bluuebunny/crossref_metadata_2025 huggingface dataset:
The Association of Third-Generation Cephalosporin Use and Invasive Candidiasis in Extremely Low Birth-Weight Infants
Authors: Cotten C. Michael , McDonald Scott , Stoll Barbara , Goldberg Ronald N. , Poole Kenneth , Benjamin Daniel K. ,   on behalf of the National Institute for Child Health and Human Development Neonatal Research Network
Published: August 2006

OBJECTIVES. Previous studies have shown that incidence of invasive candidiasis varies substantially among centers, and previous use of broad-spectrum antibiotics is a risk factor for candidiasis in extremely low birth-weight infants. Differences in center practices, such as antibiotic strategies and the effects of these strategies on center incidence of candidiasis, are not reflected in assessments of an individual's risk of candidiasis. We evaluated the relationship between empirical antibiotic practices for extremely low birth-weight infants and center incidence of candidiasis.

METHODS. We studied a cohort of extremely low birth-weight infants who survived ≥72 hours and were admitted to 1 of 12 tertiary centers between 1998 and 2001. Multivariable logistic regression was used to validate previous broad-spectrum antibiotics use as a risk factor for subsequent candidiasis in individual infants. We calculated correlation coefficients to assess the relationship between center incidence of candidiasis with antibiotic practice patterns.

RESULTS. There were 3702 infants from 12 centers included, and 284 (7.7%) developed invasive candidiasis. Broad-spectrum antibiotics use was associated with candidiasis for individual infants. Center candidiasis incidence ranged from 2.4% to 20.4%. Center incidence of candidiasis was correlated with average broad-spectrum antibiotics use per infant and average use of broad-spectrum antibiotics with negative cultures per infant.

CONCLUSIONS. Center incidences of invasive candidiasis differ substantially, and antibiotic practice differences are possible contributors to center variation in candidiasis risk.
Glutathione S-Transferase M1 and P1 Genotype, Passive Smoking, and Peak Expiratory Flow in Asthma
Authors: Palmer Colin N.A. , Doney Alex S.F. , Lee Simon P. , Murrie Inez , Ismail Tahmina , Macgregor Donald F. , Mukhopadhyay Somnath
Published: August 2006

OBJECTIVES. Our purpose with this work was to assess the contribution of glutathione S-transferase gene variants to asthma susceptibility and pulmonary function in relation to tobacco smoke exposure in the home.

METHODS. Young individuals with asthma (age: 3–21 years; n = 504) were recruited through primary and secondary care throughout Tayside, Scotland (BREATHE Study). Spirometry was obtained on 407 individuals. Binary logistic regression and general linear modeling were used to explore phenotypic characteristics by genotype and tobacco smoke exposure status in younger children (3–12 years; n = 384) and teenagers and young adults (13–21 years; n = 120).

RESULTS. Three- to 12-year-olds with asthma, null for the GSTM1 gene or homozygous for the GSTP1Val105 allele, were overrepresented in the group exposed to environmental tobacco smoke. No differences in lung function values could be detected in this group. In contrast, 13- to 21-year-olds with the GSTM1-null genotype or homozygous for the GSTP1Val105 allele from smoking households were more likely to have a substantially lower percentage of predicted peak expiratory flow rates than those from nonsmoking households (83% vs 98%).

CONCLUSIONS. Three- to 12-year-olds who are null for GSTM1 or homozygous for the GSTP1Val105 allele are more susceptible to asthma associated with environmental tobacco smoke exposure than those with more intact glutathione S-transferase status. In the 13- to 21-year-olds, GSTM1-null status interacts with environmental tobacco smoke exposure to substantially reduce peak expiratory flow rate. The environmental tobacco smoke effect in GSTM1-null children with asthma could be cumulative over time, resulting in detrimental effects on peak expiratory flow rate in 13- to 21-year-olds with asthma.
Antenatal Hydronephrosis as a Predictor of Postnatal Outcome: A Meta-analysis
Authors: Lee Richard S. , Cendron Marc , Kinnamon Daniel D. , Nguyen Hiep T.
Published: August 2006

OBJECTIVE.Antenatal hydronephrosis is diagnosed in 1% to 5% of all pregnancies; however, the antenatal and postnatal management of hydronephrosis varies widely. No previous studies define the risk of postnatal pathology in infants with antenatal hydronephrosis. Our objective was to review the current literature to determine whether the degree of antenatal hydronephrosis and related antenatal ultrasound findings are associated with postnatal outcome.

METHODS. We searched Medline (1966–2005), Embase (1991–2004), and the Cochrane Library databases for articles on antenatal hydronephrosis. We required studies to have subjects selected on the basis of documented measurements of antenatal hydronephrosis and followed to a postnatal diagnosis. We excluded case reports, review articles, and editorials. Two independent investigators extracted data.

RESULTS. We screened 1645 citations, of which 17 studies met inclusion criteria. We created a data set of 1308 subjects. The risk of any postnatal pathology per degree of antenatal hydronephrosis was 11.9% for mild, 45.1% for moderate, and 88.3% for severe. There was a significant increase in risk per increasing degree of hydronephrosis. The risk of vesicoureteral reflux was similar for all degrees of antenatal hydronephrosis.

CONCLUSIONS. The findings of this meta-analysis can potentially be used for prenatal counseling and may alter current postnatal management of children with antenatal hydronephrosis. Overall, children with any degree of antenatal hydronephrosis are at greater risk of postnatal pathology as compared with the normal population. Moderate and severe antenatal hydronephrosis have a significant risk of postnatal pathology, indicating that comprehensive postnatal diagnostic management should be performed. Mild antenatal hydronephrosis may carry a risk for postnatal pathology, but additional prospective studies are needed to determine the optimal management of these children. A well-defined prospective analysis is needed to further define the risk of pathology and the appropriate management protocols.
Comparison of Accidental and Nonaccidental Traumatic Head Injury in Children on Noncontrast Computed Tomography
Authors: Tung Glenn A. , Kumar Monica , Richardson Randal C. , Jenny Carole , Brown William D.
Published: August 2006

OBJECTIVE. Mixed-density convexity subdural hematoma and interhemispheric subdural hematoma suggest nonaccidental head injury. The purpose of this retrospective observational study is to investigate subdural hematoma on noncontrast computed tomography in infants with nonaccidental head injury and to compare these findings in infants with accidental head trauma for whom the date of injury was known.

PATIENTS AND METHODS. Two blinded, independent observers retrospectively reviewed computed tomography scans with subdural hematoma performed on the day of presentation on 9 infant victims of nonaccidental head injury (mean age: 6.8 months; range: 1–25 months) and on 38 infants (mean age: 4.8 months; range: newborn to 34 months) with accidental head trauma (birth-related: 19; short fall: 17; motor vehicle accident: 2).

RESULTS. Homogeneous hyperdense subdural hematoma was significantly more common in children with accidental head trauma (28 of 38 [74%]; nonaccidental head trauma: 3 of 9 [33%]), whereas mixed-density subdural hematoma was significantly more common in cases of nonaccidental head injury (6 of 9 [67%]; accidental head trauma: 7 of 38 [18%]). Twenty-two (79%) subdural hematomas were homogeneously hyperdense on noncontrast computed tomography performed within two days of accidental head trauma, one (4%) was homogeneous and isodense compared to brain tissue, one (4%) was homogeneous and hypodense, and four (14%) were mixed-density. There was no statistically significant difference in the proportion of interhemispheric subdural hematoma, epidural hematoma, calvarial fracture, brain contusion, or subarachnoid hemorrhage.

CONCLUSIONS. Homogeneous hyperdense subdural hematoma is more frequent in cases of accidental head trauma; mixed-density subdural hematoma is more frequent in cases of nonaccidental head injury but may be observed within 48 hours of accidental head trauma. Interhemispheric subdural hematoma is not specific for inflicted head injury.
Methicillin-Resistant Staphylococcus aureus Colonization and Its Association With Infection Among Infants Hospitalized in Neonatal Intensive Care Units
Authors: Huang Yhu-Chering , Chou Yi-Hong , Su Lin-Hui , Lien Rey-In , Lin Tzou-Yien
Published: August 2006

OBJECTIVES. We conducted this study to assess the rate of methicillin-resistant Staphylococcus aureus colonization and its association with infection among infants hospitalized in methicillin-resistant S aureus–endemic NICUs.

METHODS. Between March 2003 and February 2004, surveillance culture specimens from the nares, postauricular areas, axillae, and umbilicus of infants admitted to the NICUs at a children’s hospital in Taiwan were obtained weekly for the detection of methicillin-resistant S aureus. All colonized and clinical isolates from each study infant with methicillin-resistant S aureus infection were genotyped with pulsed-field gel electrophoresis, with Sma1 digestion, and compared.

RESULTS. A total of 783 infants were included in this study. Methicillin-resistant S aureus colonization was detected for 323 infants during their NICU stays, with detection with the first 2 samples for 89%. Nares and umbilicus were the 2 most common sites of initial colonization. Methicillin-resistant S aureus colonization was associated significantly with premature birth (≤28 weeks) and low birth weight (≤1500 g), and infants with colonization had a significantly higher rate of methicillin-resistant S aureus infection, compared with those without colonization (26% vs 2%). Methicillin-resistant S aureus colonization was noted for 84 of 92 infants with methicillin-resistant S aureus infections. Of the 68 episodes with previous colonization and isolates available for genotyping analysis, colonized and clinical isolates were indistinguishable in 63 episodes, highly related in 2 episodes, and distinct in 3 episodes.

CONCLUSIONS. More than 40% of the hospitalized infants were colonized with methicillin-resistant S aureus during their stay in methicillin-resistant S aureus–endemic NICUs; this was associated significantly with methicillin-resistant S aureus infection. Most infants with methicillin-resistant S aureus infections had previous colonization with an indistinguishable strain.
Cerebral Palsy in a Term Population: Risk Factors and Neuroimaging Findings
Authors: Wu Yvonne W. , Croen Lisa A. , Shah Sameer J. , Newman Thomas B. , Najjar Daniel V.
Published: August 2006

OBJECTIVE. The purpose of this work was to study risk factors and neuroimaging characteristics of cerebral palsy in term and near-term infants.

PATIENTS AND METHODS. Among a cohort of 334339 infants ≥36 weeks’ gestation born at Kaiser Permanente Medical Care Program in northern California in 1991–2003, we identified infants with cerebral palsy and obtained clinical data from electronic and medical charts. Risk factors for cerebral palsy among infants with different brain abnormalities were compared using polytomous logistic regression.

RESULTS. Of 377 infants with cerebral palsy (prevalence: 1.1 per 1000), 273 (72%) received a head computed tomography or MRI. Abnormalities included focal arterial infarction (22%), brain malformation (14%), and periventricular white matter abnormalities (12%). Independent risk factors for cerebral palsy were maternal age >35, black race, and intrauterine growth restriction. Intrauterine growth restriction was more strongly associated with periventricular white matter injury than with other neuroimaging findings. Nighttime delivery was associated with cerebral palsy accompanied by generalized brain atrophy but not with cerebral palsy accompanied by other brain lesions.

CONCLUSIONS. Cerebral palsy is a heterogeneous syndrome with focal arterial infarction and brain malformation representing the most common neuroimaging abnormalities in term and near-term infants. Risk factors for cerebral palsy differ depending on the type of underlying brain abnormality.
Brain Developmental Abnormalities in Prader-Willi Syndrome Detected by Diffusion Tensor Imaging
Authors: Yamada Kenichi , Matsuzawa Hitoshi , Uchiyama Makoto , Kwee Ingrid L. , Nakada Tsutomu
Published: August 2006

OBJECTIVE. The purpose of this work was to detect brain developmental abnormalities in Prader-Willi syndrome by using diffusion tensor imaging based on a high-field MRI system.

METHODS. Eight patients with Prader-Willi syndrome and 8 age- and gender-matched normal control subjects were examined using a high-field (3.0 T) MRI system. Trace value and fractional anisotropy were assessed simultaneously in multiple representative brain regions: the deep gray matter (putamen, caudate head, and dorsomedial thalamus) and the white matter structures (frontal and parietal white matter, posterior limb of internal capsule, and corpus callosum).

RESULTS. In Prader-Willi syndrome patients, trace value was found to be significantly higher in the left frontal white matter and the left dorsomedial thalamus, whereas fractional anisotropy was significantly reduced in the posterior limb of the internal capsule bilaterally, the right frontal white matter, and the splenium of the corpus callosum. The observed diffusivity characteristics indicate developmental abnormalities in these areas, which are highly consistent with the clinical features of Prader-Willi syndrome.

CONCLUSIONS. The study provides the first objective evidence that Prader-Willi syndrome patients indeed have developmental abnormalities in specific areas of the brain, providing a new window toward understanding the pathophysiology of Prader-Willi syndrome.
Guiding Principles for Managed Care Arrangements for the Health Care of Newborns, Infants, Children, Adolescents, and Young Adults
Authors:   Committee on Child Health Financing
Published: August 2006

By including the precepts of primary care and the medical home in the delivery of services, managed care can be instrumental in increasing access to a full range of health care services and clinicians. If not designed and administered carefully, managed care plans result in underutilization of appropriate services and reduced quality of care. Therefore, the American Academy of Pediatrics urges the use of the key principles outlined in this statement in designing and implementing managed care for newborns, infants, children, adolescents, and young adults. This policy statement replaces the 2000 policy statement “Guiding Principles for Managed Care Arrangements for the Health Care of Infants, Children, Adolescents, and Young Adults.”
Mechanical properties of nacre constituents and their impact on mechanical performance
Authors: Barthelat François , Li Chun-Ming , Comi Claudia , Espinosa Horacio D.
Published: August 2006

The mechanical properties of nacre constituents from red abalone were investigated. Electron microscopy studies revealed that the tablets are composed of single-crystal aragonite with nanograin inclusions. Both nanoasperities and aragonite bridges are present within the interfaces between the tablets. By means of nanoindentation and axial compression tests, we identified single tablet elastic and inelastic properties. The elastic properties are very similar to those of single-crystal aragonite. However, their strength is higher than previously reported values for aragonite. A finite element model of the interface accounting for nanoasperities and the identified properties revealed that the nanoasperities are strong enough to withstand climbing and resist tablet sliding, at least over the initial stages of deformation. Furthermore, it was observed that the model over-predicts strength and under-predicts ductility. Therefore, we conclude that other interface features must be responsible for the enhanced performance of nacre over its constituents.
Spherical indentation load-relaxation of soft biological tissues
Authors: Mattice Jason M. , Lau Anthony G. , Oyen Michelle L. , Kent Richard W.
Published: August 2006

Elastic-viscoelastic correspondence was used to generate displacement–time solutions for spherical indentation testing of soft biological materials with time-dependent mechanical behavior. Boltzmann hereditary integral operators were used to determine solutions for indentation load-relaxation following a constant displacement rate ramp. A “ramp correction factor” approach was used for routine analysis of experimental load-relaxation data. Experimental load-relaxation tests were performed on rubber, as well as kidney tissue and costal cartilage, two hydrated soft biological tissues with vastly different mechanical responses. The experimental data were fit to the spherical indentation ramp-relaxation solutions to obtain values of short- and long-time shear modulus and of material time constants. The method is used to demonstrate linearly viscoelastic responses in rubber, level-independent indentation results for costal cartilage, and age-independent indentation results for kidney parenchymal tissue.
Anisotropic nanomechanical properties ofNephila clavipesdragline silk
Authors: Ebenstein Donna M. , Wahl Kathryn J.
Published: August 2006

Spider silk is a material with unique mechanical properties under tension. In this study, we explore the anisotropic mechanical properties of spider silk using instrumented indentation. Both quasistatic indentation and dynamic stiffness imaging techniques were used to measure the mechanical properties in transverse and longitudinal sections of silk fibers. Quasistatic indentation yielded moduli of 10 ± 2 GPa in transverse sections and moduli of 6.4 ± 0.5 GPa in longitudinal sections, demonstrating mechanical anisotropy in the fiber. This result was supported by dynamic stiffness imaging, which also showed the average reduced modulus measured in the transverse section to be slightly higher than that of the longitudinal section. Stiffness imaging further revealed an oriented microstructure in the fiber, showing microfibrils aligned with the drawing axis of the fiber. No spatial distribution of modulus across the silk sections was observed by either quasistatic or stiffness imaging mechanics.
Nanoindentation: Application to dental hard tissue investigations
Authors: Angker L. , Swain M.V.
Published: August 2006

In the last decade, most publications on the mechanical properties of dental calcified tissues were based on nanoindentation investigation. This technique has allowed a better understanding of the mechanical behavior of enamel, dentin, and cementum at a nanoscale. The indentations are normally carried out using pointed or spherical indenters. Hardness and elastic modulus are measured as a function of indenter penetration depth and from the elastic recovery upon unloading. The unique microstructure of each calcified tissue significantly contributes to the variations in the mechanical properties measured. As complex hydrated biological composites, the relative proportions of the composite components, namely, inorganic material (hydroxyapatite), organic material, and water, determines the mechanical properties of the dental hard tissues. Many pathological conditions affecting dental hard tissues cause changes in mineral levels, crystalline structures, and mechanical properties that may be probed by nanoindentation. This review focuses on relevant nanoindentation techniques and their applications to enamel, dentin, and cementum investigations.
Indentation micromechanics of three-dimensional fibrin/collagen biomaterial scaffolds
Authors: Mooney R.G. , Costales C.A. , Freeman E.G. , Curtin J.M. , Corrin A.A. , Lee J.T. , Reynolds S. , Tawil B. , Shaw M.C.
Published: August 2006

The underlying relationships between the microstructure and time-dependent mechanical properties of hydrated fibrin, collagen, and fibrin/collagen composite materials have been explored using an adaptation of the classical rigid, cylindrical, flat punch loaded normally to a planar specimen surface. A suite of quasi-static elastic and viscoelastic indentation experiments have been conducted with uniformly mixed fibrin, collagen, and fibrin/collagen composites, in addition to macrolayered collagen materials. Coupled with insights obtained from optical and confocal fluorescence microscopy, a simple micromechanics model has been developed for the effect of local microstructural variables on the macroscopic mechanical stiffness. These results demonstrate the efficacy of this technique to efficiently and reproducibly probe hydrated engineered tissue replacement materials for local variations in viscoelastic material behavior without the need for extensive specimen preparation or grips, as well as being suitable for performing directly comparable measurements with explants of human skin.
Quasistatic and dynamic nanomechanical properties of cancellous bone tissue relate to collagen content and organization
Authors: Donnelly Eve , Williams Rebecca M. , Downs Seth A. , Dickinson Michelle E. , Baker Shefford P. , van der Meulen Marjolein C.H.
Published: August 2006

Cancellous bone plays a crucial structural role in the skeleton, yet little is known about the microstructure-mechanical property relationships of the tissue at the microscale. Cancellous tissue is characterized by a microstructure consisting of layers interspaced with transition zones with different proportions of collagen and mineral. In this study, the quasistatic and dynamic mechanical properties of lamellar and interlamellar tissue in human vertebrae were assessed with nanoindentation, and the collagen content and organization were characterized with second harmonic generation microscopy. Lamellar tissue was 35% stiffer, 25% harder, and had a 13% lower loss tangent relative to interlamellar tissue. The stiff, hard lamellae corresponded to areas of highly ordered, collagen-rich material, with a relatively low loss tangent, whereas the compliant, soft interlamellar regions corresponded to areas of disordered or collagen-poor material. These data suggest an important role for collagen in the tissue-level mechanical properties of bone.
Paracoccidioidomicose do sistema nervoso central: análise de 13 casos
Authors: Fagundes-Pereyra Walter J. , Carvalho Gervásio Teles Cardoso , Góes Alfredo de Miranda , Silva Francisco das Chagas Lima e , Sousa Atos Alves de
Published: August 2006

A paracoccidioidomicose (PCM) é infecção granulomatosa sistêmica, causada pelo fungo Paracoccidioides brasiliensis, prevalente na América Latina, particularmente no Brasil. Acomete o sistema nervoso central (SNC) em 10% dos casos. Foram estudados 13 pacientes com paracoccidioidomicose no SNC, entre 1991 e 2001, com ênfase para os aspectos clínicos, neuroradiológicos e terapêuticos. Onze pacientes eram do sexo masculino (84,6%) e dois do feminino (15,4%), com idade entre 30 e 71 anos (M= 47,1 ± 11,6 Me= 46). Os sintomas mais freqüentes foram déficits motores (53,8%), alterações cognitivas (53,8%), emagrecimento (46,1%), cefaléia (46,1%) e crises convulsivas (46,1%). O diagnóstico foi confirmado pela detecção do P. brasiliensis no SNC. Todos os pacientes apresentavam a forma granulomatosa e quatro (30,8%) tinham a forma meningoencefalítica associada. Todos foram estudados com tomografia computadorizada (TC) de crânio e um caso com ressonância magnética (RM) encefálica. Dez pacientes (76,9%) realizaram sorologia para o HIV, todos com resultados negativos. A anfotericina B foi utilizada em 12 casos (92,3%), em um deles por via intratecal. Em oito casos (61,5%) o sulfametoxazol-trimetropim foi utilizado; em dois (15,4%) a sulfadiazina e pirimetamina, e o fluconazol, cetoconazol e itraconazol, cada um deles em um paciente. Seis pacientes (46,1%) morreram e sete evoluíram satisfatoriamente. O tempo de seguimento variou de 2 a 74 meses (M=30,9). Conclui-se que as manifestações clínicas assim como os exames de imagem na PCM do SNC são inespecíficos.
Atypical presentation of Prader-Willi syndrome with Klinefelter (XXY karytype) and craniosynostosis
Authors: Carvalho Daniel R. , Trad Clovis S. , Pina-Neto João M.
Published: August 2006

Prader-Willi syndrome is a mental retardation genetic disorder also characterized by hypogonadism, hyperphagia and obesity. We report on a four-years-old boy, born to consanguineous parents, with uncommon co-occurrence of Prader-Willi syndrome, 47,XXY karyotype (Klinefelter syndrome) and coronal craniosynostosis. These are different unrelated conditions and it was not described before in the same patient to the best of our knowledge.
Forma intermediária de síndrome de Foix-Chavany-Marie / síndrome de Worster-Drought associada a movimentos involuntários: aspectos neuropsicológicos e fonoaudiológicos
Authors: Vasconcelos Marcio Gadelha , Fiorot Jr José Antonio , Sarkovas Caroline , Pinto Aline Pereira Martins , Barsottini Orlando G P , Gabbai Alberto Alain
Published: August 2006

A síndrome de Foix-Chavany-Marie (SFCM) caracteriza-se por apraxia da fala associada à paralisia bilateral da face, palato mole, língua e musculatura da faringe, mas com preservação das funções reflexas e automáticas. Na síndrome de Worster-Drought (SWD), há predomínio da disartria. Descrevemos o caso de uma jovem de 18 anos, que apresenta os achados clínicos e radiológicos compatíveis com a forma intermediária de SFCM/SWD, acompanhados de movimentos involuntários (coréia e distonia), fato de ocorrência rara na descrição destas síndromes.
Neurocisticercose em zona urbana do estado do Piauí: relato de caso
Authors: Monteiro Alexandre Vitor Tapety e Silva do Rego , Silva Júnior Antônio Norberto Campelo da , Leite Daniel Amorim , Mendes Lucas Cronemberger Maia , Cordeiro Marcelo de Assunção , Lima Rafael Ferreira Correia , Lima Fernando Correia , Batista Marcus Sabry Azar
Published: August 2006

A neurocisticercose é grave problema de saúde pública que acomete predominantemente locais com condições sanitárias e de higiene precárias. O Piauí não faz parte do mapa da neurocisticercose no Brasil mas, como ilustra este estudo, apenas por falta de dados epidemiológicos. Demonstramos a presença desta patologia no Estado através do relato de caso de um homem de 39 anos, acompanhado por 17 meses. O diagnóstico foi realizado através de tomografia tomputadorizada de crânio (TC) e o paciente foi tratado com albendazol por 10 dias. Uma nova TC mostrou ausência de lesões. Ele precisou ser tratado novamente após recorrência do quadro clínico, ocorrida 6 meses após o primeiro tratamento, com posterior desaparecimento das novas lesões.
Variação estacional da mortalidade infantil no município do Salvador, BA, Brasil
Authors: Dias Célia Guimarães Netto
Published: August 2006

O movimento estacional da mortalidade infantil, neonatal, e pós-neonatal, por grupos de causas no município do Salvador, foi estudado a partir de uma revisão dos óbitos de crianças com menos de um ano de idade no período de 1962 a 1971. Os índices de variação estacional foram estimados utilizando-se o método dos relativos em cadeia ou método dos elos relativos. Os maiores índices estacionais da mortalidade infantil em Salvador ocorreu de um modo geral de fevereiro a julho, isto possivelmente devido às precárias condições de saneamento básico associados a uma maior precipitação pluviométrica neste período, sendo que os mínimos estacionais foram verificados de agosto a novembro.
Inquérito entre migrantes atendidos pela Central de Triagem e Encaminhamento, na capital do Estado de São Paulo, Brasil: I. Aspectos demográficos
Authors: Roncada Maria José
Published: August 2006

São descritos os aspectos demográficos de uma pesquisa sobre hipovitaminose A, realizada entre migrantes nacionais que passaram pela Central de Triagem e Encaminhamento (CETREN), na Capital do Estado de São Paulo, Brasil. Entre 1.097 indivíduos entrevistados, oriundos de todas as Regiões do país, de 15 a 60 anos de idade, cerca de dois terços eram do sexo masculino. A idade modal foi 22 anos. Foi apurada a procedência imediata e remota, originando resultados que mostraram ser os Estados de Minas Gerais, Bahia e Pernambuco, zonas de repulsão de populações, atuando os Estados de São Paulo (Capital e interior) e Paraná como áreas de atração. Dentre os motivos apontados para o deslocamento atual, 45,3% referiram-se a atividades primárias (trabalho em lavoura).
Absenteísmo por doença em mulheres
Authors: Nogueira Diogo Pupo , Laurenti Ruy
Published: August 2006

Procurando verificar no Brasil a veracidade da afirmativa de que trabalhadores do sexo feminino apresentam absenteísmo por doença muito superior ao do sexo masculino, foi feito um estudo, durante um período de 3 anos, de um grupo de trabalhadores têxteis, dos quais 43,8% eram do sexo masculino e 56,2% do feminino, observando-se o coeficiente de freqüência, o coeficiente de gravidade e a duração média das ausências dos trabalhadores masculinos e dos femininos. Nestes foram estudadas as ausências por quaisquer doenças, exceto ginecopatias, e as ausências apenas por ginecopatias. Foi verificado que o coeficiente de freqüência médio dos homens foi de 2,67 e das mulheres de 2,88 e 0,072; o coeficiente de gravidade foi, respectivamente, de 9,35 e de 8,56 e 0,456. Quanto à duração média das ausências por período, os homens atingiram 3,49 e as mulheres 2,97 com exclusão das ginecopatias; estas, porém, implicavam valor médio de 6,32. Conclui-se que no grupo estudado o absenteísmo por doença masculino e feminino praticamente se equivalem, mas que as ausências ao trabalho por ginecopatias, não obstante sua freqüência e gravidade baixas, devem merecer a atenção médica pela duração média das ausências, por período, ser apreciavelmente elevada.
Produção de interferon ou substância semelhante em culturas EB3 inoculadas com soros humanos contendo antígeno Austrália
Authors: Candeias J. A. N.
Published: August 2006

Culturas de células EB3, quando inoculadas com soros humanos contendo antígeno Austrália, produzem interferon ou substância semelhante em títulos significativamente mais elevados do que as culturas controle, não inoculadas. As culturas de células EB3 inoculadas com soros humanos negativos para o antígeno Austrália comportam-se de modo idêntico às culturas controle, no que respeita aos títulos de interferon, ou substância semelhante. Sugere-se a possibilidade daquele efeito poder servir de indicador de uma possível interação entre as células EB3 e o antígeno Austrália.
Asbestose no Brasil: um risco ignorado
Authors: Nogueira Diogo Dupo , Certain Diógenes A. , Uesugui Setsuko Jo , Koga Rosa Kioko , Ribeiro Herval Pina
Published: August 2006

É descrito o caso de um trabalhador da indústria de cimento-amianto, portador de quadro de asbestose comprovado clínica, funcional e radialogicamente; trata-se do primeiro caso dessa pneumoconiose descrito na literatura médica brasileira. É chamada a atenção para a possibilidade de que casos dessa doença estejam passando desapercebidos no Brasil, onde é crescente a utilização do amianto pela indústria.
Avaliação preliminar do Serviço de Saúde Escolar da IX Região Administrativa, Rio de Janeiro: estudo da população coberta e análise operacional de um subprograma
Authors: Gaspar Eneida Duarte , Almeida Márcio José de , Taddei José Augusto A. C. , Ribeiro Eliana Cláudia O. , Pereira Sandra da Silva , Vilanova Maria Cristina T. , Cordeiro Hésio de Albuquerque , Souza Jeiel C. Ferreira de
Published: August 2006

Foi realizada uma avaliação preliminar do Serviço de Saúde Escolar da IX Região Administrativa do Estado do Rio de Janeiro, como resultado do convênio firmado entre o Instituto de Medicina Social da Universidade do Estado do Rio de Janeiro e a Secretaria de Saúde do Estado. Através de estudo do nível de saúde entre os escolares e da análise operacional do subprograma de Registro de Saúde, diagnosticaram-se elevados índices de morbidade e pequena proporção de crianças com assistência médica prévia, além de determinar-se a efetividade do programa e de identificar-se problemas no processo técnico-administrativo do Serviço. Dentre as conclusões destaca-se a necessidade de completar a avaliação do Serviço, através da determinação dos critérios de eficiência, eficácia e rendimento, tendo em vista o fornecimento de subsídios para as tarefas de planejamento e administração. É enfatizada a necessidade de ampliação das medidas integradoras dos serviços universitários com os serviços da comunidade, no sentido de fornecer aos primeiros as condições de realizar, através de prestação de serviços, uma formação dos recursos humanos de acordo com a situação de saúde da comunidade, e aos segundos a necessária implementação de novas técnicas e modelos de assistência.
Fatores de erros na mensuração da mortalidade infantil
Authors: Laurenti Ruy
Published: August 2006

Dentre os indicadores de saúde tradicionalmente utilizados a mortalidade infantil destaca-se como um dos mais importantes. Frequentemente é utilizada por profissionais de saúde pública na caracterização do nível de saúde e em avaliações de programas. Existem, porém, vários fatores de erros que afetam o seu valor e dentre esses são destacados: a definição dos nascidos vivos e sua aplicação na prática, o sub-registro de óbito e de nascimento, o registro do óbito por local de ocorrência, a definição de nascido vivo no ano e a declaração errada na idade. Existem também erros qualitativos que dizem respeito, principalmente, a declarações erradas da causa de morte. Vários desses fatores foram medidos para São Paulo.
Tétano e vacinação antitetânica: estudo na população urbana de Londrian (PR), Brasil
Authors: Baldy José Luís da Silveira , Landgraf Adelino , Queiroz Antonio Carlos de , Verenhitach Antonio , Verenhitach Hugo , Cattoni Agenor Mário , Magalhães Eli Villela de
Published: August 2006

Inquérito realizado em três grupos da população urbana de Londrina (PR), representados por 602 donas-de-casa, 464 colegiais e 778 universitários, com o objetivo de: determinar o número de vacinados contra o tétano; avaliar índices de conhecimento sobre o tétano, a vacina e o soro antitetânicos; correlacionar esses índices com algumas características de cada grupo da população estudada. Concluiu-se que conceitos incorretos e carência de informação quanto ao tétano e à vacina antitetânica prevalecem na população da zona urbana de Londrina (PR). Foi discutido o significado e a decorrência desses fatos afirmando-se que a morbidade do tétano, persistentemente elavada no Brasil, deve representar séria advertência para as autoridades de saúde pública em nosso país, com vista à reformulação dos programas de vacinação antitetânica e à revisão dos métodos de educação sanitária adotados na divulgação dessa doença e dos recursos científicos disponíveis para sua profilaxia.
Cadastramento bacteriológico antituberculose: estudo preliminar para sua implantação em uma comunidade do Estado de São Paulo (Brasil)
Authors: Arantes Gilberto Ribeiro , Trivellato Luiz Benjamin
Published: August 2006

Foi elaborada esta pesquisa para determinar a necessidade de se conhecer certas características da comunidade, antes de se implantar a busca de casos pelo cadastramento bacteriológico. Foram estudadas 30.885 pessoas residentes com 15 anos e mais de idade, que se matricularam no Centro de Saúde de Ribeirão Preto, SP (Brasil), durante 12 meses consecutivos. Houve boa aceitação do cadastramento embora tenha ocorrido uma significativa proporção de falsos assintomáticos. A incidência de doentes entre os sintomáticos examinados foi de 5,3% e a ocorrência de casos positivos apenas à cultura chegou a 35%. Estimou-se que a prevalência de sintomáticos respiratórios na população de referência seja no mínimo igual a 4,3%.
Um modelo de análise sócio-econômica: construção e resultados obtidos
Authors: Ferrante Vera Lúcia S. Botta , Vertuan Valdemar , Toledo Benedicto Egbert Correa de
Published: August 2006

Apresenta-se um modelo de análise sócio-econômica, construído com o objetivo de chegar a um escalonamento possível da posição de uma determinada população na estrutura da sociedade. Tal modelo foi construído a partir de um conjunto de indicadores previamente selecionados como os mais significativos para a avaliação do nível sócio-econômico da população amostrada. Pretendeu-se, com a construção desse modelo, mostrar a interferência de fenômenos de natureza sócio-econômica na ocorrência de determinados problemas bucais. A investigação mostrou a seguinte composição da população estudada: baixa inferior, 21,8%; baixa superior, 39,9%; média inferior, 26,6%; média superior, 9,1%; alta inferior, 1,7% e alta superior, 0,5%.
Characterization of the non-apparent clinical form in the initial phase of schistosomiasis mansoni
Authors: Rocha Manoel Otávio da Costa , Pedroso Enio Roberto Pietra , Neves Jayme , Rocha Roberto Sena , Greco Dirceu Bartolomeu , Lambertucci José Roberto , Rocha Regina Lunardi , Katz Naftale
Published: August 2006

In this paper the history of 115 recruits that had bathed simultaneously in streams contaminated with Schistosoma mansoni, during military maneuvers, is reported. Thirty four of the infected patients presented the initial phase of the infection diagnosed through epidemiologic, clinical and laboratorial parameters. Three out of the 34 patients did not reveal the clinical picture of the infection, thus being considered representatives of the non-apparent form of the disease. Differences between the intensity of blood eosinophilia, the area of immediate cutaneous reaction and the number of Schistosoma eggs eliminated in the stools proved not to be statistically significant (p>0.05) when the non-apparent and acute cases of schistosomiasis were compared. These cases actually may be considered evidences of the non-apparent form hitherto merely taken for granted in the literature.
Reduced schedule of human anti-rabies immunization with Fuenzalida & Palacios vaccine: additional data
Authors: Favoretto S.R. , Carrieri M.L. , Tino M.S. , Assis A. , Zanetti C.R. , Pereira O.A.C.
Published: August 2006

It was reevaluated a reduced schedule for anti-rabies post-exposure immunization with newborn mice nervous tissue vaccine (Fuenzalida 8c Palacios) in a group of 30 non exposed volunteers. The vaccine was administered by intramuscular injections on days zero, 2, 4, 16 and 27, in the deltoid area. Antibody levels were determinated by a simplified serum neutralization microtest on days zero, 16 and 37. On days 16 and 37 the antibody levels of the whole group was >0.5 IU/ml and >1.0 IU/ml, respectively. The cell mediated immunity was precociously detected (on day 4) by the delayed type hipersensitivity skin test. Our results show that this reduced schedule elicited an early and effective humoral and cellular immune response. However it is necessary other studies with larger groups of vaccinees in order to obtain definitive conclusion.
Antibodies against non-structural c100/3 and structural core antigen of hepatitis C virus (HCV) in hemodialysis patients
Authors: Yoshida C.F.T. , Takahashi Y. , Vanderborght B.O.M. , Rouzere C.D. , França M.S. , Takahashi C. , Takamizawa A. , Yoshida I. , Schatzmayr H.G.
Published: August 2006

Two groups of patients undergoing hemodialysis (HD) maintenance were evaluated for their antibody response to non-structural c100/3 protein and structural core protein of hepatitis C virus (HCV). Forty-six patients (Group 1) never presented liver abnormalities during HD treatment, while 52 patients (Group 2) had either current or prior liver enzyme elevations. Prevalence rates of 32.6% and 41.3% were found for anti-c100/3 and anti-HCV core antibodies, respectively, in patients with silent infections (Group 1). The rate of anti-c100/3 in patients of Group 2 was 71.15% and reached 86.5% for anti-HCV core antibodies. The recognition of anti-c100/3 and anti-core antibodies was significantly higher in Group 2 than in Group 1. A line immunoassay composed of structural and non-structural peptides was used as a confirmation assay. HBV infection, measured by the presence of anti-HBc antibodies, was observed in 39.8% of the patients. Six were HBsAg chronic carriers and 13 had naturally acquired anti-HBs antibodies. The duration of HD treatment was correlated with anti-HCV positivity. A high prevalence of 96.7% (Group 2) was found in patients who underwent more than 5 years of treatment. Our results suggest that anti-HCV core ELISA is more accurate for detecting HCV infection than anti-c100/3. Although the risk associated with the duration of HD treatment and blood transfusion was high, additional factors such as a significant non-transfusional spread of HCV seems to play a role as well. The identification of infective patients by more sensitive methods for HCV genome detection should help to control the transmission of HCV in the unit under study.
Esporotricose do gato doméstico (Felis catus): transmissão humana
Authors: Marques Silvio Alencar , Franco Sonia R.V.S. , Camargo Rosângela M. Pires de , Dias Lisette D. Figueiredo , Haddad Júnior Vidal , Fabris Viciany Erique
Published: August 2006

No presente trabalho relata-se caso de paciente, funcionário de hospital veterinário, infectado através de arranhadura de gato doméstico portador de esporotricose. Inquérito domiciliar junto aos proprietários do animal fonte de infecção, revelou dois outros casos presuntivos de esporotricose humana transmitida por gatos, e confirmou o diagnóstico, por cultivo do Sporotrix schenckii, em 3 gatos domésticos adicionais. A esporotricose felina caracteriza-se por lesões cutâneas ulceradas e tendência à disseminação sistêmica e evolução fatal. A transmissão intra e inter-espécie é facilitada pela exuberância de fungos nas lesões cutâneas de felinos infectados.
Epidemic dengue 4 in the Yucatán, México, 1984
Authors: Loroño Pino Maria Alba , Farfán Ale José Arturo , Rosado Paredes Elsy del Pilar , Kuno Goro , Gubler Duaue J.
Published: August 2006

An outbreak of dengue 4 occurred in the Yucatán, México in 1984. During the course of the outbreak, 538 of 5486 reported cases of dengue-like illness were studied; 200 were confirmed as dengue serologically and/or virologically. Dengue 4 virus was isolated from 34 patients and dengue 1 from one. Severe haemorrhagic symptoms were observed in 9 laboratory confirmed patients, including four deaths. Thus, the outbreak in Yucatán is the second dengue epidemic in the Americas after the Cuban epidemic in 1981 in which a number of patients suffered from haemorrhagic complications. It was notable that 5 of 9 hospitalized, severe cases were young adults and that only one met the WHO criteria of DHF, in contrast to primary pediatric nature of DHF in Southeast Asia. In this paper we describe clinical, serologic, and virologic studies conducted during the outbreak.
A prospective study with children whose mothers had dengue during pregnancy
Authors: Figueiredo Luiz Tadeu Moraes , Carlucci Rita Helena , Duarte Geraldo
Published: August 2006

Dengue congenital disease was not confirmed in 10 children whose mothers had the infection during pregnancy. The fetal sera presented anti-dengue IgG antibodies which progressively declined, and disappeared after 8 months. IgM antibodies to dengue were not observed in the sera. Other normal data suggesting the healthy state of the children included: absence of malformations, pregnancy time, Apgar index, weight, and placenta aspect
Bacterial agents isolated from cerebrospinal fluid of patients with Acquired Immunodeficiency Syndrome (AIDS) and neurological complications
Authors: Landgraf Ilka Maria , Palaci Moisés , Vieira Maria de Fátima Paiva , Ueki Sueli Yoko Mizuka , Martins Maria Conceição , Sato Daisy Nakamura , Ferrazoli Lucilaine , Telles Maria Alice Silva , Gorla Maria Cecília Outeiro , Vaz Tania Mara Ibelli , Lorenço Rosemarie , Marques Lilian Regina Macelloni
Published: August 2006

Cerebrospinal fluid (CSF) samples from 2083 patients with acquired immunodeficiency syndrome (AIDS) and neurological complications were bacteriologically examined during a period of 7 years (1984-1990). The percentage of patients who had at least one bacterial agent cultured from the CSF was 6.2%. Mycobacterium tuberculosis was the most frequently isolated agent (4.3%), followed by Mycobacterium avium complex or MAC (0.7%), Pseudomonas spp (0.5%), Enterobacter spp (0.4%), and Staphylococcus aureus (0.3%). Among 130 culture positive patients, 89 (68.5%) had M. tuberculosis and 15 (11.6%) had MAC. The frequency of bacterial isolations increased from 1988 (5.2%) to 1990 (7.2%), partly due to the increase in MAC isolations. Bacterial agents were more frequently isolated from patients in the age group 21-30 years and from women (p<0.05).
Anti-HCV related to HCV PCR and risk factors analysis in a blood donor population of Central Brazil
Authors: Martins R. M. B. , Vanderborght B. O. M. , Rouzere C. D. , Santana C. L. , Santos C. O. , Mori D. N. , Ferreira R. G. , Yoshida C. F. T.
Published: August 2006

Data concerning HCV infection in Central Brazil are rare. Upon testing 2,350 voluntary blood donors from this region, we found anti-HCV prevalence rates of 2.2% by a second generation ELISA and 1.4% after confirmation by a line immunoassay. Antibodies against core, NS4, and NS5 antigens of HCV were detected in 81.8%, 72.7%, and 57.5%, respectively, of the positive samples in the line immunoassay. HCV viremia was present in 76.6% of the anti-HCV-positive blood donors. A relation was observed between PCR positivity and serum reactivity in recognizing different HCV antigens in the line immunoassay. The majority of the positive donors had history of previous parenteral exposure. While the combination of ALT>50 IU/l and anti-HBc positivity do not appear to be good surrogate markers for HCV infection, the use of both ALT anti-HCV tests is indicated in the screening of Brazilian blood donors.
Chagas' infection in university students of Santa Cruz de la Sierra, Bolivia. A serologic-electrocardiographic study
Authors: Gianella A. , Von Poser B. , Zamora P.
Published: August 2006

In order to learn the prevalence of Chagas' infection among students from Santa Cruz de la Sierra's universities, a random sample of 372 new students was drawn. All participants have had electrocardiograms (EKG) and serologic analysis (IHAT). 64/372 (17.2%) had serologic evidence of Chagas' infection, and from those, 10/64 (15.6%) had some EKG alterations. Among students presenting negative serologic test, 31/308 (10.1%) had EKG alterations. There was no statistical association between Chagas' infection and EKG alterations (X2=1.67, p=0.2). There was a positive association between Chagas' infection and intraventricular conduction defects and this association was higher among the students of 19 years of age or less (O.R. 10.4, p<0.05).
Clinical-epidemiologic study of schistosomiasis mansoni in Ponte do Pasmado, a village in the municipality of Itinga, State of Minas Gerais, Brazil, 1992
Authors: Rodrigues Rogéria Nobre , Murta Cláudia , Teixeira Júnior Marcos Aurélio Cota , Cury Geraldo Cunha , Rocha Manoel Otávio da Costa
Published: August 2006

A clinical-epidemiologic study of schistosomiasis mansoni was conducted in the population of Ponte do Pasmado, a village in the municipality of Itinga, state of Minas Gerais, Brazil. Faecal Parasitology by the Kato-Katz method and clinical examination were performed in 93.8% and 82.8% of the local population, respectively. A socioeconomic survey was also made and the signs and symptoms presented by the patients were recorded, as well as their contacts with natural waters. The rate of Schistosoma mansoni infection was 50.3%; the peak of infection occurred during the second decade of life; there was a predominance of low egg counts in faeces (85.89% of positive patients eliminated less than 500 eggs per gram of faeces); the splenomegaly rate was 1.23%. When the risk factors for S. mansoni infection were studied, significant risks were detected in activities such as fetching water, washing dishes, bathing, and crossing streams.