Resumo em Espanhol:
El objetivo de este estudio es presentar la epidemiología descriptiva del cáncer en los niños menores de 15 años a nivel mundial y nacional. Se realizó una revisión de la literatura internacional y nacional de los artículos publicados sobre cáncer en los niños, seleccionando aquellos que trataran los aspectos epidemiológicos de tiempo, lugar y persona y analizándose tanto la incidencia como la mortalidad por cáncer en niños. La incidencia mundial es de 100 a 150 casos x 10(6) niños/año. La incidencia específica varía de acuerdo al tipo cáncer, el país o región que se estudie. El patrón latinoamericano de neoplasias lo constituyen las leucemias, los linfomas y los tumores del sistema nervioso central (TSNC); en el norteamericano y europeo los TSNC ocupan el segundo lugar; y en el africano predominan los linfomas. La incidencia es mayor en los menores de 5 años en el medio urbano y existe un incremento de 1% anual de cánceres en los niños de Estados Unidos de América. La mortalidad por cáncer en niños ha disminuido de forma importante principalmente en los países desarrollados, como Estados Unidos e Inglaterra; en los subdesarrollados permanece estable o hay una leve disminución. La incidencia es mayor en países desarrollados; sin embargo, en los países subdesarrollados puede estar subestimada. Aún hay muchos datos que se desconocen sobre la epidemiología del cáncer en el niño, por lo que son necesarios más estudios.Resumo em Inglês:
The object of this study is to present the descriptive epidemiology of cancer in children at the world and national levels. The international and national literature published on cancer in children was comprehensively reviewed, with emphasis on reports treating epidemiological aspects of time, place and person. For practical reasons and with the aim of integrating the information, only the more relevant publications were included. Incidence and child mortality were analyzed. Overall incidence is between 100 and 150 (annual rates = cases x 10(6) children). Specific incidence varies according to the type of cancer, the region and the country. The Latin American pattern of neoplasms is constituted by leukemias, lymphomas, and central nervous system tumors (CNST); in the Northamerican/European pattern the CNST appear in second place and in the African pattern, lymphomas show predominance. Incidence is higher among the younger than 5 year olds, from urban environments, and there is a 1% annual increase of cancer in Northamerican children. Child mortality has diminished remarkably, mainly in developed countries, whereas in developing or underdeveloped countries, incidence remains stable or shows a slight fall. The incidence of cancer in children is greater in developed countries, but in underdeveloped countries it may be underestimated. These countries have not managed to reduce the incidence of child mortality caused by cancer, as have the United States or Great Britain. Further studies on the epidemiology of cancer in children are necessary, since many data remain unknown.Resumo em Espanhol:
Escherichia coli es el agente causal más frecuente de las infecciones urinarias (IU), cuyo diagnóstico suele basarse en métodos bacteriológicos. No obstante, los métodos de tamizaje pueden ser útiles para hacer un diagnóstico preliminar con rapidez, pese a que algunos de ellos tienen poca sensibilidad y son caros. Con el fin de investigar la posibilidad de usar otra técnica de diagnóstico, se estandarizó un inmunoensayo de tipo antigénico-ensayo inmunoenzimático por electrodifusión (ELIEDA, por enzyme-linked immunoelectrodiffusion assay)-para hacer el tamizaje de este tipo de infección. El ELIEDA, que consiste en el uso combinado de contrainmunoelectroforesis y un ensayo inmunoenzimático, requiere muestras de orina concentrada, una membrana celulosa con acetato, anticuerpos policlonales contra E. coli formados en conejos, y anticuerpos de cordero marcados con peroxidasa contra inmunoglobulinas G (IgG) de conejo. Esta técnica de ELIEDA se evaluó con 244 especímenes urinarios: 76 tenían E. coli; 47 tenían bacterias heterólogas y 121 carecían de bacterias. Al compararlo con los métodos bacteriológicos, el ELIEDA mostró una sensibilidad, especificidad y valores predictivos positivo y negativo de 93,4%, 95,9% y 97,1%, respectivamente. Los resultados obtenidos indican que este ensayo es útil para el tamizaje diagnóstico de rutina de las IU causadas por E. coli. Además, el ensayo facilita la realización de estudios retrospectivos, ya que las membranas teñidas usadas para el ELIEDA son almacenables.Resumo em Inglês:
Escherichia coli is the most common causative agent of urinary tract infection (UTI), and diagnosing this infection usually relies on bacteriologic methods. Nevertheless, screening methods can be useful for a rapid presumptive diagnosis even though some of these screening methods have low sensitivity or are expensive. To investigate a possible new alternative approach, an antigen-based immunoassay-enzyme-linked immunoelectrodiffusion assay (ELIEDA)-was standardized for screening for this bacterial infection. Combining counter immunoelectrophoresis with an immunoenzymatic assay, the ELIEDA requires concentrated urine specimens, a cellulose acetate membrane, polyclonal antibodies to E. coli raised in rabbits, and peroxidase-labeled sheep antibodies to rabbit immunoglobulin G (IgG). This ELIEDA technique was evaluated using 244 urine specimens, 76 of them with E. coli, 47 with heterologous bacteria, and 121 without bacteria. In comparison to bacteriologic methods, the sensitivity, specificity, and positive and negative predictive values for the ELIEDA were 93.4%, 98.2%, 95.9%, and 97.1%, respectively. The data obtained suggest that this assay is useful for routine diagnostic screening for UTI caused by E. coli. In addition, since the ELIEDA stained membranes can be stored, this assay makes retrospective studies possible.Resumo em Espanhol:
El objetivo de este trabajo fue identificar algunos factores de riesgo que pudiera presentar la madre durante el embarazo, asociados con la incidencia de bajo peso al nacer (menos de 2500 g). Se diseñó un estudio con 378 casos y 649 controles del Hospital Gineco-Obstétrico Provincial de Sancti Spíritus, Cuba, durante el año 1994. Los datos se obtuvieron de la historia clínica, el registro de partos y una entrevista personal con la madre. Se realizó un análisis bivariado y se controlaron los posibles factores de confusión utilizando la regresión logística dicotómica, mediante los programas Epi Info 5 y SPSS. Por medio del modelo multivariado final se identificaron como factores de riesgo significativos de bajo peso al nacer la hipertensión arterial durante el embarazo, la consulta extemporánea de evaluación del embarazo, los abortos anteriores, último intervalo intergenésico menor de 2 años y el aumento de peso materno menor de 8 kg. Se debe dar prioridad a estas tres últimas variables para mantener buenos indicadores en el programa maternoinfantil de la Provincia de Sancti Spíritus, Cuba.Resumo em Inglês:
The objective of this work was to identify some risk factors that women could present during pregnancy and that are associated with low birthweight (less than 2500 g). A study was performed during 1994 with 378 cases and 649 controls at the Provincial Obstetric-Gynecologic Hospital of Sancti Spíritus, Cuba. The data were obtained from clinical histories, the registry of births, and personal interviews with mothers. A bivariate analysis was carried out and possible confounding factors were controlled utilizing dichotomous logistic regression, using the Epi Info 5 and SPSS software programs. With the final multivariate model, the following risk factors for low birthweight were identified as significant: hypertension during pregnancy, infrequent checkups during pregnancy, previous abortions, a period of less than 2 years since the last birth, and a maternal weight increase of less than 8 kg. Priority should be given to these last three variables in order to maintain the high standards of the maternal and child health program of Sancti Spíritus Province, Cuba.Resumo em Português:
Em pleno período de transição epidemiológica e demográfica, também marcado pela melhoria na qualidade dos registros de óbitos no Brasil, é crucial entender o comportamento recente da mortalidade por doenças infecciosas e parasitárias neste país. Este trabalho apresenta as mudanças nos padrões de mortalidade por causas infecciosas e parasitárias para o Brasil e seus estados durante a década de 1980. Foram utilizados para tanto os dados de mortalidade provenientes do Sistema de Informações sobre Mortalidade do Ministério da Saúde, classificados de acordo com a Classificação Internacional de Doenças (nona revisão). O resultado desta análise revela mudanças nos padrões de mortalidade com acentuadas quedas nas taxas de mortalidade por doenças infecciosas e parasitárias para o Brasil (variação de 41% para homens e 44% para mulheres), em particular para os estados das regiões Norte e Nordeste. No entanto, estes estados ainda são detentores das mais elevadas taxas de mortalidade do país. Em termos de distribuição etária, as variações atingiram com maior intensidade os extremos de idade, especialmente o grupo de menores de 1 ano. Dentre as doenças infecciosas e parasitárias, o estudo observou ainda o comportamento da mortalidade por doenças infecciosas intestinais (na sua maioria classificadas como mal definidas), tuberculose e septicemia. As taxas de mortalidade por doenças infecciosas intestinais e tuberculose apresentaram uma expressiva queda; o risco de morte por septicemia, por sua vez, apresentou um aumento real durante a década. Apesar do decréscimo global das taxas de mortalidade e da diminuição da mortalidade proporcional por doenças infecciosas e parasitárias, a mortalidade por esta causa ainda permanece elevada no Brasil, e exige atenção prioritária por parte dos setores competentes.Resumo em Inglês:
Brazil has been undergoing a period of epidemiological and demographic transition, which has included an improvement in the quality of death certificate registrations and major changes in the patterns of mortality from infectious and parasitic diseases. This article outlines the changes in the mortality patterns that were observed in the country and in its states during the decade of the 1980s. We used data from the Ministry of Health Mortality Information System, classified according to the International Classification of Diseases, 9th Revision. Our analysis showed important changes in mortality patterns in Brazil. Mortality from infectious diseases decreased by 41% among men and by 44% among women. While these types of changes were especially noticeable in the states of the North and Northeast, these states still have the highest mortality rates in the country. The changes particularly affected the extreme limits of the age continuum, most especially children under 1 year of age. Within the group of infectious and parasitic diseases, we also assessed the mortality due to intestinal infectious diseases, tuberculosis, and septicemia. We found that in the 1980s there was a major decrease in the rates of mortality due to intestinal infectious diseases and to tuberculosis. However, there was an increase in the risk of death from septicemia during the decade. In conclusion, we find that the rate of mortality caused by infectious and parasitic diseases remains high in Brazil. Therefore, Brazilian health authorities still need to give priority attention to this cause of death.Resumo em Espanhol:
Una encuesta serológica sistemática y domiciliaria para detectar serorreactividad a Trypanosoma cruzi se llevó a cabo en tres comunidades contiguas de la municipalidad de Olapa, en el departamento de Chiquimula, Guatemala. Se examinaron mediante inmunoadsorción enzimática muestras de sangre obtenidas de un total de 292 habitantes que residían en 63 viviendas. La tasa de seropositividad varió de 0 a 20,8% en las tres comunidades y tuvo una media de 15,1%. Los modelos logarítmico-lineales mostraron una asociación significativa entre la seroprevalencia y la edad (P < 0,05), pero no entre aquella y el sexo. No obstante, cuando el grupo de edad que tuvo la seroprevalencia más baja (el de 1 a 9 años) se excluyó del análisis, la edad dejó de ser un factor significativo (P = 0,55). Datos obtenidos de una muestra estratificada recogida simultáneamente se combinaron con los de la muestra sistemática con el fin de analizar la relación entre la seropositividad y algunas variables que podrían ser explicativas. Los modelos logarítmico-lineales, aplicados en 586 habitantes de 129 viviendas incluidas en ambas encuestas, revelaron una asociación positiva significativa entre la seropositividad y la presencia de techo de paja (P = 0,01).Resumo em Inglês:
A systematic, house-based serological survey for Trypanosoma cruzi seroreactivity was conducted in three contiguous communities in Olopa municipality, Chiquimula Department, Guatemala. Blood samples from a total of 292 individuals in 63 households were examined by enzyme-linked immunosorbent assay. The seropositive rate ranged from 0% to 20.8% for the three communities, with a mean of 15.1%. Log-linear models showed that seroprevalence was significantly related to age (P < 0.005) but not to sex. However, when the age group with the lowest prevalence (1-9 years) was excluded from the analysis, age was not a significant factor (P = 0.55). Data from a stratified sample collected at the same time were combined with those of the systematic sample to analyze the relationship between seropositivity and possible explanatory variables. Log-linear models, based on 586 individuals in 129 households from the two surveys, revealed a significant positive association between seropositivity and thatched roofs (P = 0.01).Resumo em Espanhol:
En 1994 se inició un estudio comunitario para determinar la efectividad del uso de productos lácteos fluorados, distribuidos mediante el Programa Nacional de Alimentación Complementaria, con el fin de lograr una disminución de la caries dental infantil en zonas rurales de Chile en las que esta tiene una alta prevalencia. Se determinaron los índices de prevalencia de caries dental en dos comunidades rurales de la Sexta Región de Chile: una en la que los niños recibieron productos lácteos fluorados (comunidad de estudio: Codegua) y otra en la que recibieron productos lácteos no fluorados (comunidad testigo: La Punta). Después de recibir productos lácteos fluorados durante 3 años, los índices de prevalencia de caries dental presentaron una significativa mejoría en la comunidad de estudio. Al comparar la prevalencia actual de la caries dental en los preescolares de Codegua con la que presentaban antes de la fluoración de los productos lácteos, se comprueba que disminuyó entre 40 y 60% en niños de 3 a 6 años. En los grupos de 3 y 4 años de edad, la proporción de niños sin antecedentes de caries dental aumentó en 74% (de 40,7 a 70,8%) y 71% (de 33,3 a 56,9%), respectivamente. Estos resultados, similares a los obtenidos tras la introducción de programas de fluoración del agua potable, se consiguieron sin ningún otro tipo de intervención adicional en el funcionamiento normal del Programa Nacional de Alimentación Complementaria, como podrían ser campañas de motivación de las madres o de educación para el consumo de productos de este programa.Resumo em Inglês:
A study was done in 1994 to determine the effectiveness of the fluoridated dairy products that the Chilean National Program for Supplementary Feeding had been distributing to reduce the high prevalence of children’s dental caries in rural areas of that country. For the study, the prevalence of caries was assessed in two rural communities of the Sixth Region of Chile. Children in the study community of Codegua had received fluoridated dairy products, while children in the control community of La Punta had received nonfluoridated dairy products. Three years after the program began in Codegua, the community showed a significant improvement in the indices of prevalence of caries. Over that time period, the prevalence of caries among children 3 to 6 years old declined between 40% and 60%. Among children 3 years old, the proportion of them without a history of caries increased by 74%, from 40.7% to 70.8%. Among 4-year-olds, that proportion rose by 71%, from 33.3% to 56.9%. Similar to results obtained elsewhere with programs to fluoridate drinking water, the outcomes in Codegua were achieved without any other steps by the National Program for Supplementary Feeding, such as motivational campaigns for mothers or educational efforts to encourage consumption of the program’s food products.Resumo em Inglês:
It is difficult to collect precise data on every epizootic and to document the direct and indirect effects of each one. This situation makes it impossible to assess the damage that Venezuelan equine encephalitis (VEE) causes in the Region of the Americas, as well as to identify new encephalitis strains, wild reservoirs, types of vectors in each enzootic cycle, and the period of immunity that the TC-83 vaccine provides. This all shows that, in order to improve prevention and control activities, it is essential to have a standard information and epidemiological surveillance system that involves the official public health and animal health services. This text describes general aspects of VEE and the epidemiological features to consider in order to increase the predictive ability of epidemiological surveillance programs and to reduce the negative socioeconomic effects of the disease. The piece also describes laboratory diagnostic procedures to confirm suspected encephalitis cases. Finally, the text describes the characteristics and structure of an information system that will generate useful data to investigate enzootic foci and areas at risk, make forecasts on outbreaks and epidemics, detect encephalitides quickly, and guide prevention and control measures.Resumo em Espanhol:
En años recientes, muchos países han avanzado en el transporte y almacenamiento adecuado de las vacunas y han mejorado la cadena fría que ayuda a conservar su potencia. No obstante, estas mejoras se han producido de manera muy poco uniforme y aún falta mucho para que se aprovechen al máximo las vacunas disponibles. El conocer la estabilidad de ciertas vacunas puede ayudar a establecer las condiciones en que deben almacenarse y a saber si determinados lotes deben usarse o no. En este trabajo se presentan dos cuadros donde se resumen muchos datos actualizados sobre la termoestabi li dad de las vacunas, según informa una nueva publicación de la Organización Mundial de la Salud.