RESUMO
Visceral leishmaniasis (VL) is a parasitic disease that is endemic in more than 80 countries, and leads to high fatality rates when left untreated. We investigate the relationship of VL cases in dogs and human cases, specifically for evidence of VL in dogs leading to excess cases in humans. We use surveillance data for dogs and humans for the years 2007-2011 to conduct both spatial and spatio-temporal analyses. Several models are evaluated incorporating varying levels of dependency between dog and human data. Models including dog data show marginal improvement over models without; however, for a subset of spatial units with ample data, models provide concordant risk classification for dogs and humans at high rates (â¼70%). Limited reported dog case surveillance data may contribute to the results suggesting little explanatory value in the dog data, as excess human risk was only explained by dog risk in 5% of regions in the spatial analysis.
Assuntos
Leishmaniose Visceral/epidemiologia , Animais , Brasil/epidemiologia , Demografia , Doenças do Cão/epidemiologia , Cães , Humanos , Leishmaniose Visceral/etiologia , Vigilância em Saúde Pública , Fatores de Risco , Análise Espaço-Temporal , Zoonoses/epidemiologia , Zoonoses/etiologiaRESUMO
BACKGROUND: Because of the changing referral patterns, operative pediatric supracondylar humerus fractures are increasingly being treated at tertiary referral centers. To expedite patient flow, type II fractures are sometimes pinned in a delayed manner. We sought to determine if delay in surgical treatment of modified Gartland type II supracondylar humerus fractures would affect the rate of complications following closed reduction and percutaneous pinning. METHODS: We performed a retrospective review of a consecutive series of 399 modified Gartland type II supracondylar fractures treated operatively at a tertiary referral center over 4 years. Mean patient age in the type II group was 5 years (range, 1 to 15 y). A total of 48% were pinned within 24 hours, 52% pinned >24 hours after the injury. RESULTS: No difference was in detected in rates of major complications between the early and delayed treatment group. Four percent of patients sustained a complication (16 patients). There were no compartment syndromes, vascular injuries, or permanent nerve injuries. Complications included nerve injury (3), physical therapy referral for stiffness (3), pin site infection (2 treated with oral antibiotics, 4 treated with debridement), refracture (2), and loss of fixation or broken hardware (2). Of the 3 patients who sustained nerve injuries, all underwent surgery within 24 hours of injury. One patient developed an ulnar motor and sensory nerve palsy after fixation with crossed K-wires. This resolved by 7 weeks postoperatively. Two patients presented with an anterior interosseous nerve palsy-1 resolved 1 week after surgery, the other by 8 weeks postoperatively. CONCLUSIONS: Delay in surgery did not result in an increased rate of major complications following closed reduction and percutaneous pinning of type II supracondylar humerus fractures in children. Further prospective work is necessary to determine if there are subtle treatment benefits from emergent treatment of type II supracondylar humerus fractures. LEVEL OF EVIDENCE: Level III-retrospective comparative series.
Assuntos
Fraturas do Úmero/cirurgia , Complicações Pós-Operatórias/classificação , Complicações Pós-Operatórias/epidemiologia , Período Pré-Operatório , Centros de Atenção Terciária/estatística & dados numéricos , Adolescente , Pinos Ortopédicos , Fios Ortopédicos , Criança , Pré-Escolar , Síndromes Compartimentais/epidemiologia , Desbridamento , Feminino , Seguimentos , Fixação Intramedular de Fraturas , Humanos , Úmero/cirurgia , Lactente , Masculino , Traumatismos dos Nervos Periféricos/epidemiologia , Modalidades de Fisioterapia , Falha de Prótese , Recidiva , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Infecção da Ferida Cirúrgica/epidemiologia , Fatores de Tempo , Resultado do TratamentoRESUMO
The incidence of low-birth weight babies in the Santo Tomás maternity ward was 9% between the first of August of 1992 and the 31 of July of 1993. We found a higher risk of having low birth weight babies if the mother was toxemic, without prenatal care of low socioeconomic status and if she was single. We did not find an association with adolescence, short mother's height, low educational status and primi- or multiparity of 5 or more
Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Recém-Nascido de Baixo Peso , Complicações na Gravidez/epidemiologia , Cuidado Pré-Natal , Fatores Socioeconômicos , Idade Materna , Incidência , Panamá/epidemiologia , Paridade , Índice de ApgarRESUMO
The incidence of low-birth weight babies in the Santo Tomás maternity ward was 9% between the first of August of 1992 and the 31 of July of 1993. We found a higher risk of having low birth weight babies if the mother was toxemic, without prenatal care of low socioeconomic status and if she was single. We did not find an association with adolescence, short mother's height, low educational status and primi- or multiparity of 5 or more.
Assuntos
Recém-Nascido de Baixo Peso , Índice de Apgar , Feminino , Humanos , Incidência , Recém-Nascido , Masculino , Idade Materna , Panamá/epidemiologia , Paridade , Gravidez , Complicações na Gravidez/epidemiologia , Cuidado Pré-Natal , Fatores SocioeconômicosRESUMO
The sulfated polysaccharides that occur in the tunic of ascidians differ markedly in molecular weight and chemical composition. A high molecular weight fraction (F-1), which has a high galactose content and a strong negative optical rotation, is present in all species. Several structural differences were observed among the F-1 fractions obtained from three species of ascidians that were studied in detail. Large numbers of alpha-L-galactopyranose residues sulfated at position 3 and linked glycosidically through position 1----4 are present in F-1 from all three ascidians. However, alpha-L-galactopyranose units, 1----3-linked and partially sulfated at position 4, comprise about half of the sugar units in the central core of F-1 from Ascidian nigra. In addition, L-galactopyranose nonreducing end units occur in F-1 from Styela plicata and A. nigra, but comprise only a minor fraction of F-1 from Clavelina sp. The combination of these various component units gives a complex structure for F-1 from S. plicata and A. nigra, whereas F-1 from Clavelina sp. possesses a simpler structure. The structures of these ascidian glycans are unique among all previously described sulfated polysaccharides, since they are highly branched (except that from Clavelina sp), sulfated at position 3, and contain large amounts of L-galactose without its D-enantiomorph. These data show unusual examples of polyanionic glycans with structural function in animal tissues.
Assuntos
Galactanos/isolamento & purificação , Urocordados/análise , Animais , Carboidratos/análise , Cromatografia DEAE-Celulose , Cromatografia em Gel , Cromatografia por Troca Iônica , Especificidade da EspécieAssuntos
Ácidos Carboxílicos/urina , Doenças em Gêmeos , Hipoglicemia/complicações , Síndrome de Reye/complicações , Cromatografia Gasosa , Diarreia/complicações , Diarreia/urina , Humanos , Hipoglicemia/urina , Lactente , Insulina/sangue , Masculino , Síndrome de Reye/urina , Vômito/complicações , Vômito/urinaRESUMO
Twin male infant siblings who presented in Harrow, UK, with a Reye's-like syndrome associated with profound hypoglycaemia, vomiting, diarrhoea, coma and death in one child, with dicarboxylic aciduria, and similarities to Jamacian vomiting sickness (hypoglycin toxicity) have been shown to excrete large amounts of a previously unrecorded urinary organic acid. This has been identified as 5-hydroxyhexanoic acid by gas chromatography mass spectrometry using a synthesized standard. Concentrations observed were 340 and 330 mg g-1 creatinine in the two patients. The metabolic precursor of the urinary acid is suggested to be hex-4-enoic acid, a probable chemical toxin closely related to the active organic acid metabolite of hypoglycin. The possibility of omega - 1 oxidation of hexanoic acid to 5-hydroxyhexanoic acid in these and other patients with dicarbocylic aciduris is also discussed.