Eliane S. Azevêdo

Destaques éticos nos periódicos nacionais das áreas médicas

OBJECTIVE: To evaluate the Brazilian journals cited by the four CAPES medical areas, qualified as A national or I international, regarding the relevance given to ethics in the instructions for authors. METHODS: The instructions for authors of twenty Brazilian journals were studied and 36 types of ethical concerns were identified allowing the following categorization: I - Ethics in human research; II - Scientific integrity; III - Editorial policy. RESULTS: The results on Category I show that the most frequent instructions (50%) requires previous approval of the research by a institutional Ethics Committee (CEP), followed by indication on how to cite this approval in the body of the article (35%), plus presentation of a copy of the CEP approval (30%). However, none advert on the importance of the CEP being recognized by the CONEP. On Category II, 55% of the journal require declarations of conflict of interest, and 40% of them inquire about the type of interest; however, all (100%) journal do not mentione prevention conflict of interests between authors and peer reviewers, neither on frauds, plagiarisms or data fabrication. Finally, in Category III, 65% of the journals require the authors to transfer publications rights to them, while the remaining 35% do not mention copyright CONCLUSION: These results are discussed in relations to the Brazilian present situation regarding ethics in the scientific production of researches using human subjects for the prevention of scientific dishonesty.

Genetic causes involved in Leishmania Chagasi infection innortheastern: Brazil

A sample of 502 individuals from 94 families from Jacobina, State of Bahia, Brazil, was investigated to determine the causal mechanisms involved in Leishmania chagasi (the causal agent of visceral leishmaniasis in the American hemisphere) infection, as measured by the intradermic reaction to antigens derived from this parasite, using complex segregation analyses. The results showed evidence of a major genetic mechanism acting on infection, with a frequency of a recessive (or additive) susceptibility gene (q) of approximately 0.45. A small multifactorial component (H = 0.29) acting in conjunction with a major recessive gene (q = 0.37) is not ruled out as a concomitant causative factor.

A relação médico-paciente em Rio Branco/AC sob a ótica dos pacientes

OBJETIVO: Avaliar, em uma Unidade de Saude de Rio Branco, o nivel de satisfacao dos pacientes com a relacao medico-paciente (RMP) praticada. METHODS: Estudo descritivo-analitico. Foram entrevistados 50 pacientes egressos de internacao recente na Fundacao Hospital Estadual do Acre (FUNDHACRE), com idades entre 18 e 50 anos. Foram excluidos pacientes em dialise ou UTI, com estado de consciencia alterado, portadores de deficiencia mental, impossibilitados de comunicacao verbal e que nao concordaram em participar. O teste de Qui-quadrado (c2) foi usado para comparacao entre as variaveis categoricas, com grau de significância para p<0,05. A variavel-dependente avaliacao da RMP foi associada a variaveis ligadas ao modo de comunicacao praticado entre medico e paciente. Essa avaliacao foi baseada em conceitos, considerando bom e otimo como satisfacao. Este estudo foi aprovado pelo Comite de Etica em Pesquisa da FUNDHACRE. RESULTADOS: O tempo medio de visita medica foi de 4,61 minutos, variando entre 0 (zero) e 15; cinco (10%) dos pacientes estudados nao receberam visitas medicas durante a internacao. Com relacao a comunicacao, 35 (70%) pacientes nao consideraram suficientes as informacoes oferecidas pelos medicos. Para 32 (64%) pacientes, a RMP interfere diretamente na evolucao do caso. Em seus casos particulares, 62% avaliaram que houve interferencia da RMP na evolucao de seu tratamento. Quanto a avaliacao geral, 35 (70%) pacientes consideraram-se satisfeitos com a RMP praticada. CONCLUSOES: A satisfacao com a RMP apontada tem associacao com variaveis que sao ligadas ao modo de comunicacao praticado entre o medico e o paciente.

Genetic and Anthropological Studies in the Island of Itaparica, Bahia, Brazil

The ongoing racial admixture was studied in the island of Itaparica off the coast of the State of Bahia, in Brazil. The following gene frequencies were observed: Hb S = 0.039; Hb C = 0.022; PGD C = 0.024; Gd A = 0.217 and Gd A = 0.052, among 293 mixed school children whose black phenotype index (medium mulatto + dark mulatto + black/total) was 0.457. Data on racial groups, obtained from 898 death certificates of three periods (1889-1890, 1934-1937 and 1975-1980) showed that in about 90 years (three generations) the proportion of mulattoes had doubled, the whites had decreased to one third, and the blacks showed no variation. Changes in the frequencies of surnames within the whites over the same 90 years indicated a growing proportion of individuals with black ancestry flowing into the white group. Higher reproductive rates among the more negroid individuals is probably the leading force directing the racial admixture in the island.

Racial effect on serum creatine-kinase: implications for estimation of heterozygosity risks for females at-risk for Duchenne dystrophy.

Duchenne muscular dystrophy (DMD), a lethal X-linked recessive genetic disorder of childhood, is the most common and severe of the muscular dystrophies. Until no effective treatment is found to cure or arrest the progression of the disease, prevention of new cases through detection of carriers and genetic counseling is fundamental. About 50% to 80% of the heterozygotes for the DMD gene have increased creatine-kinase (CK) and pyruvate-kinase (PK) levels [l-4]. Studies on DNA polymorphisms have greatly improved identification of heterozygotes in informative families. However, techniques of DNA analysis are expensive and time consuming, and the results are not always absolute. Very often, they must be expressed in terms of probabilities, combined with results of serum enzymes determinations. Therefore, serum enzyme determinations will still be important first, as a screening test and second, for calculation of conditional probabilities (combined with DNA marker information through Bayesian methods) in heterozygosity risk estimations for females at risk for DMD [5,6]. Studies on serum CK in normal people from different racial background have shown that the black population has higher serum CK levels than the caucasoids or mongoloids [7-lo]. In a recent study, we have compared serum CK and PK in healthy adult females .of different black admixture. The preliminary results suggested that while PK did not differ among the different subgroups, CK was significantly higher in the black females than in the caucasoids [ll].

Multivariate Study of Birth Weight and Maternal Heterozygosity for Sickle Cell Anemia in Bahia, Brazil

A series of 1,008 newborns of indigent mothers from a mixed Brazilian population was studied with respect to the effect on birth weight of heterozygosity for sickle cell anemia, fetal sex, maternal age, parity, smoking, alcohol consumption and black admixture. Maternal heterozygosity for sickle cell anemia had no measurable effect on birth weight. Significant effects were found for male sex (increase) and smoking (decrease).

Frequencies of atypical serum cholinesterase in a mixed population of northeastern Brazil.

Frequencies of the CHE1*A allele were estimated in 84 Whites and 772 Negroids from a random sample of Salvador, Bahia. The overall frequency of this gene in Negroids was estimated as 0.842 +/- 0.233%. This indicates that this sample presents around 50 +/- 17% of White admixture and that the estimate of the risk of developing prolonged apnoea in individuals submitted to suxamethonium is around 0.035%, that is about 1 out of 2,900.

Breves considerações na convergência ciência e religião

Discussions on science and religion may be approached by various routes. We shall try one of them. Science and religion are both secular institutions, sharing histories and wisdom created by the same human kind. In the western human history there are knowledge common to Abrahamic religions as well as to science. Some of these knowledge remain as inspirations for scientific investigations; were of concern before the rise of modern science; were in the core of the XVII century scientific revolution, and remain up to date in science and in religion, in spite of their doctrinarian diversity. Finally, we shall say a few words on present interest in science and religion studies.

Encomium: Oswaldo Frota-Pessoa

Angela M. Vianna-Morgante, Eliane S. Azeviido, Paulo A. Otto, and John M. Opitz Department of Biology, Instituto de Biocikncia, Universidade de Stio Paulo, SP, Brazil (A.M.V.-M., P.A.O.); University Hospital Edgar Santos, Universidade Federal da Bahia, Salvador, BA, Brazil (E.S.A.); and Foundation for Developmental and Medical Genetics, Helena, and Montana State University, Bozeman, Montana (J.M.O.)

Liver total protein in relation to cause of death in man

Abstract Human liver samples obtained from 343 autopsies at the Instituto Medico Legal Nina Rodrigues in Salvador, capital of Bahia State, Brazil, were studied for protein determination in parallel with ADH activity levels. There is no effect of age, race, or sex on the level of protein concentration, or on ADH levels. However, cause of death was found to be an important factor on total liver protein concentration in a similar manner as previously reported for ADH. Livers from patients dying from sudden traumatic accident had higher levels of protein concentration than those dying from acute illness. Also the acute illness group had higher protein concentration than those patients dying of chronic illness. Similar types of association were also confirmed for ADH activity levels in the present data. The possible mechanisms responsible for lowering liver protein during diseases are discussed.