[Nutritional status and immunoglobulin and cytokine concentrations in children with malaria]. / Estado nutricional y niveles de inmunoglobulinas y citocinas en niños con malaria.

OBJECTIVES: To relate nutritional status and concentrations of immunoglobulins and cytokines in children with malaria from two areas with different risk of malaria transmission. METHODS: We performed a descriptive, cross-sectional study comparing children aged 4-11 years old from two areas with different risk of malaria transmission in Colombia. The sample consisted of 66 children from El Bagre and Zaragoza (high transmission area) and 62 children from Turbo (low transmission area). To determine the risk of undernutrition, height/weight, age/height and weight/age indexes were calculated, and serum concentrations of interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-alpha), total IgE and malaria-specific IgE were measured. RESULTS: In the high transmission area, concentrations of total and specific IgE and of TNF-alpha were significantly higher. In both areas, the values obtained for total IgE (84 %), specific-IgE (32 %), TNF-alpha (72 %) and IL-10 (84 %) were higher than standard values. Anthropometric indicators revealed acute undernutrition (wasting) in 33 %, chronic undernutrition (stunting) in 52 %, and global undernutrition in 56 % of the population. CONCLUSIONS: Malaria and protein-energy malnutrition were highly prevalent in both areas. In children from the low transmission area, stunting was significantly greater. In the high transmission area, the mean total IgE was twice that found in the low transmission area and no association with nutritional status was observed. Levels of specific IgE did not differ according to the species of Plasmodium infection.

Estado nutricional y niveles de inmunoglobulinas y citocinas en niños con malaria / Nutritional status and immunoglobulin and cytokine concentrations in children with malaria

Objetivos: Relacionar el estado nutricional y los niveles de inmunoglobulinas y citocinas en niños maláricos de dos zonas con diferente riesgo para malaria. Métodos: Mediante un estudio descriptivo transversal se compararon 2 grupos de niños entre 4-11 años de edad procedentes de dos zonas con diferente riesgo para malaria en Colombia: 66 niños de los municipios de El Bagre y Zaragoza (zona de mayor riesgo malárica) y 62 niños de Turbo (zona de menor riesgo). Se calcularon los índices peso/talla, talla/edad y peso/edad para establecer el riesgo de desnutrición y se midieron concentraciones séricas de interleucina 10 (IL-10), factor de necrosis tumoral alfa (TNF- ), inmunoglobulina E (IgE) total e IgE específica para malaria. Resultados: En la zona de mayor riesgo fueron significativamente mayores los niveles de IgE total, IgE específica, y TNF- .Ambas zonas presentaron niveles superiores a los establecidos por los estándares para IgE total (84 por ciento), IgE específica (32 por ciento), TNF- (72 por ciento) e IL-10 (84 por ciento). Los riesgos de desnutrición fueron: aguda, 33 por ciento; crónica, 52 por ciento, y global, 56 por ciento. Conclusiones: La malaria y la desnutrición coexisten con alta frecuencia en ambas zonas. En la zona de menor riesgo malárico hay significativamente más desnutrición crónica. El promedio de IgE total en la zona de mayor riesgo malárico es el doble del que existe en la zona de menor riesgo y no hay asociación con el estado nutricional. Los valores de IgE específica no difieren por especie de Plasmodium infectante (AU)

[Pharmaceutical care in people who have had acute coronary episodes (TOMCOR study)]. / Atención farmacéutica en personas que han sufrido episodios coronarios agudos (Estudio TOMCOR).

BACKGROUND: This study evaluates the effects on coronary patients of a new practice in community pharmacies called Pharmaceutical Care (PhC) as compared to the traditional pattern of pharmacy practice. It attempts to ascertain whether pharmaceutical care is feasible in addition to ascertaining differences in effectiveness for coronary patients' pharmacotherapeutic health outcomes, potentially attributable to PhC. METHODS: A randomized prospective controlled-intervention study was conducted in 83 community pharmacies in the provinces of Asturias, Barcelona, Madrid and Biscay in a one-year monitoring of the drug-use of 735 patients at the start of the study (330 intervention patients and 405 control) and 600 at the end. RESULTS: Differences were fund in favor of the intervention group in: a) the use of health care services as a morbidity indicator such as frequency of hospital emergency room visits 1.27 I (CI95%; 1.10-1.44) and 1.63 C (CI95%; 1.36-1.90) or average length-of-stay in Intensive Care Units 2.46 I (CI95%; 1.56-3.36) and 5.87 C (CI95%; 3.57-8.17), both due to coronary causes; b) health-related quality of life score (physical functioning dimension difference of 4.7 (p < 0.05); c) average patient knowledge of coronary heart disease risk factors having improved by 10% (p < 0002-0.007 depending on dimension); d) patient knowledge of the name and identification of their drugs having improved by 10% (p < 0.001) along with their subjective perception of the antiagregans drugs relative importance having improved by 12% (p < 0.009) and effects of beta-blockers having improved by 25% (p < 0.02); e) average satisfaction with pharmaceutical care service and perception of pharmacist's professional competence having improved by 2% (p < 0.000 to 0.05 depending on dimension). CONCLUSIONS: A decrease in emergency health care demand due to coronary causes, a fewer number of patient hospitalizations and a shorter length-of-stay in Coronary Intensive Care Units due to hospitalization regarding coronary patients on pharmaceutical care would suggest that patients who suffered an acute coronary heart episode made a better use of drugs and would tend to be less ill. Furthermore, coronary patients who received pharmaceutical care services showed a better knowledge of the reasons for their pharmacotherapy and therefore took better advantage of health care resources and improved their health condition.

[Lung cancer mortality trends in Asturias (1976-1989)]. / Tendencia de la mortalidad por cáncer de pulmón en Asturias (1976-1989).

BACKGROUND: The Trend of lung cancer mortality rates in Asturias during 14 years is studied in order to know whether it shows the same change pattern described for other countries. METHODS: With this purpose, a graphic study of adjusted and age specific rates, including and analysis of birth cohorts, is carried out, and the change average percentage per year and the sex ratio are calculated. RESULTS: In men, the continuous increase of mortality stands out (change average percentage per year of age adjusted rates of 4.83%) with the only exception of the age group of 45-54 years, which had a variation per year of 1.90%, whereas in women, an overall decrease (-1.18 %) was observed, with the exception of women older than 74 years, who showed an increase of 1.73% per year. In men, the cohorts analysis showed on increasing cohort effect in all generations and a decreasing effect in some women. CONCLUSIONS: Lung cancer will probably go on increasing in Asturias in the next years, among men, whereas in women, it seems that a generalized decrease has been initiated, mainly in the youngest ones and the, increase, observed in other countries in previous years, is not evident. Additional studies, focused on the reasons for these trends, will be necessary and basically the following up of the evolution in men of 45-54 years, whose incipient decrease may indicate a change of trend, which facilitates hypothesis generation and verification.