RESUMO
O presente trabalho teve por objetivo identificar as espécies medicinais nativas em um fragmento de mata situada na Fazenda Azulão, em Dourados/MS, baseando-se no conhecimento popular de mateiros da região, com intuito de gerar subsídios para perpetuar a preservação, a diversidade e variabilidade das espécies, bem como, incentivar populações locais a valorizar e preservar esses recursos naturais, retardando o impacto sobre a biodiversidade. Partes das plantas indicadas como medicinais foram coletadas, as quais foram identificadas mediante literaturas especializadas e por comparações com plantas depositadas no Herbário da Cidade Universitária de Dourados. Foram identificadas 61 espécies distribuídas em 35 famílias e 53 gêneros. As famílias Asteraceae (9), Fabaceae (5) e Piperaceae (4) foram as que apresentaram o maior número de espécies. Dentre as formas de vida encontradas na vegetação nativa do local, as espécies medicinais de hábito arbustivo (39,34%) foram as que apresentaram os maiores valores, seguido pelas herbáceas (27,86%), arbóreas (24,6%), e lianas (8,2%). As partes das plantas mais utilizadas são as folhas, seguidas da raiz e casca. Com base nos resultados obtidos nesse estudo, as indicações da utilização das plantas medicinais podem fornecer subsídios para estudos bioquímicos e farmacológicos, diminuindo os custos e o tempo na extração de princípios ativos, bem como, permitir o fortalecimento do conhecimento cultural da comunidade local, incentivando a preservação ambiental de diversas espécies medicinais utilizadas na região. Novos estudos devem ser conduzidos no Estado do Mato Grosso do Sul, a fim de se garantir o registro de dados mais precisos sobre as espécies medicinais ocorrentes.
This study aimed to identify the native medicinal species in a forest fragment located at Azulão Farm in Dourados/ MS, based on the popular knowledge of the bushmen of the region, aiming to generate data to perpetuate the preservation, diversity and variability of the species, as well as to encourage local people to value and preserve these natural resources, slowing the impact on biodiversity. Samples of plants indicated as medicinal were collected, and then identified by the specialized literature and by comparison with plants deposited in the Herbarium of the University City of Dourados. We identified 61 species belonging to 35 families and 53 genera.The Asteraceae (9), Fabaceae (5) and Piperaceae (4) showed the largest number of species. Among the life forms found in the local native vegetation, the medicinal species of shrubby habit (39.34%) were the ones that presented the highest values, followed by the herbaceous (27.86%), trees (24.6%), and lianas (8.2%). The most frequently used plant parts are the leaves, followed by the roots and bark. Based on the results of this study, the indications of use of medicinal plants can provide subsidies for biochemical and pharmacological studies, reducing the costs and the time for the extraction of active ingredients, also contributing with the cultural knowledge of the local community, encouraging environmental preservation of many medicinal species used in the region. Further studies should be conducted in the State of Mato Grosso do Sul, in order to ensure the registration of more accurate data on the existing medicinal species.
Assuntos
Humanos , Masculino , Idoso , Plantas Medicinais/anatomia & histologia , Coleta de Dados/métodos , Florestas , Conservação dos Recursos Naturais/tendênciasRESUMO
OBJECTIVES: To determine seroprevalence and determinants of herpes simplex virus 2 (HSV-2) seropositivity, in a random sample of a population based cohort of 10 049 women of Guanacaste, Costa Rica, using a highly sensitive and specific serological assay. METHODS: Seroprevalence was determined by a type specific HSV-2 ELISA assay in an age stratified random sample of 1100 women. Univariate and multivariate logistic regression was used to calculate odds ratios and 95% confidence intervals for risk factors of seropositivity. RESULTS: Overall age adjusted HSV-2 seroprevalence was 38.5% (95% CI, 37.5 to 39.5), and it was strongly associated with increasing age (p(Trend<0.0001)), both among monogamous women and women with multiple sexual partners. A greater number of lifetime sexual partners increased the risk of seropositivity, with a 28.2% (95% CI, 24.4 to 32.2) seroprevalence among monogamous women and 75% (95% CI, 65.6 to 83.0) seroprevalence for those with four or more partners (OR = 7.6 95% CI, 4.7 to 12.4 p(Trend<0.0001)). Barrier contraceptive use was negatively associated with HSV-2 seropositivity (OR 0.54, 95% CI, 0.31 to 0.94). Women with antibodies against HPV 16, 18, or 31 were 1.6 times more likely to be HSV-2 seropositive (OR 1.6, 95% CI, 1.2 to 2.1). CONCLUSIONS: HSV-2 infection is highly endemic in Guanacaste, even among lifetime monogamous women, suggesting a role of male behaviour in the transmission of the infection. Until vaccination against HSV-2 is available, education to prevent high risk sexual behaviour and the use of condoms appear as preventive measures against HSV-2.
Assuntos
Herpes Genital/epidemiologia , Herpesvirus Humano 2 , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Costa Rica/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Reação em Cadeia da Polimerase , Fatores de Risco , Saúde da População Rural , Estudos Soroepidemiológicos , Parceiros SexuaisRESUMO
BACKGROUND: Human papillomavirus (HPV) is the main cause of cervical neoplasia. Because few population-based studies have investigated the prevalence of type-specific infection in relation to cervical disease, we studied a high-risk population, estimating the prevalence of HPV infection and the risk associated with various HPV types. METHODS: We screened 9175 women in Guanacaste, Costa Rica, to obtain a referent standard final diagnosis, and tested 3024 women for more than 40 types of HPV with a polymerase chain reaction-based system. RESULTS: Among women with normal cytology, HPV infections peaked first in women younger than 25 years, and they peaked again at age 55 years or older with predominantly non-cancer-associated types of HPV and uncharacterized HPV types. Low-grade squamous intraepithelial lesions (LSILs) (n = 189) decreased consistently with age. The prevalence of high-grade squamous intraepithelial lesions (HSILs) (n = 128) peaked first around age 30 years and again at age 65 years or older. Seventy-three percent of LSILs were HPV positive, with HPV16 being the predominant type (16% of positive subjects). HPV was found in 89% of HSILs and 88% of cancers, with HPV16 being strongly predominant (51% and 53% of positive subjects). Virtually all HSILs and cancers had cancer-associated HPV types, with high odds ratios (ORs) and attributable fractions around 80%. Risk for HPV16 was particularly high (OR for HSILs = 320, 95% confidence interval [CI] = 97-1000; OR for cancer = 710, 95% CI = 110-4500). CONCLUSIONS: We confirm the early decline of HPV infection with age but note increased prevalence after menopause, which could be related to a second peak of HSILs, an observation that warrants further investigation. At least 80% of HPVs involved in cervical carcinogenesis in this population have been characterized. Polyvalent vaccines including the main cancer-associated HPV types may be able to prevent most cases of cervical disease in this region.
Assuntos
Papillomaviridae , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Vigilância da População , Saúde da População Rural/estatística & dados numéricos , Infecções Tumorais por Vírus/epidemiologia , Infecções Tumorais por Vírus/virologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia , Adulto , Distribuição por Idade , Idoso , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/virologia , Costa Rica/epidemiologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Razão de Chances , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/diagnóstico , Reação em Cadeia da Polimerase , Prevalência , Infecções Tumorais por Vírus/diagnóstico , Neoplasias do Colo do Útero/diagnósticoRESUMO
OBJECTIVES: This study was undertaken to evaluate the relationship between vaginal pH and factors related to cervical cancer. STUDY DESIGN: In a population-based sample of 9161 women from Guanacaste Province in Costa Rica women were categorized into 2 groups, those with vaginal pH in the reference range (4.0-4.5) and those with elevated vaginal pH (5.0-5.5). Odds ratios were used to estimate the relationship between elevated pH and its potential determinants. RESULTS: Aging was strongly associated with increasing vaginal pH, starting at around 45 years of age and continuing into old age. Menopause was responsible for an additional 1.7-fold increase in the odds of having an elevated pH (odds ratio 1.7, 95% confidence interval 1.4-2.0). Human papillomavirus infection and cervical intraepithelial neoplasia were not associated with changes in pH. CONCLUSIONS: Our data indicate that vaginal pH is strongly related to age and to menopausal status and thus could be a marker of age-related hormonal changes. Elevated pH does not appear to be associated with risk of high-grade intraepithelial neoplasia among women infected with human papillomavirus.
Assuntos
Envelhecimento , Menopausa , Vagina/química , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Costa Rica , Feminino , Humanos , Concentração de Íons de Hidrogênio , Menstruação , Pessoa de Meia-Idade , Papillomaviridae , Infecções por Papillomavirus/metabolismo , Valores de Referência , Infecções Tumorais por Vírus/metabolismo , Displasia do Colo do Útero/metabolismoRESUMO
BACKGROUND: Automated cytology devices have utility in quality assurance applications, but the effectiveness of these devices in primary screening is unknown. METHODS: Enrollment smears obtained from 7323 women participating in a population-based study sponsored by the National Cancer Institute were screened manually in Costa Rica and then evaluated independently in the U.S. with the PAPNET system (Neuromedical Systems, Inc., Suffern, NY), a semiautomated, neural network-based device. Smears with abnormal PAPNET images were microscopically rescreened and then diagnosed by a U.S. cytopathologist. ThinPrep slides (Cytyc Corporation, Boxborough, MA), prepared from rinses of the cytologic sampler, and cervigrams (National Testing Laboratories, Fenton, MO) were also evaluated. Women with any abnormal cytologic diagnosis or a positive cervigram were referred for colposcopy with biopsy and definitive therapy if indicated. RESULTS: Based on the U.S. cytotechnologist's review of the PAPNET images, 1017 (13.9%) of 7323 smears were selected for manual screening, resulting in the selection of 492 (6.7%) possibly abnormal slides for referral to the U.S. pathologist. Ultimately, 312 smears (4.3% of the total) were diagnosed as containing squamous cells of undetermined significance or a more severe abnormality (> or =ASCUS), resulting, hypothetically, in the referral of 66.5% of women with a final diagnosis of a squamous intraepithelial lesion or a more severe abnormality (> or =SIL) and 86.0% of patients with > or =high grade SIL. Conventional microscopic screening performed in Costa Rica resulted in the hypothetical referral of 6.5% of patients with > or =ASCUS for colposcopy, including 69.5% of patients with > or =SIL and 79.8% of those with > or =high grade SIL. CONCLUSIONS: In this study, PAPNET-assisted cytologic screening accurately identified smears obtained from women with high grade SIL or carcinoma. Determination of the clinical cost-effectiveness of PAPNET-assisted screening in routine practice awaits future study.
Assuntos
Programas de Rastreamento/métodos , Teste de Papanicolaou , Lesões Pré-Cancerosas/patologia , Neoplasias do Colo do Útero/patologia , Esfregaço Vaginal/métodos , Estudos de Coortes , Costa Rica , DNA Viral/isolamento & purificação , Feminino , Humanos , Redes Neurais de Computação , Papillomaviridae/isolamento & purificação , Lesões Pré-Cancerosas/virologia , Estudos Prospectivos , Encaminhamento e Consulta , Estados Unidos , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal/instrumentaçãoRESUMO
This paper reports on the enrollment phase of a population-based natural history study of cervical neoplasia in Guanacaste, a rural province of Costa Rica with consistently high rates of invasive cervical cancer. The main goals of the study are to investigate the role of human papillomavirus (HPV) infection and its co-factors in the etiology of high-grade cervical neoplasia, and to evaluate new cervical cancer screening technologies. To begin, a random sample of censal segments was selected and enumeration of all resident women 18 years of age and over was conducted with the aid of outreach workers of the Costa Rican Ministry of Health. Of the 10738 women who were eligible to participate, 10049 (93.6%) were interviewed after giving written informed consent. After the interview on cervical cancer risk factors was administered, a pelvic examination was performed on those women who reported previous sexual activity. The pelvic examination included a vaginal pH determination and collection of cervical cells for cytologic diagnosis using three different techniques. Additional cervical cells were collected for determination of the presence and amount of DNA from 16 different types of HPV, and two photographic images of the cervix were taken and interpreted offsite by an expert colposcopist. Finally, blood samples were collected for immunologic and micronutrient assays. Women with any abnormal cytologic diagnosis or a positive Cervigram, as well as a sample of the whole group, were referred for colposcopy, and biopsies were taken when lesions were observed. The enrollment screening will serve as the basis for a prevalent case-control study, and the members of the cohort free from serious disease will be followed actively, at intervals of no more than a year, to study the natural history of HPV infection and the origins of high-grade squamous intraepithelial lesions (HSIL). Details of the field operation are outlined, with particular reference to the realization of this kind of study in developing countries. Descriptive data on the prevalence of disease and exposure to various risk factors are also presented.
Assuntos
Carcinoma in Situ/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Papillomaviridae/patogenicidade , Infecções por Papillomavirus/epidemiologia , Infecções Tumorais por Vírus/epidemiologia , Displasia do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma in Situ/sangue , Carcinoma in Situ/etiologia , Carcinoma de Células Escamosas/sangue , Carcinoma de Células Escamosas/etiologia , Estudos de Coortes , Colposcopia , Comorbidade , Costa Rica/epidemiologia , DNA Viral/análise , Dieta , Métodos Epidemiológicos , Feminino , Seguimentos , Humanos , Incidência , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/complicações , Prevalência , História Reprodutiva , Fatores de Risco , População Rural , Fumar/epidemiologia , Fatores Socioeconômicos , Infecções Tumorais por Vírus/complicações , Doenças do Colo do Útero/sangue , Doenças do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/sangue , Neoplasias do Colo do Útero/etiologia , Esfregaço Vaginal , Displasia do Colo do Útero/sangue , Displasia do Colo do Útero/etiologiaRESUMO
The purpose of this descriptive study was to detect regional differences in the mortality of women 15 to 44 years of age, especially mortality due to preventable causes. The regions studied corresponded to the health regions of Costa Rica. The deaths of women 15 to 24, 25 to 34, and 35 to 44 recorded from 1987 to 1989 in the National Deaths Register were classified as due to preventable causes or nonpreventable causes and grouped by region. The nationwide mortality rate for women 15 to 44 years of age was 6.9 per 10,000 women. The highest rates were recorded in the Huetar Atlántica (10.05) and Brunca (8.29) regions, and the lowest in the West Central region (4.38). Some 44.4% of the deaths were preventable, mainly by secondary prevention measures or a mix of measures. The lowest proportions of preventable mortality were found in the North Central and Brunca regions (35.2% and 36.7%, respectively), and the highest in the West Central (64.7%). The nonpreventable deaths mostly corresponded to causes not easily avoided and to the remainder of causes not included under other headings of the Taucher International Classification. Ill-defined causes represented 1.2% of total deaths in the study period. Almost all the peripheral regions showed higher mortality than the central plateau, which may be because of their lesser degrees of socioeconomic and infrastructure development and of access to health services. Another influence may be the more subordinate status of women in rural areas. This situation can be changed by making better use of available resources and improving the quality of services. It is recommended that this type of study be continued in order to monitor trends in women's mortality.