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1.
Journal of public health and epidemiology ; 2(2): 20-24, Apr. 2010. tab, graf
Artigo em Inglês | MedCarib | ID: med-17676

RESUMO

Our aim was to determine whether the use of serum inflammatory markers such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and procalcitonin (PCT), either individually or in combination, is significantly associated with community-acquired pneumonia and to determine the role in assessment of the severity and outcome. This study was a prospective cohort study, included forty Trinidadian patients diagnosed with community acquired pneumonia. Blood samples were collected to measure inflammatory markers. Patients were classified according to the pneumonia severity index (PSI) scoring where after serum marker levels were compared among respective groups. Proportions test for positive predictive value of the serum marker indicated that CRP (P=0.001) and ESR (P=0.001) had higher sensitivities to community acquired pneumonia than PCT (P=0.05). There was no association between each of the serum markers and PSI. Eighty three percent low risks had a length of stay of two weeks, while only 18% of high risk stayed for the same duration. The combination of highly sensitive markers like CRP and ESR and a specific marker such as PCT emphasize their importance in better risk assessment in community acquired pneumonia patients.


Assuntos
Humanos , Infecções Comunitárias Adquiridas , Pneumonia , Trinidad e Tobago
2.
Rev. panam. salud p£blica ; 24(5): 304-313, Nov. 2008. tab, ilus, graf
Artigo em Inglês | MedCarib | ID: med-17457

RESUMO

OBJECTIVE: In Latin America and the Caribbean, routine vaccination of infants against Streptococcus pneumoniae would need substantial investment by governments and donor organizations. Policymakers need information about the projected health benefits, costs, and cost-effectiveness of vaccination when considering these investments. Our aim was to incorporate vaccine, demographic, epidemiologic, and cost data into an economic analysis of pneumococcal vaccination of infants in Latin America and the Caribbean. METHODS: We previously used a structured literature review to develop regional estimates of the incidence of disease. Cost data were collected from physician interviews and public fee schedules. We then constructed a decision analytic model to compare pneumococcal conjugate vaccination of infants with no vaccination across this region, examining only vaccine's direct effects on children. RESULTS: Pneumococcal vaccination at the rate of diphtheria-tetanus-pertussis vaccine coverage was projected to prevent 9500 deaths per year in children aged 0 to 5 years in the region, or approximately one life saved per 1 100 infants vaccinated. These saved lives as well as averted cases of deafness, motor deficit, and seizure result in 321000 disability-adjusted life years (DALYs) being averted annually. At vaccine prices between US$5 and US$53 per dose, the cost per DALY averted from a societal perspective would range from US$154 to US$5252. CONCLUSION: Pneumococcal conjugate vaccine was highly cost-effective up to $40 per dose. Introduction of pneumococcal vaccine in the Latin American and Caribbean region is projected to reduce childhood mortality and to be highly cost-effective across a range of possible costs.


Assuntos
Humanos , Streptococcus pneumoniae , Vacinas Pneumocócicas , Custos e Análise de Custo , Árvores de Decisões , Otite Média , Pneumonia , Sepse , Meningite , América Latina , Região do Caribe
3.
The Brazilian journal of infectious diseases ; 9(3): 231-240, June 2005. tab
Artigo em Inglês | MedCarib | ID: med-17417

RESUMO

We determined the frequency of Streptococcus pneumoniae, Haemophilus influenzae,Staphylococcus aureus, and Gram-negative enteric bacteria (GNEB) in pneumonia patients,determined the antibiograms of these pathogens, and investigated the relationship between pneumonia and selected risk factors. Sputum and demographic data were collected from 124pneumonia patients. Sputum was cultured for S. aureus, GNEB, H. influenzae and S. pneumoniae.The disc diffusion method was used to determine resistance to eight antimicrobial agents. Amongthe 124 sputum samples, eight (6.5%) were positive for S. aureus, 15 (12.1%) for GNEB, two(1.6%) for S. pneumoniae and one (0.8%) for H. influenzae. Hospitals, gender, ethnicity, comorbidities and symptoms did not significantly (p > 0.05; ö2) affect the prevalence of these bacteria.GNEB infection was most prevalent (47%) in patients over 70 years old. Gentamicin and levofloxacin were the most effective against these bacteria.


Assuntos
Humanos , Escarro/efeitos dos fármacos , Pneumonia/tratamento farmacológico , Trinidad e Tobago , Região do Caribe
4.
West Indian med. j ; 42(suppl.3): 13, Nov. 1993.
Artigo em Inglês | MedCarib | ID: med-5497

RESUMO

Ongoing epidemiological surveillance for nosocomial Legionnaires' Disease (LD) was initiated after control of an initial outbreak involving eight cases at a Nova Scotia Hospital in 1984. All cases of nosocomial pneumonia were screened for LD, and water samples were cultured for Legionella at intervals. No clinical cases of LD were identified until April, 1987, although there were occasional positive cultures from water samples in different areas of the hospital. Subsequently, six to seven cases have been identified over each 12-month period with no more than two cases in any month. The mean age of patients was 67.7 years (range 54 - 83) with a male to female ratio 2.5:1. The mean time of onset of pneumonia after admission was 19.9 days (range 8 - 27) with diagnosis being made in most cases by sputum culture. Risk factors included smoking, immunosuppressive therapy and admission to a specific wing of the hospital. Water samples from the specific wing of the hospital were persistently positive at high levels until certain plumbing revisions were instituted. In contrast to the initial outbreak, these cases represent an endemic level of nosocomial LD related to a specific area of the hospital. Ongoing surveillance is required for detection and control (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Doença dos Legionários/transmissão , Pneumonia , Infecção Hospitalar , Controle de Doenças Transmissíveis , Canadá
6.
Bahamas Med J;4(1): 8-9, 1990.
em Inglês | MedCarib | ID: med-4159

RESUMO

The medical records of 100 children (mean age 1.8 years) consecutively admitted to the ward with a diagnosis of bronchopneumonia, are reviewed. All the patients had a full blood work-up and chest x-rays on admission. All patients were commenced and continued on antibiotics - 95 percent interavenously, 55 percent of the total leukocyte counts and 56 percent of the chest x-rays were normal while 91 percent of the blood cultures were sterile. The management of respiratory infections needs review. Blood cultures and chest x-rays are imporant diagnostic tools which should be used judiciously. (AU)


Assuntos
Criança , Lactente , Humanos , Pneumonia
7.
Eur J Pediatr ; 144(3): 255-8, Sept. 1985.
Artigo em Inglês | MedCarib | ID: med-9330

RESUMO

The incidence and clinical features of pneumonia have been examined in children with homozygous sickle cell (SS) disease and in age/sex matched control children with a normal haemoglobin (AA) genotype followed in a cohort study of sickle cell disease from birth. Survival curve analysis indicated a similar incidence of pneumonia in the two genotypes up to the ages of 8 months after which pneumonia became significantly more prevalent in SS disease, the relative risk exceeding a factor of four by 4 years of age. Children with SS disease were also more prone to multiple episodes.Comparison of clinical features in the two genotypes yielded no difference in sex or seasonal involvement, or in the results of bacteriological and radiological investigations. Children with SS disease and pneumonia had an increased frequency and increased duration of hospital admission, and mortality was confined to this group. It is concluded that children with SS disease have an increased prevalence of single and multiple attacks of pneumonia and that these events run a more serious clinical course than in control children. (AU)


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Masculino , Feminino , Anemia Falciforme/complicações , Pneumonia/complicações , Anemia Falciforme/genética , Seguimentos , Homozigoto , Hospitalização , Jamaica , Tempo de Internação , Pneumonia/diagnóstico , Estudos Prospectivos , Risco
8.
In. Cruickshank, Robert; Standard, Kenneth L; Russell, Hugh B. L. Epidemiology and community health in warm climate countries. Edinburgh, Churchill Livingstone, 1976. p.1-11.
Monografia em Inglês | MedCarib | ID: med-10178
9.
Br J Haematol ; 24(4): 491-501, Apr. 1973.
Artigo em Inglês | MedCarib | ID: med-13317

RESUMO

The clinical and haematological features of 90 Jamaican patients with haemoglobin SC disease are reviewed. Mean haemoglobin levels indicated mild anaemia although individual haemoglobin levels were often within the normal range. The clinical features were qualitatively similar to those of homozygous sickle cell disease(SS disease) although they were generlly less frequent and of lesser severity. Ocular pathology was an exception, occuring more frequently in SS disease even in age-sex-matched groups. There is some evidence that the higher haemoglobin level in SC disease may be aetiologically related to retinal vascular disease. (AU)


Assuntos
Humanos , Criança , Adolescente , Adulto , Masculino , Feminino , Anemia Falciforme/complicações , Doença da Hemoglobina C/complicações , Fatores Etários , Bilirrubina/sangue , Doenças Cardiovasculares/complicações , Eletroforese em Gel de Amido , Contagem de Eritrócitos , Oftalmopatias/complicações , Hematócrito , Hemoglobinas/análise , Hepatomegalia/complicações , Jamaica , Artropatias/complicações , Pneumonia/complicações , Reticulócitos , Fatores Sexuais , Esplenomegalia/complicações
10.
Thorax ; 26(3): 331-8, May 1971.
Artigo em Inglês | MedCarib | ID: med-13036

RESUMO

The belief that chronic bronchitis is more prevalent among Indians than Africans in the Caribbean area was investigated by a community survey in Guyana. Respiratory symptoms were assessed by a standard questionnaire, ventilatory capacities were measured, and chest radiographs were taken of some 800 African and Indian men and women aged 35 to 54 years living in adjacent and similar communities. Histories of morning cough, chronic cough, morning phlegm, and chronic phlegm (chronic bronchitis) were more common in Indians than Africans. Although these respiratory symptoms were much more common in smokers than non-smokers, the higher prevalence rates in Indians could not be explained by smoking habits which were similar in the two races. Chronic bronchitis occurred in 17.3 percent of Indian and 2.4 percent of African male smokers and in 6.1 percent and 2.2 percent of Indian and African female non-smokers respectively. Judging by the history, lung infection, and clinical signs, chronic bronchitis was more severe in Indians than Africans. The condition was more common among field labourers on sugar estates but, although the majority of field labourers were Indian, this occupational difference only partially explained the difference in prevalence between Indians and Africans. Indians, for reasons unknown, appear to have a greater susceptibility than Africans to chronic bronchitis.(AU)


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Grupos Étnicos , Doenças Respiratórias/epidemiologia , África , Asma/epidemiologia , Bronquite/epidemiologia , Tosse/epidemiologia , Guiana , Índia , Pneumonia/epidemiologia , Fatores Sexuais , Tabagismo , Espirometria , Radiografia Torácica , Tuberculose Pulmonar/epidemiologia
11.
West Indian med. j ; 20(1): 60-8, Mar. 1971.
Artigo em Inglês | MedCarib | ID: med-10910

RESUMO

The clinical features in the first 12 years of life of 100 patients with homozygous SS anaemia are described. The majority of patients presented before age 2 years. The earliest diagnosis was made at 3 months of age. The hand foot syndrome, painful crisis and megaloblastic change were early manifestations of disease, whereas leg ulceration did not occur until beyond the age of 6 years. No examples of haemolytic crises were seen. Growth did not appear to be retarded by Jamaican standards. Death occurred in 2 cases (AU)


Assuntos
Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Anemia Falciforme/diagnóstico , Anemia Falciforme/complicações , Anemia Falciforme/genética , Anemia Falciforme/mortalidade , Estatura , Peso Corporal , Doenças Ósseas/complicações , Eritrócitos Anormais , Auscultação Cardíaca , Hemoglobinas/análise , Hepatomegalia/complicações , Homozigoto , Colestase/complicações , Úlcera da Perna/complicações , Doenças do Sistema Nervoso/complicações , Dor/complicações , Pneumonia/complicações , Fatores Sexuais , Esplenomegalia/complicações , Jamaica
12.
Br Med J ; 3(713): 31, July 4 1970.
Artigo em Inglês | MedCarib | ID: med-14863

RESUMO

Acute pulmonary diseases in patients with sickle cell anaemia are usually diagnosed as pneumonia, but in our experience their rate of resolution and clinical course is different from pneumonia occuring in patients with normal haemoglobins. To confirm this we analysed the clinical course of these clinical episodes in a group of patients with sickle cell anaemia and compared them with a control group of patients with acute lobar pneumonia (AU)


Assuntos
Humanos , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Anemia Falciforme/complicações , Pneumopatias/etiologia , Diagnóstico Diferencial , Infarto/etiologia , Pneumonia/diagnóstico , Pneumonia/etiologia , Circulação Pulmonar
13.
Thorax ; 25(2): 141-9, Mar. 1970.
Artigo em Inglês | MedCarib | ID: med-9566

RESUMO

Observations made on wet and dry slices of inflated human lungs taken at necropsy have been used to give a more complete account of the alveolar duct system, the basic respiratory structure. This includes consideration of the central spiral alveolar duct fibre, which is thought to consist of elastic and collagen, the spiral arrangement of alveoli and the special nature of the terminal alveolus, the interdigitation of alveoli from adjacent alveolar ducts and the arrangement of pulmonary arterioles. This suggests that the alveolar duct system is specifically designed so that changes in volume are not accompanied by changes in alveolar surface area.(AU)


Assuntos
Pulmão/patologia , Colágeno , Tecido Elástico , Pneumonia/patologia , Alvéolos Pulmonares/patologia , Artéria Pulmonar , Circulação Pulmonar
15.
West Indian med. j ; 10(4): 234-9, Dec. 1961.
Artigo em Inglês | MedCarib | ID: med-12724

RESUMO

Owing to the relatively high incidence of atypical pneumonia and other unspecified pneumonias reported in young children and adults in Jamaica, and due to the growing interest in the prevalence of Q. fever over the world, it was thought useful to do a survey of this disease in man and animals. Three hundred and four sera were examined during the period 1952-6, and 185 specimens of sera in 1960 - from man and animals in Jamaica. Of these two series, 122 sera were from abattoir workers. The sera were examined by the Compliment Fixation Test using antigen prepared from the Henzerling, Ninemile and Herzberg strains of the Rickettsia burnetti, supplied by Behringwerke, Germany. Only three sera were positive in the 1952/6 series, titres 1:20, 1:40 and 1:80. Two of the positive sera and 10 doubtful sera were checked at the virus laboratory U.S. P.H. Service, CDC Montgomery, Alabama, 2 months later with two doubtful reslts (1:4 or 1:8 titres) the others with essentially negative results. In the 1960 series there were no positive sera. The above results suggest that Q. fever is not at present prevalent in Jamaica. A follow up of this work should be done 5-10 years later. (AU)


Assuntos
Humanos , 21003 , Febre Q/imunologia , Formação de Anticorpos , Pneumonia/etiologia , Testes Sorológicos , Jamaica , Febre Q/epidemiologia , Febre Q/transmissão
16.
West Indian med. j ; 10(2): 140, June 1961.
Artigo em Inglês | MedCarib | ID: med-7583

RESUMO

The latest period for which detailed and final figures on causes of mortality are available is the year 1956. At this time among the 10 principal causes of death there were still 5 communicable diseases - pneumonia, gastro-enteritis, respiratory tuberculosis, malaria and syphilis. Infective and parasitic diseases accounted for 12.7 percent of total deaths but this represented a reduction of more than 50 percent over the 10 year period prior to 1956 and the specific death rates for these diseases, excepting gastro-enteritis, are declining steadily. The majority of deaths from pneumonia, gastro-enteritis, malaria and syphilis occurs in the 0-4 years age groups and the respiratory tuberculosis death rates are now highest in the older age groups. Of the other reportable diseases large increases have been noted in the number of cases of infectious hepatitis reported (AU)


Assuntos
Humanos , Criança , Doenças Transmissíveis , Jamaica/epidemiologia , Pneumonia , Gastroenterite , Tuberculose , Malária , Sifilinismo em Homeopatia
17.
Jamaican Nurse ; 2(2): 33-4, Feb. 1963.
Artigo em Inglês | MedCarib | ID: med-13474
18.
Br Guiana Med Ann ; 26: 83-94, 1943.
Artigo em Inglês | MedCarib | ID: med-8850

RESUMO

One hundred cases of pneumonia treated with sulphapyridine were investigated. There was one death (a case of broncho pneumonia seen on the 34th day of illness, organism Streptococcus viridans, with terminal vasomotor failure ) giving a mortality rate of 1 percent; the figure for the three previous years, without chemotherapy, was 13.6 percent. The reactions of the white cell count and blood sedimentation rate are shown. Clinical improvement occurred about eight hours after administration of the drug, which was well tolerated by the children. Resolution was complete, and recoveries were uniformly uneventful. A few cases displayed some sensitivity to the drug, and the indications are that some patients are hypersensitive to sulphapyridine; as this sensitivity is obvious from the outset ordinary care will prevent any catastrophe. The danger if the drug is not used under medical supervision is no less obvious. The comparatively short interval of administration made dietary restrictions easy and readily adaptable. There was a marked absence of toxic effects as a result of the administration of sulphapyridine (Summary)


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Pneumonia/tratamento farmacológico , Criança , Sulfapiridina/administração & dosagem , Sulfapiridina/uso terapêutico , Comportamento Alimentar , Sedimentação Sanguínea/efeitos dos fármacos , Sulfapiridina/efeitos adversos
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