RESUMEN
A majority of patients with neurological disorders with chronic exposures to toxigenic molds and mycotoxins has vitamin B12 deficiency that is unrelated to dietary insufficiency. Vitamin B12 is a source of coenzymes, and participates in intracellular recycling of methionine, and in methionine synthase reactions. The biochemical processes that lead to B12 depletion and deficiency are not fully understood. This paper examines and assesses various most likely biochemical reasons that could impede upon the normal intracellular functions of vitamin B12 that lead to neurological manifestations. By biochemical implications and derivations, it is most likely that mycotoxins interrupt the structure and function of vitamin B12 through reactive interference with the normal One-Carbon metabolism leading to the observed clinical neurological manifestations such as nerve damage and, demyelination, degeneration of PNS leading to paralysis, progressive peripheral neuropathy, and spinal degeneration.
Asunto(s)
Hongos/química , Micotoxinas/toxicidad , Deficiencia de Vitamina B 12/fisiopatología , Vitamina B 12/química , Vitamina B 12/metabolismo , Animales , Carbono/metabolismo , Humanos , Micotoxinas/efectos adversos , Enfermedades del Sistema Nervioso/inducido químicamente , Enfermedades del Sistema Nervioso/genética , Enfermedades del Sistema Nervioso/metabolismo , Enfermedades del Sistema Nervioso/patologíaRESUMEN
Aging is an inevitable process in human development, which follows a time course that can be delayed, or hastened, by lifestyles, diseases and events. The factors that affect the aging process can be delayed, but not prevented. This paper evaluates the neurochemical changes in the aging process and their relevance in the modality of elderly medication. For clarity and understanding of the relevant neurobiochemical process and effects, the neuroanatomical, physiological, and neurobehavioral changes are reviewed as they relate to medication in the elderly.
Asunto(s)
Envejecimiento/fisiología , Encéfalo/fisiología , Proteínas del Tejido Nervioso/metabolismo , Vías Nerviosas/fisiología , Plasticidad Neuronal/fisiología , Adaptación Fisiológica/fisiología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Neuroquímica/métodosRESUMEN
The endemicity of malaria in tropical areas of the world persists, especially in countries south of Saharan Africa. The efforts and concerns invested by the World Health Organization and other health agencies to eradicate malaria are commendable. However, in spite of all these efforts, the loss in economic and human resources continues. In a previous report, the long-term health effects of insecticide-impregnated bednet (IIBN) use were highlighted with the expectation of attracting serious thoughts and further research on the issue. This present paper is an update on that expectation. Results from a comprehensive literature search show that not much work has been done on the effects of long-term exposure to IIBNs in combating malarial infection. The efficacy of IIBNs is not in question. What is in question is whether long-term exposure to IIBNs have any health effects. The aims and outcomes of the research found in the literature on the subject to date seem to support only the efficacy of the temporal use of plain bednets, but not the use of IIBNs, and do not tell much about the long-term effects of IIBN exposure. All pesticides are toxic by nature and present risks of adverse effects. While there is agreement that IIBNs can be effective in reducing malarial morbidity and mortality under field trials, a number of factors relating to their long-term-exposure health effects have yet to be determined. Further reliable research projects are recommended urgently. However, some of the anticipated behavioral effects caused by insecticidal use will be avoided by the use of untreated nets instead.
Asunto(s)
Enfermedades Endémicas/prevención & control , Exposición a Riesgos Ambientales/efectos adversos , Salud , Insecticidas/efectos adversos , Malaria/prevención & control , Control de Mosquitos , Animales , Exposición a Riesgos Ambientales/estadística & datos numéricos , Humanos , Insecticidas/administración & dosificación , Insecticidas/farmacologíaRESUMEN
Epilepsy is a common neurological disorder; however, in Nigeria and other tropical regions, the causes of epileptic seizures differ greatly in etiology. This paper is an attempt to highlight some possible microbiological aspects of epileptic seizures. A literature review was carried out to identify the extent to which microbial infections were involved in the elicitation of epileptic seizures. Data were collected from several clinics in the community and hospitals in Nigeria and correlated with the evidence from the literature review. It was found that different microbial agents including viral, bacterial, protozoa, and fungal agents were involved in several aspects of epileptic seizures. Malaria was found to cause more than 88% of childhood epileptic seizures and 12% of adult seizures. Generalized tonic-clonic seizures occurred in more than 40% of adult patients. Partial seizures were uncommon. Cases of epileptic seizures associated with bacteria (e.g., brucellosis), viral, fungal, and protozoa infections were frequently reported. Malaria, tapeworm, and cysticercosis were some of the common infectious causes of epilepsy; however, in some cases, the cause remained unknown. From these findings, it was evident that microbiological aspects of epilepsies are possible research areas that might be developed. It is believed that the unraveling of the various microbiological factors in epileptic seizures would have important implications for understanding the underlying neurobiology, evaluating treatment strategies, and perhaps planning health-care resources for the affected. It will also help to improve the prognostic factors in initial seizure symptomatic etiology and presence of any structural cerebral abnormalities.
Asunto(s)
Epilepsia/microbiología , Epilepsia/parasitología , Adolescente , Adulto , Niño , Preescolar , Epilepsia/diagnóstico , Femenino , Humanos , Malaria/complicaciones , Masculino , Persona de Mediana Edad , Nigeria , Clima Tropical , Virosis/complicacionesRESUMEN
Sensible physical exercise is shown to prevent certain neurovascular problems. However, in recent times, non-traumatic sudden death in young athletes has been observed and the incidence level is always very disturbing, because of the spontaneous nature of the occurrence. It most commonly occurs fivefold more in male than female athletes. Although it is believed that congenital cardiovascular disease is the leading cause of non-traumatic sudden athletic death, however, sudden physical alteration in the biochemical composition of the body system may, at least in part, play an important role. The role of antioxidants in the general maintenance of homeostasis has already been established. In this study, total antioxidant function in athletes subjected to controlled physical exercise was evaluated to determine the extent to which intensive physical exercise could alter the health conditions if adequate actions are not taken to adjust the biochemistry of the body system. Ten male field-track athletes were exercised using a fixed workload treadmill test. Blood samples were drawn before and after the exercise. The subjects exercised almost to their maximum running distance at a higher "fatigue" workload for a maximum of 20 min each day for five days. The lymphocytes' total antioxidant function was measured by addition of a peroxide (oxidative stress) to complete the medium. Lymphocyte growth response with peroxide was reported as a percentile of growth responses from a reference range of apparently healthy individuals. Values below the 25th percentile indicate a deficient antioxidant function. The results showed that although vitamin B3, B6, and B12 requirements were normal, there was a consistent low value in the total percentile of vitamins B1 (<79%), B2 (<54%), folate (<33%, and biotin (<70%). There was a dramatic decrease in the mean values of antioxidant function (38.1%) in all the subjects as opposed to the reference range of <75%. Overall reduction antioxidant function indicates decreased ability to resist oxidative stress, or an increased oxidant load, suggesting increased antioxidant utilization and/or cellular "tear and wear" scenario. It is therefore suggested that after intensive physical exercise, antioxidant functions should be monitored and supplemented whenever necessary to maintain the integrity of the cellular function.
Asunto(s)
Antioxidantes/metabolismo , Ejercicio Físico/fisiología , Homeostasis/efectos de los fármacos , Aptitud Física/fisiología , Carrera/fisiología , Complejo Vitamínico B/sangre , Adolescente , Adulto , Antioxidantes/análisis , Muerte Súbita/etiología , Prueba de Esfuerzo , Humanos , Linfocitos/sangre , Masculino , Estrés Oxidativo/fisiología , Peroxidasa/metabolismo , Medicina Deportiva , Atletismo/fisiologíaRESUMEN
It is an accepted fact that many food products that we eat today have the possibility of being contaminated by various chemicals used from planting to processing. These chemicals have been shown to cause illnesses for which some concerned government agencies have instituted regulatory mechanisms to minimize the risks and the effects on humans. It is for these concerns that reliable and accurate rapid determination techniques are needed to effect proper regulatory standards for the protection of people's nutritional health. This paper, therefore, reports the comparative evaluation of the extraction methods in the determination of atrazine (commonly used in agricultural as a herbicide) residues in foods using supercritical fluid chromatography (SFC) and enzyme-linked immunosorbent assay (ELISA) techniques. Supercritical fluid extraction (SFE) and microwave solvent extraction (MSE) methods were used to test samples of frozen vegetables, fruit juice, and jam from local food markets in Houston. Results showed a high recovery percentage of atrazine residues using supercritical fluid coupled with ELISA and SFC than with MSE. Comparatively, however, atrazine was detected 90.9 and 54.5% using SFC and ELISA techniques, respectively. ELISA technique was, however, less time consuming, lower in cost, and more sensitive with low detection limit of atrazine residues than SFC technique.
Asunto(s)
Atrazina/análisis , Cromatografía con Fluido Supercrítico/métodos , Ensayo de Inmunoadsorción Enzimática/métodos , Análisis de los Alimentos/métodos , Contaminación de Alimentos/análisis , Herbicidas/análisis , Cromatografía con Fluido Supercrítico/economía , Ensayo de Inmunoadsorción Enzimática/economía , Manipulación de Alimentos , Microondas , Solventes , TexasRESUMEN
BACKGROUND: AIDS-related stigma discourages individuals who are aware of their HIV-positive status from sharing information about their status with their sexual partners and families, and makes it difficult to prevent the spread of the infection or to plan a secure future for surviving children and family members. It is essential that barriers to screening, prevention, and care are understood and removed so that persons living with HIV/AIDS can benefit optimally from available health and social services. OBJECTIVES: The objectives of this article are to summarize the literature on barriers posed by stigma to HIV/AIDS prevention and care in sub-Saharan Africa, to analyze the contexts in which AIDS-related stigma and discrimination are manifested, and to suggest potential prevention strategies. METHODS: The authors collected and reviewed published studies from standard research databases and reference lists of relevant articles. RESULTS: The ways in which AIDS stigma is overtly or covertly expressed are shaped by a range of social, cultural, political, and economic factors. Stigma plays into existing social inequalities and is manifested at all levels: in the wider society, in institutions, in families, and at the individual level. IMPLICATIONS FOR POLICY AND PRACTICE: Influences on AIDS-related stigma and discrimination are rooted in the structure of communities and societies, and therefore effective interventions should be based on a sound theoretical foundation and include attention to individual as well social and structural barriers. Given the diversity of cultures among the various countries in Africa, interventions to reduce AIDS stigma are likely to be more effective if they are context-specific and sensitive to the prevailing sociocultural and economic environment of each country.
Asunto(s)
Serodiagnóstico del SIDA/psicología , Síndrome de Inmunodeficiencia Adquirida/psicología , Actitud Frente a la Salud , Prejuicio , Síndrome de Inmunodeficiencia Adquirida/etnología , Síndrome de Inmunodeficiencia Adquirida/prevención & control , África del Sur del Sahara/etnología , Trazado de Contacto , Cultura , Humanos , Opinión Pública , Medio SocialRESUMEN
Malaria is a protozoan disease caused in humans by the genus Plasmodium of which four species are known: P. falciparum, P. vivax, P. ovale, and P. malariae. It is transmitted through the bite of infected female mosquitoes of the genus Anopheles. Malaria is endemic in tropical and subtropical regions of the world. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Approximately 40% of the world''s population, mostly those living in the poorest nations, are at risk. Much of the deaths due to malaria occur in Africa, mostly among children. The search for prevention and control interventions that are effective and sustainable remains an abiding challenge for national governments and international health agencies. To this end, the World Health Organization and several nongovernmental organizations are investing in the use of insecticide-treated mosquito nets (ITMNs) as a viable option. Trials of ITMNs in the 1980s and 1990s showed that they reduce deaths in young children by an average of 20% and multilateral agencies, spearheaded by Roll Back Malaria (RBM), seek to have 60% of the populations at risk sleeping under ITMNs by 2005. All pesticides are toxic by nature and present risks of adverse effects that depend on toxicity of the chemical and the degree of exposure. While there is agreement that ITMNs can be effective in reducing malaria morbidity and mortality under field trials, a number of factors relating to their sustainability and contribution to health improvement in less-developed countries have yet to be determined. In particular, the adverse effects associated with their long-term use and misuse has yet to be fully evaluated. Although this paper examines potential neurotoxic and neurobehavioral effects of long-term use of ITMNs and discusses priority public health actions for protecting the health of users, it forms the basis for further research.
Asunto(s)
Enfermedades Endémicas/prevención & control , Insecticidas/efectos adversos , Malaria/prevención & control , Control de Mosquitos/métodos , Ropa de Cama y Ropa Blanca , Sistema Nervioso Central/efectos de los fármacos , Humanos , Insecticidas/administración & dosificación , Neoplasias/inducido químicamente , Piretrinas/administración & dosificación , Piretrinas/efectos adversosRESUMEN
This paper evaluates the possible reasons for consistent vitamin B12 deficiency in chronic toxigenic mold exposures and the synergistic relationships with the possible mycotoxic effects on one-carbon metabolism that lead to the manifestations of clinical neuropathological symptomology. Vitamins are first defined in general and the nutritional sources of vitamin B12 are evaluated in particular. Since patients with chronic exposures to toxigenic molds manifest vitamin B12 deficiencies, the role of mycotoxins in vitamin B12 metabolism is assessed, and since vitamin B12 plays important biochemical roles in one-carbon metabolism, the synergistic effects with mycotoxins on humans are reviewed. An outline of the proposed mechanism by which mycotoxins disrupt or interfere with the normal functions of vitamin B12 on one-carbon metabolism is proposed. The overall functions of vitamin B12 as a source of coenzymes, in intracellular recycling of methionine, in methionine synthase reaction, in the prevention of chromosome breakage, in methylation, and in maintaining a one-carbon metabolic balance are reviewed. Signs, symptoms, and clinical neurological indications of vitamin B12 deficiency are also cited. By implication and derivation, it is likely that the interruption of the structure and function of vitamin B12 would in turn interfere with the one-carbon metabolism leading to the neurological manifestations. This review is an attempt to formulate a basis for an ongoing research investigation on the subject.
Asunto(s)
Hongos/aislamiento & purificación , Espacio Intracelular/fisiología , Micotoxinas/metabolismo , Enfermedades del Sistema Nervioso/microbiología , Vitamina B 12/fisiología , Animales , Enfermedad Crónica , Exposición a Riesgos Ambientales/efectos adversos , Humanos , Deficiencia de Vitamina B 12/microbiologíaRESUMEN
Onychomycosis is a common nail disease responsible for approximately 50% of diseases of the nail. It occurs more in the elderly, though several cases have been reported among children. Several factors influence, such as climate, geography, and migration. The two dermatophytes most commonly implicated in onychomycosis are Trichophyton rubrum and T. mentagrophytes, accounting for more than 90% of onychomycoses. Nonetheless, several other toxigenic molds have been implicated. For convenience, onychomycosis is divided into four major clinical presentations: distal subungal, which is the most common form of the disease; proximal subungal, which is the most common form found in patients with human immunodeficiency virus infection; superficial; and total dystrophic onychomycosis. Epidemiology of onychomycosis in adults and children is evaluated and the most common clinical symptoms addressed. Although the risk factors are discussed, the multifactorial nature of onychomycosis makes this inexhaustible. The diagnosis and treatments are difficult and the choice of appropriate antifungal drugs complex and require the knowledge of the chemical structures of the metabolites of the molds that cause onychomycosis and their interaction with the antifungal drugs. This is true because most of the antifungal drugs are derived from mold/fungal metabolism. Treatment with griseofulvin and amphotericin is displaced by the use of newer drugs from azole compounds, pyrimidines, and allylamines derivatives. Amorolfine, itraconazole, and ciclopirox nail lacquer solution 8 have gained support globally, but the side effects, drug resistance, and persistence of the disease are still a serious concern to the patients, just as economics and quality of life. Hence, the search for safer and more efficacious drug treatments are continuing.
Asunto(s)
Antifúngicos/uso terapéutico , Onicomicosis/tratamiento farmacológico , Onicomicosis/epidemiología , Antifúngicos/química , Humanos , Estructura MolecularRESUMEN
This paper evaluates the monthly, quarterly, and seasonal variation of antigenic bacterial infections among the working class in the inner city of Houston using the Wellcogen Rapid Test methods. One of the aims was to demonstrate how this method could be used effectively in screening patients at risk and preventing the spread of antigenic bacteria such as Streptococcus pneumoniae, Haemophilus influenzae b, Streptococcus (Strep b), and Neisseria meningitidis (mainly group c and b). A total of 2,837 patients were screened for bacterial infections; 908 (32%) were male and 1,929 (68%) were female. The age range was between 2 and 70 years. Of the total group, 356 (12.5%) patients were positive; 203 (57%) were female while 153 (43%) were male (male/female ratio of 1:1.3). Medically underserved and immune suppressed populations are the most affected by these bacterial infections. Blacks are the most affected (48%) compared to Native Americans (1%), but children under 10 years of age have the highest incidence. This research showed, in addition, that the Wellcogen Rapid Tests are effective (356 cases identified) for a rapid screening of infectious bacteria. Explanation for these results was probably due to poor living conditions, poor hygiene, and viral immune suppression in adults and immature immune systems in neonates and children under 10 years of age.
Asunto(s)
Variación Antigénica , Infecciones Bacterianas/epidemiología , Clase Social , Población Urbana , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Infecciones por Haemophilus/epidemiología , Infecciones por Haemophilus/genética , Haemophilus influenzae tipo b/aislamiento & purificación , Humanos , Masculino , Infecciones Meningocócicas/epidemiología , Infecciones Meningocócicas/genética , Persona de Mediana Edad , Neisseria meningitidis/aislamiento & purificación , Infecciones Neumocócicas/epidemiología , Serotipificación/métodos , Infecciones Estreptocócicas/epidemiología , Streptococcus agalactiae/aislamiento & purificación , Streptococcus pneumoniae/aislamiento & purificación , Texas/epidemiologíaRESUMEN
Intermittent photic stimulation (IPS) in patients with photosensitive epilepsy (PSE) leads to EEG abnormalities, which include generalized discharges with spike and wave activity. This paper investigates 33 PSE patients, 14 (42%) males and 19 (58%) females. The age range was between 8 and 45 years. After the treatment of the patients with sodium valproate (VPA), the EEG examinations showed that the generalized discharges disappeared, while the occipital spikes persisted. The mechanism of action of VPA was re-evaluated in order to ascertain whether or not the persistent occipital was due to a failure in inhibitory postsynaptic potential (IPSP). It was concluded that the possible causes of VPA's inefficacy in abolishing occipital spikes in PSE was not necessarily due to a failure in IPSP, but rather it could be due to a time-dependent failure of certain cells of the visual system to respond positively to the VPA's modulatory activity, probably involving the ionic channels, neurotransmitters, and the second messenger systems. The relationship between occipital spikes and visual evoked response is discussed. The extent to which metabolic processes and neurotransmitters are involved is also evaluated.
Asunto(s)
Potenciales de Acción/efectos de los fármacos , Epilepsia Refleja/tratamiento farmacológico , Lóbulo Occipital/anomalías , Ácido Valproico/uso terapéutico , Adolescente , Adulto , Niño , Electroencefalografía , Epilepsia Refleja/patología , Potenciales Evocados/efectos de los fármacos , Potenciales Evocados Visuales/efectos de los fármacos , Potenciales Postsinápticos Excitadores/efectos de los fármacos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Lóbulo Occipital/efectos de los fármacos , Lóbulo Occipital/patología , Resultado del Tratamiento , Ácido Valproico/efectos adversos , Corteza Visual/anomalías , Corteza Visual/efectos de los fármacos , Corteza Visual/patologíaRESUMEN
Epidemiological evidence arising mainly from studies undertaken in sub-Saharan Africa suggests that sleeping under insecticide-treated mosquito nets is a cost-effective and efficacious method of controlling malaria. For this reason, promotion of use of insecticide-treated nets (ITNs) has become a key malaria control strategy. In 1999, the United Nations Children's Fund (UNICEF) and WHO set the goal of providing 32 million nets and 320 million net treatments a year for the next 10 years to protect 80% of African households against malaria. All pesticides are toxic by nature and are associated with adverse health risks that depend on the toxicity of each chemical, as well as the type and degree of exposure. Thus, massive scale-up of use of ITNs in malaria endemic poor countries can be expected to present tangible risks to health, especially where the insecticides for net treatment and re-treatment are handled mostly by untrained persons in uncontrolled settings. This paper examines potential health risks of mass use of ITNs in malaria endemic poor countries and calls for the implementation of strategies to minimize potential risks through careful selection of products, appropriate labeling (including labeling in the local languages of the user communities), pesticide safety education of the public and training of health personnel, and active monitoring of adverse health effects to document actual and potential hazards, and to facilitate planning of mitigation efforts.
Asunto(s)
Ropa de Cama y Ropa Blanca , Enfermedades Endémicas/prevención & control , Insecticidas/administración & dosificación , Malaria/prevención & control , Control de Mosquitos/métodos , Países en Desarrollo , Educación en Salud , Humanos , PobrezaRESUMEN
Patients with photosensitive epilepsy are susceptible to seizures due to photoparoxysmal response (PPR). This response adversely precipitates factors that modify the functional status of the visual system. Such factors may or may not be evident superficially, but may lead to ocular defects due to trauma, hormonal imbalance, abnormal intraocular pressure (IOP), or any other reflex-inducing stimuli. The extent to which photosensitive epileptic patients suffer from PPR-related ocular defects has not been documented fully. In this investigation, ocular defects in patients with photosensitive epilepsy are studied using visual-evoked response (VER). A total of 212 photosensitive epileptic patients were studied to ascertain the magnitude and distribution of ocular defects using the changes in EEG and visual-evoked potential (VEP); 51% of the patients were female, the age range was 1-46 years. The major ocular defects and complications found were visual field defects, optic nerve abnormalities, nystagmus, cataracts, amblyopia, and migraine. These findings were analyzed according to age and sex. The relationship between the ocular abnormalities and the interpretations of the changes in the characteristics of the VEP indicated that optic-related atrophies, visual defects, optic neuritis, chiasmal compression, nystagmus, migraine headache, cataracts, and amblyopia were prevalent in photosensitive epileptic patients at varying degrees. The results showed that although ocular defects in photosensitive epilepsy may not be obvious differentially, VEP can be used in their diagnosis, contrary to earlier studies reporting that VEP is not of much value in epilepsy diagnosis.
Asunto(s)
Epilepsia Refleja/complicaciones , Potenciales Evocados Visuales/fisiología , Oftalmopatías/fisiopatología , Adolescente , Adulto , Distribución por Edad , Ambliopía/etiología , Ambliopía/fisiopatología , Catarata/etiología , Catarata/fisiopatología , Niño , Preescolar , Electroencefalografía , Oftalmopatías/etiología , Femenino , Glaucoma/etiología , Glaucoma/fisiopatología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Trastornos Migrañosos/etiología , Trastornos Migrañosos/fisiopatología , Enfermedades del Nervio Óptico/etiología , Enfermedades del Nervio Óptico/fisiopatología , Trastornos de la Visión/etiología , Trastornos de la Visión/fisiopatologíaRESUMEN
Chronic exposure to toxigenic molds in water-damaged buildings is an indoor environmental health problem to which escalating health and property insurance costs are raising a statewide concern in recent times. This paper reviews the structural and functional properties of mycotoxins produced by toxigenic molds and their interactive health implications with antifungal drugs. Fundamental bases of pathophysiological, neurodevelopmental, and cellular mechanisms of mycotoxic effects are evaluated. It is most likely that the interactions of mycotoxins with antifungal drugs may, at least in part, contribute to the observable persistent illnesses, antifungal drug resistance, and allergic reactions in patients exposed to chronic toxigenic molds. Safe dose level of mycotoxin in humans is not clear. Hence, the safety regulations in place at the moment remain inconclusive, precautionary, and arbitrary. Since some of the antifungal drugs are derived from molds, and since they have structural and functional groups similar to those of mycotoxins, the knowledge of their interactions are important in enhancing preventive measures.
Asunto(s)
Antifúngicos/farmacología , Exposición a Riesgos Ambientales/efectos adversos , Enfermedades Ambientales/etiología , Micotoxinas/antagonistas & inhibidores , Contaminación del Aire Interior/efectos adversos , Enfermedad Crónica , Farmacorresistencia Fúngica , Enfermedades Ambientales/microbiología , Enfermedades Ambientales/terapia , Hongos/efectos de los fármacos , Humanos , Modelos Biológicos , Micotoxinas/química , Micotoxinas/envenenamiento , Enfermedades del Sistema Nervioso/etiologíaRESUMEN
This study was conducted to assess factors that influence use of antenatal care services with both quantitative and qualitative designs. Methods used were structured questionnaire interviews and focus group discussions in the Kampung District, Kampot Province in Cambodia with a volunteer sample of 260 postnatal mothers. The outcome measure was factors influencing use of antenatal care services. The results showed that first-time mothers (primigravidas) were more likely to use antenatal services than multiparous mothers (OR = 1.87; p = 0.001). Mothers with some school education used antenatal services more than those with no school education (OR = 2.0; p = 0.01). Mothers engaged in professional occupations by virtue of their higher levels of educational attainment were more likely to use antenatal services than those engaged in agriculture (OR = 2.54; p = 0.001). Use of antenatal care services was higher in the districts whose health centers were supported by a foreign nongovernmental organization as compared to other districts with no such support (OR = 2.44; p = 0.001). Although services were generally inadequate, those that existed were underutilized by the mothers. Major factors influencing use of services include distance, lack of transport, and lack of awareness of the benefits of antenatal care by the mothers, thus resulting in a general notion that antenatal care is only important when problems occur during pregnancy. It is concluded that for remote villages, mobile antenatal clinics should be provided to improve access, and greater emphasis should be placed on health educating the mothers about the potential benefits of antenatal care, with special attention to multiparous mothers and those from the lower socio-economic class, among whom use of antenatal services was lowest.
Asunto(s)
Atención Prenatal/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Cambodia/epidemiología , Femenino , Grupos Focales , Encuestas de Atención de la Salud/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Humanos , Entrevistas como Asunto , Masculino , Paridad , Embarazo , Complicaciones del Embarazo/epidemiología , Calidad de la Atención de Salud/estadística & datos numéricos , Servicios de Salud Rural/estadística & datos numéricos , Factores Socioeconómicos , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
Chlorinated dioxins are the group of environmental pollutants consisting of 210 chlorinated dibenzo-p-dioxins and dibenzofurans. They are highly toxic and persistent. They are lipophilic and can easily biomagnify in the food chain, hence posing a serious threat to human health. The daily consumption of low-level contaminated food, mainly of animal origin, leads to the accumulation of dioxins in the human body. The exposures of the general human population to dioxins and the specific issues of a risk assessment of dioxin pose serious concerns in public environmental and nutritional health. This paper reviews the analysis of chlorinated dioxins in ground beef. The sources of contamination of chlorinated dioxins in ground beef are first reviewed to form a basis for a clear understanding of the health implications of chlorinated dioxins in the human food chain and why it is necessary to monitor the level of dioxins in animal food products, especially ground beef. The methods of collection, sampling, and processing of ground beef, and the methods of sample clean up prior to the analysis, are reviewed. Emphasis is laid on the new techniques that are available and that might be effective in the analysis of chlorinated dioxins in ground beef. Among these new methods and techniques are: the synergistic combination of ELISA/GC/MS, direct sample introduction to /GC/MS-MS, automated clean-up method, and the supercritical fluid extraction methods. The possible treatments of results from each method and technique are discussed and their respective efficiencies are compared. Finally, quality control and quality assurance parameters are evaluated for levels of accuracy, reproducibility, and precision.
Asunto(s)
Monitoreo del Ambiente/métodos , Carne/análisis , Dibenzodioxinas Policloradas/metabolismo , Animales , Bovinos , Ensayo de Inmunoadsorción Enzimática/métodos , Ensayo de Inmunoadsorción Enzimática/tendencias , Contaminación de Alimentos/análisis , Cromatografía de Gases y Espectrometría de Masas/métodos , Cromatografía de Gases y Espectrometría de Masas/tendenciasRESUMEN
Patients with photosensitive epilepsy (PSE) are said to lose photosensitivity with age. That is, they do not suffer from photosensitive epileptic seizures after the third decade of life. This claim seems to be an over generalised statement and does not take into account all other important confounding factors that determine the duration and process of neurological illnesses. Hence, there are contradictions pertaining to age of freedom of photosensitivity in epilepsy and in epilepsy with photosensitivity. Often patients are declared free from epileptic activity; however, some of these patients are still found to have seizures a few years later. This paper assesses the freedom photosensitivity in 58 PSE patients to ascertain validity of the claim that patients lose their photosensitivity with age. Thirty-nine of the 58 patients (67%) were female whilst (33%) were male, giving a female/male ratio of 3:1. The average age of onset of photosensitivity was 7 years. Of all the cases studied forty-one (71%) had a family history of photosensitive epilepsy, while seventeen (29%) had no family history of photosensitive epilepsy. Proof of photosensitivity in all the patients was determined by persistent EEG abnormalities including occipital spike and wave discharges. Results show that photosensitivity persisted beyond adolescence; hence, there was no specific age limit of freedom from photosensitivity in patients, especially in those with family history of photosensitive epilepsy. However, those patients who were having regular antiepileptic medication and/or were taking adequate preventive measures had a temporary period of freedom from sensitivity which lasted 1-4 years. These findings suggest that freedom from photosensitivity is not age-dependent, especially in those patients with family history of photosensitive epilepsy.
Asunto(s)
Distribución por Edad , Epilepsia Refleja/fisiopatología , Adolescente , Adulto , Edad de Inicio , Niño , Preescolar , Factores de Confusión Epidemiológicos , Electroencefalografía , Epilepsia Refleja/tratamiento farmacológico , Epilepsia Refleja/epidemiología , Epilepsia Refleja/genética , Femenino , Humanos , Incidencia , Masculino , Estados Unidos/epidemiologíaRESUMEN
Mycotic demyelinating optic neuritis is a neurological disorder of the visual system caused by mycotoxins released by indoor toxic molds. Although the health effect of indoor toxic mold on the population worldwide is now one of the "emerging diseases", its involvement in chronic demyelinating optic neuritis has not been reported. Most of the neurological and immunologic abnormalities associated with toxic mold mycotoxins are very difficult to treat successfully, especially neural demyelination of the central and peripheral nervous systems. This paper presents the case of a 42-year-old white female, in whom chronic demyelinating optic neuritis with persistent visual defects due to chronic exposure to toxic molds was diagnosed at the age of 34 years. In spite of all the therapeutic services given to her for over 8 years, her illness persisted and was difficult to treat. However, we successfully treated her with a combination of intravenous immune globulin (IVIG) and itraconozole (Sporanox) when all other treatment modalities failed. This is probably the first report where persistent toxic mold-induced neurological and immunologic disorders were successfully treated with a combination of itraconozole and IVIG.
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Enfermedades Desmielinizantes/tratamiento farmacológico , Hongos/inmunología , Inmunoglobulinas Intravenosas/uso terapéutico , Itraconazol/uso terapéutico , Micotoxinas/efectos adversos , Neuritis Óptica/tratamiento farmacológico , Adulto , Antifúngicos/uso terapéutico , Autoanticuerpos/sangre , Enfermedad Crónica , Enfermedades Desmielinizantes/complicaciones , Enfermedades Desmielinizantes/inmunología , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Exposición a Riesgos Ambientales , Potenciales Evocados Visuales/efectos de los fármacos , Femenino , Humanos , Micotoxinas/inmunología , Neuritis Óptica/complicaciones , Neuritis Óptica/inmunologíaRESUMEN
The phenomenon of building-related diseases is attracting much research interest in recent years because of the extent to which it affects people with compromised immune systems, especially children. In this study, we reported the neurological findings in children who attended our Center because of chronic exposure to toxic molds. Clinical neurological and neurobehavioral questionnaires were administered with the cooperation of the children's parents. The children then underwent a series of neurophysiological tests including electroencephalogram (EEG), brainstem evoked potential (BAEP), visual evoked potential (VEP), and somatosensory evoked potential (SSEP). The results showed high levels of abnormalities in the analysis of the subjective responses derived from the questionnaires. The EEG examination was abnormal in seven out of ten of the patients compared to the controls with only one in ten with episodes of bihemispheric sharp activity. In all the patients, there was frontotemporal theta wave activity that seemed to indicate diffuse changes characteristic of metabolic encephalopathies. Also, there was highly marked 1 to 3 Hz delta activity that was asymmetrical in the right hemisphere of the brain in three out of ten patients. The waveforms of BAEP showed abnormalities in 90% of the patients with both 15' and 31' check sizes compared to none in the controls. There were significant delays in waveform V in a majority of the patients representing dysfunctional cognitive process and conductive hearing loss in both ears. VEP showed clear abnormalities in four in ten of the patients with P100 amplitudes and latencies decreased bilaterally. In all the patients, there was slowing of conduction in the right tibial at an average of 36.9 ms and there was significant decrease in amplitude of response at the proximal stimulation site. Sensory latencies obtained in the median, ulnar, and sural nerves bilaterally showed abnormalities in five out of ten compared to none in the controls. The median, ulnar, and sural sensory potentials were abnormal in six out of ten patients. There was prolongation of the median distal sensory latencies bilaterally at an average of 4.55 ms on the right and an average of 6.10 ms on the left as compared to the ulnars of 2.55 ms bilaterally. There was no abnormality in the controls. These findings represent evidence of diffuse polyneuropathy to which three patients demonstrated borderline slow motor conduction at an average of 41.1 ms. Overall, the objective neurophysiological measurements (EEG, BAEP, VEP, and SSEP) were abnormal, indicating significant neurological deficits in all the patients. Our findings revealed the extent to which toxic molds can affect the neurological and behavioral status of children. Further work should be encouraged in this regard.