OBJECTIVE To analyze the temporal trend of asthma and rhinoconjunctivitis prevalences as well as their symptoms in adolescents.METHODS Two cross-sectional studies were conducted using the same methodology and questionnaire as was used for adolescents aged 12 to 14 years in the Brazilian city of Florianopolis, SC, Southern Brazil. Based on the international protocol of the International Study of Asthma and Allergies in Childhood (ISAAC) study, adolescents were evaluated in 2001 and 3,150 in 2012. The schools included in this study were the same as in the 2001 study. These schools were randomly selected after stratification by network (public and private) and geographic location. The total average percentage variation was estimated for the prevalence of asthma and rhinoconjunctivitis and their symptoms.RESULTS The prevalence of reported asthma was 10.9% in 2001 and 14.8% in 2012, with an average variation of 2.8% in the period. The highest average variation in the period was observed among female adolescents (4.1%). In parallel a significant increase occurred in reported physician-diagnosed asthma, 7.3% in 2001 and 11,1% in 2012, with an annual variation of 4.5%. The largest increases in reported physician-diagnosed asthma were seen in female (5.9%) and male (4.5%) public school pupils. In addition, a significant increase in reported rhinoconjunctivitis occurred, with the average variation in the period being 5.2%. Reports of severe asthma symptoms remained unchanged during the period, while the annual variation for reported current wheezing (-1.3%) and wheezing during exercise (-1.2%) decreased.CONCLUSIONS The results showed a significant increase in the annual average variation for asthma and rhinoconjunctivitis prevalence during the 2001 to 2012 period.
Introduction: Despite the great advances in serological testing for transfusion-transmitted infections, the selection of blood donors by blood bank operators remains the only way to avoid transmission within the testing window period. Part of this selection is the self-exclusion form, on which the donors can exclude their blood from donation without any explanation. This study assessed the clinical and epidemiological characteristics related to positivity for viral hepatitis and to the use of the confi dential self-exclusion (CSE) form. Methods: This transversal study analyzed the data collected from blood donors' fi les in a hospital in Southern Brazil. Univariate and multivariate analyses identifi ed the clinical and epidemiological variables related to positive serologies of viral hepatitis and to whether the donor was self-excluded. Results: Of the 3,180 donors included in this study, 0.1% tested positive for HBsAg, 2.1% for anti-HBc, and 0.9% for anti-HCV. When the 93 donors with positive serologies for viral hepatitis were compared with those who were negative, a greater proportion of the positive serology group was found to have had a history of blood transfusions (OR=4.908; 95%CI=1.628 -14.799; p<0.01), had repeatedly donated (OR=2.147; 95%CI=1.236 -3.729; p<0.01), and used the CSE form for self-exclusion (OR=7.139; 95%CI=2.045 -24.923; p<0.01). No variables were independently associated with self-exclusion. Conclusions: A history of blood transfusion, repeated donations, and self-exclusion are factors that should be considered during viral hepatitis screenings in blood banks.
Los autores presentan un estudio colaborativo que en forma prospectiva ha involucrado 14 maternidades del sector público, 10 del Ministerio de Salud (MINSA) y 4 del Instituto Peruano de Seguridad Social (IPSS); así mismo 9 correspondieron a Lima y 5 establecimientos estuvieron en otras regiones del país. Entre marzo y julio de 1993 se logró reunir un total de 4205 casos de cesárea entre 21797 partos atendidos durante el mismo período, lo que representa una frecuencia de 19,3%. No hubo mayor diferencia en la tasa entre los hospitales de Lima y Provincias, pero si se encontró una frecuencia mayor en el IPSS cuando se comparó con el MINSA. Las seis causas más importantes de cesárea en el Perú son: cesareada anterior, sufrimiento fetal agudo, parto podálico, pelvis estrecha, desproporción fetopélvica y toxemia, que mantienen más o menos la misma distribución entre el MINSA y el IPSS. Algunas otras características epidemiológicas presentan diferencias entre las pacientes atendidas en el IPSS y el MINSA y entre aquellas atendidas en Lima y en Provincias. Un tercio de las cesareadas presentaron complicaciones postoperatorias, siendo estas más frecuentes entre las mujeres atendidas en el MINSA y en Lima. La mortalidad perinatal fue 49 por mil, a predominio de los casos atendidos en provincias. La muerte materna fue del orden de 100 por cien mil y sólo ocurrió en el MINSA. Se comenta sobre la tasa de cesárea que va en aumento y acerca de la posibilidad y necesidad de bajarla, incidiendo en una evaluación mejor de las causas que con frecuencia conducen a la operación.
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