RESUMO
BACKGROUND: Several studies suggest that the prevalence of allergic diseases has been increasing worldwide in recent years; then it is very important to identify some risk factors that could be related. OBJECTIVE: To know some hereditary and environmental risk factors that could be related to the development of allergic diseases in open population from Mexico City. PATIENTS AND METHOD: It was an open-population, cross-sectional trial, in two phases with a random sample size of 4272 individuals in 214 public health centers. A questionnaire was applied by health workers. Statistical analysis was made with Excel 97-2004 using the Mann-Whitney U test for continuous variables and chi-square-test for discrete variables. p < 0.001 was considered statistically significant. RESULTS: The prevalence of allergic diseases in Mexico City was 42.6%, allergic rhinitis was the most frequent. The most important risk factors for allergic diseases were: family history of atopy in first and second degree; early consumption of cow's milk; early weaning with cereal, egg, beef, fish and pulses; living with some animals, indoor plants, active and passive smoking, to keep stuffed toys in the rooms, as well as living in dwellings with dust, cold temperatures, wall saltpeter and with dampness (mold growth). CONCLUSION: Because genetic factors can not be modified, it is important to identify environmental factors related to the development of allergic diseases in order to promote preventive measures.
Assuntos
Hipersensibilidade/epidemiologia , Hipersensibilidade/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , México , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Saúde da População Urbana , Adulto JovemRESUMO
BACKGROUND: There is a considerable variation in the prevalence of allergic disorders in developing countries. These differences may be attributable to different methodological problems and to the lack of operational definitions. Several studies suggest that the prevalence of allergic diseases has been increasing worldwide in recent years. However, in Mexico, there is no data in open population. OBJECTIVE: To know in open population the prevalence of allergic diseases in the counties of Mexico City, the frequence of symptoms in each allergic disease, the therapeutic modalities that patients seek, the school and work annual absences and the amount of money that each patient spends in antiallergic drugs. PATIENTS AND METHODS: It was an open-population, cross-sectional trial, in two phases with a random sample size of 8,000 individuals from 214 public health centers. Statistical analysis was made with Excel 97-2004: Mann-Whitney U test for continuous variables and chi-square-test for discrete variables, p < 0.05 was considered statistically significant. RESULTS: The prevalence of allergic diseases in Mexico City was 42.6%, allergic rhinitis was the most frequent. Children are the largest age group affected. The highest prevalence was found in Tlahuac county. Coexistence of allergic diseases was found in 19.9%. The 44.2% of allergic patients attended to their general practitioner. 20.4% of all patients spent 10-20% of their income in medicines and 26% do not have money to buy antiallergic drugs. School and work annual absences are 3.37 +/- 3.86 and 6.2 +/- 12.84 days, respectively. CONCLUSION: Allergic diseases must be considered a public-health problem in Mexico City.
Assuntos
Hipersensibilidade/epidemiologia , Saúde da População Urbana , Absenteísmo , Adolescente , Adulto , Idoso , Antialérgicos/economia , Antialérgicos/uso terapêutico , Criança , Pré-Escolar , Conjuntivite Alérgica/epidemiologia , Estudos Transversais , Dermatite Atópica/epidemiologia , Países em Desenvolvimento , Feminino , Humanos , Hipersensibilidade/tratamento farmacológico , Hipersensibilidade/economia , Lactente , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Honorários por Prescrição de Medicamentos , Prevalência , Hipersensibilidade Respiratória/epidemiologia , Estudos de Amostragem , População Urbana/estatística & dados numéricos , Urticária/epidemiologia , Adulto JovemRESUMO
UNLABELLED: Since mechanical retractors in endoscopic plastic surgery cause certain drawbacks, we developed a model in dogs, which, by insufflating CO2 into a subcutaneous cavity, we were able to maintain. We evaluated the magnitude of subcutaneous emphysema and absorption of CO2 by insufflating different pressures and the efficacy of external pressure on the skin with the purpose of limiting the subcutaneous emphysema. Sixteen dogs were divided in 3 groups, A, B, and C. We controlled the pulmonary function by using a volume-cycle ventilator. In all groups, we maintained a subcutaneous cavity by insufflating CO2. Groups A and C were insufflated at 15 mm Hg; group B, at 8 mm Hg. We placed circumferential Esmarch bandages on the thorax of groups B and C to delimit superiorly and inferiorly the surgical area. Arterial blood gas analyses (ABGA) were taken from the femoral artery 60 minutes after intubation, 60 minutes after Esmarch bandage was placed and at the end of the CO2 insufflation. Statistically, results were analyzed by Wilcoxon test. P < 0.05 was considered statistically significant. Group A showed extensive subcutaneous emphysema. Two dogs died. The systemic increase of the CO2 showed a median of 9.6 mm Hg (P < 0.05). In Group B, Esmarch bandages caused increase in CO2, with a median of 1.65 mm Hg (P < 0.028). None of these dogs showed subcutaneous emphysema during the insufflation after CO2 insufflation pressure augmented with a median of 3.7 mm Hg (P < 0.028). In Group C, chest restriction increased CO2 median of 6.1 mm Hg (P < 0.043), and subcutaneous emphysema shown was less extensive than group A. The CO2 increased after insufflation a median of 16 mm Hg (P < 0.043). CONCLUSIONS: Subcutaneous cavities can be maintained open with CO2 insufflation at 8 mm Hg, limiting perfectly the surgical area; as done with Esmarch bandages, it reduces CO2 absorption and makes this procedure safe.
Assuntos
Dióxido de Carbono/administração & dosagem , Insuflação/métodos , Enfisema Subcutâneo/etiologia , Tórax , Animais , Estudos de Casos e Controles , Cães , Endoscopia , Enfisema Subcutâneo/prevenção & controleRESUMO
INTRODUCTION: Nitric oxide is an important modulator of numerous physiological and pathophysiological processes. An indirect form to detect NO production has been the quantification of its stable end products, nitrites and nitrates (NO2- + NO3-). These metabolites can be detected with a commercial kit, but it is somewhat expensive and not accessible to some laboratories in our country. OBJECTIVE: To validate an easy, accessible and less expensive assay for detecting nitrates and nitrites in biological fluids. MATERIAL AND METHODS: In this study we determined nitrates and nitrites by reducing nitrates enzymatically with nitrate reductase, followed by nitrites quantification using the Griess reagent. To validate the assay, NO3- concentration was evaluated in aliquots with known amounts of sodium nitrate, also NO2- + NO3- concentrations were detected in plasma containing known amounts of sodium nitrate, finally NO2- + NO3- levels were evaluated in plasma (n = 17) and ascites (n = 11) samples of cirrhotic patients. In samples of patients, NO2- + NO3- levels were also detected by using a commercial kit. RESULTS: The assay that we describe here detects nitrates in the range between 25 to 400 microM/L and nitrites between 25 to 100 microM/L. When specific concentrations of nitrates were added to plasma samples, the recovery percentage in most cases was greater than 95%. In plasma samples of cirrhotic patients, average concentrations of NO2- + NO3- was 44.6 +/- 22.4 microM (mean +/- SD), similar to that found using the commercial kit, 40.9 +/- 18.3 microM/L (p = 0.107). In ascitis samples, similar results using both methods were seen, 64.5 +/- 42.0 vs. 58.2 +/- 39.3 microM/L (p = 0.172) respectively. CONCLUSIONS: Our results suggest that the method described here could be considered as an alternative instead of commercial kits to determine NO2- + NO3- in plasma and ascites samples. In addition, this assay results more attractive because, it does not, require special equipment, it is very accessible to most laboratories, it may be use to assay one or more samples at any given time, but the most important advantage, is its cost effectiveness; thus each sample determination is about one fifth of the cost using the commercial kit.
Assuntos
Líquidos Corporais/química , Nitratos/análise , Nitritos/análise , Humanos , Valores de ReferênciaRESUMO
BACKGROUND: It is estimated that up to 70% of community-based patients with heartburn have no evidence of esophageal mucosal injury or non-erosive gastroesophageal reflux disease (NERD). Studies in NERD patients using esophageal pH monitoring and symptom index (SI) have suggested different subgroups or clinical forms. OBJECTIVE: Our aim was to investigate frequency of different subgroups of patients with NERD according to esophageal pH-monitoring parameters and SI, and to determine esophageal acid exposure characteristics and the relationship between symptoms and acid reflux in NERD. MATERIAL AND METHODS: Patients with heartburn at least 3 times per week during 12 weeks during the last year and negative upper GI endoscopy were studied. All patients were submitted to 24 h esophageal pH-metry and SI was calculated. Patients were classified into three groups: group I, patients with abnormal pH-metry; group II, patients with normal pH-metry and positive SI (> or = 50%), and group III, patients with normal pH-metry and negative SI (< 50%). Total number of reflux episodes, length of episode, % time pH < 4, and Johnson-DeMeester score were evaluated. RESULTS: Three hundred patients, 206 women and 94 men, were included. A total of 137 (46%) were classified in group I, 62 (21%) in group II, and 101 (33%) in group III. There were no significant differences in gender and age among groups. All pH parameters were significantly higher in group I. In group II, there was good correlation between heartburn and acid reflux. Esophageal acid exposure in group III was minimal and there was no relationship among symptoms and acid reflux episodes. CONCLUSIONS: Subjects with NERD represent a heterogeneous group of patients. Three subgroups of patients with NERD were identified by pH-metry and SI; a) patients with abnormal acid exposure; b) patients with hypersensitive esophagus (heartburn with physiologic amounts of acid reflux), and c) patients with no correlation between symptoms and acid reflux.
Assuntos
Refluxo Gastroesofágico , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Antiulcerosos/administração & dosagem , Antiulcerosos/uso terapêutico , Endoscopia , Feminino , Ácido Gástrico , Refluxo Gastroesofágico/classificação , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/tratamento farmacológico , Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/metabolismo , Azia/diagnóstico , Azia/etiologia , Humanos , Concentração de Íons de Hidrogênio , Incidência , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Omeprazol/administração & dosagem , Omeprazol/uso terapêutico , Inibidores da Bomba de Prótons , Fatores Sexuais , Fatores de TempoRESUMO
OBJECTIVE: Gastric cancer (CG) and colorectal cancer (CCR) are the two most common neoplasms of the digestive system in the world. We performed a study to determine incidence and relation between CG and CCR in five hospitals in Mexico City. METHODS: Patients with admitted diagnosis of CG and CCR at Hospital General de Mexico, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Hospital Español de México, Centro Médico Nacional "20 de Noviembre" from the Instituto de Salud y Seguridad Social para Trabajadores del Estado, and Hospital Central Militar from January 1978 to December 2001 were studied. RESULTS: A total of 7,136 patients were studied. (CG 3,830, CCR 3,306). At Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" CG was the most common digestive neoplasm; from 1999, ratio was inverted to < 1. At Hospital General de México, from the beginning and until 1984, ratio was > 2, and later had an average of 1.31. For Hospital Español, ratio always was < 1 without changes. At Centro Médico Nacional "20 de Noviembre", initially CCR was more frequent, then CG, and finally CCR. At Hospital Central Militar ratio was constant, > CG. At the beginning, was global behavior > CG, ratio seemed to invert, but since 1998 CG/CCR ratio was < 1 and continued that way. CONCLUSIONS: In this study, we found that changes of CG/CCR ratio in a period of 24 years showed elevation of CCR incidence at five Mexican hospitals.
Assuntos
Neoplasias Colorretais/epidemiologia , Neoplasias Gástricas/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Inquéritos sobre Dietas , Feminino , Humanos , Pacientes Internados , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
The clinical suspicion of hereditary spherocytosis (HS) must be confirmed at the clinical laboratory. The osotic fragility test (OFT) and the autohemolysis test (AHT) are the worlwide accepted assays to establish a definitive diagnosis of HS; however, they have some disadvantages. We describe herein our experience with the cryohemolysis test (CHT) as a tool to confirm the HS diagnosis. We included four groups of subjects, namely, patients with clinical HS, patients with mechanical heart valve prosthesis, malignant hematological diseases and healthy blood donors. CHT was carried out in all the groups, while OFT and AHT only in the HS patients and healthy individuals. OFT and AHT were performed according to previously described techniques. CHT was performed using red blood cells incubated in a hypertonic solution, preheated for 10 min and then tranferred to an ice bath for an additional 10 min. The resulting cryohemolysis was determined mesuring the free hemoglobin in the sample. There were no differences among the groups in terms of general characteristics. All HS suspicious patients had a positive OFT and AHT. CHT was positive in all patients from the HS group but in none of the subjects from the control groups (p<0.001). We found that CHT is a faster and easier-to-perform assay compared with OFT and AHT. Moreover, using CHT, the zone between normal and abnormal results is wider than OFT or AHT. We propose 0.7 to 11 percent hemolysis as reference values for CHT