RESUMO

Two community-based density case-control studies were performed to assess risk factors for cholera transmission during inter-peak periods of the ongoing epidemic in two Haitian urban settings, Gonaives and Carrefour. The strongest associations were: close contact with cholera patients (sharing latrines, visiting cholera patients, helping someone with diarrhoea), eating food from street vendors and washing dishes with untreated water. Protective factors were: drinking chlorinated water, receiving prevention messages via television, church or training sessions, and high household socioeconomic level. These findings suggest that, in addition to contaminated water, factors related to direct and indirect inter-human contact play an important role in cholera transmission during inter-peak periods. In order to reduce cholera transmission in Haiti intensive preventive measures such as hygiene promotion and awareness campaigns should be implemented during inter-peak lulls, when prevention activities are typically scaled back.

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RESUMO

The International Diabetes Federation Taskforce on Epidemiology and Prevention of Diabetes convened a consensus working group of diabetologists, endocrinologists, surgeons and public health experts to review the appropriate role of surgery and other gastrointestinal interventions in the treatment and prevention of Type 2 diabetes. The specific goals were: to develop practical recommendations for clinicians on patient selection; to identify barriers to surgical access and suggest interventions for health policy changes that ensure equitable access to surgery when indicated; and to identify priorities for research. Bariatric surgery can significantly improve glycaemic control in severely obese patients with Type 2 diabetes. It is an effective, safe and cost-effective therapy for obese Type 2 diabetes. Surgery can be considered an appropriate treatment for people with Type 2 diabetes and obesity not achieving recommended treatment targets with medical therapies, especially in the presence of other major co-morbidities. The procedures must be performed within accepted guidelines and require appropriate multidisciplinary assessment for the procedure, comprehensive patient education and ongoing care, as well as safe and standardized surgical procedures. National guidelines for bariatric surgery need to be developed for people with Type 2 diabetes and a BMI of 35 kg/m² or more.

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Assuntos

RESUMO

A cross-sectional study was conducted on a 20-74-year-old population in an urban white-Hispanic population in Paraguay to determine the prevalence of diabetes mellitus (DM), impaired glucose tolerance (IGT), and associated cardiovascular disease (CVD) risk factors. In total 1606 subjects completed the study (response rate 80.3%; 1094 women, 512 men). The overall prevalences were: DM 6.5%, IGT 11.3%, hypertension 17.1%, and obesity 31.6% with more obesity in women (35.7% vs 22.8%, p < 0.05). Age-standardized prevalences were: DM 6.5%, IGT 13.5% in females and DM 5.5%, IGT 7.2% in males. DM and IGT subjects had two or more CV risk factors significantly more often than the normal population. In conclusion, DM, IGT, hypertension, and obesity are common in this South American Hispanic urban population, particularly in women. Public health measures, such as lifestyle education, are required to decrease these noncommunicable diseases.

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RESUMO

La clasificación de la diabetes mellitus y los exámenes usados para su diagnóstico fueron introducidos por el National Diabetes Data Group de EE.UU. y el Segundo Comité de Expertos sobre Diabetes Mellitus de la Organización Mundial de la Salud en 1979 y 1980, respectivamente. Salvo modificaciones menores hechas por la OMS en 1985, poco ha cambiado desde entonces. Sin embargo, existen nuevos conocimientos sobre la etiología de las distintas formas de diabetes y más información acerca del valor predictivo de distintos valores de glucosa en sangre para las complicaciones de la diabetes. Por ello, la OMS realizó una Consulta paralela al informe del Comité de Expertos de la Asociación Americana de Diabetes para reexaminar los criterios diagnósticos y la clasificación. Este documento incluye las conclusiones de dicha Consulta para su difusión y discusión, antes de presentar las propuestas finales a la OMS para su aprobación. Los principales cambios propuestos son los siguientes: El valor diagnóstico de glucosa plasmática en ayunas ha sido disminuido a >7.0 mmol/l(6.1 mmol l/l). La tolerancia a la glucosa alterada (TGA) se modificó para dar lugar al nuevo nivel en ayunas. Se propone una nueva categoría para la glucemia de ayunas alterada (GAA), abarcando los valores por encima del normal, pero inferiores al valor diagnóstico de corte para diabetes (plasma>6.1 a<7.0 mmol/l sangre entera >5.6 a <6.1 mmol l/l). El concepto de diabetes mellitus gestacional (DMG) ahora incluye tanto la TGA gestacional como la DMG previa. La clasificación define los procesos y los estadios de la enfermedad (AU)

Assuntos

RESUMO

La clasificación de la diabetes mellitus y los exámenes usados para su diagnóstico fueron introducidos por el National Diabetes Data Group de EE.UU. y el Segundo Comité de Expertos sobre Diabetes Mellitus de la Organización Mundial de la Salud en 1979 y 1980, respectivamente. Salvo modificaciones menores hechas por la OMS en 1985, poco ha cambiado desde entonces. Sin embargo, existen nuevos conocimientos sobre la etiología de las distintas formas de diabetes y más información acerca del valor predictivo de distintos valores de glucosa en sangre para las complicaciones de la diabetes. Por ello, la OMS realizó una Consulta paralela al informe del Comité de Expertos de la Asociación Americana de Diabetes para reexaminar los criterios diagnósticos y la clasificación. Este documento incluye las conclusiones de dicha Consulta para su difusión y discusión, antes de presentar las propuestas finales a la OMS para su aprobación. Los principales cambios propuestos son los siguientes: El valor diagnóstico de glucosa plasmática en ayunas ha sido disminuido a >7.0 mmol/l(6.1 mmol l/l). La tolerancia a la glucosa alterada (TGA) se modificó para dar lugar al nuevo nivel en ayunas. Se propone una nueva categoría para la glucemia de ayunas alterada (GAA), abarcando los valores por encima del normal, pero inferiores al valor diagnóstico de corte para diabetes (plasma>6.1 a<7.0 mmol/l sangre entera >5.6 a <6.1 mmol l/l). El concepto de diabetes mellitus gestacional (DMG) ahora incluye tanto la TGA gestacional como la DMG previa. La clasificación define los procesos y los estadios de la enfermedad

Assuntos

Assuntos

RESUMO

During the period January to December 1979, 75 g glucose tolerance tests were performed on 311 patients in the Chemical Pathology Department of the University Hospital. There were 14 (4.5 percent) non-pregrant adult patients, not previously diagnosed as diabetic, whose 2-h post-ingestion blood glucose values, using venous whole blood, fell within the range 140-200 mg percent (8-11 mmol/l). On these results they were diagnosed as impaired glucose tolerance (IGT) and no therapy given except for dietary advice. Two years later, during the month of January 1982, they were contacted by postal telegrams to return to the hospital for reassessment. A 75-g glucose load was given to each respondent and a 2-h post-ingestion blood glucose level determined. Eight (57 percent) had normal values of mean blood glucose 115 mg percent (6.4 mmol/l): 4 were female, and 4 male; age range 20-76 yr, mean age 40 yr; body mass index range 19.7-35.1, mean value 29.2 (>26 regarded as obesity). Two (14.3 percent) females remained in the IGT group: mean blood glucose value 173 mg percent (9.6 mmol/l); mean age 32 yr; and mean body mass index 29.7. Four (28.6 percent) were frank diabetics, mean blood glucose 347 mg percent (19.3 mmol/l): 3 males 1 female; age range 20-66 yr, mean age 48 yr; body mass index range 24.1-28.7, mean value 25.7

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