OBJECTIVES: To analyse existing problems in health care to economic immigrants from the point of view of health and social professionals, health authorities and economic immigrants and to know which will be their proposals and priorities to improve economic immigrants's health assistance. METHODS: Qualitative approach study made in Majorca island. (Spain). Three focus groups and three nominal groups with health and social workers from primary health care and hospital services were carried out as well as two partially structured interviews to health authorities, one Autonomic Authority and one Governmental Authority, and twelve partially structured interviews to economic immigrants identified trough key informants. RESULTS: Health and social workers perceive the increase in the number of economic immigrants as a massive arrival. The main problems identified are: access restrictions to public health services for economic immigrants, the follow-up of these patients and diagnostic difficulties because lack of training in tropical medicine. Health and social workers's first proposal for improving this situation is their own training in tropical medicine. Autonomic Authority priorities are to guarantee access to public health services for all immigrants and to look actively for health problems in these population. Governmental Authority, instead, holds the legalization for all. In fact, economic immigrants are not concerned on health care because legalization and housing problems. CONCLUSIONS: The main barriers identified by health and social workers in health care to economic immigrants are: access restrictions, follow-up and lack of training in tropical medicine. Health and social first proposal to improve this situation is their own training in tropical medicine while Autonomic and Central Authorities's priorities are not the same. For economic immigrants, health assistance is not their biggest concern.

Delivery of Health Care↗

PubMedDate not supplied

A rat model for the study of intestinal heterotopic gastropathy.

This study analyzes an experimental model for the study of reactions from gastric tissue exposed to enteric environment. Morphological studies were performed by histological, histochemical and immunohistochemical methods, using formalin-fixed biopsies of full-wall-thickness gastric implants in a whole-wall jejunal defect. These grafts suffered severe lesions, characterized by chronic atrophic gastritis, foveolar hyperplasia, glandular cystic transformation, and intestinal metaplasia. Increase in acidic mucins was also observed. There was no proliferating cell nuclear antigen (PCNA) overexpression. The results suggest that this model can be useful to investigate the heterotopic grastropathy and can be applied in further research studies.

Animals↗

PubMedDate not supplied

[The laboratory diagnosis and epidemiology of cutaneous leishmaniasis in Paraná State, southern Brazil].

Between 1986 and 1997 a total of 1418 patients were examined at the Clinical Analysis Teaching and Research Laboratory of Maringá State University (LEPAC/UEM) for cutaneous leishmaniasis by direct examination of stained smears made from the lesions, the Montenegro skin test and the indirect immunofluorescent antibody test. Nine hundred and fifty five patients (67.3%) were positive for at least one of the three tests and of these 804 (84.2%) were considered to have contracted the disease in Paraná State; 665 (69.6%) were between 15 and 49 years old; 658 (68.9%) were males; 523 (54.8%) sought medical advice during the first three months of their infections and 74 (7.7%) had mucosal lesions. Of the 83 counties of Paraná State, where the patients had most probably acquired their infections, 44.7% were from the counties of São Jorge do Ivaí (10.2%), Doutor Camargo (9.8%), Terra Boa (7.3%), Maringá (7.3%), Jussara (6.0%) and Cianorte (4.5%). Seventy seven strains of Leishmania (Viannia) braziliensis were isolated and 63.6% of these strains belong to serodema 1.

Adolescent↗

PubMedDate not supplied

Bcl-2 oncogene (B cell lymphoma/leukemia-2) levels correlate with systemic lupus erythematosus disease activity.

OBJECTIVE: Bcl-2 translocation or overexpression is found in many types of malignancy, possibly through alteration of the apoptosis mechanism. It has also been suggested that similar apoptotic alterations may be important in the pathogenesis of systemic lupus erythematosus (SLE). It is believed that a process of apoptosis at the stage of maturation or differentiation of lymphocytes may be related to the beginning of an autoimmune event, due to the non-elimination of autoreactive lymphocytes. The aim of this study is to test bcl-2 antigen expression in human SLE peripheral blood and to analyze its relationship with disease activity. MATERIALS AND METHODS: Serum levels of bcl-2 were studied by enzyme-linked immunoabsorbent assay in whole blood samples in 68 patients with SLE and its correlation with disease activity according to SLE disease activity index (SLEDAI). RESULTS: No significant differences were found in bcl-2 levels between all SLE patients and controls. We observed increased levels of bcl-2 in active SLE patients in relation to inactive (p = 0.0003) and controls (p = 0.02). Our results show a significant correlation between bcl-2 levels and SLEDAI values (R = 0.46, P < 0.001). CONCLUSIONS: These results suggest that bcl-2 levels are related to disease activity and that this protein may play a role in the pathogenesis of SLE.

Adolescent↗

PubMedDate not supplied

[Obesity in children].

Obesity during childhood and adolescence is an increasingly common complaint in our daily clinical practice. The increase in its prevalence makes paediatrician worry about this disease, which is now considered an epidemic by the World Health Organisation. Obesity is a complex disease. Its aetiology is not yet clear, due to the multiple factors involved: environment, genetics, behaviour, life style, neuroendocrinology and metabolism. Persistent obesity increases the risk of suffering from diabetes, cardiovascular disease, hypertension, and gallbladder disease. The treatment of obesity is problematic and there are few patients who persist on a long term weight reduction programme. A multidisciplinary approach is therefore required. Paediatricians, dieticians, nurses, psychologists and psychiatrist should intervene in the treatment programme. Dietary changes must combine a decrease in energy intake and an increase in energy expenditure, inculcating both healthy eating habits and lifestyle without interfering in the child's growth and development.

Child↗

PubMedDate not supplied

Relationship of oncogenes (sFas, Bcl-2) and cytokines (IL-10, alfa-TNF) with the activity of systemic lupus erythematosus.

BACKGROUND: Different oncogenes (Fas and bcl-2) and diverse cytokines (IL-10 and alfa-TNF) may have an effect on the regulation of apoptosis. The majority of studies to date have evaluated only one or two of these elements independently and it is difficult to obtain a global view of apoptosis disregulation in the pathogenesis of systemic lupus erythematosus (SLE) and their role in disease activity. The aim of this study was to evaluate serum levels of sFas, bcl-2, IL-10 and alfa-TNF in human SLE patients and to analyze their relationship with disease activity and with regulation of the apoptotic process. PATIENTS AND METHODS: Serum levels of sFas and cytokines IL-10 and alfa-TNF were studied by enzyme-linked immunoabsorbent assay. Bcl-2 antigen expression was analyzed in lysated lymphocytes from 51 SLE patients. The disease activity was analyzed according to the SLE disease activity index (SLEDAI). RESULTS: SLE patients had higher levels of sFas (p=0.0006) and alfa-TNF (p<0.0001) than the control group. No relationship was found between the levels of bcl-2 and IL-10 from SLE patients and the control group. However, there was a significant correlation between SLEDAI and bcl-2 (p<0.001) and IL-10 levels (p=0.004). In contrast, we found that sFas and alfa-TNF were not related with disease activity. A significant correlation of sFas with alfa-TNF serum levels (p=0.003, R= +0.41) and bcl-2 antigen expression (p=0.02, R=+0.32) was observed. CONCLUSION: sFas and alfa-TNF serum levels are increased in SLE patients. sFas levels seems to be secondary to alfa-TNF action, which is enhanced in inflammatory conditions such as SLE. Bcl-2 antigen expression and IL-10 serum levels are related to the maintenance of SLE activity. These alterations may interfere with the apoptotic process, promoting lymphocyte hyperactivity secondary to increased cytokine levels, and causing the characteristic features of SLE.

Adolescent↗