RESUMO
Telomere biology disorders (TBD) are a heterogeneous group of diseases arising from germline mutations affecting genes involved in telomere maintenance. Telomeres are DNA-protein structures at chromosome ends that maintain chromosome stability; their length affects cell replicative potential and senescence. A constellation of bone marrow failure, pulmonary fibrosis, liver cirrhosis and premature greying is suggestive, however incomplete penetrance results in highly variable manifestations, with idiopathic pulmonary fibrosis as the most common presentation. Currently, the true extent of TBD burden is unknown as there is no established diagnostic criteria and the disorder often is unrecognised and underdiagnosed. There is no gold standard for measuring telomere length and not all TBD-related mutations have been identified. There is no specific cure and the only treatment is organ transplantation, which has poor outcomes. This review summarises the current literature and discusses gaps in understanding and areas of need in managing TBD.
RESUMO
OBJECTIVE: To examine health services use and barriers for recently arrived immigrants from the Horn of Africa. METHOD: A cross-sectional study conducted in Melbourne, Australia, with a convenience sample of newly arrived immigrants (n=126) from Somalia (n=67), Ethiopia (n=24), Eritrea (n=26) and Sudan (n=6). RESULTS: GPs were the major health providers for participants, yet 22 (17%) respondents had not yet accessed health services in Australia. Thirty-three (26%) participants reported having had an unmet health concern for which they would have liked to seek advice. The most commonly identified barriers to health care and recommendations for improving services were associated with communication. CONCLUSIONS: This study illustrates unmet health needs among new arrivals and a need for linguistically appropriate information about the use of Australia's health system. IMPLICATIONS: The findings support increased use of professional interpreting services and support for new arrivals in making initial contact with the health system.
Assuntos
Emigração e Imigração , Acessibilidade aos Serviços de Saúde , Serviços de Saúde/estatística & dados numéricos , Adolescente , Adulto , África do Norte/etnologia , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , VitóriaRESUMO
Intestinal parasite infections are a major cause of ill health in many resource-poor countries. This study compares the types and rates of these infections and their risk factors in recently arrived and long-term immigrants in Australia. Cross-sectional surveys of 127 East African and 234 Cambodian immigrants and refugees were undertaken in 2000 and 2002, respectively, to assess the burden of intestinal parasites and collect demographic information. Serum samples were assessed for eosinophilia and Strongyloides stercoralis and Schistosoma antibodies, and feces examined for ova, cysts, and parasites. Intestinal parasites were identified in 77/117 fecal samples from East African and in 25/204 samples collected from Cambodian participants. Eleven percent (14/124) of East Africans and 42% (97/230) of Cambodians had positive or equivocal serology for S stercoralis. Schistosoma serology was positive or equivocal in 15% (19/124) of East African participants. Potentially serious intestinal parasite infections are common among recent and longer term immigrants despite multiple visits to health care providers. Immigrants and refugees from high-risk countries would benefit from comprehensive health checks soon after resettlement.
Assuntos
Emigração e Imigração , Enteropatias Parasitárias/epidemiologia , Adolescente , Adulto , África Oriental/etnologia , Idoso , Idoso de 80 Anos ou mais , Animais , Anticorpos Antiprotozoários/sangue , Camboja/etnologia , Estudos Transversais , Fezes/parasitologia , Feminino , Humanos , Enteropatias Parasitárias/sangue , Enteropatias Parasitárias/etnologia , Enteropatias Parasitárias/etiologia , Enteropatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Schistosoma/imunologia , Schistosoma/isolamento & purificação , Esquistossomose/sangue , Esquistossomose/epidemiologia , Esquistossomose/etnologia , Esquistossomose/etiologia , Esquistossomose/parasitologia , Strongyloides stercoralis/imunologia , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/sangue , Estrongiloidíase/epidemiologia , Estrongiloidíase/etnologia , Estrongiloidíase/etiologia , Estrongiloidíase/parasitologia , Vitória/epidemiologiaAssuntos
Antimetabólitos Antineoplásicos/efeitos adversos , Tronco Encefálico/efeitos dos fármacos , Desoxicitidina/análogos & derivados , Distonia/induzido quimicamente , Fluoruracila/análogos & derivados , Mandíbula/efeitos dos fármacos , Boca/efeitos dos fármacos , Adenocarcinoma/tratamento farmacológico , Antimetabólitos Antineoplásicos/administração & dosagem , Povo Asiático , Tronco Encefálico/patologia , Capecitabina , Desoxicitidina/administração & dosagem , Desoxicitidina/efeitos adversos , Esquema de Medicação , Fluoruracila/administração & dosagem , Fluoruracila/efeitos adversos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias Retais/tratamento farmacológicoRESUMO
BACKGROUND: Immigrants and refugees are at particular risk of incomplete immunisation and may be unaware of their vaccination status. There is a paucity of data on the immunisation status of adult immigrants from African countries. AIMS: To review the immunisation status of adult immigrants from East Africa, and to identify missed opportunities for vaccination. METHODS: A community survey was conducted using self-reported vaccination status, Mantoux skin tests, and serological testing for immunity to hepatitis B, tetanus, diphtheria and measles. RESULTS: Proven inadequate immunity against at least one of tetanus (67%), hepatitis B (41%), diphtheria (34%) or measles (3%) was found among 100/126 (81%) participants despite a median of seven visits to vaccine providers since immigration. A positive Mantoux test occurred in 17% of participants. CONCLUSIONS: Pre- and post-arrival health assessments are currently failing to address vaccination needs in recently arrived East African adult immigrants. Immigrants should have their immunisation status assessed, with opportunistic vaccination provided wherever possible.