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Id: 17305 Autor: Daisley H; Alexander D; Pitt-Miller, P. Título: Acute myocarditis following Tityus trinitatis envenoming: morphological and pathophysiological characteristics Fonte: Toxicon;37(1):159-165, January 1999. ilus. Idioma: En. Resumo: The clinicopathological features of four cases of scorpion envenoming by Tityus trinitatis are presented. The cardiac histopahtology is recorded in the two fatal cases. The pathology of the acute myocarditis was a mixed picture of a toxic myocarditis and coagulative myocytolysis. These cardiac lesions are also seen in catecholamine induced cardiotoxicity and lend support to the theory that an adrenergic surge follows scorpion envenoming. A brief review of scorpion envenoming syndrome is undertaken in the light of these findings (AU) Responsável: TT5 - Médical Sciences Library TT5; W1 TO95J

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Id: 17280 Autor: Perry, Henry B; Ross, Allen G; Fernand, Facile. Título: Assessing the causes of under-five mortality in the Albert Schwitzer Hospital service area of rural Haiti Fonte: Rev. panam. salud pública = Pan am. j. public health;18(3):178-186, Sept. 2005. maps, tab, gra. Idioma: En. Resumo: OBJECTIVES: Limited information is available regarding the causes of under-five mortality in nearly all of the countries in which mortality is the highest. The purpose of this study was to use a standard computerized protocol for defining the leading causes of death among children in a high-mortality rural population of Haiti and to highlight the need for similar studies elsewhere in Haiti and throughout the high-mortality areas of Latin America and the Caribbean. METHODS: In 2001 a standardized, closed-ended verbal autopsy questionnaire endorsed by the World Health Organization was administered to a representative, population-based sample of the mothers or other caregivers of 97 children who had died before reaching 5 years of age between 1995 and 1999 in the service area of the Albert Schweitzer Hospital, which is located in the rurual Artibonite Valley of Haiti.With the data from the questionnaires we used a computerized algorithm to generate diagnoses of the causes of death; the algorithm made it pssible to have more than one cause of death. RESULTS: Acute lower respiratory infection (ALRI) was the leading diagnosis, present in 45 percent of all under-five deaths, followed by enteric diseases, present in 21 percent of deaths. Neonatal tetanus, preterm birth, and other early neonatal causes unassociated with ALRI or diarrhea were present in 41 percent of the neonatal deaths. Among children 1-59 months of age, ALRI were present in 51 percent of the deaths, and enteric diseases in 30 percent. Deaths were concentrated during the first few months of life, with 35 percent ocurring during the first month. Among the neonatal deaths, 27 percent occurred on the first day of life, and 80 percent occurred during the first 10 days of life. CONCLUSIONS: In the Albert Schweitzer Hospital program area - and presumably in the areas of Haiti as well - priority needs to be given to the prevention of and the early, effective treatment of ALRI, diarrhea, and early neonatal conditions. This study points to the needs for more, similar standardized assessments to guide local, regional and national programs(AU) Responsável: TT5 - Médical Sciences Library TT5; W1 RE712AW

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Id: 17081 Autor: Perry, Henry B; Ross, Allen G; Fernand, Facile. Título: Assessing the causes of under-five mortality in the Albert Schweitzer Hospital service area of rural Haiti Fonte: Rev. panam. salud pública = Pan am. j. public health;18(3):178-186, Sept. 2005. maps, tab, gra. Idioma: En. Resumo: OBJECTIVES. Limited information is available regarding the causes of under-five mortality in nearly all countries in which mortality is the highest. The purpose of this study was to use a standard computerized protocol for defining the leading cause of death among children in a high-mortality rural population of Haiti and to highlight the need for similar studies elsewhere in Haiti and throughout the high-mortality areas of Latin America and the Caribbean. METHODS. In 2001 a standardized, closed-ended verbal autopsy questionnaire endorsed by the World Health Organization was administered to a representative, population-based sample of the mothers or other caregivers of 97 children who had died before reaching 5 years of age between 1995 and 1999 in the service area of the Albert Schweitzer Hospital, which is located in the rural Artibonite Valley of Haiti. With the data from the questionnaires we used a computerized algorithm to generate diagnoses of the cause of death; the algorithm made it possible to have more than one cause death. RESULTS. Acute lower respiratory infection (ALRI) was the leading diagnosis, present in 45 percent of all under-five deaths, followed by enteric diseases, present in 21 percent of deaths. Neonatal tetanus, preterm birth, and other early neonatal causes unassociated with ALRI or diarrhea were present in 41 percent of the neonatal deaths. Among children 1-59 months of age, ALRI was present in 51 percent of the deaths, and enteric diseases in 30 percent. Deaths were concentrated during the first few months of life, with 35 percent occuring during the first month. Among the neonatal deaths, 27 percent occurred on the first day of life and 80 percent occured during the first 10 days of life. CONCLUSIONS. In the Albert Schweitzer Hospital program area - and presumably in other areas of Haiti as well - priority needs to be given to the prevention of and early, effective treatment of ALRI, diarrhea, and early neonatal conditions. This study points to the need for more, similar standardized assessments to guide local, regional, and national programs (AU) Responsável: TT5 - Médical Sciences Library TT5; W1 RE712AW

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Id: 16993 Autor: Bachrach, Lela Rose; Meeks Gardner, Julie. Título: Caregiver knowledge, attitudes, and practices regarding childhood diarrhea and dehydration in Kingston, Jamaica Idioma: En. Resumo: Objective. To study the knowledge, attitudes, and practices of caregivers in Kingston, Jamaica, regarding childhood diarrhea and dehydration in order to determine if limited caregiver knowledge about the prevention and treatment of diarrhea and dehydration puts children at increased risk of presenting at the hospital for these concerns. Methods. The study was an observational case-control study conducted between February 1997 and May 1997 at the Bustamante Hospital for Children in Kingston. Convenience sampling was used and data were collected by face-to-face interviews with two groups of caregivers of children under 5 years of age. One group (n=117) presented with children with acute gastroenteritis, and the other group (n=98) presented with acute concerns unrelated to gastroenteritis. While 197 of the 215 caregivers interviewed were the mother of a child, there were also 9 guardians, 5 fathers, and 4 grandmothers in the sample. Results. The mean caregiver age, level of education, and socioeconomic status were similiar for the two groups. The caregivers in the gastroenteritis group were more likely to present with younger children and to have less convenient access to running water or a refrigerator. Children of caregivers who had never heard of oral rehydration therapy were at increased risk of presenting with gastroenteritis and dehydration (odds ratio [OR], 4.6; 95 percent confidence interval [CI], 1.8-11.7), as were children of caregivers with low knowledge scores about the prevention and treatment of diarrhea and dehydration (OR, 3.7; 95 percent CI, 1.6-8.8). Another independent risk factor was a caregiver's poor sense of self-reliance in managing a child's diarrhea (OR, 2.3; 95 percent CI, 1.1-4.9). Conclusions. These findings highlight a need to enhance educational efforts that will empower caregivers to protect their children from diarrhea-associated morbidity and mortality (AU) Responsável: TT5 - Médical Sciences Library

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Id: 16981 Autor: Martin, Thomas C; Brinkman, William. Título: The spectrum of accidental childhood poisoning in the Caribbean Fonte: Rev. panam. salud publica = Pan am. j. public health;12(5):313-316, Nov. 2002. tab. Idioma: En. Resumo: Objective. To assess accidental poisoning in children in the Caribbean country of Antigua and Barbuda, including the incidence, the types of substances ingested, the age of the children involved, and the clinical outcomes. The results from Antigua and Barbuda were compared with results of other reports from the English-speaking Caribbean and from the United States of America. Design and Methods. We performed a retrospective review of the charts of all patients less than 13 years old admitted to the Children's Ward at Holbertson Hospital in Antigua for accidental poisoning between March 1989 and March 1999. Those data were compared with data from earlier reports from Barbados, Guyana, Jamaica, and the United States of America. Results. In Antigua and Barbuda there were 255 hospital admissions for accidental poisoning among children below 13 years old over that 10-year period. Of the 255 ingestions, 115 of them (45 percent) were in 1-year-old children, 69 (27 percent) were in 2-year-old children, and 26 (10 percent) were in 3-year-old children. These proportions in Antigua and Barbuda are similiar to the age patterns seen in the other countries with which we made comparisons. In Antigua and Barbuda there was an annual average of 26 hospital admissions for poisoning for the roughly 20, 000 children below 13 years of age, for a rate of 1.3 per 1,000. In comparing the patterns of childhood poisoning in all the countries we studied, we found that, as economic levels rose, there was a shift in the substances ingested, with hydrocarbon and plant ingestions decreasing and chemical and medication ingestions increasing. Conclusions. There is an increasing variety and complexity of poisonous substances ingested as economic conditions improve. This trend would make the establishment of a poison control center for the English-speaking Caribbean a logical step (AU) Responsável: TT5 - Médical Sciences Library TT5; W1 RE712AW

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Id: 16959 Autor: Landaverde, Mauricio; Venczel, Linda; de Quadros, Ciro A. Título: Brote de poliomielitis en Haiti y la Republica Dominicana debido a un virus derivado de la vacuna antipoliomielitica oral / Poliomyelitis outbreak caused by vaccine-derived virus in Haiti and the Dominican Republic Fonte: Rev. panam. salud publica = Pan am. j. public health;9(4):272-274, Apr. 2001. Idioma: Es. Resumo: In October 2000, the Ministries of Helth of the Dominican Republic and Haiti notified two cases of acute flaccid paralyis (AFP) in rural areas, one of them in a 9-month-old female, and the other in a 2-year-old female, respectively. Stool samples that were obtained from these cases, which occured in July and August 2000, after a 9-year interruption of wild poliovirus circulation in the Western Hemisphere, revealed the presence of type 1 poliovirus. Genetic sequencing, which was later performed at the CEnters for Disease Control and Prevention, in Atlanta, Georgia, United States of America, revealed an atypical descendant of the virus used in the manufacture of the oral polio vaccine (OPV), but with 3 percent genetic divergence with respect to the parent strain. Normally, viral isolates that derive from vaccine components show 99.5 percent genetic agreement with the parent strain; in wild polioviruses, on the other hand, this agreement is usually less than 82.0 percent. Thus, the 3 percent genetic divergence detected in this study suggests that, in areas with low vaccine coverage, the virus used in the vaccine remained in circulation for at least two years, during which it recovered the neurovirulence and communicability of wild poliovirus type 1. This report describes the characteristics and results of the active search for cases of AFP that was sparked by the detection of the two index cases. It also looks at the public health implications of this outbreak for the entire Region of the Americas (AU) Responsável: TT5 - Médical Sciences Library TT5; W1 RE712AW

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Id: 16910 Autor: Paganini, Jose Maria. Título: La cobertura de la atencion de salud en America Latina y el Caribe / Health services coverage in Latin America and the Caribbean Fonte: Rev. panam. salud publica = Pan am. j. public health;4(5):305-10, Nov.1998. tab. Idioma: Es. Resumo: Since the 1970s the Member States of the World Health Organization have pledged themselves to the goal of "health for all" and to broadening the coverage, quality, and efficiency of the health care services they provide. In spite of that commitment, there has been little progress in the conceptual understanding and development of indicators to help evaluate the characteristics of the populations with and without coverage, as well as in knowing the relationship between coverage and the characteristics of health care services. Most of the countries of Latin America and the Caribbean are in the process of reforming their health care sectors, and they could benefit from new insight in these areas. To help build that knowledge, this study looked at the population without health care services in the countries of Latin America and the Caribbean, using four indicators: vaccination for poliomyelitis, tuberculosis (BCG) vaccination, prenatal care for pregnant women, and childbirths attended by a health professional. In 1995, out of a total population of 474 million in Latin America and the Caribbean, the number without coverage was a minimum of 40 million, calculated using the indicator of BCG vaccination coverage. Using the indicator for prenatal care, the number of persons without health care coverage was 137 million. By analyzing these four indicators in each country, it is possible to develop health services profiles that would suggest different health sector reform policies. The study also analyzed some characteristics of the structure and coverage of the health systems in 46 countries and territories and their correlation with indicators of result or impact. Five indicators of health care resources were used, along with ten indicators of coverage and seven indicators of result or level of health achieved. A statistically significant association (P=0.05) was found between the coverage of prenatal care and professionally attended childbirths and the results as measured by rates of infant mortality and maternal mortality (AU) Responsável: TT5 - Médical Sciences Library TT5; W1 RE712AW

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Id: 16887 Autor: Bautista, Leonelo E. Título: Duration of maternal breast-feeding in the Dominican Republic Fonte: Rev. panam. salud publica = Pan am. j. public health;1(2):104-11, Feb.1997. tab. Idioma: En. Resumo: The study reported here explored the influence of maternal, health care, pregnancy, and child-related factors upon the duration of total breast-feeding (DTBF) in the Dominican Republic. The data for the study, which included 1984 mother-child pairs representative of the Domonican population, came in from the National HEalth Survey of 1991. The child in each of the mother-child pairs was the mother's last-born child who had been breast-fed and was less than three years of age at the time of the survey. Interviews with the mothers were used to collect information about the duration of breast-feeding and the factors studied (including maternal age, urban/rural residence, parity, mother's socioeconomic status, maternal education, maternal employment, mother's desire for pregnancy, type of delivery, the type of health worker attending the delivery, the child's sex, the child's birth weight, the time elapsed between delivery and initiation of breast-feeding, the child's age at complete weaning, and the child's age at the time of the survey)... According to the study results, the country's breast-feeding programs should give special attention to mothers with university educations, those giving birth in private health facilities, and those with low socioeconomic status giving birth to their first child, since these groups tended to breast-feed their children for relatively short periods of time. Also, breast-feeding promotion strategies should stress the importance of delaying the introduction of foods other than breast-milk into the child's diet, as this appears to be the one factor having the greatest adverse effect on the duration of breast-feeding (AU) Responsável: TT5 - Médical Sciences Library TT5; W1 RE712AW

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Id: 16879 Autor: St. John, M. Anne. Título: Neonatal chlamydial conjunctivitis in Barbados Fonte: Tropical doctor;22(4):184, Oct. 1992. Idioma: En. Resumo: Chlamydia trachomatis has been reported to be amongthe most frequent of pathogens in sexually transmitted diseases (AU) Responsável: TT5 - Médical Sciences Library TT5; W1 TR88G

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Id: 16783 Autor: Pan American Health Organization. Título: Health conditions in the Americas: health of children and adolescents. Fonte: Washington; PAHO; 1990. 41 p. ilus, tab. Idioma: En. Resumo: Children's health is one of the most critical problems in the Region of the Americas. It is critical both because of the magnitude of the problem, since close to 500,000 children under 5 years of age die annually, and because defined and proven strategies now exist that could markedly alter this state of affairs. The Region's countries present a special situation with regard to children's health conditions. Added to the problems typical of underdevelopment (malnutrition, infectious diseases, low coverages of basic health activities) are problems that emerge in more developed societies (accidents, perinatal diseases, psychosocial maladjustments, environmental pollution). This situation results from complex factors that are related to the type of development taking place in these societies, which is characterized by unequal distribution of income; high demographic growth rates that outpace the expansion of public services, mainly in such areas as education and health; and an increase in the marginal urban population because of mass migration from the countryside to cities. Responsável: TT5 - Médical Sciences Library TT5; WA 900 DA1 H4342 1990

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