To evaluate the possible effects of the introduction of the pneumococcal conjugate 10-valent vaccine schedule in the state of Parana on pneumococcal meningitis cases and to assess the distribution of ...serotypes among cases.
Cross-sectional study with retrospective data collection of cases of pneumococcal meningitis in the state of Paraná reported to Sistema de Informação de Agravos de Notificação (SINAN), from 1998 to 2011. A total of 1,339 cases of pneumococcal meningitis were analyzed; 1,205 cases from the pre-vaccine period (1998-2009) were compared to 134 cases from the post-vaccine period (2010-2011). Descriptive and comparative statistical analyses (chi-squared test and prevalence ratio) were performed using JMP 5.1.2 statistical software (JMP Statistical Discovery, North Carolina, USA) and EPI INFO 6 (Centers for Disease Control and Prevention, Georgia, EUA).
There was a significant reduction in the mean rates of incidence and mortality in the general population. The analysis of cases in the pre- and post-vaccination periods in the age groups covered by vaccination (younger than 2 years) showed significant reductions in incidence rates (6.01 cases/100,000 to 2.49 cases/100,000 individuals) and mortality (1.85 cases/100,000 population to 0.47 cases/100,000 population), while the mean lethality rate did not change significantly. There was a significant reduction in cases whose serotypes are included in the vaccine (80.7% to 53.3%).
Even after a short time of use, the 10-valent pneumococcal conjugate vaccine has already had a significant impact in reducing the incidence and mortality of meningitis cases among infants, as well as the reduction of cases whose serotypes are included in the vaccine.
Avaliar os possíveis efeitos da introdução da vacina pneumocócica conjugada 10 valente no calendário vacinal no Paraná sobre os casos de meningite pneumocócica; avaliar a distribuição dos sorotipos dentre os casos.
Estudo observacional, transversal, com coleta de dados retrospectiva dos casos de meningite pneumocócica no Estado do Paraná, notificados ao SINAN, no período de 1998 a 2011. Foram analisados 1339 casos de meningite pneumocócica e comparados os 1205 casos do período pré-vacina (1998 a 2009) com os 134 do período pós-vacina (2010 a 2011). A análise estatística descritiva e comparativa (teste qui-quadrado e razão de prevalência) foi realizada no software de estatística JMP 5.1.2 (JMP Statistical Discovery, Carolina do Norte, EUA) e no Programa EPI INFO 6.
Observou-se redução significativa das taxas médias de incidência e mortalidade na população geral. A análise dos casos nos períodos pré e pós-vacina nas faixas etárias contempladas pela vacinação (menores de 2 anos) mostrou reduções significativas das taxas de incidência (6,01 casos/100.000 para 2,49 casos/100.000 habitantes), mortalidade (1,85 casos/100.000 habitantes para 0,47 casos/100.000 habitantes), enquanto que a letalidade média não apresentou variação significativa. Houve redução significativa dos casos cujos sorotipos estão incluídos na vacina (80,7% para 53,3%).
Mesmo com um tempo reduzido de uso, a vacina pneumocócica conjugada 10 valente já apresentou um impacto relevante na diminuição dos coeficientes de incidência e mortalidade dos casos de meningite entre os lactentes, além de redução de casos cujos sorotipos estão incluídos na vacina.
In some Amazonian river basins, hair mercury concentration is above the recommended levels. We evaluated the influence of birth geographical location in the hair mercury level of Amazonian riverine ...children.
Hair mercury concentration was measured in 219 children living in four Amazonian riverine communities: Tapajós River (São Luiz do Tapajós and Barreiras villages, n = 110), Tocantins River (Limoeiro do Ajurú village, n = 61), and Caeté River (Caratateua village, n = 48). We used Poisson regression analysis to evaluate the association between native and non-native children from each village and its hair mercury concentration.
Higher mercury exposure was found in native children from São Luiz do Tapajós (range = 0.81-22.38 µg/g) followed by native children from Barreiras (range = 0.48-13.46 µg/g), non-native children from São Luiz do Tapajós (range = 0.26-22.18 µg/g), non-native children from Barreiras (range = 0.43-20.76 µg/g), followed by the children from Caeté and Tocantins river basins. We observed that Tapajós villages' native children had higher prevalence of mercury exposure children than other children (p < 0.05).
Birth geographical location has association to mercury levels in the hair of children who lived in a same community with history of mercury exposure.
This study evaluates the performance of individual and combinations tests used for pediatric tuberculosis diagnosis at a reference center.
Diagnostic test outcomes from children with presumed ...pulmonary tuberculosis evaluated from January 2005 - July 2010 were compared to a standard diagnosis made by an expert panel of physicians.
Presence of at least one sign/symptom, history of contact, or abnormal chest X-ray (aCXR) individually showed the highest sensitivity (85.7%). While the combination of history of contact, at least one sign/symptom, positive tuberculin skin test, and aCXR had low sensitivity of 20%, but the specificity and a positive predictive value were 100%, respectively. The combination of tests used in the International Union Against Tuberculosis and Lung Disease and the Brazilian Ministry of Health systems showed sensitivity of 28.6% and 71.4% and specificity of 95.8% and 97.0%, respectively.
In the absence of a gold standard, the combination of clinical history, tuberculin skin test, and aCXR, as well as the Brazilian scoring system serve as simple, low-cost approach that can be used for pediatric TB diagnosis by first-contact care providers.
Fabry disease is an X-linked inborn error of glycosphingolipid catabolism due to deficient activity of α-galactosidase A that leads to accumulation of the enzyme substrates, mainly ...globotriaosylceramide (Gb3), in body fluids and lysosomes of many cell types. Some pathophysiology hypotheses are intimately linked to reactive species production and inflammation, but until this moment there is no
in vivo study about it. Hence, the aim of this study was to investigate oxidative stress parameters, pro-inflammatory cytokines and Gb3 levels in Fabry patients under treatment with enzyme replacement therapy (ERT) and finally to establish a possible relation between them. We analyzed urine and blood samples of patients under ERT (n
=
14) and healthy age-matched controls (n
=
14). Patients presented decreased levels of antioxidant defenses, assessed by reduced glutathione (GSH), glutathione peroxidase (GPx) activity and increased superoxide dismutase/catalase (SOD/CAT) ratio in erythrocytes. Concerning to the damage to biomolecules (lipids and proteins), we found that plasma levels of malondialdehyde (MDA) and protein carbonyl groups and di-tyrosine (di-Tyr) in urine were increased in patients. The pro-inflammatory cytokines IL-6 and TNF-α were also increased in patients. Urinary Gb3 levels were positively correlated with the plasma levels of IL-6, carbonyl groups and MDA. IL-6 levels were directly correlated with di-Tyr and inversely correlated with GPx activity. This data suggest that pro-inflammatory and pro-oxidant states occur, are correlated and seem to be induced by Gb3 in Fabry patients.
► We tested urine and blood samples of treated Fabry patients and compared to controls. ► Patients presented higher levels of pro-inflammatory and pro-oxidant biomarkers. ► Oxidative stress and inflammation were directly correlated with globotriaosylceramide. ► Globotriaosylceramide accumulated seems to induce these findings
in vivo.
Fusarium oxysporum has been described as a pathogen causing onychomycosis, its incidence has been increasing in immunocompetent and disseminated infection can occur in immunosuppressed individuals. ...We describe the first case of congenital onychomycosis in a child caused by Fusarium oxysporum. The infection being acquired in utero was proven by molecular methods with the identification of the fungus both in the nail and placenta, most probably as an ascending contamination/infection in a HIV-positive, immunosuppressed mother.
Luminance contrast sensitivity and colour vision are considered to have great predictive value in the evaluation of type 2 diabetic retinopathy. However, these two visual characteristics have seldom ...been investigated in the same group of patients. In the present study we measured contrast sensitivity and colour vision in a group of patients with type 2 diabetes and correlated the results with estimates of common metabolic markers for the disease. A subgroup of the patients had no clinical signs of retinopathy.
The vision of 27 patients (n = 50 eyes) with type 2 diabetes, with retinopathy (n = 20 eyes), or without retinopathy (n = 30 eyes) were evaluated using two psychophysical tests, the Farnsworth-Munsell 100 hue test (FM 100), and measurements of the luminance contrast sensitivity at 11 spatial frequencies. The results were compared with measurements obtained from an age-matched control group (n = 32), and were correlated with the level of glycated haemoglobin, glycaemic level, and time of disease onset. Signs of retinopathy were identified during the ophthalmological examinations.
Contrast sensitivity and colour vision impairments were present at different levels in diabetes patients. Eyes with retinopathy showed more severe vision loss than eyes without retinopathy. The FM 100 test was more sensitive for separation of patients from controls. Colour vision loss had no colour axes preference. The contrast sensitivity test appeared to have some advantage in differentiating patients with retinopathy from patients without retinopathy.
Both methods can be useful to follow the visual function of diabetic patients and should be used together to discriminate patients from controls, as well as to identify early signs of retinal damage.
Venous Leg Ulcers and Emotional Consequences Souza Nogueira, Graziela; Rodrigues Zanin, Carla; Miyazaki, Maria Cristina O. S. ...
International journal of lower extremity wounds,
12/2009, Letnik:
8, Številka:
4
Journal Article
Recenzirano
Venous leg ulcers are a chronic disease that affects populations around the world. For sufferers, it leads to physical, social, economic, and emotional consequences. The aim of this study was to ...assess the presence of anxiety and depression, as well as to investigate possible associations with sociodemographic variables. A total of 30 patients, both men and women, with venous ulcers receiving care under outpatient treatment in a teaching hospital of a provincial city of São Paulo State, were included in this study. The evaluation tools used were the following: the Hospital Anxiety and Depression Scale (HADS) and a sociodemographic questionnaire that included job status, religion, marital status, gender, duration of disease, and age. A descriptive analysis of the data was performed. Statistical analysis used means, the Student t test, and the χ 2 test. Anxiety was identified in 30% of the patients and depression in 40%. No statistically significant correlation was found between anxiety or depression and the sociodemographic variables. Patients with chronic venous ulcers may present with anxiety and depression independent of socioeconomic variables such as religion, occupation, marital status, and duration of lesion.
The administration of lipopolysaccharide (LPS) to experimental animals results in a septic shock-like syndrome characterized by hypotension, and the hemodynamic management includes the restoration of ...adequate tissue perfusion by administration of resuscitation fluids to achieve an effective circulating volume. In the present study, we sought to investigate the effects of hypertonic saline solution administration on vasopressin secretion and mean arterial pressure in endotoxic shock. The pressor response to isotonic saline solution (0.9% sodium chloride) or hypertonic saline (7.5% sodium chloride, 4 mL/kg i.v.) was evaluated 4 h after LPS (1.5 mg/kg) administration. At this moment, plasma vasopressin did not differ from control; however, the blood pressure was lower in the LPS-treated group. The hypertonic saline administration was followed by an immediate recovery of blood pressure and also by an increase in plasma vasopressin levels compared with isotonic saline solution. The vasopressin V1 receptor antagonist (10 microg/kg, i.v., 5 min before infusion) blocked the pressor response to hypertonic saline solution. These data suggest that the recovery of blood pressure after hypertonic saline solution administration during endotoxic shock is mediated by vasopressin secretion.
To evaluate the possible effects of the introduction of the pneumococcal conjugate 10‐valent vaccine schedule in the state of Parana on pneumococcal meningitis cases and to assess the distribution of ...serotypes among cases.
Cross‐sectional study with retrospective data collection of cases of pneumococcal meningitis in the state of Paraná reported to Sistema de Informação de Agravos de Notificação (SINAN), from 1998 to 2011. A total of 1,339 cases of pneumococcal meningitis were analyzed; 1,205 cases from the pre‐vaccine period (1998‐2009) were compared to 134 cases from the post‐vaccine period (2010‐2011). Descriptive and comparative statistical analyses (chi‐squared test and prevalence ratio) were performed using JMP 5.1.2 statistical software (JMP Statistical Discovery, North Carolina, USA) and EPI INFO 6 (Centers for Disease Control and Prevention, Georgia, EUA).
There was a significant reduction in the mean rates of incidence and mortality in the general population. The analysis of cases in the pre‐ and post‐vaccination periods in the age groups covered by vaccination (younger than 2 years) showed significant reductions in incidence rates (6.01 cases/100,000 to 2.49 cases/100,000 individuals) and mortality (1.85 cases/100,000 population to 0.47 cases/100,000 population), while the mean lethality rate did not change significantly. There was a significant reduction in cases whose serotypes are included in the vaccine (80.7% to 53.3%).
Even after a short time of use, the 10‐valent pneumococcal conjugate vaccine has already had a significant impact in reducing the incidence and mortality of meningitis cases among infants, as well as the reduction of cases whose serotypes are included in the vaccine.
Avaliar os possíveis efeitos da introdução da vacina pneumocócica conjugada 10 valente no calendário vacinal no Paraná sobre os casos de meningite pneumocócica; avaliar a distribuição dos sorotipos dentre os casos.
Estudo observacional, transversal, com coleta de dados retrospectiva dos casos de meningite pneumocócica no Estado do Paraná, notificados ao SINAN, no período de 1998 a 2011. Foram analisados 1339 casos de meningite pneumocócica e comparados os 1205 casos do período pré‐vacina (1998 a 2009) com os 134 do período pós‐vacina (2010 a 2011). A análise estatística descritiva e comparativa (teste qui‐quadrado e razão de prevalência) foi realizada no software de estatística JMP 5.1.2 (JMP Statistical Discovery, Carolina do Norte, EUA) e no Programa EPI INFO 6.
Observou‐se redução significativa das taxas médias de incidência e mortalidade na população geral. A análise dos casos nos períodos pré e pós‐vacina nas faixas etárias contempladas pela vacinação (menores de 2 anos) mostrou reduções significativas das taxas de incidência (6,01 casos/100.000 para 2,49 casos/100.000 habitantes), mortalidade (1,85 casos/100.000 habitantes para 0,47 casos/100.000 habitantes), enquanto que a letalidade média não apresentou variação significativa. Houve redução significativa dos casos cujos sorotipos estão incluídos na vacina (80,7% para 53,3%).
Mesmo com um tempo reduzido de uso, a vacina pneumocócica conjugada 10 valente já apresentou um impacto relevante na diminuição dos coeficientes de incidência e mortalidade dos casos de meningite entre os lactentes, além de redução de casos cujos sorotipos estão incluídos na vacina.
OBJECTIVES: To evaluate the possible effects of the introduction of the pneumococcal conjugate 10-valent vaccine schedule in the state of Parana on pneumococcal meningitis cases and to assess the ...distribution of serotypes among cases. METHOD: Cross-sectional study with retrospective data collection of cases of pneumococcal meningitis in the state of Paraná reported to Sistema de Informação de Agravos de Notificação (SINAN), from 1998 to 2011. A total of 1,339 cases of pneumococcal meningitis were analyzed; 1,205 cases from the pre-vaccine period (1998-2009) were compared to 134 cases from the post-vaccine period (2010-2011). Descriptive and comparative statistical analyses (chi-squared test and prevalence ratio) were performed using JMP 5.1.2 statistical software (JMP Statistical Discovery, North Carolina, USA) and EPI INFO 6 (Centers for Disease Control and Prevention, Georgia, EUA). RESULTS: There was a significant reduction in the mean rates of incidence and mortality in the general population. The analysis of cases in the pre- and post-vaccination periods in the age groups covered by vaccination (younger than 2 years) showed significant reductions in incidence rates (6.01 cases/100,000 to 2.49 cases/100,000 individuals) and mortality (1.85 cases/100,000 population to 0.47 cases/100,000 population), while the mean lethality rate did not change significantly. There was a significant reduction in cases whose serotypes are included in the vaccine (80.7% to 53.3%). CONCLUSION: Even after a short time of use, the 10-valent pneumococcal conjugate vaccine has already had a significant impact in reducing the incidence and mortality of meningitis cases among infants, as well as the reduction of cases whose serotypes are included in the vaccine.
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