RESUMEN

The aim of this report is to describe how to calculate if an acid-base balance is trustworthy.

Asunto(s)

RESUMEN

The aim of this report is to describe how to calculate if an acid-base balance is trustworthy.(AU)

Asunto(s)

RESUMEN

The present knowledge of epidemiological methods, applied to assess the correlation between industrial contaminants and rates of congenital anomalies is reviewed. The concept of congenital anomalies may be extended to include other adverse reproductive outcomes, such as malformations, infant mortality, stillbirths, spontaneous abortions, intrauterine growth retardation, ectopic pregnancies, multiple births, altered secondary sex ratio, and parental sub-fertility. The review of occupational exposures associated with congenital anomalies indicated: (1) inconsistency of the reported associations; (2) more positive than negative associations; (3) solvents are the best studied, and the most frequently reported teratogenic chemicals; (4) common congenital anomalies are the most frequently studied diagnostic categories, while other defects are grouped into larger categories, with little biological meaning. The review of environmental exposures indicated that: (1) single-site studies outnumber multi-site ones; (2) results are heterogeneous; (3) congenital anomalies are, in general, unspecific, and grouped into large categories, such as those defined by anatomic systems. Recent developments in molecular biology anticipate the possibility to measure exposures directly, instead of by different "proxies", as well as to analyze the genetic predisposition for the teratogenic response to given environmental agents. The strategy of building up large banks of biological materials has already started in several birth defects registries. The following procedural guidelines to assess the teratogenicity of a pollutant are recommended: (1) strength of the association; (2) consistency of findings in different studies; (3) specificity of the association; (4) time-exposure relationship; (5) existence of a dose-response gradient between exposure and disease occurrence; (6) biological plausibility; (7) coherence of the evidence with natural history of the disease; (8) experimental (or quasi-experimental) evidence and (9) reasoning by analogy.

Asunto(s)

RESUMEN

In this study, we analyze the association between industrial activity and the occurrence of 34 congenital anomalies. We selected 21 counties in Argentina during 1982-1994 and examined a total of 614,796 births in these counties in consecutive series. We used the International Standard Industrial Classification of All Economic Activities (United Nations, 1968) as an indicator of exposure to 80 specific industrial activities. Incidence rate ratios for each congenital anomaly were adjusted by the socioeconomic level of the county according to a census index of social deprivation. For a given exposure/anomaly association to be considered as significant and relevant, the exposure had to be a statistically significant risk for the occurrence of the anomaly and an increase in the birth prevalence rate of the congenital anomaly type involved had to be observed in those counties where the putative causal activity was being performed. Significant associations (p < 0.01) were identified between textile industry and anencephaly, and between the manufacture of engines and turbines and microcephaly. These observations are consistent with previous reports on occupational exposure, and their further investigation by means of case-control studies is recommended.

Asunto(s)

RESUMEN

The birth prevalence of specific types of congenital anomalies at low and high altitudes in South America were compared after adjustment for prenatal growth, ethnicity, and socioeconomic status. The material includes all 1,668,722 consecutive births occurring in 53 hospitals participating in the Latin-American Collaborative Study of Congenital Malformations (ECLAMC), having registered at least 100 malformed/control pairs between 1967 and 1995. The lowland subsample (below 2,000 m above the sea level) included 46,729 case-control pairs, ascertained in 1,539,432 births from 49 hospitals in 38 cities. The highlands (above 2,000 m) comprised 3,498 case-control pairs from 129,301 births, occurring in four hospitals from three cities. Unconditional logistic regression was used to estimate the relative risks for the exposure at high altitudes, adjusted by ethnicity (Amerindian yes/no), type of health service (public/private), and birth weight (below/equal and greater than 2, 500 g). The adjusted relative risks showed significantly (P < 0.01) higher values in the high than in the lowlands for four types of defects: cleft lip [relative risks (RR): 1.57; 95% confidence interval (CI): 1.27-1.94], microtia (RR: 3.21; 95% CI: 2.35-4.79), preauricular tag (RR: 2.09; 95% CI: 1.86-2.36), branchial arch anomaly complex (RR: 1.79; 95% CI: 1.23-2.61), constriction band complex (RR: 1.92; 95% CI: 1.11-3.31), and anal atresia (RR: 1.61; 95% CI: 1.01-2.57). Conversely, lower risks in the highlands were registered for two neural tube defects: anencephaly (RR: 0.33; 95% CI: 0.20-0.54), spina bifida (RR: 0.57; 95% CI: 0.37-0.78), as well as for hydrocephaly (RR: 0.41; 95% CI: 0.22-0.77) and pes equinovarus (RR: 0.70; 95% CI: 0.51-0.96). Even though some of these differences may be caused by undetected confounders, the coincidental finding of four types of craniofacial defects with higher, and two types of neural tube defect with lower frequencies in the highlands, suggest a real biological foundation.

Asunto(s)

RESUMEN

The first step of all healthcare actions aimed at promoting an appropriate quality of life for infants affected by Down syndrome (DS) is to ensure their survival. This investigation was aimed at estimating the infant mortality rate of infants affected with DS in urban populations of South America. Thirty-three hospitals included in the Latin American Collaborative Study of Congenital Malformations (ECLAMC) distributed in 23 cities of 5 South American countries followed 360 liveborn DS cases born during the 1988-1992 period. Families were recontacted after the infant should have reached the age of one year. The collected data included information about health status; i.e., frequency and dates of diagnosed illnesses and hospital admissions, and, in case of death, information on date, place and cause of death, and illness immediately before death. Information about the interviews included place, date, and name of the interviewer. A closed questionnaire was employed by the interviewers, mostly physicians, nurses, and social workers. Life table analysis up to the age of one year was performed by the actuarial survival method. The overall mean survival at age one year was 0.736 (SE=0.023). Thirty-three (9.2%) of the 360 cases died neonatally, and 62 (17.2%) within the remaining 2-to-12-month interval. The probability of survival at one year of age did not differ between public (209 cases; mean 0.718; SE=0.031) and private (151 cases; mean: 0.762; SE=0.035) (chi2:0.87; df:1; P >0.05) health systems. The 150 DS cases with a congenital heart defect (CHD) had a significantly lower P robability of survival at the age of one year (mean: 0.660; SE: 0.039) than did the 210 cases without CHD (mean: 0.790; SE: 0.028) (chi2:6.67; df:1; P <0.01). The death rate in the first year of life for DS cases without a detected cardiac defect (21%) is significantly higher than that reported in developed countries; namely, 16% from Italy, 11% from Canada, 10% from England, and 7% from Denmark.

Asunto(s)

RESUMEN

Efectuamos un seguimiento de 138 pacientes a largo plazo durante un período mínimo de 1,5 años y máximo de 11 con el objeto de determinar en nuestra población de pacientes con AR clásica o definida la morbimortalidad y obtener información respecto a su evolución . 112 mujeres y 26 hombres edad media 54 (+15 años)(rango :10 a 90 años). 20 pacientes ( 14,5 por ciento )fallecieron durante el seguimiento y las causas fueron:sépticas:5 pacientes;cardíacas:5;neoplasias:4;digestivas:2; insuficiencia respiratoria:2;neurológicas:1;endócrinas:1.La mortalidad fue mayor en los hombres (27 por ciento) que en las mujeres (11,6 por ciento) (p<0,001).40 por ciento de los muertos tenían clase funcional III-IV y el 85 por ciento de ellos tuvieron 2 o más admisiones hospitalarias (p<0,005).El 80por ciento de los fallecidos y el 41 por ciento de los vivos presentaron infecciones graves (p<0,005).El 55 por ciento de los que fallecieron tenían cardiopatías y fribosis pulmonar y el 30 por ciento de ellos desarrollaron neoplasias. El 85 por ciento de los muertos tuvo queratoconjuntivitis sicca y el 45,8por ciento de los vivos (p<0,005).El 89 por ciento de los fallecidos tuvieron Factor Reumatoideo en títulos superiores a 1/1280 y el 43,5 por ciento de los vivos e hipergammaglobulinemia mayor de 2g por ciento el 58,8 por ciento y 21,3 por ciento respectivamente (p<0,005).Conclusiones:La mortalidad global fue del 14,5 por ciento y las enfermedades infecciosas y cardiovasculares fueron las principales causas.Parámetros de mayor morbimortalidad resultaron :sexo masculino,clase funcional III-IV,presencia de QC sicca,fibrosis pulmonar,cardiopatías,infecciones graves,altos títulos de Factor Reumatoideo y marcada hipergammaglobulinemia.

Asunto(s)

RESUMEN

Efectuamos un seguimiento de 138 pacientes a largo plazo durante un período mínimo de 1,5 años y máximo de 11 con el objeto de determinar en nuestra población de pacientes con AR clásica o definida la morbimortalidad y obtener información respecto a su evolución . 112 mujeres y 26 hombres edad media 54 (+15 años)(rango :10 a 90 años). 20 pacientes ( 14,5 por ciento )fallecieron durante el seguimiento y las causas fueron:sépticas:5 pacientes;cardíacas:5;neoplasias:4;digestivas:2; insuficiencia respiratoria:2;neurológicas:1;endócrinas:1.La mortalidad fue mayor en los hombres (27 por ciento) que en las mujeres (11,6 por ciento) (p<0,001).40 por ciento de los muertos tenían clase funcional III-IV y el 85 por ciento de ellos tuvieron 2 o más admisiones hospitalarias (p<0,005).El 80por ciento de los fallecidos y el 41 por ciento de los vivos presentaron infecciones graves (p<0,005).El 55 por ciento de los que fallecieron tenían cardiopatías y fribosis pulmonar y el 30 por ciento de ellos desarrollaron neoplasias. El 85 por ciento de los muertos tuvo queratoconjuntivitis sicca y el 45,8por ciento de los vivos (p<0,005).El 89 por ciento de los fallecidos tuvieron Factor Reumatoideo en títulos superiores a 1/1280 y el 43,5 por ciento de los vivos e hipergammaglobulinemia mayor de 2g por ciento el 58,8 por ciento y 21,3 por ciento respectivamente (p<0,005).Conclusiones:La mortalidad global fue del 14,5 por ciento y las enfermedades infecciosas y cardiovasculares fueron las principales causas.Parámetros de mayor morbimortalidad resultaron :sexo masculino,clase funcional III-IV,presencia de QC sicca,fibrosis pulmonar,cardiopatías,infecciones graves,altos títulos de Factor Reumatoideo y marcada hipergammaglobulinemia.

Asunto(s)

RESUMEN

Due to persistence of poliomyelitis cases in the Pacific Coast of Mexico and particularly in the state of Sinaloa, a house to house vaccination strategy named "Sinaloa Operation" was carried out in 100% of the territory of this state. Sinaloa was divided in small geographical and statistical unit area (AGEB). Simultaneously, teams of nurse carried out a population census of children under five years old and pregnant women. Nurses vaccinated the children with Sabin trivalent vaccine in undiscriminating form. These activities were made in three phases. In the last phase (February 1991) 301, 441 Sabin vaccine doses were administered. This figure represents an extension of the vaccination coverage to the children of the seasonal migrant workers from other parts of the country. As a result of this programme. Sinaloa has not had any other polio case since two years ago.

Asunto(s)

RESUMEN

Three large and comparable series of births were used to test the working hypothesis that if there is a real seasonal variation in the frequency of a given congenital malformation; it would have to be shown by adequate analysis; to be more overt in non-tropical areas; and to be six months out of phase in northern and southern hemispheres. The data set were hospital births from tropical (287,165 births) and non-tropical (582,585 births) South America, and from Italy (508,536 births). Sixteen well-defined malformation types were tested: anencephaly, spina bifida, cephalocoele, hydrocephaly, microtia, cleft palate, cleft lip, oesophageal atresia, anal atresia, hypospadias, pes equino-varus, pes talovalgus, postaxial polydactylyl, pre-axial polydactylyl, diaphragmatic hernia, and Down's syndrome. No seasonal variation was proven (p less than 0.01) for any malformation type in any of the three series of data by means of Walter and Elwood's test, or Hewitt et al's non-parametric test2 applied to seven instances with sample sizes smaller than 50 cases. Variations of borderline significance (p less than 0.05) included oesophageal atresia in tropical South America, none in non-tropical South America, and anencephaly in Italy. It is concluded that seasonal variation in the occurrence of congenital malformations is a rare phenomenon when tests are strictly used within their recommended limitations.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Kainic acid (KA) was given in ovo to 6-day-old chick embryos. Examination of the retina after treatment indicated an immediate damage of cell in the ganglion layer. One week later, numerous cells died in the middle inner portion of the nuclear layer, apparently by the lack of an adequate number of targets in the ganglion cell layer.

Asunto(s)

RESUMEN

Coverage of intraoral ablative defects presents many different problems. Free dermal grafts have been used to cover exposed mandibular bone in dogs. Grafts were placed in animals both before and after irradiation. Grafts were uniformly successful in animals not previously irradiated but failed when placed after irradiation.

Asunto(s)

RESUMEN

The use of free autogenous grafts to the alveolus during root submergence was shown to be a method that might be used to prevent the loss of masticatory mucosa and vestibular depth, which have been regarded as problems associated with the procedure.

Asunto(s)

RESUMEN

Carcinoma of the esophagus is a devastating disease that produces various degrees of esophageal obstruction by virtue of its circumferential, constricting type of growth pattern. Because of the relatively small diameter of the esophageal lumen, a limited-sized tumor can produce severe obstructive symptoms. Carcinoma of the esophagus is, as a rule, fairly well localized to its wall or the immediate mediastinal parietes in cases where there is extension beyond the esophageal musculature.(1) Large, bulky, exophytic types of esophageal carcinomas that produce symptoms mainly as a result of extrinsic pressure are unusual.

Asunto(s)

Asunto(s)

Asunto(s)