Asthma and Rhinitis in South America: How Different They are From Other Parts of the World

Asthma and rhinitis epidemiology has wide variations around the world. The aim of this review was verify the prevalence of asthma and rhinitis in South America and report differences from other regions of the world. We reviewed studies with International Study of Asthma and Allergies in Childhood (ISAAC) methodology in South America, Phases I and III. In South America the ISAAC Phase I ranked four countries among top ten in prevalence of asthma and three countries among top ten in prevalence of rhinoconjunctivitis. ISAAC Phase III showed little changes in asthma and rhinitis prevalence in South American countries. The prevalence increases of asthma and rhinitis in South American centers indicate that the burden of both is continuing to rise, but the differences in prevalence are lessening.     

Factors associated with caregivers' perception of children's health and oral health status: a study of 6- to 36-month-olds in Uganda

Background.  The impact of oral diseases on quality of life of children and their families has not been thoroughly investigated.
Aim.   Focusing on Ugandan infants aged 6–36 months and their caregivers, this study examined the degree to which clinical and psychosocial factors were associated with caregivers' overall evaluation of their children's oral health and health status.
Design.  Eight hundred and sixteen children were examined for dental caries and anthropometric status in 2007. A questionnaire was completed by the caregivers.
Results.  Poor child oral health was reported by 40.2% and 17.5% of caregivers who reported their children's health as, respectively, poor and good. Having the least family wealth [odds ratio (OR) = 1.9] and reporting distressed family activities (OR = 2.3) were associated with higher odds of reporting poor child oral health, whereas being a rural resident (OR = 0.4) and reporting no symptoms during tooth eruption (OR = 0.3) were associated with lower odds. Perception of poor child oral health (OR = 2.8) and having the least family wealth (OR = 1.7) were associated with higher odds of reporting poor child health status, whereas no stunting was associated with lower odds (OR = 0.5).
Conclusion.  The results support the growing recognition of oral health as a predictor of health and well-being in early childhood.     

Implementation of a Multidisciplinary Inpatient Cardiology Service to Improve Heart Failure Outcomes in Guyana

Background

Guyana is a small developing country with a high burden of cardiovascular disease and extensive barriers to optimal care delivery. We investigated the effectiveness of a newly established multidisciplinary inpatient cardiology service in this setting.

White Matter Changes in Depression and Alzheimer's Disease: A Review of Magnetic Resonance Imaging Studies

This article reviews magnetic resonance imaging (MRI) studies of white matter lesions in depression and Alzheimer's disease. Although conflicting reports exist, many studies show that white matter lesions are more prevalent in both conditions, with depression associated with deep white matter lesions (DWML) and Alzheimer's disease with periventricular lesions (PVL). In normal ageing and depression there is some evidence that such lesions may be associated with neuropsychological dysfunction, though the relationship is less clear for Alzheimer's disease. One difficulty in drawing firm conclusions from work so far is that confounding variables, such as cerebrovascular risk factors, have now always been taken into account. Most studies have been cross-sectional so there is little information regarding the progression, prognostic significance and pathogenesis of such lesions. These issues merit examination in longitudinal studies combining serial MRI with clinical assessments of subjects who have been fully assessed for vascular risk factors.     

CLINICAL STUDIES OF INDUCTION AGENTS XXXIV: FURTHER INVESTIGATIONS WITH ETHANOL

A re-evaluation of dilute (8 per cent w/v) ethanol as a soleintravenous anaesthetic agent (with various premedicants), in300 patients undergoing minor gynaecological surgery, is reported.It confirms that adequate doses will rapidly induce sleep. Sedativeor analgesic premedication, notably with promethazine, can makeethanol a more effective and acceptable induction agent, withthe maximum dosage (44 g) employed in this study but it wasnot as reliable for induction as the barbiturates or eugenolderivatives. Its safety in experienced hands was demonstratedand cardiovascular stability was a notable feature. Marked individualvariation in response was observed widi this agent, most notablyafter chlordiazepoxide premedication, where a significantlyhigher dosage was required to produce sleep than with control(atropine) patients. Though complications were rare during anaesthesia,the incidence of emergence delirium, headache and emetic sequelaewith this agent were higher than with the barbiturates or eugenols.Although these could be minimized by heavy opiate premedication,the consequent respiratory depression and prolonged drowsinessmade this undesirable. This study has made it possible to observethe various interactions of ethanol with premedicant drugs,and an antagonism by large doses of chlordiazepoxide has beendemonstrated.     

Antibiotic sales and the prevalence of symptoms of asthma, rhinitis, and eczema: The International Study of Asthma and Allergies in Childhood (ISAAC)

BACKGROUND: It has been hypothesized that antibiotic use early in life may increase the subsequent risk of asthma. We have conducted an ecologic analysis of the relationship between antibiotics sales and the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema in 99 centres from 28 countries. METHODS: Data for antibiotics sales for 28 countries were obtained from the Institute for Medical Statistics (IMS), Health Global Services, UK and converted to defined daily doses (DDD). Data on the prevalence of symptoms of asthma, rhinitis, and eczema in 13-14 year olds were based on the responses to the written and video questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC). The analysis was adjusted for gross national product (GNP) as an estimate of the level of affluence. RESULTS: In general, there was a positive association between per capita antibiotics sales and the prevalence of symptoms for asthma, rhinitis, and eczema, but the associations generally became negative once the analyses had been adjusted for GNP. In particular, there were non-significant negative associations between total antibiotics sales and the prevalence of wheeze ever, wheeze in the last 12 months, nose problems with itchy-watery eyes, itchy rash in the last 12 months, and eczema ever. On the other hand there were weak non-significant positive associations for asthma ever, nose problems ever, nose problems in the last 12 months, and itchy rash ever. There was a statistically significant positive association with wheeze at rest as measured by the asthma video questionnaire; however, even this association was weak and would not account for more than a 1% difference in asthma prevalence between countries. CONCLUSIONS: These findings are generally not consistent with the hypothesis that antibiotic use increases the risk of asthma, rhinitis, or eczema. If there is a causal association of antibiotic use with asthma risk, it does not appear to explain the international differences in asthma prevalence.