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Background: Treatment for critical care conditions, such as acute respiratory distress syndrome (ARDS), requires ready-to-administer injectable mesenchymal stromal cells (MSCs). A validated cryopreserved therapy based on MSCs derived from menstrual blood (MenSCs) is an attractive option that offers advantages over freshly cultured cells and allows its use as an off-the-shelf therapy in acute clinical conditions. The main goal of this study is to provide evidence on the impact of cryopreservation on different biological functions of MenSCs and to determine the optimal therapeutic dose, safety, and efficacy profile of clinical-grade, cryopreserved (cryo)-MenSCs in experimental ARDS. Methods: Biological functions of fresh versus cryo-MenSCs were compared in vitro. The effects of cryo-MenSCs therapy were evaluated in vivo in ARDS-induced (Escherichia coli lipopolysaccharide) C57BL/6 mice. After 24 h, the animals were treated with five doses ranging from 0.25×105 to 1.25×106 cells/animal. At 2 and 7 days after induction of ARDS, safety and efficacy were evaluated. Results: Clinical-grade cryo-MenSCs injections improved lung mechanics and reduced alveolar collapse, tissue cellularity, and remodelling, decreasing elastic and collagen fiber content in alveolar septa. In addition, administration of these cells modulated inflammatory mediators and promoted pro-angiogenic and anti-apoptotic effects in lung-injured animals. More beneficial effects were observed with an optimal dose of 4×106 cells/Kg than with higher or lower doses. Conclusion: From a translational perspective, the results showed that clinical-grade cryopreserved MenSCs retain their biological properties and exert a therapeutic effect in mild to moderate experimental ARDS. The optimal therapeutic dose was well-tolerated, safe, and effective, favouring improved lung function. These findings support the potential value of an off-the-shelf MenSCs-based product as a promising therapeutic strategy for treating ARDS.
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The pandemic of COVID-19 brought to the world an unprecedented challenge. This single center observational study aimed to evaluate the impact of staff preparedness by comparing the outcomes between two intensive care units (ICUs) from a hospital that had to expand ICU beds to deal with an incremented volume of critical patients. Patients consecutively admitted to these ICUs with suspected COVID-19, from March 1st until April 30th, 2020, were included. Both ICUs attended a similar population and had the same facilities, what differed was the staff: one previously well-established (ICU-1) and another recently assembled (ICU-2). 114 patients with severe respiratory syndrome were included. In-hospital mortality was 40%. Compared with patients in the well-established ICU-1, patients in the recently assembled ICU-2 were older (54 versus 61.5, p=0.045), received more antibiotics (93% versus 98%, p=0.001) and chloroquine/hydroxychloroquine 6% versus 30%, p=0.001), had a higher proportion of invasive mechanical ventilation (44% versus 52%, p=0.008) and had greater in-hospital mortality (30% versus 50%, p=0.017). The proportion of patients considered at high risk for death according to PSI was similar between the two ICU populations. Age ≥ 60 years (adjusted OR 2.33; 95% CI 1.02-5.31), need of invasive mechanical ventilation (adjusted OR 2.79; 95% CI 1.22-6.37), and ICU type (recently assembled) (adjusted OR 2.38; 95% CI 1.04-5.44) were independently associated with in-hospital mortality . This finding highlights the importance of developing support strategies to improve preparedness of staff recently assembled to deal with emergencies.
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COVID-19 , Pandemias , Estudos de Coortes , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Pessoa de Meia-Idade , Respiração Artificial , SARS-CoV-2RESUMO
Introducción: La enfermedad respiratoria aguda es la entidad más frecuente en la vida del ser humano y las enfermedades respiratorias agudas se encuentran entre las causas de muerte. La autopsia es el mejor método del estudio del enfermo y su realización es una fortaleza del sistema de salud cubano. Objetivo: Determinar las características demográficas y morfológicas que se encontraron en las autopsias de fallecidos con enfermedad respiratoria aguda. Método: Se realizó un estudio descriptivo y de corte transversal, de los fallecidos a quienes se realizó autopsia, en el periodo de 1986 al 2019. Se estudiaron las variables edad, sexo, comorbilidades, causas de muerte y relación clínico - patológica. Resultados: La población quedó conformada por 390 autopsias que presentaban estas afecciones (2,5 por ciento). El grupo de edades entre 65 a 84 años fue el más afectado en ambos sexos. En las causas directas de muerte predominó la bronconeumonía bacteriana. Se destaca la elevada coincidencia en las causas directas de muerte y las discrepancias en las causas básicas. La línea de tendencia indica el incremento progresivo en el transcurso de los años estudiados. Conclusiones: Las características demográficas muestran que todos los grupos de edades están afectados, con predominio de 65 a 84 años, en ambos sexos. El pulmón fue el órgano más afectado en las causas directas de muerte, con predominio de la bronconeumonía, mientras que la mayoría presenta enfermedad respiratoria aguda como causa básica de muerte, con elevada discrepancia en su relación clínico patológica(AU)
Introduction: Acute respiratory disease is the most frequent entity in human life and acute respiratory diseases are among the causes of death. The autopsy is the best method of studying the patient and it is a strength of the Cuban health system. Objective: To determine the demographic and morphological characteristics found in the autopsies of the deceased with acute respiratory diseases. Method: A descriptive and cross-sectional study was carried out of the deceased who underwent autopsy, in the period from 1986 to 2019. The variables age, sex, comorbidities, causes of death and clinical-pathological relationship were studied. Results: The population was made up of 390 autopsies with these conditions (2.5 percent). The 65 to 84 age group was the most affected in both sexes. In direct causes of death, bacterial bronchopneumonia predominated. The high coincidence in the direct causes of death and the discrepancies in the basic causes stand out. The trend line indicates the progressive increase in the course of the years studied. Conclusions: The demographic characteristics show that all age groups are affected, with a predominance of 65 to 84 years, in both sexes. The lung was the most affected organ in direct causes of death, with a predominance of bronchopneumonia, while the majority had acute respiratory disease as the basic cause of death, with a high discrepancy in its clinical-pathological relationship(AU)
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Humanos , Doenças Respiratórias , Autopsia , Broncopneumonia , Causa Básica de Morte , Estudos Transversais , Causalidade , Grupos EtáriosRESUMO
OBJECTIVES: In this ancillary analysis of a multicenter, double-blinded, randomized, placebo-controlled trial, we investigated the effect of a single high dose of vitamin D3 on the length of hospital stay of patients with severe 25-hydroxyvitamin D deficiency and COVID-19. METHODS: The primary outcome was length of hospital stay, defined as the total number of days that patients remained hospitalized from the date of randomization until the date of hospital discharge. Secondary outcomes included serum levels of 25-hydroxyvitamin D, mortality during hospitalization, number of patients admitted to the intensive care unit, and number of patients who required mechanical ventilation. ClinicalTrials.gov: NCT04449718. RESULTS: Thirty-two patients were included in the study. The mean (SD) age was 58.5 (15.6) years, body mass index was 30.8 (8.6) kg/m2, and 25-hydroxyvitamin D level was 7.8 (1.6) ng/mL. No significant difference was observed in the median interquartile range of length of hospital stay between the vitamin D3 group (6.0 [4.0-18.0] days) versus placebo (9.5 [6.3-15.5] days) (log-rank p=0.74; hazard ratio, 1.13 [95% confidence interval (CI), 0.53-2.40]; p=0.76). Vitamin D3 significantly increased serum 25-hydroxyvitamin D levels in the vitamin D3 group compared with that in the placebo group (between-group difference, 23.9 ng/mL [95% CI, 17.7-30.1]; p<0.001). CONCLUSIONS: A dose of 200.000 IU of vitamin D3 did not significantly reduce the length of hospital stay of patients with severe 25-hydroxyvitamin D deficiency and COVID-19.
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Humanos , Pessoa de Meia-Idade , Deficiência de Vitamina D/tratamento farmacológico , COVID-19 , Vitamina D/análogos & derivados , Método Duplo-Cego , Colecalciferol , SARS-CoV-2 , Tempo de InternaçãoRESUMO
Resumen La infección por SARS-CoV2 es una pandemia. Se creía que el primer caso de esta enfermedad ocurrió el 8 de diciembre de 2019 en la provincia de Hubei en China, aunque posteriormente se indicó que el primer caso confirmado por laboratorio ocurrió el 1.( de diciembre de 2019 ante la presencia de un brote de neumonía en 59 pacientes sospechosos en un mercado local de mariscos en Wuhan. No solo produce patología respiratoria, con frecuencia compremete el sistema cardiovascular ya que produce lesión miocárdica, miocarditis, y, con cierta frecuencia, aumenta la descompensación de enfermedades cardiovasculares preestablecidas. En este artículo se trata de dilucidar el componente cardiovascular hasta ahora existente en la literatura y se sugieren algunos pasos a seguir en pacientes con estas enfermedades, acorde con la evidencia actual.
Abstract Infection due to SARS-CoV2 is a pandemic. It is believed that the first case occurred on 8 December 2019 in Hubei province in China, although it was later indicated that the first laboratory-confirmed case occurred on 1 December 2019 due to the presence of an outbreak of suspected pneumonia in 59 patients in a shellfish market in Wuhan. It not only caused a respiratory disease, it often compromised the cardiovascular system since it produces a myocardial lesion, myocarditis, and, less often, increased the decompensation of pre-established cardiovascular diseases. An attempt is made in this article to elucidate the cardiovascular component presented in the current literature, and to suggest some steps to follow in patients with these diseases in accordance with the current evidence.
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Humanos , Masculino , Feminino , Coronavirus , Insuficiência Cardíaca , Pneumonia , Síndrome do Desconforto Respiratório do Recém-Nascido , Traumatismo por Reperfusão Miocárdica , Síndrome Respiratória Aguda Grave , MiocarditeRESUMO
A novel human adenovirus was isolated from a pediatric case of acute respiratory disease in Panama City, Panama in 2011. The clinical isolate was initially identified as an intertypic recombinant based on hexon and fiber gene sequencing. Based on the analysis of its complete genome sequence, the novel complex recombinant Human mastadenovirus D (HAdV-D) strain was classified into a new HAdV type: HAdV-84, and it was designated Adenovirus D human/PAN/P309886/2011/84[P43H17F84]. HAdV-D types possess usually an ocular or gastrointestinal tropism, and respiratory association is scarcely reported. The virus has a novel fiber type, most closely related to, but still clearly distant from that of HAdV-36. The predicted fiber is hypothesised to bind sialic acid with lower affinity compared to HAdV-37. Bioinformatic analysis of the complete genomic sequence of HAdV-84 revealed multiple homologous recombination events and provided deeper insight into HAdV evolution.
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Adenovírus Humanos/genética , Proteínas do Capsídeo/genética , Genoma Viral , Genótipo , Análise de Sequência de DNA , Infecções por Adenoviridae/virologia , Adenovírus Humanos/isolamento & purificação , Proteínas do Capsídeo/metabolismo , Humanos , Panamá , Filogenia , Ligação Proteica , Recombinação Genética , Homologia de Sequência , Ácidos Siálicos/metabolismoRESUMO
BACKGROUND: Worldwide, acute respiratory infections (ARI) are the leading cause of death of children under 5 years of age. AIM: To assess the accomplishment of the Millennium Development Goal on under-5 mortality particularly related to ARI in developing countries, and to explore the associations between country characteristics and ARI in children under 5 taking into account child, mother and household attributes. METHODS: The study included a representative sample of 354,633 children under 5 years from 40 developing nations. A multilevel analysis of data from the Demographic and Health Surveys and the World Bank was conducted. RESULTS: The prevalence of ARI was 13%. Country inequalities were associated with the disease - GINI index (95% CI 1.01-1.04). The country's per capita gross domestic product (GDP) (95% CI 1.00-1.01) and health expenditure (95% CI 1.01-1.01) affected the relationship between immunization and ARI, while inequalities influenced the relationship between household wealth (95% CI 0.99-0.99) and the disease. Other factors positively associated with ARI were male gender, low birthweight, working mothers and a high-risk indoor environment. Factors associated with ARI reduction were older children, immunization, breastfeeding for more than 6 months, older maternal age, maternal education and planned pregnancy. CONCLUSIONS: In developing countries, public health campaigns to target ARI should consider the country's macro characteristics. At country level, inequalities but not health expenditure or GDP were associated with the disease and were independent of child, family and household characteristics. The effect of immunization on reducing ARI is greater in countries with a higher GDP and health expenditure. The effect of household wealth on ARI is less in countries with fewer inequalities. Reduction of inequalities is an important measure to decrease ARI in developing countries.
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Países em Desenvolvimento , Infecções Respiratórias/epidemiologia , Doença Aguda , Pré-Escolar , Estudos Transversais , Países em Desenvolvimento/estatística & dados numéricos , Feminino , Gastos em Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Prevalência , Fatores de Risco , Fatores SocioeconômicosRESUMO
Objetivos: Disminuir los episodios de enfermedad respiratoria aguda (ERA) en las familias, mediante un enfoque modificado del modelo ecológico de Morelatto para identificar y trabajar colectivamente determinantes que influyen en la salud respiratoria de niños y niñas. Materiales y Métodos: Durante el proceso se realizaron actividades encaminadas a prevenir las principales causas de ERA basadas en el modelo transteórico del comportamiento con el fin de generar cambios conductuales en las familias. Para ello se creó una escala de valoración del riesgo de ERA como instrumento de medición de la efectividad de las actividades realizadas, otorgándole a cada familia un puntaje antes y después de la intervención para determinar si hubo disminución del mismo. Resultados: Las actividades realizadas conducen a cambios evidenciados en las prácticas cotidianos de las madres y sus familias, reflejadas en la escala de valoración de riesgos a partir de la disminución de conductas que favorecen la enfermedad respiratoria aguda y sus complicaciones en la primera infancia afiliada a la FAR -Génesis. Conclusiones: Una menor exposición a eventos y complicaciones de la ERA en miembros de grupos familiares de la FAR -Génesis puede contribuir a mejorar la resiliencia y disminuir la vulnerabilidad socioeconómica de las familias afectadas regularmente por la ERA sus complicaciones.
Objectives: To reduce acute respiratory disease (ARD) in children under six years of age. An ecological model approach modified by Morelatto guided community actions to identify and improve respiratory health determinants. Materials and Methods: During this process activities were implemented to change behaviors at the family level, regarding respiratory health practices according to the trans theoretical model of behavior. A risk scoring scale was used as a tool to track change in respiratory health related practices. Results: Project activities lead to behavioral changes in daily practices related ot ARD in mothers and their families, traced through the risk scoring scale. This approach allowed a participatory intervention of determinants related to ARD at different levels to improve respiratory health of children under six years of age. Conclusions: Fewer episodes and complications of respiratory disease among households may improve resilience and reduce socioeconomic vulnerability of families previously exposed to frequent events and complications of acute respiratory disease.
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Se realizó un estudio sobre la contaminación ambiental por ruido y emisiones de material particulado PM10 asociado a fuentes móviles en la conurbación Pereira-Dosquebradas. Objetivo: Analizar la relación salud con el ruido ambiental y el PM10 asociado al flujo vehicular. Metodología: Se realizaron mediciones de flujo vehicular y ruido ambiental en tres sitios de interés por congestión vehicular. Adicionalmente, se reunió información de estaciones de calidad del aire disponibles en la zona de estudio y población con enfermedad respiratoria aguda (ERA). A partir de estos datos, se desarrollaron modelos para estimar el ruido ambiental a partir de condiciones del flujo vehicular y se proponen dos modelos de simulación reuniendo características de la dinámica de crecimiento poblacional, flujo vehicular y posibles emisiones de material particulado, para estimar el efecto potencial sobre la salud y los costos inducidos asociados a la contaminación. Resultados: En los sitios estudiados, se encontró que el flujo vehicular y el ruido ambiental son estadísticamente mayores en horas pico de la tarde (5 pm a 7 pm). El mayor flujo vehicular se encontró en el sector de la avenida sur de Pereira con un promedio de 2693 veh-Eq/h. Adicionalmente, se pudo estimar que los costos ambientales asociados a la contaminación atmosférica (PM10) podrán llegar a ser del orden del 2% del presupuesto para el municipio de Pereira. Conclusión: El ruido ambiental está correlacionado con el flujo vehicular. El ruido ambiental generado principalmente por efecto del flujo vehicular puede llegar a superar los límites permitidos en la norma nacional para sitios cerca de hospitales. De acuerdo con los modelos de simulación desarrollados, si las condiciones de crecimiento del parque automotor circulante continúan a igual ritmo, en menos de ocho años los efectos de las concentraciones elevadas de material particulado causarán un efecto evidente sobre la morbilidad por enfermedad respiratoria aguda y en los costos ambientales estimados.
A study on noise contamination and particle pollution of PM10 associated with mobile sources in the Pereira-Dosquebradas conurbation was carried out. Objective: To analyze the relationship between health, environmental noise and PM10 due to vehicular flow. Methodology: Measurements of environmental noise and vehicular flow in three sites of interest by traffic congestion were carried out. Additionally, information from air quality stations available in the study area and population with acute respiratory disease (ARD) was collected. From these data, models to estimate the environmental noise from traffic flow conditions were developed and two simulation models using dynamic characteristics of population growth, traffic flow and potential emissions of particulate matter are proposed in order to estimate the potential effect on health and associated induced costs associated with pollution. Results: In the sites studied, it was found that the flow of traffic and environmental noise are statistically higher in the afternoon peak hour (5 pm to 7 pm). The higher traffic flow was found in the sector of Avenida Sur in Pereira with an average of 2,693 veh-Eq/h. Furthermore, from the simulation models, it was found that the environmental costs associated with air pollution (PM10) may become around 2% of the budget for the municipality of Pereira. Conclusion: Environmental noise is correlated with traffic flow. Environmental noise is generated mainly by the effect of traffic flow and it may exceed the limits established in the national standard for sites near hospitals. According to the simulation models developed, if the growth conditions of the vehicle fleet continue in the same tendency, in less than eight years the effects of high concentrations of particulate matter will cause a significant effect on morbidity due to acute respiratory disease and a higher estimated environmental cost.
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Humanos , Poluição do Ar , Doenças Respiratórias , Poluição Relacionada com o Tráfego , RuídoRESUMO
BACKGROUND: Between September 2000 and November 2005, approximately 10% of the retrospectively examined human adenovirus (HAdV)-positive pediatric cases of acute respiratory disease (ARD) requiring hospitalization at the Hospital Nacional de Pediatria Juan P. Garrahan in Buenos Aires, Argentina, were found to have a HAdV-B2 infection. OBJECTIVE: To characterize genetically and antigenically the HAdV-B2 virus isolates. STUDY DESIGN: Restriction enzyme analysis (REA), hexon and fiber gene sequencing and virus neutralization assays (VN) were carried out on 8 HAdV-B2 respiratory virus isolates. RESULTS: REA showed that the 8 examined HAdV-B2 virus isolates were HAdV11, belonging to two genomic variants: HAdV11a and a BclI variant of HAdV11c which we designated 11c4. Molecular analysis of the hexon genes showed that both REA variants had a HAdV11-like hexon gene. Confirming previous reports, the 7 HAdV11a virus isolates were found to have HAdV14-like fiber genes and therefore are HAdV H11/F14. The fiber gene of the HAdV11c4 virus isolates most closely resembled that of various strains of HAdV7. In VN assays, the 4 tested HAdV11a strains were serotyped as HAdV11-14. The HAdV11c4 strain was serotyped as HAdV11 but also showed a weak but significant reactivity with antiserum to HAdV7. Compared with the other HAdV-positive cases in our study, infection with HAdV11 caused a similarly severe disease. CONCLUSIONS: Our results provide evidence to the long term world-wide circulation of HAdV H11/F14 as a causative agent of ARD. Combined, our molecular and serology data support the rationale to base the molecular typing and designation of recombinant viruses on the sequences of the hexon and fiber genes.
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Infecções por Adenoviridae/virologia , Adenovírus Humanos/classificação , Doenças Respiratórias/virologia , Adenovírus Humanos/genética , Adenovírus Humanos/imunologia , Adenovírus Humanos/isolamento & purificação , Argentina , Criança , Pré-Escolar , DNA Viral/química , DNA Viral/genética , Feminino , Genótipo , Humanos , Lactente , Masculino , Epidemiologia Molecular , Dados de Sequência Molecular , Testes de Neutralização , Polimorfismo de Fragmento de Restrição , Proibitinas , Análise de Sequência de DNA , SorotipagemRESUMO
Cada año un grupo importante de niños ven limitadas su capacidad funcional e integración social como consecuencia de una Parálisis Cerebral Infantil. Esta además constituye potencialmente una limitación para su expectativa de vida. Con el objetivo de diseñar una propuesta de intervención para facilitar el manejo de los padres de niños con Parálisis Cerebral Infantil portadores de enfermedades respiratorias agudas, se realizó un estudio descriptivo retrospectivo de pacientes portadores de esta afección, nacidos en el periodo 1986-2005 en la provincia de Camagüey, pertenecientes al área de salud del policlínico Rodolfo Ramírez Esquivel del municipio Camagüey. Al evaluar el expediente clínico de cada caso se constató en 10 por ciento, de la muestra 11, de un universo de 18 niños, de los cuales habían ingresado entre 1 y 5 veces al año como consecuencia de infecciones respiratorias. Las mayores cifras fueron en menores de 5 años, 7 (63,63 por ciento) que se corresponde con encamamiento prolongado por lo que favorece el factor predisponente a las infecciones respiratorias. Hubo un predominio de variables de edad, sexo, frecuencia de ingresos y factores asociados a las Infecciones Respiratorias Agudas. Se destaca la importancia de educar a la familia a través de una propuesta de intervención domiciliaria acerca del manejo, tratamiento postural y fisioterapia respiratoria como vía para prevenir infecciones respiratorias agudas en el Paralítico Cerebral, afección que compromete la expectativa de vida de estos casos
Every year, a significant group of children are affected in their functional capacity and social integration as a result of infantile cerebral palsy. This disease is a potential limitation for their life expectancy. With the objective of designing an intervention proposal to facilitate the management of parents of children with infant cerebral palsy and acute respiratory diseases, a retrospective and descriptive study of patients carrying this illness, born in 1986 to 2005 period in Camaguey province and living in the health area of Rodolfo Ramirez Esquivel polyclinics was made. On evaluating the clinical records of each case, it was found in 10 percent of the sample, that is, 11 of a universe of 18 children, who had been hospitalized one to five times from respiratory infections. The highest figures corresponded to children under 5 years of age, 7 (63.63 percent), which agreed with the prolonged bedding that favors the predisposing factor for respiratory diseases. Age, sex, frequency of admissions to hospital and acute respiratory infection-related factors were predominant. The study underlined the importance of educating the family through a proposal of intervention at home about management, posture treatment and respiratory physiotherapy to prevent acute respiratory diseases in the cerebral palsy patients, an illness that compromises their life expectancies
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Humanos , Criança , Paralisia CerebralRESUMO
Human adenoviruses (HAdV) are a major cause of acute respiratory diseases (ARD), gastroenteritis, conjunctivitis and urinary infections. Between November 2000-April 2007, a total of 468 nasopharyngeal aspirate samples were collected from children with ARD at the Clinics Hospital of Uberlândia. These samples were tested by immunofluorescence assay (IFA) and 3 percent (14/468) tested positive for the presence of HAdV. By performing polymerase chain reaction (PCR) to detect HAdV DNA in samples that tested negative or inconclusive for all viruses identifiable by IFA (respiratory syncytial virus, parainfluenza viruses 1, 2 and 3, influenza viruses A and B and HAdV), as well as negative for rhinoviruses by reverse transcription-PCR, additional 19 cases were detected, for a total of 33 (7.1 percent) HAdV-positive samples. Nucleotide sequences of 13 HAdV samples were analyzed, revealing that they belonged to species B, C and E. Further analyses showed that species C (HAdV-2) was the most prevalent among the sequenced samples. To our knowledge, this is the first report describing the presence of HAdV-4 in Brazil. We also detected an isolate that was 100 percent identical to a part of the feline adenovirus hexon gene sequence.
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Animais , Gatos , Pré-Escolar , Humanos , Infecções por Adenovirus Humanos , Adenovírus Humanos , DNA Viral , Nasofaringe , Infecções Respiratórias , Adenovírus Humanos , Sequência de Bases , Brasil , Dados de Sequência Molecular , Filogenia , Reação em Cadeia da Polimerase , Infecções Respiratórias , Estações do AnoRESUMO
En nuestro país de manera general, y en el Cantón Ventanas en particular, se agudiza periódicamente el alto riesgo de enfermar y en algunos casos, morir, de los menores de 4 años por enfermedades prevenibles, tal como enfermedades infecciosas y parasitarias, infecciones respiratorias agudas, diarreas y desnutrición, asociadas con otras enfermedades infecciosas como malaria, tuberculosis, dengue, chagas, meningitis, las cuales tratadas con terapéutica accesible a la población, producirá resultados positivos, que permitirán mejorar el crecimiento y desarrollo del niño y por ende el nivel de vida de la familia (1, 13).Objetivos: Determinar las 10 principales patologías en menores de 4 años en el cantón Ventanas, durante el primer semestre, año 2003. Determinar la incidencia de las 2 principales patologías. Realizar un estudio comparativo retrospectivo de las referidas patologías.Resultados: De los 2722 niños, 893 presentaron enfermedad respiratoria aguda, 632 enfermedad diarreica aguda y 601 con diagnóstico de paludismo.La incidencia de la enfermedad respiratoria aguda y paludismo fue mayor en el mes de marzo, mientras que la enfermedad diarreica aguda tuvo su mayor incidencia en el mes de febrero.Conclusión: Las tres patologías señaladas, son las principales causas de morbilidad de los niños menores de 4 años; la incidencia de estas enfermedades está en relación con las características geográficas y de infraestructura de salud en el cantón Ventanas.
In our country in the general population and in Ventanas canton in particular it has become a seriously periodically problem the high risk that exists for children less than 4 years old to become sick or in many cases die of preventable diseases like infectious diseases, parasitosis, acute respiratory infections, diarrhea and malnutrition. They are associated with other diseases such as malaria, tuberculosis, dengue, chagas and meningitis. If the diseases are treated with accessible therapeutic measures it would have a positive result in the population. This would allow for child to have a better development and lead to a better life for the family.Objectives:XTo determine the 10 main pathologies that will affect a child less than 4 years of age in Ventanas Canton during the first semester of year 2003.XTo determine the incidence of the 2 main pathologies.XTo have a retrospective comparative study of the pathologies referred to in this article.Results: Of the 2722 children studied, 893 had acute respiratory diseases, 632 acute diarrhea disease and 601 were diagnoses with malaria.The incidence of acute respiratory disease and malaria was higher during the month of March while acute diarrhea disease had a higher incidence during the month of February.Conclusion: The three pathologies that were pointed out in this study are the main cause of morbidity in children less then 4 years of age. The incidence of this diseases are in relation to the geographic characteristics and of the health infrastructure in Ventanas Canton.