Assuntos
Antígenos de Bactérias/líquido cefalorraquidiano , Cromatografia de Afinidade , Enterococcus faecalis/imunologia , Meningites Bacterianas/imunologia , Streptococcus pneumoniae/imunologia , Idoso , Amoxicilina/uso terapêutico , Anticorpos Antibacterianos/imunologia , Antígenos de Bactérias/imunologia , Técnicas de Tipagem Bacteriana , Ceftriaxona/farmacologia , Ceftriaxona/uso terapêutico , Reações Cruzadas , Diagnóstico Tardio , Farmacorresistência Bacteriana , Substituição de Medicamentos , Quimioterapia Combinada , Endocardite/complicações , Endocardite/microbiologia , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/isolamento & purificação , Reações Falso-Positivas , Gentamicinas/uso terapêutico , Humanos , Masculino , Meningites Bacterianas/líquido cefalorraquidiano , Meningites Bacterianas/etiologia , Meningites Bacterianas/microbiologia , Especificidade da Espécie , Punção EspinalRESUMO
OBJECTIVE: To determine the relationship between pulse pressure, traditional risk factors, vision impairment and different clinical forms of diabetic retinopathy. METHODS: A cross-sectional study was conducted between December 1st, 2004 and July 16th, 2005 within the care centers of Kinshasa, DRC. The origin population (n=3010 diabetics) served to estimate the diabetic retinopathy prevalence while a random sample of 301 diabetics participated to this analytic study: age>or=20 years, anthropometry, components of blood pressure, fasting glycaemia, optometry, fundoscopy, stages of diabetic retinopathy. RESULTS: The rate of diabetic retinopathy was 31.6% 95 CI: 26.3-36.9 in Kinshasa town. In the random sample, diabetic retinopathy was non proliferative in the majority (90%). Subjective decrease of acuity was associated with diabetic retinopathy in the sample (OR=2.7; 95% CI 1.1-5.4; p<0.05), among women (OR=2.7; 95% CI 1.3-5.7; p<0.05), and in patients with type 2-diabetes (OR=2; 95% CI 1.1-3.4; p<0.05). Objective decrease of acuity was associated with diabetic retinopathy in the study sample (OR=3.6; 95% CI 1.1-12.6; p<0.05). Visual impairment was significantly associated with diabetic retinopathy in women (OR=3.6; 95% CI 1.1-12.6; p<0.05) and proliferative diabetic retinopathy. Pregnancy after diabetes mellitus onset was a significant risk factor of diabetic retinopathy for women (OR=3.2; 95% CI 1.1-13.2; p<0.05). Using logistic regression analysis, family history of diabetic retinopathy (OR=3.2; 95% CI 1.2-8.8; p<0.05), diabetes duration >/=4 years (OR=3.4; 95% CI 1.4-8.5; p<0.01), and pulse pressure>or=60 mmHg (OR=5; 95% CI 2-12.8; p<0.001) were the independent and significant predictors of diabetic retinopathy. CONCLUSION: Urgent programme of prevention and control of diabetic retinopathy and its risk factors is needed.