RESUMO
Anemia is a complex condition associated with diet, chronic infections, and blood loss. Children living at high altitudes have higher absolute hemoglobin levels due to hypoxemia. However, they are exposed to repeated infections and dietary limitations. We conducted a cross-sectional study to identify factors affecting the hemoglobin concentration in children living in high-altitude rural communities in the Anta province of Peru. All children 3-16 years of age attending public schools were invited to participate. We enrolled children 3-16 years old in schools and visited their homes to collect demographic, socioeconomic, medical history, and anthropometric data. Children provided blood and stool samples for complete blood counts, iron status markers, and helminth infection testing. Among the 2,000 children enrolled, the mean age was 9.9 (±3.4) years, 1,004 (50.2%) were female, and the median residence altitude was 3,398 (interquartile range 3,35-3,497) meters. The mean hemoglobin level was 15 (±1.15) mg/dL; 320 (16%) had anemia as defined by WHO. Children with anemia were more likely to have lower serum iron levels (odds ratio [OR] 2.8 [95% CI 2.2-3.6], P <0.001) and serum transferrin saturation (OR 2.8 [95% CI 2-3.9], P <0.001). Younger age (OR 0.85 [95% CI 0.82-0.89], P <0.001), stunting (OR 0.68 [95% CI 0.59-0.79], P <0.001), education of the mother (OR 0.94 [95% CI 0.91-0.98], P <0.005), and low eosinophils (OR 0.49 [95% CI 0.26-0.9], P = 0.022) were associated with anemia. Helminth infections were not associated with anemia. Anemia among children at high altitude is multifactorial, but iron deficiency is a contributing factor. Further studies are needed to evaluate iron status and anemia in children living at high altitudes.
Assuntos
Altitude , Hemoglobinas , Ferro , Humanos , Peru/epidemiologia , Criança , Feminino , Masculino , Hemoglobinas/análise , Hemoglobinas/metabolismo , Pré-Escolar , Adolescente , Estudos Transversais , Ferro/sangue , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/sangue , Biomarcadores/sangue , Anemia/epidemiologia , Anemia/sangue , População Rural/estatística & dados numéricosRESUMO
Fasciola hepatica is a neglected parasitic infection with significant human health and livestock industry impact. The Andean Altiplano harbors an estimated 50% of the Fasciola's world infection burden. There is scarce data regarding the spatial associations between different Fasciola hosts. In this project, we aimed to determine the geospatial relationships between Fasciola eggs passed in feces of different livestock species and the risk of infection among each household as a unit. We used data from a cross-sectional study evaluating children and livestock feces for Fasciola infection around households in three districts of Anta province, in the Cusco region of Peru. Each sample was geographically tagged and evaluated for fascioliasis using microscopy methods. A total of 2070 households were included, the median age was 9.1 years (6.7-11.8), 49.5% were female, and 7.2% of the households had at least one infected child. A total of 2420 livestock feces samples were evaluated. The infection rate in livestock samples was 30.9%. The highest infection rate was found in sheep with 40.8%, followed by cattle (33.8%), and swine (26.4%). The median distance between a household with an infected child to a positive animal sample was 44.6 meters (IQR 14.7-112.8) and the distance between a household with no infected children to a positive animal sample was 62.2 meters (IQR 18.3-158.6) (p = 0.025). The multivariable logistic regression adjusted by presence of poor sanitation, unsafe water consumption, altitude, and presence of multiple infected children per household demonstrated an association between household infection and any cattle feces at a 50 meters radius (Uninfected: OR 1.42 (95%CI 1.07-1.89), p = 0.017. Infected: OR 1.89 (95%CI 1.31-2.73), p = 0.001), positive cattle feces at a 100 meters radius (OR 1.35 (95% CI 1.08-1.69), p = 0.008), and negative cattle feces at a 200 meters radius (OR 1.08 (95% CI 1.01-1.15), p = 0.022). We identified potential hot and cold spots for fascioliasis in the Anta province. An association between environmental contamination with feces from different livestock species and infected children in rural households was found in our study. Local health authorities may apply this strategy to estimate the risk of infection in human populations and apply targeted interventions.
Assuntos
Doenças dos Bovinos , Fasciola hepatica , Fasciola , Fasciolíase , Animais , Bovinos , Doenças dos Bovinos/parasitologia , Estudos Transversais , Fasciolíase/parasitologia , Fezes/parasitologia , Feminino , Humanos , Gado/parasitologia , Masculino , Peru/epidemiologia , Ovinos , SuínosRESUMO
Los elevados niveles de violencia y polivictimización a nivel global, constituyen una importante causa de mortalidad y morbilidad; ello da cuenta su alcance para la salud pública. Esta investigación tuvo por objetivo establecer las principales características bibliométricas de la investigación en polivictimización como constructo de relevancia para la salud pública. Se analizaron los artículos y revisiones indexados en la colección principal de Web of Science, considerando indicadores de producción e impacto, estructura de citas, ocurrencia y co-ocurrencia de palabras clave, así como categorización de la centralidad y densidad de temas. Se observó que la polivictimización es un campo emergente (con 461 documentos), desarrollado fundamentalmente en naciones industrializados (G7) y centrado en la conexión entre diversos tipos de violencia interpersonal y sus efectos, particularmente a nivel de salud mental. Los países con mayor impacto presentan alta diversidad geográfica, no integran el G7 mayoritariamente y abarcan los 5 continentes; entre ellos, Estados Unidos se destaca por el volumen de su producción e impacto alcanzado (publicaciones en revistas ranqueadas, 9750 citas e Índice-H de 46), concentrando en los años iniciales mayor número de artículos influyentes. Actualmente los estudios de polivictimización exhiben un ritmo acelerado de crecimiento, ingreso de nuevos autores y una estructura con varios temas motores y emergentes, lo cual permite suponer que ganará especificidad en la medida en que se consoliden, y ello plantea desafíos para futuras investigaciones(AU)
The high levels of violence and polyvictimization at a global level represents an important cause of mortality and morbidity; this accounts for its scope for public health. This research aimed to establish the main bibliometric characteristics of polyvictimization research as a construct of relevance for public health. Articles and reviews indexed in the main collection of Web of Science were analyzed, considering indicators of production and impact, citation structure, occurrence and co-occurrence of keywords, as well as categorization of the centrality and density of topics. It was observed that polyvictimization is an emerging field (with 461 documents), mainly developed in industrialized nations (G7) and focused on the connection among different types of interpersonal violence and its effects, particularly on mental health. The countries with the greatest impact have high geographical diversity, are not members of G7 mostly, and belong to the 5 continents; among them, the United States stands out for the volume of its production and impact attained (publications in ranked journals, 9750 citations and H-Index of 46), concentrating in the initial years a higher number of influential articles. Currently, polyvictimization studies show an accelerated rate of growth, the entry of new authors and a structure with several motor and emerging themes, which indicates that it will gain specificity as well as consolidation, and this represents challenges for future research(AU)
Assuntos
Humanos , Masculino , Feminino , Bibliometria , Fatores de Risco , Vítimas de Crime/psicologia , Exposição à Violência/psicologia , ChileRESUMO
Fascioliasis is a zoonotic trematode infection that is endemic in the highlands of Peru. Chronic fascioliasis can be asymptomatic and remain undiagnosed for years. Chronic malnutrition in children, as manifested by stunting, leads to delayed cognitive development and lost productivity. We hypothesized that fascioliasis is among the factors associated with stunting in children from endemic areas. We conducted a cross-sectional study among children attending pre-school and school in 26 communities in the Anta province in the Cusco region of Peru. We conducted interviews to collect information on demographic, socioeconomic, and medical history. Blood was collected and tested for complete cell count and FAS2 ELISA for Fasciola antibodies. Three stool samples per participant were tested for parasites by Kato-Katz and Lumbreras rapid sedimentation methods. Chronic fascioliasis was determined by the presence of ova in stool. Children's height, weight, and age were recorded and used to calculate height for age Z scores (HAZ). Three thousand children participated in the study. Nine percent (264) of children had at least one positive test for Fasciola infection, 6% (164) had chronic fascioliasis, and 3% (102) had only positive antibody tests. The median HAZ was -1.41 (IQR: -2.03 to -0.81) and was similar in males and females. Twenty six percent (776) of children had stunting with HAZ < -2. Children with chronic fascioliasis had a lower median HAZ than children without Fasciola (-1.54 vs. -1.4, p = 0.014). History of treatment for malnutrition, history of treatment for anemia, having other helminths in stool, lower socioeconomic score, living at a higher elevation, and fewer years of schooling of both parents were associated with a lower HAZ score. In a multiple regression analysis, older age and a lower socioeconomic score were associated with a lower HAZ score. While fascioliasis and other helminths were associated with lower HAZ, they were not independent of the socioeconomic score.
Assuntos
Fasciolíase/epidemiologia , Fezes/parasitologia , Transtornos do Crescimento/epidemiologia , Fatores Socioeconômicos , Adolescente , Altitude , Anemia , Animais , Anticorpos Anti-Helmínticos/sangue , Criança , Transtornos da Nutrição Infantil/epidemiologia , Pré-Escolar , Estudos Transversais , Fasciola/imunologia , Fasciola/isolamento & purificação , Fasciolíase/imunologia , Feminino , Helmintos/isolamento & purificação , Humanos , Masculino , Peru/epidemiologiaRESUMO
Fascioliasis is a zoonotic infection linked to significant economic losses in the livestock industry. Infection prevalence and estimated financial burden vary across locations owing to different diagnostic tests used. The accuracy of liver condemnation to estimate the prevalence and costs of fascioliasis has seldom been evaluated. We performed a pilot study to determine the prevalence and burden of Fasciola hepatica infection among cattle slaughtered at the municipal abattoir in the Anta province of the Cusco highlands in Peru. We compared liver condemnation with bile microscopy for the diagnosis of infection and prediction of carcass weight. Data were collected from 2009 slaughtered cattle for 1 year. The overall prevalence of Fasciola infection by bile microscopy was 62.5% (1247/2009). A higher prevalence was observed after the rainy season from March to August than from September to February (p < 0.01). Fascioliasis prevalence during the first 6 months was 77.4% (714/923), combining the results of condemnation and microscopy. Bile microscopy diagnosed more infections than liver condemnation (62.7% (579/923) versus 55.4% (511/923), McNemar test p < 0.01). The agreement of the bile microscopy testing with liver condemnation was fair (κ = 0.247). Animal age, gender, breed, and liver condemnation predicted carcass weight [F (df 4, 704) = 61.1, p < 0.001]. Liver condemnation and bile microscopy are complementary tools for evaluation of the prevalence and burden of fascioliasis in livestock. Large scale studies are warranted to confirm our results.
Assuntos
Doenças dos Bovinos , Fasciola hepatica , Fasciolíase , Animais , Bile , Bovinos , Doenças dos Bovinos/epidemiologia , Fasciolíase/epidemiologia , Fasciolíase/veterinária , Fígado , Microscopia/veterinária , Peru/epidemiologia , Projetos Piloto , PrevalênciaRESUMO
Abstract In kidney biopsies reviews, scleroderma renal crisis (SRC) is characterized by vascular endothelial injuries, C4d deposits on peritubular vessels, and acute and chronic injuries coexisting on the same biopsy. The clinical signs of thrombotic microangiopathy (TMA) are described in systemic sclerosis (SSc), nevertheless, it has not been related to acute injuries described on kidney biopsies. We report a case of SRC in a patient with scleroderma-dermatomyositis overlap syndrome, which also showed clinical and histopathological data of TMA. On fundus examination, a severe acute hypertensive retinopathy was found. The kidney biopsy showed severe endothelial damage with widening of mucoid cells at the level of the intima, focal concentric proliferation on most small arterioles, and C3, C4d, and IgM deposits along the capillary walls. The genetic study of complement only showed the presence of membrane cofactor protein (MCP) risk haplotypes, without other genetic complement disorders. We understand that in a patient with TMA and SSc, the kidney damage would be fundamentally endothelial and of an acute type; moreover, we would observe clear evidence of complement activation. Once further studies correlate clinical-analytical data with anatomopathological studies, it is likely that we will be forced to redefine the SRC concept, focusing on the relationship between acute endothelial damage and complement activation.
Resumo Nas revisões de biópsias renais, a crise renal esclerodérmica (CRE) é caracterizada por lesões endoteliais vasculares, depósitos de C4d em vasos peritubulares e lesões agudas e crônicas que coexistem na mesma biópsia. Os sinais clínicos de microangiopatia trombótica (MAT) são descritos na esclerose sistêmica (ES); no entanto, não foram relacionados às lesões agudas descritas nas biópsias renais. Relatamos um caso de CRE em um paciente com síndrome de superposição de esclerodermia-dermatomiosite, que também apresentou dados clínicos e histopatológicos de MAT. No exame de fundo do olho, foi encontrada uma retinopatia hipertensiva aguda grave. A biópsia renal mostrou lesão endotelial grave com alargamento das células mucoides ao nível da íntima, proliferação concêntrica focal na maioria das pequenas arteríolas e depósitos de C3, C4d e IgM ao longo das paredes dos capilares. O estudo genético do complemento mostrou apenas a presença de haplótipos de risco da proteína cofator de membrana (PCM), sem outros distúrbios genéticos do complemento. Entendemos que em um paciente com MAT e ES, o dano renal seria fundamentalmente endotelial e do tipo agudo; além disso, observaríamos evidências claras de ativação do complemento. Uma vez que novos estudos correlacionam dados clínico-analíticos com estudos anatomopatológicos, é provável que sejamos forçados a redefinir o conceito de CRE, enfocando a relação entre dano endotelial agudo e ativação do complemento.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Doença de Raynaud/complicações , Transtornos da Visão/etiologia , Injúria Renal Aguda/etiologia , Rim/irrigação sanguínea , Capilares/metabolismo , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Imuno-Histoquímica , Papiledema/patologia , Dermatomiosite/complicações , Dermatomiosite/imunologia , Retinopatia Hipertensiva/diagnóstico , Retinopatia Hipertensiva/patologia , Retinopatia Hipertensiva/tratamento farmacológico , Injúria Renal Aguda/diagnóstico , Anemia Hemolítica/diagnóstico , Anemia Hemolítica/etiologia , Rim/patologia , Rim/diagnóstico por imagemRESUMO
Strongyloides stercoralis affects 30-100 million people worldwide. The burden is underestimated because of the paucity of studies, limited geographical areas surveyed, and poor quality of diagnostic tests. This study aimed at determining the epidemiology of strongyloidiasis using sensitive microscopy testing in rural populations living at different altitudes in Cusco, Peru. Data were collected from subjects aged > 3 years living in Quellouno (elevation 2,600 ft) and Limatambo (elevation 8,379 ft) districts. Subjects provided one fresh stool sample and answer a standardized questionnaire. Fresh stool was tested on site using the Baermann's test and agar plate culture. Formalin-preserved stool was tested by rapid sedimentation. Eighty percent (585/715) of eligible subjects consented to participate; after excluding subjects with missing data, 65% (462/715) were included. Fifty-five percentage were female; the median age was 33 years (interquartile range 13-52), and 72% had government health insurance. Half had intestinal parasites, and Strongyloides was the most common (24.5%) followed by Giardia (15.5%), Blastocystis (14.9%), and hookworm (11.5%). The agar plate culture detected more cases of Strongyloides than Baermann's or sedimentation tests. Strongyloides infection was more common at low altitude (26.4%) than at high altitude (18.6%), but the difference was not statistically significant (P = 0.08). Older age, walking barefoot, bathing in rivers/streams, and using municipal sewage were associated with strongyloidiasis. Strongyloides was the most prevalent parasite in the areas studied and was associated with demographic, socioeconomic, and sanitary factors.
Assuntos
Altitude , População Rural/estatística & dados numéricos , Estrongiloidíase/epidemiologia , Adolescente , Adulto , Animais , Estudos Transversais , Fezes/parasitologia , Feminino , Humanos , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Prevalência , Fatores de Risco , Strongyloides stercoralis , Adulto JovemRESUMO
In kidney biopsies reviews, scleroderma renal crisis (SRC) is characterized by vascular endothelial injuries, C4d deposits on peritubular vessels, and acute and chronic injuries coexisting on the same biopsy. The clinical signs of thrombotic microangiopathy (TMA) are described in systemic sclerosis (SSc), nevertheless, it has not been related to acute injuries described on kidney biopsies. We report a case of SRC in a patient with scleroderma-dermatomyositis overlap syndrome, which also showed clinical and histopathological data of TMA. On fundus examination, a severe acute hypertensive retinopathy was found. The kidney biopsy showed severe endothelial damage with widening of mucoid cells at the level of the intima, focal concentric proliferation on most small arterioles, and C3, C4d, and IgM deposits along the capillary walls. The genetic study of complement only showed the presence of membrane cofactor protein (MCP) risk haplotypes, without other genetic complement disorders. We understand that in a patient with TMA and SSc, the kidney damage would be fundamentally endothelial and of an acute type; moreover, we would observe clear evidence of complement activation. Once further studies correlate clinical-analytical data with anatomopathological studies, it is likely that we will be forced to redefine the SRC concept, focusing on the relationship between acute endothelial damage and complement activation.
Assuntos
Injúria Renal Aguda/etiologia , Rim/irrigação sanguínea , Doença de Raynaud/complicações , Transtornos da Visão/etiologia , Injúria Renal Aguda/diagnóstico , Anemia Hemolítica/diagnóstico , Anemia Hemolítica/etiologia , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Capilares/metabolismo , Dermatomiosite/complicações , Dermatomiosite/imunologia , Humanos , Retinopatia Hipertensiva/diagnóstico , Retinopatia Hipertensiva/tratamento farmacológico , Retinopatia Hipertensiva/patologia , Imuno-Histoquímica , Rim/diagnóstico por imagem , Rim/patologia , Masculino , Pessoa de Meia-Idade , Papiledema/patologia , Doença de Raynaud/patologia , Escleroderma Sistêmico/complicações , Escleroderma Sistêmico/imunologia , Resultado do Tratamento , Transtornos da Visão/diagnósticoRESUMO
Fasciola hepatica is the most widely distributed trematode-affecting humans. The Andes Mountains are highly endemic for fascioliasis. We report results of a cross-sectional study evaluating the epidemiology of Fasciola among children in 26 agricultural communities in the Cusco region of Peru. Children 3 to 16 years old were enrolled in preschools and schools. Blood from participants was tested for complete blood counts, transaminases, and Fasciola antibodies. Stool samples were tested for Fasciola and other parasites. A total of 2,515 children were included in the analysis and the mean age was 9.6 years (±3.6). Ten percent (253) of the children had at least one positive test for Fasciola, 6% had chronic infection, and 0.4% acute infection. The rest of the subjects had only antibodies against Fasciola. The prevalence of infection varied from 0% to 20% between communities. Children with evidence of Fasciola exposure were older, lived at higher altitudes, and had a lower socioeconomic status than children without infection. The logistic regression analysis showed that children from Ancahuasi district, older children, and children with higher measures of poverty were more likely to have Fasciola exposure. Fascioliasis is common in the Cusco region and associated with poverty. However, the distribution varies markedly between communities.
Assuntos
Fasciolíase/epidemiologia , Fezes/parasitologia , Fatores Socioeconômicos , Doença Aguda/epidemiologia , Adolescente , Agricultura , Animais , Anticorpos Anti-Helmínticos/sangue , Criança , Pré-Escolar , Estudos Transversais , Fasciola hepatica/imunologia , Fasciolíase/imunologia , Feminino , Humanos , Modelos Logísticos , Masculino , Peru/epidemiologia , Prevalência , Fatores de Risco , População Rural/estatística & dados numéricosRESUMO
AbstractLatin America is among the highly endemic regions for cystic echinococcosis (CE). In Peru, an estimated 1,139 disability-adjusted life years are lost annually from surgical treatment of CE. This is comparable with the combined total for Argentina, Brazil, Uruguay, and Chile. The prevalence of human infection has been investigated in the central Peruvian Andes, but there are no community-based screening data from other regions of Peru. We carried out a population survey in January 2015 using abdominal ultrasound to estimate the prevalence of abdominal CE in the Canas and Canchis provinces, in the Cusco region of Peru. Among 1,351 subjects screened, 41 (3%) had CE. There was significant variation between communities with similar socioeconomic features in a small geographical area. A history of CE was reported by 4.1% of the screened subjects, among whom 30.3% still had CE on ultrasound. Among patients reporting previous CE treatment, 14.9% had CE in active stages. Limited education, community of residence, and knowing people with CE in the community were associated with CE. These results demonstrate a significant burden of CE in the region and suggest the need for further investigations, control activities, and optimization of clinical management for CE in this area.
Assuntos
Equinococose/diagnóstico por imagem , Equinococose/epidemiologia , Abdome/diagnóstico por imagem , Abdome/parasitologia , Adulto , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Peru/epidemiologia , Projetos Piloto , Prevalência , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco , Ultrassonografia , Adulto JovemRESUMO
Hymenolepis nana is the most common cestode infection in the world. However, limited information is available regarding its impact on affected populations. We studied the epidemiology and symptoms associated with hymenolepiasis among children 3-16 years old in 16 rural communities of the highlands of the Cusco region in Peru. Information on demographics, socioeconomic status, symptoms as reported by parents, and parasitological testing was obtained from the database of an ongoing Fasciola hepatica epidemiologic study. A total of 1,230 children were included in the study. Forty-five percent were infected with at least one pathogenic intestinal parasite. Giardia spp. (22.9%) was the most common, followed by Hymenolepis (17.4%), Fasciola (14.1%), Ascaris lumbricoides (6.1%), and Strongyloides stercoralis (2%). The prevalence of Hymenolepis infection varied by community, by other parasitic infections, and by socioeconomic status. However, only years of education of the mother, use of well water, and age less than 10 years were associated with Hymenolepis infection in the multivariate analysis. Hymenolepis nana infection was associated with diarrhea, jaundice, headaches, fever, and fatigue. Children with > 500 eggs/g of stool were more likely to have symptoms of weight loss, jaundice, diarrhea, and fever. Hymenolepis nana infection and age were the only factors retained in the multivariate analysis modeling diarrhea. Hymenolepiasis is a common gastrointestinal helminth in the Cusco region and is associated with significant morbidity in children in rural communities. The impact caused by the emergence of Hymenolepis as a prevalent intestinal parasite deserves closer scrutiny.
Assuntos
Himenolepíase/epidemiologia , Hymenolepis nana/isolamento & purificação , Enteropatias Parasitárias/epidemiologia , Adolescente , Animais , Ascaris lumbricoides/isolamento & purificação , Criança , Pré-Escolar , Estudos Transversais , Fasciola hepatica/isolamento & purificação , Fezes/parasitologia , Feminino , Humanos , Himenolepíase/diagnóstico , Enteropatias Parasitárias/diagnóstico , Masculino , Análise Multivariada , Peru/epidemiologia , Prevalência , Fatores Socioeconômicos , Strongyloides stercoralis/isolamento & purificaçãoRESUMO
The sensitivity of the Kato-Katz test is suboptimal for the evaluation of intestinal helminth prevalence. Moreover, during mass deworming, as helminth egg burden decreases, the sensitivity is likely to decrease. The Lumbreras rapid sedimentation (Lumbreras) is a low-cost non-quantitative test, but may provide useful information in low burden areas. We compared the prevalence of intestinal helminth infections assessed by the Kato-Katz and the Lumbreras rapid sedimentation test on 3 stool specimens from each of 1083 children. The sensitivities were compared using the McNemar paired test. Using the combined outcome of the 3 different stool tests as the standard, Kato-Katz had lower sensitivity than Lumbreras rapid sedimentation tests for Ascaris lumbricoides (85.1% vs. 95.1%, p = 0.03), Hymenolepis nana (77.7% vs. 97.9%, p < 0.01), Trichuris trichura (41.7% vs. 100%, p = 0.01), hookworm (0% vs. 100%, p = 0.01), and Strongyloides stercoralis (0% vs. 88%, p < 0.01). Kato-Katz demonstrated significantly lower sensitivity, missing most T. trichiura, hookworm, and S. stercoralis infections. The combination of Kato-Katz and Lumbreras rapid sedimentation tests enables the detection of more intestinal helminths infections in post-deworming low prevalence areas.
Assuntos
Ascaris lumbricoides/isolamento & purificação , Técnicas de Laboratório Clínico , Fezes/parasitologia , Helmintíase/epidemiologia , Helmintíase/parasitologia , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Serviços de Saúde Escolar , Animais , Criança , Pré-Escolar , Feminino , Helmintíase/diagnóstico , Humanos , Enteropatias Parasitárias/diagnóstico , Masculino , Contagem de Ovos de Parasitas , Prevalência , Instituições Acadêmicas , Sensibilidade e EspecificidadeRESUMO
We present findings describing the epidemiology of non-severe acute respiratory syndrome human coronavirus-associated influenza-like illness from a population-based active follow-up study in four different regions of Peru. In 2010, the prevalence of infections by human coronaviruses 229E, OC43, NL63, or HKU1 was 6.4% in participants with influenza-like illness who tested negative for influenza viruses. Ten of 11 human coronavirus infections were identified in the fall-winter season. Human coronaviruses are present in different regions of Peru and are relatively frequently associated with influenza-like illness in Peru.
Assuntos
Resfriado Comum/epidemiologia , Infecções por Coronavirus/epidemiologia , Coronavirus/isolamento & purificação , Influenza Humana/epidemiologia , Infecções Respiratórias/epidemiologia , Adulto , Pré-Escolar , Estudos de Coortes , Resfriado Comum/diagnóstico , Infecções por Coronavirus/diagnóstico , Feminino , Seguimentos , Humanos , Lactente , Influenza Humana/diagnóstico , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Prevalência , Estudos Prospectivos , Características de Residência , Infecções Respiratórias/diagnóstico , Estações do AnoRESUMO
OBJECTIVE: to determine the frequency and clinical characteristics of patients with keratoconus and a corneal transplant (CT) at an ophthalmology reference hospital. METHODS: retrospective, cross-sectional, observational, descriptive study of 166 patients with diagnosis of keratoconus and CT. RESULTS: average age of 37.59 years, 97 males (58.43%), 69 females (41.56%). The primarily affected eye was the left one (95 cases, 57 %). Coef C -0.01265. The age at the keratoconus diagnosis was between 20 and 29 years (77 cases, 46.40 %), with an average of 24.5 years. The most frequent signs and symptoms were blurred vision: 140 (84.33 %), itching: 100 (60.24 %), photophobia: 20 (12.04 %). Associated systemic diseases: Down Syndrome 2 cases, (1.20 %), asthma 6 cases (3.61 %), atopic dermatitis 14 cases (8.43 %), allergic rhinitis 10 cases (6.02 %). Related ocular diseases: allergic conjunctivitis 72 cases (43.47 %). CONCLUSIONS: There is strong association between the corneal microtrauma secondary to itching resulting from allergic processes and keratoconus. A timely diagnosis is of great importance to diminish the progression to corneal scarring requiring a CT.
Assuntos
Transplante de Córnea , Ceratocone/epidemiologia , Ceratocone/cirurgia , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
Objetivo: Determinar si se presentan alteraciones histológicas de la glándula lagrimal que apoyen al diagnóstico etiológico de la uveítis crónica. Material y métodos: Se trata de un estudio clínico-histopatológico, observacional, prospectivo y transversal, desarrollado en el Hospital General de México. Se practicó examen oftalmológico completo a un grupo de 16 pacientes con uveítis crónica idiopática y a un grupo control de 14 pacientes sin uveítis. Se hicieron estudios de laboratorio para descartar enfermedades infecciosas o bien para enfermedades autoinmunes o procesos infiltrativos de órbita. La biopsia de glándula lagrimal se hizo bajo anestesia tópica y el estudio histopatológico con microscopia de luz. Resultados: No se encontraron alteraciones en el grupo control; en el grupo de estudio se incluyeron 14 pacientes, 13 mujeres y un hombre, con edad promedio de 44.9 años (intervalo de 25 a 66 años). Se observó infiltración linfocitaria grado II "ligera" en dos pacientes con uveitis anterior no granulomatosa, un hombre de 36 años con niveles altos de IgG y una mujer de 47 años con enzima convertidora de angiotensina (ECA) ligeramente elevada y prueba de Schimer positiva; observando infiltrados nodulares sin centros germinales, compuestos por linfocitos maduros y linfocitos plasmocitoides, con ensanchamiento del estroma e infiltración acinar, uno de los cortes mostró necrosis con la consiguiente pérdida focal de la glándula. En una mujer de 31 años de edad con ligera elevación de la IgG y prueba de Schirmer positiva, se observaron alteraciones compatibles con un cistadenoma. Conclusiones: La mayoría de las glándulas lagrimales de los pacientes con uveítis (85.8 por ciento) no mostraron alteraciones histológicas y fueron muy similares a las del grupo control, por lo que consideramos que la biopsia de la glándula lagrimal debe practicarse sólo en casos donde se sospeche enfermedad específica que afecta la glándula, como es la sarcoidosis o en el síndrome de Sjögren