Effects of radiation therapy on the structure and function of the pelvic floor muscles of patients with cancer in the pelvic area : a systematic review

Purpose Radiation therapy (RT) is often recommended in the treatment of pelvic cancers. Following RT, a high prevalence of pelvic floor dysfunctions (urinary incontinence, dyspareunia, and fecal incontinence) is reported. However, changes in pelvic floor muscles (PFMs) after RT remain unclear. The purpose of this review was to systematically document the effects of RT on the PFM structure and function in patients with cancer in the pelvic area. Methods An electronic literature search using Pubmed Central, CINAHL, Embase, and SCOPUS was performed from date of inception up to June 2014. The following keywords were used: radiotherapy, muscle tissue, and pelvic floor. Two reviewers selected the studies in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). Out of the 369 articles screened, 13 met all eligibility criteria. The methodological quality was assessed using the QualSyst scoring system, and standardized mean differences were calculated. Results Thirteen studies fulfilled all inclusion criteria, from which four were of good methodological quality. One presented strong evidence that RT affects PFM structure in men treated for prostate cancer. Four presented high-level evidence that RT affects PFM function in patients treated for rectal cancer. Meta-analysis was not possible due to heterogeneity and lack of descriptive statistics. Conclusion There is some evidence that RT has detrimental impacts on both PFMs’ structure and function. Implications for cancer survivors A better understanding of muscle damage and dysfunction following RT treatment will improve pelvic floor rehabilitation and, potentially, prevention of its detrimental impacts.

Effects of radiation therapy on the structure and function of the pelvic floor muscles of patients with cancer in the pelvic area : a systematic review

Purpose Radiation therapy (RT) is often recommended in the treatment of pelvic cancers. Following RT, a high prevalence of pelvic floor dysfunctions (urinary incontinence, dyspareunia, and fecal incontinence) is reported. However, changes in pelvic floor muscles (PFMs) after RT remain unclear. The purpose of this review was to systematically document the effects of RT on the PFM structure and function in patients with cancer in the pelvic area. Methods An electronic literature search using Pubmed Central, CINAHL, Embase, and SCOPUS was performed from date of inception up to June 2014. The following keywords were used: radiotherapy, muscle tissue, and pelvic floor. Two reviewers selected the studies in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). Out of the 369 articles screened, 13 met all eligibility criteria. The methodological quality was assessed using the QualSyst scoring system, and standardized mean differences were calculated. Results Thirteen studies fulfilled all inclusion criteria, from which four were of good methodological quality. One presented strong evidence that RT affects PFM structure in men treated for prostate cancer. Four presented high-level evidence that RT affects PFM function in patients treated for rectal cancer. Meta-analysis was not possible due to heterogeneity and lack of descriptive statistics. Conclusion There is some evidence that RT has detrimental impacts on both PFMs’ structure and function. Implications for cancer survivors A better understanding of muscle damage and dysfunction following RT treatment will improve pelvic floor rehabilitation and, potentially, prevention of its detrimental impacts.

Systematic review of the impact of unemployment on levels of happiness

The wealth on na economy is traditionally measured by its level of productivity. However, do countries with the highest level of productivity report equal levels of happiness and general well-being? As a matter of fact, there is no direct relationship between both variables and there can actually be, from a productive point of view, less wealthy countries reporting higher levels oh hapiness. hence, there have been recente studies and theriores- such as the Economics of Happiness- that are attempting to demonstrate the term hapiness has made its way into economics literature as the result of the dissatisfaction of economists who believe hapiness should become a matter of study in economics. Onde of the variables aconomists most research about- unemployment- has a direst relationship with happiness, which is why it is particular importante for economics to study it. As many authors have been suggesting, arguing and proving, the autonomy- both methodological and philsophial-, reliability and added value of happiness would contribute fo a more complete economic analysis. Althougth there have beeen many failed attempts to incorporate happiness as a study variable in economics, this new current is expected to succeed, not only due to the rising importance of happiness in people`s daily lives, but also, and mostly, due to the increasing number of authors that are investigating and defending it beingn studied by economics. The fact that this time the "happiness" variable is seen as multidisciplinar and not only assigned to na economic point economics will not come to fail this time around.

Essays on firm behaviour in the euro area

This thesis examines firms' real decisions using a large panel of unquoted euro area firms over the period 2003-2011. To this end, this thesis is composed of five chapters in which three are the main empirical chapters. They assess the dimensions of firm behaviour across different specifications. Each of these chapters provide a detailed discussion on the contribution, theoretical and empirical background as well as the panel data techniques which are implemented. Chapter 1 describes the introduction and outline of the thesis. Chapter 2 presents an empirical analysis on the link between financial pressure and firms' employment level. In this set-up, it is explored the strength of financial pressure during the financial crisis. It is also tested whether this effect has a different impact for financially constrained and unconstrained firms in the periphery and non-periphery regions. The results of this chapter denote that financial pressure exerts a negative impact on firms' employment decisions and that this effect is stronger during the crisis for financially constrained firms in the periphery. Chapter 3 analyses the cash policies of private and public firms. Controlling for firm size and other standard variables in the literature of cash holdings, empirical findings suggest that private firms hold higher cash reserves than their public counterparts indicating a greater precautionary demand for cash by the former. The relative difference between these two type of firms decreases (increases) the higher (lower) is the the level of financial pressure. The findings are robust to various model specifications and over different sub-samples. Overall, this chapter shows the relevance of firms' size. Taken together, the findings of Chapter 3 are in line with the early literature on cash holdings and contradict the recent studies, which find that the precautionary motive to hold cash is less pronounced for private firms than for public ones. Chapter 4 undertakes an investigation on the relation between firms' stocks of inventories and trade credit (i.e. extended and taken) whilst controlling for the firms' size, the characteristics of the goods transacted, the recent financial crisis and the development of the banking system. The main findings provide evidence of a trade-off between trade credit extended and firms' stock of inventories. In other words, firms' prefer to extend credit in the form of stocks to their financially constrained customers to avoid holdings costly inventories and to increase their sales levels. The provision of trade credit by the firms also depends on the characteristics of the goods transacted. This impact is stronger during the crisis. Larger and liquid banking systems reduce the trade-off between the volume of stocks of inventories and the amount sold on credit. Trade credit taken is not affected by firms' stock of inventories. Chapter 5 presents the conclusions of the thesis. It provides the main contributions, implications and future research of each empirical chapter.

Nitrate in groundwater in a recharge area of Guarany aquifer in Brazil.

The region of Ribeirão Preto City located in São Paulo State, southeastern Brazil, is an important sugarcane, soybean and corn producing area. This region is also an important recharge area (Espraiado) for groundwater of the Guarany aquifer, a water supply source for the city and region. It has an intercontinental extension that comprises areas of eight Brazilian states, as well as significant portions of other South American countries like Argentina, Uruguay, and Paraguay, with a total area of approximately 1,200,000 Km2. Due to the high permeability of some soils present in this region, the high mobility of the herbicides and fertilizers applied, and being a recharge area, it is important to investigate the potential transport of applied fertilizers to underlying aquifer. The cultivation sugar cane in this area demands the frequent use of nitrogen as fertilizer. This research was conducted to characterize the potential contamination of groundwater with nitrogen in the recharge area of groundwater. Seven groundwater sample points were selected in the Espraiado stream watershed, during the years of 2005 and 2006. Samples were collected during the months of March, July, and December of each year. Three replications were collected at each site. Groundwater was also collected during the same months from county groundwater wells located throughout the city. The following six wells were studied: Central, Palmares, Portinari, Recreio Internacional, São Sebastião, and São José. Nitrate water samples were analyzed by Cadmium Reduction Method. No significant amount of nitrate was found in the recharge, agricultural, area. However, nitrate levels were detected at concentrations higher than the Maximum Concentration Level (MCL) of 10mg/L in downtown, urban, well located away from agricultural sites with no history of fertilizer or nitrogen application.

Digital soil mapping using reference area and artificial neural networks.

Digital soil mapping is an alternative for the recognition of soil classes in areas where pedological surveys are not available. The main aim of this study was to obtain a digital soil map using artificial neural networks (ANN) and environmental variables that express soillandscape relationships. This study was carried out in an area of 11,072 ha located in the Barra Bonita municipality, state of São Paulo, Brazil. A soil survey was obtained from a reference area of approximately 500 ha located in the center of the area studied. With the mapping units identified together with the environmental variables elevation, slope, slope plan, slope profile, convergence index, geology and geomorphic surfaces, a supervised classification by ANN was implemented. The neural network simulator used was the Java NNS with the learning algorithm "back propagation." Reference points were collected for evaluating the performance of the digital map produced. The occurrence of soils in the landscape obtained in the reference area was observed in the following digital classification: medium-textured soils at the highest positions of the landscape, originating from sandstone, and clayey loam soils in the end thirds of the hillsides due to the greater presence of basalt. The variables elevation and slope were the most important factors for discriminating soil class through the ANN. An accuracy level of 82% between the reference points and the digital classification was observed. The methodology proposed allowed for a preliminary soil classification of an area not previously mapped using mapping units obtained in a reference area

EL PROCESO DE URBANIZACION EN LA PERIFERIA DEL AREA METROPOLITANA: LOS CASOS DE TURRUCARES Y MONTE DE LA CRUZ

Este avance de investigación pretende ofrecer una visión preliminar de un fenómeno bastante reciente que se está dando en Costa Rica y particularmente en el Valle Central: la urbanización del espacio agrícola. Este proceso se está desarrollando más allá del espacio suburbano y presenta una especialidad diferente, ya que aquí la organización social campesina y las actividades agropecuarias siguen siendo predominantes. Sin embargo, esta extremadamente vinculado con el proceso de metropolizacion que surge en el país. Se está asistiendo, pues, a una reubicación de los espacios residenciales de las clases de mejores ingresos, las cuales influenciadas tal vez por un modelo ideológico importado, buscan poder disfrutar de las ventajas que ofrece el espacio rural pero con la posibilidad de seguir trabajando en la ciudad y seguir gozando de los servicios urbanos. La  rural-urbanización dentro de una estrategia global de estructuración del espacio puede ser considerada como un mecanismo de selección y una apropiación de los mejores lugares donde se dará la futura de expansión urbana. Desde esta perspectiva, resulta interesante llamar la atención de cómo ciertos sectores sociales están proyectando desde ahora la futura expansión del espacio metropolitano.   SUMMARY This preliminary investigative report presents a viewpoint about a very recent phenomenon that is occurring in Costa Rica and especially in the Central Valley: the urbanization of the agrarian space. This process is developing beyond the suburban areas and presents a different spacial structure because in these areas, the rural social structures and the livestock and agricultural activities are still predominant. Nevertheless, such activities are very much related to the urbanization process occurring in the country. As such, we are witnessing a reubication of the residential structure of the high-income classes, of which, influenced perhaps by an improved idiologic model, hope to enjoy the advantages offered by a rural area but also taking advantage of the convenience offered by the urban benefits; plus the opportunity to keep working in the city. The process of rural urbanization conceived in a global strategy of spatial structures, can be considered as a selection and appropriation mechanism of the best areas for the future urban expansion. From this perspective, it is interesting to call attention to the process by which certain social sectors are now projecting the future organization of the metropolitan area.  In reference to the real-estate capital invested in the study areas, and specifically to Costa Rica capital, this investment in the promotion of real-estate, acts as a shelter sector, by changing the course of direction of the capital accumulated in the other economic sectors, especially considering that the real-estate sector insures more secure profits in spite of the relatively insignificant recuperation rate of the capital investment comparison to the industrial sector, where more capital risks occur, above all during an economic crisis.  At present, the zones influenced by rural urbanization are affected by a modification in their productive structure, in other words, what were once agricultural zones, are now converted to residential zones. This produces spectacular changes in the composition of the work force by producing service-oriented employment that leads to the following abandonment of the agricultural activities.  From a social point of view, this rural urbanization pattern provokes a marked spatial segregation, in which an exclusive high income social group with a particularly consuming life style is noted at one level, and on the other, social groups that inhered patterns of rural life with more traditional lifestyles. In reference to the community level in the study areas, localized conflicts have emerged between local people and the new residents. These conflicts are highly conditioned by the insertion in the communities of these new residents.       RESUME   Ce document préliminaire décrit un phénomène assez récent au Costa Rica, qui affecte plus particulièrement la « Vallée Centrale ». il s’agit de l’urbanisation de l’espace agricole.  Ce sont des espaces franchement ruraux, bien au-delà des banlieues, qui sont affectés par ce processus qui, en conséquence, montre des caractères différents: comme se maintien de la organisation social liée aux activités agricoles; en face l’infiltration d’un autre mode de vie dû à sa transformation en espace résidentiel pour classes aux revenus élevés qui, peut-être, influencées par un modèle culturel importé, préfèrent une localisation qui puisée leus offrir à  la fois les avantages de vivre dans un espace rural avec ceux de la ville, lieu de travail suffisamment proche dont elles continuent à pouvoir utiliser ses services. Ce modèle culturel doit être considère en fonction du processus de métropolitain apparu dan le pays. L’urbanisation de l’espace rural, dans une stratégie globale de structuration de l’espace peut se considérer comme un mécanisme de sélection et d’appropriation des meilleurs sites de l’expansion urbaine future.  Dans cette perspective, il est intéressant de constater qu’il existe déjà, de la part certains secteurs sociaux, un projet d’organisation de l’espace métropolitain futur. Le foncier est considéré comme un secteur refuge pour les capitaux nationaux d’où l’intérêt de la spéculation pour ces zones. En effet, ce placement, plus sûr, malgré un plus faible taux de récupération du capital, est préfère à d’ autres- comme l’investissement industriel- plus rentables, mais plus risqués, surtout en temps de crise. L’urbanisation de l’espace rural s’accompagne d’une modification des structures productives : moins d’agriculture et évolution de l’emploi vers le tertiaire liée à la présence de nouveaux résidents. Du point de vue social, cette situation se traduit par une très nette ségrégation spatiale. D’un côte, un group socio-économique aux revenus élèves représentant  la société de consommation ; de l’autre, les ruraux au style de vie plus traditionnel. Il en résulte une certaine tension entre les deux groupes.

Identification of resistance factors to the main wheat diseases in the Mediterranean area

Several diseases challenge bread and durum wheat productions worldwide. The importance of these cereals requires adequate protection to pathogens that can cause strong yield and grain quality losses. The main work of this thesis was related to phenotype GDP (Global Durum Panel) in the Mediterranean region (Italy, Egypt, Lebanon, Morocco and Turkey) and Argentina across three years (2019-2021) for yellow rust resistance (infection type and severity). GWAS shows in particular, loci in chromosome 1B, 2B, 4B, 5A, 6A, 7B showed high significance across nurseries/years, with various patterns of GxE. The second chapter is about Zymoseptoria tritici, agent of STB (Septoria Tritici Blotch), a foliar pathogen that yearly causes high damages if not controlled. In recent years research in durum wheat breeding is focused on the identification of novel, underexploited resistance genes to be subsequently and conveniently moved into the pre-breeding and breeding stream. The plants were phenotyped for disease height characters, infection type at the flag leaf and infection type at the level of the canopy below the flag leaf. This experiment opens up a rich scenario of analysis and opportunities to investigate and discover new loci of resistance to STB. Third chapter is about Fusarium head blight (FHB) is a fungal disease caused by pathogens belonging to the genus Fusarium. In particular, Fusarium culmorum and Fusarium graminearum species cause severe grain yield losses and accumulation of mycotoxins in wheat that compromise food safety. Over 250 QTL/genes for FHB resistance have been identified in bread wheat, such as Fhb 1 and Fhb 5 but only a small number of FHB resistance loci have been mapped in durum wheat. The aim of this work is to find loci of partial resistance to FHB already present in durum and bread wheat germplasm and therefore easily cumulative.

Characterization and management of particular classes of waste at a regional level. case study: Marche region

There are various methods to analyse waste, which differ from each other according to the level of detail of the compositio. Waste composed by plastic and used for packaging, for example, can be classified by chemical composition of the polymer used for the specific product. At a more basal level, before dividing a waste according to the specific chemical material of which it is composed it is possible and also important to classify it according to the material category. So, if the secondary aim is to consider the particular polymer that constitutes a plastic waste, or what kind of natural polymer composes a specific waste made of wood, the first aim is to classify the product category of the material that makes up the waste, so, if it is wood made, or plastic, or glass made or metal, or organic. There are not specific instruments to make this subdivision, not specific chemical tests, but only a manual recognition of the material that makes up the product or waste. The first steps of this study is a recognition of the materials of which the waste is composed, the second is a the quantification of differentiated and unsorted waste produced in the area under study, the third is a mass balance of the portions of waste sent for recovery in order to obtain information on quantities that can be effectively recovered and ready for new life cycle as raw material; the fourth and last step is an environmental assessment that provides information on the environmental cost of the recovery process. This process scheme is applied to various specific kinds of waste from separate collection generated in a specific area with the aim to find a model analysis appliable to other portions of territory in order to improve knowledge of recovery technologies.

Analysis of the long-term subsidence in the urban area of Bologna

Land subsidence in urban areas represents a widespread geological hazard and a pressing challenge for modern society. This research focuses on the subsidence process affecting the city of Bologna (Italy). Since the 1960s, Bologna has experienced ground deformation due to aquifers overexploitation that peaked during the 1970s with rates of 10 cm/year. Despite a general reduction in these rates over the subsequent decades, thanks to groundwater regulations policies, recent data underscore a substantial subsidence resurgence. To reconstruct the subsurface stratigraphic architecture of Bologna’s urban area and generate a 3D geological model, a multidisciplinary approach centred on a stratigraphic analysis relying on the lithofacies criterion was adopted. The convergence of the analyses within this framework resulted in partitioning the study area into three geological domains exhibiting unique morphological features and depositional stacking patterns. Subsequently, since long-term data are crucial for a comprehensive understanding of ongoing subsidence, a methodology was developed to generate cumulative ground displacement time series and maps by integrating ground-based and remotely-sensed measurements. While the reconstructed long-term subsidence field consistently aligns with the primary geological variations summarised in the 3D model, the generated cumulative displacement curves systematically match pluriannual trends observed in groundwater level and pumping monitoring data. Lastly, to evaluate the expression of the observed relationships from a geotechnical perspective, a series of one-dimensional subsidence calculations were conducted considering the mechanical properties of the investigated deposits and piezometric data. These analyses provided valuable insight into the overall mechanical behaviour of the existing soils, as well as the post-pumping groundwater level and pore pressure distributions, consistent with field data. The methodological approach employed enables a comprehensive analysis of land subsidence in urban areas, allowing the exploration of individual factors governing the deformation process and their interactions, even within complex stratigraphic and hydrogeological environments such as Bologna’s urban area.

Random Access Procedures in 5G IoT via NTN: System level performances

The Internet of Things (IoT) is a critical pillar in the digital transformation because it enables interaction with the physical world through remote sensing and actuation. Owing to the advancements in wireless technology, we now have the opportunity of using their features to the best of our abilities and improve over the current situation. Indeed, the Internet of Things market is expanding at an exponential rate, with devices such as alarms and detectors, smart metres, trackers, and wearables being used on a global scale for automotive and agriculture, environment monitoring, infrastructure surveillance and management, healthcare, energy and utilities, logistics, good tracking, and so on. The Third Generation Partnership Project (3GPP) acknowledged the importance of IoT by introducing new features to support it. In particular, in Rel.13, the 3GPP introduced the so-called IoT to support Low Power Wide Area Networks (LPWAN).As these devices will be distributed in areas where terrestrial networks are not feasible or commercially viable, satellite networks will play a complementary role due to their ability to provide global connectivity via their large footprint size and short service deployment time. In this context, the goal of this thesis is to investigate the viability of integrating IoT technology with satellite communication (SatCom) systems, with a focus on the Random Access(RA) Procedure. Indeed, the RA is the most critical procedure because it allows the UE to achieve uplink synchronisation, obtain the permanent ID, and obtain uplink transmission resources. The goal of this thesis is to evaluate preamble detection in the SatCom environment.

Geochemistry Of Acid Mine Drainage From A Coal Mining Area And Processes Controlling Metal Attenuation In Stream Waters, Southern Brazil.

Acid drainage influence on the water and sediment quality was investigated in a coal mining area (southern Brazil). Mine drainage showed pH between 3.2 and 4.6 and elevated concentrations of sulfate, As and metals, of which, Fe, Mn and Zn exceeded the limits for the emission of effluents stated in the Brazilian legislation. Arsenic also exceeded the limit, but only slightly. Groundwater monitoring wells from active mines and tailings piles showed pH interval and chemical concentrations similar to those of mine drainage. However, the river and ground water samples of municipal public water supplies revealed a pH range from 7.2 to 7.5 and low chemical concentrations, although Cd concentration slightly exceeded the limit adopted by Brazilian legislation for groundwater. In general, surface waters showed large pH range (6 to 10.8), and changes caused by acid drainage in the chemical composition of these waters were not very significant. Locally, acid drainage seemed to have dissolved carbonate rocks present in the local stratigraphic sequence, attenuating the dispersion of metals and As. Stream sediments presented anomalies of these elements, which were strongly dependent on the proximity of tailings piles and abandoned mines. We found that precipitation processes in sediments and the dilution of dissolved phases were responsible for the attenuation of the concentrations of the metals and As in the acid drainage and river water mixing zone. In general, a larger influence of mining activities on the chemical composition of the surface waters and sediments was observed when enrichment factors in relation to regional background levels were used.

Advancing Bag-of-visual-words Representations For Lesion Classification In Retinal Images.

Diabetic Retinopathy (DR) is a complication of diabetes that can lead to blindness if not readily discovered. Automated screening algorithms have the potential to improve identification of patients who need further medical attention. However, the identification of lesions must be accurate to be useful for clinical application. The bag-of-visual-words (BoVW) algorithm employs a maximum-margin classifier in a flexible framework that is able to detect the most common DR-related lesions such as microaneurysms, cotton-wool spots and hard exudates. BoVW allows to bypass the need for pre- and post-processing of the retinographic images, as well as the need of specific ad hoc techniques for identification of each type of lesion. An extensive evaluation of the BoVW model, using three large retinograph datasets (DR1, DR2 and Messidor) with different resolution and collected by different healthcare personnel, was performed. The results demonstrate that the BoVW classification approach can identify different lesions within an image without having to utilize different algorithms for each lesion reducing processing time and providing a more flexible diagnostic system. Our BoVW scheme is based on sparse low-level feature detection with a Speeded-Up Robust Features (SURF) local descriptor, and mid-level features based on semi-soft coding with max pooling. The best BoVW representation for retinal image classification was an area under the receiver operating characteristic curve (AUC-ROC) of 97.8% (exudates) and 93.5% (red lesions), applying a cross-dataset validation protocol. To assess the accuracy for detecting cases that require referral within one year, the sparse extraction technique associated with semi-soft coding and max pooling obtained an AUC of 94.2 ± 2.0%, outperforming current methods. Those results indicate that, for retinal image classification tasks in clinical practice, BoVW is equal and, in some instances, surpasses results obtained using dense detection (widely believed to be the best choice in many vision problems) for the low-level descriptors.

Defective Apoptosis In Intestinal And Mesenteric Adipose Tissue Of Crohn's Disease Patients.

Crohn's disease (CD) is associated with complex pathogenic pathways involving defects in apoptosis mechanisms. Recently, mesenteric adipose tissue (MAT) has been associated with CD ethiopathology, since adipose thickening is detected close to the affected intestinal area. However, the potential role of altered apoptosis in MAT of CD has not been addressed. To evaluate apoptosis in the intestinal mucosa and MAT of patients with CD. Samples of intestinal mucosa and MAT from patients with ileocecal CD and from non-inflammatory bowel diseases patients (controls) were studied. Apoptosis was assessed by TUNEL assay and correlated with the adipocytes histological morphometric analysis. The transcriptional and protein analysis of selected genes and proteins related to apoptosis were determined. TUNEL assay showed fewer apoptotic cells in CD, when compared to the control groups, both in the intestinal mucosa and in MAT. In addition, the number of apoptotic cells (TUNEL) correlated significantly with the area and perimeter of the adipose cells in MAT. Transcriptomic and proteomic analysis reveal a significantly lower transcript and protein levels of Bax in the intestinal mucosa of CD, compared to the controls; low protein levels of Bax were found localized in the lamina propria and not in the epithelium of this tissue. Furthermore, higher level of Bcl-2 and low level of Caspase 3 were seen in the MAT of CD patients. The defective apoptosis in MAT may explain the singular morphological characteristics of this tissue in CD, which may be implicated in the pathophysiology of the disease.

Imported Malaria In A Non-endemic Area: The Experience Of The University Of Campinas Hospital In The Brazilian Southeast.

Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject. A retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011. Amongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria. Plasmodium vivax and Plasmodium falciparum were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between P. vivax (14 cases, 9%) and P. falciparum (7 cases, 10%) infections. Severe malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that P. vivax infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment.