RESUMO
1. The clonidine suppression of urinary metanephrines as a criterion for the diagnosis of pheochromocytoma is described. Twenty-four patients were divided into 3 groups: Group I, 10 patients with pheochromocytoma (confirmed by tomography and surgery); Group II, 9 patients with suspected pheochromocytoma (clinical evidence plus one mildly elevated value of urinary metanephrines, but with negative tomography); Group III, 5 patients with proven essential hypertension. 2. Urinary metanephrine levels were determined in urine collected before (basal) and 3 h after a single oral dose of clonidine (0.4 or 0.8 mg). 3. Mean basal urinary metanephrine levels were above normal for group I (9.2 +/- 2.2 micrograms/mg creatinine) and group II (2.2 +/- 0.3 micrograms/mg creatinine) but were within the normal range for group III (0.6 +/- 0.1 microgram/mg creatinine). After clonidine administration, urinary metanephrine levels remained elevated for all patients with pheochromocytoma but decreased to within the normal range for all but one patient in group II. The urinary metanephrine levels of group III were not significantly altered by clonidine. 4. These data demonstrate that, when monitored by the clonidine suppression test, urinary metanephrine levels are useful for the diagnosis of pheochromocytoma, permitting the differentiation of affected patients from those exhibiting essential hypertension and increased sympathetic drive.
Assuntos
Neoplasias das Glândulas Suprarrenais/diagnóstico , Clonidina , Epinefrina/análogos & derivados , Metanefrina/urina , Feocromocitoma/diagnóstico , Neoplasias das Glândulas Suprarrenais/urina , Pressão Sanguínea , Humanos , Feocromocitoma/urinaRESUMO
Hepatitis B is a severe disease when acquired during the neonatal period. The identification of the infected pregnant women allows prevention of newborn infection by active and passive immunization soon after birth. We studied pregnant women in their first visit to eight different primary medical centers in Butantan, a subdistrict of S. Paulo city. 477 samples were tested for anti-HBc. From 44 (9.2%) anti-HBc positive samples, 2 (0.4%) were HBsAg positive and 37 (7.7%) were anti-HBs positive. A risk factor for hepatitis B could only be detected in 8 (18.9%) of the 44 anti-HBc positive samples.
Assuntos
Centros Comunitários de Saúde , Anticorpos Anti-Hepatite B/sangue , Antígenos da Hepatite B/sangue , Hepatite B/imunologia , Complicações Infecciosas na Gravidez/imunologia , Encaminhamento e Consulta , População Urbana , Adulto , Biomarcadores/sangue , Brasil/epidemiologia , Distribuição de Qui-Quadrado , Centros Comunitários de Saúde/estatística & dados numéricos , Feminino , Hepatite B/epidemiologia , Humanos , Incidência , Pessoa de Meia-Idade , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Encaminhamento e Consulta/estatística & dados numéricos , Estudos Soroepidemiológicos , População Urbana/estatística & dados numéricosRESUMO
481 pregnant women attended at first consultation from a São Paulo city suburb-subdistrict of Butantan-São Paulo State, Brazil, from April to October of 1988, were investigated regarding the prevalence of verminosis. The mean age was 24.5 years (range 14-46), the average family income was 0.97 PCMW (per capita minimum wage) and the average number of members of the family was 4 (1 to 15). The verminosis prevalence was 45.1% among the women. The most frequent parasites were: Ascaris lumbricoides (19.0%), ancilostomídeos (16.7%) and Trichuris trichiura (15.9%). The verminosis prevalence was significantly higher among the pregnant women (p < 0.05) who belonged to the families with income below 0.5 PCMW and greater than 4 members.
Assuntos
Helmintíase/epidemiologia , Complicações Parasitárias na Gravidez/epidemiologia , Infecções por Protozoários/epidemiologia , Adolescente , Adulto , Assistência Ambulatorial , Animais , Brasil/epidemiologia , Eucariotos/isolamento & purificação , Feminino , Helmintíase/parasitologia , Helmintos/isolamento & purificação , Humanos , Pessoa de Meia-Idade , Gravidez , Complicações Parasitárias na Gravidez/parasitologia , Prevalência , Infecções por Protozoários/parasitologia , Fatores SocioeconômicosRESUMO
Three hundred and sixty-three pregnant women enrolled in the Pregnancy Medical Care Program of S. Paulo Health Department in the district of Butantan, S. Paulo city, Brazil, were studied at their first routine consultation between April and October, 1988. Their average age was 25 and 65.9% of them belonged to families with a monthly income below US$50.00 per capita. Only 3.1% presented an income above US$150.00 per capita. Taking the minimum transferrin saturation threshold of 15% as determining iron deficiency, a 4.6% prevalence of iron deficiency was observed in the first trimester, 17.3% in the second trimester and 42.8% in the third trimester, resulting in an overall prevalence of 12.4%. There was no significant difference between prevalences of iron deficiency according to the number of pregnancies. The prevalence of iron deficiency was higher in women presenting incomes below US$50.00 per capita.
Assuntos
Anemia Hipocrômica/epidemiologia , Deficiências de Ferro , Complicações Hematológicas na Gravidez/epidemiologia , Adulto , Anemia Hipocrômica/sangue , Brasil/epidemiologia , Distribuição de Qui-Quadrado , Feminino , Deficiência de Ácido Fólico/sangue , Hemoglobinas/análise , Humanos , Ferro/sangue , Gravidez , Complicações Hematológicas na Gravidez/sangue , Cuidado Pré-Natal , Prevalência , Fatores Socioeconômicos , Transferrina/análiseRESUMO
Three hundred and sixty-three pregnant women enrolled in the Pregnancy Medical Care Program of S. Paulo Health Department from the district of Butantan, S. Paulo city, Brazil, were studied at the first routine consultation. At the time they were examined they were not given any medicine containing iron, folic acid or vitamin B12. Their average age was 25 and 65.9% belonged to families with a monthly per capita income below US$ 50.00. Only 3.1% had a per capita income above U$$ 150.00. The prevalence of anemia was 12.4%. The hemoglobin concentration (grams/dl) in the first trimester was significantly higher than in the second and third trimester of pregnancy. The prevalence of anemia in the first trimesters (3.6%) was significantly smaller than that found in the second (20.9%) and third semesters (32.1%). Those women who had had more than three gestations presented a higher prevalence of anemia than those with less than three, and the prevalence of anemia was higher in the group whose families had a monthly per capita income below US$ 25.00.
Assuntos
Anemia Hipocrômica/epidemiologia , Complicações Hematológicas na Gravidez/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Feminino , Hemoglobinas/análise , Humanos , Renda , Pessoa de Meia-Idade , Paridade , Gravidez , PrevalênciaRESUMO
The diagnosis of some infectious diseases contracted during pregnancy is very important, as these diseases can be transmitted to the fetus. Four hundred and eighty-one pregnant women were studied, of an average 24.5 years of age (from 14 to 46), during their first prenatal visit to the State of S. Paulo's Health Care Centres in the subdistrict of Paz (Butantan), City of S. Paulo, Brazil, between April and October, 1988. Classified by trimester of pregnancy, 230 patients (47.8%) fell into the first, 203 (42.2%) into the second and 48 (10%) into the third trimester. Of the 474 patients that declared their income, 309 (65.2%) earned 1 MSPC (minimum salary per capita) per month, which gives some indication of the low socioeconomic status of our patients is. The serologic tests for syphilis, toxoplasmosis and Chagas' disease were analysed for each patient, more than one technique being used for each. The results were as follows: 25 patients (5.2%) had a positive test for syphilis; in 67 patients (13.9%) active toxoplasmosis was diagnosed (Presence of IgM antibodies in 6); 14 patients (2.9%) were positive for Chagas' disease, among which 10 (71.4%) came from the States of Bahia and Minas Gerais, where this disease has a high prevalence.
Assuntos
Doença de Chagas/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Sorodiagnóstico da Sífilis , Toxoplasmose/diagnóstico , Adolescente , Adulto , Brasil , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Testes Sorológicos , Fatores SocioeconômicosRESUMO
No periodo compreendido entre abril e outubro de 1988, foram estudadas 481 gestantes de primeira consulta, as quais estavam inscritas no Programa de Atendimento a Gestante em oito Centros de Saude da Secretaria do Estado da Saude de Sao Paulo. Do total estudado, 86 gestantes nao trouxeram amostras de fezes para analise, mesmo apos varias solicitacoes. A idade media da populacao estudada foi de 24,5 anos (idade minima de 14 e maxima de 46 anos); a renda media das familias das gestantes foi de 0,97 SMPC (salario minimo per capita) e o numero medio de pessoas que compunham suas familias foi de quatro (um a quinze pessoas). A prevalencia de verminose foi de 45,1 por cento (n=395). Os parasitas mais frequentes foram: Ascaris lumbricoides (19,0 por cento); ancilostomideos (16,7 por cento) e Trichuris trichiura (15,9 por cento). Das 248 gestantes infectadas de enteroparasitas, 70 (28,2 por cento) eram portadoras somente dos seguintes protozoarios: Endolimax nana, Entamoeba coli e Iodamoeba butschllii. A prevalencia de parasitas intestinais foi significativamente maior (p<0,05) nas gestantes pertencentes as familias com renda de ate 0,5 SMPC e compostas por 5 pessoas ou mais.