Resumo em Espanhol:

En cuatro ciudades de Venezuela se llevó a cabo un estudio para evaluar las características epidemiológicas, clínicas y etiológicas de la diarrea aguda en niños menores de 5 años. Entre junio de 1993 y mayo de 1995 se estudiaron 2 552 niños con diarrea y 793 controles que fueron atendidos en el hospital. Para el análisis estadístico de los resultados se empleó la prueba exacta de Fisher. Los rotavirus fueron los agentes más importantes, tanto por su frecuencia (30%) como por su asociación con la deshidratación (58%). Le siguieron en importancia Campylobacter spp. (13%) y Escherichia coli serogrupos O clásicos (9%), pero su asociación con la diarrea solo fue estadísticamente significativa en los niños menores de 3 meses, hecho de particular importancia desde el punto de vista del tratamiento. Se confirmó la importancia de la edad como factor determinante de la prevalencia y gravedad de la diarrea.

Resumo em Inglês:

In four cities of Venezuela a study was carried out to evaluate the epidemiological, clinical, and etiological characteristics of acute diarrhea in children under 5 years of age. The study was done between June 1993 and May 1995 and involved children who were seen in a hospital, 2 552 with diarrhea and 793 controls. The Fisher exact test was used for the statistical analysis of the results. Rotaviruses were the most important agents, both in terms of their frequency (30%) and their association with dehydration (58%). Following in importance were Campylobacter spp. (13%) and Escherichia coli classical O serogroups (9%), but their association with diarrhea was only statistically significant among children less than 3 months old, a fact that is particularly important from the standpoint of treatment. The importance of age was confirmed as a determining factor in the prevalence and severity of diarrhea.

Resumo em Português:

A toxoplasmose é uma protozoonose de distribuição mundial, que pode infectar uma grande variedade de espécies. No presente estudo, avaliou-se a presença de toxoplasmose em 345 moradores da zona rural do Município de Jaguapitã, Estado do Paraná, Brasil. A freqüência dos títulos nas amostras de soro humano foi comparada com a freqüência dos títulos encontrados em 1 420 amostras de diversas espécies animais com as quais os moradores da região tinham contato. A prevalência de anticorpos anti-Toxoplasma gondii foi de 66% entre a população do estudo (reação de imunofluorescência indireta). Foram considerados positivos os títulos maiores ou iguais a 16. O maior título encontrado foi de 65 536 (1%) e os títulos mais freqüentes foram de 256 (29%) e 1024 (19%). A comparação entre seres humanos e animais revelou uma correlação positiva e significativa entre a distribuição dos títulos de anticorpos de humanos e felinos (r = 0,78; P = 0,01) e de humanos e caninos (r = 0,64; P= 0,05). Os participantes do estudo foram também testados pela tela de Amsler, sendo que 22% deles (75/345) relataram algum tipo de alteração ocular; destas pessoas, 77% (58/75) foram sororreagentes à toxoplasmose. Quarenta e uma das 58 pessoas foram encaminhadas para exame oftálmico de fundo de olho. Neste grupo, 22% dos pacientes (9/41) apresentaram lesões características de coriorretinite cicatrizada, sugestivas de toxoplasmose ocular (idade entre 34 e 78 anos). Nenhum paciente apresentou processo inflamatório. Dentre seis pacientes (67%) com lesões unilaterais, quatro apresentaram título de anticorpos de 256. O inquérito epidemiológico revelou que os indivíduos sororreagentes tinham 2,06 vezes mais possibilidades de apresentarem problemas oculares do que os não reagentes. Neste sentido, não foram verificadas diferenças significativas com relação a sexo, contato com animais, consumo de carne crua ou mal passada e leite cru e abate de animais para consumo próprio. Os resultados sugerem que a toxoplasmose está amplamente distribuída na região, com significativa incidência de lesões oculares provocadas pelo Toxoplasma gondii. É recomendável um maior controle por parte das autoridades sanitárias, visando diminuir o risco de infeção toxoplásmica, principalmente entre gestantes.

Resumo em Inglês:

Toxoplasmosis is a protozoal zoonosis common among a great variety of species worldwide. The objective of this study was to assess the presence of toxoplasmosis among 345 residents in a rural area in Jaguapitã municipality, Paraná state, Brazil. The frequency of titers in human serum samples was compared with the frequency of titers found in 1 420 samples obtained from various animal species with which local residents came into contact. Titers > or = 16 were considered positive. The highest titer found was 65 536 (1%), and the most frequent titer levels were 256 (29%) and 1 024 (19%). The comparisons between humans and animals revealed a positive and significant correlation between humans and felines (r = 0.78; P = 0.01) and humans and canines (r = 0.64; P = 0.05) in terms of titer distribution. Study participants were also tested with the Amsler grid. Seventy-five of the 345 people (22%) reported some type of ocular degradation. Of these 75, 58 of them (77%) were seropositive for toxoplasmosis. Forty-one of these 58 people underwent an ophthalmologic exam. Of these 41, 9 of them, who were between 34 and 78 years old, presented lesions characteristic of healed chorioretinitis, suggesting ocular toxoplasmosis. None of the 9 had ocular inflammation. Six of the 9 patients (67%) had unilateral lesions; 4 of these 6 presented a titer level of 256. The epidemiological survey showed that the probability of presenting ocular problems was 2.06 times as great for reactive patients as for nonreactive ones. No significant differences were observed in terms of sex, contact with felines or other animals, consumption of raw or rare meat and raw milk, and slaughtering of animals for personal consumption. Our results suggest that toxoplasmosis is common in the region, with a significant incidence of ocular lesions caused by Toxoplasma gondii. Health authorities should increase their monitoring and control activities in order to decrease the risk of toxoplasmic infections, especially among pregnant women.

Resumo em Espanhol:

Entre julio y diciembre de 1992 se llevó a cabo un estudio transversal con el fin de evaluar el estado nutricional, el desarrollo cognoscitivo y la interacción entre madres e hijos en un grupo de 153 niños refugiados nicaragüenses que vivían en Costa Rica. Se evaluó el estado nutricional según índices antropométricos. El desarrollo cognoscitivo se determinó mediante la Escala de Desarrollo Mental de Bayley. La interacción entre madre e hijo se evaluó con dos intrumentos: la Nursing Child Assessment Teaching Scale [Escala Didáctica para la Evaluación de Lactantes] y el Home Observation and Measurement of the Environment Inventory [Inventario de Observación y Medición del Medio Ambiente] de Caldwell. Se hizo un análisis de correlación para determinar la relación entre el puntaje en la escala del desarrollo cognoscitivo infantil y las mediciones de la interacción entre madre e hijo, así como entre las medidas antropométricas y los puntajes en la escala de desarrollo cognoscitivo infantil. Se aplicó un análisis de regresión múltiple para evaluar la relación entre las mediciones de la interacción y los puntajes en la escala de desarrollo cognoscitivo, después de controlar el efecto de las medidas antropométricas. Se encontró que 33% de los niños tenían valores inferiores al décimo percentil en la relación entre talla y edad. No se observó ninguna correlación significativa entre la frecuencia total de la interacción entre madres e hijos y el desarrollo cognoscitivo del niño. No obstante, ciertos aspectos del ambiente domiciliario mostraron correlación con el desarrollo cognoscitivo, particularmente las características de la respuesta emocional y verbal de la madre hacia su hijo, y la organización del medio ambiente del niño en términos físicos y temporales. El análisis de regresión múltiple reveló que las características de la respuesta emocional de la madre y la relación entre el peso y la talla del niño eran factores de importancia para predecir el desarrollo cognoscitivo infantil. La relación entre el peso y la talla del niño y ciertos aspectos del ambiente domiciliario desempeñaron un papel importante en el desarrollo cognoscitivo de esta población de refugiados. Estos resultados demuestran la importancia de evaluar el estado nutricional en esta población.

Resumo em Inglês:

A cross-sectional study was conducted between July and December 1992 to assess the nutritional status, cognitive development, and mother-child interactions in a group of 153 Nicaraguan refugee children living in Costa Rica. Nutritional status was assessed using anthropometric indices. Cognitive development was assessed with the Bayley Scale of Mental Development. Mother-child interaction was assessed with the Nursing Child Assessment Teaching Scale and Caldwell's Home Observation and Measurement of the Environment Inventory. Correlational analysis was performed to examine the relationship between child cognitive development scores and mother-child interaction measures and also between anthropometric measures and child cognitive development scores. Multiple regression analysis was performed to evaluate the relationship between the mother-child interaction measures and cognitive development scores, after adjusting by anthropometric measures. Thirty-three percent of the children were below the 10th percentile for height-for-age. There was no significant correlation between the total amount of mother-child interaction and child cognitive development. However, certain aspects of the home environment correlated with cognitive development, specifically the manner in which the mother responded emotionally and verbally to her child, and the organization of the child's physical and temporal environment. Multiple regression analysis revealed that the manner in which the mother responded and the child's weight-for-height were important in predicting child cognitive development. The child's weight-for-height and certain aspects of the home environment played an important role in the cognitive development of this refugee population. The findings indicate the importance of assessing nutritional status in this refugee population.

Resumo em Espanhol:

El objetivo de este trabajo es presentar los resultados de 26 meses de actividad (enero de 1996 a febrero de 1998) del Servicio de Internación Domiciliaria Diferenciada de Agudos. Este servicio funcionó para 20 camas domiciliarias con dos equipos, cada uno formado por un médico y una enfermera, con una modalidad de atención similar a la de una sala de internación hospitalaria. Se evaluaron las características de la población internada, sus trastornos, las vías de administración de medicamentos, la satisfacción del grupo cuidador, los índices de rendimiento y los costos del sistema. Un total de 1 789 pacientes tuvieron internación domiciliaria en ese período, con una estancia mediana de 4 días. El 76,5% ingresaron desde la internación hospitalaria. Los trastornos cardiorrespiratorios fueron los más frecuentes (45,5%) y el porcentaje de pacientes con enfermedad en fase terminal alcanzó 14,2%. La vía de administración de medicamentos fue oral en 74% de los pacientes y parenteral en 26%. La satisfacción de los pacientes fue muy buena y el costo de la internación se redujo a 70% del costo de la internación hospitalaria. La participación familiar fue fundamental en esta modalidad de atención.

Resumo em Inglês:

This study presents the results of 26 months of work, from January 1996 through February 1998, of the Distinct Home Hospitalization Service for Acute Patients. This service managed 20 home beds with two teams, each with a physician and a nurse, with a care approach similar to that for a room in a hospital. Among the items evaluated were the attributes of the admitted population, their illnesses, the form of administering drugs, the satisfaction of the caregivers, the indices of performance, and the costs with this approach. A total of 1 789 patients had home hospitalizations over the period, with a median stay of 4 days. Of the patients, 76.5% were admitted from in-hospital care. The most frequent illnesses were cardiorespiratory ones (45.5%), and the proportion of patients with a terminal illness was 14.2%. Drugs were administered orally with 74% of the patients and parenterally in 26%. The patients' satisfaction level was very high, and the cost of the hospitalization was 70% of that for in-hospital care. Family involvement was key in this approach to care.

Resumo em Espanhol:

En 1997 se realizó un estudio descriptivo con énfasis cualitativo con objeto de documentar los conocimientos y las prácticas relacionados con la leishmaniasis cutánea, según el sexo, en los habitantes de 14 años en adelante de siete comunidades del departamento del Chocó, Colombia. Los residentes de esa zona de la costa del Pacífico estaban en alto riesgo de contraer leishmaniasis, que se conoce localmente con los nombres de bejuco y yateví, ya que las actividades de control llevadas a cabo por el Servicio Seccional de Salud del Chocó no habían tenido el éxito deseado. Se recogieron datos cualitativos involucrando directamente a cada comunidad en talleres de discusión y entrevistando a informantes calificados. Sobre esa base, se elaboró una encuesta de 10 preguntas cerradas, que los investigadores administraron a todas las personas mayores de 14 años presentes en cada hogar elegido de forma aleatoria para ser visitado. Los resultados indican que 94% de la población estudiada conocía la leishmaniasis como una enfermedad de la piel y este concepto era más común entre los hombres que entre las mujeres. En cuanto a la forma de transmisión, 35% relacionaron la enfermedad con la picadura de un insecto, pero ignoraban el agente etiológico y consideraban que la producía un gusano que vive en el monte. En las comunidades estudiadas se empleaba una gran variedad de tratamientos para curar la enfermedad. Estos se basaban en el uso de plantas, sustancias químicas, quemadura de las lesiones con metales calientes y, en menor proporción, medicamentos. A pesar de que las mujeres tenían la responsabilidad de cuidar a los enfermos en el hogar, su falta de conocimientos sobre el tratamiento fue una variable de análisis estadísticamente significativa, pues no estaban familiarizadas con los tratamientos tradicionales de su comunidad. De las personas encuestadas, 45% no sabían cómo prevenir la enfermedad, especialmente las mujeres, según pudo observarse en 102 de 155 respuestas. No se encontraron diferencias atribuibles al género en los conocimientos y prácticas acerca de la leishmaniasis, con excepción de la falta de conocimiento de las mujeres acerca del tratamiento de la enfermedad. Esta investigación resalta la importancia de estudiar los conocimientos y prácticas de los habitantes locales antes de diseñar y organizar programas educativos sobre el control de la leishmaniasis.

Resumo em Inglês:

In 1997 a descriptive study with a qualitative emphasis was carried out in order to document, by gender, the knowledge and practices related to cutaneous leishmaniasis among inhabitants 14 years and older in seven communities of Colombia's Pacific coastal department of Chocó. Since the control activities carried out by the Chocó Sectional Health Services had not had the desired results, the residents of the region were at high risk of contracting leishmaniasis, which they called bejuco (liana) and yateví. Qualitative data were collected by directly involving each community in discussion workshops and by interviewing knowledgeable informants. Using these materials as a foundation, the researchers prepared a survey with 10 closed-ended questions, which they administered to all persons over 14 years of age in each randomly chosen home visited. The results indicate that 94% of the population knew that leishmaniasis appeared as a skin disease; those not knowing that were more often women than men. With respect to the mode of transmission, 35% of the respondents connected the disease to the bite of an insect, but they did not what the etiologic agent was and thought that the bite was inflicted by a worm that lives in the mountains. In the communities studied, the residents used a great variety of treatments to cure the disease. The treatments were based on plants, chemical substances, burning the lesions with a piece of heated metal, and, to a lesser degree, drugs. Despite being responsible for taking care of sick persons in the household, women were not acquainted with the traditional treatments used in the community. This gender difference in treatment knowledge was statistically significant, the only such statistically significant gender difference found in the research. Of the people surveyed, 45% did not know how to prevent the disease. This was more often true for women; 102 of the 155 respondents saying they did not know how to prevent the disease were women. This research emphasizes the importance of studying the knowledge and practices of local inhabitants before designing and organizing educational programs to control leishmaniasis.

Resumo em Português:

O papel desempenhado pelo padrão de ingesta alcoólica sobre a incidência de hipertensão arterial ainda não está totalmente esclarecido; além disso, são raros os estudos realizados em populações de trabalhadores. Assim, o objetivo do presente trabalho foi avaliar a associação entre alcoolismo e hipertensão arterial entre trabalhadores de uma refinaria de petróleo em Mataripe, Estado da Bahia, Brasil, de 1986 a 1993. O estudo foi de coorte retrospectiva, com 7 anos de seguimento, em uma amostra estratificada sistemática de 335 trabalhadores da refinaria. O diagnóstico de hipertensão arterial foi feito com base nas medidas da pressão arterial obtidas nos exames médicos periódicos. A partir dos resultados do teste CAGE, aplicado ao início do período de observação, estabeleceram-se três grupos de indivíduos: não-bebedores (n = 121), CAGE- negativos (n = 116), e CAGE-positivos (n = 98). O grupo CAGE-positivo apresentou maior risco relativo e atribuível de desenvolver hipertensão arterial do que o grupo CAGE-negativo (RR = 2,58; RA = 24,95% pessoas-ano) e que o grupo não-bebedor (RR = 2,06; RA = 20,97% pessoas-ano). As frações atribuíveis foram 61% e 51%, respectivamente, para as mesmas comparações. A padronização de taxas pela idade e hábito de fumar não modificaram substancialmente estes resultados. O alcoolismo é um importante fator de risco para o desenvolvimento de hipertensão arterial.

Resumo em Inglês:

The role of alcohol ingestion in the incidence of arterial hypertension has not been completely established. In addition, there are few studies addressing this point in relation to populations of workers. The objective of this study was to evaluate the association between alcoholism and arterial hypertension among workers in an oil refinery in Mataripe, Bahia, Brazil, from 1986 to 1993. We designed a retrospective cohort study with a 7-year follow-up in a stratified systematic sample of 335 workers from the refinery. Arterial hypertension was diagnosed based on blood pressure measurements done during routine medical examinations. At the beginning of follow-up, three groups were defined using the CAGE test of alcohol dependency: nondrinkers (n = 121), CAGE-negative workers (n = 116), and CAGE-positive workers (n = 98). In comparison with the CAGE-negative group, the CAGE-positive group had both greater relative risk and greater attributable risk for developing arterial hypertension (RR = 2.58; AR = 24.95 per 1 000 person-years). The CAGE-positive group also had greater risks compared to nondrinkers (RR = 2.06; AR = 20.97 per 1 000 person-years). The attributable fractions for the same two comparisons of groups were 61% and 51%, respectively. Rate standardization by age or smoking habit did not substantially change the results. Alcoholism is an important risk factor for arterial hypertension.

Resumo em Espanhol:

Este trabajo detalla algunos aspectos de la prueba en el terreno de dos encuestas rápidas efectuadas en el Ecuador en 1995. Examina el diseño y la aplicación de las encuestas; la preparación y el uso de computadoras de bolsillo preprogramadas para la inclusión de los datos; los criterios de selección del equipo de entrevistadores, y el diseño del adiestramiento. Se extraen lecciones que ayudarán a los profesionales de la salud a mejorar en su futuro desempeño la forma de planificar y llevar a cabo sus actividades de recolección rápida de datos. El objetivo del estudio fue evaluar la fiabilidad y validez de los datos recolectados durante las encuestas rápidas, en comparación con las de una encuesta nacional reciente que sirvió de "patrón de oro". Se aplicó un diseño factorial de doble vía para controlar el efecto de las diferencias de muestreo (probabilidad frente a quasi-probabilidad) y de los métodos de recolección de datos (en papel o en computadora de bolsillo). Se detectaron pocas diferencias entre las encuestas efectuadas con computadoras de bolsillo en comparación con las efectuadas en papel, pero hubo menos diferencias entre datos de procedencia urbana y rural respecto al uso de anticonceptivos en las encuestas rápidas que en la encuesta anterior, de alcance nacional. Esto indica que debe observarse precaución a la hora de interpretar los datos desglosados recogidos mediante estas encuestas rápidas. Las entrevistas a fondo revelaron dos rasgos de las encuestas rápidas que gozaron de gran popularidad: las computadoras de bolsillo por la rapidez con la que se incorporan los datos, y el cuestionario corto por su "poco impacto" en el tiempo del encuestado. La creencia general de que los encuestados se sentirían incómodos con las computadoras no se observó en la realidad. Aun sin tener experiencia en el uso de computadoras, los entrevistadores aprendieron a manejar la nueva tecnología sin dificultad.

Resumo em Inglês:

This paper presents details from the field test of two rapid surveys in Ecuador in 1995. It focuses on how the surveys were designed and implemented, including descriptions of the sampling procedures, the preparation and use of preprogrammed palmtop computers for data entry, the selection criteria for the interviewing team, and how the training was designed. Lessons are drawn that will assist health professionals plan and carry out better rapid data collection in the future. The objective of the study was to evaluate the reliability and validity of data gathered during the rapid surveys as compared with a recent "gold standard" national survey. A two-way factorial design was used to control for differences in sampling (probability versus quasi-probability) and methods of data collection (paper versus palmtop computer). Few differences were detected between the surveys done on palmtops as compared to paper ones, but urban and rural differentials in contraceptive use were less pronounced in the rapid surveys than in the earlier, national survey. This suggests that caution should be exercised in interpreting the disaggregated data in these rapid surveys. In-depth interviews revealed two features of the rapid surveys that were especially popular: the palmtops for their speed of data entry, and the short questionnaire for its "low impact" on a respondent's time. The common belief that computers would disturb respondents was not found to be the case. Even with no computer experience, the interviewers rapidly mastered the new technology.

Resumo em Espanhol:

Los cuatro objetivos principales de este estudio descriptivo fueron los siguientes: 1) diseñar un instrumento de medición de calidad para los registros de cáncer institucionales (RCI), 2) evaluar los RCI ya existentes en Colombia con dicho instrumento, 3) clasificar por categorías los distintos registros según su calidad y dar prioridad a iniciativas para promover el mejoramiento de los registros con los recursos limitados disponibles, y 4) determinar qué institución tiene las mayores probabilidades de establecer con buenos resultados el segundo registro de cáncer de base poblacional. En 1990 el Instituto Nacional del Cáncer de Colombia creó 13 registros de cáncer institucionales en diferentes ciudades colombianas con el fin de promover la recolección de datos de un extenso grupo de centros de diagnóstico y tratamiento del cáncer. En la primera mitad de 1997, esta evaluación abarcó 12 registros, ya que uno de los 13 originales había desaparecido. Todas las instituciones colombianas (hospitales) que mantienen registros de cáncer poblacionales se incluyeron en el estudio. En cada institución se administró una encuesta al director del hospital, al coordinador del registro y a la persona encargada de incorporar los datos. Los investigadores estudiaron cada institución teniendo presentes seis áreas que están en uso en el ámbito internacional. Dentro de cada área se formularon y escogieron preguntas mediante el método Delphi. A cada área y cada pregunta se les asignó un peso mediante un proceso consensual. En la mayor parte de los casos, dos entrevistadores fueron a cada lugar a recoger la información. Los hospitales universitarios en Cali, Pereira y Medellín tuvieron puntajes bastante más altos como consecuencia de su buen rendimiento. Cuatro de las 12 instituciones tenían muy poca actividad de registro de casos de cáncer. Cinco de los 12 directores de hospitales sentían que la información proporcionada en los registros de cáncer influía en sus decisiones administrativas. Tres de los registros tenían datos sobre la supervivencia de los pacientes. Cuatro de las instituciones adjudicaban recursos específicos para llevar sus registros de cáncer; en los otros ocho hospitales no había ninguna adjudicación de fondos explícitamente para este fin. Siete de los directores de hospitales no pudieron identificar cinco o más de los objetivos de un registro de cáncer. La mayoría de las instituciones tenían un manejo de datos deficiente y una insuficiencia de recursos. En resumen, el sistema de registros de cáncer en Colombia varía enormemente de una institución a otra. Algunos de los hospitales llevan bien esta actividad, mientras que otros han descuidado sus registros. Las altas puntuaciones totales que sacaron por igual Medellín y Pereira sugieren que serían buenos lugares para establecer nuevos registros de cáncer poblacionales similares al que existe en Cali. No obstante, las características generales de Pereira podrían ofrecer un ambiente más propicio para el segundo registro, con Medellín como segunda opción.

Resumo em Inglês:

The four primary objectives of this descriptive study were to: 1) design a quality-measurement instrument for institutional cancer registries (ICRs), 2) evaluate the existing ICRs in Colombia with the designed instrument, 3) categorize the different registries according to their quality and prioritize efforts that will efficiently promote better registries with the limited resources available, and 4) determine the institution with the greatest likelihood of successfully establishing Colombia's second population-based cancer registry. In 1990 the National Cancer Institute of Colombia developed 13 institution-based cancer registries in different Colombian cities in order to promote the collection of data from a large group of cancer diagnostic and treatment centers. During the first half of 1997, this evaluation reviewed 12 registries; one of the original 13 no longer existed. All of the Colombian institutions (hospitals) that maintain institution-based cancer registries were included in the study. At each institution, a brief survey was administered to the hospital director, the registry coordinator, and the registrar (data manager). Researchers investigated the institutions by looking at six domains that are in standard use internationally. Within each domain, questions were developed and selected through the Delphi method. Each domain and each question were assigned weights through a consensus process. In most cases, two interviewers went to each site to collect the information. The university hospitals in Cali, Pereira, and Medellín had substantially higher scores, reflecting a good level of performance. Four of the 12 institutions had almost no cancer registry work going on. Five of the 12 hospital directors considered that the information provided by the cancer registries influenced their administrative decisions. Three of the registries had patient survival data. Four of the institutions allocated specific resources to operate their cancer registries; in the other 8 hospitals there was no clear budget allocation. Seven of the hospital directors could not identify five or more objectives of a cancer registry. Data management was usually poor and resources insufficient at most of the institutions. In summary, the cancer registry system in Colombia varies greatly from institution to institution. A few of the hospitals do a good job while others have neglected the registries. The high, identical total scores for Pereira and Medellín suggest they would be good locations to establish new population-based cancer registries similar to the existing one in Cali. However, the overall characteristics in Pereira may provide a more appropriate environment for the second registry, with Medellín as an alternative.

Resumo em Inglês:

Defective drugs have been found during the postmarketing phase in various countries, regardless of those nations' level of economic development. This paper proposes guidelines for a program to uncover drug defects in the postmarketing surveillance period. Such a program should be run by a center or service organized for that purpose within the framework of a national drug surveillance system.

Resumo em Inglês:

This document provides a brief review of the situation of HIV/aids and of sexually transmitted infections (STIs) in the Americas. Among the subjects covered are appropriate care models for HIV/aids, including access to antiretroviral drugs; preventing transmission from mother to child; improved activities for preventing and controlling STIs; and interprogram activities to guarantee the safety of donated blood and blood products.