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Background: Extramedullary hematopoiesis depends on complex pathophysiological mechanisms linked to hematopoietic stem cells and the proteins considered mediators of the inflammation. The identification of hematopoietic cells outside bone marrow in the adult is an occurrence that can occasionally follows the inflammatory response, was considered a secondary occurrence, but current biomolecular studies have changed that concept., Aim: Describe the presence of clusters of precursor cells of platelets (megakaryocytes), and cells of the inflammatory response in the abdominal wall and spleen of rats with experimentally induced incisional hernias and repaired with different synthetic prostheses., Methods: Twenty-five rats with incisional hernias previously performed, were divided into groups of five animals each: Group 1, repair of the hernia defect without prosthetic implant; Group 2, repair with polypropylene prosthesis; Group 3, repair using polypropylene with low weight; Group 4, the use of polypropylene and polyglecaprone prosthesis; Group 5, of polypropylene and polyglactin prosthesis. All prostheses were cut in rhombus format with area 2,625 cm². The animals were reoperated after 10 days, the abdominal walls were removed with the viscera attached to them and the material was processed for histological study., Results: Megakaryocyte niches in the abdominal wall and spleen, occasionally removed together with the adhesions produced in animals with implantation of prostheses and significant inflammatory reaction., Conclusion: The intense inflammatory reaction due to the prostheses with polypropylene in their composition was disproportionate to the expected response, indicating that further studies should be accomplished including immunophenotyping evaluation and specific panels of monoclonal antibodies to better understand the findings.

Objective: To analyze the self-care of patients with type 2 diabetes mellitus in the Family Health Strategy in Teresina-PI., Method: Search cross selected by simple random sampling, 331 people with diabetes mellitus. Data collection took place from August to December 2012 with the use of Self-Care Activities Questionnaire with Diabetes and structured instrument for recording information socioeconomic and guidance received by the professional nurse., Results: The data revealed that patients have poor adherence to blood glucose monitoring, the physical exercise and foot care, but with good adherence to the medication. Only 38.7% of the sample examined the feet of fi ve to seven days a week. Statistically significant association between self-care activities with their feet and orientations of nurses (p < 0,05)., Conclusion: That there is need to raise awareness with regard to the development of skills for self-care.

Background: Partial portal vein ligation causes an increase in portal pressure that remains stable even after the appearance of collateral circulation, with functional adaptation to prolonged decrease in portal blood flow., Aim: To assess whether different constriction rates produced by partial ligation of the vein interfere with the results of this experimental model in rats., Methods: Three groups of five rats each were used; in group 1 (sham-operated), dissection and measurement of portal vein diameters were performed. Portal hypertension was induced by partial portal vein ligation, reducing its size to 0.9 mm in the remaining 10 animals, regardless of the initial diameter of the veins. Five animals with portal hypertension (group 2) underwent reoperation after 15 days and the rats in group 3 after 30 days. The calculation of the constriction rate was performed using a specific mathematical formula (1 - π r 2 / π R2) x 100% and the statistical analysis with the Student t test., Results: The initial diameter of the animal's portal vein was 2.06 mm, with an average constriction rate of the 55.88%; although the diameter of the veins and the constriction rate in group 2 were lower than in group 3 (2.06 mm - 55,25% and 2.08 mm - 56.51%, respectively), portal hypertension was induced in all rats and no significant macroscopic differences were found between the animals that were reoperated after 15 days and after 30 days respectively, being the shorter period considered enough for the evaluation. Comparing the initial diameter of the vein and the rate of constriction performed in groups 2 and 3, no statistic significance was found (p>0.05)., Conclusion: Pre-hepatic portal hypertension in rat can be induced by the reduction of the portal vein diameter to 0.9 mm, regardless the initial diameter of the vein and the vessel constriction rate.

Objective: to identify the frequency of components of Metabolic Syndrome (MetS) among university students., Method: descriptive study with 550 students, from various courses run by a public university. The socioeconomic data, lifestyle, and components of MetS were filled out using a questionnaire. Blood sample collection was undertaken in the university itself by a contracted clinical analysis laboratory., Results: 66.2% were female, with a mean age of 22.6±4.41; 71.7% were sedentary; 1.8% stated that they smoke; and 48.5% were classified as at medium risk for alcoholism. 5.8% had raised abdominal circumference and 20.4% had excess weight; 1.3% and 18.9% had raised fasting blood glucose levels and triglycerides, respectively; 64.5% had low HDL cholesterol and 8.7% had blood pressure levels compatible with borderline high blood pressure. Thus, of the sample, 64.4% had at least one component for MetS; 11.6% had two, and 3.5% had three or more., Conclusion: a significant proportion of the population already has the components for metabolic syndrome, and this profile reinforces the importance of early diagnosis so as to reduce the risk of developing chronic comorbidities.

The purpose of this study was to identify the knowledge, attitudes and practices for the prevention of diabetic foot in patients with diabetes mellitus type 2. This study was based on a cross-sectional survey conducted in two Family Health Units, in the city of Picos--PI, Brazil, with 85 diabetics of both sexes, by means of a semi-structured Knowledge, Attitude and Practice questionnaire. There was a predominance of females in the study (62.4%). On the topic of foot care, 49.4% had no knowledge on hygiene or what to observe in their feet. In relation to nail care, 56.5% were unaware of the correct way to cut nails. Regarding attitudes, 80% were willing to engage in self-care. In terms of practice, results showed that activities such as washing, drying, moisturizing and massaging were not executed together. It is therefore necessary to develop educational strategies to create awareness, both for diabetics and health professionals, on the effective prevention of diabetic foot.

Global concern in relation to child mortality gained visibility with the release of the Millennium Development Goals in 2000 in which the reduction of child mortality is included under goal number four, which proposes to reduce the mortality rate of children under five years by two thirds between 1990 and 2015. Reducing child mortality has been a major priority of social health policies of the Brazilian government. The identification of risk factors associated with infant mortality can assist in the planning of actions to restructure and improve care for pregnant women and newborns in order to reduce child mortality. With this in mind, this study sets out to analyze the use of the linkage method to identify risk factors associated with infant mortality. An integrative review of the literature was conducted for this purpose and eight complete articles published between 2008 and 2013 were analyzed using the following key words: infant mortality, risk factors and information systems. The use of the linkage method proved to be very useful, enabling adequate investigation of the factors most strongly related to child mortality, showing its relevance to the study of public health problems.

This is a qualitative study, anchored in the Theory of Social Representation and Jodelet thoughts, realized in an Intensive Care and Oncology Unit of a university hospital. The objective was to understand the social representations of nurses on religiosity while caring for dying patients. The data was collected between 2010 May and August, using the technique of Content Analysis of Bardin. The religiosity representations inserted in the caring practice for dying patients, value professional's beliefs about death, its meaning allowing for the development of coping mechanisms. It is considered that the awareness will occur through the understanding of reality and introducing the theme in the discussion of the quality of health and training of professionals.

Objective: This study sought to evaluate infections related to health care caused by coagulase-negative Staphylococci in a neonatal intensive care unit by assessing antimicrobial susceptibility profiles and potentially effective antibiotic regimens., Methods: This was a retrospective descriptive study performed on a case series of healthcare-associated infections, and the antimicrobial susceptibility profiles were evaluated. Newborns from other hospitals who were admitted to a neonatal intensive care unit in Rio de Janeiro between January 1, 2010, and June 30, 2012, were studied., Results: In total, 765 patients were admitted, totaling 3,051 patient-days, and the incidence density of general infection was 18.9 per 1,000 patient-days. The rate of central venous catheter use was 71.6%, and the positive culture rate for all sites and all infections related to health care were 68.4%. Coagulase-negative Staphylococci were identified in 11 (19.2%) of 57 health care-related infections, and infections with extended-spectrum beta-lactamase producing Klebsiella pneumoniae and Candida sp. constituted 5 cases each. Of the 11 cases of coagulase-negative Staphylococci, 10 (90.9%) were primary bloodstream infections. The sensitivity of the coagulase-negative Staphylococci isolates to vancomycin, clindamycin, ciprofloxacin, oxacillin and gentamycin was 100%, 81.8%, 72.7%, 27.2% and 22.2%, respectively. There were no deaths directly attributed to coagulase-negative Staphylococci infection., Conclusion: Coagulase-negative Staphylococci was the main agent identified in healthcare-associated infections, with low rates of infections related to central venous catheter. In hospitals with a high oxacillin resistance profile, similar to those included in this study, vancomycin may be used as an initial therapy, although clindamycin represents a viable alternative.

Objective: to study the changes in health-related quality of life from beginning of anticoagulation therapy to six-month follow-up, and to study associations of sociodemographic and clinical characteristics with measures of quality of life and general health status at six-month follow-up, in individuals using oral anticoagulation due to various medical indications for the therapy., Method: prospective study performed at a city in the state of Paraná, Brazil, composed of 78 patients. Measures included the Duke Anticoagulation Satisfaction Scale and the Medical Outcomes Survey Short Form SF-36., Results: mean age was 57 years (S.D.= 16) and 54% were women. Compared to the beginning of therapy, there was a statistically significant improvement in health-related quality of life at six-month follow-up. Linear regression analyses explained 32% and 30%, respectively, of the variance of the Duke Anticoagulation Satisfaction Scale and of the general health status. There was improvement in all components of the SF-36, except Mental Health., Conclusion: The use of oral anticoagulation therapy was associated with improvement in health-related quality of life in the first six months of therapy. This study is longitudinal and therefore, has fewer limitations than cross-sectional studies published to date in the Nursing literature in Brazil.

This is a descriptive cross-sectional study, which aimed to analyze the health related quality of life (HRQoL) and its relationship with gender, age, duration and indication for the use of oral anticoagulants. A total of 178 patients were interviewed and the HRQoL was assessed through eight domains of the SF-36. The descriptive statistics used were, the Student's t, ANOVA and Tukey's tests for the comparison of the means between the groups. The indication for use was predominantly the metallic prosthetic heart valve (50%) with warfarin the most widely prescribed anticoagulant (83.3%). The means of the domains of the SF-36 ranged from 82 (Social aspects) to 54.8 (Physical aspects). Women, elderly, patients diagnosed with atrial fibrillation and with less than one year of medication use, presented a worse HRQoL evaluation. The results obtained can guide nursing actions, in that they indicate possible associations between the HRQoL and the sociodemographic and clinical variables of the patients.

Objective: To report the experience with the vacuum-assisted venous drainage (VAVD) technique in cardiopulmonary bypass (CPBP) and blood transfusion need., Methods: A retrospective study was made about data from 111 patients who were operated, using VAVD between October 2006 and February 2008, at the Esperança Hospital, Recife, Pernambuco. The necessity of blood transfusion was verified on the single group of patients who underwent VAVD, comparing with sex, age and weigh, before the beginning of the CPBP and during the surgery, using Chi-square test and t-student test., Results: Before the beginning of the CPBP only 10% of patients had need for blood transfusion and 12% during the surgery. It was observed that 17% of women received blood transfusion versus 4.7% of men before the beginning of CPBP (P=0.51), and 38% of women versus 9% of men during the surgery (P<0.001). The weight of patients who received blood transfusion were lower both before the beginning of the CPBP as during the surgery (P=0.049 e P=0.001, respectively)., Conclusion: The VAVD technique has been used safely and satisfactorily, optimizing venous drainage during CPBP, in the hospital that conducted the study. However, prospective and comparative investigations between conventional drainage and VAVD are needed to better clarify this relation with blood transfusion.

It aimed to learn the daily habits related to the physical activity practice among private state schools adolescents in Fortaleza-Brazil. We investigated 307 students between 12 and 17 years old from six private schools, in the months March to June 2007. We applied a form which recorded sedentarism, BMI, blood pressure and blood glucose. The chi-squared test was used for to analysis the proportions. About 68% of young people were sedentary. The sedentarism was higher in females surveyed (p=0, 000) and those with over-weight (p=0,001). Among adolescents active exercise was the most practiced football (42%) and weights (19%). The health education in schools can assist in combating the sedentarism of the adolescents.

The purpose of this study is to investigate the socio-demographic, clinical and laboratory profile of individuals in the follow-up period due to the use of oral anticoagulants. This is a descriptive study, cross performed in the clinic of oral anticoagulation in a tertiary hospital in the state of São Paulo, Brazil. Data were collected through interviews and examinations of the patients' medical records. 180 subjects participated. The results show that the most females (65.6%), with an average age of 55 years, use warfarin (83.3%) for 6.9 years or more, due to the presence of metallic prosthetic heart (50%). These results provide subsidies for nurses to plan the assistance of their patients in oral anticoagulation therapy as a way of reducing complications related to therapy and increasing adherence to treatment.

The research aimed at learning food habits of adolescents from public schools in Fortaleza, CE, Brazil. Seven hundred students age ranging from 4 to 19 years-old were interviewed from twelve education institutions by means of a structured form. From the usual food consumed the energetic rice and bread were highlighted, consumed by 95.8% and 85.2% of the adolescents, respectively (p=0.0001). Within constructor food, meat and beans are ingested by 60.6% and 75.0%, respectively (p=0.0001). Regulative food like fruit and vegetables do not have a usual consumption among adolescents, since just (34.3%) and (47.6%) respectively consume them (p=0.0001 and p=0.226). An unbalance in proper nutrient ingestion for the adolescence was stated, favoring overweight and, consequently, chronic diseases like mellitus diabetes.

With the aim of measuring the prevalence of anti-parvovirus B19 IgG antibodies during pregnancy up to 24 weeks of gestation and detecting cases of nonimmune hydrops fetalis, 249 sera from pregnant women attending a reference hospital in Rio de Janeiro city, from June 2003 to November 2004 were collected. They were followed-up until the end of pregnancy, with 17 cases of fetal hydrops detected. Four cases were caused by parvovirus B19 and two of them occurred in pregnant women living in the western zone of the city, during February 2005. Anti-parvovirus B19 IgG antibodies were found in 172 (71.6%) pregnant women (CI 95% 65.5%-77.7%); this antibody prevalence is similar to results found for others Brazilian cities. The only variable associated with previous acquisition of IgG antibodies to parvovirus B19 was number of pregnancies greater than one (p= 0.02, CI 95% 0.36-0.94).

The aim of the study was to typify a malaria focus in Guarapiranga, in the district of São José de Ribamar, MA. A questionnaire regarding identification, economic situation, habits of the residents and characteristic of the residences was applied to each family. Fifty four families were visited and 207 inhabitants were interviewed (113 men and 95 women); 95 individuals were aged between 5 and 24 years old. Agriculture and fishing are the basis of the local economy; 64.8% of the families earn less than one living wage. The majority of the residences are constructed of mud walls, straw roofs, a beaten earth floor, with no basic sanitation. 62.2% of the residences are partially protected against the entry of mosquitoes. Water for domestic use comes from natural waterholes in 78.8% of the residences. Rubbish is left in the open air in 53.7% of the residences. 106 cases of malaria by Plasmodium vivax were notified. Anopheles (N) aquasalis was the probable vector and treatment with chloroquine associated with primaquine showed good results.

Background: To study the prevalence of cardiovascular risk associated to the lifestyle of school children from the 5th to 8th grade, in public and private schools., Methods: Eighty seven randomly selected school rooms were visited adding up to 2,125 students who completed the questionnaire and whose body mass index was calculated. This sample represents around 2% of students from two school districts in the city of Sao Paulo., Results: Of the 2,125 students, 24% were overweight or obese, 53.3% presented inappropriate food habits, 15.4% were sedentary, 62.6% drank alcohol, and 23.1% smoked. Between the 5th and 8th grade, the number of students who drank alcohol doubled and the number of male and female adolescents who tried out smoking increased 3-fold and 5-fold, respectively. Conversely, inappropriate food habits decreased. This situation is found in 40% of students from public schools and in 58% of those in private schools, by the time they reach the 8th grade. Overweight and obesity are more prevalent in private schools and the reduction noted as grades progress did not reach a significance level. Sedentarism is more prevalent in public schools. In private ones, sedentarism is lower among older students, contrary to public schools, where it increases with age. Female adolescents attend fewer physical education classes. Inappropriate food habits were characterized by the habits of adding more salt to pre-prepared food, lower intake of dairy products, fruit and vegetables also a higher intake of soft drinks, butter and snacks., Conclusion: Early detection of these cardiovascular risks associated to the lifestyle of these school children endorses the preventive practice of providing health education in schools.

Unlabelled: A non-controlled, prognostic cohort study was performed with the aim of establishing markers of neurological development and defining a clinical and epidemiological profile of preterm newborns at 3, 6, 9, and 12 months of gestation-corrected age in terms of primitive reflexes evolution., Results: At 3 months old of corrected age, all primitive reflexes were present. At 6 months old, all children showed plantar grasp and 2.7% still showed Moro and palmar grasp. Plantar grasp was the unique primitive reflex found at 9 and 12 months of corrected age., Conclusion: It was possible to evaluate the occurence, as well as the disappearing of primitive reflexes in preterm newborns. The results show delay in the disappearing of primitive reflexes even with the use of corrected age.

Descriptive-exploratory type study, carried with 168 inhabitants of the basin of Rio Acre - Brazil, which aimed to investigate preservative use and the risk for Sexually Transmited Diseases. For data collection it was used an application form with spontaneous participation and anonymate guaranty. As result, stands out the 64.3% masculine gender, 75.0% married/joined, 57.1% had incomplete first degree and 31.0% were illiterate. At that time 78.0% did not bring preservative when coming to the city, and 6.0% just came out seeking for sexual activity; 62.0% had already used the masculine preservative, with 67.2% of acceptance and 77.8% had kept it in the back pocket of the pants, with danger of damaging and infection risk and undesired pregnancy; 8.9% had had venereal disease, being 80.0% for the gonorrhea. Of these, 46.7% had negotiated respectively with pharmacist and doctor. Thus, 89.3% considered the prevention campaigns as great/good.

This study presents the distribution of leishmaniasis in the town of Buriticupu, Maranhão, Brazil, by month, season, occupation, gender, and age from 1996 to 1998. These data were compared with those on sand flies obtained by other authors during the same period. The disease affected all age groups, in the following order: 0-5 years (4.1%), 6-10 (7.1%), 11-15 (13.6%), 16-21 (20.8%), 22-30 (21.1%), and > 30 (33.3%). The disease predominantly affected males (70.1%) and agricultural workers (52.5%), followed by students (17.7%), and domestic workers (16.0%). Like the sand fly vector, the disease was distributed throughout the year, but the greatest concentration of cases was recorded in the dry season (58.5%), while sand flies presented bimodal peaks in the first two years and occurred more frequently in the rainy season in 1998. The disease continues to present the same characteristics as in the past, but there was a proportional increase in cases among children and females, suggesting transmission in the anthropic environment.

Purpose: To report the efficacy of vigabatrin in seizures control, as well as the electroencephalographic abnormalities in children with tuberous sclerosis and West syndrome., Method: Retrospective study, with clinical, neuroimaging, and electroencephalographic data., Results: Seven patients were followed, and the median time of follow-up was 10 years. Four of them were females and all were white. The mean age of seizures onset was 3.4 months. All patients used antiepileptic drugs associations, at least 2 drugs each therapeutic scheme, each one of the patients have used at least two different schemes. Vigabatrin as monotherapy or adjuvant was started in a mean age of seven years or 4 years after the onset of symptoms. Five from seven patients on vigabatrin became seizure free., Conclusion: Vigabatrin was efficient in seizures control, leading to a better prognosis.

In this study the diversity of the species and relative abundance of the sand flies in the Amazonian community of Lagoas, in Buriticupu, Maranhão State, was determined. The study consisted of adult sandflies captured with CD light-traps, Shannon-trap and manual aspiration tube, between 18 PM and 6 AM, once a month, from December/95 to January/97, in a forest fragment and in the domestic environment (peri and intra). In all, 9,393 specimens were captured (4,302 males and 5,140 females) distributed among 38 species (1 Brumptomyia and 37 Lutzomyia). The diversity and abundance of species was higher in the forest, followed by the peri and intra. The predominance in the wild ambient is a consequence of the potentialities found in the remaining fragments of the forest which have survived the lumber yard exploitation and agricultural activities. In the forest environment Lutzomyia whitmani (64.9%), L. migonei (27%) and L. serrana (3.6%) were the most frequent species. In the peri and intra domicile L. evandroi predominated (55.4% and 97.9%). The species, L. whitmani (33.4%) and L. migonei (6.4%), were important in the peri domicile. The peridomestic habit of 7.7% of the sand flies showed the greatest epidemiologic importance, due to the existence of patients with leishmaniasis ulcers, who believe they were infected near their habitations.

A comparative study on children aged 0-15 years, with American tegumentary leishmaniasis (ATL), in the endemic regions of Buriticupu (MA) and Corte de Pedra (BA), whereby 214 cases were detected between 1982 and 1993, 78 (36.4%) of them originated from Corte de Pedra and 136 (63.6%) from Buriticupu. In Corte de Pedra, most cases were observed in patients aged between 0-5 years. Twenty nine (37.2%) cases; 62% of those were male. In the Buriticupu region, 88 (64.7%) cases occurred in patients of 11-15 years of age, where in 73.8% consisted of male. In both researched regions, brunetts were predominant, with a ratio of 65.4% in Corte de Pedra and 75% in Buriticupu. Twenty six (33.3%) children in the village of Corte de Pedra were farmers, predominantly male (57.7%), generating statistical significance (chi 2 = 11.21). Twenty one (80.8%) farmers were aged 11-15 years. Thirty seven and a half per cent of the children from Buriticupu were students, however, 41 (30.2%) were farmers, representing 39 (44.3%) cases; all of them male. Both in Buriticupu and Corte de Pedra, the unique wound was predominant, corresponding to 57.7% and 53.7%, respectively. The wounding time stood out from one to three months, with 45 (69.2%) cases in Corte de Pedra and 73 (61%) in Buriticupu (chi 2 = 11.82). As to the wound locations, it has been observed that they were most constantly present on the lower limbs, with 77.2% in Corte de Pedra and 58.9% in Buriticupu (chi 2 = 27.9). The cutaneous case mostly found in Corte de Pedra was the ulcerous one (91%). IDRM was positive in 61 (78.2%) children originated from Corte de Pedra, wherein no statistical difference was detected between age ratio and positivity of the test (chi 2 = 0.0669).

Visceral leishmaniasis (kala-azar) was definitively an important disease of the state of Maranhão, Brasil since 1982. Since of then, many authors have been working with this topic in spite of reports. Nevertheless, the aspects of diagnosis, treatment an control of cure went through still hard worried the authors have been studying the disease, that came at São Luís Island since of the destabilization of the ecotopes of Lutzomya longipalpis, most important sandflies bites. After 1993 the constatation of cases with bad response to pentavalent antimonial (Glucantime) comes to add the other worries. This actual trial accost the disease and conclude about an existence of failures to Glucantime being important to have much vigilance in the diagnosis, treatment and control of cure of the patients.

Seven species belonging the subgenus Nyssorhyncus were found. Anopheles (N.) darlingi, the principal vector of human malaria, was the most abundant (53.1%) followed by A. (N.) evansae (21.0%, A. (N.) triannulatus (17.4%) e A. (N.) nuñeztovari (4.8%). The others, A. (N.) argyritarsis. A. (N.) oswaldoi and A. (N.) rangeli, were less frequently found, representing only 3.7% of the total sample. The anophelines were most frequent in both the extra (51.7%) and peridomiciles (45.7%). The intradomicile was visited by some specimens of the A. (N.) darlingi and A. (N.) evansae (active in both the rain and dry seasons, especially in the former, when the malaria reached high levels of transmission.

The authors analysed the visceral leishmaniasis (VL) aspects in the state of Maranhão, Brazil, from 1982 to 1993. The disease happens to occur predominantly in São Luís Island (MA) and during the epidemic period, town of São Luís was pointed out as the main endemic area. The greatest frequency of cases occurred in 1993, despite the use of insecticide and dogs control. There was predominance of age between 0- to 4-year-old population with 58.04% of cases. Neither the human disease nor the rainfall index had significant seasonal variation. However they were correlated moderately, with high number of cases after the period of great precipitation of rain. After this study, the data obtained will allow a better control of the disease, despite some factors such as: the urbanization, localization and dynamic of transmission in endemic areas in the Maranhão state.

The authors describe a retrospective and prospective study of 6 patients with diffuse cutaneous leishmaniasis observed in the state of Maranhão, since 1974. The patients come from different rural regions of the state and in all of them Leishmania (Leishmania) amazonensis was the cause five of the patients initiated their disease in the first decade of life. All the patients first had a solitary, nodular lesion, that after a variable period of time, disseminated and acquired other aspects. Sequentially the patients presented multiple nodular and ulcerative lesions, negative Leishmania skin tests and a refractory response to the therapeutic schedules used up to the present.

A uniform therapeutic schedule of Chloroquine 1500mg (three days) and Primaquine 75mg (adult 15mg x 5 days) was used in 1232 patients suffering from malaria due to Plasmodium vivax occurring in Island of São Luis Maranhão State in the period between January of 1984 and December 1985. Of the cases, 499 (40.5%) concluded treatment, and of these 448 were cured. Fifty one patients who relapsed responded to a second course of the treatment.