RESUMEN
The author examines fertility trends among immigrants in California. "Women born in Mexico accounted for well over half (61 percent) of all Hispanic women giving birth and more than one-fourth (27 percent) of all California births in 1992." Implications for the future are considered.
Asunto(s)
Emigración e Inmigración , Etnicidad , Fertilidad , Hispánicos o Latinos , Américas , Cultura , Demografía , Países Desarrollados , Países en Desarrollo , América Latina , México , América del Norte , Población , Características de la Población , Dinámica Poblacional , Migrantes , Estados UnidosRESUMEN
Propylthiouracil, which is commonly used in the treatment of hyperthyroidism, has been associated in adults with antineutrophil cytoplasmic autoantibody, a serologic marker of vasculitis. Severe renal disease has not been reported as a complication of therapy with this drug. We report severe antineutrophil cytoplasmic autoantibody-positive vasculitis in children receiving propylthiouracil, as well as rapidly progressive crescentic glomerulonephritis after administration of this drug.
Asunto(s)
Autoanticuerpos/análisis , Glomerulonefritis/inducido químicamente , Propiltiouracilo/efectos adversos , Adolescente , Anticuerpos Anticitoplasma de Neutrófilos , Biomarcadores/análisis , Niño , Femenino , Glomerulonefritis/inmunología , Humanos , Hipertiroidismo/tratamiento farmacológico , Masculino , Propiltiouracilo/uso terapéuticoRESUMEN
The possible cerebral sparing effect of thiopental was evaluated in 32 severely asphyxiated neonates randomly assigned to either a thiopental treatment or control group. All infants had neurologic manifestations of asphyxia and required assisted ventilation. Thiopental was begun at a mean age of 2.3 hours and was given as a constant infusion that delivered 30 mg/kg over 2 hours. Treatment was continued at a lower dose for 24 hours. Seizure activity occurred in 76% of infants given thiopental and 73% of control infants at a mean age of 1.5 and 2.5 hours, respectively. Although initial arterial blood pressure was similar in both groups, hypotension occurred in 88% of treated and 60% of control infants. The amount of blood pressure support required was significantly greater (P less than 0.005) in the thiopental treatment group. Three infants died in the control group, and five in the treatment group. Developmental assessment was performed at a minimum of 12 months of age in 22 infants. There were no significant differences in neurologic, cognitive, or motor outcome between groups. Deteriorating performance over time was a consistent trend in both groups. These findings indicate that treatment of severe perinatal asphyxia with thiopental does not appear to have a cerebral sparing effect and may be associated with significant arterial hypotension.
Asunto(s)
Asfixia Neonatal/tratamiento farmacológico , Tiopental/uso terapéutico , Puntaje de Apgar , Asfixia Neonatal/complicaciones , Asfixia Neonatal/terapia , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Isquemia Encefálica/prevención & control , Desarrollo Infantil , Ensayos Clínicos como Asunto , Estudios de Seguimiento , Edad Gestacional , Humanos , Recién Nacido , Infusiones Parenterales , Presión Intracraneal/efectos de los fármacos , Examen Neurológico , Evaluación de Procesos y Resultados en Atención de Salud , Distribución Aleatoria , Convulsiones/etiología , Convulsiones/terapia , Tiopental/administración & dosificación , Tiopental/efectos adversosAsunto(s)
Trasplante de Médula Ósea , Toxoplasmosis/etiología , Adolescente , Niño , Combinación de Medicamentos/uso terapéutico , Humanos , Terapia de Inmunosupresión/efectos adversos , Masculino , Sulfametoxazol/uso terapéutico , Toxoplasmosis/diagnóstico , Toxoplasmosis/inmunología , Toxoplasmosis/prevención & control , Trimetoprim/uso terapéutico , Combinación Trimetoprim y SulfametoxazolRESUMEN
Extramembranous glomerulonephritis is an uncommon but distinct pathologic lesion in children. The diagnosis is established by the characteristic light, immunofluorescent, and ultrastructural abnormalities in renal biopsy specimens. This report describes seven of the ten children with this lesion studied in the past 11 years. Emphasis is given to the comparison of four children with idiopathic membranous glomerulonephritis with three others who presented with a nephrotic syndrome but subsequently developed evidence of systemic lupus erythematosus. Two of the latter three children, and three others with SLE and MGN not described in detail, demonstrated deposition of IgA by immunofluorescence along glomerular capillaries. Five of six children with SLE and MGN had microtubular structures in glomerular endothelial cells demonstrable by electron microscopy. These observations suggest that children with MGN require careful and continuing study for evidence of SLE.