Mucopolysaccharidoses in Brazil: What happens from birth to biochemical diagnosis?

Mucopolysaccharidoses (MPS) form a group of inherited metabolic disorders characterized by intralysosomal storage of glycosaminoglycans. This study aimed to investigate the path followed by Brazilian patients from birth to diagnosis. An interview was conducted with patient`s parents or guardians with subsequent review of patient`s medical records. One hundred thirteen patients with MPS were included (MPS I: 18, MPS II: 43, MPS III: 2, MPS IIIB: 3, MPS IIIC: 1, MPS IVA: 15, MPS IVB: 1, MPS VI: 29, MPS VII: 1) from 97 families. Median age at the onset of sings/symptoms was 18 months (MPS I: 18, MPS II: 24, MPS IVA: 8, MPS IV: 8). Skeletal abnormalities (for MPS IVA and MPS VI), joint contracures (for MPS II), and typically first signs/symptoms. Several health professionals were involved in patient`s care as of the onset of symptoms until biochemical diagnosis was established. Median age at diagnosis was 76 months (MPS I: 75, MPS II: 95, MPS IVA: 75, MPS VI: 52). Considering the group as a whole, there was a 4.8-year delay between the onset of signs/symptoms and establishment of the diagnosis. Considering that specific therapies are available for some of these disorders and that early treatment is likely to change more favorably the natural history of the disease, efforts should be made to minimize this delay. We believe that this situation can be improved by measures that both increase awareness of health professionals about MPS and improve access to diagnostic tests. (C) 2008 Wiley-Liss, Inc.

POSTMARITAL RESIDENCE PRACTICE IN SOUTHERN BRAZILIAN COASTAL GROUPS: CONTINUITY AND CHANGE

The coastal plains of the States of Parana and Santa Catarina, in Southern Brazil, were first settled around 6000 B.P. by shellmound builders, a successful fisher-hunter-gatherer population that inhabited the coastal lowlands practically unchanged for almost five thousand years. Shellmounds were typically occupied as residential sites as well as cemeteries, and are usually associated with rich alimentary zones. Around 1200 B.P., the first evidence of ceramics brought from the interior is found in coastal areas, and together with ceramics there is a progressive abandonment of shellmound construction in favor of flat cold shallow sites. Here we consider if these changes were reflected in the postmarital residence practice of coastal groups, i.e., if the arrival or intensification of contact with groups from the interior resulted in changes in this aspect of social structure among the coastal groups. To test the postmarital residence practice we analyzed within-group variability ratios between males and females, following previous studies on the topic. and between-group, correlations between Mahalanobis distances and geographic distances. The results suggest that in the pre-ceramic series a matrilocal, postmarital residential system predominated, while in the ceramic period there was a shift toward patrilocality. This favors the hypothesis that the changes experienced by coastal groups after 1200 B.P. affected not only their economy and material culture, but important aspects of their sociopolitical organization as well.