RESUMO
Human neurocysticercosis (NC) is a parasitic disease caused by TAENIA SOLIUM when its larvae lodge in the central nervous system. NC prevalence estimates are obscured by the variable and often asymptomatic clinical picture. While infection depends on exposure, severity is possibly related with various host factors (immunity, genes and gender). This epidemiological study of cranial CT scans in an endemic rural community found that 9.1% of apparently healthy subjects had calcified lesions and were completely asymptomatic. Silent NC cases did not correlate with the exposure factors tested but showed family aggregation and higher rates of positive serology. Thus, NC prevalence may be higher than currently considered and host-related factors appear to be involved in infection and pathogenesis.
Assuntos
Calcinose/epidemiologia , Calcinose/etiologia , Neurocisticercose/complicações , Neurocisticercose/epidemiologia , População Rural/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Animais , Calcinose/diagnóstico por imagem , Criança , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Neurocisticercose/diagnóstico por imagem , Prevalência , Suínos , Taenia solium/isolamento & purificação , Tomografia Computadorizada por Raios XRESUMO
PIP: This work questions the view of the family as a closed physical, economic, and emotional unit with longterm stability that has been the usual basis of demographic data collection and analysis, population policy formulation, and family planning program implementation. Simple models of the family assume that the parents and children live in the same household and function in a unified family economy, in which childbearing decisions reflect a longterm view of costs and benefits. But in reality, parents often live apart due to labor migration, polygamy, divorce, remarriage, or extramarital procreation. The hypothesis that family members share a household is valid only in some places, as Demographic and Health Survey (DHS) data have demonstrated. In families separated by migration for economic reasons, distance often loosens economic ties, especially with the passage of time. Financial exchanges are precarious when the father and mother are not united by marriage. It is frequently assumed that satisfaction of the family planning needs of couples is equivalent to satisfying the needs of men and women separately, but this assumption may be erroneous for nonmonogamous individuals. Recent research demonstrates that single women and their partners are a potentially important group of family planning users. The assumption that increasing costs of children in developing countries will discourage parents from having large families may overlook parental efforts to have some of the cost assumed by other relatives or the older children, or to invest in only some of their children. As new proofs of the limitations of the conventional view of the family are found, the need becomes clear for research including men, adding an individual perspective to the attention usually focused on couples, and establishing a more realistic perspective on the family in all its manifestations.^ieng
Assuntos
Comportamento Contraceptivo , Países Desenvolvidos , Países em Desenvolvimento , Estudos de Avaliação como Assunto , Características da Família , Política de Planejamento Familiar , Serviços de Planejamento Familiar , Fertilidade , Casamento , Dinâmica Populacional , Anticoncepção , Demografia , População , Política Pública , Ciências SociaisRESUMO
Cimetidine and antacids are the mainstays of therapy for the prophylaxis of stress-induced ulceration in critically ill children. Previous cimetidine dosing recommendations have been empiric because of a lack of knowledge about cimetidine disposition kinetics in children. Thirty children, mean age 9 +/- 3.2 years, were admitted to the study with the following primary diagnoses: closed head injury (23 patients), sepsis (four), gunshot wound (two), and bleeding gastric ulceration (one). The mean dose of cimetidine was 26 mg/kg/day, administered intravenously over 15 minutes in four divided doses. Cimetidine disposition was best described by a biphasic elimination curve with t1/2 values for cimetidine, cimetidine sulfoxide, and hydroxymethyl cimetidine of 1.39, 2.6, and 4.7 hours, respectively. Cimetidine plasma concentrations were maintained at greater than or equal to 0.5 microgram/ml for a significantly longer time in patients who received greater than or equal to 20 mg/kg/day. Most patients had a plasma cimetidine concentration below 0.5 to 1.0 microgram/ml 4 hours after infusion. The mean apparent volume of distribution and total body clearance for cimetidine were 1.23 L/kg and 10.4 ml/min/kg, respectively. A significant correlation was found between age and either apparent volume of distribution (r = 0.76, P less than 0.001) or total body clearance (r = 0.75, P less than 0.001). No significant correlation between cimetidine concentrations in either plasma or gastric juice and gastric pH could be determined. However, seven of nine patients who received only cimetidine had a gastric pH of greater than or equal to 4 at 2 hours after infusion when the plasma cimetidine concentration was greater than or equal to 1.0 or the gastric juice concentration was greater than or equal to 2.0 microgram/ml. The mean gastric pH was 2.2 at 6 hours, when plasma and gastric juice concentrations of cimetidine were greater than or equal to 1.0 microgram/ml. On the basis of our data, a cimetidine dosage of 20 to 30 mg/kg/day administered in six divided doses should provide for average steady-state plasma cimetidine concentrations of 1.3 to 2.0 micrograms/ml.