Clinical classification of tetanus patients

The authors propose a clinical classification to monitor the evolution of tetanus patients, ranging from grade I to IV according to severity. It was applied on admission and repeated on alternate days up to the 10th day to patients aged > or = 12 years admitted to the State University Hospital, Recife, Brazil. Patients were also classified upon admission according to three prognostic indicators to determine if the proposed classification is in agreement with the traditionally used indicators. Upon admission, the distribution of the 64 patients among the different levels of the proposed classification was similar for the groups of better and worse prognosis according to the three indicators (P > 0.05), most of the patients belonging to grades I and II of the proposed classification. In the later reclassifications, severe forms of tetanus (grades III and IV) were more frequent in the categories of worse prognosis and these differences were statistically significant. There was a reduction in the proportion of mild forms (grades I and II) of tetanus with time for the categories of worse prognostic indicators (chi-square for trend: P = 0.00006, 0.03, and 0.00000) whereas no such trend was observed for the categories of better prognosis (grades I and II). This serially used classification reflected the prognosis of the traditional indicators and permitted the comparison of the dynamics of the disease in different groups. Thus, it becomes a useful tool for monitoring patients by determining clinical category changes with time, and for assessing responses to different therapeutic measures.

Epidemiologia de las enfermedades del ganado bovino en Suriname / Epidemiology of cattle diseases in Suriname

The prevalence of certain cattle diseases in Suriname was studied over the period June-August 1985. The diseases were selected for their economic importance and association observed in the cattle with respiratory diseases, reproductive inefficiency, and neonatal mortality. Random samples were taken at two cattle-raising ranches, a dairy farm, and an abattoir in the District of Suriname. The study included a total of 478 animals, which were tested by indirect immunofluorescence for each of the diseases selected. Basically the serologic study revealed the presence of brucellosis, bovine viral diarrhea, parainfluenza 3, bovine infectious rhinotracheitis, and bovine coronavirus but not respiratory syncytial virus. The prevalence of parainfluenza 3 and bovine viral diarrhea was low compared with rates in other countries. It is recommended that a system, specially designed to meet the needs of this country, be established for the ongoing surveillance of data on animal health