Base de dados : MedCarib Pesquisa : B01.150.900.649.801.400.112.400.400 [Categoria DeCS] Referências encontradas : 13299 [refinar] Mostrando: 1 .. 10   no formato [Longo]

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Id: 17384 Autor: Chadee Dave D(aut); Tilluckdharry, Clive C(aut); Maharaj, Paramanand(aut); Sinanan, C(aut). Título: Reactivation of plasmodium malariae infection in a Trinidadian man after neurosurgery Fonte: The New England journal of medicine;342(25):1924-1924, June 2000. Idioma: en. Resumo: Malaria often presents as an acute febrile illness with fever, headache, rigors, anemia, and splenomegaly. The only malaria parasite associated with cerebral complications, Plasmodium falciparum usually blocks cerebral capillaries because of its endothelial adhesiveness. Infections with P. marlariae can persist for decades and are associated with splenomegaly and the nephrotic syndrome but not with cerebral complications. We describe P. malariae infection that was reactivated after neurosurgery after decades of latency. Infections with P. malariae may be asymptomatic and can be reactivated decades after the initial infection. The epidemiologic significance of asymptomatic cases of P. malariae infection has been well documented during outbreaks in Trinidad and Tobago and Grenada. Most of the symptomatic cases were detected by microscopial analysis, whereas the asymptomatic cases were diagnosed with the use of immunofluorescence antibody assays. Subclinical infections in humans may serve as the source of the protozoa in mosquitoes. Consequently, it is recommended that a sensitive technique that is based on the polymerase chain reaction be used to screen persons for persistent malaria infections, especially those who live in regions where the disease was once common but has since been eradicated Responsável: TT5 - Médical Sciences Library TT5; W1, NE388

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Id: 17383 Autor: Zambelli-Weiner, April(aut); Ehrlich, Eva(aut); Stockton, Maria L(aut); Zhang, Shu(aut); Levett, Paul N(aut); Beaty, Terri H(aut); Barnes, Kathleen C(aut); Grant, Audrey V(aut). Título: Evaluation of the CD14/-260 polymorphism and house dust entotoxin exposure in the Barbados Asthma Genetics Study Fonte: The journal of allergy and clinical immunology;115(6):1203-1209, June 2005. tab. Idioma: en. Resumo: BACKGROUND: Both a functional promoter polymorphism in the gene encoding CD14 (C-260T) and exposure to endotoxin are believed to play key roles in modulating the immune response and expression of atopic disease. OBJECTIVE: We aimed to evaluate the role of the CD14 C-260T polymorphism in a population of African descent and to test for interaction between this genotype and house dust endotoxin (HDE) exposure on atopic phenotypes. METHODS: Asthmatic probands and their families were recruited as part of the Barbados Asthma Genetics Study. The C-260T polymorphism and two additional CD14 promoter markers (G-1461T, C-1721T) were genotyped. Endotoxin was measured in house dust samples. RESULTS: Using a Family-Based Association Test, the C-260T allele appeared to be protective against asthma (z=−2.444; P=.015) and asthma severity (z=−2.615; P=.009) under a recessive model. No significant associations were observed for the G-1461T and C-1721T markers both individually and in haplotypes. In a case-control analysis, the CD14 TT genotype was found to reduce risk of asthma compared with the CD14 CC/CT genotypes (odds ratio [OR], 0.26; 95% CI, 0.14-0.49) and was associated with lower asthma severity scores (P < .002). The TT genotype might protect against asthma for individuals with low HDE (OR, 0.09; 95% CI, 0.03-0.24), but may be a risk factor for individuals with high HDE (OR, 11.66; 95% CI, 1.03-131.7), suggesting a gene-environment interaction. CONCLUSION: These data suggest that the CD14-260 polymorphism may play a role in controlling risk to atopic disease and underscore the importance of incorporating key environmental exposures into studies of genetic risk factors. Responsável: TT5 - Médical Sciences Library TT5; W1, JO534S

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Id: 17380 Autor: Peter, Sebastian A(aut); Johnson, Rebecca(aut); Taylor, Charles(aut); Hanna, Andrea(aut); Roberts, Patrick(aut); McNeil, Percival(aut); Archer, Beverly(aut); SinQuee, Corrine(aut); Roberts, Paul(aut). Título: The incidence and prevalence of type-1 diabetes mellitus Fonte: Journal of the National Medical Association;97(2):250-252, Feb. 2005. ^atab. Idioma: en. Resumo: AIM: To determine the incidence, prevalence of type-1 diabetes mellitus (DM) and the presence of islet-cell antibodies (ICAs) in people of African ancestry in the Bahamas. METHOD: Hospital records of type-1 DM were reviewed. Seventeen consecutive patients had postmeal C-peptide and ICA determined. RESULTS: The incidence and prevalence of type-1 DM in the Bahamas were: incidence:- 10.1/100 000, age 0-14 years; and prevalence- 31/100 000, age 0-24 years. Only two out of 17 (11.8 per cent) patients had ICAs. CONCLUSION: Type -1 DM is common in children of African ancestry in the Bahamas. ICAs were absent in the majority of patients. Responsável: TT5 - Médical Sciences Library TT5; W1, JO941N

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Id: 17376 Autor: Morgan, Craig(aut); Mallett, Rosemarie(aut); Hutchinson, Gerard(aut); Bagalkote, Hemant(aut); Morgan, Kevin(aut); Fearon, Paul(aut); Dazzan, Paola(aut); Boydell, Jane(aut); McKenzie, Kwame(aut); Harrison, Glynn(aut); Murray, Robin(aut); Jones, Peter(aut); Craig, Tom(aut); Leff, Julian(aut). Título: Pathways to care and ethnicity. 2: Source of referral and help-seeking Fonte: The British journal of psychiatry;186:290-296, April 2005. ^atab. Idioma: en. Resumo: BACKGROUND: Previous research has found that AfricanûCaribbean and Black African patients are likely to come into contact with mental health services via more negative routes, when compared with White patients. We sought to investigate pathways to mental health care and ethnicityin a sample of patients with a first episode of psychosis drawn from two UK centres. METHOD: We included all White British, other White, AfricanûCaribbean and Black African patients with a first episode of psychosis who made contact with psychiatric services over a 2-year period and were living in defined areas. Clinical, socio-demographic and pathways to care data were collected from patients, relatives and case notes. RESULTS: Compared with White British patients, general practitioner referral was less frequent for both AfricanûCaribbean and Black African patients and referral by a criminal justice agency was more common. With the exception of criminal justice referrals for Black African patients, these findings remained significant after adjusting for potential confounders. CONCLUSIONS: These findings suggest that factors are operating during a first episode of psychosis to increase the risk that the pathway to care for Black patients will involve non-health professionals. Responsável: TT5 - Médical Sciences Library TT5; W1, BR616

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Id: 17375 Autor: Morgan, Craig(aut); Mallett, Rosemarie(aut); Hutchinson, Gerard(aut); Bagalkote, Hemant(aut); Morgan, Kevin(aut); Fearon, Paul(aut); Dazzan, Paola(aut); Boydell, Jane(aut); McKenzie, Kwame(aut); Harrison, Glynn(aut); Murray, Robin(aut); Jones, Peter(aut); Craig, Tom(aut); Leff, Julian(aut). Título: Pathways to care and ethnicity. 1: Sample characteristics and compulsory admission Fonte: The British journal of psychiatry;186:281-289, April 2005. ^atab. Idioma: en. Resumo: BACKGROUND: Many studies have found high levels of compulsory admission to psychiatric hospital in the UK among AfricanûCaribbean and Black African patients with a psychotic illness. AIMS: To establish whether AfricanûCaribbean and Black African ethnicity is associated with compulsory admission in an epidemiological sample of patients with a first episode of psychosis drawn from two UK centres. METHOD: All patients with a first episode of psychosis who made contact with psychiatric services over a 2-year period and were living in defined areas were included in the (ãSOP) study. For this analysis we included all White British, other White, AfricanûCaribbean and Black African patients from the ãSOP sampling frame. Clinical, socio-demographic and pathways to care data were collected from patients, relatives and case notes. RESULTS: AfricanûCaribbean patients were significantly more likely to be compulsorily admitted than White British patients, as were Black African patients. AfricanûCaribbean men were the most likely to be compulsorily admitted. CONCLUSION: These findings suggest that factors are operating at or prior to first presentation to increase the risk of compulsory admission among AfricanûCaribbean and Black African patients. Responsável: TT5 - Médical Sciences Library TT5; W1, BR616

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Id: 17374 Autor: Li, T. C(aut); Ramsewak, S. S(aut); Klentzeris, L(aut); Lenton, E. A(aut); Cooke, I. D(aut); Dockery, P(aut). Título: The variation of endometrial response to a standard hormone replacement therapy in women with premature ovarian failure. An ultrasonographic and histological study Fonte: British journal of obstetrics and gynaecology;98(7):656-661, July, 1991. graf. Idioma: en. Resumo: The endometrial response to a standard hormone replacement therapy in 18 women with premature ovarian failure was examined by serial ultrasonographic measurement of endometrial thickness and histological study of endometrial biopsy taken on day 19 of the cycle. Women with idiopathic ovarian failure (n = 10) had significantly better response than women with Turner's syndrome (n = 4), whereas women with premature ovarian failure associated with previous chemotherapy (n = 4) had an intermediate response. These observations suggest that the endometria of women with Turner's syndrome responded suboptimally to steroid hormones. However, all endometrial biopsies studied revealed secretory changes. Overall, the results of histological dating of endometrial biopsy were found to be positively correlated with endometrial thickness on day 19 of the cycle (r = 0.72, P < 0.01). The plasma concentration of oestradiol on days 15, 19 and 29 of the artificial cycle were found to be significantly higher than those on the corresponding days of the natural cycle. Responsável: TT5 - Médical Sciences Library TT5; W1, BR586

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Id: 17373 Autor: Balkaran, B. N(aut); Roberts, L. A(aut); Ramcharan, J(aut). Título: Systemic lupus erythematosus in Trinidadian children Fonte: Annals of tropical paediatrics;24(3):241-244, Sept. 2004. ^atab. Idioma: en. Resumo: Thirty-three children with a diagnosis of systemic lupus erythematosus (SLE) were studied. At diagnosis, 29 of them (88%) were aged between 10 and 17 years and the other four (12%) between 5 and 9 years. The majority were girls (28, 82%) and the male:female ratio was 1:6.6. Children of East Indian and mixed racial origin formed the largest groups (37 and 39%, respectively) and mortality was higher in these two groups. The most common symptoms at diagnosis were: fever for > 1 week (75.8%), musculoskeletal symptoms (arthralgia, arthritis and myalgia (69.7%) and renal involvement (63.6%). Malar and discoid rashes were common, 39 and 37%, respectively. Central nervous system involvement at presentation was a rare but important cause of mortality. The mortality rate during follow-up was high at 39.3% and the commonest cause of death was renal failure. Childhood SLE is uncommon in Trinidad and Tobago. Diagnosis is often delayed because of the protean and non-specific manifestations. This study reports a higher prevalence, a more severe course and greater mortality in children of East Indian and mixed descent than in children of African origin. It also shows that the symptomatology at first presentation is consistent with other studies and should be recognised early. Early diagnosis and prompt and appropriate management are essential in order to reduce the high mortality still associated with SLE. Responsável: TT5 - Médical Sciences Library TT5; W1, AN627U

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Id: 17372 Autor: Bhowmik, A (aut); Seemungal, T. A. R (aut); Donaldson, G. C (aut); Wedzicha, J. A (aut). Título: Effects of exacerbations and seasonality on exhaled nitric oxide in COPD Fonte: European respiratory journal;26(6):1009-1015, Dec. 2005. graf. Idioma: en. Resumo: Exhaled nitric oxide (eNO) appears to be associated with airway inflammation seen in chronic obstructive pulmonary disease (COPD). The present authors studied the effects of exacerbation, season, temperature and pollution on eNO. eNO was measured seasonally and at exacerbations in 79 outpatients suffering from COPD (mean forced expiratory volume in one second = 42%). The effects of exacerbation symptoms, physiological and environmental parameters were analysed. Stable eNO levels were correlated positively with arterial oxygen tension. Median levels were found to be lower in smokers (5.3 ppb) than in ex- or nonsmokers (6.8 ppb). Levels were higher during October to December (6.9 ppb) than in April to June (4.6 ppb). Levels were also higher during 68 exacerbations in 38 patients (7.4 ppb) than in stable conditions (5.4 ppb), independent of the effects of smoking. The rise in eNO was greater in exacerbations that were associated with colds, a sore throat or dyspnoea combined with a cold. In conclusion, exhaled nitric oxide levels were higher in colder weather and in the autumn, perhaps related to the increased prevalence of viral infection at this time of year. The levels were lower in more severe chronic obstructive pulmonary disease. Exhaled nitric oxide levels were raised at the onset of exacerbation, particularly in the presence of a cold. Responsável: TT5 - Médical Sciences Library TT5; W1, EU727K

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Id: 17370 Autor: World Health Organization. Título: AIDS epidemic update 2007. Fonte: Geneva; United Nations Program on HIV/AIDS and World Health Organization; Dec. 2007. 50 p. ilus. Idioma: en. Resumo: In 2007, advances in the methodology of estimations of HIV epidemics applied to an expanded range of country data have resulted in substantial changes in estimates of numbers of persons living with HIV worldwide. Because estimates of new HIV infections and HIV-associated deaths are derived through mathematical models applied to HIV prevalence estimates, new estimates of HIV incidence and mortality in 2007 also differ substantially from earlier assessments. The AIDS epidemic update reports on the latest developments in the global AIDS epidemic and has been published annually since 1998. The 2007 edition provides the most recent estimates of the epidemicÆs scope and human toll and explores new trends in the epidemicÆs evolution. The major elements of methodological improvements in 2007 included greater understanding of HIV epidemiology through population-based surveys, extension of sentinel surveillance to more sites in relevant countries, and adjustments to mathematical models because of better understanding of the natural history of untreated HIV infection in low- and middle- income countries. These adjustments to the methodology used are explained in more detail in the box ôNew data lead to changes in assumptions and improved estimates.ö Responsável: TT5 - Médical Sciences Library TT5; WC 503.41, A288, 2007

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Id: 17359 Autor: Partridge, Robert(aut); Proano, Lawrence(aut); Skarbek-Borowski, George(aut); Bouslough, David(aut); Cohen, Scott(aut). Título: Emergency medical training for health promoters in Central and South America Fonte: Rev. panam. salud ptionblica;22(6):425-431, Dec. 2007. ^ailus. Idioma: en. Resumo: Underserved regions in the developing world are challenging areas to provide emergency medical care. As populations in these often remote or isolated districts may have minimal access to regular health care, contacts with medical providers are frequently episodic and driven by an acute condition. Health promotersùpractitioners who provide basic medical care and promote public health in numerous countries across Central and South America, Asia and Africaùhelp to fill this void. Typically, health promoters are certified through a formal training program in their country and come from the same population as the clients they serve, which helps them form a link between their community and the dominant health care system in the region (1-2). Access to health and social services in regions served by health promoters is usually minimal, resulting in high morbidity and mortality associated with preventable diseases. Health promoters strive to improve the overall health of these communities by supplementing and improving the curative, preventive, and promotional aspects of the existing health system. Responsável: TT5 - Médical Sciences Library TT5; W1, RE712AW

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