RESUMO
Molecular and epidemiological studies of Cryptosporidium infections amongst 28 Cuban children (aged 2-8 years) with diarrhoea are described. As few of the younger infected children but most of the older infected children had been breastfed, short-term protection from maternal antibodies passed to infants during breastfeeding may result in a lack of cryptosporidial infection in infancy. This protection of breastfeeding children may, however, result in such children developing less anti-Cryptosporidium immunity of their own (than their bottle-fed counterparts), so that, by school age, the children who had been breastfed are those most likely to be found infected. In the present study, in contrast with the observations made during a previous study of cryptosporidiosis in Cuban children, vomiting was rare (7%) whereas abdominal pain was common (57%). These differences in expression of symptoms between studies may be age-related. As seen in other studies from similar countries, including those of the Caribbean and Latin America, C. hominis was found to predominate, the results of the successful molecular analyses revealing 10 C. hominis infections but no C. parvum. Subgenotyping (at the gp60 locus) indicated that the C. hominis infections included a wide range of subtypes, with isolates from three subtype families (Ia, Ib and Id) being detected.
Assuntos
Criptosporidiose/epidemiologia , Cryptosporidium/genética , Animais , Anorexia/epidemiologia , Anorexia/parasitologia , Sequência de Bases , Criança , Pré-Escolar , Cuba/epidemiologia , Diarreia/epidemiologia , Diarreia/parasitologia , Fezes/parasitologia , Feminino , Genes de Protozoários , Genótipo , Humanos , Masculino , Dados de Sequência Molecular , Oocistos , RNA Ribossômico 18S/análiseRESUMO
Stool samples containing Giardia duodenalis cysts were collected from 95 primary-school children in central Cuba, and preserved by storing at -20 degrees C in 70% ethanol. Clinical data were collected for each child. Although 57% of the children were asymptomatic, the remaining 43% each reported between one and three symptoms. Following cyst quantification and isolation, molecular analyses were attempted on all cyst isolates, with the focus on the parasite's beta-giardin and glutamate-dehydrogenase (gdh) genes. Unfortunately, the cyst-preservation procedure appeared to have a deleterious effect on the cysts, since genotyping data could only be obtained for 20 of the 95 isolates. These data indicated, however, an approximately equal distribution between assemblage A (nine isolates) and assemblage B (11 isolates). Children found to be excreting relatively large numbers of cysts were more likely to be symptomatic than children who were excreting fewer cysts, and children with Giardia isolates from assemblage B were more likely to have symptomatic infections than children with isolates from assemblage A. Although considerable sequence variability was seen in the assemblage-B isolates, the assemblage-A isolates were relatively genetically homogeneous. This is the first publication from the Caribbean in which the Giardia genotypes circulating within the population have been identified, the first from the Americas providing information on associations between clinical presentation and the assemblage of the infecting Giardia, and the first to indicate that levels of cyst excretion may have clinical significance.
Assuntos
DNA de Protozoário/análise , Giardia/genética , Giardíase/parasitologia , Animais , Criança , Cuba/epidemiologia , DNA de Protozoário/isolamento & purificação , Feminino , Genótipo , Giardia/isolamento & purificação , Giardíase/epidemiologia , Humanos , Masculino , Saúde da População Rural , Análise de Sequência de DNA/métodosRESUMO
We tested 869 subjects attending either an urban adolescent medicine clinic or a school-based clinic for antibody to hepatitis C virus. Demographic data indicated a representative study sample, and behaviors associated with hepatitis C virus transmission. One subject (0.1%) was seropositive for antibody to hepatitis C virus, indicating a very low prevalence of hepatitis C virus exposure in adolescents.
Assuntos
Anticorpos Anti-Hepatite C/sangue , Saúde da População Urbana , Adolescente , Comportamento do Adolescente , Adulto , Transfusão de Sangue/estatística & dados numéricos , Boston/epidemiologia , Criança , Exposição Ambiental , Feminino , Comportamentos Relacionados com a Saúde , Antígenos do Núcleo do Vírus da Hepatite B/análise , Hepatite C/transmissão , Hospitais Pediátricos , Humanos , Masculino , Massachusetts/epidemiologia , Prevalência , Assunção de Riscos , Serviços de Saúde Escolar , Comportamento Sexual , Infecções Sexualmente Transmissíveis/epidemiologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Saúde da População Urbana/estatística & dados numéricosRESUMO
Compared with the estimated injury fatality rate for workers in all occupations (nine in 100,000 in 1988) the farm fatality rate (48 in 100,000) was among the highest in the nation; in 1993, these rates were eight and 35 in 100,000, respectively. On-road farm-vehicle fatalities have been identified as a significant problem, yet these events apparently have not been investigated in a comprehensive manner. The purpose of this study was to investigate the circumstances surrounding all on-road, non-truck, farm-vehicle crash fatalities in the United States form 1988 through 1993. The National Highway Traffic Safety Administration's Fatal Accident Reporting System, which includes data for all US fatal on-road motor vehicle crashes, was the source of data. Driver-related variables were compared among farm vehicles, vehicles in collisions with farm vehicles, and all other vehicles in rural, fatal crashes; environmental variables were compared between rural farm-vehicle and non-farm-vehicle crashes. During 1988 to 1993, in rural areas, 444 farm-vehicle occupants were killed; in addition, 238 occupants of other vehicles or pedestrians were killed in collisions with the farm vehicles. The farm vehicles were disproportionately involved in overturns, rear-end collisions, and incidents in which the injured person fell from the vehicle, when compared with all other non-farm vehicles involved in rural-area fatal crashes. Of the farm vehicles involved in fatal crashes at night, dawn, or dusk, 65% were struck in the rear, compared with 4% of vehicles involved in fatal non-farm-vehicle crashes. Compared with drivers in all other rural crashes, farm-vehicle operators were more likely to be male, have a greater proportion of convictions for driving while intoxicated, and a lower proportion of previous speeding convictions. From this initial investigation, it appears that the fatal-crash involvement of farm vehicles are related to vehicle and environmental factors that are changeable. Given the proportion of overturns associated with farm-vehicle crashes (21%) compared with non-farm vehicles (9%), there is a need to investigate design characteristics of the farm vehicles. The large proportion of farm vehicles struck in the rear during daylight (24%) as well as night, dawn, or dusk hours (65%), compared with non-farm vehicles (4% and 4%, respectively), suggest factors related to visibility and perception of the farm vehicles' speed that provide a basis for further study.
Assuntos
Acidentes de Trabalho/mortalidade , Acidentes de Trânsito/mortalidade , Agricultura , Acidentes de Trabalho/prevenção & controle , Acidentes de Trânsito/prevenção & controle , Adolescente , Adulto , Distribuição por Idade , Idoso , Segurança de Equipamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Porto Rico/epidemiologia , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
A 5 year old boy with normal phenotype and normal renal function presented tetany. Hypocalcemia and hyperphosphatemia, with increased serum levels of parathyroid hormone (PTH) were detected in serial measurements. Pseudohypoparathyroidism was diagnosed. This disease presents the biochemical abnormalities of hypoparathyroidism (hypocalcemia, hyperphosphatemia) with peripheral resistance to PTH activity. The patient was treated effectively with calcium and vitamin D supplements. The causes of hypocalcemia related to parathyroid gland activity are reviewed and the physiopathology of pseudohypoparathyroidism is described.
Assuntos
Pseudo-Hipoparatireoidismo/fisiopatologia , Fosfatase Alcalina/sangue , Cálcio/sangue , Cálcio/uso terapêutico , Pré-Escolar , Humanos , Magnésio/sangue , Masculino , Fosfatos/sangue , Pseudo-Hipoparatireoidismo/tratamento farmacológicoRESUMO
A 5 year old boy with normal phenotype and normal renal function presented tetany. Hypocalcemia and hyperphosphatemia, with increased serum levels of parathyroid hormone (PTH) were detected in serial measurements. Pseudohypoparathyroidism was diagnosed. This disease presents the biochemical abnormalities of hypoparathyroidism (hypocalcemia, hyperphosphatemia) with peripheral resistance to PTH activity. The patient was treated effectively with calcium and vitamin D supplements. The causes of hypocalcemia related to parathyroid gland activity are reviewed and the physiopathology of pseudohypoparathyroidism is described.
Assuntos
Transtornos do Crescimento/parasitologia , Tricuríase/complicações , Antropometria , Estatura , Peso Corporal , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Fatores SexuaisRESUMO
A survey was carried out to determine values for the prevalence and intensity of infection of intestinal helminths in children living in Cocle Province, Republic of Panama. The data set consisted of the results of microscopic examinations (modified Kato Katz technique) of stool samples collected in November 1987 from 661 children attending primary schools in 4 communities in the province. The overall prevalences of Ascaris lumbricoides, hookworm and Trichuris trichiura infections were found to be 18.2, 12.0 and 27.5% respectively. There were significant differences between the infection prevalence values for children attending the different schools, but not with respect to age or sex. Positive associations were detected between particular pairs of infections and these were most evident when Trichuris trichiura was involved. The data revealed evidence of a positive association between siblings at one school only for each helminth infection. There was extreme variation in the values for intensity of infection (20-126180 epg for A. lumbricoides). Highly significant, and unexplained, differences were observed in the intensity of A. lumbricoides infection by primary school; this finding did not apply to hookworm or T. trichiura. The analysis also revealed that children heavily infected with A. lumbricoides were also likely to be heavily infected with T. trichiura. Comparisons with the results of surveys carried out in Cocle Province in 1926 and 1974 indicate that these infections are declining in this region of Panama.