RESUMO
BACKGROUND: Stroke burden is highest and is still rising in low- and middle-income countries. Epidemiologic stroke data are lacking in many of these countries. Stroke prevalence in Argentina has been unexplored for almost three decades. AIM: This population-based study aims to determine prevalence of stroke in a representative sample of the Argentinean population. METHODS: We performed a door-to-door survey of randomly selected households in a city of 18,650 inhabitants. A structured questionnaire screening for potential stroke cases was used. All subjects screened positive were then evaluated by stroke neurologists for final adjudication. Data about stroke subtypes, neurological status, vascular risk factors, medications, and diagnostic tests were also collected. RESULTS: Among 2156 surveys, 294 were screened positive for a possible stroke. After neurological evaluation, there were 41 confirmed cases. The adjusted stroke prevalence was 1,974/100,000 inhabitants older than 40 years, and it was higher in men than in women (26.3 vs 13.2, p<0.01). Prevalence of ischemic stroke, intracranial hemorrhage, and transient ischemic attack were 15.8, 2.93, and 2.93, respectively. The most prevalent vascular risk factors in stroke survivors were hypertension, obstructive sleep apnea, and dyslipidemia. CONCLUSION: Approximately 2 in every 100 subjects older than 40 years in this population are stroke survivors. Stroke prevalence in Argentina has remained stable over the last 30 years; it is higher than in most Latin American countries and similar to western populations.
Assuntos
Ataque Isquêmico Transitório , Acidente Vascular Cerebral , Argentina/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Acidente Vascular Cerebral/epidemiologiaRESUMO
A very high prevalence of multiple sclerosis (MS) has been reported in some Western European and North American countries. The few surveys of MS epidemiology in South America reveal lower prevalence rates, implying that susceptibility varies between distinct ethnic groups, thus forming an important determinant of the geographic distribution of the disease. The objective of this study is to review MS prevalence estimates in different Latin American and Caribbean countries. We reviewed surveys of regional MS prevalence from 1991 to 2011. Sources included an online database, authors' reports and proceedings or specific lectures from regional conferences. We obtained a total of 30 prevalence surveys from 15 countries, showing low/medium MS prevalence rates. Both the number and the quality of prevalence surveys have greatly improved in this region over recent decades. This is the first collaborative study to map the regional frequency of MS. Establishment of standardized methods and joint epidemiological studies will advance future MS research in Latin America and the Caribbean.
Assuntos
Esclerose Múltipla/epidemiologia , Região do Caribe/epidemiologia , Coleta de Dados , Notificação de Doenças , Etnicidade , Geografia , Humanos , América Latina/epidemiologia , Prevalência , América do Sul/epidemiologia , Raios UltravioletaRESUMO
There are few studies reporting multiple sclerosis prevalence rates in the Buenos Aires region, Argentina (latitude 34 degrees S) (between 12-18.5/100 000 inhabitants), and no studies have been performed in the larger region between parallels 36 degrees and 55 degrees S. The aim of this study is to determine the prevalence rates and clinical features of multiple sclerosis in residents of the Argentine Patagonia. Four cities from the region were selected for this study, giving a sample population of 417 666 inhabitants (approximately 24% of the total Patagonia population). 1(st) March 2002 was determined as prevalence day. Patients were ascertained using multiple case-finding methods. The point prevalence rate was 17.2/100 000 (17.2 age-adjusted to the world population). Prevalence rates were higher for women than for men, 22.1 versus 12.2/100 000 inhabitants (21.4 versus 12.7 sex-adjusted to the world population). The study population was mainly of European descent and mestizoes. Clinical features were similar to those reported in other countries. This study shows that Argentine Patagonia is a medium-risk area with no south-north gradient between parallels 55 degrees and 36 degrees S. The Patagonia population shows recent internal migration that makes it difficult to determine whether the exposure to potential risk factors has been long enough to modify the disease incidence.
Assuntos
Esclerose Múltipla Crônica Progressiva/epidemiologia , Esclerose Múltipla Recidivante-Remitente/epidemiologia , Adolescente , Adulto , Argentina/epidemiologia , Feminino , Humanos , Incidência , Indígenas Sul-Americanos/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Dinâmica Populacional , Prevalência , Fatores de Risco , Distribuição por Sexo , População Branca/estatística & dados numéricosRESUMO
OBJECTIVE: To assess the prognosis of epilepsy, the possibility of achieving remission of seizures, in patients who were identified in a population-based study carried out in Junín, a city of about 70,000 inhabitants in Buenos Aires Province, Argentina. On January 1, 1991 (prevalence day), 106 people had epilepsy, including 64 (60%) with the condition active. METHODS: Eight years later, we revisited the patients identified in the prevalence study. We analyzed risk factors in relation to remission of seizures. We also confirmed the specific cause of death. RESULTS: Ninety-six patients were revisited (10 were completely lost to follow-up). We divided them into two groups: the group in terminal remission (defined as a seizure-free period that extended from prevalence day until the visit day in 1998) which included 64 people (66.7%), and the group of those who continued to have seizures which included 32 (33.3%) patients, of whom eight (25%) died. The overall standardized mortality ratio was 2.45; the rate was two and a half times that of the general national population. CONCLUSION: The better prognosis was observed in the group with generalized idiopathic epilepsy syndrome. Patients with epilepsy secondary to underlying structural causes had the worst prognosis, with higher mortality.
Assuntos
Epilepsia/epidemiologia , Adolescente , Adulto , Argentina/epidemiologia , Causalidade , Criança , Pré-Escolar , Estudos Transversais , Epilepsia/etiologia , Epilepsia/mortalidade , Feminino , Seguimentos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Vigilância da População , Prognóstico , Fatores Sexuais , Taxa de SobrevidaRESUMO
For Parkinson's disease (PD), little is known about how the choice of diagnostic criteria affects research results. Using data on PD from three community studies (from Argentina, the Netherlands, Italy), we compared the impact on prevalence of several sets of diagnostic criteria. Each set was based on cardinal signs--resting tremor, bradykinesia, rigidity, impaired postural reflexes--and required that other parkinsonism be excluded. Some sets had additional requirements related to duration of symptoms, asymmetry of signs, or response to medication. In terms of prevalence, much lower estimates were associated with the requirements of asymmetry of signs and response to medication. The assessment of these clinical features may not be practical in community studies. Impaired postural reflexes, as a cardinal sign, seemed superfluous. For community studies of PD, we recommend the following diagnostic criteria: at least two of resting tremor, bradykinesia, or rigidity, in the absence of other apparent causes of parkinsonism.
Assuntos
Medicina Comunitária/métodos , Doença de Parkinson/diagnóstico , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Argentina , Humanos , Itália , Pessoa de Meia-Idade , Países Baixos , Doença de Parkinson/epidemiologia , PrevalênciaRESUMO
We investigated the prevalence of Parkinson's disease (PD) in a South American city: Junín, Buenos Aires Province, Argentina. At dwellings systematically selected, the case finding involved household screenings and neurological examinations (i.e., a two-phase survey approach). Only persons 40 years of age or older were eligible (N = 7,765). There were 51 cases of PD identified, yielding a crude prevalence of 656.8 per 100,000 population. The age-specific prevalence was consistently higher in men than women, and it increased with advancing age for both sexes. In addition to prevalence figures. we present tallies related to clinical features of PD, as well as tallies related to other subtypes of parkinsonism.
Assuntos
Comparação Transcultural , Doença de Parkinson Secundária/epidemiologia , Doença de Parkinson/epidemiologia , População Urbana/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/diagnóstico , Doença de Parkinson Secundária/diagnóstico , Fatores SexuaisRESUMO
El objetivo de la investigación fue determinar el perfil de mortalidad comunitario, a partir del análisis de las actas de defunción. El estudio se realizó en Junín (B), ciudad de 84.295 habitantes (52 por ciento mujeres y 48 por ciento hombres, Censo Nacional 1991), desde el 1/9/91 al 31/1/93. Se consideraron 1088 actas de defunción (documento fuente), relevadas mensualmente del Registro Provincial de Identificación Civil. Las causas básicas de muerte y afecciones concomitantes se corroboraron con el médico firmante, el médico de cabecera, y datos de las historias clínicas, y exámenes complementarios del sistema de efectores de salud. La mortalidad por enfermedades del aparato circulatorio (CIE-9 390-459) fue del 41,1 por ciento. El rubro "Otras formas de enfermedad del corazón" (CIE-9 420-429) representó el 15,4 por ciento; la enfermedad cerebrovascular (CIE-9 430-438) el 14,4 por ciento, y la enfermedad isquémica del corazón (CIE-9 410-414) el 6,5 por ciento del total de todas las muertes. Para la ECV no hubo diferencias entre ambos sexos. Sin embargo, analizados los tipos de ACV, en la hemorragia intracerebral (CIE-9 431.0-431.9) hubo predominio del sexo femenino. Considerando la variable edad para la ECV, se observó un marcado incremento de las defunciones a partir de los 65 años. La información obtenida sirve como orientación para implementar programas regionales de prevención entre los grupos de mayor riesgo (AU)
Assuntos
Humanos , Masculino , Feminino , Transtornos Cerebrovasculares/mortalidade , Doenças Cardiovasculares/mortalidade , Doenças Arteriais Cerebrais/mortalidade , Infarto Cerebral/mortalidade , Embolia e Trombose Intracraniana/mortalidade , Mortalidade , Argentina , Hemorragia Cerebral , Hemorragia SubaracnóideaRESUMO
El objetivo de la investigación fue determinar el perfil de mortalidad comunitario, a partir del análisis de las actas de defunción. El estudio se realizó en Junín (B), ciudad de 84.295 habitantes (52 por ciento mujeres y 48 por ciento hombres, Censo Nacional 1991), desde el 1/9/91 al 31/1/93. Se consideraron 1088 actas de defunción (documento fuente), relevadas mensualmente del Registro Provincial de Identificación Civil. Las causas básicas de muerte y afecciones concomitantes se corroboraron con el médico firmante, el médico de cabecera, y datos de las historias clínicas, y exámenes complementarios del sistema de efectores de salud. La mortalidad por enfermedades del aparato circulatorio (CIE-9 390-459) fue del 41,1 por ciento. El rubro "Otras formas de enfermedad del corazón" (CIE-9 420-429) representó el 15,4 por ciento; la enfermedad cerebrovascular (CIE-9 430-438) el 14,4 por ciento, y la enfermedad isquémica del corazón (CIE-9 410-414) el 6,5 por ciento del total de todas las muertes. Para la ECV no hubo diferencias entre ambos sexos. Sin embargo, analizados los tipos de ACV, en la hemorragia intracerebral (CIE-9 431.0-431.9) hubo predominio del sexo femenino. Considerando la variable edad para la ECV, se observó un marcado incremento de las defunciones a partir de los 65 años. La información obtenida sirve como orientación para implementar programas regionales de prevención entre los grupos de mayor riesgo
Assuntos
Humanos , Masculino , Feminino , Doenças Cardiovasculares/mortalidade , Doenças Arteriais Cerebrais/mortalidade , Embolia e Trombose Intracraniana/mortalidade , Infarto Cerebral/mortalidade , Transtornos Cerebrovasculares/mortalidade , Mortalidade , Argentina , Hemorragia Subaracnóidea , Hemorragia CerebralRESUMO
A two-phase prevalence survey of major neurological disorders was conducted in the city of Junín, Buenos Aires, Argentina. In phase 1, a sample of households was screened to identify persons who possibly had a disorder of interest. In phase 2, persons screened as positive in phase 1 were clinically examined by neurologists. This article describes the survey methods used, discusses related methodologic issues (e.g., the problem of false negatives), and presents demographic findings and attrition tallies. A brief account of the pilot investigations is also included as an appendix.
Assuntos
Encéfalo/fisiopatologia , Transtornos Cerebrovasculares/epidemiologia , Epilepsia/epidemiologia , Ataque Isquêmico Transitório/epidemiologia , Doença de Parkinson/epidemiologia , Convulsões/epidemiologia , Adolescente , Adulto , Idoso , Argentina/epidemiologia , Transtornos Cerebrovasculares/diagnóstico , Criança , Pré-Escolar , Coleta de Dados , Emprego , Epilepsia/diagnóstico , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Ataque Isquêmico Transitório/diagnóstico , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Doença de Parkinson/diagnóstico , Projetos Piloto , Prevalência , Convulsões/diagnósticoRESUMO
Para determinar la prevalencia de esclerosis múltiple en el partido de Junín (B), Argentina, a 34º de latitud S, se utilizó como estrategia para el hallazgo de casos, aquella aplicable para enfermedades crónicas y raras. Estas estrategias fueron: uso de sistema de registro de prestadores de salud; examen en dos fases; red de muestreo; sistema bola de nieve; fuentes múltiples de información y sensibilización de la población. Nosotros utilizamos el criterio de diagnóstico delineado en el Workshop de la Universidad de Boston de 1982. Para la recolección de datos en pacientes con E.M. o probable enfermedad, usamos el modelo de historia clínica y ficha epidemiológica provista por la Asociación Civil Argentina Anti-Esclerosis Múltiple. Se tomó como día de prevalencia el 1 de enero de 1991 y la tasa de prevalencia de esclerosis múltiple fue 12 por 100.000 habitantes. Zona de riesgo medio. Edad media al diagnóstico era de 30 años para los hombres, 42 años para la mujer, y 36 para ambos sexos. La tasa de prevalencia ha sido significativamente más alta para mujeres que para hombres(AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Esclerose Múltipla/epidemiologia , Argentina/epidemiologia , Neurologia/estatística & dados numéricos , Esclerose Múltipla/classificação , Esclerose Múltipla/diagnóstico , Prevalência , Incidência , Estudos TransversaisRESUMO
Para determinar la prevalencia de esclerosis múltiple en el partido de Junín (B), Argentina, a 34º de latitud S, se utilizó como estrategia para el hallazgo de casos, aquella aplicable para enfermedades crónicas y raras. Estas estrategias fueron: uso de sistema de registro de prestadores de salud; examen en dos fases; red de muestreo; sistema bola de nieve; fuentes múltiples de información y sensibilización de la población. Nosotros utilizamos el criterio de diagnóstico delineado en el Workshop de la Universidad de Boston de 1982. Para la recolección de datos en pacientes con E.M. o probable enfermedad, usamos el modelo de historia clínica y ficha epidemiológica provista por la Asociación Civil Argentina Anti-Esclerosis Múltiple. Se tomó como día de prevalencia el 1 de enero de 1991 y la tasa de prevalencia de esclerosis múltiple fue 12 por 100.000 habitantes. Zona de riesgo medio. Edad media al diagnóstico era de 30 años para los hombres, 42 años para la mujer, y 36 para ambos sexos. La tasa de prevalencia ha sido significativamente más alta para mujeres que para hombres
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Argentina/epidemiologia , Neurologia/estatística & dados numéricos , Esclerose Múltipla/epidemiologia , Incidência , Prevalência , Estudos Transversais , Esclerose Múltipla/classificação , Esclerose Múltipla/diagnósticoRESUMO
Este trabajo se realizó siguiendo una metodología de investigación usada por el Instituto Nacional de Salud de los EE!UU!, adaptando y ajustando el cuestionario para rastreo de enfermedades neurológicas. Este estudio se desarrolla en tres etapas: la primera etapa consiste en probar el instrumento antes mencionado, contando con un grupo de 20-25 pacientes que padecen los desórdenes a estudiar y otro similar sin enfermedad alguna. La segunda etapa es realizar una experiencia piloto. Esta se desarrolló en A.Roca, pequeña localidad cercana a la ciudad de Junín, donde se llevará a cabo el estudio final. La tercera etapa es desarrollar esta experiencia en un grupo de 25.000 personas en la ciudad de Junín (Pcia. de Buenos Aires). Se completaron al momento la primera y segunda etapa. Los resultados obtenidos permiten concluir que el instrumento (cuestionario) utilizado, con algunas modificaciones, sería de absoluta confiabilidad, sensibilidad y especificidad. (AU)
Assuntos
Prevalência , Estudos Transversais/métodos , Pesquisa , Inquéritos Epidemiológicos , Doenças do Sistema Nervoso/epidemiologiaRESUMO
Este trabajo se realizó siguiendo una metodología de investigación usada por el Instituto Nacional de Salud de los EE!UU!, adaptando y ajustando el cuestionario para rastreo de enfermedades neurológicas. Este estudio se desarrolla en tres etapas: la primera etapa consiste en probar el instrumento antes mencionado, contando con un grupo de 20-25 pacientes que padecen los desórdenes a estudiar y otro similar sin enfermedad alguna. La segunda etapa es realizar una experiencia piloto. Esta se desarrolló en A.Roca, pequeña localidad cercana a la ciudad de Junín, donde se llevará a cabo el estudio final. La tercera etapa es desarrollar esta experiencia en un grupo de 25.000 personas en la ciudad de Junín (Pcia. de Buenos Aires). Se completaron al momento la primera y segunda etapa. Los resultados obtenidos permiten concluir que el instrumento (cuestionario) utilizado, con algunas modificaciones, sería de absoluta confiabilidad, sensibilidad y especificidad.
Assuntos
Prevalência , Estudos Transversais , Doenças do Sistema Nervoso/epidemiologia , Inquéritos Epidemiológicos , PesquisaAssuntos
Doenças do Sistema Nervoso Central/etiologia , Febre Hemorrágica Americana/complicações , Adolescente , Adulto , Proteínas Sanguíneas/análise , Doenças do Sistema Nervoso Central/sangue , Doenças do Sistema Nervoso Central/líquido cefalorraquidiano , Proteínas do Líquido Cefalorraquidiano/análise , Criança , Pré-Escolar , Feminino , Febre Hemorrágica Americana/sangue , Febre Hemorrágica Americana/líquido cefalorraquidiano , Humanos , Masculino , Pessoa de Meia-Idade , RecidivaRESUMO
The Argentine hemorrhagic fever (AHF) is an infectious disease, endemo-epidemical, of viral etiology, produced by the Junin virus and limited to the Buenos Aires Province, South of Córdoba, East of La Pampa, and South of Santa Fe. It generally assails rural workers at harvest-time, especially during corn-harvest. The incubation period of the disease does not exceed 12 days. A feverish syndrome with asthenia, adynamia, myalgias, migraine, photophobia, epigastralgia etc., appear. The patient has a facial erythema, petechias on the skin, enantema on the palate, conjunctive micropolyadenopaty injection. The laboratory shows a low erytro, leukopenia with aneosinophilia, thrombopenia and a urine with albuminuria and virous cells. After the fourth day, hemorrhage and a neurological case appears. The laboratory tends to normalize and cast appears in the urine. The most striking neurological signs are the following: muscular hypotonia, proprioceptive hyporreflexia or arreflexia, marinesco reflex, shakings, difficulty to stand and walk, oscillations in consciousness level, and ocular disturbances. The cytochemical test of the C.L. Rachis in the usual ways of the AHF is within its normal characteristics; on the other hand there are modifications in the nervous cases: the total proteins are nearly always increased and the cells augmented with a great predominance of mononuclear cells. The electroencephalogrammes were always abnormal, varying from a brief disorganization up to a diffusive and permanent slowness. The half of which additionally presented paroxisms generalized by slow waves. The pathological anatomy over the central nervous system makes us think that the lesion would not primitively neuronal but that the action of the virus would be indirectly done through the capillar wall. This capillar lesion is produced by multiple focuses. The neuronal destruction with necrosis by microinfarcts is minimum. The symptoms and neurological signs are present in 10% of the clinical cases; the death-rate in the nervous clinical cases having reached 50% of them. The premature treatment allows the death-rate to diminish and the cases that survive have not many after effects.