Boletin de la Oficina Sanitaria Panamericana. Pan American Sanitary Bureau最新文献

A solid-phase enzyme immunoassay (ELISA) for measuring tetanus antitoxin activity in human serum is described; the assay is based on a combination of the indirect method and ultramicro analysis. This rapid test, which has the capacity to analyze 78 blood samples per reagent plate (at a volume of 10 microL of diluted serum per sample), is proposed as an alternative to the traditional mouse bioassay system based on the neutralization of a known dose of tetanus toxin. Results from both tests showed a high correlation in the lineal regression analysis (r = 0.99; CI95%: 0.985 to 0.993). It is recommended that the ultramicro ELISA assay be used in the field to evaluate tetanus toxoid vaccines and to identify hyperimmune plasmas suitable for producing antitetanus immunoglobulin.

The purpose of this study was to determine the polymorphism of insertion segment 6110 (IS6110) in strains of Mycobacterium tuberculosis isolated from Colombian patients as well as the current status of resistance to antituberculosis drugs in the department of Quindío, Colombia. To this end, a prospective study was performed with a consecutive sample of 59 patients who sought care at local health centers and hospitals in rural and urban areas of Quindío from March to July 1993. The patients in the sample had symptomatic pulmonary tuberculosis confirmed by bacteriologic inspection of sputum, with and without a history of treatment, and were participants in the Tuberculosis Control Program of the Sectional Health Institute of Quindío in Armenia, Colombia. Sputum cultures and drug sensitivity tests were done. Later, restriction fragment length polymorphisms (RFLP) of IS6110 were analyzed in accordance with the protocols of van Soolingen et al. (1992). Cases were classified by treatment history, applying the criteria of WHO (1991). The results showed 44 cultures positive for M. tuberculosis and one positive for M. africanum. Primary drug resistance was found in 4 of 42 cultures, or 9.5% (CI 95%: 0.6 to 18); 4.8% were resistant to isoniazid (INH) and 4.8% to isoniazid and streptomycin (INH-SM). Acquired resistance was found in two of three cultures, or 66% (to isoniazid, rifampicin, and streptomycin [INH-RM-SM] and to isoniazid, ethambutol, rifampicin, and streptomycin [INH-EMB-RM-SM]). In 27 strains submitted to RFLP analysis, the number of copies of IS6110 varied from 6 to 17. Similarity coefficients revealed five distinct groups.(ABSTRACT TRUNCATED AT 250 WORDS)

In 1994, the Visual Health Program of the State Social Enterprise, MetroSalud, created in 1991, accomplished its goal of performing complete optometric exams on all students 5-14 years of age (almost 350,000 children) enrolled in the public schools of Medellín and providing treatment to those children who needed it. In order to estimate the prevalence of visual disorders in this population group, a sample of 17,697 records from the Visual Health Program's database was selected randomly and analyzed. The sample represented 20% of the 88,485 children examined in 1993. The results indicated that 48% of the students in Medellín had refraction defects, which were slight in 8 out of 10 cases. The study also showed a 1.2% prevalence of amblyopia associated with more serious refraction defects, especially astigmatism. Rates of cataracts and glaucoma were 8.3 and 1.2 per 10,000, respectively.

Intrauterine growth retardation and low birthweight--factors that strongly influence the physical and mental development of a child--are in turn affected by the nutritional status of the mother during pregnancy and, to a certain extent, by her pregestational nutritional status. Pregnant adolescents constitute a high-risk group for nutritional problems because their own bodies are still growing. In order to examine the correlation between several variables related to body composition and nutritional status in a group of pregnant adolescents and certain indicators of neonatal development, a prospective longitudinal study was carried out in Valdivia, Chile, from September 1988 to May 1992. The study cohort was made up of 184 pairs consisting of mothers under 17 years of age who had attended a prenatal monitoring program and their newborns. The following groups of variables were tested for correlation: indicators of maternal body composition before pregnancy (pregestational weight recorded by the mother, height measured during the first visit to the program, and body mass index [pregestational weight/(height upon entering the program)]; indicators of maternal body composition during pregnancy (weight and body mass index upon entering the program and before giving birth, weekly weight gain, and total weight gain); and indicators of neonatal development (weight and length at birth, gestational age, and cranial perimeter). The weight of the mother before giving birth was statistically significantly correlated with the gestational age, length, weight, and cranial perimeter of the newborn. The body mass index prior to giving birth was weakly correlated with the weight and length of the newborn, and a significant direct correlation was also observed between the weight of the pregnant adolescent upon entering the program and the weight of her child at birth. No correlation was found between the indicators of fetal development and those of maternal pregestational body composition or nutritional status. These results show that interventions conducive to a good increase in maternal weight during pregnancy will help prevent a bad neonatal prognosis.

A study to determine what sources of information influence the prescription habits of Peruvian physicians, how those habits are modified by experience, and how appropriate the prescribed drug treatment is for certain common ailments was carried out from September 1991 to December 1992. A questionnaire was administered to 800 physicians in two urban fringe areas of Lima and Chimbote. Of those doctors, 184 had established practices and 309 were recent graduates. The questionnaire asked what sources of information determined prescribing behavior, what medicines were and were not indispensable in outpatient clinical practice, and what drug treatments were appropriate for iron deficiency anemia and lower urinary tract infections in women. The answers showed that knowledge acquired in medical school had little influence on the prescribing habits of either group of doctors. More than two-thirds stated that their principal source of pharmacologic information was the scientific literature: 69.9% of the practicing physicians and 79.9% of the recent graduates, with the difference between the groups being statistically significant (P < 0.01). The drugs that were indispensable in ambulatory practice were correctly identified by 28.8% of the physicians, while 28.9% correctly answered the question on what groups of drugs should not be prescribed. The differences between the two groups were not significant. On the other hand, 60% of the established physicians and 52% of the recent graduates gave the right answers to the questions on treatment of iron deficiency anemia and urinary tract infection, and there was no significant difference between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)