RESUMEN
In parasitology, routine laboratory diagnosis involves conventional methods, such as optical microscopy, used for the morphological identification of parasites. Currently, molecular biology techniques are increasingly used to diagnose parasite structures in order to enhance the identification and characterization of parasites. The objective of the present study was to review the main current and new diagnostic techniques for confirmation of parasite infections, namely: polymerase chain reaction (PCR), real-time polymerase chain reaction (RT-PCR), loop-mediated isothermal amplification (LAMP), Luminex xMAP, random amplified polymorphic DNA (RAPD), amplified fragment length polymorphism (AFLP), and restriction fragment length polymorphism (RFLP), in addition to microsatellites. Molecular assays have comprehensively assisted in the diagnosis, treatment and epidemiological studies of parasitic diseases that affect people worldwide, helping to control parasitic disease mortality.
Asunto(s)
Análisis del Polimorfismo de Longitud de Fragmentos Amplificados , Enfermedades Parasitarias/diagnóstico , Enfermedades Parasitarias/epidemiología , Técnicas de Diagnóstico Molecular , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Reacción en Cadena de la Polimerasa/métodos , Técnica del ADN Polimorfo Amplificado Aleatorio/métodosRESUMEN
OBJECTIVE: The purpose of this investigation is to analyze childhood blood lead levels and growth status (ages 2-12) in Dallas, Texas lead smelter communities in the 1980s and 2002, where smelters operated from 1936 to 1990. METHODS AND MATERIALS: A sample of convenience study design was used in two cohorts (n=360): 1980-1989 (n=191) and 2002 (n=169). Multivariate analysis of variance and covariance and tandem multiple regressions were used to evaluate the association between stature and blood lead level in two time periods. RESULTS: In 2002 average child blood lead level (1.6 microg/dL+/-0.2 SE) was significantly (p<0.001) lower compared to the 1980 cohort mean level (23.6 microg/dL+/-1.3 SE). Average height and weight in 2002 were 4.5 cm and 4.0 kg greater, respectively, than in 1980. Lowered blood lead level was associated with 3.9 cm, 3.5 kg and 1.1 units greater height, weight and body mass index (BMI), respectively. Cohort effect was associated with greater height (0.6 cm), weight (0.5 kg) and BMI (0.1). CONCLUSION: This investigation reports on child growth in a community before and after the transition from high to low blood lead levels over several decades. Using child growth as a proxy, health status of Dallas's lead smelter communities increased markedly over the past two decades, primarily because of lower blood lead levels, while the poverty rate was only marginally lower.
Asunto(s)
Negro o Afroamericano/estadística & datos numéricos , Exposición a Riesgos Ambientales , Trastornos del Crecimiento/epidemiología , Hispánicos o Latinos/estadística & datos numéricos , Plomo/sangre , Metalurgia , Estatura , Índice de Masa Corporal , Peso Corporal , Niño , Preescolar , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Trastornos del Crecimiento/sangre , Trastornos del Crecimiento/etiología , Humanos , Lactante , Plomo/efectos adversos , Masculino , Pobreza , Texas/epidemiología , Población Urbana/estadística & datos numéricosRESUMEN
Neonatal lupus erythematosus (NLE) is a passively acquired autoimmune syndrome resulting from transplacental passage of maternal anti-Ro/SSA and/or anti-La/SSB antibodies to the fetus. Characteristic manifestations of NLE include transient dermatitis, hepatic and hematologic abnormalities and congenital heart block. Skin lesions in NLE resemble subacute cutaneous lupus erythematosus and typically consist of annular, erythematous, scaly plaques. Telangiectasias, vascular abnormalities resulting from dilation of superficial dermal vessels, may also affect the skin in a minority of patients. The etiology of telangiectasias in NLE is unknown, but disordered angiogenesis likely plays a role. Hemangiomas are a common disorder of angiogenesis frequently encountered in infancy. There have been no reported cases of neonatal lupus associated with the development of hemangiomas. We present a case of an infant diagnosed with NLE after manifesting classic dermatitis, hepatic and hematologic abnormalities who later developed mucocutaneous and visceral hemangiomas. We further postulate that disordered angiogenesis, possibly dysregulated production of vascular endothelial growth factor, may play a primary role in the development of these cutaneous vascular lesions in NLE.
Asunto(s)
Hemangioma Capilar/etiología , Complicaciones del Embarazo/inmunología , Telangiectasia/etiología , Adulto , Antiinflamatorios/uso terapéutico , Anticuerpos Antinucleares/inmunología , Femenino , Hemangioma Capilar/tratamiento farmacológico , Hemangioma Capilar/patología , Humanos , Recién Nacido , Enfermedades del Recién Nacido , Hepatopatías/inmunología , Hepatopatías/patología , Lupus Eritematoso Sistémico/complicaciones , Prednisolona/uso terapéutico , Embarazo , Ribonucleoproteínas/inmunologíaRESUMEN
BACKGROUND: The introduction of any surgical procedure brings with it new technical challenges. The use of laparoscopy offers patients a reduction in pain and better cosmesis. However, over time, new technical challenges associated with laparoscopic surgery are becoming more evident. In particular, the closure of the small trocar site fascial incisions is often awkward and time consuming. The aim of this article is to introduce a closing procedure that facilitates the safe approximation of the abdominal fascia in these wounds. METHOD: One hemostat is used to visualize the fascia of one side of the wound and separate the fascia from the underlying abdominal viscera. Another hemostat retracts the opposite side of the wound. The suture needle is passed through the fascia and between the open tips of the hemostat. The tips of the second hemostat grasp the driven needle and carry it out of the wound. CONCLUSION: The use of two hemostats to close these wounds not only facilitates the closure but is also probably safer than the standard technique.
Asunto(s)
Laparoscopía/métodos , Técnicas de Sutura/instrumentación , HumanosRESUMEN
Responding to the medical needs of the homeless population across the United States exact large costs on the health care system. To provide effectively for such vulnerable populations, health care systems require creative and efficient strategies of service organization tailored to the specific needs of the homeless. However, such needs often vary by geographic region due to the inherent diversity of the population. Currently, no published medical evaluation of the urban homeless in Texas exists. Therefore, this study examines 93,074 diagnoses given to 20,331 homeless patients seen in a seven-year period in a primary care mobile and fixed clinic system. The most frequent disease conditions evaluated in this cohort of patients are reported. These findings may be useful to clinical site managers and health care planners contemplating an outreach program for the homeless.
Asunto(s)
Personas con Mala Vivienda/estadística & datos numéricos , Morbilidad , Evaluación de Necesidades , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Política de Salud , Encuestas Epidemiológicas , Humanos , Lactante , Masculino , Auditoría Médica , Persona de Mediana Edad , Atención Primaria de Salud/organización & administración , Texas/epidemiología , Población UrbanaRESUMEN
PURPOSE: We determined the total serum IgE levels among healthy individuals and atopic patients with respiratory symptoms in Porto Alegre. METHODS: Atopic patients (n: 92) and normal controls (n: 86) were stratified according to age and sex. Presence of atopy was recorded by history, clinical examination and skin prick test reactivity to common aeroallergens. Serum IgE was measured by Pharmacia Immuno-Cap System. RESULTS: It was demonstrated that total serum IgE is higher in males than in females. Total serum IgE levels were significantly higher in the atopic group (404 UI/mL) in comparison with the non-atopics controls (54.4 UI/mL). Our study provided the normal range for total serum IgE among atopics and non-atopics individuals in Porto Alegre. CONCLUSIONS: The profile of serum IgE among our population (atopics and non-atopics) is similar to the one observed in other countries.
Asunto(s)
Asma/sangre , Inmunoglobulina E/sangre , Rinitis/sangre , Adolescente , Adulto , Asma/fisiopatología , Biomarcadores/sangre , Brasil , Femenino , Humanos , Masculino , Rinitis/fisiopatología , Factores Sexuales , Pruebas CutáneasRESUMEN
OBJETIVO: Determinar em nossa cidade o nível sérico de IgE em indivíduos sadios, não- atópicos e em pacientes atópicos com manifestações respiratórias. MÉTODOS: Foram estudados 92 pacientes atópicos e 86 indivíduos sadios de ambos os sexos, classificados em grupos de acordo com faixa etária e sexo. A presença de atopia foi determinada através da história, exame físico e reatividade a testes cutâneos de puntura com alérgenos inalantes. A IgE sérica foi avaliada utilizando-se o sistema Pharmacia Immuno-Cap. RESULTADOS: Observou-se que o nível de IgE no soro é mais elevado no sexo masculino. Os valores médios de IgE total nos pacientes atópicos (401 UI/mL) são significativamente maiores que àqueles observados entre indivíduos não-atópicos (54,4 UI/mL). Através desse levantamento foi possível determinar os valores normais para as faixas etárias estudadas entre indivíduos sadios de Porto Alegre. CONCLUSÕES: Nosso estudo permitiu observar que o nível de IgE entre pacientes atópicos e indivíduos não-atópicos apresenta distribuição similar àquela verificada em outros países.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Asma/sangre , Inmunoglobulina E/sangre , Rinitis/sangre , Asma/fisiopatología , Brasil , Pruebas Cutáneas , Rinitis/fisiopatología , Distribución por SexoRESUMEN
A retrospective review of five hundred and seven consecutive admissions to a state-wide paediatric burns unit over a three year period was made to assess the characteristics of the burn injuries and to see which, if any, characteristics would help to distinguish accidental burns from burns which were due to abuse or neglect. In 86% of admissions (the 'accident group') it was considered that the injury was accidental, with no evidence of deliberate injury or gross neglect. Eight percent of admissions (the 'abuse/neglect group') were referred to the State Department of Community Services for abuse or neglect resulting in the Department becoming involved in the family's management. In six percent of cases (the 'concern group') the Unit had concerns that the family's emotional or social situation was a significant factor in the child's injury, or made further injury more likely, and discussed the family's situation with the Department, but formal intervention was not undertaken by the Department. There were no differences between the groups in age or mortality. Children in the 'abuse/neglect' and the 'concern' groups were more likely to require skin grafting and treatment in the intensive care unit. They were more likely to come from single parent families and were more likely to have burns involving both hands or both legs. There were few other distinguishing factors. The incidence of prior notification for abuse and neglect was four percent for the 'accident' group, 14% for the 'concern' group and 46% for the 'abuse/neglect' group. This is considerably higher in the 'concern' and 'abuse/neglect' groups than the annual state incidence of 1.73% for abuse and neglect notifications. While the clinical features of a burn may often not be helpful in reaching a diagnosis of abuse or neglect as a cause of the burn, it appears that many children who have non-accidental burns have also had prior notifications for other types of abuse or neglect.
Asunto(s)
Quemaduras/etiología , Maltrato a los Niños , Accidentes , Adolescente , Unidades de Quemados/estadística & datos numéricos , Quemaduras/diagnóstico , Quemaduras/epidemiología , Niño , Maltrato a los Niños/diagnóstico , Maltrato a los Niños/estadística & datos numéricos , Preescolar , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Notificación Obligatoria , Nueva Gales del Sur/epidemiología , Admisión del Paciente/estadística & datos numéricos , Estudios Retrospectivos , Índices de Gravedad del TraumaRESUMEN
We compared the effectiveness in identifying infants with positive results on urine screening for drugs of abuse of a universal screening program and a targeted screening program on the basis of clinical suspicion. A carefully run targeted screening program identified 24.3% of the admissions for toxicology testing and would have found all but two of the infants with positive results.
Asunto(s)
Tamizaje Masivo/métodos , Salas Cuna en Hospital , Efectos Tardíos de la Exposición Prenatal , Trastornos Relacionados con Sustancias/orina , Chicago/epidemiología , Femenino , Humanos , Recién Nacido , Tamizaje Masivo/estadística & datos numéricos , Embarazo , Evaluación de Programas y Proyectos de Salud , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/prevención & controlRESUMEN
Despite steady advances in surgical instrumentation and technique, ocular trauma continues to be a leading cause of visual loss in the United States. Almost half of the patients with posterior penetrating injuries are left with severe visual impairment. Controversy persists over the optimal management of the injured eye, including the proper use of prophylactic antibiotics, prophylactic cryopexy, and prophylactic scleral buckling. The role and timing of vitrectomy surgery in severe ocular trauma also remain topics of considerable debate, as does the role of vitrectomy in the management of magnetic intraocular foreign bodies. Each of these issues is discussed, with particular emphasis on conflicting views presented in the relevant literature.