RESUMEN
BACKGROUND: Clinical supervision promotes the professional development of specialist registrars (SpRs). Our objective was to investigate and compare the perceived quality of supervision (PQS) in a university teaching hospital (UTH) and a district teaching hospital (DTH) and to identify aspects of supervision that could be improved. METHODS: The Cleveland Clinic's teaching effectiveness instrument (CCTEI) was used to measure the quality of supervision of attending doctors. Fifteen items reflecting good teaching ability were rated on a 5-point Likert-scale (1-5 = poor-excellent). RESULTS: SpRs rated 47 attending doctors using the CCTEI. A total of 416 ratings were obtained. Overall, the mean PQS was 3.85 (SD = 0.29) in the DTH and 3.56 (SD = 0.44) in the UTH (P = 0.02). A significant difference in PQS was found in 6 items. The supervisors in the DTH scored better on all these items. The best predictor of PQS was the item 'Organises time to allow for both teaching and care giving'. CONCLUSIONS: Overall, PQS was better in the DTH compared to the UTH. In both settings, generating a good learning environment and respecting the autonomy of the SpRs scored favourably. Supervisory roles focusing on improving cost-effective practice and communicative skills need more emphasis.
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Competencia Clínica/normas , Educación de Postgrado en Medicina/normas , Hospitales de Distrito , Hospitales de Enseñanza , Cuerpo Médico de Hospitales/psicología , Enseñanza/métodos , Actitud del Personal de Salud , Humanos , PercepciónRESUMEN
Three girls of Moroccan descent, aged 9, 10 and 7 years, presented with fever, joint pain and other symptoms. After Streptococcus infection and carditis were confirmed and the Jones criteria for acute rheumatic fever were met, the patients were treated with penicillin and acetylsalicylic acid. All 3 patients recovered. However, the second girl presented 2 months later with cardiac decompensation caused by valve disorders, after which aortic and mitral valvuloplasty was performed. The third girl developed joint pain again after 3 weeks and was diagnosed with juvenile idiopathic arthritis; treatment was adjusted accordingly. The prevalence of rheumatic heart diseases is 10-20 times higher in developing countries than in industrialised nations. The diagnosis 'acute rheumatic fever' should be considered in children of school age with unexplained fever, also when the Jones criteria have not yet been met. This may apply to migrant children in particular.
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Fiebre Reumática/diagnóstico , Enfermedad Aguda , Antiinflamatorios no Esteroideos/uso terapéutico , Insuficiencia de la Válvula Aórtica/etiología , Insuficiencia de la Válvula Aórtica/cirugía , Artralgia/etiología , Aspirina/uso terapéutico , Niño , Femenino , Fiebre/etiología , Humanos , Insuficiencia de la Válvula Mitral/etiología , Insuficiencia de la Válvula Mitral/cirugía , Marruecos/etnología , Países Bajos/epidemiología , Penicilinas/uso terapéutico , Fiebre Reumática/complicaciones , Fiebre Reumática/tratamiento farmacológico , Fiebre Reumática/patología , Resultado del TratamientoRESUMEN
We report on the first radioactive beam experiment performed at the recently commissioned REX-ISOLDE facility at CERN in conjunction with the highly efficient gamma spectrometer MINIBALL. Using 30Mg ions accelerated to an energy of 2.25 MeV/u together with a thin (nat)Ni target, Coulomb excitation of the first excited 2+ states of the projectile and target nuclei well below the Coulomb barrier was observed. From the measured relative deexcitation gamma-ray yields the B(E2;0(+)gs-->2(+)1) value of 30Mg was determined to be 241(31)e2 fm4. Our result is lower than values obtained at projectile fragmentation facilities using the intermediate-energy Coulomb excitation method, and confirms the theoretical conjecture that the neutron-rich magnesium isotope 30Mg resides outside the "island of inversion."
RESUMEN
Three children presented with bilious vomiting due to malrotation at the age of 3, 5 and 12 years, respectively. They were treated surgically and recovered fully. In the period 1989-2002, 12 patients were operated for malrotation after the first year of life in the Emma Children's Hospital AMC, Amsterdam, the Netherlands. The mean age at operation was 5 years (range: 1-15). The most important symptoms were (bilious) vomiting and abdominal pain. Four patients had a history of bilious vomiting in the neonatal period. Nine patients had been previously admitted to a hospital with abdominal complaints. The most sensitive imaging technique was an upper gastrointestinal contrast study. Malrotation with intermittent volvulus can cause recurrent abdominal complaints and vomiting in children. Bilious vomiting is pathologic at any age and should lead to further investigations, preferably an upper gastrointestinal contrast study to exclude malrotation or other obstructions.
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Vólvulo Intestinal/complicaciones , Vólvulo Intestinal/cirugía , Vómitos/etiología , Adolescente , Factores de Edad , Bilis , Niño , Preescolar , Femenino , Humanos , Lactante , Vólvulo Intestinal/patología , Masculino , PronósticoRESUMEN
A 14-month-old boy presented with fever and an itching papulous skin eruption. Based on the clinical presentation and the histopathologic findings in the skin biopsy, the diagnosis of Gianotti-Crosti syndrome was made.
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Acrodermatitis/diagnóstico , Acrodermatitis/patología , Biopsia , Exantema/etiología , Exantema/patología , Fiebre/etiología , Humanos , Lactante , Masculino , Piel/patologíaRESUMEN
Four children (two boys aged 1.5 and 10 years and two girls aged 2 and 9 years) vomited for one-half to four weeks. In one child, ataxia was later also noted and another tilted his head constantly to the left, but this was initially not alarming. In all four cases CT revealed a brain tumour, for which they were operated. Postoperatively, one child had residual tumour tissue that caused no further problems, in two children the tumour was completely excised with no further symptoms and no recurrence in the following 2 years, and in one child complete excision was not possible so that chemotherapy and radiotherapy were given, but metastases nevertheless developed 10 months later and the child died. Vomiting is common in children and in most cases the result of infectious or gastrointestinal causes. Intracranial pathology also can cause vomiting, both by increased intracranial pressure and by direct stimulation of the vomiting centre in the brainstem. Brain tumours in children often lack specific neurological signs in their clinical presentation. Intractable or chronic vomiting without nausea or deregulation of the water and electrolyte balance could therefore indicate the presence of an intracranial process, even when other neurological signs are absent.
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Neoplasias Encefálicas/diagnóstico , Vómitos/etiología , Neoplasias Encefálicas/complicaciones , Neoplasias Encefálicas/cirugía , Tronco Encefálico , Niño , Preescolar , Diagnóstico Diferencial , Resultado Fatal , Femenino , Humanos , Lactante , Masculino , Náusea , Tomografía Computarizada por Rayos XRESUMEN
Regarding declining resources epidemiological data on needs for oral rehabilitation are required. Within the framework of an oral health survey a non-stratified two-stage random sample was taken to represent the over 14-year-old population of Saxony/Germany. The participation rate was 55%. Normative need was determined by dental assessment and guidelines developed in a consensus process, subjective prosthetic treatment need by self-complete questionnaire. About 97% of the realized sample could be planned within the guidelines. About 81% had normative prosthetic treatment need. Compared with the rate of normative need the rate of subjective need (13%) was considerably lower (chi(2) P < 0;01). Different predictive parameters of subjective need were identified by logistic regression. Besides other factors subjective need was associated with giving dentist's recommendation as significant reason for prosthetic restorations [odds ratio (OR)=5;43], not believing that the own teeth were all right (OR=0;17), and the existence of prosthetic restorations (OR=3;87 for fixed restorations; OR=4;05 for removable dentures). The guidelines proved their suitability to assess normative prosthetic treatment need in oral health surveys. Further research is necessary to find adequate options for including patients' preferences in an adequate need definition.
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Prótesis Dental/estadística & datos numéricos , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Adulto , Anciano , Análisis de Varianza , Actitud Frente a la Salud , Distribución de Chi-Cuadrado , Estudios Transversales , Restauración Dental Permanente/estadística & datos numéricos , Dentadura Completa/estadística & datos numéricos , Dentadura Parcial Fija/estadística & datos numéricos , Dentadura Parcial Removible/estadística & datos numéricos , Femenino , Predicción , Alemania/epidemiología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Rehabilitación Bucal/estadística & datos numéricos , Análisis Multivariante , Oportunidad Relativa , Satisfacción del Paciente , Curva ROC , Salud Rural/estadística & datos numéricos , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Salud Urbana/estadística & datos numéricosRESUMEN
BACKGROUND: This analysis was based on an oral health survey with dental examination and interview by questionnaire. METHOD: The data set comprised a representative random sample of the over 14-year-old residents of the German Federal State of Saxony (n=714), in which a multivariate logistic regression analysis was conducted. The dependent variable was the debris index (DI) score of the oral hygiene index scoring system. The subjects were split into 2 groups by dividing DI scores into tertiles: those with acceptable oral hygiene (1st tertile, DI 0.00< or =1.20) and unacceptable oral hygiene (2nd and 3rd tertile, DI>1.20). The most important explanatory variable was the community periodontal index of treatment need (CPITN). RESULTS: The higher the CPITN score, the lower the probability of acceptable oral hygiene. In relation to the reference category score 0, higher CPITN scores were associated with acceptable oral hygiene, with an odds ratio 0.05 (95% confidence interval (CI)=0.01-0.23) for CPITN score 1, and an odds ratio 0.02 (95% CI: 0.01-0.08) for score 4. Further significant variables were: self-evaluation of tooth condition, gender, and the number of missing teeth.
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Actitud Frente a la Salud , Salud Bucal , Índice Periodontal , Adolescente , Encuestas de Salud Bucal , Femenino , Alemania/epidemiología , Humanos , Masculino , Análisis Multivariante , Oportunidad Relativa , Índice de Higiene Oral , Muestreo , Encuestas y CuestionariosRESUMEN
STATEMENT OF PROBLEM: The choice of soft materials for maxillofacial prostheses is important for covering extraoral defects after tumor surgery or radiation therapy. The use of cast commercially pure titanium as reinforcement seems to be a suitable option. PURPOSE: Making use of the advantages of titanium frameworks for maxillofacial prostheses requires exploring ways of combining it with soft materials. This study investigated such combinations and evaluated discoloration of the soft material to determine whether it was attributable to the titanium reinforcement. MATERIAL AND METHODS: Five soft materials used for maxillofacial prostheses and their bond strengths to cast titanium were tested. Different ways of conditioning the titanium surface and different adhesives were used. Plain mechanical retention was also studied. The Gretag SPM 100 was used to determine the potential effects on coloring after 24 hours of radiation in the Suntest rapid exposure unit. RESULTS: Suitable material combinations for bonding soft materials to titanium were found for all soft materials studied. Bond strength varied depending on the chemical basis of the soft material. Results indicated that maximal bond strengths were obtained by the combinations Supersoft with Super-Bond, Supersoft with subsequent silicoating, and bonding with Dentacolor connector. Few color shifts attributable to the titanium reinforcement were evident in the 2-mm layers of the soft materials applied. CONCLUSION: The results of this study showed that it is possible to combine a titanium framework and soft silicone materials.
Asunto(s)
Materiales Biocompatibles/química , Recubrimiento Dental Adhesivo , Prótesis Maxilofacial , Titanio/química , Resinas Acrílicas/química , Resinas Acrílicas/efectos de la radiación , Adhesivos/química , Adhesivos/efectos de la radiación , Materiales Biocompatibles/efectos de la radiación , Bisfenol A Glicidil Metacrilato/química , Bisfenol A Glicidil Metacrilato/efectos de la radiación , Compuestos de Boro/química , Compuestos de Boro/efectos de la radiación , Color , Dimetilpolisiloxanos/química , Dimetilpolisiloxanos/efectos de la radiación , Humanos , Metacrilatos/química , Metacrilatos/efectos de la radiación , Metilmetacrilatos/química , Metilmetacrilatos/efectos de la radiación , Ácidos Polimetacrílicos/química , Ácidos Polimetacrílicos/efectos de la radiación , Polimetil Metacrilato/química , Polimetil Metacrilato/efectos de la radiación , Polivinilos/química , Polivinilos/efectos de la radiación , Coloración de Prótesis , Dosis de Radiación , Cementos de Resina/química , Cementos de Resina/efectos de la radiación , Silanos/química , Silanos/efectos de la radiación , Siliconas/química , Siliconas/efectos de la radiación , Siloxanos/química , Siloxanos/efectos de la radiación , Estrés Mecánico , Luz Solar , Propiedades de Superficie , Titanio/efectos de la radiaciónRESUMEN
OBJECTIVES: Few clinical data on the use of titanium for restorative appliances are available. The aim of this study was to clinically evaluate titanium restorations compared to gold alloy restorations with regard to plaque, gingival health and post-operative sensitivity. METHODS: In 54 patients, 99 titanium restorations were placed. The control group comprised 56 patients with 96 high gold alloy restorations. The material was chosen by random. Each patient received one or two Class II restorations. Plaque Index (Silness and Löe, 0-3), Gingival Index (Löe and Silness, 0-3), and post-operative sensitivity (1-4, 1=none) were rated at 2 weeks, 3 months, 6 months, 12 months, and 18 months, post-operatively. RESULTS: The mean plaque scores ranged from 0.89 to 0.99 in the titanium group, and from 0.88 to 1.04 in the gold group. The mean gingival scores ranged from 0.91 to 1.07 in the titanium group, and from 0.82 to 0.99 in the gold group. The mean plaque and gingival scores of the titanium and gold group did not differ significantly at any visit (P>0.05). To evaluate post-operative sensitivity, patients with one MOD restoration each were included, resulting in 46 titanium and 44 high gold restored teeth. Mean values of the post-operative sensitivity scores in the titanium group were significantly higher than in the gold group (P<0.05). The restoration material was found to be the dominating variable with regard to post-operative sensitivity, which was not influenced by age, sex and the application of calcium hydroxide liner. CONCLUSIONS: It is concluded that neither higher plaque scores nor adverse effects on gingival health are to be expected in titanium restorations.
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Placa Dental/etiología , Sensibilidad de la Dentina/etiología , Gingivitis/etiología , Incrustaciones , Titanio , Adolescente , Adulto , Factores de Edad , Anciano , Hidróxido de Calcio/uso terapéutico , Recubrimiento de la Cavidad Dental , Índice de Placa Dental , Recubrimiento de la Pulpa Dental , Femenino , Estudios de Seguimiento , Aleaciones de Oro/química , Humanos , Incrustaciones/clasificación , Masculino , Persona de Mediana Edad , Índice Periodontal , Factores Sexuales , Estadística como Asunto , Estadísticas no Paramétricas , Titanio/químicaRESUMEN
STATEMENT OF PROBLEM: Color stability, strength, and accuracy of fit are the main requirements for complete-ceramic crowns. The Procera AllCeram crown system is a CAD/CAM system used to fabricate individual complete-ceramic crowns that have a dry sintered, aluminum oxide core and appear to match clinical requirements. However, there are few articles about the clinical fit of all-ceramic crowns. PURPOSE: This in vivo study measured the accuracy of fit of Procera AllCeram crowns in anterior and posterior teeth. MATERIAL AND METHODS: The clinical fit of 80 anterior and posterior Procera AllCeram crowns was evaluated by a replica technique with a light body silicone to fill space between crown and tooth and a heavy body silicone to stabilize the light body film. After removal from the artificial crowns, the replicas were segmented, and measurements of the film thickness were performed with a light microscope. RESULTS: Medians of mean marginal gap widths were between 80 and 95 microm in anterior teeth and between 90 and 145 microm in posterior teeth. Medians of maximal marginal gap widths ranged from 80 to 180 microm in anterior teeth and from 115 to 245 microm in posterior teeth. CONCLUSION: The accuracy of fit achieved by Procera AllCeram was comparable to other conventional and innovative systems.
Asunto(s)
Coronas , Adaptación Marginal Dental , Porcelana Dental , Adulto , Anciano , Diseño de Prótesis Dental , Femenino , Humanos , Masculino , Aleaciones de Cerámica y Metal , Persona de Mediana Edad , Modelos Dentales , Ajuste de Prótesis , Técnicas de Réplica , Estadísticas no Paramétricas , TitanioRESUMEN
OBJECTIVES: Unalloyed titanium may be an economical substitute for gold alloys. The purpose of this study was to evaluate the suitability of unalloyed titanium as an alternative to gold alloys for posterior inlay and onlay restorations. METHODS: Fifty-four patients received 99 titanium restorations, 56 patients 96 gold alloy restorations. All titanium restorations were cast in a vacuum-pressure casting machine. Two weeks after insertion the clinical margin integrity was evaluated by replica technique. The maximum marginal gaps were assessed under the optical measuring microscope. The two tailed t-test for independent samples was used for statistical analysis. RESULTS: Accuracy of fit was significantly better in gold alloy than in titanium restorations. Mean maximum marginal gap between restoration margin and tooth structure were 72 +/- 18 microns (mean +/- S.D.) for titanium and 64 +/- 18 microns (mean +/- S.D.) for gold restorations. SIGNIFICANCE: Though marginal gap widths in titanium restorations did not yet match the gold standard, the data justify the use of titanium as an alternative to gold alloy for inlay and onlay restorations.
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Adaptación Marginal Dental , Aleaciones de Oro , Incrustaciones , Titanio , Adolescente , Adulto , Humanos , Persona de Mediana EdadAsunto(s)
Etnicidad , Pediatría , Derivación y Consulta , Adolescente , Asma/etnología , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Marruecos/etnología , Países Bajos/epidemiología , Servicio Ambulatorio en Hospital , Pediatría/estadística & datos numéricos , Derivación y Consulta/estadística & datos numéricos , Turquía/etnologíaRESUMEN
Three children, a girl aged 9 and two boys aged 2.5 and 6 years, presented with a stiff neck and fever. They had been treated for vomiting and diarrhoea with among other drugs metoclopramide or domperidone suppositories. As a result extrapyramidal signs had developed. These were cut by intravenous injection of biperiden. It is argued that gastroenteritis in children should be treated by oral rehydration only and that there is no place for antiemetics.
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Antieméticos/efectos adversos , Enfermedades de los Ganglios Basales/inducido químicamente , Domperidona/efectos adversos , Gastroenteritis/tratamiento farmacológico , Metoclopramida/efectos adversos , Antieméticos/administración & dosificación , Enfermedades de los Ganglios Basales/diagnóstico , Niño , Preescolar , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Meningitis/diagnóstico , Metoclopramida/administración & dosificación , SupositoriosRESUMEN
The efficacies and safeties of a 3-day, 3-dose course of azithromycin (10 mg/kg of body weight per day) and a 10-day, 30-dose course of erythromycin (40 mg/kg/day) for the treatment of acute lower respiratory tract infections in children were compared in an open randomized multicenter study. Sixty-eight of 85 evaluable patients (80%) had radiologically proven pneumonia, and 20% had bronchitis. Treatment success defined as cure or major improvement was achieved in 42 of 45 (93%) azithromycin recipients versus 36 of 40 (90%) erythromycin recipients. Adverse events were reported in 12 of 45 and 6 of 40 of the patients treated with azithromycin and erythromycin, respectively, a difference which was not statistically significant. In conclusion, a 3-day course of azithromycin is as effective as a 10-day course of erythromycin in the treatment of community-acquired lower respiratory tract infections in children, with comparable safety and acceptability profiles. This shorter treatment course might have a beneficial effect on compliance, especially in the pediatric age group.
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Antibacterianos/uso terapéutico , Azitromicina/uso terapéutico , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Eritromicina/uso terapéutico , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Adolescente , Antibacterianos/administración & dosificación , Azitromicina/administración & dosificación , Azitromicina/efectos adversos , Bronquitis/tratamiento farmacológico , Niño , Preescolar , Eritromicina/administración & dosificación , Eritromicina/efectos adversos , Estudios de Seguimiento , Humanos , Neumonía/tratamiento farmacológico , Estudios ProspectivosRESUMEN
In order to determine the incidence of sudden infant death syndrome (SIDS) in Zimbabwe, a prospective study was done in infants aged 1 month to 1 year who were certified as dead at home and brought to the accident and emergency department of Mpilo Central Hospital in Bulawayo from July 1992 to June 1993. There were four cases of SIDS among a total of 18,889 registered live births, giving an incidence rate for SIDS of approximately 0.2/1000 (95% CI 0.004-0.4/1000). SIDS appears to be uncommon in black Africans of low socio-economic status in Zimbabwe. Child rearing practices, parental lifestyle and a home environment different from that of Europeans might explain the low incidence of SIDS in the population.
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Crianza del Niño/etnología , Muerte Súbita del Lactante/epidemiología , Adulto , Negro o Afroamericano , Población Negra , Lactancia Materna , Femenino , Humanos , Incidencia , Lactante , Estudios Longitudinales , Masculino , Postura , Zimbabwe/epidemiologíaRESUMEN
From July 1992 to May 1993 a study was performed of the relationship between bacteraemia, nutritional status and HIV status in 212 out of 334 consecutive infants and children aged 0-5 years, who had died at home in Bulawayo, Zimbabwe. The remaining 122 children were excluded because the time period between death and arrival at the hospital was over 3 h. A pathogen was isolated from 92 (43%) children and Klebsiella species were most commonly isolated. A positive HIV-1 serology was found in 122 (58%) children and 110 (52%) children were malnourished. Malnutrition was significantly associated with bacteraemia at death after adjustment for the confounding effect of age and HIV status (odds ratio 4.28; 95% CI 2.27-8.07; P < 0.001). No association was found between either HIV serostatus or proven HIV infection and bacteraemia, which could not be attributed to nutritional status. Conclusion. Bacteraemia, in particular with Gram-negative bacteria, is an important cause of death in malnourished children in Zimbabwe regardless of their HIV-1 antibody status.
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Infecciones Oportunistas Relacionadas con el SIDA/patología , Bacteriemia/patología , Países en Desarrollo , Seropositividad para VIH/patología , Desnutrición Proteico-Calórica/patología , Infecciones Oportunistas Relacionadas con el SIDA/mortalidad , Bacteriemia/mortalidad , Técnicas Bacteriológicas , Causas de Muerte , Preescolar , Diagnóstico Diferencial , Femenino , Seropositividad para VIH/mortalidad , Humanos , Lactante , Infecciones por Klebsiella/mortalidad , Infecciones por Klebsiella/patología , Pulmón/patología , Masculino , Oportunidad Relativa , Estudios Prospectivos , Desnutrición Proteico-Calórica/mortalidad , Zimbabwe/epidemiologíaRESUMEN
UNLABELLED: A cardiac services team at Dartmouth-Hitchcock Medical Center (DHMC) launched multiple efforts to improve the quality and value of their services. The team developed a critical path for coronary artery bypass grafting (CABG) and tracked important clinical outcomes, such as mortality rates and wound complications. The team also studied the patient's view of the process. Staff used focus groups and surveys to distill the "voice of the customer" into six quality characteristics and developed methods to better involve patients in clinical decision making and evaluation of treatment efficacy. RESULTS: CABG mortality declined from 5.7 percent in 1992 to 2.7 percent in 1994, 16 months after the critical path was developed. Mean total intubation time for patients following open-heart surgery was reduced from 22 hours to 14 hours. Median postoperative length of stay decreased from seven days to six for elective CABG patients. The number of patients discharged in five days or less increased from 20 percent to 40 percent. Readmission to the hospital following discharge remained stable, despite the shorter length of stay.
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Servicio de Cardiología en Hospital/normas , Protocolos Clínicos , Puente de Arteria Coronaria/normas , Puente de Arteria Coronaria/mortalidad , Hospitales con 300 a 499 Camas , Mortalidad Hospitalaria , Relaciones Paciente-Hospital , Humanos , New Hampshire/epidemiologíaRESUMEN
Beckwith-Wiedemann syndrome is an easily recognised syndrome in its complete form with macroglossia and exomphalos. The three cases reported here are an attempt to increase awareness of the existence of this syndrome which has serious consequences. All our patients had the combination of macroglossia and exomphalos, but none developed symptomatic hypoglycaemia. Growth patterns were distinctly different in all cases. One patient was the first of a pair of twins. The syndrome is inherited in an autosomal dominant fashion with incomplete penetrance and variable expressivity. Early diagnosis should alert the clinician to the risk of eventual neonatal hypoglycaemia and long term follow up is warranted because of a possible development of malignancies in childhood. The reason for the very low incidence of the syndrome in Bulawayo remains unexplained.
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Síndrome de Beckwith-Wiedemann/diagnóstico , Cefalometría , Femenino , Crecimiento/fisiología , Humanos , Lactante , Recién Nacido , Masculino , ZimbabweRESUMEN
A prospective study was done of children less than 13 years of age, who died at home or on their way to hospital and those who died in hospital, over a one year period. Fifty seven (86%) of the 66 children who were dead on arrival and 94 (77%) of the 122 children who died after admission were 2 years old or less. The main causes of death in both groups were identical and infections were the most frequent diagnosis. AIDS was the most common cause with 23 (35%) of the deaths in the children who were dead on arrival and 27 (22%) of the deaths in the children who died after admission. An overall positive HIV-I serology was found in 31 (47%) of the children in the dead on arrival group and in 50 (41%) of the children in the group that died after admission.