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1.
Bull Soc Pathol Exot ; 95(1): 3-7, 2002 Mar.
Artículo en Francés | MEDLINE | ID: mdl-12012960

RESUMEN

In July 1999, after the return of the Kosovar refugees to their country, an outbreak of acute hepatitis A (HAV) and E (HEV) occurred. Epidemic hepatitis and diarrhoea are closely monitored communicable diseases which had been singled out as priorities by the health authorities of the former Republic of Yougoslavia. Several field surveys were undertaken: description of reported cases, serological study of clinical patients, study of anti-HAV seroprevalence in a school and a case control study to assess risk factors. The analysis of the reports indicates an epidemic peak at the end of September, 2 or 3 weeks after the start of the new school year, with an increase of cases relative to the age of the children in school. In a serologic study of 104 samples, we found an anti-HAV IgM positivity in 88% of the cases. Children were more likely to be positive when compared to teenagers and adults; likewise, consumers of well-water as versus those drinking network water (p = 0.03). The study of seroprevalence showed that transmission had taken place within the school. The case control study, in spite of its imperfections, indicated that consumption of water melon, the only fruit cultivated locally, is a factor which facilitates the HAV transmission. Circulation of the hepatitis E virus was confirmed for 4 sick persons (including 2 co-infected HAV-HEV) and in 4 persons without clinical symptoms. These results show the permanent risk of faeco-oral infections in this area and the need to develop a relevant prevention policy.


Asunto(s)
Hepatitis A/epidemiología , Hepatitis E/epidemiología , Estudios Seroepidemiológicos , Pruebas Serológicas , Adolescente , Adulto , Niño , Preescolar , Femenino , Frutas , Hepatitis A/diagnóstico , Hepatitis A/transmisión , Virus de la Hepatitis A/inmunología , Anticuerpos Antihepatitis/sangre , Hepatitis E/diagnóstico , Humanos , Inmunoglobulina M/sangre , Lactante , Masculino , Persona de Mediana Edad , Refugiados , Instituciones Académicas , Yugoslavia/epidemiología
2.
Environ Health Perspect ; 106(6): 361-4, 1998 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-9618353

RESUMEN

Lead (Pb) poisoning has numerous effects on the erythropoietic system, but the precise mechanism whereby high dose exposure causes anemia is not entirely clear. We previously reported that Pb exposure is associated with depressed serum erythropoietin (EPO) in pregnant women residing in a Pb mining town and in a nonexposed town in Kosovo, Yugoslavia. In a prospective study, we tested the hypothesis that blood Pb concentration (BPb) may be associated with depressed EPO in children. BPb, hemoglobin (Hgb), and serum EPO were measured at ages 4.5, 6.5, and 9.5 years in 211, 178, and 234 children, respectively. At 4.5 years of age, mean BPbs were 38.9 and 9.0 microg/dl in the exposed and nonexposed towns, respectively; BPbs gradually declined to 28.2 and 6.5 microg/dl, respectively, by age 9.5 years. No differences were found in Hgb at any age. At age 4. 5 years, a positive association between BPb and EPO (beta = 0.21; p = 0.0001), controlled for Hgb, was found. The magnitude of this association declined to 0.11 at age 6.5 years (p = 0.0103) and 0.03 at age 9.5 years (p = 0.39). These results were confirmed using repeated measures analyses. We concluded that in Pb-exposed children, the maintenance of normal Hgb requires hyperproduction of EPO. With advancing age (and continuing exposure), this compensatory mechanism appears to be failing, suggesting a gradual loss of renal endocrine function due to Pb exposure.


Asunto(s)
Exposición a Riesgos Ambientales , Eritropoyetina/biosíntesis , Intoxicación por Plomo/fisiopatología , Factores de Edad , Niño , Preescolar , Eritrocitos/efectos de los fármacos , Eritrocitos/fisiología , Femenino , Hematopoyesis/efectos de los fármacos , Hemoglobinas/efectos de los fármacos , Humanos , Riñón/efectos de los fármacos , Riñón/fisiología , Masculino
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