RESUMO
In a field study carried out in three rural communities in Paraguay in a zone endemic for Chagas disease, we implemented three different vector control interventions--spraying, housing improvement, and a combination of spraying plus housing improvement--which effectively reduced the triatomine infestation. The reduction of triatomine infestation was 100% (47/47) in the combined intervention community, whereas in the community where housing improvement was carried out it was 96.4% (53/55). In the community where fumigation alone was used, the impact was 97.6% (40/41) in terms of domiciliary infestation. In all the houses where an intervention was made, an 18-month follow-up showed reinfestation rates of less than 10%. A serological survey of the population in the pre- and post-intervention periods revealed a shift in positive cases towards older age groups, but no significant differences were observed. The rate of seroconversion was 1.3% (three new cases) in the community with housing improvement only, but none of these cases could have resulted from vector transmission. The most cost-effective intervention was insecticide spraying, which during a 21-month follow-up period had a high impact on triatomine infestation and cost US$ 29 per house as opposed to US$ 700 per house for housing improvement.
PIP: Chagas disease is most commonly spread by vectors in areas where inadequate housing, crowding, and poor hygienic conditions facilitate the proliferation of triatomines and help to maintain their domestic cycle. Chagas disease is widely distributed in America, from the southern US to southern Argentina, with a prevalence of 5-60%. In 3 rural communities in Paraguay in a zone endemic for Chagas disease, insecticide spraying, housing improvement, and a combination of spraying plus home improvement were implemented in a field study to control the vectors of Chagas disease. The insecticide applied was lambdacyhalothrin in a wettable powder formulation, while houses were modified to have smooth, flat, crack-free walls and ceiling surfaces, as well as better ventilation and illumination. Each intervention effectively reduced the vector of Chagas disease, with triatomine infestation reduced by 100% in the combined intervention community, 96.4% in the community in which only houses were improved, and 97.6% in terms of domiciliary infestation where only fumigation was used. In all houses in which an intervention was made, an 18-month follow-up showed reinfestation rates of less than 10%. A serological survey of the population during the pre- and post-intervention periods showed a shift in positive cases toward older age groups, but no significant differences were observed. The rate of seroconversion was 1.3% (3 new cases) in the community with housing improvement only, but none of those cases could have resulted from vector transmission. Insecticide spraying was the most cost-effective intervention: US$29 per house compared to US$700 per house for housing improvement.
Assuntos
Doença de Chagas/prevenção & controle , Doenças Endêmicas/prevenção & controle , Controle de Insetos/métodos , Triatoma/parasitologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Animais , Doença de Chagas/epidemiologia , Doença de Chagas/parasitologia , Doença de Chagas/transmissão , Criança , Pré-Escolar , Análise Custo-Benefício , Doenças Endêmicas/estatística & dados numéricos , Feminino , Humanos , Lactente , Controle de Insetos/economia , Masculino , Pessoa de Meia-Idade , Paraguai/epidemiologia , Avaliação de Programas e Projetos de Saúde , Saúde da População Rural , Estudos SoroepidemiológicosRESUMO
Apparently healthy preschool children (46 boys, 52 girls) aged 27-50 mo from low socioeconomic conditions who attended daycare centers in Santiago participated in a 14-mo long double-blind zinc supplementation trial. Unlike most previous studies, no additional inclusion criteria such as short stature or slow growth rate were considered. Subjects were pair matched according to sex and age and randomly assigned to two experimental groups: the supplemented group, which received 10 mg Zn/d, and the placebo group. Selected anthropometric, clinical, dietary, biochemical, and functional indexes were determined at the beginning of the study and after 6 and 14 mo of intervention. Actual dietary zinc intake was 66% of the recommended dietary allowance. Height gain after 14 mo was on average 0.5 cm higher in the supplemented group (P = 0.10). The response, however, was different between sexes. Boys from the supplemented group gained 0.9 cm more than those in the placebo group (P = 0.045). No effect was seen in girls. Although no significant differences were observed in the rest of the variables studied, trends (0.05 < P < 0.10) in the supplemented group compared with the placebo group for increased midarm muscle area in boys, improved response to tuberculin, and reduced rates of parasite reinfestation were noted. We conclude that in preschool children of low socioeconomic status, zinc is a limiting factor in the expression of growth potential.
Assuntos
Crescimento/efeitos dos fármacos , Zinco/farmacologia , Administração Oral , Análise de Variância , Estatura/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Pré-Escolar , Chile , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Cabelo/química , Humanos , Masculino , Classe Social , Zinco/administração & dosagemRESUMO
PIP: This article describes some negative effects from modernization and urban growth in South America, including disease, pesticides, occupational hazards, poor environmental controls of water and garbage, sanitation, and environmental degradation. South America is following the global trend toward urbanization and the problems that accompany it. Agricultural expansion led to an expanded market for pesticides that includes the deadly DDT, paraquat, and heptachlor. Brazil and Colombia are the largest consumers. Latin American officials justify use of DDT, which is banned in the US and many European countries, as an effective means of combating mosquitos that carry malaria. Exposure occurs during harvesting, transporting, forestry, livestock farming, and vector control activities. Methyl bromide, which is used post-harvest and as a soil fumigant, is dangerous enough to be banned in the US in 2001, and in developing countries in 2002. Exposure to toxic chemicals can severely inhibit enzyme action that is necessary for neurological functioning. A hot climate, which prevents protective clothing, lack of education on proper application, and absence of water to wash exposed skin, make pesticide protection very difficult. Over 40 million agricultural workers are at risk of pesticide poisoning. Habitat destruction has contributed to increased mosquito infestations. Children in the workplace are at even greater risk of noise pollution and chemical poisoning. South America pollutes almost 11 times more fresh water per capita than Europe. About 70% of domestic garbage is collected, and about 30% is disposed of correctly. Only 10% of urban wastewater is treated before discharge into waterways. The loss of coastal wetlands reduces the ability of waterways to filter and absorb nutrients. Environmental health problems suggest an interlinkage between environmental sustainability, human health, and economic growth.^ieng
Assuntos
Países em Desenvolvimento , Saúde Ambiental/tendências , Poluentes Ambientais , Saúde Ocupacional , Crescimento Demográfico , Surtos de Doenças , Humanos , Praguicidas/efeitos adversos , Praguicidas/economia , Fatores Socioeconômicos , América do Sul , População Urbana , Gerenciamento de ResíduosRESUMO
An alternative vector control method, using lambda-cyhalothrin impregnated wide-mesh gauze covering openings in the walls of the houses was developed in an area in the Eastern part of the interior of Suriname. Experimental hut observations showed that Anopheles darlingi greatly reduced their biting activity (99-100%) during the first 5 months after impregnation. A model assay showed high mortality both of mosquitoes repelled by the gauze as well as of those that succeeded in getting through it. A field application test in 270 huts showed good acceptance by the population and good durability of the applied gauze. After introducing the method in the entire working area, replacing DDT residual housespraying, the malaria prevalence, of 25-37% before application dropped and stabilized at between 5 and 10% within one year. The operational costs were less than those of the previously used DDT housespraying program, due to a 50% reduction in the cost of materials used. The method using wide-mesh gauze impregnated with lambda-cyhalothrin strongly affects the behavior of An. darlingi. It is important to examine the effect of the method on malaria transmission further, since data indirectly obtained suggest substantial positive results.
PIP: Field application testing in Suriname confirmed that use of wide-mesh gauze impregnated with lambda-cyhalothrin to cover openings in the walls of Bush Negro homes represents an effective, acceptable, and low-cost vector control method. In experimental hut observations in the Eastern part of the interior of Suriname, this method reduced the biting activity of Anopheles darlingi by 99-100% in the first 5 months after impregnation. A model assay showed high mortality among mosquitoes repelled by the gauze and 100% mortality in insects that were able to cross through the mesh. A field application test in 270 huts showed good acceptance by the population, with no conflicts with local cultural customs, and excellent durability. After replacement of DDT residual house-spraying (associated with a malaria prevalence of 25-37%) with the impregnated gauze method, malaria prevalence dropped to 5-10% and material costs were halved. When the Suriname Government resumed responsibility for health care in the interior in 1992 when political strife stopped, use of this vector control method was not continued despite its demonstrated benefits.
Assuntos
Anopheles , Insetos Vetores , Inseticidas , Controle de Mosquitos/métodos , Animais , Malária/prevenção & controle , SurinameRESUMO
OBJECTIVE: To compare morbidity and mortality rates of low birth weight (LBW) and appropriate birth weight infants born at term, focusing on diarrheal and respiratory infections. STUDY DESIGN: A cohort of 133 LBW infants (1500 to 2499 gm) and 260 appropriate birth weight infants (3000 to 3499 gm), individually matched by sex and season of birth, were followed for the first 6 months of life. None had congenital anomalies and all were from poor families living in the interior of Pernambuco, northeast Brazil. Data on infant deaths, hospitalizations, and morbidity were collected prospectively through daily home visits (except Sundays) from birth through week 8, then twice weekly for weeks 9 to 26. The effects of birth weight were assessed with a variety of multivariable techniques, controlling for confounders. RESULTS: Of the LBW infants, 56% were wasted (thin), 23% were stunted, and 17% were both wasted and stunted. The LBW infants (median 2380 gm) experienced a sevenfold higher mortality rate and fourfold higher rate of hospitalization than appropriate birth weight infants. Almost all deaths and hospitalizations were in the postneonatal period. The LBW infants also experienced 33% more days with diarrhea and 32% more days with vomiting (p = 0.003 in each case). The prevalences of cough and fever were not significantly different. CONCLUSIONS: Infant deaths, hospitalizations, and diarrheal morbidity are increased in term LBW infants who have only a modest weight deficit.
PIP: During January-December 1993, in the interior of Pernambuco State, northeast Brazil, researchers recruited 133 low birth weight (LBW) (1500-2499 g) infants and 260 sex- and birth season-matched controls of appropriate birth weight (ABW) (3000-3499 g) from the maternity wards of hospitals in five communities. All infants were randomly assigned to receive either 1 mg zinc/day for 8 weeks or a placebo. All infants came from low income families. The researchers compared their morbidity, especially diarrhea and respiratory tract infections, and mortality rates during the first 6 months of life. Zinc supplement had no effect on any of the outcome measures. LBW infants were more likely than ABW infants to die (7.5% vs. 0.8%; adjusted hazard rate ratio [AHRR] = 6.58; p = .006) and to be hospitalized (24.8% vs. 6.5%; AHRR = 4.09; p .001) during the first 6 months of life. Yet the rate of consultations with medical personnel was essentially the same for both groups. 90% of the LBW deaths occurred in the postneonatal period, the underlying causes being diarrhea and respiratory infections. For both LBW and ABW infants, diarrhea was the main cause of hospitalization. Both groups experienced little diarrhea during the first 6 weeks of life. Thereafter, LBW infants suffered a higher prevalence of diarrhea than ABW infants up until 5 months. Beginning with day 1, LBW infants experienced more vomiting than ABW infants. Both groups experienced increasing rates of cough and fever throughout the 6-month period. Differences between the two groups were less pronounced than they were for diarrhea or vomiting. LBW infants were more likely to be sick longer with diarrhea and vomiting than ABW infants (p .001), but the difference in prevalence was less significant (p = .043). The onset of diarrhea was strongly associated with feeding mode (hazard rate ratio = 1.56 for partially breast-fed infants and 2.34 for infants no longer breast fed; p .001) as was the onset of vomiting (0.95 and 1.86, respectively; p .001 for the latter). LBW infants suffered more deaths, hospitalizations, and diarrhea morbidity than ABW infants.
Assuntos
Países em Desenvolvimento , Diarreia Infantil/epidemiologia , Recém-Nascido de Baixo Peso , Infecções Respiratórias/epidemiologia , Brasil/epidemiologia , Diarreia Infantil/mortalidade , Feminino , Hospitalização , Humanos , Recém-Nascido , Funções Verossimilhança , Masculino , Morbidade , Distribuição de Poisson , Prevalência , Modelos de Riscos Proporcionais , Infecções Respiratórias/mortalidadeRESUMO
OBJECTIVE: To compare the safety and efficacy of an oral rehydration solution (ORS) containing 75 mmol/L of sodium and glucose each with the standard World Health Organization (WHO) ORS among Egyptian children with acute diarrhea. METHODS: One hundred ninety boys, aged 1 to 24 months, who were admitted to the hospital with acute diarrhea and signs of dehydration were randomly assigned to receive either standard ORS (311 mmol/L) or a reduced osmolarity ORS (245 mmol/L). Intake and output were measured every 3 hours. RESULTS: In the group treated with reduced osmolarity ORS, the mean stool output during the rehydration phase was 36% lower (95% confidence interval, 1%, 100%) than in those treated with WHO ORS. The relative risk of vomiting during the rehydration phase was significantly lower in children treated with reduced osmolarity ORS (relative risk, 2.4; 95% confidence interval, 1.2, 4.8). During the maintenance phase, stool output, mean intake of food and ORS, duration of diarrhea, and weight gain were similar in the treatment groups. The relative risk of treatment failure (need for unscheduled administration of intravenous fluids) was significantly increased in children receiving standard WHO ORS (relative risk, 7.9; 95% confidence interval, 1.1, 60.9). The mean serum sodium concentration at 24 hours was significantly lower in children receiving the reduced osmolarity ORS solution (134 +/- 6 mEq/L) than in children receiving the standard WHO ORS (138 +/- 7 mEq/L) (p < 0.001). The relative risk of the development or worsening of hyponatremia was not increased in children given the reduced osmolarity ORS, and urine output was similar in the treatment groups. CONCLUSION: The reduced osmolarity ORS has beneficial effects on the clinical course of acute diarrhea in children by reducing stool output, and the proportion of children with vomiting during the rehydration phase, and by reducing the need for supplemental intravenous therapy. These results provide support for the use of a reduced osmolarity ORS in children with acute noncholera diarrhea.
PIP: Between July 1993 and March 1994, clinical researchers in Egypt enrolled 190 male children aged 1-24 months with acute diarrhea at the Abu El Reeche Hospital in Cairo in a randomized double-blind clinical trial to evaluate the relative efficacy of a reduced osmolarity oral rehydration solution (ORS) containing 75 mmol/l of both sodium and glucose (total osmolarity, 245 vs. 311 mmol/l for the standard ORS recommended by the World Health Organization and UNICEF) for treating acute noncholera diarrhea. They measured intake and output every three hours. Over the entire course of the study, the mean stool output was significantly lower in the reduced osmolarity ORS group than the standard ORS group (4.3 vs. 5 g/kg/hour; p 0.05). During the rehydration phase, the mean stool output was 36% lower in the reduced osmolarity ORS group than in the standard ORS group (p 0.05). The proportion of children vomiting during rehydration was much lower in the reduced osmolarity ORS group than the standard ORS group (17% vs. 33%; relative risk [RR] = 2.4; p 0.01). During the maintenance phase, the two groups shared similar stool output, mean intake of food and ORS, duration of diarrhea, and weight gain. Treatment failure was significantly more common in the standard ORS group than the reduced osmolarity ORS group (8% vs. 1%; RR = 7.9; p 0.01). The mean serum sodium level at 24 hours were much lower in the reduced osmolarity ORS group (134 vs. 138 mEq/l; p 0.001) but remained within the normal range in both groups. Children in both groups developed hyponatremia or their hyponatremia worsened at the same rate. Urine output was about the same in both groups. These findings suggest that the reduced osmolarity ORS has advantages over the standard ORS as a treatment for acute noncholera diarrhea. This safe and effective rehydration treatment reduces stool output and vomiting during rehydration as well as reduces the need for supplemental intravenous therapy.
Assuntos
Diarreia Infantil/terapia , Hidratação/métodos , Glucose/análise , Soluções para Reidratação/química , Soluções para Reidratação/uso terapêutico , Sódio/análise , Doença Aguda , Método Duplo-Cego , Egito , Humanos , Lactente , Masculino , Concentração Osmolar , Risco , Resultado do Tratamento , Organização Mundial da SaúdeRESUMO
Most micronutrient deficiencies affect relatively few people in the Caribbean; however, many Caribbean residents are affected by anemia that appears due primarily to a lack of dietary iron. While generally substantial, the prevalences of such anemia have differed a good deal from place to place and study to study, observed rates ranging from 27% to 75% in pregnant women, 19% to 55% in lactating women, and 15% to 80% in young children. Severe anemia, defined by a blood hemoglobin concentration below 8 g/dl, has been found in approximately 6% of the pregnant women and 11% of the preschool children in some Caribbean countries. The principal ways of controlling iron deficiency anemia are through food fortification, control of intestinal parasites, direct oral supplementation, and dietary modification. Progress has been made in iron fortification of wheat flour and wheat products (the principal foodstuffs consumed by the general public in most of the English-speaking Caribbean). Data on control of relevant parasites in the Caribbean (primarily hookworm and to a lesser extent whipworm) are limited. Health services throughout the English-speaking Caribbean have been providing direct iron supplementation for pregnant women, but high levels of anemia during pregnancy still exist because of coverage, monitoring, and compliance problems. All the Caribbean countries also have education programs, which mainly advise pregnant women about iron-rich foods and iron absorption inhibitors and enhancers.
Assuntos
Anemia Ferropriva/prevenção & controle , Deficiências Nutricionais/prevenção & controle , Anemia Ferropriva/epidemiologia , Região do Caribe/epidemiologia , Deficiências Nutricionais/epidemiologia , Feminino , Alimentos Fortificados , Humanos , Ferro/uso terapêutico , Masculino , Inquéritos NutricionaisRESUMO
PIP: In Guadalajara and Mexico City, Mexico, researchers collected and analyzed semen samples from fertile men who were sexually abstinent for 3 days to evaluate the effect heparin has on sperm nuclear decondensation patterns and motility. They used 3 sesquiterpene-lactones to inactivate the thiol groups on the outer membrane of sperm cells: I (17, 18 dehydroviguiepinin), II (Budlein A), and III (Zaluzanin A). Sesquiterpene-lactones I, II, an III had an inhibitory effect of 81%, 73%, and 27%, respectively, 6 hours after the sperm had been incubated with heparin for 6 hours. First mixing the sperm with reduced glutathione before adding 17, 18 dehydroviguiepinin increased the decondensating effect of heparin 350% above that of sperm not incubated with both glutathione and heparin. Sperm motility fell 80%, 60%, and 16%, respectively, 15 minutes after incubation with sesquiterpene-lactones I, II, and III. When sperm was incubated with heparin only, sperm motility was consistently higher for 5 hours. None of the compounds used to incubate the sperm affected sperm viability. The findings provided more information about the molecular biology of mammalian spermatozoa and suggested that sesquiterpene-lactones may be effective male contraceptives.^ieng
Assuntos
Células , Anticoncepção , Compostos Orgânicos , Imobilizantes dos Espermatozoides , Transporte Espermático , Espermatozoides , América , Biologia , Fenômenos Químicos , Química , Anticoncepcionais , Países em Desenvolvimento , Serviços de Planejamento Familiar , Genitália , Células Germinativas , Técnicas In Vitro , América Latina , México , América do Norte , Fisiologia , Pesquisa , Espermicidas , Sistema UrogenitalRESUMO
The period from late 1949 through 1951 was an extraordinarily productive one in steroid chemistry and especially so at Syntex S.A. in Mexico City. Two of the most important Syntex contributions--the synthesis of 19-nor-17 alpha-ethynyltestosterone (norethindrone) and of cortisone from diosgenin--are described from a historical perspective.
PIP: The pharmaceutical industry contributed more to the published record of steroid research during the 1950s than any industry has ever contributed before to any chemical subdiscipline. Syntex, a research-oriented company in Mexico city, contributed much of the publication of industrial research of steroids. Dr. Djerassi arrived at Syntex in 1949 as associate director of chemical research. He conducted partial aromatization studies leading him to the 1st synthesis of an oral contraceptive (OC) on October 15, 1951. This steroid was 19-nor-17 alpha-ethynyltestosterone, later called norethistrone or norethindrone. Syntex submitted the product to a commercial laboratory in Madison, Wisconsin, for biological evaluation. It was indeed the most active, orally effective progestational hormone at the time. Syntex applied for a patent in November 1951. In November 1954, clinical results of norethindrone used to treat various menstrual disorders and fertility problems was presented. G.D. Searle & Co. filed for a patent for the synthesis of the double bond isomer 13 of norethindrone called norethynodrel in August 1953. Acid or human gastric juice converts norethynodrel into norethindrone. Had it not been for Searle using norethindrone in its antimotion sickness drug, Dramamine, Syntex would have filed suit against Searle. Syntex sponsored contraceptive trials with norethindrone. Various incidents prevented Syntex from obtaining US Food and Drug Administration approval to use norethindrone for contraceptive indications before Searle obtained approval to use norethynodrel. By 1964, 3 companies including Syntex were marketing 2 mg doses of Syntex's norethindrone, the most widely used active ingredient in OCs. Dr. Djerassi also played a key role in the synthesis of cortisone from diosgenin, a chemical derived from Mexican yams. This synthesis was a more economical industrial route to cortisone than previous routes.
Assuntos
Anticoncepcionais Orais Hormonais , Cortisona , Indústria Farmacêutica/história , Tecnologia Farmacêutica/história , Anticoncepcionais Orais Hormonais/síntese química , Anticoncepcionais Orais Hormonais/química , Cortisona/síntese química , Cortisona/química , Diosgenina/química , História do Século XX , Humanos , México , Noretindrona/síntese químicaRESUMO
PIP: In 1989, Pro-Pater, a private, nonprofit family planning organization in Brazil, used attractive ads with the message Vasectomy, An Act of Love to promote vasectomy. The number of vasectomies performed/day at Pro-Pater clinics increased from 11 to 20 during the publicity campaign and fell after the ads stopped but continued at higher levels. Word of mouth communication among friends, neighbors, and relatives who had vasectomies maintained these high levels. This type of communication reduced the fear that often involves vasectomies because men hear from men they know and trust that vasectomies are harmless and do not deprive them of potency. In Sao Paulo, the percentage of men familiar with vasectomies and how they are performed increased after the campaign, but in Salvador, knowledge did not increase even though the number of vasectomies in Pro-Pater clinics increased. Organizations in Colombia and Guatemala have also been effective in educating men about vasectomies. These successes were especially relevant in Latin American where machismo has been an obstacle of family planning programs. The no-scalpel technique 1st introduced in China in 1974 reduces the fear of vasectomy and has fewer complications than the conventional technique. Further trained physicians can perform the no-scalpel technique in about 10 minutes compared with 15 minutes for the conventional technique. In 1987 during a 1-day festival in Thailand, physicians averaged 57 no-scalpel vasectomies/day compared with only 33 for conventional vasectomies. This technique has not spread to Guatemala, Brazil, Colombia, the US, and some countries in Asia and Africa. Extensive research does not indicate that vasectomy has an increased risk of testicular cancer, prostate cancer, and myocardial infarction. Physicians are working on ways to improve vasectomy.^ieng
Assuntos
Publicidade , Atitude , Estudos de Avaliação como Assunto , Medo , Relações Interpessoais , Conhecimento , Meios de Comunicação de Massa , Silicones , Reversão da Esterilização , Televisão , Vasectomia , América , Ásia , Sudeste Asiático , Comportamento , Brasil , Fenômenos Químicos , Química , China , Comunicação , Países em Desenvolvimento , Economia , Emoções , Características da Família , Serviços de Planejamento Familiar , Ásia Oriental , Compostos Inorgânicos , América Latina , Marketing de Serviços de Saúde , Psicologia , Silício , América do Sul , Esterilização Reprodutiva , TailândiaRESUMO
This paper combines results from a study of the determinants of condom quality and use conducted by The Population Council in two countries in the Caribbean with results from a condom breakage study conducted by Family Health International (FHI) in the United States. The studies, conducted two years apart, compared the breakage rates of condoms from the same lot during human use to their performance in laboratory test results. Breakage rates of 12.9% for Barbados, 10.1% for St. Lucia and 6.7% for the United States compared to passing ASTM laboratory tests suggest that existing laboratory tests as used with the current pass/fail standards are either not sufficiently sensitive or not well-defined to reliably predict condom performance during human use. The study also suggests that user behaviors and practices may be a factor in condom breakage. If the condom is to be an effective method against unplanned pregnancy and STD/HIV infection, and if consumer confidence is to be retained, condom breakage during sexual intercourse must be reduced.
PIP: Family Health International (FHI) in North Carolina sampled and tested 52mm contour condoms with a reservoir tip and silicone lubrication in November 1988 and March 1990. Condoms from this same lot were used in 2 human use studies conducted in 2 Caribbean countries and in the US. The Population Council conducted 1 human use study in Barbados and St. Lucia among 50 heterosexual male condom users from each country. FHI conducted the other study in the Research Triangle area of North Carolina among 50 heterosexual male condoms users. Condom breakage rates of the human studies were high (12.9% in Barbados, 10.1% for St. Lucia, and 6.7% for North Carolina) in comparison with other studies (1-7%). Breakage did not occur due to poor storage conditions or oil based lubricant use. The researchers thought that it occurred due to men misusing the condoms or other user behaviors and practices. This belief was supported by the differences in breakage between the Caribbean men and the US men. More men experienced multiple condom breakages than those who experienced only 1 breakage. Condoms used in the study were from the same lot which passed elongation and tensile strength standards of the American Society for Testing and Materials (ASTM) in both 1988 and 1990, but failed the International Organization of Standardization (ISO) airburst tests in 1988 and just barely passed in 1990. Apparently the standards are not sensitive enough to predict increases in condom breakage. These findings suggest that the ISO standard for airburst testing is a more accurate predictor of condom quality than the ASTM standards for tensile strength and elongation. Further the breakage rates are too high given the AIDS epidemic. Moreover high breakage reduces customer confidence. In conclusion, researchers need to conduct studies on sexual behavior and practices to determine their effect on condom breakage rates.
Assuntos
Dispositivos Anticoncepcionais Masculinos/normas , Barbados , Falha de Equipamento , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Masculino , Controle de Qualidade , Estados UnidosRESUMO
PIP: Researchers conducted a dietary survey of 59 households selected at random in the marginal community of Peralta in San Salvador, El Salvador to ascertain nutritional needs of the families and identify factors which affect intrafamilial distribution and consumption of food. A nutritionist weighed all the food consumed by each family member in 1 day. 50% of the family members consumed just grain, sugar, oil, and/or beans. 93% of the people ate 90% of the required quantity of vitamin A. 88% ate inadequate amounts of riboflavin, 77% iron, and 40% protein. Moreover 58% of the households spent 61-100% of their income on food. No association occurred between caloric sufficiency and family size and between age and dietary adequacy. Therefore each family evenly distributed food among family members. Further poorer families consumed less food than the families of the higher socioeconomic group.^ieng
Assuntos
Economia , Ingestão de Energia , Características da Família , Abastecimento de Alimentos , Renda , Ferro , Métodos , Inquéritos Nutricionais , Pobreza , Proteínas , Vitamina A , Vitaminas , América , Biologia , América Central , Fenômenos Químicos , Química , Conservação dos Recursos Naturais , Países em Desenvolvimento , El Salvador , Meio Ambiente , Saúde , Compostos Inorgânicos , América Latina , Metais , América do Norte , Fenômenos Fisiológicos da Nutrição , Fisiologia , Classe Social , Fatores SocioeconômicosRESUMO
PIP: A meeting in Singapore of principal investigators from 7 countries in a WHO collaborative study on hypertensive disease of pregnancy, also called pre-eclampsia or eclampsia, pointed out women at risk, suggested management guidelines, and summarized operations research projects involving administration of aspirin or calcium supplements. Hypertensive disease of pregnancy may ultimately end in fatal seizures. It is often marked by warning signs of severe headaches and facial and peripheral edema. A survey in Jamaica found that 0.72% of a group of 10,000 pregnant women had eclamptic seizures. These were the cause of almost one-third of all obstetric deaths in the period 1981-1983. 10.4% of the pregnant women had hypertension, and half of these had proteinuria. Associated risk factors were primigravida, age 30, abnormal weight gain, edema, 1+ proteinuria. A phased program of management guidelines for identifying and treating affected women is being instituted in half of Jamaica's parishes. An operations research project involves administration of low-dose aspirin vs. placebo. Another controlled trial, in Peru, is testing calcium supplements. A third trial in Argentina will compare 2 drug regimens.^ieng
Assuntos
Pressão Sanguínea , Cálcio , Circulação Cerebrovascular , Congressos como Assunto , Edema , Cefaleia , Hipertensão , Cooperação Internacional , Complicações na Gravidez , Gravidez , Antagonistas de Prostaglandina , Fatores de Risco , Equilíbrio Hidroeletrolítico , Organização Mundial da Saúde , América , Argentina , Biologia , Sangue , Região do Caribe , Fenômenos Químicos , Química , Países em Desenvolvimento , Doença , Sistema Endócrino , Homeostase , Compostos Inorgânicos , Agências Internacionais , Jamaica , América Latina , Metais , América do Norte , Organizações , Peru , Fisiologia , Prostaglandinas , Sinais e Sintomas , América do Sul , Nações Unidas , Doenças VascularesRESUMO
(1) Pseudolaric acids--Novel diterpenes, Pseudolaric acid A, B, C and D were isolated from Pseudolarix kaempferi Gorden (pinaceae). Their structures were assigned by spectroscopic data and chemical correlations. In the continuous studies, the absolute configurations, the conformations in the solutions, the fragmentation mechanisms of MS and assignments of all NMR spectral signals were also reported. They showed the antifungal and cytotoxic activities. (2)--Daphnane diterpenes--In the further studies on the plants of Thymelaeaceae, besides 10 known diterpenes, 16 new daphnane diterpenes were isolated from Daphne genkwa, D. tangutica, D. giraldii, Wikstroemie chamaedaphne. They showed the antifertilities activities. (3) Tripterygium diterpenes--14 new diterpenes were isolated from Triperygium wilfordii, T. regeli and T. hypoglaucum. Some of them showed the antitumour activities. The CD spectra showed that A/B ring of all compounds have trans configuration as same as tripdiolide and triptolide determined by X-ray diffraction. (4) Pregnane glycosides from Marsdenia koi--Two new pregnane glycosides marsdenikoiside A and marddenikoiside B which can terminate the early pregnancy were isolated from Marsdeia koi. Their structures were elucidated by hydrolysis and spectroscopic methods.
PIP: Bioactive terpenes were isolated from the following plant species: 1) Pseudolaric acids: The active compounds of novel diterpenes, Pseudolaric acid A, B, C, and D, were isolated from Pseudolarix kaempferi Gordon (pinaceae). Their structures were determined by spectroscopic data and chemical correlations. In continuous studies, absolute configurations, confirmation in solutions, fragmentation mechanisms of MS, and assignments of all nuclear magnetic resonance (NMR) spectral signals were also reported. They showed antifungal and cytotoxic activities. Pseudolaric acid A 1 and B 2 showed antifungal activities. Recently, pseudolaric acid B was established as a general cytotoxic agent against P-388 lymphocytic leukemia, KB carcinoma of the nasopharynx, HT-1080 fibrosarcoma, H00 578T breast cancer, human melanoma, human lung cancer, and human colon cancer cell lines. 2) Daphnane diterpenes: In further studies on the plants of Thymelaeaceae, besides 10 known diterpenes, 16 new daphnane diterpenes were isolated from Daphne genkwa, D. tangutica, D. giraldii, Wikstroemie chamaedaphne that showed antifertility activities. In continuous studies, besides 6 known compounds, 17 new daphnane diterpenes were isolated. 3) Tripterygium diterpenes: 14 new diterpenes were isolated from Tripterygium wilfordii, T. regeli and T. hypoglaucum. Tripterygium wilfordii has been used as an anticancer drug, male contraceptive, and immunedepressant in Chinese folk medicine for a long time. Some of them showed antitumor activities. The CD spectra showed that A/B ring of all diterpenes had the same transconfiguration as tripdiolide and triptolide as determined by X-ray diffraction. In 1972 triptolide, tripdiolide and triptonide were isolated with significant anti-tumor activities. Celastrol demonstrated immunodepressive activities. In addition to 10 known triterpenes, 15 new diterpenes were isolated from the plants of Tripterygium by silica gel chromatography. 4) Pregnane glycosides from Marsdenia koi: Two new pregnane glycosides, marsdenikoiside A and marsdenikoiside B, which can terminate early pregnancy were isolated from Marsdenia koi. Their structures were elucidated by hydrolysis and spectroscopic methods.
Assuntos
Diterpenos/isolamento & purificação , Medicamentos de Ervas Chinesas/química , Glicosídeos/isolamento & purificação , Anticoncepcionais/química , Anticoncepcionais/isolamento & purificação , Diterpenos/química , Glicosídeos/química , Humanos , Espectroscopia de Ressonância Magnética , Conformação Molecular , Estrutura Molecular , Relação Estrutura-AtividadeRESUMO
The objective of this study was to compare lactoferrin (LF) levels and unsaturated iron-binding capacity (UIBC) of colostrum from Brazilian women aged 20-38 years of low (N = 28) and high (N = 15) socioeconomic level. Both groups received a similar amount of supplemental iron (25-65 mg/day) during pregnancy. We also determined the relationship between LF levels and UIBC, and between these components and maternal iron status. Both groups (low and high socioeconomic level) showed adequate and similar mean hematocrit (35.0 +/- 1.3% and 35.9 +/- 1.3%, respectively) and serum ferritin (64 +/- 12 micrograms/l and 57 +/- 12 micrograms/l, respectively) levels. Furthermore, LF levels (5.7 +/- 0.9 mg/ml and 5.5 +/- 0.6 mg/ml) and UIBC (3.8 +/- 0.3 micrograms/ml and 3.1 +/- 0.3 micrograms/ml) were not significantly different in the two groups of women, nor were they related to maternal hematocrit or serum ferritin. UIBC was significantly (P = 0.009), although weakly positively correlated (r = 0.45) with LF levels, suggesting that other colostrum ligands may contribute substantially to the capacity of colostrum to bind exogenous iron.
Assuntos
Colostro/metabolismo , Ferro/metabolismo , Lactoferrina/metabolismo , Adulto , Brasil , Feminino , Ferritinas/sangue , Hematócrito , Humanos , Ferro/administração & dosagem , Gravidez , Radioimunoensaio , Fatores SocioeconômicosRESUMO
Investigated the effects of behavioral stress and smoking cigarettes on the lipid, lipoprotein, neuroendocrine, and cardiovascular responses of female smokers who either used or did not use oral contraceptives (OC). Thirty-five healthy female smokers (20 of whom used OC) relaxed, smoked, or sham smoked and then prepared, delivered, and reviewed a speech presented in front of a video camera. Results show that behavioral stress increased total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglyceride, and free fatty acid levels, with significant increases in cholesterol, LDL-C, and free fatty acids apparent only among women who smoked during the session. In addition, OC users exhibited larger increases in triglyceride and blood pressure responses during stress than did nonusers whether or not they smoked during the protocol. Possible physiological mechanisms for each of the effects, as well as implications of the findings for understanding epidemiological associations among OC use, smoking, and coronary heart disease in women are discussed.
PIP: 35 females smokers, of whom 20 had taken combined oral contraceptives for 6 months or more, participated in a study of the effect of smoking and social stress on cardiovascular response, catecholamines and lipoproteins. The stress consisted of giving a 4-minute videotaped extemporaneous speech, after smoking 1 cigarette or sham-smoking. Testing was done in the luteal phase or on Days 15-22 of a pill cycle, after an overnight fast without smoking. Neither smoking nor stress affected catecholamines. Blood pressures and heart rate increased significantly during speech preparation, delivery and review in all subjects; and during inhalation in smoking women. Oral contraceptive users had higher baseline levels of total cholesterol and triglycerides, and their cholesterol and triglycerides increased more than did nonusers during the speech, triglycerides significantly so. Pill users also had higher systolic and diastolic blood pressure increases during delivery of the speech than did nonusers. This study corroborates previous reports that smoking increases cardiovascular responses additively to stress, and is the first report higher increases in triglycerides and cholesterol during stress in pill users.
Assuntos
Nível de Alerta/efeitos dos fármacos , Anticoncepcionais Orais/efeitos adversos , Doença das Coronárias/sangue , Lipídeos/sangue , Lipoproteínas/sangue , Fumar/efeitos adversos , Adolescente , Adulto , Nível de Alerta/fisiologia , Pressão Sanguínea/efeitos dos fármacos , Anticoncepcionais Orais/administração & dosagem , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Fatores de Risco , Fumar/sangue , Estresse Psicológico/complicaçõesRESUMO
PIP: The organochlorines DDT and hexachlorocyclohexane (HCH) were determined in mothers' milk in 21 women from rural towns and 21 from urban Botucatu, Sao Paulo, Brazil, and correlated with environmental factors such as prevalence of house spraying, smoking, and agricultural work. Extraction and gas chromatography methods were those published by the U.S. EPA. Average DDT levels in urban milk samples were 34.9 ppb, and in rural milk 16.5 ppb. Higher meat intake was probably a factor in higher urban yield. In contrast, rural levels of HCH were 46.3 ppb, compared to 14.4 ppb in urban mothers. DDT levels were consistently lower in women who had nursed 3 or more children, than those with 1 or 2. House spraying was related to higher DDT levels in rural areas only. DDT levels were much higher in women who smoked. HCH content was higher in younger women than older, and in houses that had been sprayed, especially in rural zones, where spraying programs are run by the public health authorities. Dieldrin was detected in only 3 urban samples.^ieng
Assuntos
Hidrocarbonetos Clorados , Inseticidas/análise , Leite Humano/análise , Adolescente , Adulto , Brasil , Monitoramento Ambiental , Feminino , Humanos , Inseticidas/metabolismo , Pessoa de Meia-Idade , População Rural , População UrbanaRESUMO
The rupture time of two types of soft jelly capsules (treated and non-treated) containing Nonoxynol-9 after its vaginal insertion was investigated in 96 women. Subjects were allocated in four study groups: Group I (n = 24), women with clinical vaginal infection; Group II (n = 24), subjects without vaginal infection; Group III (n = 24), patients with vaginal infection; and Group IV (n = 24), women without vaginal infection. Groups I and II received the treated capsules, and Groups III and IV the non-treated capsules. The capsules remained in the vagina for 2.5 to 5 minutes. The weight of the capsules was measured before insertion and after their extraction. Additionally, vaginal pH and distribution of the compound were assessed. The results disclosed that in Groups I, III and IV, the capsules ruptured within 2.5 minutes, whereas in Group II the rupture did not occur until 3 minutes. The largest number of non-ruptured capsules was observed in Group II. The major capsule weight loss occurred at minute 5 in most of the groups. The conditions currently observed in cases of non-ruptured capsules were: alkaline pH, multiparity and vaginal dryness. The vaginal distribution of the compound was observed at its upper portion. In women with vaginal infections, there were more cases of rupture and a significant weight loss between the treated capsules than the non-treated capsules. Further postcoital tests are required to assess its effectiveness.
PIP: The rupture time of 2 types of soft jelly capsules (treated and non-treated) containing Nonoxynol-9 after its vaginal insertion was investigated in 96 women in Mexico. Subjects were allocated in 4 study groups: Group I (n=24), women with clinical vaginal infection; Group II (n=24), subjects without vaginal infection; Group III (n=24), patients with vaginal infection; and Group IV (n=24), women without vaginal infection. Groups I and II received the treated capsules, and Groups III and IV the non-treated capsules. The capsules remained in the vagina for 2.5 to 5 minutes. The weight of the capsules was measured before insertion and after their extraction. Additionally, vaginal ph and distribution of the compound were assessed. The results disclosed that in Groups I, III and IV, the capsules ruptured within 2.5 minutes, whereas in Group II the rupture did not occur until 3 minutes. The largest number of non-ruptured capsules was observed in Group II. The major capsule weight loss occurred at minute 5 in most of the groups. The conditions currently observed in cases of non-ruptured capsules were: alkaline ph, multiparity and vaginal dryness. The vaginal distribution of the compound was observed at its upper portion. In women with vaginal infections, there were more cases of rupture and a significant weight loss between the treated capsules than the non-treated capsules. Further postcoital tests are required to assess its effectiveness.
Assuntos
Polietilenoglicóis , Espermicidas , Administração Intravaginal , Cápsulas , Ensaios Clínicos como Assunto , Feminino , Humanos , Masculino , Nonoxinol , Doenças Vaginais/fisiopatologiaRESUMO
PIP: Lead exposure even at low levels has adverse effects for the central nervous system (CNS), but pregnant women, neonates, lactating infants, and preschool and school age children are most susceptible to it. In rats anatomical alterations included swelling in the mitochondria of renal duct cells (at 26 mcg/dl); biochemical effects involved marked reduction of cytochrome content in the cerebral cortex (36 mcg/dl); and physiological effects were induced at the level of 30-50 mcg/dl. Central nervous system effects entailed persistent decrease of visual acuity (65 mcg/dl at birth and 7 mcg/dl 90 days later), the increase of the latency of primary and secondary components of evoked visual responses during the prenatal and adult period (65 mcg/dl and 7 mcg/dl on days 21 and 90 after birth, respectively). 30 and even 20 mcg/dl of lead in the blood produced nerve conductivity deficits. A study of 425 children with lead poisoning showed a 39% rate of mental retardation and convulsions impervious to treatment. Lead levels within a range of 10-25 mcg/dl reduced the score on the mental development inventory by 4-8 points. The population of the Valley of Mexico numbers 15-20 million with 50% of Mexico's industry. A who investigation indicated blood levels of an average of 22.5 mcg/dl in a group of school teachers, the highest in 10 major population centers in the world. Blood levels in 405 pregnant women in Mexico City averaged 20.3 mcg/dl, and the sample from the umbilical cord of fetuses showed 13.6 mcg/dl. Another study disclosed blood levels of 16 mcg/dl in mothers and 13 mcg/dl in their offspring. The most probable sources of lead are: leaded gasoline, secondary recapture of lead for making batteries, use of paints, ceramics used for storing and cooking food, lead seal of milk containers, and consumption of food contaminated with lead.^ieng
Assuntos
Animais de Laboratório , Sistema Nervoso Central , Desenvolvimento Infantil , Poluição Ambiental , Indústrias , Chumbo , Troca Materno-Fetal , Transtornos Mentais , América , Biologia , Fenômenos Químicos , Química , Países em Desenvolvimento , Doença , Economia , Meio Ambiente , Compostos Inorgânicos , América Latina , Metais , México , América do Norte , Fisiologia , Gravidez , Reprodução , PesquisaRESUMO
The purpose of this study was to assess the concentration and binding pattern of zinc, iron, folate and vitamin B12 in milk of Brazilian women of low socioeconomic status giving birth at term or preterm, during early lactation. Protein, fat, total solids and ash concentrations were also determined. Protein and zinc concentrations decreased significantly as lactation proceeded whereas milk fat and folate increased with the lactation period. Total solids, ash, iron and vitamin B12 remained unchanged. Zinc was present mainly in the whey fraction while less than half of the total iron was present in this fraction, with no significant change due to stage of lactation. Unsaturated folate and vitamin B12 binding capacities and percentage of saturation of the folate binding protein increased with the stage of lactation. The vitamin B12 binding protein was highly unsaturated in all samples. There was no significant difference between term and preterm samples in the parameters investigated. Correlation analysis between milk components indicated significant relationships between total solids and fat, total zinc and whey zinc, folate and total folate binding capacity, unsaturated and total folate binding capacity, and unsaturated and total B12 binding capacity. In general, the nutrient concentrations found in this study are in good agreement with published data on milk composition of women from developed countries, with the possible exceptions of folate, which was lower, and iron, which was higher. The correlation of folate concentration with its binding protein found in this work supports the hypothesis of a regulatory role for folate levels in milk exerted by the folate binding protein in the mammary gland.