RESUMO
This work describes the new facility for applied nuclear physics at the University of Sao Paulo, mainly for irradiation of electronic devices. It is a setup composed of a quadrupole doublet for beam focusing/defocusing plus multiple scattering through gold foils to produce low intensity, large-area, and high-uniformity heavy-ion beams from 1H to 107Ag. Beam intensities can be easily adjusted from 102 particles cm2/s to hundreds of nA for an area as large as 2.0 cm2 and uniformity better than 90%. Its irradiation chamber has a high-precision motorized stage, and the system is controlled by a LabViewTM environment, allowing measurement automation. Design considerations and examples of use are presented.
RESUMO
Ataxias are one of the most frequent complaints in Neurogenetics units worldwide. Currently, more than 50 subtypes of spinocerebellar ataxias and more than 60 recessive ataxias are recognized. We conducted an 11-year prospective, observational, analytical study in order to estimate the frequency of pediatric and adult genetic ataxias in Argentina, to describe the phenotypes of this cohort and evaluate the diagnostic yield of the algorithm used in our unit. We included 334 ataxic patients. Our diagnostic approach was successful in one-third of the cohort. A final molecular diagnosis was reached in 113 subjects. This rate is significantly higher in the subgroup of patients with a positive family history, where the diagnostic yield increased to 55%. The most prevalent dominant and recessive ataxias in Argentina were SCA-2 (36% of dominant ataxias) and FA (62% of recessive ataxias), respectively. Next generation sequencing-based assays were diagnostic in the 65% of the patients requiring these tests. These results provide relevant epidemiological information, bringing a comprehensive knowledge of the most prevalent subtypes of genetic ataxias and their phenotypes in our territory and laying the groundwork for rationally implementing genetic diagnostic programs for these disorders in our country.
Assuntos
Algoritmos , Ataxia Cerebelar/genética , Heterogeneidade Genética , Técnicas de Diagnóstico Molecular/métodos , Adolescente , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Ataxia Cerebelar/classificação , Ataxia Cerebelar/diagnóstico , Ataxia Cerebelar/epidemiologia , Criança , Pré-Escolar , Doença Crônica , Progressão da Doença , Genes Dominantes , Genes Recessivos , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Pessoa de Meia-Idade , Nistagmo Patológico/genética , Estudos Prospectivos , Adulto JovemRESUMO
BACKGROUND: A Diagnostic Laboratory Hub (DLH) was set up in Guatemala to provide opportunistic infection (OI) diagnosis for people with HIV (PWH). METHODS: Patients newly presenting for HIV, PWH not receiving antiretrovirals (ARVs) for >90 days but returned to care (Return/Restart), and PWH on ARVs with symptoms of OIs (ARV treatment) were prospectively included. Screening for tuberculosis, nontuberculous mycobacteria (NTM), histoplasmosis, and cryptococcosis was done. Samples were couriered to the DLH, and results were transmitted electronically. Demographic, diagnostic results, disease burden, treatment, and follow-up to 180 days were analyzed. RESULTS: In 2017, 1953 patients were included, 923 new HIV infections (an estimated 44% of all new HIV infections in Guatemala), 701 on ARV treatment, and 315 Return/Restart. Three hundred seventeen (16.2%) had an OI: 35.9% tuberculosis, 31.2% histoplasmosis, 18.6% cryptococcosis, 4.4% NTM, and 9.8% coinfections. Histoplasmosis was the most frequent AIDS-defining illness; 51.2% of new patients had <200 CD4 cells/mm3 with a 29.4% OI incidence; 14.3% of OIs in new HIV infections occurred with CD4 counts of 200-350 cells/mm3. OIs were the main risk factor for premature death for new HIV infections. At 180 days, patients with OIs and advanced HIV had 73-fold greater risk of death than those without advanced disease who were OI-free. CONCLUSIONS: The DLH OI screening approach provides adequate diagnostic services and obtains relevant data. We propose a CD4 screening threshold of <350 cells/mm3. Mortality remains high, and improved interventions are required, including expansion of the DLH and access to antifungal drugs, especially liposomal amphotericin B and flucytosine.
RESUMO
Resumen Introducción: La hipnosis anestésica puede ser un recurso útil para procedimientos dolorosos. Desarrollo: Se reporta caso de una joven que requiere exodoncia de terceros molares, con uso de hipnosis como único anestésico. El proceso de enfermería inicia con la valoración según patrones funcionales, impresiona lo sana que se encuentra, sin antecedentes mórbidos relevantes ni contraindicación para anestesia química. Se selecciona diagnóstico NANDA de Disposición para mejorar el confort. Dentro del plan se incorporan el NIC 5920 Hipnosis y 5922 Facilitar la autohipnosis, con buena evolución según lo planificado. Resultados: La extracción con hipnosis anestésica se desarrolló de forma similar a la cirugía con anestesia química, la cual se realizó sin dolor. En posoperatorio, paciente practica autohipnosis, sin necesitar analgésicos y evolucionó favorablemente. Discusión: La hipnosis requiere mayor evidencia científica, pero su uso es prometedor. Se constataron los beneficios de la hipnosis en el abordaje del dolor. Conclusión: La hipnosis anestésica, fue útil como intervención de enfermería en cirugía dental. La autohipnosis contribuyó al buen resultado. El profesional de Enfermería entrenado en hipnosis está en condiciones de incorporarla en la gestión del cuidado. El caso resulta interesante, dado que la paciente opta por la hipnosis, sin contraindicación para anestesia química, ya que no se encontró otro reporte de hipnoanestesia inducida por profesional de Enfermería, como anestésico único. Anecdóticamente, durante la filmación del procedimiento, una periodista entra espontáneamente en trance, por lo que requiere intervención del profesional de Enfermería para salir de él.
Abstract Introduction: Anesthetic hypnosis can be a useful resource to address painful procedures. Development: The case is of a young female patient requiring third-molars exodontia who underwent it under anesthetic hypnosis. The nursing process began with the assessment according to functional patterns. The patient was found healthy and without relevant morbid antecedents nor drug-anesthesia contraindications. A comfort improving disposition NANDA diagnosis was selected. NIC 5922 and 5920 were incorporated to the intervention plan. Results: The extraction under anesthetic hypnosis was performed in a similar form in comparison to a drug-anesthesia extraction procedure. During the post operatory stage, the patient used self-hypnosis and responded favorably without analgesics. Discussion: While hypnosis requires more scientific evidence, its use appears to be promising. In this case, diverse benefits from using hypnosis to address a painful procedure were acknowledged. Conclusion: Anesthetic hypnosis proved being helpful in a dental-surgery related nursing intervention. Self-hypnosis also contributed to the favorable outcome. A nursing professional who is well trained in hypnosis can incorporate this kind of procedure into her care management approach. This particular case was interesting because the patient chose hypnosis over drug anesthesia, and no other report on a nursing staff induced anesthetic hypnosis was found. Anecdotally, during the filming of this procedure, a journalist suffered an emotional trance which required immediate nursing intervention.
Resumo Introdução: A hipnose anestésica pode ser um recurso útil para procedimentos dolorosos. Desenvolvimento: Informa-se o caso de uma garota que requer exodontia de terceiros molares, com uso de hipnoses como único anestésico. O processo de enfermagem inicia com a valoração segundo padrões funcionais, impressiona o saudável que se encontra, sem antecedentes mórbidos relevantes nem contraindicação para anestesia química. Seleciona-se diagnóstico NANDA de Disposição para melhorar o conforto. Dentro do plano se incorporam o NIC 5920 Hipnose e 5922 Facilitar a auto-hipnose, com boa evolução segundo o planejado. Resultados: A extração com hipnose anestésica desenvolveu-se de forma similar à cirurgia com anestesia química, a qual se realizou sem dor. Em pós-operatório, o paciente prática auto-hipnose, sem precisar analgésicos e evolucionou favoravelmente. Discussão: A hipnose requer maior evidencia científica, mas seu uso é promissor. Verificaram os benefícios da hipnose na abordagem da dor. Conclusão: A hipnose anestésica foi útil como intervenção de enfermagem em cirurgia dental. A auto-hipnose contribuiu para o bom resultado. O profissional de Enfermagem treinado em hipnose está em condições de incorporá-la na gestão do cuidado. O caso resulta interessante, dado que a paciente opta pela hipnose, sem contraindicação para anestesia química, já que não se encontrou outro relatório de hipnoanestesia induzida por profissional de Enfermagem, como anestésico único. Anedoticamente, durante a filmagem do procedimento, uma jornalista entrou espontaneamente em transe, pelo qual se requereu intervenção do profissional de Enfermagem para sair dele.
RESUMO
Abstract NUMEN proposes cross sections measurements of Heavy-Ion double charge exchange reactions as an innovative tool to access the nuclear matrix elements, entering the expression of the life time of Neutrinoless double beta decay (0νββ). A key aspect of the projectis the use at INFN-Laboratori Nazionali del Sud (LNS) of the Superconducting Cyclotron (CS) for the acceleration of the required high resolution and low emittance heavy-ion beams and of MAGNEX large acceptance magnetic spectrometer for the detection of the ejectiles. The experimental measurements of double charge exchange reactions induced by heavy ions present a number of challenging aspects, since such reactions are characterized by very low cross sections. First experimental results give encouraging indication on the capability to access quantitative information towards the determination of the Nuclear Matrix Elements for 0νββ decay.
Resumen NUMEN propone mediciones de secciones eficaces de reacciones de intercambio de carga doble de iones pesados como una herramienta innovadora para acceder a los elementos de la matriz nuclear, entrando en la expresión del tiempo de vida de la desintegración beta doble sin neutrino (0νββ). Un aspecto clave del proyecto es el uso en INFN-Laboratori Nazionali del Sud (LNS) del ciclotrón superconductor (CS) para la aceleración de los haces de iones pesados de alta resolución y baja emitancia requeridos y del espectrómetro magnético de gran aceptación MAGNEX para la detección de los residuos eyectados. Las mediciones experimentales de reacciones de intercambio de carga doble inducidas por iones pesados presentan una serie de aspectos desafiantes, ya que tales reacciones se caracterizan por secciones eficaces muy bajas. Los primeros resultados experimentales dan una indicación alentadora sobre la capacidad de acceder a información cuantitativa para la determinación de los Elementos de la Matriz Nuclear para la descomposición de 0νββ.
RESUMO
Guatemala is a developing country in Central America with a high burden of HIV and endemic fungal infections; we attempted to estimate the burden of serious fungal infections for the country. A full literature search was done to identify epidemiology papers reporting fungal infections from Guatemala. We used specific populations at risk and fungal infection frequencies in the population to estimate national rates. The population of Guatemala in 2013 was 15.4 million; 40% were younger than 15 and 6.2% older than 60. There are an estimated 53,000 adults with HIV infection, in 2015, most presenting late. The estimated cases of opportunistic fungal infections were: 705 cases of disseminated histoplasmosis, 408 cases of cryptococcal meningitis, 816 cases of Pneumocystis pneumonia, 16,695 cases of oral candidiasis, and 4,505 cases of esophageal candidiasis. In the general population, an estimated 5,568 adult asthmatics have allergic bronchopulmonary aspergillosis (ABPA) based on a 2.42% prevalence of asthma and a 2.5% ABPA proportion. Amongst 2,452 pulmonary tuberculosis patients, we estimated a prevalence of 495 for chronic pulmonary aspergillosis in this group, and 1,484 for all conditions. An estimated 232,357 cases of recurrent vulvovaginal candidiasis is likely. Overall, 1.7% of the population are affected by these conditions. The true fungal infection burden in Guatemala is unknown. Tools and training for improved diagnosis are needed. Additional research on prevalence is needed to employ public health measures towards treatment and improving the reported data of fungal diseases.
Assuntos
Micoses/epidemiologia , Micoses/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Comorbidade , Feminino , Guatemala/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto JovemAssuntos
Distonia/genética , Epilepsia/genética , Deficiência Intelectual/genética , Transtornos Mentais/genética , Mutação , Receptores de Ácido Caínico/genética , Adulto , Consanguinidade , Distonia/diagnóstico , Epilepsia/diagnóstico , Feminino , Estudo de Associação Genômica Ampla , Humanos , Deficiência Intelectual/diagnóstico , Masculino , Transtornos Mentais/diagnóstico , Linhagem , Fenótipo , Receptor de GluK2 CainatoRESUMO
El objetivo de esta investigación fue evaluar el efecto de la inclusión de diferentes niveles de biomasa de levaduras, producidos al fermentar hidrolizados de residuos de la industria bananera, sobre los parámetros zootécnicos de pollos de engorde, evaluando además el impacto económico de su uso en las dietas. Se utilizaron 210 pollos de engorde de un día de edad, distribuidos completamente al azar en cinco tratamientos, en una relación de seis réplicas por tratamiento y siete pollos por réplica. El periodo experimental comprendió 42 días; el alimento y el agua se dispensaron a voluntad. Las dietas experimentales fueron: T1- Control negativo sin levadura, T2- Control positivo con levadura comercial a razón de 1,5 kg ton-1 de alimento, T3- Levadura experimental a razón de 0,5 kg ton-1 de la dieta, T4- Levadura experimental a razón de 1,0 kg ton-1 de la dieta y T5- Levadura experimental a razón de 1,5 kg ton-1 de la dieta. Se observó mayor consumo de acumulado alimento en el tratamiento 4 (1kg ton-1 de levadura) con respecto a los demás tratamientos evaluados. No hubo diferencias significativas (P>0.05) en las otras variables evaluadas en el estudio. Se constató beneficio económico con el uso del tratamiento 4 pues se obtuvieron mejores retornos (precio de venta del pollo - costo de la alimentación) que fueron mayores a los observados en los tratamientos 1, 2, 3 y 5 en 153, 82, 62 y 161 pesos($) ave-1, respectivamente.
The objective of this study was to evaluate both the effect of including different levels of yeast biomass produced during the fermentation of banana waste residues on broiler productivity and the economic return of the exercise. We used 210 one-day-old broilers, which were distributed at random into five treatments, with six replicates per treatment and seven chicks per replicate, housed in vertical batteries equipped with electric heating. Feed and water were provided ad libitum. The experimental period lasted 42 days and the experimental diets were: T1- Negative control without yeast, T2- Positive control with commercial yeast at 1.5 kg ton-1 of feed, T3- experimental yeast at 0.5 kg ton-1 of diet, T4- experimental yeast at 1.0 kg ton-1 of diet and T4- experimental yeast at 1.5 kg ton-1 of the diet. Both animal productivity and economical return were evaluated. Significant differences (P>0.05) were present in the cumulative feed intake in treatment 4 (1kg ton-1 yeast) with respect to the other treatments. No significant differences were found in the other variables assessed in the study. There was an economic benefit to including treatment 4, in the form of higher returns (chicken sale price minus feed costs) of 153, 82, 62 and 161 Colombian pesos ($) bird-1, compared to those observed in treatments 1, 2, 3 and 5, respectively.
RESUMO
The Isomeric State Measurement System (SISMEI) was developed to search for isomeric nuclear states produced by fusion-evaporation reactions. The SISMEI consists of 10 plastic phoswich telescopes, two lead shields, one NaI(Tl) scintillation detector, two Compton suppressed HPGe γ-ray detectors, and a cone with a recoil product catcher. The new system was tested at the 8 UD Pelletron tandem accelerator of the University of São Paulo with the measurement of two known isomeric states: (54)Fe, 10(+) state (E = 6527.1 (11) keV, T(1/2) = 364(7) ns) and the 5/2(+) state of (19)F (E = 197.143 (4) keV, T(1/2) = 89.3 (10) ns). The results indicate that the system is capable of identifying delayed transitions, of measuring isomeric state lifetimes, and of identifying the feeding transitions of the isomeric state through the delayed γ-γ coincidence method. The measured half-life for the 10(+) state was T(1/2) = 365(14) ns and for the 5/2(+) state, 100(36) ns.
RESUMO
PURPOSE: To describe an extremely uncommon outbreak of eye lesions in a specific area of the Brazilian Amazonia. METHODS: Prospective noncomparative case series. Fifty-nine patients who developed eye lesions after swimming in the Araguaia river of Tocantins state in Brazil were examined. A team of ophthalmologists equipped with a slit-lamp, gonioscopic lenses, and indirect ophthalmoscopy performed full eye examination. Analysis of the flora and fauna of the river water was undertaken by a group of experts. RESULTS AND CONCLUSIONS: Eighty-three eyes were affected. The most common lesions were corneal opacities seen in 34 eyes and conjunctival nodules diagnosed in 12 eyes. Severe visual acuity loss was detected in seven children with unilateral anterior chamber lesions. Spicules of the sponge species Drulia uruguayensis and Drulia ctenosclera were found inside three blind eyes that have been enucleated for diagnostic purposes. All eye lesions could be attributed to an outbreak of foreign bodies from fresh water sponges. Organic enrichment of the water resulting from the absence of sanitation probably was the key factor, which initiated a cycle of ecological imbalance that provoked human disease.
Assuntos
Doenças da Túnica Conjuntiva/epidemiologia , Opacidade da Córnea/epidemiologia , Surtos de Doenças , Corpos Estranhos no Olho/epidemiologia , Poríferos , Dióxido de Silício , Animais , Câmara Anterior/patologia , Brasil/epidemiologia , Criança , Doenças da Túnica Conjuntiva/diagnóstico , Opacidade da Córnea/diagnóstico , Corpos Estranhos no Olho/diagnóstico , Feminino , Água Doce , Humanos , Masculino , Estudos Prospectivos , Transtornos da Visão/diagnóstico , Transtornos da Visão/epidemiologia , Acuidade VisualRESUMO
La Bacteriuria Asintomática se refiere a la presencia de bacterias que se multiplican activamente en las vias urinarias sin provocar sintomas. Los objetivos de este estudio son: determinar la incidencia actual de la Bacteriuria Asintomática en el embarazo en nuestro medio y los factores de riesgo que los determinan.
Assuntos
Humanos , Masculino , Feminino , Bacteriúria , Infecções Urinárias , Bolívia , GravidezRESUMO
Comunicamos nuestra experiencia en sesenta (60) pacientes con lesiones del aparato urinaio secundarias a procedimientos ginecológicos y obstetricos quirúrgicos, destacando sus etiologías más frecuentes, las caracteristicas de las lesiones estudiadas, la metodología que consideramos adecuada para su diagnóstico y estadificación, las técnicas seguidas para solucionar cada lesión en particular y finalmente, para informar los excelentes resultados obtenidos con los procedimientos descritos.
Assuntos
Humanos , Feminino , Cirurgia Geral/instrumentação , Cirurgia Geral/métodos , Cirurgia Geral/normas , Ginecologia , Obstetrícia , Procedimentos Cirúrgicos Obstétricos/instrumentação , Procedimentos Cirúrgicos Obstétricos/métodos , Procedimentos Cirúrgicos Obstétricos/normas , Procedimentos Cirúrgicos Obstétricos/psicologia , Procedimentos Cirúrgicos Obstétricos/reabilitação , UrologiaRESUMO
The Yanomami are one of the last primitive groups of Indians living in Brazil. They have almost no contact with other cultures. The epidemiology of eye disease among Yanomami is virtually unknown. For the first time, a trachoma survey was conducted among Yanomami Indians in the State of Amazonas near the Venezuelan border of the Brazilian rain forest. Ophthalmic examination was carried out on a total of 613 individuals (338 males and 275 females) from eight Yanomami villages along the Maraui River located in the upper Rio Negro Basin. Age was classified into three categories (children, adults, and elderly) and trachoma was classified into five grades: follicular, inflammatory intense, cicatricial, trichiasis, and corneal opacity. Trachoma was endemic in all villages visited. Overall, 30.3% of the subjects had trachoma. Females were significantly more affected (37.4%) than males (23.9%). The inflammatory trachoma rate reached 24.9% in children and the cicatricial form increased with age, reaching 13.9% among adults and 35.21% among the elderly. Trichiasis or corneal opacities were not detected and treatment of the entire population was initiated with 1 g azithromycin. The detection of endemic trachoma among the Yanomami is relevant for the understanding of the epidemiology of this disease in the Brazilian rain forest and underscores the necessity for a program of trachoma control in this region.
Assuntos
Indígenas Sul-Americanos , Tracoma/epidemiologia , Adulto , Distribuição por Idade , Idoso , Brasil/epidemiologia , Pré-Escolar , Estudos Transversais , Doenças Endêmicas , Feminino , Humanos , Masculino , Fatores de Risco , Distribuição por Sexo , Tracoma/etnologiaRESUMO
The Yanomami are one of the last primitive groups of Indians living in Brazil. They have almost no contact with other cultures. The epidemiology of eye disease among Yanomami is virtually unknown. For the first time, a trachoma survey was conducted among Yanomami Indians in the State of Amazonas near the Venezuelan border of the Brazilian rain forest. Ophthalmic examination was carried out on a total of 613 individuals (338 males and 275 females) from eight Yanomami villages along the Marauiá River located in the upper Rio Negro Basin. Age was classified into three categories (children, adults, and elderly) and trachoma was classified into five grades: follicular, inflammatory intense, cicatricial, trichiasis, and corneal opacity. Trachoma was endemic in all villages visited. Overall, 30.3 percent of the subjects had trachoma. Females were significantly more affected (37.4 percent) than males (23.9 percent). The inflammatory trachoma rate reached 24.9 percent in children and the cicatricial form increased with age, reaching 13.9 percent among adults and 35.21 percent among the elderly. Trichiasis or corneal opacities were not detected and treatment of the entire population was initiated with 1 g azithromycin. The detection of endemic trachoma among the Yanomami is relevant for the understanding of the epidemiology of this disease in the Brazilian rain forest and underscores the necessity for a program of trachoma control in this region
Assuntos
Humanos , Pré-Escolar , Feminino , Adulto , Idoso , Indígenas Sul-Americanos , Tracoma , Distribuição por Idade , Brasil , Estudos Transversais , Doenças Endêmicas , Fatores de Risco , Distribuição por Sexo , TracomaRESUMO
El Ultrasonido Endoscópico (USE) es un método efectivo para visualizar la pared del tracto gastrointestinal, ganglios y órganos adyacentes a través de imágenes dadas por sondas de altas frecuencias. El motivo fue evaluar las ventajas del USE en patologías colorectales. Se realizó un estudio prospectivo entre Enero de 1999 y Abril del 2001 a 50 pacientes quienes presentaron patologías colorectal. El rango etario estuvo entre los 2-74 años, predominando el sexo masculino (56 por ciento). En 46,6 por ciento de los pacientes se cambió la conducta luego del USE. En los 26 casos con ADC colorectal 5 fueron N1, se le realizó punción con aguja fina (PAF) a 5 pacientes, obteniendo en 4 casos material que corroboró el diagnóstico de ganglio con metástasis tumoral. El USE es ideal para complementar la evaluación de la patología colorectal; en carcinoma tienen la mayor sensibilidad y especificidad
Assuntos
Humanos , Masculino , Feminino , Colo , Endossonografia/métodos , Endossonografia , Reto , Gastroenterologia , VenezuelaRESUMO
INTRODUCTION: Epidemiological surveillance activities undertaken after the detection of an active trachoma case in the APAE-SP are described. MATERIAL AND METHOD: A total of 1,009 pupils, employees and household contacts had an eye examination. Treatment control was carried out at the institution 4 times at 45 day-intervals. RESULTS: The overall prevalence was of 5.9%, 5.1% being of follicular trachoma (TF), 0.3% of intense trachoma (TF/TI) and 0.5% of cicatricial trachoma (TS). At the first control exercise 45.5% of the trachoma cases had no signs of the disease and 40.0% underwent treatment. At the last control exercise 20% were found to have been cured with no vestigial scars. Non-attendance was of 38.2%. The distribution of secondary cases showed great dispersion, suggesting dissemination throughout Greater S. Paulo. DISCUSSION AND CONCLUSIONS: The trachoma control activities do not show satisfactory results, perhaps due to the prolonged duration of the treatment and follow-up. The development of strategies of clinical intervention should be implemented for better control of the disease.
Assuntos
Vigilância da População , Tracoma/epidemiologia , Adolescente , Adulto , Brasil , Criança , Pré-Escolar , Humanos , PrevalênciaRESUMO
For the confirmation of trachoma foci in places where no previous cases had been reported, the State Health Secretariat of S. Paulo makes provision for the realization of laboratory exams, particularly because the disease was considered to have been eradicated from the State in the seventies. During the epidemiological investigations, conjunctival scrapings were collected from the subjects with inflammatory trachoma (TF/TI), clinically diagnosed. The results of the immunofluorescence (DFA) exams were analysed in the light of the frequency of the appropriate exams and their positive results, by the quantity of elementary bodies (EB) found. A total of 385 slides were studied, the criteria for positivity being 5 or more EBs. The test's sensitivity was 19.9%. The DFA test is considered to be the best laboratorial exam to be used in field work, though it does not show a sufficient sensitivity to confirm all clinically diagnosed cases of trachoma; it can only confirm the circulation of the aetiological agent within a community. In endemic areas the clinical diagnosis continues to be the criterion for case confirmation.
Assuntos
Tracoma/diagnóstico , Chlamydia trachomatis/isolamento & purificação , Túnica Conjuntiva/microbiologia , Técnica Direta de Fluorescência para Anticorpo , Humanos , Sensibilidade e Especificidade , Tracoma/microbiologiaRESUMO
A school-based prevalence survey of trachoma was conducted in three rural municipalities in the state of Sao Paulo, Brazil, in 1989. A total of 950 children aged 4-11 years were examined. The prevalence of inflammatory trachoma was found to be 6.3%, peaking at 24.1% in the 4 year-old age group. The prevalence of trachomatous scarring was 2.7% and was more prevalent in older children. Risk factors included household sleeping arrangements and nasal discharge.
PIP: In December 1989, researchers gathered data on 950 4-11 year old children attending preschool or primary schools in the rural municipalities of Olimpia, Guaraci, and Cajobi in northwestern Sao Paulo State, Brazil to measure prevalence of active trachoma and to identify its risk factors. Overall prevalence of trachoma was 8.6%. Physicians treated all trachoma cases with topical 1% tetracycline twice daily for 6 weeks and examined them later at a local health care center. Prevalence of inflammatory trachoma stood at 6.3%. This was similar to its prevalence in an Olimpia's neighboring town called Bebedouro. Prevalence of trachomatous scarring was 2.7%. Thus the northwestern part of Sao Paulo state was an important focus of endemic trachoma infection. Inflammatory trachoma was highest among the 4 year olds (24.1%) and fell to 0 by age 11. On the other hand, trachomatous scarring was relatively rare in 4-5 year olds then increased to 7% in 10-11 year old children. In fact, the mean age for inflammatory trachoma was 6.6 years and for trachomatous scarring 8.5 years. Perhaps the recently implemented trachoma control activities in Olimpia explained the lowest prevalence of inflammatory trachoma (5.4%). Guaraci experienced the highest prevalence rate (9.6%), but did not have any cases of trachomatous scarring. Children who slept with others were significantly more likely to have inflammatory trachoma than were those who slept alone (p.005). Sleeping pattern was the only personal hygiene variable significantly associated with inflammatory trachoma. Not even face washing was significantly associated with it. The only clinical symptom significantly associated with inflammatory trachoma was nasal discharge (p.001). A considerable community-based epidemiological survey would qualify these results.
Assuntos
Tracoma/epidemiologia , Fatores Etários , Brasil/epidemiologia , Criança , Pré-Escolar , Humanos , Prevalência , Fatores de Risco , População RuralRESUMO
Trachoma was considered to have been 'eradicated' from the state of São Paulo, Brazil, until 1982 when a number of new cases of trachoma were reported in preschool children in Bebedouro, a small town in northwestern São Paulo. A household survey was undertaken to assess the prevalence and epidemiological characteristics of trachoma. A total of 2939 people of all ages was examined having been selected from a two-stage probalilistic household sampling frame based on census data. Overall, 7.2% of the population had evidence of one or more signs of trachoma and 2.1% had inflammatory trachoma. Inflammatory trachoma was more common in children aged one to ten years, especially in the peripheral urban and rural areas, and was more common in boys. The presence of chlamydia was confirmed by direct fluorescent antibody cytology. No cases of blindness due to trachoma were seen. A number of socioeconomic and hygiene variables were studied in order to determine the independent risk factors for trachoma in a household. Variables significantly associated with the occurrence of trachoma in the household were the number of children in the house aged one to ten years, the 'per capita' water consumption, the frequency of garbage collections, source of water, and the educational level of the head of household. Clustering of trachoma in different parts of this community was entirely explained by the concentration of households with these characteristics.