AIM: To evaluate the prevalence of celiac disease in a group of Brazilian individuals over 60 years of age and compare it with the previously known prevalence in a pediatric group living in the same geographical area....AIM: To evaluate the prevalence of celiac disease in a group of Brazilian individuals over 60 years of age and compare it with the previously known prevalence in a pediatric group living in the same geographical area.METHODS: The research protocol was approved by the Ethics Committee of the University of Brasilia School of Medicine, Brasilia, Brazil. Blood samples from 946 individuals (295 male and 651 female) aged 60 years or older were collected between May 2010 and July 2011. The study subjects' mean and median ages were 68.1 and 67 years, respectively, ranging from 60 to 92 years. That age distribution closely corresponded to the age distribution of the Brazilian population according to the Brazilian 2010 census. The participants were consecutive and unselected outpatients undergoing blood tests at the University of Brasilia Hospital's Clinical Pathology Laboratory. All sera were tested for immunoglobulin A anti-transglutaminase antibodies (IgA-tTG) by enzymelinked immunosorbent assay, and those that were positive were further tested for immunoglobulin A antiendomysium antibodies (IgA-EMA). Human leukocyte antigen (HLA) genotyping was performed for all individuals who exhibited positive serologic results for IgA-tTG and/or IgA-EMA.RESULTS: Out of the 946 studied patients, only one previously diagnosed case of biopsy-proven celiac disease was detected. For the remaining subjects, nine serum samples tested positive for IgA-tTG antibodies; however, none of them tested positive for IgA-EMA antibodies. The HLA genotyping of those nine subjects revealed that one was carrying DQA1*0501 and two were carrying DQB1*0201 alleles. These data showed that, among those 946 elderly individuals, the prevalence of celiac disease (CD) was 0.1% (95%CI: 0.00-0.59). The prevalence of CD for the elderly group was compared with that observed for the group of 2034 children younger than 15 years (age range, 1-14 years; mean age, 8 years) who took part in our previous CD prevalence screening study. All the children came from the same geographical region and shared a similar ethnic and low-income background. As in the elderly group in the current study, the younger group was made up of consecutive outpatients who underwent blood evaluation at the University of Brasilia Hospital's Clinical Laboratory. The prevalence of biopsy-proven CD among those children was 0.54% (95%CI: 0.27-0.57). The comparative analysis between the two groups resulted in the following values: odds ratio = 0.19 (95%CI: 0.01-1.45) Fisher testP = 0.06. CONCLUSION: The prevalence of CD among the children of our previous study was 5.4 times higher than that found in the present elderly group.展开更多
Purposes: The purpose of this study was to determine the pattern of mortality in children’s Federal District. Knowledge of the epidemiology of injuries is essential for planning, implementation and evaluation of prev...Purposes: The purpose of this study was to determine the pattern of mortality in children’s Federal District. Knowledge of the epidemiology of injuries is essential for planning, implementation and evaluation of preventive measures. Methods: We analyzed the forensic examination documents of all children under 12 years sent to the IML-DF, during 2010. The data analyzed included age, gender, cause of death (i.e.natural or external), mechanism of death (traffic accident, asphyxia, firearm injuries, poisoning, heat injuries) and the medical cause of death. Results: A large number of children (n = 123 total;n = 71 males, n = 52 females) were examined in the IML-DF, Brasília, Brazil. Mean age was 37.96 months, with a median of 12 months, and 21% of children were younger than 1 month. There were 62 cases (33 males and 29 female) classified as natural deaths. The average age for natural deaths was 18.72 months. Most cases of natural death occurred in the first year of life (n = 50), being prevalent in the first month of life (n = 24). Among the 62 cases analyzed, six were stillborns, 13 suffered intrauterine fetal distress (e.g. placental insufficiency, prematurity and meconium aspiration), 36 had lung problems (e.g. Acute respiratory distress syndrome (ARDS), bronchopneumonia, pulmonary hemorrhage, interstitial pneumonitis and infant respiratory distress syndrome (IRDS)), five had neurologicalproblems (e.g. hydrocephalus, hydranencephaly,convulsive seizures and meningitis) and two had undetermined cause of death. There were also isolated cases of heart disease, leukemia, diabetic ketoacidosis, peritonitis causedby acute appendicitisand amniotic bandsyndrome. There were 61 cases of deaths from external causes, as a consequence of the following: blunt instrument, firearm, physical agent (i.e.heat), physicochemical agent (i.e.asphyxia) and chemical agent (i.e.poisoning). Conclusions: The profile of deaths from external causesin this developing country follows a trend similar to trends reported in the literature for other developing countries. The majority of deaths are accidental, with traffic accidents being the most frequent cause, followed by asphyxia (i.e.aspiration of gastric contents and drownings). Sporadic cases of poisoning, injuries from firearms, accidents and fires also occur.展开更多
文摘AIM: To evaluate the prevalence of celiac disease in a group of Brazilian individuals over 60 years of age and compare it with the previously known prevalence in a pediatric group living in the same geographical area.METHODS: The research protocol was approved by the Ethics Committee of the University of Brasilia School of Medicine, Brasilia, Brazil. Blood samples from 946 individuals (295 male and 651 female) aged 60 years or older were collected between May 2010 and July 2011. The study subjects' mean and median ages were 68.1 and 67 years, respectively, ranging from 60 to 92 years. That age distribution closely corresponded to the age distribution of the Brazilian population according to the Brazilian 2010 census. The participants were consecutive and unselected outpatients undergoing blood tests at the University of Brasilia Hospital's Clinical Pathology Laboratory. All sera were tested for immunoglobulin A anti-transglutaminase antibodies (IgA-tTG) by enzymelinked immunosorbent assay, and those that were positive were further tested for immunoglobulin A antiendomysium antibodies (IgA-EMA). Human leukocyte antigen (HLA) genotyping was performed for all individuals who exhibited positive serologic results for IgA-tTG and/or IgA-EMA.RESULTS: Out of the 946 studied patients, only one previously diagnosed case of biopsy-proven celiac disease was detected. For the remaining subjects, nine serum samples tested positive for IgA-tTG antibodies; however, none of them tested positive for IgA-EMA antibodies. The HLA genotyping of those nine subjects revealed that one was carrying DQA1*0501 and two were carrying DQB1*0201 alleles. These data showed that, among those 946 elderly individuals, the prevalence of celiac disease (CD) was 0.1% (95%CI: 0.00-0.59). The prevalence of CD for the elderly group was compared with that observed for the group of 2034 children younger than 15 years (age range, 1-14 years; mean age, 8 years) who took part in our previous CD prevalence screening study. All the children came from the same geographical region and shared a similar ethnic and low-income background. As in the elderly group in the current study, the younger group was made up of consecutive outpatients who underwent blood evaluation at the University of Brasilia Hospital's Clinical Laboratory. The prevalence of biopsy-proven CD among those children was 0.54% (95%CI: 0.27-0.57). The comparative analysis between the two groups resulted in the following values: odds ratio = 0.19 (95%CI: 0.01-1.45) Fisher testP = 0.06. CONCLUSION: The prevalence of CD among the children of our previous study was 5.4 times higher than that found in the present elderly group.
文摘Purposes: The purpose of this study was to determine the pattern of mortality in children’s Federal District. Knowledge of the epidemiology of injuries is essential for planning, implementation and evaluation of preventive measures. Methods: We analyzed the forensic examination documents of all children under 12 years sent to the IML-DF, during 2010. The data analyzed included age, gender, cause of death (i.e.natural or external), mechanism of death (traffic accident, asphyxia, firearm injuries, poisoning, heat injuries) and the medical cause of death. Results: A large number of children (n = 123 total;n = 71 males, n = 52 females) were examined in the IML-DF, Brasília, Brazil. Mean age was 37.96 months, with a median of 12 months, and 21% of children were younger than 1 month. There were 62 cases (33 males and 29 female) classified as natural deaths. The average age for natural deaths was 18.72 months. Most cases of natural death occurred in the first year of life (n = 50), being prevalent in the first month of life (n = 24). Among the 62 cases analyzed, six were stillborns, 13 suffered intrauterine fetal distress (e.g. placental insufficiency, prematurity and meconium aspiration), 36 had lung problems (e.g. Acute respiratory distress syndrome (ARDS), bronchopneumonia, pulmonary hemorrhage, interstitial pneumonitis and infant respiratory distress syndrome (IRDS)), five had neurologicalproblems (e.g. hydrocephalus, hydranencephaly,convulsive seizures and meningitis) and two had undetermined cause of death. There were also isolated cases of heart disease, leukemia, diabetic ketoacidosis, peritonitis causedby acute appendicitisand amniotic bandsyndrome. There were 61 cases of deaths from external causes, as a consequence of the following: blunt instrument, firearm, physical agent (i.e.heat), physicochemical agent (i.e.asphyxia) and chemical agent (i.e.poisoning). Conclusions: The profile of deaths from external causesin this developing country follows a trend similar to trends reported in the literature for other developing countries. The majority of deaths are accidental, with traffic accidents being the most frequent cause, followed by asphyxia (i.e.aspiration of gastric contents and drownings). Sporadic cases of poisoning, injuries from firearms, accidents and fires also occur.