Pertussis epidemiology in Argentina: trends over 2004-2007.

OBJECTIVES: Pertussis continues causing significant morbidity and mortality worldwide. Although its epidemiology has been studied in many developed countries, the current pertussis situation in South America is scarcely known. This review summarizes the most important recent data concerning pertussis in a country of South America, Argentina. METHODS: CDC criteria were used for pertussis diagnosis. Proportion of pertussis cases by age, immunization status, and immunization coverage rate evaluated at the Argentinean National Pertussis Reference Centers was reported. Bordetella pertussis isolates were characterized and compared with vaccine strains. RESULTS: From 2002 to nowadays, a steady increase of pertussis cases was observed. Most of these cases correspond to patients younger than six months old that received less than three doses of vaccine. However, cases in adolescent and adults have also been detected. For this situation, which is not peculiar to Argentina, several explanations have been proposed. Among them, the inability of current vaccines to induce long-lasting immunity is the most widely accepted as a cause of pertussis resurgence. Furthermore, antigenic divergence between local clinical isolates and vaccine strains may have aggravated the effect of waning immunity. CONCLUSIONS: Pertussis is an important problem for public health in Argentina. Divergence between vaccine strains and local isolates could contribute to the described pertussis epidemiology.

[Clinical evaluation of a method of total intravenous anesthesia in various types of surgical patients]. / Valutazione clinica di una metodica di anestesia endovenosa totale in talune categorie di pazienti chirurgici.

Inhaled anaesthetic agents (gases and vapours) may be detrimental to the health of patients and cause a chronic operating room air pollution. Therefore, the authors expound the results obtained using a total intravenous anesthesia technique including propofol to induce and maintain hypnosis integrated with pancuronium bromide, droperidol and fentanyl. Patients have been ventilated with mixture of air and oxygen 30%. This technique has been tried in 60 cases of various kind of elective surgical patients obtaining very good results: in 40% of cases the anaesthetic level was excellent, while in some patients it was not adequate on account of intraoperative pressure increases. This technique of total intravenous anesthesia deserves wider use on account of the good tolerance to propofol, the excellent awakening without postoperative troubles (nausea and vomiting).