RESUMO
BACKGROUND: To analyse specific immune response to the 23-valent pneumococcal polysaccharide vaccine by measuring pneumococcal antibodies in children with asthma and with respiratory recurrent infection (RRI) as compared to healthy children. METHODS: The study included 60 children, divided into three groups: 20 with asthma, 20 with RRI, and 20 healthy controls. Post-vaccination specific IgG antibodies against 10 pneumococcal serotypes (S1, S3, S4, S5, S6B, S9V, S14, S18C, S19F, and S23F) contained in the 23-valent pneumococcal polysaccharide vaccine (PPV) were measured. A specific IgG concentration ≥1.3µg/mL was considered a protective response to the vaccine. For statistical analysis, levels of specific IgG antibodies against each of the 10 pneumococcal serotypes were compared across the three groups of children using the x(2) test. RESULTS: All of the children showed antipneumococcal antibody levels >1.3µg/mL for over 70% of the serotypes, considered within the normal range of response. Average IgG antibody levels and percentages of children protected were statistically comparable among the three groups studied. CONCLUSION: The asthmatic children without RRI had pneumococcal antibody levels and percentages of serotype-specific protection to PPV comparable to those of healthy children. Asthmatic children with recurrent infections should be evaluated for specific antibody deficiency (SAD). Because asthma patients are at high risk for invasive pneumococcal infections, it would be worthwhile to explore systematic administration of PPV in children over the age of two years who have not received a pneumococcal conjugate vaccine, considering the positive response to PPV reported here.
Assuntos
Anticorpos Antibacterianos/sangue , Asma/imunologia , Vacinas Pneumocócicas/imunologia , Infecções Respiratórias/imunologia , Streptococcus pneumoniae/imunologia , Adolescente , Asma/sangue , Criança , Pré-Escolar , Chile , Feminino , Voluntários Saudáveis , Humanos , Imunoglobulina G/sangue , Síndromes de Imunodeficiência/diagnóstico , Masculino , Vacinas Pneumocócicas/administração & dosagem , Estudos Prospectivos , Infecções Respiratórias/sangue , VacinaçãoRESUMO
There is an urgent need in multinational studies for efficient and sensitive tests for the evaluation of dementias. These tests are used to investigate the regional characteristics of dementias, providing possible insight into the different etiologies of the disorders. These tests are also utilized to assess the outcome of treatment interventions at multinational levels. We validated and standardized the Syndrom Kurztest, a brief European neuropsychological test, in a population of elderly Chileans, possessing high levels of illiteracy. In our sample, the SKT was found to be an effective instrument for the diagnosis of dementias, and for differentiating mild-moderate from severe degrees of the disease. There was a good correlation between the scores on the SKT and the age of the participants, but the gender and the years of schooling had no effect. The test is a useful contribution to the study of dementias, found in the aging developing world, particularly because it can be used in illiterate populations.
Assuntos
Doença de Alzheimer/diagnóstico , Comparação Transcultural , Países em Desenvolvimento , Idioma , Testes Neuropsicológicos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Chile , Escolaridade , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos TestesRESUMO
Cholera returned to South America in January 1991, after almost a century of absence. The hygienic status of the countries affected, aggravated by economic and political difficulties, allowed the disease to spread rapidly. In Peru, fishery products were incriminated from the outset, although without conclusive evidence. However, epidemiological and laboratory findings in other countries have confirmed the transmission of the disease by these products. The authors discuss the effects of the recent cholera epidemic on the trade and consumption of fishery products in countries of South America. The actual risk of cholera transmission by food and in particular by the consumption of fishery products is discussed, and a basis for conducting an accurate evaluation of these risks is proposed. Finally, the authors summarise the measures recommended to prevent the transmission of cholera by fishery products.
Assuntos
Cólera/transmissão , Surtos de Doenças , Produtos Pesqueiros/microbiologia , Animais , Cólera/epidemiologia , Cólera/prevenção & controle , Pesqueiros/normas , Humanos , Fatores de Risco , América do Sul/epidemiologiaRESUMO
OBJECTIVE: To critically analyze the level and quality of infrastructure, human resources and organization of long term care institutions for the elderly in Mexico City and to describe the functional status and care requirements of their residents. MATERIAL AND METHODS: A census was made of the institutions located in the metropolitan area of Mexico City which totalled 115. These were classified according to their belonging to the public or private sector (for profit and non-profit). In each category we made a random selection of 33 institutions which were all assessed according to the methodology described by Firevicius and applied by PAHO in several countries in Latin-America. This questionnaire was applied by a single interviewer. Within the selected institutions, 30% of the residents, who were also randomly selected were assessed by means of the Kuntzman's care requirements scale. Out of a total population of 1955, 617 (34%) residents were assessed. RESULTS: The mean score obtained by the institutions was under 50% of the maximum possible score with a great deal of dispersion of the results. The lowest scores were identified in the private for profit sector and in a subgroup of public institutions. The highest scores were found among private non-profit institutions and a sector of the public institutions. The most important shortcomings identified were related to infrastructure and quality of human resources. The mean age of the institutionalized elderly is 76; 48.1% are functionally independent, 21.3% partially dependent and 30.6% totally dependent. When trying to correlate the mean functional status of the population of a given institution with its resources for care-giving we usually found no correlation. It is commonplace to find highly dependent populations living in poorly staffed or inadequately equipped institutions and vice versa CONCLUSIONS: Quality of care in long term care institutions in Mexico City is often poor and this is particularly true for private for profit institutions. Lack of norms and supervision pertaining to the functioning of such institutions contributes greatly to this reality.
Assuntos
Instituição de Longa Permanência para Idosos , Assistência de Longa Duração , Idoso , Idoso de 80 Anos ou mais , Estudos de Avaliação como Assunto , Necessidades e Demandas de Serviços de Saúde , Instituição de Longa Permanência para Idosos/organização & administração , Instituição de Longa Permanência para Idosos/normas , Humanos , Assistência de Longa Duração/organização & administração , Assistência de Longa Duração/normas , México , Qualidade da Assistência à Saúde , Inquéritos e QuestionáriosRESUMO
Las infecciones y la malnutrición asociada son la causa de una proporción importante de los 13 millones de defunciones de lactantes y niños menores de 5 años que cada año se producen en el mundo. Entre las enfermedades de los lactantes y niños pequeños las infecciones respiratorias ocupan el primer lugar, seguidas por las enfermedades diarreicas, que son las más perjudiciales para el crecimiento. Las causas de las enfermedades diarreicas se han atribuido tradicionalmente a problemas de abastecimiento de agua y saneamiento. Para prevenir esas enfermedades, los gobiernos y las organizaciones no gubernamentales se han centrado y a veces se han limitado a mejorar el abastecimiento de agua y el saneamiento, así como a fomentar y proteger la lactancia materna. A partir de diversos trabajos publicados, este artículo de revisión muestra que los alimentos de destete preparados en condiciones no higiénicas muchas veces están contaminados por grandes cantidades de gérmenes patógenos y son por ello una de las causas principales de enfermedad diarreica y malnutrición asociada. De los datos presentados se deduce que las direcciones de trabajo actuales no basta para prevenir las enfermedades diarreicas. Debe considerarse prioritaria la educación de las madres en los principios de inocuidad de los alimentos, en particular de los alimentos de destete. En todos los programas nacionales de alimentación infantil o de alimentación y nutrición deberían integrarse programas educativos basados en el análisis del riesgo potencial y en la determinación de puntos críticos de control, teniendo también en cuenta los factores socioculturales
Publicado en inglés en: Bull. WHO. Vol. 71(1), 1993