RESUMO
A randomized double-blind clinical trial in 39 patients envenomed by Bothrops atrox in Antioquia and Chocó, Colombia, was performed to compare the efficacy and safety of 2 equine-derived antivenoms prepared at Instituto Clodomiro Picado, University of Costa Rica. Twenty patients received a monovalent anti-B. atrox antivenom (group A) and 19 patients were treated with a polyvalent (Crotalinae) antivenom (group B). Both antivenoms were equally efficient in the neutralization of the most relevant signs of envenoming (haemorrhage and blood clotting time alteration). Fourteen patients (36%) presented early adverse reactions to antivenoms and no significant difference between the 2 groups was observed. Urticaria (18%) was the most frequent early adverse reaction and there was no life-threatening anaphylactic reaction. Based on clinical criteria and serum venom levels, estimated by an enzyme immunoassay, 15 patients were classified into 2 groups: mild and moderate/severe envenoming. With the antivenom doses used in this study (3, 6 and 9 vials for mild, moderate and severe envenoming, respectively), both antivenoms were equally efficient in clearing serum venom levels within the first hour of treatment, and the levels remained below the lower limit of venom detection for 24 h. Antivenom concentration in serum remained high for up to 24 h after antivenom infusion, suggesting that an excess of antibody in relation to circulating antigen had been administered.
Assuntos
Antivenenos/uso terapêutico , Bothrops , Venenos de Crotalídeos/sangue , Mordeduras de Serpentes/terapia , Adolescente , Adulto , Idoso , Animais , Antivenenos/efeitos adversos , Antivenenos/sangue , Coagulação Sanguínea , Criança , Pré-Escolar , Colômbia , Método Duplo-Cego , Edema/terapia , Hemorragia/terapia , Humanos , Pessoa de Meia-Idade , Mordeduras de Serpentes/complicações , Mordeduras de Serpentes/patologia , Mordeduras de Serpentes/fisiopatologia , Resultado do TratamentoRESUMO
Levels of serum antibodies against lens alpha, beta H and beta L crystallins were determined in 15 patients before and after endocapsular cataract extraction. The most abundant antibody at the time of surgery was anti-beta L, followed by anti-beta H and anti-alpha. An increase in the basal levels of these antibodies was seen after surgery in 93 percent of the cases. Relative increase was highest for anti-alpha, followed by anti-beta H and anti-beta L. There were individual variations both in the shape of the time-dependent antibody response after surgery and in the relative intensity of the response to the different antigens. The endocapsular technique therefore leads to the release of crystallins into the anterior chamber in sufficient amounts to provoke in many patients a humoral immune response.
Assuntos
Anticorpos/sangue , Extração de Catarata/métodos , Cristalinas/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Fatores de TempoRESUMO
The work herein described proposes certain essential methodological baselines in preparing nutritional guidelines for the population. Based on the general statement concerning the social and nutritional conditions of Colombia--which point out the general tendencies for Latin America--the author presents some of the actual relations between food habits and local epidemiology. The establishment of nutritional guides for the community requires a general conception of the food system and concurrent and concerted actions in the production, distribution and consumption sub-systems. The economic and sociocultural factors that must be taken into account when designing these guides, are defined in the present document. Among such factors, it is unavoidable to be fully cognizant of the food habits and practices of the population. Consequently, the development of surveys and qualitative studies that maintain actual diagnostics constitutes an indispensable tool for the adequate preparation of nutritional guides.