RESUMO
OBJECTIVE: Current epidemiological research indicates that HIV/AIDS endures and continues to be a significant vulnerability among adolescents and youths despite the increased access to antiretroviral drugs and the reduction in the global progression of the disease. This study examined the association between substance use and psychological distress within the Jamaican population of youths coping with the illness. METHOD: This is a cross-sectional survey that utilized a correlational design. The sample population consisted of 62 youths, age range 15-25 years, living with HIV/AIDS. Sociodemographic information was gathered through interviews and self-report scales were used to measure depression, anxiety, stress and substance use. Chi-square was used to assess the relationship between the variables under study: psychological distress and substance use. RESULTS: More than half the sample were heterosexuals who contracted the virus through consensual intercourse. The average age of respondents was 21.29 years and slightly more than half were female (56.5%). The majority of respondents were single (54.8%), unemployed (73%), heterosexual (69.4%) youths with a secondary level education (63%). There was a statistically significant relationship between psychological distress and substance use (χ2 = 7.3959, df = 3, p = 0.047). CONCLUSION: The emotional needs of youths living with HIV/AIDS are just as important as their medical needs.
Assuntos
Infecções por HIV/psicologia , Estresse Psicológico/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/psicologia , Adolescente , Adulto , Terapia Antirretroviral de Alta Atividade , Ansiedade/epidemiologia , Ansiedade/psicologia , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Jamaica/epidemiologia , Masculino , Adesão à Medicação/estatística & dados numéricos , Estresse Psicológico/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: Current epidemiological research indicates that HIV/AIDS endures and continues to be a significant vulnerability among adolescents and youths despite the increased access to antiretroviral drugs and the reduction in the global progression of the disease. This study examined the association between substance use and psychological distress within the Jamaican population of youths coping with the illness. METHOD: This is a cross-sectional survey that utilized a correlational design. The sample population consisted of 62 youths, age range 15-25 years, living with HIV/AIDS. Sociodemographic information was gathered through interviews and self-report scales were used to measure depression, anxiety, stress and substance use. Chi-square was used to assess the relationship between the variables under study: psychological distress and substance use. RESULTS: More than half the sample were heterosexuals who contracted the virus through consensual intercourse. The average age of respondents was 21.29 years and slightly more than half were female (56.5%). The majority of respondents were single (54.8%), unemployed (73%), heterosexual (69.4%) youths with a secondary level education (63%). There was a statistically significant relationship between psychological distress and substance use (χ2 = 7.3959, df = 3, p = 0.047). CONCLUSION: The emotional needs of youths living with HIV/AIDS are just as important as their medical needs.
OBJETIVO: La investigación epidemiológica actual indica que el VIH/SIDA perdura y sigue siendo un aspecto de vulnerabilidad significativa entre los adolescentes y jóvenes, a pesar del aumento del acceso a medicamentos antirretrovirales y la reducción de la progresión global de la enfermedad. Este estudio examinó la asociación entre el uso de sustancias y el distrés psicológico dentro de la población jamaicana de jóvenes que luchan con la enfermedad. MÉTODO: Este es un estudio transversal que utilizó un diseño correlacional. La muestra poblacional consistió de 62 jóvenes, años rango 15-25 años viven con el VIH/SIDA. Se recogió información sociodemográfica a través de entrevistas y se usaron escalas de autoreporte para medir la depresión, la ansiedad, el estrés, y el uso de sustancias. El chi-cuadrado fue utilizado para evaluar la relación entre las variables objeto de estudio: el distrés psicológico y el uso de sustancias. RESULTADOS: Más de la mitad de la muestra estuvo formada por heterosexuales que contrajeron el virus a través de relaciones sexuales consensuales. La edad promedio de los encuestados fue 21.29 años, y poco más de la mitad eran mujeres (56.5%). La mayoría de los encuestados eran solteros (54.8%), desempleados (73%), jóvenes heterosexuales (69.4%) con una educación de nivel secundario (63%). Hubo una relación estadísticamente significativa entre el distrés psicológico y el uso de sustancias (χ2 = 7.3959, df = 3, p = 0.047). CONCLUSIÓN: Las necesidades emocionales de los jóvenes que viven con el VIH/SIDA son tan importantes como sus necesidades médicas.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Estresse Psicológico/psicologia , Infecções por HIV/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Ansiedade/psicologia , Ansiedade/epidemiologia , Estresse Psicológico/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Estudos Transversais , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Terapia Antirretroviral de Alta Atividade , Depressão/psicologia , Depressão/epidemiologia , Jamaica/epidemiologiaRESUMO
PURPOSE: Conventional calculation methods of patient release criteria for compliance with NRC regulations are based on the assumption that both patient and bystander are each a single point in space. This study was intended to assess the patient-specific external radiation exposure to a bystander interacting with the patient following radionuclide therapy with 131I. METHODS: 131I-sodium iodide treatment for hyperthyroidism and thyroid cancer and 131I-tositumomab treatment of non-Hodgkin's lymphoma were considered. 131I distribution provided by the patient SPECT image was rendered on the SPECT-fused CT images. The CT images were then imported to a Monte Carlo based simulation code, MCNPX 2.7, as a source phantom. For a target phantom, we employed the adult male hybrid phantom developed at the University of Florida and National Cancer Institute. A single orientation - patient and a bystander facing one another at 1.0 m - was considered. S factors (dose per unit cumulative activity (A)) for each organ in a bystander was obtained from the MC calculations and effective dose (EDE) per A was calculated based on tissue-weighted individual organ doses. The results were compared with the calculations using UF/NCI adult hybrid source/target phantoms and the revised adult ORNL stylized source/target phantoms. RESULTS: EDE per A of the stylized phantom was 1.5% higher than that of the hybrid phantom for uniform source localization in the thyroid. However, EDE per A of the hybrid phantom was 20% less than that of stylized phantoms for a torso source. The difference is attributed to the realistic shape of the frontal body comparing to the simple ellipsoidal trunk of the stylized phantom. CONCLUSIONS: Based on the realistic hybrid phantoms and accurate MC radiation transport calculation tools, patient specific dosimetry for a bystander is feasible. S factors will be calculated using the patient CT image with 131I bio-distributions and hybrid phantoms.
RESUMO
OBJECTIVE: To construct confidence intervals for HIV prevalence in countries with generalised epidemics. METHODS: In the Bayesian melding approach, a sample of country-specific epidemic curves describing HIV prevalence over time is derived based on time series of antenatal clinic prevalence data and general information on the parameters that describe the HIV epidemic. The prevalence trends at antenatal clinics are calibrated to population-based HIV prevalence estimates from national surveys. For countries without population based estimates, a general calibration method is developed. Based on the sample of calibrated epidemic curves, we derive annual 95% confidence intervals for HIV prevalence. The curve that best represents the data at antenatal clinics and population-based surveys, as well as general information about the epidemic, is chosen to represent the best estimates and predictions. RESULTS: We present results for urban areas in Haiti and Namibia to illustrate the estimates and confidence intervals that are derived with the methodology.
Assuntos
Surtos de Doenças/estatística & dados numéricos , Infecções por HIV/epidemiologia , Adolescente , Adulto , Teorema de Bayes , Intervalos de Confiança , Coleta de Dados/métodos , Feminino , Haiti/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Namíbia/epidemiologia , Prevalência , Incerteza , Nações UnidasRESUMO
A retrospective analysis of the 1996 DEN-1 epidemic in Trinidad was undertaken to better understand the clinical and demographic expression of dengue infection in the island during one of the larger epidemics in the past 10 years and following the reintroduction of DEN-1 into the island in 1991 after a gap of 14 years. A total of 393 laboratory-confirmed cases were identified. Of these, notes for 157 patients were available for analysis. The epidemic was island-wide, though most cases occurred in the most densely populated county of St. George. There was a slight predominance of females (51.6 per cent) among the cases, and while all age groups were affected, older children and adults comprised the majority. South Asians among the population predominated. Overall, 27 clinical symptoms were reported. The most common were: fever (98.7 per cent), generalized pain (96.2 per cent) and anorexia (63.1 per cent). Rash, arthralgia, retro-orbital pain and haemorrhage (all mentioned in the WHO clinical description for dengue fever) were reported in <50 per cent of cases. Gastrointestinal symptoms were also very common and occurred in over two-thirds of cases at presentation. Bleeding manifestations were reported in 30 per cent of patients and commonly involved the gastrointestinal tract. Features of DHF were noted in only six (4 per cent)
Assuntos
Humanos , Vírus da Dengue/fisiologia , Vírus da Dengue/patogenicidade , Trinidad e Tobago/epidemiologia , Países em DesenvolvimentoRESUMO
OBJECTIVE: To determine if 1) Afro-Caribbean women prefer large body sizes, 2) the body size preference of Afro-Caribbean men and women are associated, 3) women's preferences are associated with increased risk of obesity or with weight management behaviors. DESIGN: Population samples of 314 and 487 women, ages 20-55 years, were recruited on Barbados and Dominica with response rates of 74% and 77%, respectively. Body size preferences, stress related variables, and demographic data were ascertained by questionnaire. Height and weight were also measured. On Barbados, body preference data were collected from male partners of participants, and data on intentions to perform weight management behaviors were collected from 175 women. RESULTS: Most women preferred body sizes within normal limits, although women on Dominica had a slightly larger ideal body size (IBS) than did Barbadian women (P<.05). On both islands, the size that women thought men preferred was related to their IBS (P<.0001). Likewise, IBS was associated with increased odds of being overweight (P<.001), however most overweight women (>75%) wanted to be smaller. IBS was not related to the intention to exercise or to eat high fat foods. CONCLUSIONS: It is unlikely that body size preference poses a barrier to intervention efforts to reduce the prevalence of overweight in Afro-Caribbean women.
Assuntos
Constituição Corporal/etnologia , Promoção da Saúde , Obesidade/epidemiologia , Adulto , África/etnologia , Barbados/epidemiologia , Imagem Corporal , Índice de Massa Corporal , Dominica/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Parceiros Sexuais , Redução de PesoRESUMO
OBJECTIVE: To describe and characterize a new disorder of hyaluronan metabolism associated with marked abnormalities of cutaneous tissue and to determine whether a relationship with a phenotypically similar disorder in the shar-pei dog exists. METHODS: Biopsy specimens of the skin of a child with extreme cutaneous thickening and folding were examined by light and electron microscopy. The concentration of hyaluronan and the activity of hyaluronidase were measured in the patient's serum and plasma, respectively, and the activity of hyaluronan synthase was examined in cultured dermal fibroblasts. Hyaluronan concentration was also measured in the plasma of 23 shar-pei and 34 control dogs. RESULTS: The patient's skin displayed gross accumulation of hyaluronan, and the serum concentration of hyaluronan was markedly elevated (up to 3100 microg/L) during infancy. Hyaluronan synthase activity of cultured dermal fibroblasts was increased, whereas hyaluronidase activity in plasma was normal (5.5 +/- 0.08 IU/L). Plasma hyaluronan concentration was higher in the shar-pei dogs than in control dogs (median, 378 microg/L vs 73 microg/L, respectively). CONCLUSION: The child we describe has a novel disorder of hyaluronan metabolism, which appears to result from abnormal control of hyaluronan synthesis. An analogous disorder may be present in the shar-pei dog.
Assuntos
Glicosiltransferases , Ácido Hialurônico/metabolismo , Proteínas de Membrana , Dermatopatias/etiologia , Pele/metabolismo , Transferases , Proteínas de Xenopus , Animais , Biópsia , Células Cultivadas , Cães , Fibroblastos/enzimologia , Seguimentos , Glucuronosiltransferase/metabolismo , Humanos , Hialuronan Sintases , Ácido Hialurônico/sangue , Ácido Hialurônico/genética , Hialuronoglucosaminidase/sangue , Lactente , Recém-Nascido , Masculino , Microscopia Eletrônica , Fenótipo , Pele/patologia , Dermatopatias/genética , Dermatopatias/metabolismo , Dermatopatias/patologiaRESUMO
PURPOSE: To determine whether nonreferred children with idiopathic megalencephaly show evidence of specific neurodevelopmental dysfunction compared with sibling control subjects and age-matched control subjects. DESIGN: Cross-sectional, case-control study in a large, suburban pediatric practice. Subjects included 20 children between the ages of 6 and 15 years with a head circumference at greater than the 98th percentile, 19 siblings of these children with normalsize heads, and 16 age-matched control subjects. Standardized tests of language, academic achievement, visuomotor integration, motor function, and neurodevelopmental function were administered. RESULTS: Multivariate analysis, with control for age, showed a main effect for the presence of megalencephaly (F = 3.2; p < 0.05). Follow-up univariate analyses, with control for age, showed that children with megalencephaly had poorer performance on tasks of upper limb speed, visuomotor control, running speed, bilateral coordination, visuomotor integration, naming fluency, and minor neurologic indicators. CONCLUSION: The relationship between idiopathic megalencephaly and external hydrocephalus in infants is discussed. Results show that so-called "benign" idiopathic megalencephaly in nonreferred school-age children appears to be a clinical entity associated with subtle motor problems and neurodevelopmental dysfunction.
Assuntos
Encefalopatias/complicações , Encéfalo/crescimento & desenvolvimento , Desenvolvimento Infantil , Desempenho Psicomotor , Logro , Adolescente , Braço/fisiologia , Encefalopatias/genética , Estudos de Casos e Controles , Criança , Transtornos do Comportamento Infantil/etiologia , Linguagem Infantil , Estudos Transversais , Deficiências do Desenvolvimento/etiologia , Feminino , Seguimentos , Humanos , Hidrocefalia/complicações , Desenvolvimento da Linguagem , Masculino , Destreza Motora , Análise Multivariada , Exame Neurológico , Tempo de Reação , Corrida/fisiologiaRESUMO
Among a cohort of 152 infants perinatally infected with human immunodeficiency virus type 1, and their mothers, we correlated infant outcome with material CD4+ lymphocyte count and the presence of maternal acquired immunodeficiency syndrome near delivery. In a subset of 50 mother-infant pairs, we also correlated infant outcome with maternal quantitative viral burden as measured by the nucleic acid sequence based amplification system. We found that low maternal CD4+ cell count and high viral burden were associated with decreased time to category C disease or death in infants infected with human immunodeficiency virus type 1. In a multivariate analysis, high maternal viral load and maternal acquired immunodeficiency syndrome were independently associated with shorter time to category C disease or death in infants with human immunodeficiency virus type 1 infection. High viral load in pregnant women, independent of the presence of advanced maternal disease, appears to increase the risk of rapidly progressive disease in their infected offspring.
Assuntos
Síndrome da Imunodeficiência Adquirida/diagnóstico , Contagem de Linfócito CD4 , HIV-1/isolamento & purificação , Carga Viral , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Antivirais/administração & dosagem , Antivirais/uso terapêutico , Feminino , Humanos , Recém-Nascido , Bem-Estar Materno , Reação em Cadeia da Polimerase , Gravidez , RNA Viral , Zidovudina/administração & dosagem , Zidovudina/uso terapêuticoRESUMO
Mutations of the human androgen receptor gene were identified in five subjects from four families with androgen insensitivity syndrome. Individual exons of the androgen receptor gene were amplified by the polymerase chain reaction from genomic DNA and screened for sequence-dependent differences in their melting characteristics by denaturing gradient gel electrophoresis. DNA fragments from exons with altered mobility were sequenced. Four different single nucleotide base substitutions were found within exons 5, 6, and 7 encoding the steroid-binding domain of the androgen receptor. In one subject with ambiguous genitalia, amino acid residue 763 was changed from tyrosine to cysteine (TAC-->TGC; Y763C). Four subjects, including two siblings, had complete androgen insensitivity. In one subject, residue 779 was changed from arginine to tryptophan (CGC-->TGG; R779W), another subject (M807V) had a substitution of valine (GTG) for methionine (ATG) residue at position 807, and the two siblings (R855C) had a mutation in residue 855 changing arginine (CGC) to cysteine (TGC). Binding of the synthetic androgen ligand, methyltrienolone (R1881), by the mutant receptor Y763C was decreased by 54% compared to the normal receptor. Transcriptional activation of a mouse mammary tumor virus-chloramphenicol acetyltransferase (MMTV-CAT) reporter gene by AR mutant Y763C was negligible at 0.1 nM R1881 and only 55% at 10 nM R1881 when compared to the maximal response with the normal AR, as assessed by CAT activity. Mutant M807V retained only 22% of normal R1881 binding and mutant R855C was unable to bind the steroid. In accordance with the steroid binding, transcriptional activation of MMTV-CAT by M807V rose to only 26% of control in the presence of 10 nM R1881, a concentration at which R855C remained functionally inactive. In summary, missense mutations within the exons of the androgen receptor gene encoding the steroid-binding domain of the receptor are common causes of both partial and complete forms of androgen insensitivity syndrome.
Assuntos
Síndrome de Resistência a Andrógenos/genética , Androgênios/fisiologia , Mutação Puntual , Receptores Androgênicos/genética , Adolescente , Adulto , Sequência de Aminoácidos , Sequência de Bases , Sítios de Ligação , Mapeamento Cromossômico , Feminino , Disgenesia Gonadal 46 XY/genética , Humanos , Masculino , Dados de Sequência Molecular , FenótipoRESUMO
Hepatitis D virus (HDV) is the cause of an unusually severe form of liver disease with distinct histologic features (morula cell) that occurs throughout northern South America and certain other areas of the world. Clinical studies of HDV disease worldwide indicate that there is, in fact, a wide variation in pathogenesis, and the reasons for these differences are presently unknown. One possible explanation is that factors associated with the viral genotype are determinants of HDV pathogenesis. In this study, nucleic acid sequences were determined for three different northern South American HDV isolates which were obtained from individuals with severe disease or a family history of severe disease, in areas that are hyperendemic for this disease pattern. The sequences of these three isolates are very similar to one another but only distantly related to other published HDV sequences. Comparison of the sequence of a semiconserved region from a total of 14 isolates indicates that there are at least three HDV genotypes. Most published HDV sequences, including those from North America, Europe, the Middle East, the South Pacific, and Asia, belong to a single genotype which may have some geographically based subtypes. A single Japanese isolate is the sole representative of a second HDV genotype. The South American sequences reported here constitute a third genotype. The association of a particular genotype with the severe form of type D hepatitis that occurs in northern South America supports the hypothesis that HDV genetic factors are important determinants in the pathogenesis of type D hepatitis.
Assuntos
Vírus Delta da Hepatite/classificação , Vírus Delta da Hepatite/genética , Adolescente , Sequência de Aminoácidos , Sequência de Bases , Clonagem Molecular , Primers do DNA , Genótipo , Hepatite D/microbiologia , Vírus Delta da Hepatite/isolamento & purificação , Humanos , Itália , Japão , Masculino , Dados de Sequência Molecular , Filogenia , Reação em Cadeia da Polimerase , RNA Viral/sangue , RNA Viral/isolamento & purificação , Homologia de Sequência de Aminoácidos , Homologia de Sequência do Ácido Nucleico , América do SulRESUMO
We evaluated the relationship of global cerebral blood flow, cross-brain oxygen content difference, cerebral metabolic rate for oxygen, intracranial pressure, and cerebral perfusion pressure to functional neurologic outcome in 12 comatose children on 2 consecutive days after near-drowning. Five children survived with functional neurologic outcome; five died and two survived with severe neurologic damage. Children who survived with functional neurologic outcome had a significantly higher cross-brain oxygen content difference (7.89 +/- 2.62 vs 3.91 +/- 1.59 ml/dl; p = 0.028) at 24 hours and a higher cerebral metabolic rate for oxygen 48 hours after admission (3.19 +/- 2.86 vs 0.96 +/- 0.45 ml/100 gm per minute; p = 0.030) compared with those who died or survived in a damaged state. There were no significant differences in global cerebral blood flow, intracranial pressure, and cerebral perfusion pressure between groups at either 24 or 48 hours. Our preliminary data suggest that a higher cross-brain content difference value is an important early variable associated with functional neurologic recovery after near-drowning. However, a single cross-brain oxygen content difference value must be interpreted with caution because considerable variability may occur among patient groups.
Assuntos
Encéfalo/metabolismo , Circulação Cerebrovascular , Afogamento Iminente/fisiopatologia , Doenças do Sistema Nervoso/etiologia , Consumo de Oxigênio , Adolescente , Criança , Pré-Escolar , Coma/complicações , Coma/mortalidade , Coma/fisiopatologia , Coma/terapia , Humanos , Lactente , Pressão Intracraniana , Afogamento Iminente/complicações , Afogamento Iminente/mortalidade , Afogamento Iminente/terapia , Doenças do Sistema Nervoso/epidemiologia , Fatores de Tempo , Resultado do TratamentoRESUMO
Multivoxel magnetic resonance (MR) spectroscopy and novel data analysis techniques were developed to obtain high-quality phosphorus-31 metabolite images from the human brain and to overlay each metabolite distribution directly onto corresponding hydrogen-1 MR images. The P-31 MR spectroscopic data were acquired by means of three-dimensional chemical shift imaging (phase encoding in three spatial dimensions) on a 1.5-T clinical instrument equipped with a specially designed quadrature P-31 birdcage coil constructed in the authors' laboratory. Axial, sagittal, and coronal metabolite images based on the area for any one of five peak regions (phosphodiester; phosphocreatine; gamma, alpha, and beta adenosine triphosphate) were generated from 8 X 8 X 8 or 12 X 12 X 8 CSI arrays with voxel sizes of 27 cm3 and 12 cm3, respectively. The positions of these images were aligned with anatomic features by means of the voxel-shifting capability of the Fourier transform. Direct overlays of these metabolite images on corresponding proton images demonstrated excellent correlation with anatomy, factors indicating the utility of this technique for viewing P-31 metabolite levels in all areas of the brain simultaneously.
Assuntos
Encéfalo/patologia , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética , Adulto , Neoplasias Encefálicas/diagnóstico , Glioma/diagnóstico , Humanos , MasculinoRESUMO
We report in vitro and in vivo MR studies of hemorrhage using the gradient-echo pulse sequence, FISP (steady state free precession) and FLASH (spoiling of transverse magnetization) at 1.5 Tesla. Phantoms containing methemoglobin, ferromagnetic particles, human serum and blood clot were scanned using both spin-echo and gradient-echo techniques. FLASH signal intensities were more sensitive to methemoglobin concentration than high T1-weighted spin-echo images. FISP showed little change in signal intensity with varying concentrations of methemoglobin and a contrast relationship similar to T2-weighted spin-echo techniques. FISP and FLASH showed intensity changes at lower concentrations of ferromagnetic material than T2-weighted spin-echo sequences. In vitro blood clot was less intense when observed by FISP and FLASH sequences than on the T2-weighted spin-echo sequences. Maximum contrast between clot and other blood components occurred at a flip angle of 45 degrees for FLASH and 60 degrees for FISP. FISP and FLASH scans of patients with hemorrhage demonstrated a marked decrease in signal intensity in the region of blood clot. This decrease was more pronounced with the gradient-echo sequences than with T2-weighted spin-echo images. We conclude that FLASH is useful for detecting methemoglobin and that both FISP and FLASH are useful for evaluating hemorrhage because of their sensitivity to methemoglobin.
Assuntos
Hemorragia Cerebral/diagnóstico , Imageamento por Ressonância Magnética/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos EstruturaisRESUMO
The epidemiologic features of 60 cases of feline plague from 1977-1985 in New Mexico are reviewed. The most frequent clinical presentation was lethargy, anorexia, fever, and enlarged lymph nodes or abscesses. A history of hunting rodents was reported in 75 per cent of all cases. Five human plague cases were associated with five feline cases. Recommendations are presented for prevention of plague infection and transmission to humans, including restraining cats from roaming and hunting by neutering and keeping them indoors, treating them for fleas, and seeking medical care for febrile illnesses, especially when accompanied by enlarged lymph nodes.
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Doenças do Gato/transmissão , Peste/veterinária , Animais , Doenças do Gato/epidemiologia , Gatos , Humanos , New Mexico , Peste/epidemiologia , Peste/transmissão , Fatores de Risco , Estações do Ano , Sifonápteros/microbiologiaRESUMO
Familial expression of inadequate virilization of 46XY siblings is often reported as an isolated anomaly. We recently evaluated two families with 2 siblings who had a 46XY karyotype, ambiguous genitalia or micropenis, facial anomalies and mental retardation. There is no evidence of gonadotropin deficiency, defects of steroidogenesis, or androgen insensitivity. While there was a testosterone response to human chorionic gonadotropin stimulation in all 3 tested, gonadotropin levels were elevated in 2 of the infants suggestive of faulty seminiferous tubules, 1 of whom later had elevated luteinizing hormone levels. These kindreds may represent a new syndrome with either an X-linked recessive or sex-limited autosomal dominant form of inheritance, with partial testicular failure, multiple congenital anomalies, and mental retardation.