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Biomedical subjects

G Figueroa

Publications and source records attributed to G Figueroa.

51 records · Page 3Linked to original sources

Acute diarrhoeal disease in children under 7 years of age in a peri-urban slum of Santiago, Chile.

A group of 168 families who lived in a peri-urban slum in Santiago were surveyed for 9 months. All of them had a child under 7 years of age. Medical activities and data collection were carried out at a Field Station and by means of twice-weekly visits to each home, at which time cases of diarrhoea were recorded and investigated. Faecal samples for bacteriological, parasitological and rotavirus studies were obtained during each episode. The characteristics of clinical course, hygienic practices in the family, and monthly anthropometric measurements of infants and toddlers were also recorded. The mean monthly incidence of diarrhoea was 7.1 episodes per 100 children. Of the episodes, 44.2% were associated with pathogenic bacteria, 14.4% with rotavirus, 38.4% with parasites and in 27.9% no enteropathogens were identified. It was found that adequate hygienic habits were not associated with a decreased risk of developing diarrhoea and that about 60% of children did not have diarrhoea throughout the study period. The nutritional status was adequate in most cases: weight-for-age was below the 5th percentile in 11.5% of subjects and the height-for-age was normal in all. No moderate or severe cases of malnutrition were detected.

Age Factors↗

Enteropathogen carriage by healthy individuals living in an area with poor sanitation.

Faecal carriage of bacterial enteropathogens (enteropathogenic Escherichia coli (EPEC), shigellae and salmonellae) was studied in 265 individuals: 65 infants 3-6 months of age (50 bottle-fed and 15 breast-fed), 100 school-age children 8-10 years of age and 100 adults 21-50 years of age. All were apparently healthy, did not have gastrointestinal symptoms, had not received antibiotics in the preceding fortnight and were not malnourished. Enteropathogens were isolated from the faeces of 24 individuals (9.1%). Cultures were positive for enteropathogens in 20% of the infants (both breast- and bottle-fed), 8% of school-age children and 3% of the adults. EPEC was the most frequent isolate. Twelve different serotypes were detected. The highest recoveries were E. coli 026:K60 and 044 . K74. Shigella was detected only in school-age children (2%) and salmonella only in adults (1%). Campylobacter jejuni and Yersinia enterocolitica were studied only in the school-age children: there was one isolate of each of them. Most enteropathogens isolated were susceptible to the majority of the antibiotics tested. Only four E. coli strains, isolated from bottle-fed infants, could be considered multi-resistant. Two of the strains wer E. coli 044:K74 and 020a020c:K61. The remainder were E. coli 0111:K58 and wee capable of transferring some of their antibiotic resistance traits to a recipient strain.

Adult↗

Methane deaths? Was it the cause?

In the routine performance of their jobs, three men consecutively descended into an open drainage pit to recover a fallen grate lid. Each man, in turn, was immediately overcome and died within minutes of his descent. Initial analysis of the pit's air indicated a methane level of 15%. Therefore, it was initially assumed that death was attributable to methane poisoning. Postmortem analysis of the victims' tissues, however, yielded methane levels in only faint trace quantities (0-100 mcg/100 g range). Analysis of air samples taken at various pit levels revealed that as one descended, there was a decrease in oxygen levels, from 20% at the top to 3% at the bottom. CO2 levels, however, increased from the top of the pit, and reached a level of 22% at the 6-ft. depth of the pit. The accepted lethal level is only 10%. The cause originally attributed to these deaths was shown to be in error. This paper demonstrates the importance of proper investigation of the "scene of occurrence" in order to properly certify the cause of death.

Adult↗

Dosage titration with furosemide in congestive heart failure patients.

Clinical status and diuretic requirements of a group of congestive heart failure patients were re-evaluated. A group of 115 congestive heart failure patients were hospitalized, given a comprehensive medical examination and treated with placebo for four weeks. Thirteen patients did not exhibit signs and symptoms of congestive heart failure during this phase. The remaining 102 patients were treated with 40 mg furosemide per day for a second 4-week period. Fifty-three required 80-120 mg furosemide per day and 49 were successfully controlled at 40 mg per day. Ten patients dropped out voluntarily and 39 were controlled for an additional four weeks at a dose of 20 mg bid furosemide. In the final phase, dosage was lowered to 20 mg per day and 24 of the 39 patients, (62%), were successfully controlled for four weeks, while 14, (36%), were controlled for eight weeks. Results of this study suggest that a number of congestive heart failure patients can be controlled with relatively low doses of furosemide and that there is a need for periodic re-evaluation of the clinical status and diuretic requirements of patients on maintenance therapy.

Adult↗

Enteropathogens associated with acute diarrhea in hospitalized infants.

Thirty-five infants of low socioeconomic status who were living in urban Santiago were hospitalized for acute diarrhea were prospectively evaluated for the presence of enteropathogens associated with the episode. Some degree of malnutrition was evident in 20 infants (57.1%); 15 of these (75%) were under 6 months of age. Mean duration of the hospital stay was 11.8 days for well-nourished patients and 15.7 days for the malnourished patients. One or more enteropathogens were found in 60% of the cases studied: in 17 cases (48.6%) these were bacteria and in four cases (11.4%) it was rotavirus. Parasites were not detected. In three patients, two different pathogens were demonstrated. Among the bacteria, 12 isolates (34.3%) were enteropathogenic E. coli (EPEC) and two (5.7%) were Shigella. Campylobacter jejuni was also isolated from two different cases (5.7%) and Salmonella from one case (2.9%). The recovery of pathogens was independent of the nutritional status. Mean age of detection of EPEC was 3.2 months among well-nourished infants and 6.2 months among the malnourished (p less than 0.001). Half of the EPEC strains isolated were multiresistant to antibiotics. One of these strains transferred some of its resistance in vitro to E. coli K12. Ampicillin and kanamycin were the antibiotics to which EPEC showed the greatest resistance. The other bacterial pathogens were mostly sensitive to antibiotics. Campylobacter jejuni, together with Shigella, was the second most frequent pathogen isolated during episodes of diarrhea. Campylobacter should be included in the routine study of diarrheal episodes in our setting.

Acute Disease↗