Specific immunotherapy for severe latex allergy

We studied 4 patients (3 adult females + 13y old boy) with latex allergy. All patients had anaphylaxis related with latex and oral-latex-fruit syndrome. All 3 females had severe symptoms in the workplace. The boy had spina bifida with 9 previous surgeries and needed further surgical interventions. Positive skin prick tests (SPT), the presence of serum latex specific IgE (CAP-RAST, Pharmacia-Upjohn, Sweden- class 3 in the 3 females and class 4 in the boy) demonstrated the sensitisation. All 4 patients were treated with specific immunotherapy (SIT) with aqueous extract (ALK-ALK-ABELLO SA, Spain) administered subcutaneously at the hospital, by a modified rush schedule. A maintenance dose (MD) of 0.35_g protein was established according to the magnitude of local reactions (LRs). In one patient a higher dose induced the appearance of a systemic reaction (SR) 40 min after administration, which promptly remitted with treatment. After reaching MD, all 3 females remained assymptomatic at workplace. A challenge test with latex gloves was performed. Two months after MD was reached 2 females had no symptoms and one other had mild symptoms of rhinoconjunctivitis. The boy was subjected to a surgical intervention with no allergic reaction. We also observed a reduction on skin reactivity to latex in all patients by prick tests. We consider SIT with latex to be highly effective, safe and well tolerated provided we use this dose of the allergenic extract.     

A contribution to the establishment of reference values for total mercury levels in hair and fish in amazonia

Studies on mercury levels in the Amazonian Region have typically lacked background or reference parameters. A sectional study on Hg concentration in hair and fish was conducted, together with an assessment of the prevalence of signs and symptoms related to Hg poisoning, in four communities in the Amazon Basin not impacted by gold mining, located either by a river course (Santana do Ituqui and Caxiuan?) or by a lake (Aldeia do Lago Grande and Vila do Tabatinga). Mercury determinations in hair and fish were made by flameless atomic absorption spectrophotometry. Mean total Hg in hair was 4.33 microg/g (0.40-11.60 microg/g) in 321 individuals from Santana do Ituqui, 3.98 microg/g (0.40-11.76 microg/g) for 316 persons in Aldeia do Lago Grande, 5.46 microg/g (0.37-49.85 microg/g) for 504 individuals from Vila do Tabatinga and 8.58 microg/g (0.61-45.59 microg/g) for 203 inhabitants from Caxiuan?. Fish consumption was very high in all those communities but no signs or symptoms associated with Hg poisoning were found. Mean Hg concentration in fish varied from 0.006 to 2.529 microg/g for carnivores and from 0.008 to 0.871 microg/g for noncarnivores. These values suggest that further studies including a larger number of communities would eventually lead to values of "normal" Hg concentration in the Amazonian Region quite above the limits suggested by the World Health Organization.     

Mercury exposure in Munduruku Indians from the community of Sai Cinza,State of Pará, Brazil

The objective of this cross-sectional study was to evaluate mercury exposure and health status among Munduruku Indians from the community of Sai Cinza, State of Pará, Brazil. The population studied included 330 indians, who submitted to a questionnaire, clinical exams, and collection of hair, blood, urine, and feces. Mercury was measured in hair and fish. Although no person was found to have overt mercury intoxication, the mean levels of mercury in hair were elevated (14.45 micrograms/g for children from 7 to 12 years old, 15.70 micrograms/g for women between 14 and 44 years old, and 14.1 micrograms/g for the remaining population). Mercury levels in fish were below levels recommended by the World Health Organization, but rates of fish consumption were high. These results place this indigenous populations as a group under risk of mercury toxicity from the gold production.     

Hepatitis A and B seroprevalence in Macaé, Rio de Janeiro State,Brazil

Total HAV and HBc seroprevalence rates in two socioeconomic groups in Macaé, Rio de Janeiro State, Brazil, were estimated in 1,100 surplus serum samples from routine laboratory tests identified by sex, age, neighborhood, and category of medical care, i.e., the public health system or National Unified Health System (SUS) as compared to private health services (NSUS). Seroprevalence rates by age, 95% confidence intervals, and statistical significance tests for differences between SUS and NSUS are presented. Distribution of seroprevalence rates (P) for total HAV (P = 88.8%; 95% CI = 86.8-90.6) and total HBc (P = 15.3%; 13.2-17.6) by age showed an ascending curve. Prevalence rates in the SUS group were significantly higher that in the NSUS group, for both HAV (chi2 = 31.15; p < 0.0001) and HBV (chi2 = 15.41; p < 0.0001). The high prevalence rates reflect the epidemiological pattern of HAV infection in developing countries and the relevance of the social and environmental context. The proportion of susceptible individuals in the < 5 and > 20 year groups highlights the need to vaccinate for hepatitis A and the potential increase in severe cases. High HVB prevalence among adolescents underscores the importance of vaccinating this group. The results serve as a reminder to health professionals concerning biosafety norms.     

Seizures in children with low-grade tumors： outcome after tumor resection and risk factors for uncontrolled seizures

OBJECT： The goals of this study were to define the incidence of seizures in children with low-grade tumors, study seizure outcome after lesionectomy in these children, and identify risk factors for poor seizure outcome, METHODS： The authors performed a retrospective chart review of children who harbored low-grade brain tumors, experienced seizures, and were treated in a single institution, Statistical analyses included step-wise as well as single-variable binary logistic regression analyses.     

Epidemiological analysis of bacterial strains involved in hospital infection in a university hospital from Brazil

Hospital infections cause an increase in morbidity and mortality of hospitalized patients with significant rise in hospital costs. The aim of this work was an epidemiological analysis of hospital infection cases occurred in a public University Hospital in Rio de Janeiro. Hence, 238 strains were isolated from 14 different clinical materials of 166 patients hospitalized in the period between August 1995 and July 1997. The average age of the patients was 33.4 years, 72.9% used antimicrobials before having a positive culture. The most common risk conditions were surgery (19.3%), positive HIV or AIDS (18.1%) and lung disease (16.9%). 24 different bacterial species were identified, S. aureus (21%) and P. aeruginosa (18.5%) were predominant. Among 50 S. aureus isolated strains 36% were classified as MRSA (Methicillin Resistant S. aureus). The Gram negative bacteria presented high resistance to aminoglycosides and cephalosporins. A diarrhea outbreak, detected in high-risk neonatology ward, was caused by Salmonella serovar Infantis strain, with high antimicrobial resistance and a plasmid of high molecular weight (98Mda) containing virulence genes and positive for R factor.