RESUMO
OBJECTIVE: To identify the maternal, work, and health services factors associated with a short duration of breast-feeding in working mothers. MATERIAL AND METHODS: A cross-sectional study was carried out between November 1998 and March 1999, among 265 mothers medically insured by (Instituto Mexicano del Seguro Social, IMSS) Mexican Institute of Social Security, who completed a questionnaire when their babies were 3 to 9 months old. Mothers were divided into two groups, based on breast-feeding duration: those who breast-fed for less than 3 months and those who did so for three months or more. Logistic regression was used to identify the factors associated with short duration of breast-feeding. RESULTS: One-hundred and twelve mothers (42.3%) abandoned breast-feeding early. Risk factors were: poor maternal knowledge on breast-feeding, odds ratio (OR) 5.97, 95% confidence interval (CI) 1.67-20.67; mothers with no previous breast-feeding experience OR 2.98, 95% CI 1.66-5.36; mothers planning to breast-feed their babies for less than 3 months (OR 16.24, 95% CI 5.37-49.12); and mothers with no access to breast-feeding facilities at work (OR 1.99, 95% CI 1.12-3.56). CONCLUSIONS: The main factors associated with short duration of breast-feeding were the maternal ones. The only work-related factor associated with short duration of breast-feeding was the absence of breast-feeding facilities. It is probable that maternal knowledge on breast-feeding, previous breast-feeding experience, and the availability of facilities at work for breast-feeding affect the maternal decisions on breast-feeding duration.
Assuntos
Aleitamento Materno/estatística & dados numéricos , Mulheres Trabalhadoras/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , México , Inquéritos e Questionários , Fatores de TempoRESUMO
OBJETIVO: Identificar los factores maternos, laborales y de los servicios de salud que influyen en el abandono temprano de la lactancia materna en madres trabajadoras. MATERIAL Y MÉTODOS: Entre noviembre de 1998 y marzo de 1999 se efectuó un estudio transversal comparativo con madres derechohabientes del Instituto Mexicano del Seguro Social de Ensenada, Baja California, México. A 265 madres se les aplicó un cuestionario entre los tres y nueve meses posparto. Se distribuyeron en: grupo I: madres con abandono temprano de la lactancia materna; grupo II: madres que prolongaron la lactancia materna por más de tres meses. Para identificar los factores asociados con el abandono temprano de la lactancia materna, se utilizó regresión logística. RESULTADOS: El 42.3 por ciento (112) de las madres abandonaron temprano la lactancia materna. Los factores de riesgo fueron: tener conocimientos malos sobre lactancia materna, OR 5.97 (IC 95 por ciento 1.67-20.67), la ausencia del antecedente de haberla practicado en un hijo previo OR 2.98 (IC 95 por ciento 1.66-5.36), tener un plan de duración de la misma de 0 a 3 meses, OR 16.24 (IC 95 por ciento 5.37-49.12), y la falta de facilidades en el trabajo para efectuarla, OR 1.99 (IC 95 por ciento 1.12-3.56). CONCLUSIONES: Los principales factores asociados con el abandono temprano de la lactancia materna fueron maternos. El único factor laboral fue la ausencia de facilidades para amamantar. Es probable que la calidad de los conocimientos, la experiencia previa con ella y tener facilidades laborales influyan en la decisión de prolongarla
Assuntos
Adulto , Feminino , Humanos , Aleitamento Materno/estatística & dados numéricos , Mulheres Trabalhadoras/estatística & dados numéricos , Estudos Transversais , Modelos Logísticos , México , Inquéritos e Questionários , Fatores de TempoRESUMO
Tumour necrosis factor-alpha (TNF-alpha) is a monocyte (MO)-derived cytokine that plays an essential role in the immunological system. In the present study our aim was to evaluate the levels of TNF-alpha secreted by MO from cancer patients. Blood MO were obtained from 10 lung cancer patients (LCP), 10 colorectal cancer patients (CCP) and 10 healthy donors (HD). TNF-alpha levels in MO culture supernatants spontaneously (sp) secreted or after stimulation with LPS treatment were evaluated using a commercial ELISA kit (sensibility: 10-1000 pg/ml). Mean values, expressed as pg/ml were: LCP: sp= 452.6+/-107.2, LPS= 589.5+/-126.7); CCP: sp= 84.1+/-25.0, LPS= 437.3+/-93.2; HD: sp= 74.2+/-21.5, LPS= 573.5+/-87.1. We concluded that MO from LCP secrete high levels of TNF-alpha spontaneously (p< 0.003 versus HD) and it was also observed an absence of response to LPS treatment in the 33% of the cases in these patients.
Assuntos
Neoplasias Colorretais/imunologia , Neoplasias Pulmonares/imunologia , Monócitos/imunologia , Fator de Necrose Tumoral alfa/biossíntese , Adulto , Idoso , Idoso de 80 Anos ou mais , Células Cultivadas , Neoplasias Colorretais/sangue , Ensaio de Imunoadsorção Enzimática , Humanos , Neoplasias Pulmonares/sangue , Pessoa de Meia-Idade , Valores de ReferênciaRESUMO
Monocytes (MO) from cancer patients present functional abnormalities, such as an altered secretion of soluble factors. In the present study, our aim was to evaluate the levels of interleukin-1beta (IL-1beta), tumour necrosis factor-alpha (TNF-alpha) and prostaglandin-E2 (PGE2) secreted in vitro by MO from lung cancer patients (LCP), spontaneously or after stimulation with lipopolysaccharide (LPS). Results showed that cytokine secretion was higher for MO from LCP than for MO from healthy controls, while in the 25% of the patients analysed, an absence of response to LPS treatment was found.
Assuntos
Citocinas/metabolismo , Dinoprostona/metabolismo , Neoplasias Pulmonares/metabolismo , Monócitos/metabolismo , Proteínas de Neoplasias/metabolismo , Estudos de Casos e Controles , Células Cultivadas , Humanos , Interleucina-1/metabolismo , Lipopolissacarídeos/farmacologia , Neoplasias Pulmonares/patologia , Fator de Necrose Tumoral alfa/metabolismoRESUMO
During the immune response, a great number of cytokines that modulate the function of mononuclear phagocytes are produced. Since interferons are one of the most important cytokines, the aim of this study was to evaluate the expression of HLA-DR antigen after an 18-h culture with human recombinant interferon-gamma (hrIFN-gamma) on freshly isolated peripheral blood monocytes from 16 colorectal cancer patients and 16 healthy donors, using an indirect immunofluorescence method. The results obtained showed that there was a decreased percentage of HLA-DR+ monocytes in the colorectal cancer patents (51 +/- 3%, p <0.01) compared with the healthy donors (77 +/- 2%). Treatment for 18 h with hrIFN-gamma increased the percentages of monocytes expressing HLA-DR: 71 +/- 3% for the cancer patients and 84 +/- 2% for the healthy donors (p <0.01 and <0.001, respectively). Our results demonstrate that after in vitro treatment with hrIFN-gamma, functionally altered monocytes from colorectal cancer patients can reach major histocompatibility complex II antigen expression values similar to those of healthy donors, thus improving the host's cellular immune response against the tumor.
Assuntos
Adenocarcinoma/imunologia , Antígenos de Neoplasias/biossíntese , Neoplasias Colorretais/imunologia , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Antígenos HLA-DR/biossíntese , Interferon gama/farmacologia , Leucócitos Mononucleares/imunologia , Adenocarcinoma/patologia , Antígenos de Neoplasias/genética , Neoplasias Colorretais/patologia , Técnica Indireta de Fluorescência para Anticorpo , Antígenos HLA-DR/genética , Humanos , Proteínas RecombinantesRESUMO
OBJECTIVE: To describe the results of an epidemiologic surveillance program, from 1990 to the first semester of 1997, in a new high-specialty pediatric hospital and perform a comparison with previous reports. MATERIAL AND METHODS: The total number and type of nosocomial infections, the incidence rate and density incidence for department and division, for different age groups and according to immune statues were registered. RESULTS: The global incidence of nosocomial infections during the period was 25.7 per 100 discharges, with a progressive decrease during the last three years. Although immunocompromised patients had more infections than immunocompetent ones, the difference was not significative. The three most common infections were: pneumonia, vascular line infections and upper respiratory tract infections. It is possible that upper respiratory tract infections are contributing to the elevation of global incidence rates of nosocomial infections. CONCLUSIONS: The change of infection epidemiology regarding previous experience has led to the implementation of programs to prevent the most frequent problems. It is necessary to intensify the different prevention programs and to increase their reach in order to cut down costs in a short term.
Assuntos
Infecção Hospitalar/epidemiologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Estudos de Coortes , Hospitais com 100 a 299 Leitos , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , México/epidemiologiaRESUMO
BACKGROUND: it is well known that culture cells secrete to their medium different factors that can alter their own as well as other cells' metabolism and functions. In the present study we evaluated the effect of culture supernatants originated from two cancer cell lines, Calu-1 (lung epidermoid carcinoma) and A-427 (lung adenocarcinoma) on peripheral blood monocytes (MO) from 20 healthy donors (HD). METHODS AND RESULTS: MO were incubated with supernatants or with medium only (controls) during 2 or 18 hours. There were determined the expression of HLA-DR antigen by indirect immunofluorescence technique, the formation of reactive oxygen intermediates (NBT reduction capacity) and the phagocytic capacity (Candida albicans- anti Candida albicans system). These determinations were made also in MO from 16 patients with advanced lung cancer (LCP). Percentages of expression (media +/- SE) were: HLA-DR (+) MO: Calu-1 = 30 +/- 2; A-427 = 31 +/- 2; LCP = 52 +/- 3 (p < 0.0001 vs HD: 77 +/- 1%) NBT (+)MO: Calu-1 = 47 +/- 1; A-427 = 49 +/- 1; LCP = 56 +/- 2 (p < 0.01 vs HD: 45 +/- 2%), Phagocytic MO: Calu-1 = 38 +/- 3; A-427 = 39 +/- 2; LCP = 32 +/- 3 (p < 0.0001 vs HD: 50 +/- 1%). CONCLUSIONS: we conclude that this in vitro model reproduced characteristics found in MO from lung cancer patients, since culture supernatants induced in normal MO phenotypic and functional characteristics also found in MO from patients analyzed.
Assuntos
Monócitos/efeitos dos fármacos , Células Tumorais Cultivadas/metabolismo , Meios de Cultivo Condicionados , Técnica Indireta de Fluorescência para Anticorpo , Antígenos HLA-DR/análise , Humanos , FagocitoseRESUMO
Clinical guidelines provide continuing education and help physicians in the clinical decision-making process. Clinical guidelines to manage acute respiratory infections (ARI) were developed comprehensively from a perspective where prevention, diagnosis, treatment and the patient's education were considered. Methodology. The guideline development process was comprised of two stages: 1. The building stage consisted of several steps: definition of the problem, definition of the potential users of the guidelines, and the appropriate level of care; review of updated bibliographies, and validation using the Delphi technique. 2. The start-up stage consisted of evaluating the guidelines applicable to out-patient settings. Twenty family physicians participated, using the guidelines with 115 patients. Agreement between the family physicians' diagnosis and the criteria stated in the guidelines was tested using unweighted kappa. Differences in the use of the guidelines to manage ARI patients were tested by using the X2 test or the exact Fisher test. Results. Development of guidelines considered the patient's age group. Therefore, guidelines to manage patients under five years of age and to manage patients above this age were constructed. The application of the guidelines was increased from 40 to 60%. As a result, inappropriate prescribing of antibiotics and cough syrups decreased. Although the guidelines could be helpful in treating ARI, its efficacy and effectiveness remain to be tested.
Assuntos
Fidelidade a Diretrizes , Guias de Prática Clínica como Assunto , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/tratamento farmacológico , Doença Aguda , Adolescente , Adulto , Fatores Etários , Antibacterianos/uso terapêutico , Antitussígenos/uso terapêutico , Criança , Pré-Escolar , Interpretação Estatística de Dados , Humanos , Lactente , Recém-NascidoRESUMO
Las guías clínicas son un auxilio en la decisión del médico para la atención apropiada del paciente. Se diseñó una guía clínica dirigida a los médicos del primer nivel de atención, que integra la prevención, el diagnóstico y el tratamiento de las infecciones, el diagnóstico y el tratamiento de las infecciones respiratorias agudas. Metodología. El desarrollo de la guía se realizó en dos fases: 1) La de construcción, que incluyó las siguientes etapas; definición de los problemas a resolver, definición del usuario y de los servicios de salud, revisión bibiográfica, desarrollo conceptual, desarrollo de la estructura, validación de constructo y validación de contenido por el método Delfos. 2) La implementación de la guía. Se evaluó la aplicabilidad de la guía en 115 pacientes de 20 médicos, a través de la concordancia (Kappa no ponderada) entre los diagnósticos médicos y los criterios de la guía clínica. Se midieron las diferencia en la atención de los enfermos con y sin la utilización de las guías (X² o Fisher). Resultados. Se construyó una guía para niños menores de cinco años y otra para personas mayores. La aplicación de la guía se elevó de 40 a 60 por ciento, así mismo, disminuyó la indicación de antitusígenos y de antibióticos con aumento de su indicación justificada. Conclusiones. La guía propuesta reune características para ser una herramienta auxiliar aplicable en la atención de las infecciones respiratorias agudas. Deberá evaluarse su eficacia para mejorar el diagnóstico y la prescripción médica
Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Antitussígenos/uso terapêutico , Interpretação Estatística de Dados , Guias de Prática Clínica como Assunto , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/tratamento farmacológico , Doença Aguda , Fatores Etários , Antibacterianos/uso terapêuticoRESUMO
The effect of cisplatin-containing chemotherapy regimen was evaluated on the expression of HLA-DR antigen in peripheral blood monocytes from patients with lung (LCP) and colorectal (CCP) cancer. Chemotherapeutic schedules employed in patients were etoposide and cisplatin for LCP and 5-fluorouracil and cisplatin for CCP. The results obtained showed a diminished percentage of monocytes expressing HLA-DR antigen in LCP (52.4 +/- 2.6, p < 0.004) and CCP (50.1 +/- 2.1, p < 0.001) respectively versus healthy donors (71.0 +/- 1.1%), and that their values increased during chemotherapy, raising them up to control level after the second cycle of treatment, independently of the course of the cancer growth. We conclude that both modalities of treatment allowed an increase of monocytes expressing HLA-DR antigen, suggesting that this effect may be due to cisplatin action.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cisplatino/uso terapêutico , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/imunologia , Antígenos HLA-DR/sangue , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/imunologia , Monócitos/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cisplatino/administração & dosagem , Neoplasias Colorretais/sangue , Neoplasias Colorretais/patologia , Etoposídeo/administração & dosagem , Fluoruracila/administração & dosagem , Humanos , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Valores de ReferênciaRESUMO
Objetivo. Se describen los resultados de la vigilancia epidemiológica en un nuevo hospital pediátrico de alta especialidad, de 1990 al primer semestre de 1997, y se comparan con resultados previos del mismo. Material y métodos. Se analizaron el número total y el tipo de infecciones. Para obtener la tasa de incidencia y la densidad de incidencia de acuerdo con el servicio, la división médica o quirúrgica para los diferentes grupos de edad y el estado inmunológico. Resultados. La incidencia global de infecciones nosocomiales durante este periodo fue de 25.7 por 100 egresos, con una disminución progresiva durante los últimos tres años. Aunque los pacientes inmunocomprometidos se infectaron más que los inmunocompetentes, la diferencia no fue significativa. Las tres infecciones más frecuentes fueron las neumonías, las infecciones relacionadas con líneas vasculares y las infecciones respiratorias altas. Es posible que estas últimas contribuyan a la elevación de las tasas globales de incidencia de infecciones nosocomiales. Conclusiones. El cambio en la epidemiología de las infecciones respecto a experiencias propias previas, ha creado la necesidad de implantar programas para prevenir los problemas más frecuentes. Es necesario intensificar los diferentes programas de prevención y fomentar su difusión para abatir estas infecciones a corto plazo
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Adolescente , Epidemiologia/tendências , Hospitais Pediátricos/tendências , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/etiologia , Hospitais com 100 a 299 Leitos , México/epidemiologia , Saúde Pública/tendênciasRESUMO
Bone marrow fibroblast colony-forming cells (CFU-F) were studied in fifteen consecutive untreated breast cancer patients (BCP) with clinical stages III and IV, and in sixteen normal controls (NC). A decreased number of CFU-F was observed in BCP compared to NC (p < 0.004). Confluence of the adherent cell layer was observed in all normal bone marrow mononuclear cells (MC) cultures, while a lower proportion of cultures from BCP (11/15) showed confluent adherent cell layers. When MC cultures of BCP were treated with indomethacin (Indo, 10(-6)M) 50% of them increased the number of CFU-F compared to the value obtained without treatment. In addition, a significant increase in the release of PGE2 in BCP cultures was observed before Indo treatment. Moreover, after MC were fractionated into adherent and non-adherent progenitors, the CFU-F decreased in both types of fractions of BCP compared to NC value (p < 0.02 and < 0.05, respectively). The number of light density MC per 10 ml of bone marrow aspirate and the number of trypsin-sensitive adherent progenitors were lower than NC in BCP (p < 0.02 and 0.013, respectively). Total MC and fibroblasts (fourth passage) were cultivated to evaluate the production of interleukin-1 beta (IL-1 beta) by ELISA methodology. Results indicated no difference of IL 1 beta spontaneous release when total MC cultures of both groups were compared. However, the levels of this cytokine were lower (< 10 pg/ml) in fibroblast culture supernatants of BCP compared to NC (1,217 +/- 74 pg/ml). Fibroblast cultures from BCP showed low or no release of IL-1 beta after muramyl-dipeptide (MDP. 1 microgram/ml) stimulation. In conclusion, the defective proliferative and confluence capacity of BCP fibroblastic progenitors may be related to the decrease in the production of IL-1 beta by these precursors.
Assuntos
Células da Medula Óssea/patologia , Neoplasias da Mama/patologia , Fibroblastos/patologia , Biópsia por Agulha , Células da Medula Óssea/metabolismo , Mama/citologia , Neoplasias da Mama/metabolismo , Células Cultivadas , Dinoprostona/biossíntese , Dinoprostona/metabolismo , Feminino , Fibroblastos/metabolismo , Humanos , Interleucina-1/biossíntese , Interleucina-1/metabolismo , Células-Tronco/patologiaRESUMO
We studied the production of interleukin-1 (IL-1) by peripheral blood monocytes (Mo) from twelve normal subjects (NS) and eight and nine untreated lung and colorectal cancer patients (CP), respectively. No significant changes of extracellular IL-1 biological activity was observed between CP and NS by thymocyte proliferation assay. This result was independent that the cells were treated or not with lipopolisaccharide from E. coli (LPS, 10 micrograms/ml). Moreover, CP present normal amount of antigenic IL-1 beta in LPS treated Mo culture supernatants by enzyme-linked immunosorbent assay (ELISA). The biological activity of IL-1 released was not significant modified after indomethacin (Indo, 10(-6)M) and LPS + Indo treatments. Furthermore, patients showed a low percentage of LPS activated Mo with intracytoplasmatic IL-1 (alpha + beta) compared to normal values. These results were obtained by immuno-alkaline phosphatase staining using monoclonal antibody anti IL-1 (alpha + beta). In conclusion, CP had a reduced number of Mo with intracytoplasmatic IL-1 (alpha + beta) and the difference observed may depend on degradation or in the rate of synthesis of this cytokine.
Assuntos
Neoplasias Colorretais/metabolismo , Interleucina-1/biossíntese , Neoplasias Pulmonares/metabolismo , Monócitos/metabolismo , Animais , Neoplasias Colorretais/patologia , Espaço Extracelular , Humanos , Neoplasias Pulmonares/patologia , CamundongosRESUMO
Introducción. El objetivo de este trabajo fue construir y determinar el grado de validez de una guía clínica para el diagnóstico etiológico de hepatoesplenomegalia en niños. Material y métodos. se construyó una guía clínica con cuatro algoritmos para los grupos básicos: 1) Hepatoesplenomegalia y fiebre; 2) Hepatoesplenomegalia y anemia; 3) Hepatoesplenomegalia con fiebre y anemia, y 4) Hepatoesplenomegalia sin fiebre ni anemia. La secuencia de las pruebas diagnósticas a emplearse se realizó en base a la prevalencia decreciente de los padecimientos implicados en cada grupo. La estructura de la guía fue validada por el método Delfos modificado y aplicada retrospectivamente a una muestra consecutiva de 18 pacientes con hepatoesplenomegalia sin orientación diagnóstica al momento de sus ingreso. Las varibles recabadas directamente de los expedientes clínicos se nominaron datos reales (DR). Los DR se compararon con los datos teóricos (DT) resultantes del cálculo teórico de las mismas varibles al aplicar la guía clínica propuesta a cada paciente. El análisis estadístico fue con la prueba U de Mann-Whitney. Resultados. El análisis de las siguientes variables, expresadas en mediana y amplitud, estuvo en favor del empleo de la guía clínica: tiempo para realizar la prueba que permite el diagnóstico (DT 5 {2-13} VD dr 10 {2-64} días, P < 0.05); tiempo para obtener el diagnóstico (DT 9 {2-16} vs DR 21.5 {5-64} días, P= 0.003); número de exámenes DT 10 {5-19} vs DR 22 {10-74} exámenes, P = 0.0009), y costo por caso (DT 2,048,476 {1,029,280-3,632,040} vs DR 3,735,468 {1,756,264-10,255,732} peso M.N., P = 0.0009). La utilidad de la guía clínica fue del 83 por ciento y la biopsia hepática fue el estudio que permitió conocer el diagnóstico en más de la mitad de los casos. Conclusiones. Estos resultados sugieren que la utilización de esta guía clínica puede reducir el tiempo necesario para el diagnóstico de estos pacientes, el número de exámenes utilizados y el costo de la atención. La guía deberá ser probada prospectivmente
Assuntos
Lactente , Pré-Escolar , Humanos , Masculino , Feminino , Anemia/complicações , Diagnóstico Clínico , Hemoglobinas , Hemoglobinas/análise , Hepatomegalia/diagnóstico , Hepatomegalia/etiologia , Esplenomegalia/diagnóstico , Esplenomegalia/etiologiaRESUMO
Introducción. Identificar los factores de riesgo para el desarrollo de flebitis bacteriana asociada a venoclisis (VC) en niños atendidos en un hospital de tercer nivel de atención médica. Material y Metodos. De enero de 1991 a enero de 1992 se realizó un estudio de casos y controles anidados en una cohorte. Se incluyeron todos los niños que se les instaló VC durante su hospitalización. Se evaluaron cada 24 horas para detectar la presencia de flebitis bacteriana hasta 48 horas posteriores a su retiro. Las variables consideradas fueron: edad, sexo, estado de nutrición, número de granulocitos, enfermedad subyacente, tiempo de permanencia de la VC, tipo de soluciones administradas, calidad de la instalación y las características del instalador. El análisis fue a través del cálculo de razón de momios (OR) e intervalos de confianza al 95 por ciento (IC95 por ciento). Resultados. Se vigilaron 700 niños; 52 (7.4 por ciento) desarrollaron flebitis bacteriana (casos) y el resto no la desarrollaron (controles); de estos últimos se escogieron al azar 156 para realizar el análisis. Los factores del paciente asociados al desarrollo de flebitis bacteriana fueron: permanencia del catéter por más de 48 horas (OR 7.43,IC95 por ciento 1.5-49.6); presencia de foco infecciosos al momento de la instalación de la VC (OR3.72,IC95 por ciento 1.62-8.0) y los relacionados al instalador: ser médico (OR4.96,IC95 por ciento 3.51-6.8) y tener baja destreza para la instalación (OR 8.05, IC95 por ciento 5.81-11.17). La mayor edad y número de granulocitos/mm3 fueron identificados como factores protectores. Conclusiones. Algunos de los factores de riesgo para el desarrollo de flebitis bacteriana en niños, pueden ser modificados para tratar de disminuir la morbi-mortalidad relacionada con VC en pacientes hospitalizados
Assuntos
Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Humanos , Masculino , Feminino , Cateterismo/efeitos adversos , Cateterismo/instrumentação , Flebite/etiologia , Flebite/microbiologiaRESUMO
The expression of HLA-DR antigens and their capacity to reduce nitroblue tetrazolium (NBT) have been evaluated in monocytes (Mo) from 28 patients with colorectal carcinoma (CCa) before antineoplastic treatment as well as in 29 normal control (NC). Simultaneously, circulating immune complexes (CIC) levels were studied in both groups. The results were expressed as the media of percentages. They show a decrease of Mo bearing HLA-DR (p less than 0.001 vs NC) and increase of MO with capacity to reduce NBT (p less than 0.001 vs NC). An increase of CIC levels in CCa compared to the NC (p less than 0.001) was also observed. We can postulate that the decrease in HLA-DR expression could be caused by the increase of toxic oxygen intermediates whose production was induced by CIC or tumoral antigens adherence.
Assuntos
Neoplasias Colorretais/imunologia , Antígenos HLA-DR/análise , Monócitos/metabolismo , Nitroazul de Tetrazólio/metabolismo , Complexo Antígeno-Anticorpo/análise , Neoplasias Colorretais/sangue , Humanos , OxirreduçãoRESUMO
La mucormicosis craneofacial es una complicación relativamente frecuente en el diabético; su evolución es rápidamente mortal si no se reconoce y asiste de manera oportuna. Se comunica el caso de una adolescente diabética con mucormicosis craneofacial y necrosis extensa de la cara en la que se lograron curación y rehabilitación mediante tratamiento medico-quirúrgico. Se hacen consideraciones en cuanto a su tratamiento médico y se destaca la importancia del quirúrgico, particularmente en la reconstrucción de la cara
Assuntos
Adolescente , Humanos , Feminino , Diabetes Mellitus Tipo 1/complicações , Mucormicose/complicações , Mucormicose/cirurgia , NecroseRESUMO
Sensitivity tests to different antimicrobial agents were performed in 290 strains of S. aureus isolated from healthy population and from patients with various infectious diseases. Resistance to penicillin G varied from 80 to 97% and beta-lactamase production was demonstrated in all strains with CMI greater than 1 microgram/ml. Resistance to other drugs was variable: gentamicin 29.4%, erythromycin 24.5% and rifampicin 12%. All strains were sensitive to isoxazolyl penicillins with CMI less than 1 microgram/ml. There was no difference in the sensitivity pattern to antibiotics between strains isolated from community or from hospital acquired infections with reference to the antimicrobial resistance pattern.
Assuntos
Antibacterianos/farmacologia , Staphylococcus aureus/efeitos dos fármacos , Adulto , Portador Sadio/microbiologia , Criança , Infecção Hospitalar/microbiologia , Dicloxacilina/farmacologia , Eritromicina/farmacologia , Gentamicinas/farmacologia , Humanos , Penicilina G/farmacologia , Resistência às Penicilinas , Rifampina/farmacologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificaçãoRESUMO
The sensitivity to chloramphenicol and ampicillin of 127 strains of H. influenzae was tested. One hundred and one strains were obtained from the pharyngeal exudate of 828 healthy carriers under 5 years of age and 26 from the spinal fluid of children with meningoencephalitis. Sixty per cent of isolations corresponded to type b; 40 per cent were non typical and we only identified one type e. All H. influenzae obtained from spinal fluid corresponded to type b. The frequency of healthy carriers was greater in intrafamily contacts of children with H. influenza meningoencephalitis (p less than 0.01). Percentages of resistance to ampicillin varied between 6 and 23% for the different groups; we found no statistical difference among them (p less than 0.2). The prevalence of H. influenza resistant to ampicillin in the population studied was 1.2% for type b strains and 0.2% for non typical bacteria. Fourteen per cent of penicillin resistant type b strains were identified; all 127 isolations were to chloramphenicol; therefore, we recommend this drug instead of ampicillin for the treatment of H. influenza infections, with the exception of acute otitis media.
Assuntos
Ampicilina/farmacologia , Cloranfenicol/farmacologia , Haemophilus influenzae/efeitos dos fármacos , Meningite por Haemophilus/microbiologia , Portador Sadio/microbiologia , Líquido Cefalorraquidiano/microbiologia , Pré-Escolar , Haemophilus influenzae/isolamento & purificação , Humanos , Meningoencefalite/microbiologia , México , Resistência às Penicilinas , Faringe/microbiologiaRESUMO
800 samples of pharyngeal exudate were taken from healthy children and 28 healthy intrafamilial contacts of children with meningitis caused by H. influenzae type b. H. influenzae type be was isolated in 8.7 per cent of nursery children, H. influenzae type e in 0.12 per cent and non typifiable H. influenzae in 5.8 per cent. On intrafamilial contacts, 32 per cent had H. influenzae type b and non typifiable in 3.5 per cent. Percent age of ampicillin resistant H. influenzae type b was 14 per cent. No strains were found resistant to chloramphenicol. S. pneumoniae was isolated in 37 per cent of pharyngeal exudate samples. 25.5 per cent of strains tested were penicillin sensitive; 74.5 per cent has a decrease sensitivity. Based on these results we consider chloramphenicol to the the first drug of choice for treatment of severe H. influenzae infections and penicillin for S. pneumoniae infections recommending in the latter higher doses when dealing with central nervous system infections.