RESUMO
OBJECTIVE: The purpose of this study was to look at rates of acculturation among Vietnamese immigrants, with particular emphasis on health behaviors. DESIGN: A volunteer sample was surveyed. SETTING/PARTICIPANTS: The participants were drawn from inner and western Sydney, Australia. Participants were asked for their perception of their English fluency as a measure of likely exposure to health promotion advertising and their food, social, exercise, drinking, and smoking habits. RESULTS: It was found that the longer the Vietnamese immigrants participants had lived in Australia, the less likely they were to smoke; in fact, the smoking rate of this population is as low as that of the Australian population as a whole. However the immigrants did not change their low rate of alcohol consumption. In addition, the Vietnamese who had lived longer in Australia significantly increased their daily exercise and started to eat more take-away foods. CONCLUSIONS: With respect to health promotion, these changes are mixed: smoking has decreased, but half the group had begun eating take-away foods; this factor, if combined with a lack of exercise, is likely to lead to obesity.
Assuntos
Comportamentos Relacionados com a Saúde , Aculturação , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Estudos Transversais , Emigração e Imigração , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , População Urbana , Vietnã/etnologiaRESUMO
BACKGROUND AND OBJECTIVES: Certain patient ethnic groups may require blood components from donors under-represented in the UK donor population. Selective recruitment of Afro-Caribbean donors is therefore necessary but was considered to pose an increased risk of human T-cell leukaemia/lymphoma virus (HTLV) infection. To assess this a seroprevalence study of HTLV was undertaken in Afro-Caribbean and Caucasian donors. MATERIALS AND METHODS: Sera from 1100 Afro-Caribbean and 1100 Caucasian donors were tested for antibody to HTLV. Reactive samples were confirmed for specificity using an algorithm comprising two additional assays and polymerase chain reaction (PCR) where possible. RESULTS: Six Afro-Caribbean donors (0.55%) were considered to be infected with HTLV I. CONCLUSION: Donor selection in this case caused a significantly elevated prevalence of HTLV infection and serves as a warning of the need for care in the design of policies for selective donor recruitment.
Assuntos
Doadores de Sangue , Etnicidade , Anticorpos Anti-HTLV-I/sangue , Infecções por HTLV-I/etnologia , Vírus Linfotrópico T Tipo 1 Humano/isolamento & purificação , RNA Viral/sangue , Viremia/etnologia , Adulto , África/etnologia , Infecções por HTLV-I/sangue , Infecções por HTLV-I/prevenção & controle , Infecções por HTLV-I/transmissão , Humanos , Programas de Rastreamento , Reação em Cadeia da Polimerase , Prevalência , Kit de Reagentes para Diagnóstico , Risco , Estudos Soroepidemiológicos , Reação Transfusional , Reino Unido/epidemiologia , Viremia/prevenção & controle , Viremia/transmissão , Índias Ocidentais/etnologia , População BrancaRESUMO
The seroprevalence of hepatitis C virus was evaluated in blood donors and antenatal clinic attenders in Kumasi, Ghana and seropositive subjects were tested for hepatitis C virus ribonucleic acid by the polymerase chain reaction (PCR). The overall seroprevalence among Ghanaians was 2.8% but there was a significantly higher prevalence in males (4.6%) than in females (1.0%). No risk factor for infection was identified by a questionnaire. Among those who showed evidence of active infection with a positive PCR, the most common genotype was type 2 but the subtype could not be specifically determined; these type 2 hepatitis C viruses may be indigenous to Africa.
Assuntos
Doadores de Sangue , Hepacivirus/genética , Hepatite C/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adolescente , Adulto , Feminino , Gana/epidemiologia , Hepatite C/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase/métodos , Gravidez , Complicações Infecciosas na Gravidez/virologia , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
The value of somatosensory evoked potentials (SEPs) for the prediction of outcome following severe head injury (HI) is established. The role of the electroencephalogram (EEG) in this setting is uncertain. In this comparative study, SEPs and EEGs were recorded within 3 days of severe HI in 90 patients, and the results related to outcome at 6 months. Patients with an isoelectric EEG or an EEG with repeated isoelectric intervals died. Reactivity of the EEG to external stimulation tended to be associated with favorable outcome. Grading of the EEGs on the basis of frequency composition otherwise provided no prognostic information. The presence of SEP scalp potentials bilaterally predicted favorable outcome, particularly if the central conduction times were normal. Conversely, the absence of one of both scalp potentials was associated with unfavorable outcome. EEGs thus provided useful prognostic information in only a minority of patients. By comparison, SEPs allowed prediction of both favorable and unfavorable outcomes in a much larger number of patients, and were therefore prognostically superior.
Assuntos
Lesões Encefálicas/fisiopatologia , Eletroencefalografia , Potenciais Somatossensoriais Evocados , Adolescente , Adulto , Idoso , Encéfalo/fisiopatologia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PrognósticoRESUMO
The prognostic value of short-latency somatosensory evoked potentials (SEP) during the first 4 days after severe head injury was studied in a group of 100 ICU patients. There was a strong association between the presence of bilateral cortical potentials and a good recovery or moderate disability 6 months after injury. In contrast, the bilateral or unilateral absence of cortical potential was associated with severe disability, persistent vegetative state, or death in a high percentage of patients. A reliable prediction of outcomes was obtained from SEP recorded within 24 h of head injury. Predictive accuracy was not influenced by the time of recording or cumulative analysis of consecutive daily SEP over the first 4 days after injury. Short-latency SEP can provide a reliable and accurate prognosis for sedated and curarized patients, and can have an important role in the management and triage of patients with severe head injury who are undergoing intensive therapy.
Assuntos
Lesões Encefálicas/diagnóstico , Potenciais Somatossensoriais Evocados , Adolescente , Adulto , Idoso , Lesões Encefálicas/mortalidade , Lesões Encefálicas/fisiopatologia , Criança , Feminino , Escala de Coma de Glasgow , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Fatores de Tempo , Ferimentos não Penetrantes/mortalidade , Ferimentos não Penetrantes/fisiopatologiaRESUMO
Eleven patients with severe obstructive sleep apnoea syndrome, which was fully reversed by treatment with nasal continuous positive airways pressure, underwent uvulopalatopharyngoplasty. All patients were followed for at least 12 months after surgery. One patient with large tonsils was cured. Of the remaining 10 patients, two showed minimal objective improvement at 12 months and the rest were unchanged. Four patients subsequently developed cardiac failure due to obstructive sleep apnoea. Thus uvulopalatopharyngoplasty was not effective in these patients with severe idiopathic obstructive sleep apnoea syndrome.
Assuntos
Palato Mole/cirurgia , Faringe/cirurgia , Síndromes da Apneia do Sono/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Respiração com Pressão Positiva , Período Pós-Operatório , Estudos Prospectivos , Síndromes da Apneia do Sono/fisiopatologia , Úvula/cirurgiaRESUMO
The relative prognostic value of short-latency somatosensory evoked potentials (SEPs) and brain-stem auditory evoked potentials (BAEPs) was assessed in 35 patients with post-traumatic coma. Analysis of the evoked potentials was restricted to those recorded within the first 4 days following head injury. Abnormal SEPs were defined as an increase in central somatosensory conduction time or an absence of the initial cortical potential following stimulation of either median nerve. Abnormal BAEPs were classified as an increase in the wave I-V interval or the loss of any or all of its 3 most stable components (waves I, III and V) following stimulation of either ear. SEPs reliably predicted both good and bad outcomes. All 17 patients in whom SEPs were graded as normal had a favourable outcome and 15 of 18 patients in whom SEPs were abnormal had an unfavourable outcome. Although abnormal BAEPs were associated with an unfavourable outcome in almost all patients (6 of 7), only 19 of 28 patients with normal BAEPs had a favourable outcome. The finding of normal BAEPs was therefore of little prognostic significance. These results confirm the superiority and greater sensitivity of the SEP in detecting abnormalities of brain function shortly after severe head trauma.
Assuntos
Tronco Encefálico/fisiopatologia , Traumatismos Craniocerebrais/fisiopatologia , Potenciais Evocados Auditivos , Potenciais Somatossensoriais Evocados , Adolescente , Adulto , Coma/fisiopatologia , Pessoas com Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PrognósticoRESUMO
In 1982 facilities for investigation of patients with sleep disorders were established at Auckland Hospital on a trial basis. Twenty patients with the obstructive sleep apnoea syndrome had been investigated and treated by the end of 1983. All were advised to avoid alcohol and sedatives and the obese patients were encouraged to lose weight. In the more severely affected patients either nasal continuous positive airway pressure or tracheostomy was used. The method of diagnosis and treatment are discussed.
Assuntos
Síndromes da Apneia do Sono/diagnóstico , Adulto , Peso Corporal , Doença Crônica , Terapia Combinada/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Síndromes da Apneia do Sono/epidemiologia , Síndromes da Apneia do Sono/terapia , Ronco/diagnósticoRESUMO
Seven patients with the severe obstructive sleep apnoea syndrome were treated with nasal continuous positive airway pressure for from three to 22 months. This treatment reversed all symptoms due to the syndrome in every patient and continued to be used in five patients. One patient stopped treatment after eight months and subsequently remained incapacitated and another underwent tracheostomy at the time of transphenoidal hypophysectomy. Nasal continuous positive airway pressure is a safe, non-invasive treatment, which may be used in the presence of cardiac and respiratory failure. It is able fully to reverse upper airway obstruction and can be used at home on a long term basis.
Assuntos
Respiração com Pressão Positiva , Síndromes da Apneia do Sono/terapia , Adulto , Feminino , Insuficiência Cardíaca/complicações , Humanos , Pneumopatias Obstrutivas/complicações , Masculino , Pessoa de Meia-Idade , Síndromes da Apneia do Sono/complicaçõesRESUMO
Cortical somatosensory evoked potentials (SEPs) were recorded following experimental acceleration concussion in the rat. Immediately after head injury there was a general reduction in the amplitude of the SEP, and all its components were either temporarily abolished or increased in latency. The early components of the SEP recovered much more rapidly than did the amplitude and latencies of the later potentials. The purpose of the study was to investigate the relative effects of concussion on the lemniscal system (whose activity is reflected by the discrete early components of the SEP) and the reticular activating system (whose activity is reflected by the diffuse high amplitude late component of the SEP). Contrary to a widely accepted theory, there was a delay in transmission of somatosensory information through the lemniscal pathways as well as through the reticular system following head injury. Such an observation is consistent with recent studies of SEPs recorded from humans comatose after head trauma. As the changes in the morphology of the waveform of the SEP following concussion can be simulated by simply recording evoked potentials at high rates of stimulation, this suggests that the delays are caused by a failure or malfunction of synaptic transmission, but the level at which this is occurring remains to be determined.
Assuntos
Concussão Encefálica/fisiopatologia , Potenciais Somatossensoriais Evocados , Animais , Masculino , Ratos , Formação Reticular/fisiopatologia , Córtex Somatossensorial/fisiopatologia , Sinapses/fisiologia , Transmissão SinápticaRESUMO
Compressed spectral array (CSA) transforms the electroencephalogram into a succinct graphic display of changes in frequency and amplitude. We used CSA to monitor 51 comatose patients for at least 15 hours daily for up to 49 days. The crucial CSA feature was the presence or absence of a peak of activity within the theta or alpha frequency range (4.0 to 13 Hz). Persistence or return of this peak in the first 10 days of coma was seen in all patients who made a good recovery; continued absence of the peak for 10 days, or its return and loss, was associated with death or a residual disability.
Assuntos
Coma/diagnóstico , Eletroencefalografia , Adolescente , Adulto , Idoso , Encéfalo/fisiopatologia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Somatosensory evoked potentials were recorded simultaneously from the neck and scalp following stimulation of the median nerve at the wrist in 83 normal subjects aged 10-79 years. The central somatosensory conduction time was measured by subtracting the peak latency of the major response from the upper cervical area (N14) from that of the primary cortical response (N20). The central conduction time remained constant between 10 and 49 years but increased abruptly by approximately 0.3 msec between the fifth and sixth decades. Following this increase there was no further change in the central conduction time. Changes with age in the amplitude of N14 and N20 differed both from the changes in latency and from each other. The amplitude of N14 was stable between 10 and 39 years but then declined progressively. The amplitude of N20 deceased between 10 and 39 years and then increased until the end of the seventh decade.
Assuntos
Envelhecimento , Eletroencefalografia , Condução Nervosa , Córtex Somatossensorial/fisiologia , Adolescente , Adulto , Idoso , Criança , Estimulação Elétrica , Potenciais Somatossensoriais Evocados , Feminino , Humanos , Masculino , Nervo Mediano , Pessoa de Meia-Idade , Vias Neurais/fisiologia , Tempo de Reação/fisiologiaRESUMO
In 94 patients with head injuries, conduction between the lower brainstem and the cerebral cortex was studied by recording evoked potentials from the scalp and neck following stimulation of the median nerves. A conduction time 3 SD or more above the normal mean (5.74 +/- 0.46 msec) or the absence of an evoked potential over one or both hemispheres was considered abnormal. During successive periods in the first 35 days after injury, the evoked potentials correlated with the outcome (classified as good or not good) in 75 to 84% of patients. Within 3 1/2 days the outcome was correctly predicted in 38 of 49 patients (78%). Six of the 7 surviving patients with persistent asymmetries of the cerebral evoked potentials remained hemiplegic. Serial studies over one year showed that both conduction time and amplitude recovered exponentially over many months, but differences persisted between the patients who made a good recovery and those who remained disabled.