million births per year. Such errors are expected to occur in any registry that uses the ICD-10 coding system, and must be adjusted, given its relevance worldwide., (© 2018 Wiley Periodicals, Inc.)

Introduction and Aims: Given a scenario of intense discussion about the legal situation of cannabis users worldwide, this paper aims to investigate the role of cannabis within a drug use sequencing pattern., Design and Methods: Data came from a representative sample of college students from 27 Brazilian capitals (n = 12 711). We analysed the patterns of transition from/to the first use of cannabis to/from the first use of alcohol, tobacco and seven other illegal drugs. Survival analysis methods were used to analyse age of onset data on all potential drug pairs. Drugs that were not specified as the target drug pair tested in each survival model were included as time-varying covariates in all models., Results: We found significant transitions from alcohol [adjusted hazard ratio (aHR) = 1.41, 95% confidence interval (CI) 1.15-1.73, P < 0.001] and inhalants (aHR = 1.56, 95% CI 1.26-1.93, P < 0.001) to cannabis. Moreover, we found significant transitions from cannabis to alcohol (aHR = 2.40, 95% CI 1.47-3.91, P < 0.001), cocaine (aHR = 7.47, 95% CI = 4.26-13.09, P < 0.001), prescription opioids (aHR = 2.16, 95% CI 1.29-3.63, P < 0.01) and tranquilisers (aHR = 1.51, 95% CI 1.11-2.06, P < 0.01)., Discussion and Conclusions: Overall, our findings point to a strategic role of cannabis within drug first use sequence pattern. We had an important and unexpected finding-the bi-directional relationship between alcohol and cannabis. In addition, the first use of cannabis still precedes the first use of cocaine and non-medical use of tranquilisers and prescription opioids. [Castaldelli-Maia JM, Nicastri S, Cerdá M, Kim JH, Oliveira LG, Andrade AG, Martins, SS. In-transition culture of experimentation with cannabis in Latin American college students: A new role within a potential drug use sequencing pattern. Drug Alcohol Rev 2017;00:000-000]., (© 2017 Australasian Professional Society on Alcohol and other Drugs.)

Although well documented in matrilocal primate species, group fission is still a poorly known phenomenon among patrilocal primates. In this paper we describe in detail a group fission event in the population of northern muriquis at the Reserva Particular do Patrimônio Natural-Feliciano Miguel Abdala in Caratinga, Minas Gerais, Brazil, using Social Network Analyses (SNA). Data on association patterns were collected during systematic observations from May 2002 to September 2005, and analyzed for dry (from May to October) and rainy seasons (from November to April). The fission process started with subgroup formation in the rainy season 2002-2003, and was completed by the dry season of 2003. By the dry season 2003, the parent group (Jaó) had fissioned to form a second mixed-sex group (Nadir) while a subgroup of males (MU) moved between the parent group and the newly established group. Before the Jaó group fission started (dry season 2002) and during its initial phases (rainy season 2002-2003), females that ultimately composed the daughter group (Nadir) were the most peripheral in the association network. In the rainy season 2002-2003, the median monthly (N=6) operational sex ratio (OSR) of Jaó group was 2.81. However, once Jaó females initiated the fissioning process to establish the Nadir group, the OSR was more favorable to males in the Nadir group than in the Jaó group. Our results suggest that males followed the females to escape an unfavorable OSR in their natal group., (© 2013 Wiley Periodicals, Inc.)

While individual studies from several South American countries have shown driving while intoxicated to be a problem, there are no objective systematically collected alcohol-associated driving data obtained in most South American countries. This limits their ability to implement and enforce targeted prevention strategies, evaluate whether proven prevention efforts from North America (particularly the United States and Canada) can be transferred to the South, and to sustain momentum for the improvement of road safety by demonstrating that previously implemented legal and policy changes are effective. The aim of this paper is to discuss the abysmal differences that exist between northern and southern American countries regarding the current status of driving while intoxicated prevention strategies-their implementation, impacts and effects-using Brazil as a case example. We propose a three-pronged approach to close this northern-southern American gap in driving while intoxicated prevention and intervention: (a) systematic collection on road traffic crash/injury/death as well as risk factor data, (b) passage of laws without loopholes requiring compliance with blood alcohol concentration testing and (c) provision of appropriate training and equipment to the police in concomitance with vigilant enforcement. Resources and energies must be put towards data collection, implementation of prevention strategies and enforcement in order to decrease the unacceptably high rates of these preventable driving while intoxicated deaths., (© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.)

The National Institute of Public Policy for Alcohol and Other Drugs (INPAD) is based at the Federal University of São Paulo, Brazil, and was created to collect scientific evidence regarding epidemiology, develop new therapeutic approaches, study health economics and provide education to subsidize the proper measures to change the Brazilian scenario of alcohol and drug consumption. Policies directed towards the control of alcohol and drugs in Brazil are fragmented, poorly enforced and therefore ineffective. The unregulated market of alcohol in Brazil has contributed to the worsening health of the Brazilian population. Since 1994, INPAD has participated actively in academic debates and discussions about alcohol and drug policies and their effects on the political welfare of the country. Many scientific papers and books have been published on this subject, and the internet and other media have provided excellent opportunities for the dissemination of specialized information to the general population., (© 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.)

Context: Research activity is not a mandatory component of medical education in many developing countries, including Brazil, although such experiences can have a positive impact on the quality of medical education. The interest and involvement of medical students in research and the barriers they face in accessing research training in developing countries have not been adequately addressed., Objectives: We sought to assess the availability of scientific training programmes in Brazilian medical schools, the degree of involvement of medical students in these programmes, the main barriers to student involvement in research and possible reasons for the lack of scientific training programmes., Methods: This study examined 13 medical programmes conducted in six Brazilian states. A total of 1004 medical students were interviewed. We evaluated the availability of scientific training in the institutions attended by these students, the participation of the students in such activities and students' reasons for not joining such programmes based on student answers to our questionnaire., Results: Although only 7% of the medical students expressed no interest in research, only 60% of them were involved in research training. Students regarded a lack of institutional incentive as the most significant barrier to their participation in research activities. Other significant barriers included defective infrastructure and insufficient time available for professors to mentor undergraduate students. According to the feedback from the students, eight of the 13 schools investigated featured structured programmes for scientific training. However, a mean of only 47% of students participated in scientific training programmes on their campuses and 13% of students were compelled to pursue such activities off-campus., Conclusions: Although scientific training during medical education in Brazil is still less frequent than expected, most of the students were interested in research activities. The barriers to undergraduate scientific training described in this paper may help the Brazilian government improve research training in medical schools. These issues might also be explored in other developing countries., (© Blackwell Publishing Ltd 2011.)

The revised Drug Use Screening Inventory (DUSI-R) is a self-report questionnaire designed to quantify the severity of problems that are commonly associated with consumption of alcohol and other drugs. This study extends research conducted on the US population to determine whether the DUSI-R's substance abuse scale discriminates Brazilian youths in treatment (n = 41) from a general population sample (n = 43). A Portuguese translation of the substance abuse scale was administered in paper and pencil format at the time of intake into treatment and to randomly selected youths in school. The mean score on the 15-item substance abuse scale in the treatment group was 6.7 compared to 1.9 in the comparison group (t = 6.78; p < .001). The optimal cut-off score of two positive endorsements has 85% sensitivity and 70% specificity. This study demonstrates that the DUSI-R's substance abuse scale is valid for screening Brazilian youths who require treatment.

The buttonhole technique of access of needle insertion into a single selected site in the arteriovenous fistula has proved to be a reliable alternative to older methods due to its overall low complication rates. Although the use of blunt needles improves the technique, the success rate of cannulation with these needles is difficult to predict. We analysed the short-term outcome of 16 patients receiving in-centre haemodialysis and compared clinical relevant parameters between patients with and without buttonhole technique failure. Our dialysis unit treats about 180 patients and is located in a tertiary hospital in Sao Paulo, Brazil. The variables as discussed in the paper were the same for both groups. The incidence of technique failure was 43.7%. Patients enrolled later in the study had a better buttonhole failure-free survival rates than patients enrolled at the beginning (p < 0.05). Patients' clinical characteristics did not predict the success rate of buttonhole tunnel tracks cannulation with blunt needles. This paper also reports on our successes and failures in buttonhole technique and gives some reasons and reflections for both.

Compared to other mammals, human milk is dilute which lowers the relative daily cost of lactation allowing women greater flexibility in the strategies they use to meet the energy demands of lactation. These strategies include increasing dietary intake, reducing energy expenditure, and drawing on energy stores. Women are affected by the biosocial context in which they live, including norms regarding the sexual division of labor and diet and activity patterns during lactation, as well as household-level factors such as economic strategy and the availability of social support. This paper combines longitudinal data on dietary intake, energy expenditure, and body weight of 23 lactating Amazonian women living in a subsistence-based economy with detailed ethnographic data and considers how adherence to the cultural norms and the availability of social support contributed to intra-population variation in maternal energetic strategies. Dietary intake was found to vary more than energy expenditure. Adherence to dietary restrictions during the postpartum period of resguardo significantly reduced intra-population variation in energy intake. Women with social support came closer to achieving energy balance during resguardo (t = 2.8; P = 0.01) and peak lactation (t = 2.7; P = 0.02) and lost less weight (t = 3.6; P = 0.002) than those without such support. Those with social support had higher energy (t = 2.1; P = 0.05) and carbohydrate (t = 2.1, P = 0.05) intakes during resguardo and spent significantly less time in subsistence work during peak (t = 2.6, P = 0.03) and late lactation(t = 2.4, P = 0.03). Case studies are used to place these finding in context.

Context: Reflective practice has been suggested to be an important instrument in improving clinical judgement and developing medical expertise. Empirical evidence supporting this suggestion, however, is absent. This paper reports on an experiment conducted to study the effects of reflective practice on diagnostic accuracy., Methods: Participants were 42 internal medicine residents in hospitals in 2 states in the northeast of Brazil. They diagnosed 16 clinical cases. The experiment employed a repeated measures design, with 2 independent variables: the complexity of clinical cases (simple or complex), and the reasoning approach induced to diagnose the case (participants were instructed to diagnose each case either through pattern recognition or reflective reasoning). The dependent variable was the accuracy of the diagnosis provided for each case. All participants participated in each of the 2 levels of both independent variables., Results: A main effect of case complexity emerged. There was no statistically significant main effect of reflective practice. However, a significant interaction effect was found between case complexity and mode of processing (F[1,41] = 4.48, P < 0.05), indicating that although reflective practice did not make a difference to accuracy of diagnosis in simple cases, it had a positive effect when diagnosing complex cases., Conclusions: Reflective practice had a positive effect on diagnosis of complex, unusual cases. Non-analytical reasoning was shown to be as effective as reflective reasoning for diagnosing routine clinical cases. Findings support the idea that reflective practice may particularly improve diagnoses in situations of uncertainty and uniqueness, reducing diagnostic errors.

Context: Two modes of case processing have been shown to underlie diagnostic judgements: analytical and non-analytical reasoning. An optimal form of clinical reasoning is suggested to combine both modes. Conditions leading doctors to shift from the usual mode of non-analytical reasoning to reflective reasoning have not been identified. This paper reports a study aimed at exploring these conditions by investigating the effects of ambiguity of clinical cases on clinical reasoning., Methods: Participants were 16 internal medicine residents in the Brazilian state of Ceará. They were asked to diagnose 20 clinical cases and recall case information. The independent variable was the degree of ambiguity of clinical cases, with 2 levels: straightforward (i.e. non-ambiguous) and ambiguous. Dependent variables were processing time, diagnostic accuracy and proposition per category recalled. Data were analysed using a repeated measures design., Results: Participants processed straightforward cases faster and more accurately than ambiguous ones. The proportion of text propositions recalled was significantly lower (t[15] = 2.29, P = 0.037) in ambiguous cases, and an interaction effect between case version and proposition category was also found (F[5, 75] = 4.52, P = 0.001, d = 0.232, observed power = 0.962). Furthermore, participants recalled significantly more literal propositions from the ambiguous cases than from the straightforward cases (t[15] = 2.28, P = 0.037)., Conclusions: Ambiguity of clinical cases was shown to lead residents to switch from automatic to reflective reasoning, as indicated by longer processing time, and more literal propositions recalled in ambiguous cases.

Lactation is the most energetically demanding part of human reproduction; yet, compared with pregnancy, we know little about the strategies women in different settings employ to cope with these increased energy demands. This paper takes a biocultural approach and reports longitudinal data on the anthropometry, dietary intakes and energy expenditure of a sample of 23 rural, lactating Ribeirinha women living in subsistence-based communities in the eastern Amazon. The dietary intakes of these lactating women were insufficient to meet their lactating energy needs and were least sufficient during resguardo, a 40-day period in the immediate postpartum when the women observed a series of food taboos and work restrictions. Instead, the women in this study met the increased energy demands of lactation by drawing on their energy reserves and reducing their energy expenditure in physical activity. The women showed a significant reduction in weight (P<0.001), BMI (P<0.001) and in circumferences (hip, P=0.01; waist, P=0.03) and skinfolds (thigh, P=0.03) in the gluteal femoral region. Total daily energy expenditure (TDEE) was lowest during resguardo and increased as lactation progressed (P=0.01). While the practice of resguardo reduced maternal energy expenditure and allowed women more time to spend with their newborn infants, it came at a cost (low dietary intake), which appears to be related to the loss of the adult woman from subsistence activities. By taking a biocultural approach this study illustrates the role the social environment plays in shaping the experience of lactating women., (Copyright (c) 2007 Wiley-Liss, Inc.)

Many arboreal primates descend to the ground, a custom that may occur more frequently in disturbed habitats, and in the presence of researchers to whom the primates are habituated. In this paper, we describe opportunistic observations of ground use in two groups of northern muriquis (Brachyteles hypoxanthus) at the RPPN Feliciano Miguel Abdala, Minas Gerais, Brazil. Members of both groups were observed drinking, resting, feeding, playing, and traveling on the ground to different degrees, and variation in the levels of habituation of the two groups may be responsible for the differences in the distribution of their terrestrial activities. The potential increase in vulnerability to predation or disease owing to ground use has implications for the conservation of this critically endangered species., ((c) 2007 Wiley-Liss, Inc.)

The present study is part of a large research project on growth, development, nutrition, and health of Caboclo populations from the Brazilian Amazon. The aim of this paper is to analyze the age of menarche in adolescents (N=164) and adult women (219) in the studied populations. Caboclo are admixed rural, peasant groups that live along the Amazon river and its tributaries, and there are few previous studies about them. Probit analysis of the status quo data yielded a median age at menarche of 12.29+/-1.76 years. The retrospective method was applied to recall data of the 77 post-menarcheal adolescents, yielding an average of 13.06+/-1.27 years. Number of children in the family did not show any statistical influence on age at menarche in any age group. In adult women, age at menarche decreased from 14.50 in those born in 1930 to 12.88 for those born in 1980 (F=4.371, P=0.001). The downward trend found was, on average, 0.237 year per decade in the study period. The median age at menarche in the adolescents (12.29 years) is one of the lowest values found for Central and South American populations. In the ecological context, a low age at menarche could be an adaptive advantage because it provides a greater chance for reproduction at a young age in an environment where, until recently, life expectancy was low. As has been reported for other developing countries, the change found in age at menarche in the women born from the 1930s to the 1980s is likely to be related to changes in health and nutritional factors that occurred in Brazil because this country experienced significant improvement in living standards related to education, vaccination, and health conditions, which, although not equally, reached all regions after the 1960s., (Am. J. Hum. Biol. 18:83-92, 2006. (c) 2005 Wiley-Liss, Inc.)

Birth seasonality in wild neotropical primates has been suggested to increase with latitude as a response to a stronger divergence in high-quality food availability across the year, and a higher between-year predictability at higher latitudes related to temporal differences in photoperiod. In captivity, however, monkeys are fed foods of similar quality throughout the year, and this consistency of diet should have a releasing effect on the need for birth seasonality. In this paper, we test whether 1) brown capuchin monkeys (Cebus apella) breed seasonally in captivity, and 2) given the consistency of diet in this setting, differences in latitude are reflected in the temporal pattern of birth distribution across the year. Data on the distribution of birth records of C. apella at Brazilian zoos located within three latitudinal zones (Equator perpendicular 8 degrees S, 16 degrees perpendicular 24 degrees S, and 24 degrees perpendicular 32 degrees S) are compared. Captive C. apella showed a birth peak from October to February, despite the consistent provision of food in this setting. In addition, there were no differences in the pattern of birth distribution among the latitudinal zones, which lends no support to the prediction that captive C. apella birth seasonality would increase with latitude. We suggest that if this species is not sensitive to subtle differences in photoperiod, other environmental cues may trigger the onset of reproduction at lower latitudes., (Copyright 2005 Wiley-Liss, Inc.)

This research examines phylogenetic relationships between members of the Atelinae subfamily (Alouatta, Ateles, Brachyteles, and Lagothrix), based on analysis of three genetic regions. Two loci, cytochrome c oxidase subunit II (COII) and the hypervariable I portion of the control region, are part of the mitochondrial genome. The other is a single-copy nuclear gene, Aldolase A Intron V. Analysis of these genetic regions provides support for tribe Alouattini containing the Alouatta species, while tribe Atelini contains the other three genera. However, these three genetic regions produce conflicting results for relationships among tribe Atelini members. Previous genetic studies supported grouping Brachyteles with Lagothrix, leaving Ateles in a separate subclade. The present data sets vary based on the genetic region analyzed and method of analysis suggesting all possible cladistic relationships. These results are more consistent with investigations of morphology and behavior among these primates. The primary cause of discrepancy between this study and previous genetic studies is postulated to reside in increased sampling in the present study of genetic variation among members of the Atelinae, specifically Ateles. The present study utilized samples of Ateles from all postulated species for this genetically variable primate, while previous studies used only one or two species of Ateles. This paper demonstrates that shifting relationships are produced when different species of Ateles are used to reconstruct phylogenies. This research concludes that a trichotomy should still be supported between members of tribe Atelini until further analyses, which include additional Atelinae haplotypes are conducted., (Copyright 2003 Wiley-Liss, Inc.)

Background: A single nucleotide polymorphism was described in the promoter region of the human MMP-1 gene, and this polymorphism has been associated with risk of cancer metastasis and inflammatory diseases. In this paper, we studied the possible relationship between the MMP-1 promoter polymorphism and the severity of chronic periodontitis., Methods: Genomic DNA from oral mucosa was amplified by PCR and analyzed by restriction endonuclease. The alleles were separated by polyacrylamide gel electrophoresis. The significance of the differences in observed frequencies of polymorphism in moderate and severe disease and healthy groups was assessed by Chi-squared test., Results: In the healthy group, the 2G allele was observed with a frequency of 48.7%, while in severely diseased patients the 2G allele was seen in 69.2% (P = 0.0344). The genotype 2G/2G was found in 46.15% of the group with severe periodontitis, and 24.3% and 25.0%, respectively, of the healthy and moderate groups (P = 0.0647)., Conclusion: These results show that a polymorphism in the promoter region of MMP-1 gene is associated with the severe chronic periodontitis phenotype in non-smokers.

This paper presents an osteobiographic analysis of a single skeleton found in a small rock shelter known as Toca dos Coqueiros, Piauí, Brazil. This find is of interest because of an exceptionally old radiocarbon date associated with it. The date (11,060 BP) was obtained from charcoal associated directly with the skeleton. This is an interesting find because of the rarity of osteobiographic studies of skeletons of such antiquity. Despite the existence of two projectile points in association with the burial, the morphological and molecular analyses of the skeleton demonstrated that this was a female. She was about 35-45 years of age at death. The skeleton exhibited acute and chronic bone lesions. Oral pathology was also observed, including an interproximal dental groove, probably caused by the therapeutic use of a cactus thorn. This could be one of the oldest cases of an analgesic plant used in the prehistoric Americas., (Copyright 2002 Wiley-Liss, Inc.)

The purpose of this paper is to describe the development and progress of the first heart valve homograft bank in Brazil as well as to report the 5-year clinical results. The bank was started in 1995 and employs modern techniques of cryopreservation. Organ procurement increased from 11 hearts in 1995 to 138 hearts in 2000. In the beginning of the experience, only 2 hospitals were using these valves, but this increased to 18 centers in 2000. Clinical experience at the major center includes 117 cases of the Ross procedure, 62 aortic homograft implantations, and 18 cases of mitral homografts. Five-year survival after the Ross procedure was 99.1%, and survival free from any kind of complication was 88.8%. No patients are on anticoagulants, and the incidence of thromboembolism was null. We conclude that auto- and homografts are probably the best alternative to aortic valve replacement for young patients in developing countries.

Unlabelled: Three-hundred-and-ninety-seven children aged 2-59 mo presenting to the paediatric emergency departments of five public hospitals in São Paulo, Brazil, with an acute episode of lower respiratory disease were examined. The children were classified into the following diagnostic categories: acute bronchitis, acute bronchiolitis, pneumonia, asthma, post-bronchiolitis wheezing and wheezing of uncertain aetiology. Three years after the initial study, the homes of the children diagnosed as asthmatic or as having wheezing of uncertain aetiology were visited to collect information on subsequent episodes of lower respiratory disease. This paper reports the proportional incidence of different categories of lower respiratory disease and the results of an analysis to investigate clinical features that might distinguish wheezing children between those with asthma and those with an infectious disease. The predictions made for children with wheezing of uncertain aetiology were then compared with the follow-up data. Recurrent wheezing disorders (asthma, post-bronchiolitis wheezing) were common in the study sample (47% of children). Thirty-six percent of children with an initial diagnosis of wheezing of uncertain aetiology were diagnosed as asthmatic by another doctor over the next 3 y. We were unable to identify any clinical features that were useful in identifying those children likely to be diagnosed subsequently as asthmatic., Conclusions: The use of a diagnostic category similar to that which we have called "wheezing of uncertain aetiology" might help to alert physicians early to the possibility of asthma without interfering in the management of the illness. Such a classification might also be useful in epidemiological investigations of the aetiology of lower respiratory diseases.

This paper presents an assessment of enamel defects (hypoplasias) in the permanent anterior teeth of three Tupí-Mondé-speaking groups from the Brazilian Amazonia: the Gavião, Suruí, and Zoró. These are native societies that experienced the onset of permanent contact with Brazilian national society in different periods of the 20th century. Tupí-Mondé dentition is highly hypoplastic, which is possibly related to exposure to adverse health and nutritional conditions. Data for the Gavião, Suruí, and Zoró are in agreement with results from other populations that show that certain teeth, the maxillary central incisors and the mandibular canines in particular, tend to be more hypoplastic. Although all types of teeth show hypoplasia concentrations at some enamel zones, there is substantial intertooth variation in the age at which peaks occur. It is argued that hypoplasia concentrations at certain ages are unlikely to be related to postweaning stresses for the Tupí-Mondé. Statistically significant associations between presence of enamel defects and deficits in physical growth (height-for-age) were detected in children 7-11 years of age. Diachronic assessment of enamel defects, which rested upon the potential of enamel as "memory" of past periods of systemic physiological perturbation, allowed us to unravel aspects related to the dynamics of Tupí-Mondé life during the 20th century. Frequencies of enamel zones with defects peaked during the contact years of each of the Tupí-Mondé groups, attesting to the extreme social and biological hardships that characterized the contact experiences of these native societies with Brazilian national society.

Deficiency of adrenal steroid 21-hydroxylase is the most common form of congenital adrenal hyperplasia and it is considered to be responsible for 90% of the disease. This paper describes for the first time the CYP21B mutation profile in Brazilian patients. We genotyped 41 families with at least one individual affected with the classical form of the 21-hydroxylase deficiency, representing 74 unrelated alleles. In order to characterize different disease-causing alleles, genotyping was performed by Southern blot analysis with three restriction enzymes, allele-specific oligonucleotide hybridization, and allele-specific PCR. Different alleles were distinguished by TaqI C4B RFLP, gene duplications or deletions of either CYP21A + C4B or CYP21B + C4B, large gene conversions and eight mutations that might have been introduced into CYP21B from CYP21A by microconversion events. At least one mutation was detected in 24 different disease-causing alleles, which represents about 85% of the affected alleles in those families. The frequency of the 30 kb deletion of CYP21B was lower than that described for Caucasians. The mutation Sp2 showed the highest frequency (24.65%) and was present mainly in salt-wasting patients, although it was also detected in some patients with the simple virilizing form of the disease. Conversely, I172N showed a frequency of 18.91% and was found mostly in patients affected with the simple virilizing form of the disease. Five other mutations were determined at low frequency, but CL6 was not found in any of the tested alleles.

Analysis of factor IX gene polymorphisms is considered the best approach for prenatal diagnosis and carrier detection of haemophilia B when the identification of the gene mutation is not possible. Studies involving factor IX gene polymorphisms in Black populations are scarce and essentially restricted to the North-American Black population whose composition is substantially different from that of the Brazilian and presumably other Black populations of South America. In this paper we report the analysis of eight factor IX gene polymorphisms in Brazilian Blacks: 5' BamHI, DdeI, intron 2 BamHI, XmnI, TaqI, TaqI, MspI, MnlI and HhaI. Characterization of the VNTR-like DdeI polymorphism revealed six different alleles: B, AB, A2B, A2B2, A3B and A5B, the last being described here for the first time. The 5' BamHI, DdeI, MspI and HhaI polymorphisms showed the highest heterozygosities (0.40-0.50) and are in linkage equilibrium with one another. 19 complete haplotypes could be identified in this population. Based on the results we propose a systematic strategy for carrier detection and prenatal diagnosis of haemophilia B in this population. The combined analysis of four polymorphisms (5' BamHI, HhaI, MspI and DdeI) provided an informative genetic marker in 85% of the females. The use of all eight polymorphisms allows information in 95% of females. Additionally, differences in gene frequencies and haplotype distribution suggest dissimilarities in factor IX gene polymorphisms between the Brazilian and the North-American Black populations.