ABSTRACT
Tuberculosis (TB) in children has been neglected by most countries in the Region of the Americas. After 2006 the TB surveillance and control among children was emphasized with the implementation of the World Health Organizations (WHO) Stop TB strategy. Since then the countries strengthened TB control in children and age-disaggregated data was collected. These advances have made possible this descriptive study of childhood epidemiological situation by using the information annually reported by the National Tuberculosis Program (NTP) to WHO. The analysis was performed by scenarios (quintiles of WHO estimated incidence) of TB notification rate in children under 4years old, 5 - 14 years old, and the percentage of TB notification in children under 15 years old compared to the total of TB cases reported. The conclusion was that in countries with medium-to-high and high-level TB incidence, the detection of cases in children is poor. This is especially evident in children under the 5 years old who are at high risk of developing severe forms of TB and who die as a result.
La tuberculosis (TB) en niños ha sido relegada por la mayoría de los países de la Región de las Américas. Después del año 2006 con la implementación de la estrategia Alto a la TB de la Organización Mundial de la Salud (OMS) se enfatizó la vigilancia y el control de la TB en población infantil. Desde entonces los países fortalecieron el control de la TB en niños y recolectaron datos desagregados por edad. Estos avances han hecho posible realizar este estudio que describe la situación epidemiológica de la TB en la población infantil a partir de la información reportada anualmente por los Programas Nacionales de Tuberculosis (PNT) de los países a la OMS. El análisis se realizó por escenarios (quintiles de la incidencia estimada por OMS) de las tasas de notificación de la TB en menores de 4 años, de 5 y mas años, y del porcentaje de la notificación de la TB en menores de 15 años respecto al total de casos de TB notificados. Se concluyó que en países de mediana-alta y alta incidencia de TB, la detección de casos en niños es deficiente, especialmente en menores de 5 años que tienen alto riesgo de desarrollar formas severas de TB y de morir por esta causa.
Subject(s)
Humans , Male , Adolescent , Female , Infant, Newborn , Infant , Child, Preschool , Child , Tuberculosis/epidemiology , Age Distribution , Americas/epidemiology , Epidemiology, Descriptive , Incidence , Disease Notification/statistics & numerical dataABSTRACT
PURPOSE: To identify and optimize parameters determining the diagnostic quality of three-dimensional surface models derived from craniofacial spiral CT. MATERIALS AND METHODS: Three dry bone skull specimens were scanned with 1-slice, 4-slice, and 16-slice spiral CT. A total of 60 surface models were calculated with variation of several parameters of the CT scan and calculation of the primary data set and SSD reformations. Two observers evaluated the quality of the resulting models independently using a structured questionnaire. RESULTS: Slice thickness was the only independent factor that influenced image quality. The quality of the 1-slice CT models was poor in all cases. The 4-slice CT models were rated as superior, but also showed relevant impairments. In contrast, the 16-slice CT models provided improved quality with only minor shortcomings. CONCLUSION: Actual clinical applications of three-dimensional models for surgical planning or guidance require high quality of the underlying CT data sets. The slice thickness should not exceed 1 mm. CT examination should be performed using a 4-slice system, or preferably a 16-slice system with a dedicated post-processing protocol.
Subject(s)
Image Processing, Computer-Assisted/instrumentation , Image Processing, Computer-Assisted/standards , Imaging, Three-Dimensional/instrumentation , Imaging, Three-Dimensional/standards , Quality Assurance, Health Care/standards , Skull/diagnostic imaging , Tomography, Spiral Computed/instrumentation , Tomography, Spiral Computed/standards , Artifacts , Equipment Design , Humans , Sensitivity and SpecificitySubject(s)
Aortic Valve Insufficiency/physiopathology , Aortic Valve Stenosis/physiopathology , Echocardiography/methods , Heart Valve Prosthesis , Heart Ventricles/physiopathology , Postoperative Complications/physiopathology , Adolescent , Adult , Aged , Aortic Stenosis, Subvalvular/physiopathology , Aortic Valve/physiopathology , Aortic Valve Stenosis/surgery , Female , Hemodynamics , Humans , Male , Middle Aged , Myocardial Contraction , PrognosisSubject(s)
Heart Valve Diseases/surgery , Adult , Aortic Valve Insufficiency/surgery , Aortic Valve Stenosis/surgery , Echocardiography , Female , Follow-Up Studies , Heart Valve Prosthesis , Heart Valves/physiopathology , Humans , Male , Middle Aged , Mitral Valve Insufficiency/surgery , Mitral Valve Stenosis/surgery , Myocardial Contraction , Regional Blood FlowABSTRACT
A series of 62 diarylamidine derivatives was evaluated for their antiproteolytic activity. In all but two of the compounds one or both of the amidino-substituted aryl moieties was either an indole or an indole-like ring. The latter included indene, benzimidazole, benzofuran, benzol[beta]thiophene, and several other related nitrogen-containing heterocycles. Several of the compounds exhibited considerable inhibitory potency against thrombin, trypsin, and pancreatic kallikrein. An outstanding inhibitor of trypsin was found in bis(5-amidino-2-benzimidazolyl)methane (compound 42) with a Ki value of 1.7 X 10(-8) M(pH. 8.1, 37 degrees C). Another derivative, 1,2-di(4-amidino-2-benzofuranyl)ethane (compound 21), proved to be a highly effective inhibitor of the overall blood clotting process. From a general structure-activity standpoint these compounds demonstrate that minor structural variations of low-molecular-weight inhibitors can result in significant changes in specificity and potency with regard to antiproteolytic activity.
