RESUMO
OBJECTIVES: Intercountry comparability between studies on medication use in pregnancy is difficult due to dissimilarities in study design and methodology. This study aimed to examine patterns and factors associated with medications use in pregnancy from a multinational perspective, with emphasis on type of medication utilised and indication for use. DESIGN: Cross-sectional, web-based study performed within the period from 1 October 2011 to 29 February 2012. Uniform collection of drug utilisation data was performed via an anonymous online questionnaire. SETTING: Multinational study in Europe (Western, Northern and Eastern), North and South America and Australia. PARTICIPANTS: Pregnant women and new mothers with children less than 1 year of age. PRIMARY AND SECONDARY OUTCOME MEASURES: Prevalence of and factors associated with medication use for acute/short-term illnesses, chronic/long-term disorders and over-the-counter (OTC) medication use. RESULTS: The study population included 9459 women, of which 81.2% reported use of at least one medication (prescribed or OTC) during pregnancy. Overall, OTC medication use occurred in 66.9% of the pregnancies, whereas 68.4% and 17% of women reported use of at least one medication for treatment of acute/short-term illnesses and chronic/long-term disorders, respectively. The extent of self-reported medicated illnesses and types of medication used by indication varied across regions, especially in relation to urinary tract infections, depression or OTC nasal sprays. Women with higher age or lower educational level, housewives or women with an unplanned pregnancy were those most often reporting use of medication for chronic/long-term disorders. Immigrant women in Western (adjusted OR (aOR): 0.55, 95% CI 0.34 to 0.87) and Northern Europe (aOR: 0.50, 95% CI 0.31 to 0.83) were less likely to report use of medication for chronic/long-term disorders during pregnancy than non-immigrants. CONCLUSIONS: In this study, the majority of women in Europe, North America, South America and Australia used at least one medication during pregnancy. There was a substantial inter-region variability in the types of medication used.
Assuntos
Doença Aguda/terapia , Doença Crônica/tratamento farmacológico , Medicamentos sem Prescrição/uso terapêutico , Medicamentos sob Prescrição/uso terapêutico , Adulto , Fatores Etários , Austrália , Estudos Transversais , Escolaridade , Emigrantes e Imigrantes/estatística & dados numéricos , Europa (Continente) , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Internet , América do Norte , Gravidez , Gravidez não Planejada , América do Sul , Adulto JovemAssuntos
Culicidae , Dengue , Meio Ambiente , Indústrias , Saúde Pública , Borracha , Animais , Ásia/etnologia , Comércio/economia , Comércio/educação , Comércio/história , Comércio/legislação & jurisprudência , Dengue/etnologia , Dengue/história , História do Século XIX , História do Século XX , Indústrias/economia , Indústrias/educação , Indústrias/história , Indústrias/legislação & jurisprudência , Controle de Mosquitos/economia , Controle de Mosquitos/história , Controle de Mosquitos/legislação & jurisprudência , América do Norte/etnologia , Saúde Pública/economia , Saúde Pública/educação , Saúde Pública/história , Borracha/economia , Borracha/história , América do Sul/etnologiaRESUMO
OBJECTIVE: To evaluate the safety, immunogenicity, and immunologic memory in young infants of a seven-valent (6B, 14, 19F, 23F, 18C, 4, 9V) pneumococcal vaccine conjugated to the outer membrane protein complex of Neisseria meningitidis. VACCINEES: Healthy 2-month-old infants 12- to 15-month-old control infants were recruited from participating private practices. METHODS: Infants (n = 25) were vaccinated at 2, 4, and 6 months of age with the conjugated pneumococcal vaccine, followed by a single dose of licensed pneumococcal polysaccharide vaccine (n = 20) at 12 to 15 months of age. Thirteen infants who had not received the investigational pneumococcal conjugate vaccine served as control subjects and were given a single dose of the licensed pneumococcal polysaccharide vaccine at 12 to 15 months of age. RESULTS: The investigational pneumococcal conjugate vaccine was well tolerated by infants. The vaccine was highly immunogenic in young infants, with significant increases in antibody to all seven serotypes after either two or three injections. At 12 to 15 months of age, infants who had been primed with the investigational pneumococcal conjugate vaccine had a brisk immunologic response to the booster injection of the licensed pneumococcal polysaccharide vaccine. Control infants, who received a single primary injection of the licensed pneumococcal polysaccharide vaccine, had negligible immunologic responses to four of the seven serotypes and low responses to the other three types. CONCLUSION: The investigational seven-valent pneumococcal conjugate vaccine administered to young infants was well tolerated and highly immunogenic and provided immunologic memory to an injection of the licensed pneumococcal polysaccharide vaccine.
Assuntos
Proteínas da Membrana Bacteriana Externa/imunologia , Vacinas Meningocócicas , Infecções Pneumocócicas/imunologia , Vacinas Pneumocócicas , Polissacarídeos Bacterianos/imunologia , Vacinas Conjugadas/imunologia , Proteínas da Membrana Bacteriana Externa/efeitos adversos , Avaliação de Medicamentos , Ensaio de Imunoadsorção Enzimática , Vacina Pneumocócica Conjugada Heptavalente , Humanos , Lactente , Neisseria meningitidis , Polissacarídeos Bacterianos/efeitos adversos , Vacinas Conjugadas/efeitos adversosRESUMO
RESA-IFA assays were conducted using 63 adult sera from 7 different malarious areas against 7 different strains of Plasmodium falciparum, and 28 children's sera against 3 different parasite strains. Generally, where immunity to malaria was high, there was little or no antigenic diversity among the different strains examined. However, where sera were collected from semi-immunes, or from children, some variation in the RESA-IFA endpoint titers was discernible. Correlation between antibody titers determined by RESA-IFA and in vitro parasite invasion inhibition was not complete. Sera having high RESA-IFA titers were predictably inhibitory; however, many sera having low RESA-IFA titers were as inhibitory as sera having high titers, indicating that antibodies with specificities different from the RESA may be as important, or more important, to clinical immunity to blood-stage infections.
Assuntos
Anticorpos Antiprotozoários/análise , Antígenos de Protozoários/imunologia , Antígenos de Superfície/imunologia , Malária/imunologia , Plasmodium falciparum/imunologia , Proteínas de Protozoários , Adolescente , Adulto , Animais , Variação Antigênica , Burkina Faso , Criança , Pré-Escolar , Equador , Imunofluorescência , Humanos , Indonésia , Nigéria , SudãoRESUMO
Prefacio. Reconocimientos. Bases de la operatoria dental pediátrica. Técnicas radiográficas. Anatomía de los dientes temporarios y permanentes. Principios de operatoria dental. Aislamiento. lesión de la clase 1. Lesión de la Clase 2. Lesión de la Clase 3. Lesión de la Clase 4. Lesión de la Clase 5. Matrices. Materiales dentales. Corona de acero inoxidable. Aspectos preventivos de la operatoria dental en pediatría. Principios del tratamiento pulpar. Tratamiento pulpar. Técnicas de tratmiento. Glosario. Indice analítico
Assuntos
Odontopediatria , Dentística Operatória , CriançaRESUMO
Prefacio. Reconocimientos. Bases de la operatoria dental pediátrica. Técnicas radiográficas. Anatomía de los dientes temporarios y permanentes. Principios de operatoria dental. Aislamiento. lesión de la clase 1. Lesión de la Clase 2. Lesión de la Clase 3. Lesión de la Clase 4. Lesión de la Clase 5. Matrices. Materiales dentales. Corona de acero inoxidable. Aspectos preventivos de la operatoria dental en pediatría. Principios del tratamiento pulpar. Tratamiento pulpar. Técnicas de tratmiento. Glosario. Indice analítico