RESUMEN
INTRODUCTION: Multiple Sclerosis (MS) is one of the leading causes of disability in young adults. Its prevalence varies according to different countries. In Argentina there is a wide heterogeneity regarding data published in different areas of the country. Prevalence established in most studies is 17 cases per 100,000 inhabitants; however, most of the available data comes from studies that took place in Buenos Aires. There is little or no information from other provinces, especially from Northwest of Argentina (NOA), where there are no studies of the disease prevalence. The aim of this study is to investigate MS prevalence, phenotypes and epidemiological characteristics in Salta, Argentina, in order to contribute to the current knowledge of MS epidemiology and distribution in our country. METHODS: A descriptive, observational, transversal study was carried out in the capital city of Salta. Researchers from all public and private hospitals with a Neurology Department have participated. Private researchers who are well known leaders in demyelinating diseases in the city provided valuable information. Patients who did not have medical control for the past two years as well as patients whose last address was not registered in Salta were excluded. RESULTS: 120 registries were obtained from the four hospitals that participated and from the 12 private researchers. Ten patients were excluded due to overlapping data. The population of the area based on 2010 census was 535,310, so we estimated an MS prevalence 23.8 cases per 100,000 inhabitants (95% CI 20.1-27.4), 24.1 cases per 100,000 inhabitants in female population (95% CI 21.2-28.6) and 18.2 cases per 100,000 inhabitants (95% CI 15.2-21.1) in male population. In our analysis, 64 (58.2%) were female and the average age was 42.1 years. 81.8% are recurrent remitting forms, 16.4% secondary progressive and 1.8% primary progressive. CONCLUSION: This is the first study that provides epidemiological data on the prevalence and clinical forms of MS in Salta City as well as in the entire Northwest Region of Argentina(NOA). We estimate a prevalence of 23.8 cases per 100,000 inhabitants, which establishes a moderate risk area for MS.
Asunto(s)
Esclerosis Múltiple/epidemiología , Adolescente , Adulto , Argentina/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Prevalencia , Sistema de Registros , Población Urbana/estadística & datos numéricos , Adulto JovenRESUMEN
Enteral nutrition is used as a routine therapy in patients with caloric-protein malnutrition, severe dysphagia, major burns, intestinal resection, and enterocutaneous fistulae, as long as a portion of the digestive tract still has an active absorptive function. The administration takes place by means of surgical (ostomies) or non-surgical (nasogastric) tubes. In our country, a significant number of hospitalized patients with various diseases receive this type of nutrition. Given that the colonization of the digestive tract by hospital flora is the first step towards developing intra-hospital infections, the contamination implies serious risks. The objective of this study was to study the most appropriate conditions for the manufacturing, storage and administration of the mixture of nutrients of enteral nutrition, to guarantee nutrition with a lower contamination risk. This study was conducted by the Unit of Nutritional Assistance of the Mater Dei Clinic, by means of bacteriological controls, from January 1991 to December 1992, and in 1993 in which the work systematics were reviewed. The study was prospective, and those solutions whose bacteriological counts were lower than 100.000 colony forming units (CFU), and which showed an absence of enteropathological micro-organisms, were considered acceptable, and those solutions which had a bacteriological count greater than or equal to 100.000 CFU and or the presence of enteropathological micro-organisms, were considered unacceptable. During the first period, "usual working conditions", we analyzed the infra-structure, the personnel, the constituents, and the apparatus used in the manufacturing, for which 36 samples were studied at t0 (moment of preparation). Afterwards, in the second period "special working conditions", we analyzed the manufacturing procedures, the storage and the administration of 103 solutions, corresponding to 36 patients, taking samples at t0 and t24 (after 24 hours of preparing). In the first phase, we found a 53% contamination. In the second phase, 99.03% of the solutions were within the limits of acceptability, and only 0.07% were unacceptable. We conclude that it is necessary to have access to a working area which meets the biosecurity norms, to use sterile technique in the preparation, to prefer pharmacologically sterile products for the preparation, to store the prepared mixture between 4 and 8 degrees C, and to keep it cooled during the administration. Lastly, we saw the need to continuously capacitate the nursing, dietary (ABSTRACT TRUNCATED)